Imaging of Circulatory Disturbances

Question 1

What are the different types of functional vascular imaging?

Answer 1

Radionuclide imaging
MRI functional imaging
Ultrasound

Question 2

What issues have to be considered when using vascular imaging techniques?

Answer 2

Soft tissue contrast
Functional significance of the lesions
If the treatment is effective

Question 3

What is the problem with radiographic and natural contrast?

Answer 3

Cant see blood vessels or the lumen of hollow viscera very well

Question 4

What are some problems with Iodinated contrast?

Answer 4

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

Question 5

What are the different types of anatomical vascular imaging?

Answer 5

X rays
Contrast angiography
Ultrasound
CT/MRI

Question 6

With radiographic contrast what appears black and what appears white?

Answer 6

Air appears black
Fat appears grey
Soft tissue appears white

Question 7

What are the benefits of using iodinated contrast?

Answer 7

Stable in selected body compartments
Painless
Easy to use
Cheap

Question 8

What are somethings that have to be considered before administering parenteral iodinated contrast?

Answer 8

Previous contrast allergy
Asthma/atopy
Poor renal function
Metformin

Question 9

How is catheter angiography done?

Answer 9

1. Vessel punctured and catheterised
2. Contrast injected using pump injector
3. Rapid series of images acquired

Question 10

What is done using interventional radiology?

Answer 10

Angioplasty/angiography 
Embolisation 
Catheter thrombolysis 
Drainage of abscesses 
Nephrostomy 
Vertebroplasty

Question 11

When should angioplasty be used?

Answer 11

Short stenoses
Occlusions
Sessile/concentric plaques

Question 12

What type of contrast agent is carbon dioxide?

Answer 12

A negative constant agent

Question 13

When is carbon dioxide a useful contrast agent?

Answer 13

In patients with poor renal function and in patients sensitive to iodinated contrast agents

Question 14

What are the possible problems with angioplasty?

Answer 14

Occlusion 
Dissection 
Embolisation 
Rupture 
Infection

Question 15

What are the benefits of ultrasound?

Answer 15

No radiation
Quick
Non invasive

Question 16

What is the problem with ultrasound?

Answer 16

Operator dependant

Question 17

In terms of ultrasound what is the difference between a normal vein and DVT vein?

Answer 17

Normal vein has low pressure and is compressible

DVT vein is full of thrombus and not compressible

Question 18

What are the applications of radionuclide imaging?

Answer 18

Perfusion

Blood loss

Question 19

What are the benefits of nuclear medicine?

Answer 19

IV injection only
Good patient compliance
Easy to arrange

Question 20

What are the negatives of nuclear medicine?

Answer 20

Radiation dose
Very insensitive
Very non-specific

Question 21

What are the benefits of a CT angiogram?

Answer 21

Sensitive
IV injection only
Gives info about other structures

Question 22

What are the negatives of a CT angiogram?

Answer 22

Radiation dose
High contrast dose
Expensive

Question 23

What is the benefit of magnetic resonance angiography?

Answer 23

Sensitive
Specific
No radiation
No nephrotoxic contrast

Question 24

What are the negatives of magnetic resonance angiography?

Answer 24

Very expensive
High contrast cost
Needs state of the art machinery

Question 25

What is involved in getting consent in radiology?

Answer 25

A process in which a patient learns key facts about an investigation/ treatment, including potential risks and benefits, before deciding whether or not to proceed and then informed consent continuous throughout the procedure