Imaging of circulatory disturbances Flashcards
What anatomical imaging can be used for vascular imaging?
Plain films (CXR)
Contrast angiography
Ultrasound
CT/MRI
What functional imaging is used for circulatory disturbances?
Radionuclide imaging
MRI functional imaging
Ultrasound
What are some issues in vascular imaging?
Soft tissue contrast not very clear
List some pros of iodinated contrast
Inert and painless
Stable in selected body compartments
Easy to use
Cheap
Name some cons of iodinated contrast
Major reactions Renal dysfunction Disturbance of thyroid metabolism Disturbance of clotting Seizures Pulmonary oedema
List some cons of parenteral iodinated contrast
Metallic taste
Warmth
Discomfort from arterial injection
List some pros of parenteral iodinated contrast
Rarely nausea
What is catheter angiography?
Vessel punctured and catheterised, contrast injected and images taken to view vasculature
Name some contrast agents
Iodinated contrast
Parenteral iodinated contrast
Carbon dioxide
Describe the use of carbon dioxide as a contrast agent
Negative contrast agent
Useful in those with renal impairment or sensitivity to iodinated contrast
What contrast is used in those with renal impairment or sensitivity to iodinated contrast?
Carbon dioxide
Name some problems with angioplasty
Occlusion Dissection Embolisation Rupture Infection
List some pros of ultrasound
No radiation
Quick
Non-invasive
List some cons of ultrasound
Operator dependant
Can you compress normal veins?
Yes - in DVT, vein is full of thrombus so won’t compress
What can radionuclide imaging be used for in vascular disturbances?
Assess perfusion
Assess blood loss
Name the radionuclide imaging used to analyse perfusion of the lungs
Lung scintigraphy or V/Q scan
List some pros of radionuclide imaging
Good compliance
Easy to arrange
List some cons of radionuclide imaging
IV injection
Radiation dose
Very insensitive
Very non-specific
List some pros of computed tomography angiograms
Gives info on neighbouring structures
Sensitive
List some cons of computed tomography angiograms
IV injection
Radiation dose
High contrast dose
Expensive
List some pros of MRI
Sensitive
Specific
No radiation
No nephrotoxic contrast
List some cons of MRI
Very expensive
Needs state of the art machinery
High contract cost
What important considerations must you make before using contrast agents?
Renal function
Reactions to contrast e.g. anaphylaxis
