Interventional radiology

From Academic Kids

Interventional Radiology (IR) is a subspecialty of Medical imaging (Radiology) in which minimally invasive procedures are performed using image guidance. Some of these procedures are done for purely diagnostic purposes (e.g., angiograms), while others are done for treatment purposes (e.g., angioplasties). Pictures (images) are used to direct these procedures, which are usually done with needles or other tiny instruments like small tubes called catheters. The images provide road maps that allow the Interventional Radiologist to guide these instruments through the body to the areas of interest.

Contents

History

The advancements in the field of radiological imaging, together with innovations in instrumentation, led to a rapid development in interventional procedures in the 1970s. Cardiovascular precedures were found out to be particularly well-suited for guided and minimally invasive operations, and catheterization remains as one of the main applications for interventional radiology.

Imaging methods

Common interventional imaging methods include X-ray fluoroscopy, computed tomography (CT), ultrasound (US), and magnetic resonance imaging (MRI). Fluoroscopy and computed tomography use ionizing radiation that may be potentially harmful to the patient and, in the case of fluoroscopy, the interventional radiologist. However, both methods have the advantages of being fast and geometrically accurate. Ultrasound suffers from image quality and tissue contrast problems, but is also fast and inexpensive. Magnetic resonance imaging provides superior tissue contrast, at the cost of being expensive and requiring specialized instruments that will not interact with the magnetic fields present in the imaging volume.

Procedures

Common IR procedures are:

  • Angiography: imaging the blood vessels to look for abnormalities
  • Balloon angioplasty: opening of narrow or blocked blood vessels using a balloon
  • Chemoembolization: delivering cancer treatment directly to a tumour through its blood supply
  • Drain insertions: placement of tubes into different parts of the body to drain fluids (e.g., abscess drains to remove pus)
  • Embolization: blocking abnormal blood vessels (e.g., for the purpose of stopping bleeding)
  • Thrombolysis: treatment aimed at dissolving blood clots (e.g., pulmonary emboli, leg vein thrombi, thrombosed hemodialysis accesses)
  • biopsy: taking of a tissue sample from the area of interest for pathological examination
  • Radiofrequency ablation (RF/RFA): localized destruction of tissue (e.g., tumours) by heating
  • Venous access: insertion and management of specialized kinds of intravenous devices (IVs) (e.g. PICC lines, Hickman lines, dialysis lines, subcutaneous ports)

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