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Imaging CH.26
Interventional Radiology
| Question | Answer |
|---|---|
| List the Interventional Radiography Suite Equipment | - X-ray tube. - High voltage generator. - Patient couch. - Image receptor. |
| Interventional Suite Patient Couch | -Interventional procedures do not typically use a tilt type table but newer designs are incorporating this into their capabilities. |
| Patient Couch: | -May have a STEPPING capability. -Automatically allows imaging from abdomen to feet with one single injection. -Is designed as a floating tabletop. |
| High Voltage Generator | Generators with three-phase 12 pulse power capable of at least 100 kW with low ripple are preferred are the minimum with High frequency the popular choice. |
| X-ray Tube | -Angiographic tubes create much more heat than diagnostic tubes therefore the anode is much larger. -Even though the anode is much larger, the focal spot and target angle is much smaller than diagnostic tubes. |
| Common risks of arteriography: | -Bleeding at the puncture site. -Reaction to the contrast material. -Kidney failure. -Blood clot formation. -Perforation of the artery. |
| Interventional suite image receptor | There are many types of image receptors ranging from CCD to flat panel image receptors. |
| Individuals responsible for the patient prep and procedure: | -Physician. -Scrub Tech. -Nurse. -Radiologic technologist. |
| Guide Wires | A stainless steel wire that is tapered at the end to a soft flexible tip, which allows for safe introduction of catheters in interventional procedures. |
| Seldinger Technique | Arterial Access -A hollow needle with a stylet is inserted into the femoral artery. The stylet is removed and a guidewire is inserted through the needle. The needle is removed and a catheter is placed over the guidewire to the desired location. |
| List the 5 types of image subtraction | - Temporal subtraction. - Time-interval-difference mode (TID). - Energy subtraction. - Hybrid subtraction. |
| Since that time angioplasty, thrombolysis, embolization, vascular stenting and biopsies are performed under the ____________________________. | Interventional umbrella. |
| What is subtraction? | A radiographic technique that enhances the image by subtracting the unwanted, unchanging background. |
| Subtraction techniques may be used in digital fluoroscopy to obtain... | Special images not available with conventional fluoroscopy. |
| Since the 1930's what procedures are performed under interventional radiography? | Angioplasty, thrombolysis, embolization, vascular stenting and biopsies. |
| Angiography | Opacification of vessels by injection of contrast media. |
| When/how did interventional radiography begin? | 1930's with Angiography. |
| How are flat panel image receptors being specially used? | Its magnetic capabilities are being used in specialized medicine such as cardiac and vascular imaging. |
| How are Flat Panel Image Receptor (FPIR) more accurate? | More accurate with the transfer of image information and certain special applications. |
| The new wave of technology in Digital Fluoro is to do what? | Replace CCD with FPIR. |
| Flat panel image display are quickly replacing the... | TV picture tube or CRT. |
| What is not required in Video system image display? | Interlacing. |
| What does the TV tube do in Video System Image Display? | Sweeps the target assembly continuously from top to bottom. |
| Video System Image Display | Digital fluoro reads the fluoro monitor in the progressive mode instead of the interlaced mode. |
| List the 2 types of image display | - Video display. - Flat panel display. |
| What does the flat panel image receptor do? | Captures x-rays exiting the patient and converts them directly into electronic signal. |
| Where does the flat panel image receptor take place? | Image intensifier tube. |
| What in the scintillator layer made of? | Cesium iodide. |
| What is the photodiode layer made of? | Amorphous silicon. |
| List the 4 components of a flat panel image receptor | - ADC. - Thin film transistor. - Photodiode layer. - Scintillation layer. |
| Amorphous selenium is a photoconductor that... | Detects x-rays directly. |
| What is Amorphous selenium? | A material used in DR technology to detect x-ray energy and transfer it to a charged couple device. |
| What are flat panel image receptors composed of? | Cesium iodide/ Amorphous silicon. |
| What are flat panel image receptors replacing? | Quickly replacing CCD Image Intensifiers in Digital Fluoroscopy. |
| What are CCD taking place of? | Television camera tubes. |
| What are CCD used for? | Used to link phosphor signals of Image Intensifier tube (light) to signals(electrons). |
| What happens when CCD are illuminated? | When illuminated by output phosphor, electrical charge is generated, pixel by pixel to create an image. |
| What are CCD composed of? | Crystalline silicon. |
| What does a charge couple device do in digital fluoroscopy? | Links an image intensifier tube to the Picture tube. |
| First type of digital fluoroscopy devices | Charged couple devices. |
| Digital Fluoroscopy image receptor - charged couple device is used instead of what? | A TV camera tube. |
| List the 2 types of digital fluoroscopy image receptors | - Charged couple devices - Flat panel |
| Extinction time or Pulse interval | The time required for the tube to be switched off. |
| Interrogation time or Pulse Height | The time that the x-ray tube is switched on. |
| List the 2 Pulsed-progressive fluoroscopy modes | - Interrogation time or Pulse Height. - Extinction time or Pulse interval. |
| Because exposure is higher, fluoro is... | Pulsed to reduce patient dose |
| What does higher mA do to patient exposure? | This makes patient exposure higher per image dose. |
| How many mA are used in DF high voltage generator? | Hundreds of mA are used instead of less than 5mA like conventional fluoroscopy. |
| Digital Fluoroscopy operates in what mode? | In the radiographic mode instead of fluoroscopy mode. |
| List 2 advantages of Digital Fluoroscopy | - The speed of image acquisition is faster than conventional fluoroscopy. - Post-processing to enhance the image contrast is available. |
| What is the difference between digital fluoroscopy and image intensified fluoroscopy? | - Digital Fluoro has an addition of a computer and workstation. - Image Intensified Fluoro has an image intensifier. |
| Temporal subtraction | - Mask image is created (mask mode). - Contrast is introduced. - The mask is subtracted from the image desired leaving only the contrast material. |
| What causes misregistration artifacts on Temporal Subtraction? | If the patient moves between the first mask and the last injection image a pixel shift artifact is created. |
| Time-Interval-Difference Mode (TID) | - Creates a new mask for each frame of viewing. - Subtracts the new mask from the new image. - Eliminates misregistration artifacts. |
| Energy subtraction | Uses the principles of characteristic x-ray production to subtract the k-edge of the lower and higher energy ranges leaving only the contrast material. |
| Road Mapping | Using a mask image that is acquired and stored, contrast injected, and subtraction images acquired. |
| Interventional Suite x-ray tube (angiographic tube) creates what? | Much more heat than diagnostic tubes therefore the anode is much larger. |
| Even though the anode is larger on angiographic tubes... | The focal spot and target angle is much smaller than diagnostic tubes. |
| Angiography | X-ray imaging of blood vessels after injection of contrast material. |
| Aortography | X-ray imaging of the aorta and its branches after injection of a contrast medium. |
| Arteriography | X-ray visualization of an artery after injection of contrast material. |
| Cardiac Catheterization | X-ray imaging when a thin, flexible tube is guided into the heart via a vein or an artery. |
| Myelography | X-ray imaging of the spinal cord after the injection of a contrast medium through a lumbar puncture. |
| Venography | X-ray imaging of a vein after injection of a contrast medium to detect incomplete filling of a vein, indicating an obstruction. |
| Stent Placement | Placement of a mesh tube inserted into a natural passage or conduit in the body to prevent or counteract a disease-induced, localized flow constriction. |
| Embolization | Technique used to block blood flow to a site by passing a catheter to the area and injecting a synthetic material or medication specially designed to occlude the blood vessel. |
| Intravascular Stent | Implantation of device used to reinforce the wall of a vessel and ensure its openness. |
| Thrombolysis | Destruction of a blood clot. |
| Balloon Angioplasty | A procedure in which a balloon attached to the end of a catheter is used to clear blockages in blood vessels. |
| Atherectomy | Surgical removal of plaque buildup from the interior lining of an artery. |
| Electrophysiology | The study of the electrical activity of cells. |
Created by:
sassyrad
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