interventional radiology 2
問題一覧
1
they had produced a radiograph showing the blood vessels of an amputated hand using Teichman’s mixture
haschek and lindenthal
2
first human cardiac catheterization
forssman
3
(1952) he announced a percutaneous method of catheter introduction.
seldinger
4
(1974) he introduced the doubled-lumen, ballon tip catheters.
andreas gruentzig
5
• refers to the opacification of vessels through injection of contrast media.
• Radiologic examination of vascular structures within the body after introduction of contrast media.
angiography
6
TRUE OR FALSE
ADVANTAGES OF IR
• Minimally invasive
• Reduce hospital stays in many patients.
• Help some patients avoid surgery.
• Reduce medical cost.
true
7
• fabricated of stainless steel and contain an inner core wire that is tapered at the end to a soft, flexible tip.
guidewire
8
Interventional procedure for angiography
stent placement
9
Interventional procedure for aortography
embolization
10
Interventional procedure for arteriography
intravascular stent
11
Interventional procedure for cardiac catheterization
thrombolysis
12
Interventional procedure for myelography
balloon angiography
13
• The shaped tip of the catheter is required for selective catheterization of openings into specific arteries.
catheter
14
• designed by Vincent Hinck is used for the
femoral approach to the brachiocephalic
vessels.
headhunter tip (H1)
15
• is highly curved for approach to sharply angled vessels and was also designed for cerebral angiography but was later adopted for visceral angiography.
simmons catheter
16
• has an angled tip joined to a gentle curve and is used for introduction into celiac, renal, and mesenteric arteries.
cobra catheter (C2)
17
• Have side holes for ejecting contrast media into a compact bolus.
pigtail catheter
18
• generally, is used to flush catheters.
heparinized saline
19
Advantages of non-ionic contrast media
low osmolality,less advantage reaction
20
An 18 gauge hollow needle with a stylet
seldinger needle
21
TRUE OR FALSE
RISK OF ARTERIOGRAPHY
• continued bleeding at the puncture site.
• reaction to contrast media,
• kidney failure.
• serious adverse reactions related to blood clot formation or catheter.
• guidewire penetrating injury.
true
22
• The procedure room itself should not be less than ______ ft along any wall and not less than ______ ft2.
•should have at least three means of access.
20ft and not less than 500ft2
23
• The control room should be large, perhaps _____ft2.
100ft2
24
Focal spot size
1.0mm/0.3mm
25
Disc size
15cm diameter and 5cm thick
26
Power rating
80kW
27
Anode heat capacity
1 MHU
28
ANGIOGRAPHIC TEAM
• interventional Radiologic Technologist
• Radiology Nurse
• Interventional Radiologist/Cardiologist
• Nurse Tech/Med Tech
• Echocardiographer
• Anesthesiologist
true
29
TYPES OF ANGIOPLASTIES
coaxial,balloon,stent placement,laser tip,thermal,percutaneous atherectomy
30
• First a guide wire is passed through the narrowed area of a vessel.
• Then a smaller catheter is passed over the guide wire through the stenosis to begin the dilation process.
• Finally, a larger catheter is passed over the smaller catheter to cause further dilation.
coaxial angioplasty or dotter ethod
31
• 1974 Gruentzig and Hopff introduced the double lumen, balloon tipped Catheter.
• sizes ranging from 3 to 9 Fr, with attached balloons varying in length and expanding to diameters of 2 to 20 mm or more.
• The balloon is usually inflated with a diluted contrast medium mixture for 15 to 45 seconds, depending on the degree of stenosis and the vessel being treated.
balloon angioplasty or poba
32
How can we determine the success of angioplasty?
1. Contrast medium can be injected
2. comparing transcatheter blood pressure measurements from a location distal and a location proximal to the lesion site.
• In 1978, Molnar and Stockum described the use of balloon angioplasty for dilation of strictures within the biliary system.
•Balloon angioplasty is also conducted in venous structures, ureters, and the gastrointestinal tract.
• RESTENOSIS
• 30% - 50%
true
33
• vascular stent is a wire or plastic cylinder that is introduced through a catheter
system and positioned across a stenosis to keep the narrowed area spread apart.
stent placement
34
• laser energy is directed through a special catheter and pulsed at the atheromatous mass to vaporize it.
• This process leaves a smooth, carbonized surface up to 5 mm in diameter,
laser tipped angioplasty
35
• a laser-heated probe is advanced through an atheroma to recanalize the vessel
lumen.
thermal angioplasty
36
A cylindrically shaped chamber called the housing with an opening along one side called the housing window. Opposite the housing window is a balloon that, when inflated, presses the atheromatous mass into the window. A round, rotating cutter is then advanced through the housing to cut the atheroma, which is collected in the distal housing chamber. The balloon is then deflated, and the housing window is rotated 90degrees in the vessel.
directional coronary atherectomy DCA
37
• Distention of the pelvis and calices of the kidney with urine, caused by ureteral obstruction.
hydronephrosis
38
NEPHROSTOMY TUBE
• 8 to 12 Fr
• 12 inches (30 cm) in length
• may be placed for temporary or permanent external drainage of urine.
• tubes that are left in place for a long period of time need to be exchanged periodically for new ones.
POSITION
• prone or
• anterior oblique
true
39
• Angioplasty of stenoses in the ureteral system,
• renal cyst puncture with drainage,
• Percutaneous antegrade ureteral stent placement
• is an alternative to surgical removal of relatively small kidney stones.
percutaneous nephrolithotomy
40
PERCUTANEOUS ANTGRADE URETRAL STENT PLACEMENT
1. A nephrostomy tube is initially placed to provide access to the renal pelvis and to allow a tract to form in the body.
2. At a later time, a guide wire is passed through the nephrostomy tube and down the ureter into the bladder.
3. The nephrostomy tube is removed, and the stent is inserted over the guide wire using a pusher.
4. The nephrostomy tube is replaced to provide external drainage until it is known that the stent is providing internal drainage.
5. The stent can usually be removed through the urethra by a cystoscopic procedure.
true
41
may be performed by injecting the drainage catheter to evaluate anatomy and catheter function.
periodic antegrade nephrograms
42
• is an alternative to surgical removal of relatively small kidney stones.
percutaneous nephrolithotomy
43
• It is a non-surgical and minimally invasive procedure performed in radiology, usually by an interventional radiologist.
transarterial chemoembolization
44
• places chemotherapy and synthetic materials called embolic agents into a blood vessel feeding a cancerous tumor to cut off the tumor's blood supply and trap the chemotherapy within the tumor.
tace
45
may be used as a standalone treatment or combination with surgery, ablation, chemotherapy or radiation therapy
chemoembolization
46
Types of tace
conventional tace,DEB tace
47
Chemotherapy drug
10 mg mitomycin,2.50 mg doxorubicin,100 mg cisplatin
48
Success rate _____ up to ______ years life span
70%,2 years
49
Blood clot
thrombus
50
Thrombus becomes dislodged and migrates
embolus
51
Access of IVC filter
femoral,jugular,antecubital vein
52
Types of IVC filter
permanent,temporary
53
IVC also called
umbrella filter
54
Chemoembolization may be used as a standalone treatment or in combination with:
surgery,ablation,chemotherapy
55
IVC desigbed to be placed in vena cava ranging up to
20 to 30 mm in diameter
56
• Umbrella filter
•initially compact inside an introducer catheter device and assume their functional shape as they are released
•are designed as a conical shape to trap clots in its central lumen
•designed to be placed in vena cava's ranging up to 20 to 30 mm in diameter.
IVC filter
57
The first true filter designed to trap emboli while maintaining vena cava patency was introduced in 1 967
It consisted of six metal struts joined at one end to form a conical shape that was covered by a perforated plastic canopy
mobin uddin filter
58
TRUE OR FALSE
Procedure
• Administration of anesthesia/sedation
• Draping
• Preparation of puncture site
Puncture
•Introducer sheath
• Introduction of guidewire
Inferior vena cavogram
• Deployment of IVC filter
•Post placement image
•Hemostasis
true
magnetic resonance imaging 2
magnetic resonance imaging 2
Kenneth Manlapaz · 78問 · 1年前magnetic resonance imaging 2
magnetic resonance imaging 2
78問 • 1年前computed tomography
computed tomography
Kenneth Manlapaz · 46問 · 1年前computed tomography
computed tomography
46問 • 1年前Radiationtherapy
Radiationtherapy
Kenneth Manlapaz · 79問 · 1年前Radiationtherapy
Radiationtherapy
79問 • 1年前computed tomography 2
computed tomography 2
Kenneth Manlapaz · 11問 · 1年前computed tomography 2
computed tomography 2
11問 • 1年前QAQC 2
QAQC 2
Kenneth Manlapaz · 33問 · 1年前QAQC 2
QAQC 2
33問 • 1年前radiotherapy
radiotherapy
Kenneth Manlapaz · 19問 · 1年前radiotherapy
radiotherapy
19問 • 1年前POSI 2
POSI 2
Kenneth Manlapaz · 30問 · 1年前POSI 2
POSI 2
30問 • 1年前問題一覧
1
they had produced a radiograph showing the blood vessels of an amputated hand using Teichman’s mixture
haschek and lindenthal
2
first human cardiac catheterization
forssman
3
(1952) he announced a percutaneous method of catheter introduction.
seldinger
4
(1974) he introduced the doubled-lumen, ballon tip catheters.
andreas gruentzig
5
• refers to the opacification of vessels through injection of contrast media.
• Radiologic examination of vascular structures within the body after introduction of contrast media.
angiography
6
TRUE OR FALSE
ADVANTAGES OF IR
• Minimally invasive
• Reduce hospital stays in many patients.
• Help some patients avoid surgery.
• Reduce medical cost.
true
7
• fabricated of stainless steel and contain an inner core wire that is tapered at the end to a soft, flexible tip.
guidewire
8
Interventional procedure for angiography
stent placement
9
Interventional procedure for aortography
embolization
10
Interventional procedure for arteriography
intravascular stent
11
Interventional procedure for cardiac catheterization
thrombolysis
12
Interventional procedure for myelography
balloon angiography
13
• The shaped tip of the catheter is required for selective catheterization of openings into specific arteries.
catheter
14
• designed by Vincent Hinck is used for the
femoral approach to the brachiocephalic
vessels.
headhunter tip (H1)
15
• is highly curved for approach to sharply angled vessels and was also designed for cerebral angiography but was later adopted for visceral angiography.
simmons catheter
16
• has an angled tip joined to a gentle curve and is used for introduction into celiac, renal, and mesenteric arteries.
cobra catheter (C2)
17
• Have side holes for ejecting contrast media into a compact bolus.
pigtail catheter
18
• generally, is used to flush catheters.
heparinized saline
19
Advantages of non-ionic contrast media
low osmolality,less advantage reaction
20
An 18 gauge hollow needle with a stylet
seldinger needle
21
TRUE OR FALSE
RISK OF ARTERIOGRAPHY
• continued bleeding at the puncture site.
• reaction to contrast media,
• kidney failure.
• serious adverse reactions related to blood clot formation or catheter.
• guidewire penetrating injury.
true
22
• The procedure room itself should not be less than ______ ft along any wall and not less than ______ ft2.
•should have at least three means of access.
20ft and not less than 500ft2
23
• The control room should be large, perhaps _____ft2.
100ft2
24
Focal spot size
1.0mm/0.3mm
25
Disc size
15cm diameter and 5cm thick
26
Power rating
80kW
27
Anode heat capacity
1 MHU
28
ANGIOGRAPHIC TEAM
• interventional Radiologic Technologist
• Radiology Nurse
• Interventional Radiologist/Cardiologist
• Nurse Tech/Med Tech
• Echocardiographer
• Anesthesiologist
true
29
TYPES OF ANGIOPLASTIES
coaxial,balloon,stent placement,laser tip,thermal,percutaneous atherectomy
30
• First a guide wire is passed through the narrowed area of a vessel.
• Then a smaller catheter is passed over the guide wire through the stenosis to begin the dilation process.
• Finally, a larger catheter is passed over the smaller catheter to cause further dilation.
coaxial angioplasty or dotter ethod
31
• 1974 Gruentzig and Hopff introduced the double lumen, balloon tipped Catheter.
• sizes ranging from 3 to 9 Fr, with attached balloons varying in length and expanding to diameters of 2 to 20 mm or more.
• The balloon is usually inflated with a diluted contrast medium mixture for 15 to 45 seconds, depending on the degree of stenosis and the vessel being treated.
balloon angioplasty or poba
32
How can we determine the success of angioplasty?
1. Contrast medium can be injected
2. comparing transcatheter blood pressure measurements from a location distal and a location proximal to the lesion site.
• In 1978, Molnar and Stockum described the use of balloon angioplasty for dilation of strictures within the biliary system.
•Balloon angioplasty is also conducted in venous structures, ureters, and the gastrointestinal tract.
• RESTENOSIS
• 30% - 50%
true
33
• vascular stent is a wire or plastic cylinder that is introduced through a catheter
system and positioned across a stenosis to keep the narrowed area spread apart.
stent placement
34
• laser energy is directed through a special catheter and pulsed at the atheromatous mass to vaporize it.
• This process leaves a smooth, carbonized surface up to 5 mm in diameter,
laser tipped angioplasty
35
• a laser-heated probe is advanced through an atheroma to recanalize the vessel
lumen.
thermal angioplasty
36
A cylindrically shaped chamber called the housing with an opening along one side called the housing window. Opposite the housing window is a balloon that, when inflated, presses the atheromatous mass into the window. A round, rotating cutter is then advanced through the housing to cut the atheroma, which is collected in the distal housing chamber. The balloon is then deflated, and the housing window is rotated 90degrees in the vessel.
directional coronary atherectomy DCA
37
• Distention of the pelvis and calices of the kidney with urine, caused by ureteral obstruction.
hydronephrosis
38
NEPHROSTOMY TUBE
• 8 to 12 Fr
• 12 inches (30 cm) in length
• may be placed for temporary or permanent external drainage of urine.
• tubes that are left in place for a long period of time need to be exchanged periodically for new ones.
POSITION
• prone or
• anterior oblique
true
39
• Angioplasty of stenoses in the ureteral system,
• renal cyst puncture with drainage,
• Percutaneous antegrade ureteral stent placement
• is an alternative to surgical removal of relatively small kidney stones.
percutaneous nephrolithotomy
40
PERCUTANEOUS ANTGRADE URETRAL STENT PLACEMENT
1. A nephrostomy tube is initially placed to provide access to the renal pelvis and to allow a tract to form in the body.
2. At a later time, a guide wire is passed through the nephrostomy tube and down the ureter into the bladder.
3. The nephrostomy tube is removed, and the stent is inserted over the guide wire using a pusher.
4. The nephrostomy tube is replaced to provide external drainage until it is known that the stent is providing internal drainage.
5. The stent can usually be removed through the urethra by a cystoscopic procedure.
true
41
may be performed by injecting the drainage catheter to evaluate anatomy and catheter function.
periodic antegrade nephrograms
42
• is an alternative to surgical removal of relatively small kidney stones.
percutaneous nephrolithotomy
43
• It is a non-surgical and minimally invasive procedure performed in radiology, usually by an interventional radiologist.
transarterial chemoembolization
44
• places chemotherapy and synthetic materials called embolic agents into a blood vessel feeding a cancerous tumor to cut off the tumor's blood supply and trap the chemotherapy within the tumor.
tace
45
may be used as a standalone treatment or combination with surgery, ablation, chemotherapy or radiation therapy
chemoembolization
46
Types of tace
conventional tace,DEB tace
47
Chemotherapy drug
10 mg mitomycin,2.50 mg doxorubicin,100 mg cisplatin
48
Success rate _____ up to ______ years life span
70%,2 years
49
Blood clot
thrombus
50
Thrombus becomes dislodged and migrates
embolus
51
Access of IVC filter
femoral,jugular,antecubital vein
52
Types of IVC filter
permanent,temporary
53
IVC also called
umbrella filter
54
Chemoembolization may be used as a standalone treatment or in combination with:
surgery,ablation,chemotherapy
55
IVC desigbed to be placed in vena cava ranging up to
20 to 30 mm in diameter
56
• Umbrella filter
•initially compact inside an introducer catheter device and assume their functional shape as they are released
•are designed as a conical shape to trap clots in its central lumen
•designed to be placed in vena cava's ranging up to 20 to 30 mm in diameter.
IVC filter
57
The first true filter designed to trap emboli while maintaining vena cava patency was introduced in 1 967
It consisted of six metal struts joined at one end to form a conical shape that was covered by a perforated plastic canopy
mobin uddin filter
58
TRUE OR FALSE
Procedure
• Administration of anesthesia/sedation
• Draping
• Preparation of puncture site
Puncture
•Introducer sheath
• Introduction of guidewire
Inferior vena cavogram
• Deployment of IVC filter
•Post placement image
•Hemostasis
true