Imaging of circulatory disturbances

Question 1

What anatomical imaging can be used for vascular imaging?

Answer 1

Plain films (CXR)
Contrast angiography
Ultrasound
CT/MRI

Question 2

What functional imaging is used for circulatory disturbances?

Answer 2

Radionuclide imaging
MRI functional imaging
Ultrasound

Question 3

What are some issues in vascular imaging?

Answer 3

Soft tissue contrast not very clear

Question 4

List some pros of iodinated contrast

Answer 4

Inert and painless
Stable in selected body compartments
Easy to use
Cheap

Question 5

Name some cons of iodinated contrast

Answer 5

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

Question 6

List some cons of parenteral iodinated contrast

Answer 6

Metallic taste
Warmth
Discomfort from arterial injection

Question 7

List some pros of parenteral iodinated contrast

Answer 7

Rarely nausea

Question 8

What is catheter angiography?

Answer 8

Vessel punctured and catheterised, contrast injected and images taken to view vasculature

Question 9

Name some contrast agents

Answer 9

Iodinated contrast
Parenteral iodinated contrast
Carbon dioxide

Question 10

Describe the use of carbon dioxide as a contrast agent

Answer 10

Negative contrast agent

Useful in those with renal impairment or sensitivity to iodinated contrast

Question 11

What contrast is used in those with renal impairment or sensitivity to iodinated contrast?

Answer 11

Carbon dioxide

Question 12

Name some problems with angioplasty

Answer 12

Occlusion
Dissection 
Embolisation
Rupture
Infection

Question 13

List some pros of ultrasound

Answer 13

No radiation
Quick
Non-invasive

Question 14

List some cons of ultrasound

Answer 14

Operator dependant

Question 15

Can you compress normal veins?

Answer 15

Yes - in DVT, vein is full of thrombus so won’t compress

Question 16

What can radionuclide imaging be used for in vascular disturbances?

Answer 16

Assess perfusion

Assess blood loss

Question 17

Name the radionuclide imaging used to analyse perfusion of the lungs

Answer 17

Lung scintigraphy or V/Q scan

Question 18

List some pros of radionuclide imaging

Answer 18

Good compliance

Easy to arrange

Question 19

List some cons of radionuclide imaging

Answer 19

IV injection
Radiation dose
Very insensitive
Very non-specific

Question 20

List some pros of computed tomography angiograms

Answer 20

Gives info on neighbouring structures

Sensitive

Question 21

List some cons of computed tomography angiograms

Answer 21

IV injection
Radiation dose
High contrast dose
Expensive

Question 22

List some pros of MRI

Answer 22

Sensitive
Specific
No radiation
No nephrotoxic contrast

Question 23

List some cons of MRI

Answer 23

Very expensive
Needs state of the art machinery
High contract cost

Question 24

What important considerations must you make before using contrast agents?

Answer 24

Renal function

Reactions to contrast e.g. anaphylaxis