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Prelim RIV0 32 > Lesson 1 and 2: Introduction to Interventional Radiology > Flashcards

Lesson 1 and 2: Introduction to Interventional Radiology Flashcards

1
Q

this involves the use of needles and contrast media to enter and highlight an artery

A

angiography

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2
Q

it was the first interventional radiology procedure performed in the 1930s

A

angiography

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3
Q

this involves entering select coronary arteries through an artery of the arms

A

transbrachial selective coronary angiography

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4
Q

in the 1960s, he pioneered transbrachial selective coronary angiography

A

Mason Jones

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5
Q

this involves entering an artery in the thigh

A

transfemoral angiography

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6
Q

it was developed in the 1960s to examine selective visceral, heart, and head arteries

A

transfemoral angiography

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7
Q

he introduced coronary angiography

A

Melvin Judkins

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8
Q

he introduced visceral angiography

A

Charles Dotter

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9
Q

he described a method of arterial access in which a catheter was used

A

1953 Sven Ivar Seldinger

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10
Q

an 18-gauge hollow needle with a stylet

A

seldinger needle

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11
Q

it is most often used for arterial access in angiography

A

common femoral artery

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12
Q

location of the common femoral artery

A

pulse in the groin below the inguinal ligament, which passes between the symphysis pubis and the anterior superior iliac spine (ASIS)

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13
Q

needle gauge size for olive

A

14

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14
Q

needle gauge size for orange

A

15

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15
Q

needle gauge size for purple

A

16

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16
Q

needle gauge size for pink

A

18

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17
Q

needle gauge size for brown

A

19

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18
Q

needle gauge size for yellow

A

20

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19
Q

needle gauge size for green

A

21

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20
Q

needle gauge size for black

A

22

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21
Q

needle gauge size for sky blue

A

23

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22
Q

needle gauge size for blue

A

25

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23
Q

needle gauge size for gray

A

27

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24
Q

needle gauge size for lavender

A

30

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25
Q

this allows the radiologist to position the catheter within the vascular network

A

guidewires

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26
Q

these are fabricated of stainless steel and contain an inner core wire that is tapered at the end to a soft, flexible tip

A

guidewires

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27
Q

it allows the safe introduction of the catheter into the vessels

A

guidewires

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28
Q

a variation of the tip configuration that was initially designed for use in atherosclerosis vessels filled with plaque

A

J-tip

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29
Q

similar to guidewires, these are designed in many different shapes and sizes

A

catheters

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30
Q

unit for catheter diameter

A

French (Fr) size

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31
Q

3 Fr is equivalent to _____ in diameter

A

1 mm

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32
Q

it catheter shape is used for the femoral approach to the brachiocephalic vessels

A

H1 or headhunter tip

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33
Q

he designed the H1 or headhunter tip

A

Vincent Hinck

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34
Q

it catheter shape is highly curved for approach to sharply angled vessels

A

simmons catheter

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35
Q

this catheter shape was also designed for cerebral angiography but was later adopted for visceral angiography

A

simmons catheter

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36
Q

it has an angled tip joined to a gentle curve and is used for introduction into celiac, renal, and mesenteric arteries

A

C2 or cobra catheter

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37
Q

these have side holes for ejecting contrast media into a compact bolus

A

pigtail catheter

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38
Q

purpose of catheters with side holes (pigtail catheter)

A

it help reduce a possible whiplash effect

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39
Q

it has low concentration of ions (low osmolality) which results to reduced physiologic problems and adverse reactions for patients undergoing angiographic injection

A

non-ionic contrast media

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40
Q

most common complication associated with catheter angiography

A

continued bleeding at the puncture site

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41
Q

other risk factors of angiography

A

related kidney failure

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42
Q

procedure room

A

size: not less than 20 ft. along any walls and not less than 500 ft^2

should be finished with consideration for maintaining a clean and sterile environment

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43
Q

importance of procedure room size

A

to accommodate the quantity of equipment required and the large number of people involved in most procedures

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44
Q

control room

A

size: large, perhaps 100 ft^2

this room should communicate directly with the viewing area

it should have positive air pressure and filtered incoming air

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45
Q

personnel

A

a radiographer who specializes in IR requires additional skills

two or three radiographers may be present in the IR suite, as well as the interventional radiologists and a radiology nurse, who carefully monitors the patient

during the procedure that require the patient to be highly medicated, an anesthesiologist also may be present

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46
Q

interventional radiology x-ray tube: focal spot size

A

1.0 mm or 0.3 mm

large for heat load, small for magnification radiography

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47
Q

interventional radiology x-ray tube: disc size

A

15 cm in diameter, 5 cm thick

to accommodate heat load

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48
Q

interventional radiology x-ray tube: power rating

A

80 kW

for rapid sequence, serial radiography

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49
Q

interventional radiology x-ray tube: anode heat capacity

A

1 MHU (mega heat unit)

to accommodate heat load

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50
Q

formula for magnetic factor

A

M = SID / SID - OID or
M= SID/SOD

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51
Q

formula for focal spot blur

A

focal spot blur = (effective focal spot) OID / SOD

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52
Q

this means blood vessel

A

angio

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53
Q

the radiological study of blood vessels in the body after the introduction of iodinated contrast media

A

angiography

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54
Q

it is simply a technique by which bone structures images are subtracted or canceled out from a film of bones plus opacified vessels, leaving an unobscured image of the vessels

A

subtraction

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55
Q

the acquisition of digital fluoroscopic images combined with injection of contrast material and real-time subtraction of pre- and post-contrast images to perform angiography

A

digital subtraction angiography

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56
Q

a Portuguese neurologists developed the technique of contrast x-ray cerebral angiography to diagnose diseases such as tumors and arteriovenous malformations

A

1927 Egas Moniz

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57
Q

the year Egas Moniz won the nobel prize

A

1949

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58
Q

a Dutch radiologist, he was the first to proposed the idea of subtraction images in 1935, when he was able to produce subtracted images using plain films

A

Ziedes des Plantes

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59
Q

with its introduction in the 1953, the procedure became safer as no sharp devices need to remain inside the vascular lumen

A

seldinger technique

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60
Q

photographic method used to eliminate unwanted images

no addition of information, only purpose is to make diagnostically important information to see

A

conventional subtraction technique

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61
Q

this was first described by a Dutch radiologist, Zeides des Plantes, in 1935

A

conventional subtraction technique

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62
Q

three conditions for conventional subtraction technique

A

scout film

angiogram film-contrast

no motion of head

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63
Q

principles of subtraction

A

scout film shows the structural details of the skill and the adjacent soft tissue

angiogram film shows exactly the same anatomic details, if the patient does not move, plus the opacified blood vessels

if all the information in the scout film could be subtracted from the angiogram, only the opacified vessel pattern would remain visible

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64
Q

it can change films – 6/s or 1/5s

two of these changers can be coupled electronically and mechanically and will operate out of phase or synchronously with each other

radiographs in two planes simultaneously-one mounted vertically and other horizontally

A

AOT changer

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65
Q

a large steel container, inside the container are arranged a number of strong wire separators

A

loading magzine

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66
Q

a shallow, polished metal container

lid is a sliding section in a side which can be pushed down by firm finger pressure and is retained by central spring located catch

A

receiving cassette

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67
Q

mechanically easier to wind roll films

A

roll film changer

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68
Q

this is a complex electronic device that receives the image-forming x-ray beam and converts it into a visible-light image of high intensity

A

image-intensifier tube

69
Q

it converts the pattern of the x-ray beam into a bright visible-light image

A

image-intensifier tube

70
Q

it contains the tube component

A

glass or metal envelope

71
Q

this provides structural support but more importantly maintains vacuum

A

glass or metal envelope

72
Q

it protects the tube from rough handling and breakage

A

glass ot metal envelope

73
Q

when an x-ray interacts with this, its energy is converted into visible light; this is similar to the effect of radiographic intensifying screens

A

input phosphor

74
Q

component of input phosphor

A

cesium iodide (CsI)

75
Q

they are grown as tiny needles and are tightly packed in a layer of approximately 300 µm

each crystal is approximately 5 µm in diameter

this results in micro-light-pipes with little dispersion and improved spatial resolution

A

cesium iodide (CsI)

76
Q

another active element of the image-intensifier tube, which is bonded directly to the input phosphor with a thin transparent adhesive layer

A

photocathode

77
Q

it is a thin metal layer usually composed of cesium and antimony compound that responds to stimulation of input phosphor light by the emission of electrons

A

photocathode

78
Q

this emits electrons when illuminated by the input phosphor

A

photocathode

79
Q

this is similar to thermionic emission, which refers to electron emission that follows heat stimulation

A

photoemission

80
Q

it is electron emission that follows light stimulation

A

photoemission

81
Q

the site where accelerated electrons interact and produce light

A

output phosphor

82
Q

it is located at the other side of the anode

A

output phosphor

83
Q

component of output phosphor

A

zinc cadmium sulfide

84
Q

a technique by which bone structure images are subtracted, or canceled out, from a film of bones and opacified vessels, leaving an unobscured image of the vessels

A

photographic subtraction technique

85
Q

this technique can be applied in all forms of angiography, wherever the vessels are superimposed in bone structures

A

photographic subtraction technique

86
Q

he introduced the photographic subtraction technique

A

Zeides des Plantes

87
Q

year when angiography was first successively used for the human body

A

1923

88
Q

a swedish doctor who pioneered the seldinger technique, which laid down the foundation of interventional radiology

A

1953 Sven Ivar Seldinger

89
Q

he first proposed the idea of interventional radiology

A

1963 Charles Dotter

90
Q

he opened a new era of percutaneous angioplasty through accidental operation, marking the formation of interventional radiology

A

1964 Chrales Dotter

91
Q

importance of interventional radiology in medicine

A

diagnose and treat patients using the least invasive techniques currently available in order to minimize risk to the patient and improve health outcome

these procedures have less risk, less pain, and less recovery time in comparison to open surgery

it is now a therapeutic and diagnostic specialty that comprises a wide range of minimally invasive image-guided therapeutic procedures as well as invasive diagnostic imaging techniques

92
Q

repair or unblocking of blood vessels

A

angioplasty

93
Q

a small mesh tube that treat narrow or weak arteries

A

stenting

94
Q

dissolving blood clots

A

thrombolysis

95
Q

block blood flow to cancer cells

A

embolization

96
Q

this is used to reduce nerve pain

A

radiofrequency ablation

97
Q

biopsies

A

the studies of tissues

98
Q

most common interventional radiology procedures

A

angiography

angioplasty/stent

chemoembolization

thrombolysis

biopsy

RF ablation

cryoablation

IVC filter

99
Q

benefits of interventional radiology procedures

A

increased effectiveness

reduced complications

outpatient vs. inpatient stay

lower costs

less pain

quicker recovery time

100
Q

risk of interventional radiology procedures

A

increased exposure to radiatiton

101
Q

it is introduced by Ziedes des Plantes

A

photographic subtraction

102
Q

this is a technique by which bone structure image is subtracted or cancelled out

from the film of bones and opacified vessels leaving an unobscured image of the vessels

A

photographic subtraction

103
Q

purpose of subtraction in angiography and other specialized procedure

A

to fully define all vessels containing contrast material and at the same time eliminate the confusing overlying bone images

104
Q

matching one image over another so that bony landmarks are precisely superimposed

A

registration

105
Q

reverse tone duplicate of radiographic image, showing black changed to white and white to black

A

reversal film or mask film

106
Q

film showing bone structures only, with no patient motion between it and subsequent contrast studies

A

zero film or scout film

107
Q

radiographic image obtained with the contrast media induced in the patient

A

series film

108
Q

the simplest method of photographic subtraction

A

first order subtraction

109
Q

procedures of first order subtraction

A

take scout film

the scout film is reversed using contact printer to obtain the reversal mask film

take series film

finally register the reversal mask film and series film together with blank film to obtain the final film

the process cancel out bony structure and reveal the anatomy of interest which appears in black

110
Q

the simplest zero film obtained in the first order subtraction is usually not the exact reversal of the density of the selected angiographic film

the imperfection can be corrected

A

second order subtraction

111
Q

they developed the second order subtraction

A

Hanafee and Shinno

112
Q

procedures of second order subtraction

A

take scout film

the scout film is reversed using contact printer to obtain the reversal mask film

take series film

the series film is reversed using contact printer to obtain the reversal film

register scout film and series reversal film together with a blank film to obtain the second mask film

finally register the mask film, series film, second mask film, and blank film to obtain the final film

113
Q

based on digital fluoroscopy/fluorography systems, which are equipped with special software and display facilities

A

modern DSA system

114
Q

this was developed to improved vessel contrast

A

digital subtraction angiography

115
Q

it is a technique that uses a computer to subtract two images, obtained before and after contrast media is injected into the vessels of interest

A

digital subtraction angiography

116
Q

the anatomical structures that are the same in the two images can be removed and the resulting image shows the vessels only

A

digital subtraction angiography

117
Q

the image before the contrast agent is administered

A

mask film

118
Q

it has two separate image memories, one for the mask and the other for the images with contrast medium

these two image memories are subtracted from one another arithmetically, and the result to an image processing and display unit

A

DSA processor

119
Q

adjusts contrast and brightness

A

image processing

120
Q

image processing parameters

A

remasking

pixel shifting

edge enhancement

landmarking

noise smoothing

121
Q

correcting misregistered images

A

remasking

122
Q

a process that is used to correct the inaccurate images during DSA

A

remasking

123
Q

it diminishes what is blurry on the image in the monitor

A

pixel shifting

124
Q

this enhances resolution of a certain display presented in the monitor

A

pixel shifting

125
Q

edges of the vessels can be enhanced so that small details can be made more obvious

A

edge enhancement

126
Q

it operates by reducing the statistical fluctuations in each pixel by averaging the pixel with its closest neighbor

A

noise smoothing

127
Q

this help equalize image pixel

A

noise smoothing

128
Q

the visual prominence of noise has been suppressed by averaging, but resolution is decreased

A

noise smoothing

129
Q

this gives random variation of image brightness which causes the image to appear grainy

A

noise

130
Q

noise =

A

decrease brightness

decreased resolution

131
Q

this is useful for the placement of catheters and wires in complex and small vasculature

A

roadmapping

132
Q

factors affecting image quality

A

resolution

contrast

brightness

image lag

distortion

133
Q

the proves by which something is separated into its component part

A

resolution

134
Q

this refers to the amount of detail which is observable

A

resolution

135
Q

it may be formulated on the number of pairs of black and white lines on image forming or image recording device can demonstrate in a length of ___

A

resolutiion, 1 mm

136
Q

it is determined by no. of vertical scan lines (e.g. 625)

A

vertical resolution

137
Q

in recent years the manufacturers of radio diagnostic imaging equipment have developed this definition TV system which employ ___ or even more lines

A

1249

138
Q

the ____ of the image on a TV screen clearly depends on the ____ of the original image focused onto the signal plate of the pick up tube

A

contrast

139
Q

both ___ and ___ affects the contrast of a TV image

A

camera, monitor

140
Q

this reduces contrast by a factor of approx. 0.8 and the monitor enhances by a factor of 2

A

vidicon camera

141
Q

the term ___ and ___ are often used when describing the aspect of TV image

A

luminance, brightness

142
Q

it can be defined as light emitted per unit area from a surface

A

luminance

143
Q

unit for luminance

A

candela per square meter (cd/m^2)

144
Q

this helps maintain the image intensifier exposure rate based on the subject’s thickness

A

automatic brightness control

145
Q

it is critical to the patient dose and image quality

A

automatic brightness control

146
Q

this monitors the light output from an area of the face of the image intensifier and it tries to maintain the signal travel within an approximate range of that output and adjust tube potential (kVP) and tube current (mA) according to predefined algorithm

A

automatic brightness control

147
Q

it refers to control of x-ray exposure levels

A

automatic brightness control

148
Q

if brightness is controlled by varying sensitivity the TV system, this terms is used

A

automatic gain control

149
Q

it is fairly simple and inexpensive way to control image brightness

A

automatic gain control

150
Q

the term used to describe inability of an imaging system to follow rapid changes in its input image

A

image lag

151
Q

this occur in the image intensifier or in the optical coupling system which links its output phosphor to the signal plate of the TV pick up tube

A

distortion

152
Q

indications for DSA

A

non traumatic subarachnoid hemorrhage (SAH)

arterial dissection or laceration

aneurysm

pseudoaneurysm

thrombosis

arterio-venous malformation (AVM)

arterio-venous fistula (AVF)

tumor vascularity

gastrointestinal bleed/uterine artery bleed

therapeutic

153
Q

contraindications for DSA

A

poor renal reserve

allergic to contrast media

recent barium examination – abd. angio

154
Q

a type of fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment

A

digital subtraction angiography

155
Q

a fluoroscopic technique used extensively in interventional radiology for visualizing blood vessels

A

digital subtraction angiography

156
Q

radiopaque structures such as bones are eliminated (subtracted) digitally from the image, thus allowing for an accurate depiction of the blood vessels

A

digital subtraction angiography

157
Q

it is performed for diagnostic and therapeutic purposes of vessel visualization in the body

A

digital subtraction angiography

158
Q

angiography is largely possible because of Seldinger technique for intravascular access

A

1953

159
Q

digital subtraction angiography, whereby a pre-contrast image is acquired, then subtracted from subsequent post-contrast images, was made possible because of real-time refreshing of the resulting images

A

1970s

160
Q

the development of DSA was a result of the research of medical physics groups at the University of Wisconsin, the University of Arizona and the Kinderklinik in Kiel, West Germany

A

early 1970s

160
Q

the feasibility of DSA for human subjects was demonstrated

A

1978

161
Q

prototype commercial DSA systems were introduced at the Universities of Arizona and Wisconsin, the Cleveland Clinic, and South Bay Hospital in Redondo Beach, California

A

1980

162
Q

pre-procedural evaluation

A

presence of atherosclerotic disease (e.g. prior myocardial infarction)

diabetes

renal function status

medications

allergies and previous exposure to iodinated contrast media

prior surgical procedures, especially vascular

reports from previously performed angiograms, if any

review of any relevant vascular Imaging studies (e.g. pre-procedural CT)

angiogram

163
Q

procedural technique

A

for every purpose, there is at least one technique, but common to them all is the application of DSA for visualization

164
Q

this depends on the nature of the procedure and whether it was performed on an inpatient or outpatient basis

A

post procedural care

165
Q

post procedural care:

patient should be immobilized for ___ to ___ hours and keep on ___ position, frequent observations should be done to look for ___, which is the commonest complications

A

4 to 6, puncture site hematoma

166
Q

local complications (puncture site) of DSA

A

from the puncture site: commonest complication

thrombus formation: blood clot

local tissue damage

pseudoaneurysm: false aneurysm, pooling of blood at the artery walls

arteriovenous fistula: abnormal connection of arteries and veins

166
Q

systemic complications of DSA

A

thromboembolism

air embolism

vessel dissection

contrast medicated nephrotoxicity

Prelim RIV0 32 (1 decks)

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