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.

146 results found
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Percutaneous renal biopsy

Percutaneous renal biopsy, utilising either ultrasound or CT, allows for an accurate, reliable method of acquiring renal tissue for histopathological assessment. The biopsy may be of a native or transplant kidney. It is divided into two types: non-focal or non-targeted focal or targeted (i.e....
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Percutaneous transhepatic biliary drainage

Percutaneous transhepatic biliary drainage is an interventional radiology procedure undertaken for those with biliary obstruction. It is almost exclusively performed in those with a malignant obstruction, such as cholangiocarcinoma, ampullary and pancreatic malignancies when retrograde access v...
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Percutaneous transhepatic cholangiography

Percutaneous transhepatic cholangiography (PTC) is a radiographic technique employed in visualisation 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 diagnostic p...
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Peripherally inserted central catheters

Peripherally inserted central catheters (PICC), often incorrectly termed PICC lines, are a type of central venous catheter predominantly used amongst oncology patients and those with chronic diseases (e.g. cystic fibrosis). They offer the ability to have long-term central venous access without ...
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Periprocedural anticoagulation

When planning an interventional procedure a patient’s coagulation status must be assessed and optimised to best balance the risk of bleeding and thrombosis. The following must be considered; bleeding risks associated with the procedure medications the patient is taking that alter coagulation o...
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Pinch off syndrome

Pinch-off syndrome is a spontaneous catheter fracture, which is seen as a complication of subclavian venous catheterisation. Epidemiology It is a known complication of central venous catheterisation with a much-reduced incidence in current practice and is generally considered to be rare. Radi...
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Portal vein embolisation

Portal vein embolisation (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 (FLR) and increa...
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Post ablation syndrome

Post-ablation syndrome occurs from 24 to 48 hours following ablation, and lasts no longer than 10 days1. It is believed to occur following cytokine release and tumor necrosis, causing patient fever and flu-like symptoms. If symptoms persist following 10 days after the procedure, alternate diagn...
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Post-embolisation syndrome

Post-embolisation syndrome (PES) is one of the commonest side effects of transarterial embolisation and chemoembolisation. It comprises of a constellation of fever, nausea/vomiting, and pain. It usually occurs within the first 72 hours after embolisation (liver lesion or uterine fibroids) and th...
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Post thrombotic syndrome

Post thrombotic syndrome (PTS) is a syndrome of chronic venous insufficiency following deep vein thrombosis (DVT) due to valvular incompetence, which results in chronic reflux and chronic venous hypertension. Epidemiology PTS is a common complication following extensive DVT of the limbs. Up to...
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Prostate biopsy

Transrectal ultrasound–guided biopsy is considered the standard approach for prostate biopsy and is most commonly performed on an outpatient with a positive screening for prostate cancer.  Nowadays, with the MRI capacity for depicting abnormal areas of the prostate, is possible to obtain target...
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Radioembolisation

Radioembolisation is the delivery of radioactive microspheres to cancers using an endovascular approach. It is often performed as an outpatient procedure.  Indications hepatocellular carcinoma hepatic metastases from colorectal carcinoma Contraindications Absolute contraindications excessi...
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Radiofrequency ablation

Radiofrequency ablation (RFA) is a medical procedure that uses a high-frequency alternating current produced by a radiofrequency generator oscillating in a closed loop circuit. This current heats a needle to over 60°C, which is used to cause intentional protein denaturation and tissue damage 1. ...
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Rapid ultrasound in shock

The rapid ultrasound in shock (RUSH) protocol is a structured point-of-care ultrasound (POCUS) examination performed at the time of presentation of a shocked patient. It is a more detailed and longer exam than the FAST scan, with the aim to differentiate between hypovolemic, cardiogenic, obstruc...
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Renal sympathetic denervation

Renal sympathetic denervation (RSDN), also known as renal denervation, is an interventional procedure that uses radiofrequency ablation to destroy the nerve endings in the wall of the renal arteries. Endovascular (trans-catheter) techniques are an alternative to surgical sympathectomy.  Indicat...
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Resuscitative endovascular balloon occlusion of the aorta

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a recently developed treatment for haemorrhagic shock used in major trauma patients with life-threatening abdominal or lower limb bleeding.  The aortic balloon is delivered on a catheter via the femoral artery in order to redu...
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Retroaortic left renal vein

Retroaortic left renal vein (RLRV) is a normal anatomical variant where the left renal vein is located between the aorta and the vertebra, and drains into the inferior vena cava. Its recognition is important in order to avoid complications during retroperitoneal surgery or interventional proced...
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Rotational vertebral artery occlusion syndrome

Rotational vertebral artery occlusion syndrome, also known as bow hunter's syndrome, is a rare form of vertebrobasilar insufficiency secondary to dynamic compression of the usually-dominant vertebral artery.  Pathology It has many predisposing aetiologies, but is most often due to large osteop...
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Sacroiliac joint injection

Sacroiliac joint injections can be performed using a posterior approach into the the sacroiliac joint under fluoroscopic or CT guidance.
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Segmental arterial mediolysis

Segmental arterial mediolysis (SAM) is an increasingly recognised vascular disease of the middle-aged and elderly and a leading cause of spontanoeus intra-abdominal haemorrhage. It is characterised by fusiform aneurysms, stenoses, dissections and occlusions within splanchnic arterial branches. I...
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Seldinger technique

The Seldinger technique is the mainstay of vascular and other luminal access in interventional radiology.  History The Seldinger technique was first described in 1953 by Sven-Ivar Seldinger (1921-1998), a pioneering Swedish interventional radiologist. Prior to this procedure, sharp large-bore ...
Article

Selective internal radiation therapy

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

Seromas are collections of serous fluid that usually occur as a complication of surgery, but can also be seen post-trauma. They are commonly seen as an early complication of breast surgery, where a potential space is left. Terminology Seromas are distinct from haematoma as they contain almost ...
Article

Spinal arteriovenous malformations

Spinal arteriovenous malformations (AVMs) are characterised by arteriovenous shunting with a true nidus. They represent ~25% of spinal vascular malformations.  Epidemiology Different types of spinal AVM (see below) have differing age of presentation, but overall 80% present between the age 20 ...
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Spinal epidural injection

Epidural spinal injections are one of the more frequently performed spinal interventional procedures.Three approaches to the epidural space exist: transforaminal epidural injection interlaminar epidural injection cervical interlaminar epidural injection lumbar interlaminar epidural injection...
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Spinal interventional procedures

Back pain is a common condition that is often difficult to treat. Lumbar degenerative facet joints, lumbar disc disease and sacroiliac joint pain account for nearly 70% of cases of lower back pain. Unfortunately, as the incidence of degenerative changes in the spine is so high (e.g. disc abnorm...
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Splenic embolisation

Splenic (artery) embolisation is an endovascular technique for treatment of splenic and splenic artery pathology as an alternative to splenic artery ligation or splenectomy. It often results in successfully treating the underlying pathology, while maintaining at least partial splenic function.  ...
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Splenic trauma

Splenic trauma can occur after blunt or penetrating trauma or secondary to medical intervention (i.e. iatrogenic). The spleen is the most frequently injured internal organ after blunt trauma. Epidemiology In blunt trauma, the spleen can account for up to 49% of abdominal organ injuries 2. Cli...
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Stellate ganglion block

A stellate ganglion block can be used to treat a number of conditions by reducing stimulation of the stellate ganglion, which is part of the sympathetic network. The infiltration of local anaesthetic/neurolytic around the 1 cm ganglion has been used to treat a variety of disorders. Indications ...
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Stereotactic breast biopsy

Breast biopsy is performed whenever it becomes necessary to characterise a breast lesion. This consists of the withdrawal and collection of cells (cytologic exam) or tissue fragments (histologic exam) and in the anatomical-pathological analysis of the sample tissue.  There are many different wa...
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Stereotactic mammotome

Stereotactic mammotome is method of biopsing breast lesions, particularly if they are occult on ultrasound. A vacuum-assisted core biopsy (VACB)-stereotactic breast biopsy is performed as a diagnostic approach when mammography shows irregularities with micro-calcifications, parenchymal distorti...
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Subacromial bursal injection

Subacromial corticosteroid injection is reserved for patients with no response to initial treatment with impingement syndrome, subacromial bursitis and/or rotator cuff disorders. Nonsteroidal anti-inflammatory drugs (NSAIDs) and activity modification are the initial treatments to reduce the pain...
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Supreme intercostal arteries

The supreme intercostal arteries, or superior intercostal arteries, are formed as a direct result of the embryological development of the intersegmental arteries. These arteries are paired structures of the upper thorax which normally form to provide blood flow to the first and second intercosta...
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Thoracentesis

Thoracentesis, commonly known as a pleural tap or chest tap, is a procedure where excess pleural fluid is drained from the pleural space for diagnostic and/or therapeutic reasons. Ultrasound-guided thoracentesis performed by radiologists has been shown to have fewer complications than blind thor...
Article

TIPS evaluation

TIPS evaluation is useful to ensure that the shunt 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 colour Doppler flow throughout its length. The in-stent ve...
Article

Tracheobronchial stent

A tracheo-bronchial stent is a device used in the treatment of symptomatic airway compression. This device is inserted under bronchoscopic guidance in patients with external compression from mediastinal based malignancy, for example lung or oesophageal cancers.  It may also be used in the treat...
Article

Transcatheter arterial chemoembolisation

Transarterial chemoembolisation therapy (TACE) is a localised method of administrating chemotherapy directly to a liver tumour 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-TAC...
Article

Transforaminal nerve root injection

Transforaminal nerve root injfection is performed for radicular pain treatment and diagnosis. See spinal interventional procedures for complications and equipment. cervical spine thoracic spine lumbar spine The desired needle tip position is just lateral to the pedicle immediately below the...
Article

Transjugular renal biopsy

Transjugular renal biopsy can be performed to obtain an adequate tissue sample for histopathologic diagnosis on renal dysfunctions. It is usually performed in high-risk patients in whom percutaneous renal biopsy is not feasible or is contraindicated. This is also useful in morbidly obese patient...
Article

Tumour embolisation

Tumour embolisation is a procedure to shut down the blood supply to cancer cells in order to reduce their numbers or cause complete cell death. It can be subdivided into three groups of procedures: bland embolisation chemoembolisation embolisation with radioactive particles hepatic radioembo...
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

Ultrasound guided breast biopsy

Ultrasound guided percutaneous breast biopsy is a widely used technique for an accurate histopathological assessment of suspected breast pathology. It is a fast, safe and economical procedure. Indications Ultrasound guidance is limited to lesions visible on ultrasound study, such as:  BIRADS ...
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Ultrasound-guided FNA of the thyroid

Ultrasound-guided fine needle aspiration (FNA) of the thyroid refers to a minimally invasive procedure where in which tissue samples are collected from a thyroid nodule or other suspicious thyroid lesion. It is usually done on a outpatient basis and generally complications are very minimal. Pro...
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Ultrasound guided percutaneous drainage

Ultrasound guided percutaneous drainage is one form of image guided procedure, allowing minimally invasive treatment of collections that are accessible by ultrasound study. It has several advantages and disadvantages over CT, which include: Advantages is a dynamic study, allowing greater prec...
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Ultrasound guided peripheral intravenous cannulation

Peripheral intravenous cannulation under ultrasound guidance is the placement of a cannula into a peripherally located vein under the direct vision of ultrasound. This process allows the cannulation of veins that are unable to be visualised or palpated without ultrasound. In trained individuals ...
Article

Ultrasound-guided spinal anaesthesia

With the growing incidence of obesity in the western world, ultrasound-guided anaesthesia is becoming more common. Spinal anaesthesia is traditionally administered by identifying relevant surface anatomy and imaging is rarely used for pre-procedural identification of structures.  Indications l...
Article

Upper gastrointestinal bleeding

Upper gastrointestinal bleeding (UGIB) is defined as bleeding proximal to the ligament of Treitz. Epidemiology The incidence of acute upper GI bleeding is ~100 per 100,000 adults per year. Upper GI bleeding is twice as common in men as in women and increases in prevalence with age 5. The demog...
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Ureteric stent

Ureteric stents, also known as double J stents or retrograde ureteric stents, is a urological catheter that has two "J-shaped" (curled) ends, where one is anchored in the renal pelvis and the other inside the bladder. Stents are used for the free passage of urine from the kidney to the bladder,...
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Uterine artery embolisation

Uterine artery embolisation (UAE) is an interventional radiological technique to occlude the arterial supply to the uterus and is performed for various reasons. History Uterine artery embolisation has been practised for more than 20 years for controlling haemorrhage following delivery / aborti...
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Uterine artery embolisation: MRI assessment

Uterine artery embolisation (UAE) is used as an alternative to hysterectomy in selected patients and MRI assessment is key in allowing not only pre-procedure assessment but also assessing post-procedural outcome.   For a general discussion of the underlying condition refer to the article on ute...
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Varicocele

Varicocele is the dilatation of the pampiniform plexus of veins, a network of many small veins found in the male spermatic cord. It is the most frequently encountered mass of the spermatic cord. Epidemiology The estimated incidence is at ~15% of the general male population and ~40% of subferti...
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Varicocele embolisation

Varicocele embolisation is a minimally invasive method of treating varicoceles by embolising the testicular vein (internal spermatic veins). Indications symptomatic varicocele infertility/subfertility failed surgical ligation Contraindications Relative contraindications include: intraveno...
Article

Vertebroplasty

Vertebroplasty is an imaging-guided procedure which entails percutaneous injection of surgical polymethylmethacrylate (PMMA) cement into a diseased vertebral body. Vertebroplasty provides pain relief and strengthening of the bone of vertebrae weakened by disease. Indications It can be used as ...

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