Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

22 results found
Article

Chemical ablation

Introduction Chemical ablation is a technique in which chemical ablative substances are used to cause cell death in neoplastic tissue. It is used as a standalone procedure or in combination with other techniques like TACE and radiofrequency ablation. Agents Absolute ethanol (most commonly use...
Article

EUS-guided biliary drainage

Endoscopic ultrasound (EUS)-guided biliary drainage is an alternative to conventional transpapillary and percutaneous biliary drainage in where an extra-anatomic route is created between the biliary tree and the gastrointestinal tract.  Indications failed endoscopic transpapillary biliary drai...
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Percutaneous liver tumor ablation

Percutaneous liver tumor ablation techniques are well-established and effective therapeutic alternatives for the treatment of primary and secondary liver tumors. Hepatocellular carcinoma (HCC) and colorectal oligometastatic disease are the most common indications. There are specific indications ...
Article

Esophageal varix

Esophageal varices describe dilated submucosal veins of the esophagus, and are an important portosystemic collateral pathway. They are considered distinct from gastric varices, which are less common. Epidemiology Esophageal varices are present in ~50% of patients with portal hypertension 1,2. ...
Article

Denver shunt

A Denver shunt, or peritoneovenous shunt, is a device used to shunt ascites to the superior vena cava in patients with refractory ascites. The proximal end is located in the peritoneal cavity and the distal end in the superior vena cava, with a subcutaneous course in the anterior chest wall. It...
Article

Liver biopsy (percutaneous)

Percutaneous liver biopsy, utilizing either ultrasound or CT guidance, allows for an accurate and reliable method of acquiring hepatic tissue for histopathological assessment. It is divided into two types: non-focal or non-targeted liver biopsy (used in the assessment and staging of the parench...
Article

Hepatic venous pressure gradient

Hepatic venous pressure gradient measurement is a safe and minimally invasive method to indirectly measure portal vein pressure in chronic liver disease patients suspected of developing portal vein hypertension.  Indications diagnosis of liver fibrosis and risk stratification identification o...
Article

Irreversible electroporation

Irreversible electroporation (IRE), also known as non-thermal irreversible electroporation (NTIRE), is a non-invasive soft-tissue ablation technique used for tumor ablation in regions that require very high precision and preservation of surrounding collagenous structures (vessels and ducts) and ...
Article

Percutaneous transhepatic biliary drainage

Percutaneous transhepatic biliary drainage, also known as percutaneous transhepatic cholangial drainage (PTCD), is an interventional radiology procedure undertaken for those with biliary obstruction.  It is almost exclusively performed in those with a malignant obstruction, such as cholangiocar...
Article

TIPS evaluation

TIPS evaluation is useful to ensure that a transjugular intrahepatic portosystemic shunt (TIPS) is working properly and that no stenosis has occurred within the stent. Ultrasound is often used as a first-line modality. Radiographic features Ultrasound The normal TIPS should show color Doppler...
Article

Transcatheter arterial chemoembolisation

Transarterial chemoembolisation therapy (TACE) is a localized method of administrating chemotherapy directly to a liver tumor via a catheter study. The chemoembolic agent may be delivered via a mixture with LipiodolⓇ, known as conventional TACE, or as an injection of drug-eluting beads (DEB-TACE...
Article

Endoscopic retrograde cholangiopancreatography

Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic and interventional procedure technique using both endoscopy and fluoroscopy for examination and intervention of the biliary tree and pancreatic ducts. It is typically performed by doctors with endoscopic qualifications (e.g. g...
Article

Portal vein embolization

Portal vein embolization (PVE) is a technique used to selectively occlude the blood supply to one of the liver lobes, diverting portal blood flow to the other lobe, the future liver remnant (FLR). This diversion will increase the size of the post-hepatectomy future liver remnant, which improves...
Article

Magnetic resonance cholangiopancreatography (MRCP)

Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging technique to visualize the intra and extrahepatic biliary tree and pancreatic ductal system. It can provide diagnostically-equivalent images to ERCP and and is a useful technique in high risk patients to avoid signific...
Article

T tube cholangiogram

T-tube cholangiograms are a fluoroscopic study performed in the setting of hepatobiliary disease.  This technique has been largely superseded by MRCP and ERCP. Typically a T-shaped tube is left in the common bile duct at the time of surgery (e.g. cholecystectomy) and allows for exploration of t...
Article

Radioembolization

Radioembolization is the delivery of radioactive microspheres to cancers using an endovascular approach. It is often performed as an outpatient procedure.  Indications hepatocellular carcinoma 2 hepatic metastases from colorectal carcinoma Contraindications Absolute contraindications exces...
Article

Liver and biliary interventional procedures

There is a wide range of liver and biliary interventional procedures, both diagnostic and therapeutic, most commonly using CT-guidance or ultrasound-guidance.   Vascular Interventions: transjugular intrahepatic portosystemic shunt (TIPS) transjugular liver biopsy (TJLB) Percutaneous interven...
Article

Ultrasound-guided biopsy

Ultrasound-guided biopsy is one form of image-guided biopsy, typically performed by a radiologist. It is the most common form of image-guided biopsy, offering convenience and real-time dynamic observation with echogenic markers on cannulae allowing for precise placement. It can potentially be u...
Article

Selective internal radiation therapy

Selective internal radiation therapy (SIRT), also known as hepatic radioembolization, is a relatively new and developing modality for treating non-resectable liver tumors. The procedure consists of a transcatheter injection of radioactive particles via the hepatic artery.  It is generally consi...
Article

Percutaneous cholecystostomy

Percutaneous cholecystostomy is an image-guided placement of drainage catheter into gallbladder lumen. This minimally invasive procedure can aid the stabilization of a patient to enable a more measured surgical approach with time for therapeutic planning. A 2018 study 11 demonstrate no differen...
Article

Percutaneous transhepatic cholangiography

Percutaneous transhepatic cholangiography (PTC) is a radiographic technique employed in the visualization of the biliary tree and can be used as the first step in a number of percutaneous biliary interventions (e.g. percutaneous transhepatic biliary stent placement) Indications Purely diagnost...
Article

Transjugular intrahepatic portosystemic shunt

Transjugular intrahepatic portosystemic shunt (TIPS or TIPSS) is a treatment for portal hypertension in which direct communication is formed between a hepatic vein and a branch of the portal vein, thus allowing some proportion of portal flow to bypass the liver. The target portosystemic gradient...

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