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.

64 results found
Article

Breast core biopsy

The percutaneous breast biopsy is one of the current choices for focal histopathological assessment of breast lesions. In contrast to fine needle aspiration, during a core needle biopsy, a hollow needle is used to withdraw small cores of tissue from the area of interest in the breast.  This pro...
Article

Breast ductography

Breast ductography (a.k.a. galactography) is an imaging technique which is used to evaluate lesions causing nipple discharge. It helps in precisely locating the mass within breast tissue and gives useful information for surgical approach and planning. Technique A blunt-tipped sialogram needle ...
Article

Carbon dioxide angiography

Carbon dioxide is an excellent low-density contrast material which has been used for a variety of vascular interventions since the introduction of digital subtraction angiography. Due to high solubility rate and rapid diffusibility via lung CO2 is safe for intravascular usage. Physical and chem...
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Carotid arterial stenting

Carotid arterial stenting (CAS) is a minimally invasive endovascular interventional procedure that can potentially offer the same advantage as surgery (carotid endarterectomy). Indications Indications for carotid stenting are evolving with endarterectomy trials that evaluate the carotid stenos...
Article

Catheter-directed thrombolysis (CDT)

Catheter-directed thrombolysis is an endovascular approach to the treatment of acute iliofemoral deep vein thrombosis. It involves the administration of a lytic agent directly into a thrombus.  Indications precise diagnosis of iliofemoral deep vein thrombosis  first episode of acute iliofemor...
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Caudal epidural injection

Caudal epidural injections, or sacral hiatus epidural injections, are one of several possible spinal epidural injections.  Indications Typically, epidural injections are performed in patients who are currently not surgical candidates. The caudal injection can be performed when patients are on ...
Article

Central venous catheter

Central venous catheters (CVC) or lines (CVL) refer to a wide range of central venous access devices but can broadly be divided into four categories. They may be inserted by medical, surgical, anaesthetic/ITU, or radiology specialists. Classification peripherally inserted central catheters (PI...
Article

Cervical interlaminar epidural injection

Cervical interlaminar epidural injections are one of some possible spinal epidural injections. For an alternative approach for the same region, please refer to the article on cervical transforaminal epidural injections.  Indications Typically epidural injections are performed in patients with ...
Article

CT guided adrenal biopsy

CT guided adrenal biopsy is usually performed for the diagnosis of indeterminate adrenal nodules or tumours. This procedure has declined in recent years due to improvements in, and validation of, non-invasive CT and MR techniques that can now diagnose benign adrenal lesions with a high degree of...
Article

CT guided percutaneous drainage

CT guided percutaneous drainage is one form of image-guided drainage, allowing minimally invasive treatment of collections, potentially anywhere in the body. Although less commonly used than ultrasound guidance, it is particularly valuable in gaining access to deeper or more posterior parts of t...
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CT guided thoracic biopsy

CT guided thoracic biopsy is usually performed for the diagnosis of suspicious lung, pleural or mediastinal lesions. It can be performed as an outpatient where patient monitoring and complications support are available. Indications pulmonary lesion inaccessible to bronchoscopy, or in which pri...
Article

Endoleak

Endoleaks are characterised by persistent blood flow within the aneurysm sac following endovascular aneurysm repair (EVAR). Normally the aortic stent-graft used for EVAR excludes the aneurysm from the circulation by providing a conduit for blood to bypass the sac. Epidemiology An endoleak is a...
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

Endovascular aneurysm repair

Endovascular aneurysm repair (EVAR) was first pioneered in the early 1990s. Since then technology of the devices has rapidly progressed and EVAR is now widely used as treatment of thoracic and abdominal aortic aneurysms (AAA). The advantages of endovascular repair over open repair are that they...
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Endovascular aneurysm sealing system (EVAS)

Endovascular aneurysm sealing system (EVAS) was developed with the intention to expand beyond the anatomic limitations of endovascular aneurysm repair (EVAR) devices, as well as to decrease the rates of re-intervention secondary to graft migration and type II endoleaks. EVAS was designed by End...
Article

Epidural blood patch

Epidural blood patch is a treatment option for patients with craniospinal hypotension or post lumbar puncture headaches. The procedure can be done blind or under fluoroscopic or CT guidance, and is performed predominantly by radiologists and anaesthetists.  Indications craniospinal hypotension...
Article

Femoral artery pseudoaneurysm

Femoral artery pseudoaneurysms are usually iatrogenic as the femoral artery is the vessel of choice for most endovascular arterial interventions. Pathology Aetiology iatrogenic anticoagulation therapy inadequate compression following endovascular intervention improper arterial puncture tec...
Article

Flow-diverter stent

Flow-diverter stents are relatively new and important devices in the management of intracranial aneurysms, especially ones that are large, broad-necked or fusiform.  Complications In a multi-centre study in Italy, Briganti et al reported an overall morbidity rate of 3.7% and a mortality rate o...
Article

Fluoroscopic nasojejunal tube insertion

Fluoroscopic nasojejunal (NJT) or nasogastric tube (NGT) insertion is a valuable procedure offered by radiologists in patient care. The majority of nasogastric tubes are inserted on the ward level and nasojejunal tubes may be placed in theatre at the time of surgery. In difficult cases, inserti...
Article

Fluoroscopy guided lumbar puncture

Fluoroscopy-guided lumbar puncture (LP) is a minimally invasive, image-guided diagnostic and therapeutic procedure that involves the removal of a small volume of cerebrospinal fluid (CSF) from, or an injection of medication or other substance (e.g. radiotracer, chemotherapy agents) into the lumb...
Article

Glenohumeral hydrodilatation

Glenohumeral hydrodilatation (tension arthography) is an established treatment for adhesive capsulitis of the shoulder (frozen shoulder) and can be performed under multiple modalities.  Indications adhesive capsulitis of the shoulder Contraindications anticoagulation/coagulopathy systemic s...
Article

Hepatic chemosaturation

Hepatic chemosaturation is a percutaneous technique used to locally treat unresectable hepatic metastases in patients without systemic disease. Technique The key to this technique is isolating the blood supply to the liver. This is achieved by: closure of the gastro-duodenal artery by coiling...
Article

Image guided percutaneous renal biopsy

Image guided percutaneous renal biopsy, utilising either ultrasound or CT allows for an accurate, reliable method of acquiring renal tissue for histopathological assessment. Biopsy may be of a native or transplant kidney. It is divided into two types: non-focal or non-targeted focal or target...
Article

Infusothorax

Infusothorax is a complication of central venous catheter malposition where the catheter tip is located in the pleural space and the infusion of the fluid collects inadvertantly in the pleural space in the form of a pleural effusion. Longer term complications depend on the fluid being infused.
Article

Interventional procedure article structure

Interventional articles necessarily require a different structure to other articles. It is important for them to have a consistent structure to maintain uniformity across the site. The suggested structure and headings (and heading size) are as follows: ==========================================...
Article

Intra-aortic balloon pump

Intra-aortic balloon pumps (IABP) are used in the intensive care setting to provide haemodynamic assistance to patients in cardiogenic shock. Function and physiology The device is comprised of a catheter introduced via the femoral artery, which extends retrogradely to the proximal descending t...
Article

Irreversible electroporation

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

Jugular venous catheters

The internal jugular vein is a preferred site for venous access for large lumen, long-term central venous catheters for chemotherapy, haemofiltration and plasma exchange.  Typically, the right internal jugular is used as its vertical course straight down into the superior vena cava via the righ...
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.   Percutaneous transhepatic biliary interventions percutaneous transhepatic cholangiography (PTC) percutaneous transhepatic biliary dr...
Article

Lumbar interlaminar epidural injection

Lumbar interlaminar epidural injections are one of some possible spinal epidural injections. For an alternative approach for the same region, please refer to the article on lumbar transforaminal epidural injections.  Indications Typically, epidural injections are performed in patients with rad...
Article

Multiphase CT angiography in acute ischaemic stroke

Multiphase CT angiography is an evolving imaging technique in acute ischaemic stroke. The technique aims to quickly and reliably identify brain which is potentially salvageable with intervention. Brain tissue viability depends on many factors, with this technique assessing collateral leptomening...
Article

Oesophageal stent

Oesophageal stents are a treatment option in patients with oesophageal strictures. It is most commonly used for symptomatic relief in those with dysphagia secondary to malignancy. The stent is typically covered in nature and inserted endoscopically or fluoroscopically. The distal oesophagus is t...
Article

Percutaneous cholecystostomy

Percutaneous cholecystostomy is an image-guided placement of drainage catheter into gallbladder lumen. This minimally invasive procedure can aid stabilisation of a patient to enable a more measured surgical approach with time for therapeutic planning. Indications poor surgical candidate/high r...
Article

Percutaneous endoscopic gastrostomy

Percutaneous endoscopic gastrostomy (PEG) is a procedure where a is a flexible feeding tube (commonly known as a PEG tube) is inserted through the abdominal wall and into the stomach. This may be placed under endoscopic or radiological guidance, in the latter, the procedure may be known as a per...
Article

Percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PCNL) is a surgical procedure for the extraction of large renal calculi. It is usually performed in the operating theatre either by a urologist or combined urologist-radiologist team. Indication PCNL is used to destroy and remove renal calculi, typically over 2 cm...
Article

Percutaneous nephrostomy

Percutaneous nephrostomy is a technique in which percutaneous access to the kidney is achieved under radiological guidance. The access is then often maintained with the use of an indwelling catheter. Indications urinary tract obstruction urinary diversion (e.g. ureteric injury; urine leak) a...
Article

Percutaneous nephrostomy salvage and tube exchange

Percutaenous nephrostomy salvage and tube exchange are two procedures undertaken in those with long term nephrostomies. These patients are often either unsuitable or do not wish to have ureteric stenting to relieve their urinary tract obstruction. Nephrostomy salvage Nephrostomy salvage is und...
Article

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 malignant obstruction, such as cholangiocarcinoma, ampullary and pancreatic malignancies when retrograde access via...
Article

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...
Article

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...
Article

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, allowing this future liver remnant (FLR). This will increase the size of the post hepatectomy future liver remnant (FLR) and improve...
Article

Post thrombotic syndrome

Post thrombotic syndrome (PTS) is a syndrome of chronic venous insufficiency following deep vein thrombosis 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 half o...
Article

Radio-embolisation

Radio-embolisation is the delivery of radioactive microspheres to cancers using an endovascular approach. It is often performed as an outpatient procedure.  Indications primary liver cancer or liver metastases bilirubin of < 2.0 tumour size less that than 70% of the liver size Contraindicat...
Article

Radiofrequency ablation

Radiofrequency ablation 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 Appli...
Article

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...
Article

Sacroiliac joint injection

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

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...
Article

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...
Article

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.  ...
Article

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...
Article

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...
Article

Thoracentesis

Thoracentesis, commonly known as a pleural 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 thoracen...
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

Transcatheter arterial chemoembolisation

Transarterial chemoembolisation therapy (TACE) is a localised method of administrating chemotherapy directly to the liver tumor via a catheter study. Transarterial embolisation (TAE) (i.e. without a chemotherapy agent added) is also used and there is evidence that this may be just as effective ...
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

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 ...
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 ...
Article

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...
Article

Ultrasound guided peripheral intravenous cannulation

Ultrasound (US) guided peripheral intravenous cannulation (IVC) 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 individua...
Article

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,...
Article

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...
Article

Vena cava filter

Vena cava filter is an endovascular device which is typically placed in the infrarenal inferior vena cava (IVC) to prevent pulmonary embolism in selected patients. This procedure is most often performed by interventional radiologists under fluoroscopic guidance. Indications contraindication to...
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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