Special Radiological Procedures Quiz

Hysterosalpingography (HSG) is a procedure that uses contrast medium to visualize the uterus and fallopian tubes. This can cause an allergic reaction if the contrast medium enters the bloodstream (intravasation).

T2-weighted images are excellent for visualizing fluid, making them useful for imaging the reproductive system. Dynamic contrast-enhanced MR images provide information about blood flow. Diffusion-weighted images and ADC mapping assess tissue water content.

Retrograde pyeloureterography involves injecting contrast into the ureters to visualize them. It can show the site and nature of an obstruction, but is not used to demonstrate it. It is a diagnostic procedure, not a treatment option.

Percutaneous nephrolithotomy is a minimally invasive procedure used to remove kidney stones. The equipment used includes an ultrasound machine, a puncturing needle, track dilating equipment for creating a passage, guidewires to navigate the passage, and a pump injector for delivering substances.

CT is valuable for staging gynecological malignancies (cancers) because it provides detailed anatomical information, allowing doctors to assess the spread of the tumor. It's also used for acute pelvic emergencies due to its speed and ability to visualize details.

Retrograde pyeloureterography is contraindicated in cases of acute urinary tract infection (UTI) because it risks introducing further infection. Chronic kidney disease, urinary stones, and prostate enlargement don't necessarily prevent the procedure.

During percutaneous antegrade pyelography, the contrast medium, injected through the kidney, travels down the ureters to the bladder. The patient's position helps this flow, and the semi-erect position is ideal because it encourages gravity to assist with the flow of the contrast medium downward.

Percutaneous antegrade pyelography involves injecting contrast into the kidney to visualize the collecting system. It can be used to introduce a drainage catheter into the kidney to treat a blockage.

CT staging in gynecological malignancy typically utilizes both oral and intravenous contrast to enhance visualization of the organs and surrounding tissues. This helps assess tumor size, location, and spread.

Post-nephrostomy studies, IVU studies, HSG studies, and retrograde pyeloureterography studies are typically performed after a delay to allow the patient to recover and reduce the risk of complications.

Retrograde pyeloureterography uses fluoroscopy to visualize the urinary tract. Fluoroscopy allows real-time imaging with X-rays.

The patient preparation for percutaneous antegrade pyelography and nephrostomy involves ensuring the stomach is empty to prevent potential complications from contrast medium or during the procedure. The patient might take antibiotics to prevent infection.

The Valsalva maneuver, which involves holding your breath and straining, can increase pressure in the scrotum, making varicoceles (enlarged veins) more prominent and easier to visualize during scrotal ultrasound.

Percutaneous nephrostomy is a procedure that involves placing a tube into the kidney to help drain urine or treat a blockage. It is generally safe, but is contraindicated in cases of uncontrolled bleeding diathesis (bleeding disorder) because the procedure carries a risk of bleeding.

Percutaneous renal cyst puncture involves inserting a needle into a cyst in the kidney and aspirating (removing) the contents to assess the nature of the cyst.

Ultrasound and CT are the two main imaging modalities used for guiding the needle insertion during percutaneous renal cyst puncture. Ultrasound provides real-time visualization, while CT offers precise anatomical detail.

MRI is highly effective for visualizing soft tissues and is particularly valuable for assessing endometriosis, a condition where uterine tissue grows outside the uterus.

MRI is the gold standard for local staging of endometrial and cervical cancers because it provides detailed anatomical information, including the location, size, and spread of the tumor, facilitating accurate staging.

The patient is typically positioned in the prone position (lying face down) for percutaneous renal cyst puncture. This position allows for easier access to the kidneys and reduces the risk of complications.

Axial T1-weighted spin-echo sequences are good for identifying tissues with high fat content, while axial T2-weighted spin-echo sequences are better for visualizing tissues with high water content. Sagittal sequences provide different perspectives for viewing the ovaries.

Scrotal ultrasound is the primary imaging modality for the scrotum and testes. MRI, radionuclide imaging, and venography along with angiography are used in specific cases.

During renal arteriography, a catheter is placed proximal to the renal vessels. During the flush aortography, the catheter is placed at approximately the T12 level to allow contrast medium to flush the aorta and visualize the renal vessels.

T2-weighted spin-echo scans offer excellent contrast between tissues with different water content. This makes T2 scans useful for identifying hemorrhage (bleeding), which shows up as high signal (bright) on T2 sequences.

Perfusion imaging of the uterus is primarily used to assess the effectiveness of uterine fibroid therapy. This technique measures blood flow in the uterus, helping doctors monitor the response to treatment.

Microbubble agents are injected into the uterus and fallopian tubes during sono-hysterosalpingography, a specialized ultrasound technique. These microbubbles enhance visualization and allow for assessment of uterine and fallopian tube function.

Scrotal ultrasound typically uses 7.5-15-MHz linear transducers for optimal imaging of the testes and surrounding structures.

Percutaneous nephrolithotomy is typically performed to treat large kidney stones. It is a minimally invasive procedure that removes the stones through a small incision in the back.

Ultrasound of the female reproductive system can assess various aspects including uterine size, the presence of fibroids (noncancerous tumors), endometrial thickness (the lining of the uterus), and the volume of the ovaries.

Diagnostic renal arteriography has largely been replaced by CT urography, MRI urography (MRA) or contrast-enhanced ultrasound, which offer similar information but with less invasive techniques.

Overfilling during retrograde pyeloureterography can lead to complications like pyelosinus extravasation (contrast leaking outside the renal pelvis) and pyelotubular reflux (contrast flowing back into the kidney tubules). These can cause pain, fever, and chills.

Percutaneous antegrade pyelography and nephrostomy may be performed before certain procedures like renal surgery, kidney transplant, or percutaneous nephrolithotomy (removal of kidney stones) to make these procedures safer and more effective.

A delayed complication that can occur after percutaneous nephrolithotomy is a ureteral stricture, which is a narrowing of the ureter. This can occur due to scarring from the procedure and can lead to problems with urine flow.

Diffusion-weighted imaging (DWI) is primarily used to assess the extent and staging of gynecological malignancy (cancer). This technique looks at the movement of water molecules in tissues, which can help to identify areas of cancer.

Hysterosalpingography (HSG) utilizes various equipment including a fluoroscopy unit with a spot film device for real-time imaging, vulsellum forceps to hold the cervix open, a balloon catheter to expand the uterine cavity, and a Margolin cannula to insert the contrast medium.

During postoperative (T-tube) cholangiography, 2 mL of contrast medium is typically injected to visualize the biliary tree (the network of ducts that carry bile from the liver to the gallbladder and intestines).