Intervention Radiology Flashcards
are minimally invasive radiologic procedures that use angiographic techniques to diagnose disease
interventional radiology
radiologic examination of vascular structures within the body after introduction of iodinated contrast medium or gas
angiography
are categorized as either visceral or peripheral and can be further classified into the following major procedures
angiographic procedures
image of the arteries
arteriography
imaging of the veins
venography
imaging of the heart and associated structures
angiocardiography
imaging of the lymphatic vessels/nodes
lymphography
are performed to assess the severity of a stenoisis of occlusion in a vessel caused by atherosclerosis
arteriograms
is preformed to detect and verify the existence and exact postion of the intracranial vascular lesion such as an aneurysm
cerebral angiography
needed to visualize the vessel of interest
vessel access
must be introduced to the patients vasculature through which contrast media will be injected
catheter
developed by dr. sven seldinger in 1953 where an 18 gauge hollow needle containing a stylet is used precutanously in order to gain arterial or venous access
seldinger technique
three vessels are typically considered for catherterization
femoral, brachial, axillary
used to allow the safe introduction of the catheter into the vessel
allows the radiologist to posistion the catheter within the vascular network
guidewire
similar to guidewires, different sizes and shape to fit the vessel of interest
diameter is categorized in French (Fr) sizes; 3 FR equals 1 mm in diameter
catheters
usually a water-soulble, nonionic iodinated and radiopaque compound that is injected through the catheter for visualization of vessels
contrast media
have replaced ionic compounds because of their low osmolality and reduced risk of allergic reactions and physiologic problems
nonionic contrast media
primary purpose is to provide a vascular “road map” that enables the localization and diagnosis of pathology or other anomalies of the brain and neck region
cerebral angiography
most common studies
common and internal carotid arteriography
most frequently performed angiogram study to visualize the common carotid arteries
common carotid arteriography
allows visulazation of the internal carotid arteries and the birfurcation into the anterior and middle cerecral arteries
internal carotid arteriography
demonstrates the contour and integrity of the throcaic vasculature
angiographic study of the ascending aorta, arch, descending aorta, and major branches
throacic arteriography
oblique visulaization of the aortic arch usually performed witht the pateint in a 45 degree LAO posistion
thoracic aortogram
demonstrates the arterial phase of a pulmonary angiogram, usually done to investigate for pulmonary embolus
pulmonary arteriogram
radiologic imaging of the heart and associated structures
angiocardiography
typically performed with angiocardiography to visualize the coronary arteries
coronary arteriography
performed to identify the anatomic and physicologic condition of the heart
cardiac catheterization
demonstrates the contour and integrity of abdominal vasculature
allows the visulization of abdominal vessels and possible obstruction or vessel tears
absominal angiography
radiologic exam of the peripheral vasculature after the injection of contrast media
peripheral angiography
injection by a cahther into an artery of an extremity
arteriograms
injection into a vein of the extremity
venograms
performed to visualize the lymph vessels and nodes
lymphongraphy
usually an angiographic approach to create an embolus in a vessel thus restricting blood flow
embolization
uses an angiographic approach and specilized catheters to dilate a stenosed vessel
precutaneous transluminal angioplasty and stent placement
uses a combination of interventional stents and surgical grafts to treat aortic aneurysms
stent-graft placement
uses an angiographic technique to place a filter in the inferior vena cava to tream pulmunary emboli
inferior vena cava filter
placement of venous access catheters to administer chemotherapy or large amounts of antibiotics for frequent blood tests and parenteral nutrition
insertion of venous access devices
vasuclar-interventional procedure used to treat variceal bleeding, refractory ascitis and cirrhosis
transjugular intrahepatic portosystemic shunt (TIPS)
procedure that uses a dissolving agent injected through catherter into the region of the thrombus or clot, whereby the clost is lysed (disintegrated)
thrombolysis
uses a range of agents such as vasoconstrictors, vasodilators, chemotherapeutic drugs, and radioactive materials that treat disease
infusions therapy
procedure that removes foreign bodies such as (calculi, fragments of vascular catheters or guide wires, pacemaker electrodes, and shunts) through the use of loop snares, basket catheters, or endoscopic grasping forceps
extraction of vascular foreign bodies
used to treat patients who have vertebral pain and instability caused by osteoporosis, spinal metaatases, compression fractures, or veterbral angiomas
injection of acrylic cement into the vertebral body to stablize the spine
percutaneous verterbroplasty and kyphoplasty
involves placing a stent for decrompression of the obstructed bowel done preoperatively to reduce postoperative complications in the case of bowel obstructions and a palliative measures for colonic structures
enteric stenting
performed for both diagnostic and therapeutic reasons and is useful in treating several types of kidney pathologies or disorders
used diagnostically for renal function assessment a urine culture, therapeutic reasons include stone diversion, chemolysis, and abscess drainage
nephrostomy
used as a palliative procedure for unresectable malignant disease
internal or external drainage, stone removal, dialation of obstructed bile duct, and biopsy
percutaneous biliary drainage (PBD)
indicated when abdominal or pelvic abscesses cannot be readliy treated by simple incision and when the location of the abscess is in a safe place for needle entery
percuatneous abdominal abseess drainage (PAD)
perfromed when primary or metastic malignancy is suspected
precutaneous needle biopsy
performed for extended feeding (greater than 4 weeks) of patients unable to eat, gastric decompression, dilation of upper GI tract when the oral approach fails
percutaneous gastrostomy
involves using computers in conjuction with specilized imaging equipment to produce quality diagnostic digital images
digital image acquistion
typically a multiphase format offering 12 pulses per second that offers high performance capabilities
allows high mA stations and low kVp setting that improve the visibility of contrast medium against surrounding soft tissue structures
allows for shorter exposure time which reduces exposure to the patient
generator
constructed with larger diameter anode disks combined with a larger target angle or focal spot size to accommodate for the increased heat production
xray tube
require the use of charge-couple devices (CCD) and an analog-to-digital converter to produce a digital image
CCD replaces the television camera in the vascular imaging system
analog image intensifiers
acquire images digitally so no specail concersion equipment is required
composed of silicon pixel detectors that are known as flat panels or digital detectors
digital image intensifiers
controls the speed of the imaging equipment and allows the images to be viewed in real-time
hardware
controls various components of the imaging system including the generator, xray tube, image processing hardware, and archiving storage device
computer
allows for the same delivery of large and small bolus injections of present amounts of contrast necessary for angiography
contrast medium injection devices
display the injection parameters; manipulated by interbentional radiologist; includes flow rate, rise, total volume pressure and delay
control panel
removable and disposable with a capacity of 40-260cc
syringe
thermal sleeve placed over preloaded syringe to maintain contrast medium at normal body temperature, reduces viscosity
warming device
an electromagnetic motor that moves a piston into or out of the syringe
high pressure mechanism
prevents excessive amounts of contrast from being delivered to patient
volume limiting device
prevents injection pressure from exceeding maximum presssure set prior to the injection
pressure limiting device
allows electromechanical motor to accelerate over an exact duration of time to prevent whiplash of the catheter
acceleration regulator
prevents an instant surge of injection pressure by gradually increasing the psi to preset limits
rate-rise control
typically an island-type, low attenuation table that provides acces to the patient on all sides
four-floating capabilities
adjustable height
table plate for attachement of equipment
tilting mechanism
constructed of low radiation absorbing plastic and carbon fiber material that does not degrade image quality
angiographic table
allows the monitoring of the patients venous and arterial pressures and ECG
physiologic monitoring equipment
spot filming replaced traditional spot film devices
involves the production of one image and is generally used when only a few images are needed for a procedure
digital angiography
a highly sophisticated computer - substracts or removes bone and soft tissue structures so that the resultant image demonstrates only the vessles of interest containing contrast media
(vessels in the head, chest, extremeties)
digital substraction angiography (DSA)
involves taking numerous exposures (frames) in a secon
used primarily for cardiac catherterization which requires exposure rates of 15, 30, or 60 frames per second
able to demonstrate events that are normally too fast or cannot be seen by general fluoroscopy
digital cineradiography
