Imaging Circulatory Disturbances

Question 1

What is trying to be investigated with Vascular Imaging (3)

Answer 1

• Is there a leak
• Is there a blockage (occlusion or stenosis)
• Can it be fixed

Question 2

Anatomical Imaging (4)

Answer 2

• Plain films
• Contrast angiography
• Ultrasound
• CT/MRI

Question 3

Functional Imaging (3)

Answer 3

• Radionuclide
• MRI functional imaging
• Ultrasound

Question 4

Problems with vascular imaging (4)

Answer 4

• Soft tissue contrast
• Functional significance of lesions
• Is treatment effective
• Natural contrast does not allow the visualisation of important structures such as blood vessels and lumen of hollow viscera

Question 5

Ideal Properties of man-made contrast agents (6)

Answer 5

1. Has an attenuation the same as the surrounding tissues
2. Inexpensive
3. Inert
4. Equal distribution in and out of selected body compartment
5. Painless
6. Easy to use

Question 6

Iodinated contrast (6)

Answer 6

• Differential X-Ray attenuation
• Inert
• Stable in selected body compartments
• Painless
• Easy to use
• Cheap

Question 7

Problems with iodinated Contrast (6)

Answer 7

Major reactions
Renal dysfunction
Disturbance of thyroid metabolism
Disturbance of clotting
Seizures
Pulmonary Oedema

Question 8

Parenteral Iodinated Contrast (4)

Answer 8

•	Metallic taste
•	Feeling of warmth
•	Arterial injections
-Micturition
-Discomfort
•	Rarely nausea

Question 9

Parenteral Iodinated Contrast Practical Aspects to

Discuss (4)

Answer 9

• Previous contrast allergy
• Asthma/atopy
• Poor renal function
• Metformin: can cause lactic acidosis if administered together

Question 10

Catheter Angiography (4)

Answer 10

• Vessel punctured and catheterised
• Sterile procedure
• Contrast injected using pump injector
• Rapid series of images acquired

Question 11

Interventional Radiology (6)

Answer 11

• Angiography/Angioplasty
• Embolization-blocking abnormal vessels
• Catheter thrombolysis
• Drainage of abscesses
• Nephrostomy
• Vertebroplasty

Question 12

When would you use an angioplasty (2)

Answer 12

Short stenosis or occlusion

Sessile/concentric plaques

Question 13

What contrast agent can be used for patients intolerant to iodine or renal impairment (2)

Answer 13

Carbon Dioxide

Negative contrast agents

Question 14

Problems with angioplasty (5)

Answer 14

• Occlusion
• Dissection
• Embolization
• Rupture
• Infection

Question 15

Ultrasound can be used to confirm

Answer 15

DVT

Question 16

in DVT describe the vein

Answer 16

Distended and non-compressible

Question 17

Normal vein is__

Answer 17

Low pressure and is compressible

Question 18

What is Radionuclide imaging used for (6)

Answer 18

• Perfusion
• Blood loss
• Sequential imagine
• Perfusion of transplant kidneys
• Blood loss into GI tract
• Cerebrovascular perfusion (Dementia)

Question 19

Computed Tomography Angiogram use

Answer 19

Gives information about other structures

Question 20

How is Computed Tomography Angiogram administered (5)

Answer 20

IV
Radiation dose
High contrast dose
Expensive
Sensitive

Question 21

Magnetic Resonance Angiography (7)

Answer 21

• Sensitive
• Specific
• No radiation
• No nephrotoxic
• Very expensive
• Needs state of the art machinery
• High contrast cost