Common Invasive Imaging Procedures Flashcards
What are two examples of biopsies taken under radiological guidance?
Core biopsy
Fine needle aspiration (FNA)
Describe how a core biopsy is taken and why
Using 14-18 g needle
For histopathology
Describe how an FNA is taken and why
Using a 20-25 g needle
For cytopathology
Can also be sent for microbiology
Why may aspirations be taken?
Suspected abscesses
Joint effusions
What two imaging modalities are most imaging guided biopsies and aspirations performed using?
Ultrasound
CT
Why is a hook-wire or carbon track injection done in the breast (using ultrasound)?
Aid surgical excision of impalpable lesions
Define pleurocentesis
Aspiration of pleural effusion
Define paracentesis
Aspiration of ascites
What sort of imaging are pleurocentesis and paracentesis usually performed using?
Ultrasound
What is an antegrade pyelogram?
Needle injection of contrast into pelvicalyceal system Initial step for insertion of - Nephrostomy drainage catheter - Ureteric stent - Stone removal
What is nephrostomy?
Drainage catheter inserted into pelvicalyceal system usually to relieve obstruction
What is suprapubic catheter insertion?
Urinary bladder catheter inserted
Used where urethral catheter can’t be passed/not desirable
What is percutaneous transhepatic cholangiogram (PTC)?
Used in initial part of
- Transhepatic biliary drainage/stent insertion
- Stricture dilatation/stone removal
What are two examples of percutaneous oncology treatments?
Tumour ablation
- Radiofrequency ablation
- Microwave ablation
Transarterial chemoembolisation/irradiation
- Chemotherapeutic/radioactive agents selectively delivered to arteries supplying tumour
What are the common indications for an angiograph of the aorta?
Aneurysms
Dissection
Stenosis
What are the common indications for an angiograph of the cerebral vessels?
Berry aneurysms
Haemorrhage
What are the common indications for an angiograph of the carotid arteries?
Stenosis
Occlusion
What are the common indications for an angiograph of the renal vessels?
Stenosis
Haemorrhage
What are the common indications for an angiograph of the mesenteric vessels?
Haemorrhage
What are the common indications for an angiograph of the peripheral vessels?
Stenosis
Occlusion
Aneurysm
What are the common indications for an angiograph of the coronary vessels?
Stenosis
Occlusionq
What is percutaneous transluminal angioplasty (PTA)?
Balloon dilatation of vascular stenosis
What is a vascular stent?
Implanted metallic device for maintaining vascular lumen post angioplasty
What is thrombolysis?
Dissolution of clot
What is thrombectomy or embolectomy?
Removal of clot
What is atherectomy?
Removal of atheroma
What is embolisation?
Occlusion of vessels using particulate matter/fine coils; eg: to treat bleeding
How does digital subtraction angiography (DSA) work?
1st exposure made just before contrast injected
Imaged subtracted from subsequent images
Only blood vessels with contrast shown
Create cleaner diagnostic image
What is the check list for preparing for invasive radiological procedures?
Right procedure?
Right modality?
Bleeding risk issues
Explanantion and consent
Check renal function - if contrast needed
Check local policy on withholding metformin in diabetics
Fasting if sedation needed
