Imaging of Circulatory Disturbances Flashcards

1
Q

What are the modes of anatomical vascular imaging?

A
Plain films
Ultrasound
CT
MRI 
Contrast angiography
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2
Q

What are the modes of functional vascular imaging?

A

Radionuclide imaging
MRI functional imaging
Ultrasound

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3
Q

What are the problems associated with vascular imaging?

A

Soft tissue contrast
Functional significance of lesion
Determining if treatment is effective
Blood vessels and lumen of hollow viscera not seen very well

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4
Q

What are the ideal properties of a man-made contrast agent in radiology?

A

Attenuation the same as the surrounding tissues
Not expensive
Inert
Equal distribution in and out of selected body compartments
Painless
Easy to use

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5
Q

What are the properties of iodinated contrast?

A
Differential x-ray attenuation
Inert
Stable in selected body compartments
Painless
Easy to use
Cheap
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6
Q

What are the potential problems with iodinated contrast?

A
Major reactions
Renal dysfunction
Disturbance of thyroid metabolism
Disturbance of clotting 
Seizures
Pulmonary oedema
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7
Q

What are the potential properties of parenteral iodinated contrast?

A

Metallic taste
Feeling of warmth when injected
Arterial injections may cause micturition or discomfort
Can rarely cause nausea

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8
Q

What needs to be discussed prior to parenteral iodinated contrast use?

A

Previous contrast allergy
Asthma or atopy
Poor renal function
Metformin use - will need to be stopped before contrast injection

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9
Q

How is catheter angiography carried out?

A

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

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10
Q

What are the uses of interventional radiology?

A
Angiography/angioplasty 
Embolisation
Catheter thrombolysis
Drainage of abscess
Nephrostomy
Vertebroplasty
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11
Q

When should angioplasty be used?

A

In stenosis or occlusions

Sessile/concentric plaques

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12
Q

What are the advantages and disadvantages of angioplasty?

A

Not as long lasting as surgery but not as dangerous

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13
Q

How can carbon dioxide be used in radiology?

A

Negative contrast agents

Useful in patients with poor renal function or sensitivity to iodinated contrast agents

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14
Q

What are the potential problems with angioplasty?

A
Occlusion
Dissection 
Embolisation
Rupture
Infection
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15
Q

What are the properties of ultrasound scanning?

A
No radiation dose
Quick
Non-invasive
Resolution vs penetration 
May be more physiological
Operator dependent
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16
Q

When can radionuclide imaging be used for vascular disturbances?

A
Perfusion and blood loss
Sequential imaging
Lung scintigraphy 
V/Q scan 
Perfusion of transplant kidneys
Blood loss into GI tract
17
Q

What are the properties of nuclear medicine?

A
IV injection only 
Good patient compliance
Easy to arrange 
Radiation dose
Very insensitive
Very non-specific
18
Q

What are the properties of CT angiogram?

A
Gives information about other structures
Sensitive
IV injection only 
Radiation dose
High contrast dose
Expensive
19
Q

What are the properties of MRI angiography?

A
Sensitive 
Specific
No radiation dose
No nephrotoxic contrast
Very expensive
Needs state of the art machinery 
High contrast dose
20
Q

What is involved in consenting a patient in radiology?

A

Patient learns key facts about an investigation/treatment, including potential risks and benefits, before deciding whether or not to proceed
Consent should be sought by the person doing the procedure in complex interventional radiology