PRELIMS Flashcards
interventional radiology procedures began in the _____ with angiography
1930
in the early 1960s, ______ _______ pioneered transbrachial selective coronary angiography
Mason Jones
he introduced coronary angiography
Melvin Judkins
he introduced visceral angiography
Charles Dotter
in 1953, ____ _____ _____ described a method of arterial access in which a catheter was used
Sven Ivar Seldinger
in angiography, the common _______ artery is most often used for arterial access
femoral
it allows the radiologist to position the catheter within the vascular network
guidewire
are fabricated of stainless steel and contain an inner core wire that is tapered at the end to a soft, flexible tip
guidewire
______ for guidewires is a variation of the tip configuration that was initially designed for use in atherosclerotic vessels filled with plaque
J-Tip
catheter diameter is categorized in _____ (Fr) sizes
3 Fr equaling 1 mm in diameter
French
the H1 or _______ tip is designed by Vincent Hinck is used for the femoral approach to the brachiocephalic vessels
headhunter
_________ catheter is highly curved for approach to sharply angled vessels
Simmons catheter
c2 or _____ catheter has an angled tip joined to a gentle curve and is used for introduction to celiac, renal and mesenteric arteries
cobra catheter
_________ catheters have side holes for ejecting contrast media into a compact bolus
pigtail catheters
________ iodine compounds were used for contrast injections
ionic
_________ contrast media have largely replaced ionic agents
non ionic
what is the most common complication associated with catheter angiography?
continued bleeding at the puncture site
what are the other risk factors of arteriography?
related to kidney failure
the procedure room should not be less than __ ft. along any wall and not less than ____ ft^2
20ft along any wall
not less than 500 ft^2
the control room should be large, perhaps ____ ft^2
100 ft^2
The _____ ______ for an IR suite is generally more massive, flexible, and expensive than that required for conventional radiographic and fluoroscopic imaging
x-ray apparatus
The x-ray tube used for IR procedures has a small target angle, a large diameter massive anode disc, and cathodes designed for ___________ and __________ _________.
magnification and serial radiography
The size and construction of the anode disc determine the _______ ____ capacity which in turn influences the power rating.
anode heat
An x-ray tube with a minimum __ kW rating and 1 MHU heat capacity is required.
80 kW
Other imaging and interventional procedures do not require a tilt couch, but a stationary patient couch with a _______ or ______ tabletop is used instead.
floating or movable
angio -
blood vessel
is the radiological study of blood vessel in the body after the introduction of iodinated contrast media
angiography
it is 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
subtraction
is the acquisition of digital fluoroscopic images combined with injection of contrast and real time subtraction of pre and post contrast images to perform angiography
digiral subtraction angiography
The Portuguese neurologist _____ _______, (Nobel Prize winner 1949), in 1927 developed the technique of contrast x-ray cerebral angiography to diagnose diseases, such as tumors and arteriovenous malformations.
Egas Moniz
The idea of subtraction images was first proposed by the Dutch radiologist ________ des Plantes in the 1935, when he was able to produce subtracted images using plain films
Ziedses des Plantes
3 conditions of DSA
scout film
angiogram film contrast
no motion of head
it is a large steel container, inside of it are arranged number of strong wire separatios
loading magazine
it is a shallows, polished metal container
receiving cassette
it is a sliding section which can be pushed down by firm finger pressure and is retained by central spring loaded catch
lid
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 vessel
photographic subtraction technique
repair or unblocking of blood vessels
angioplasty
small mesh tubes that treat narrow or weak arteries
stenting
dissolving blood clots
thrombolysis
block blood flow to cancer cells
embolization
studies of tissues
biopsies
matching one image over another so that bony landmarks are precisely superimposed
registration
reverse tone duplicate of radiographic image, showing black changed to white and white to black
reversal film or mask film
film showing bone structures only, with no patient motion b/n it and subsequent contrast studies
zero film or scout film
radiographic image obtained with the contrast media induced in the patient
series film
the simplest method of photographic subtraction
first order subtraction
the simplest zero film obtained in the first order subtraction is usually not the exacy reversal of the density of selected angiographic film
second order subtraction
the imperfection can be corrected with _____ order subtraction which is developed by Hanafee and Shinno
second order
correcting misregistered images
remasking
method to diminish blurry images
pixel shifting
edges of the vessels can be enhanced so that small details can be made more obvious
edge enhancement
a small amount of original image is added into the subtracted image
land marking
operates by reducing the statistical fluctuations in each pixel by averaging the pixel with its closest neighbors
noise smoothing
______ mapping is useful for the placement of catheters and wires in comples and small vasculature
road mapping
is the process by which something is separated into its component part
it refers to the amount of detail which is observable
number of pais of black and white lines which an image forming or image recording device can demonstrate in a length of 1 mm
resolution
_______ resolution is determined by number of vertical scan lines
vertical resolution
________ of the image on a tv screen clearly depends on the contrast of the original image focused onto the signsl plate of the pick up tube
both camera and monitor affets the ______ of a TV image
contrast
______ camera reduces contrast by a factor of approximately 0.8 and the monitor enhances by a factor of 2
vidicon camera
the term __________ and brightness are often used when discussing the aspect of TV image
luminance
________ can be defined as light emitted per unit area from a surface
it is measured in candela per square meter (cd/m²)
luminance
______ _______ _______ (abc) helps to maintain the image intensifier exposure rate based on the subject’s thickness
it is critical to the patient dose and image quality
automatic brightness control
________ ______ _______ (agc) it brightness is controlled by varying sensitivity of the tv system
it is fairly simple and inexpensive way to control image brightness
it does not change the xray dose rate to the patient
automatic gain control
is the term used to describe inability of an imaging system to follow rapid changes in its input image
image lag
_________ of the image 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
distortion
is a type of fluroscopy technique used in IR to clearly visualize blood vessels in a bony or dense soft tissue environment
is a fluoroscopic technique used extensively in IR for visualizing blood vessels
digital subtraction angiography
angiography is largely possible because of _________ technique for intravascular process
seldinger technique
modalities we used during IR procedure
xrays
MRI
fluoroscopy
CT
utz
evacuated electron tube that produces xray by accelersting electrons to a high velocity with a high voltage field and causing them to collide with a target
xray tube
interventional __________ uses ionizing radiation to guide small instruments such as catheters through blood vessels or other pathways in the body
interventional fluoroscopy
______ _______ are the most effective personal radiation protection means and should be worn by everyone in a fluoroscopy room
lead aprons
puncture sites
______ artery - most frequently used
______ artery - high approach is preferable
axillary artery
______ - for historical interest only
femoral artery
brachial artery
aorta
this approach is associated with a higher incidence of complication, it should only be used if femoral artery puncture is not possible
high brachial artery puncture
this approach is associated with a higher incidencr of complications and should only be used if femoral or high brachial artery puncture is not possible
axillary puncture
3 complications of catheter techniques
due to anesthetic
due to contrast medium
due to technique
____ is the persistence of luminscence after xray stimulation has been terminated
it degrades the temporal resolution of dynamic image
lag
a fall off in brightness at the periphery of an image
it is caused by the unequal collection of light at the center of the image intensifier compared with the light at its periphery
vignetting
scattering of light and the defocusing of photoelectrons within the image intensifier
it degrades object contrast at the output phosphor of the image intensifier
veiling glare
is a geometric, nonlinear magnification across the image
the distortion is easily visualized by imaging a rectangular grid with the fluoroscope
pincushion distortion
electrons within the image intensifier move in paths along designated lines of flux
this characteristics causes the image in a fluoroscopic system to distory with an S shape
s distortion
