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Radiology is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography, but today it includes all imaging modalities, including those that use no electromagnetic radiation, as well as others that do, such as computed tomography (CT), fluoroscopy, and nuclear medicine including positron emission tomography (PET). Interventional radiology is the performance of usually minimally invasive medical procedures with the guidance of imaging technologies such as those mentioned above.
Interventional radiology (IR) is a medical specialty that performs various minimally-invasive procedures using medical imaging guidance, such as x-ray fluoroscopy, computed tomography, magnetic resonance imaging, or ultrasound. IR performs both diagnostic and therapeutic procedures through very small incisions or body orifices. Diagnostic IR procedures are those intended to help make a diagnosis or guide further medical treatment, and include image-guided biopsy of a tumor or injection of an imaging contrast agent into a hollow structure, such as a blood vessel or a duct. By contrast, therapeutic IR procedures provide direct treatment—they include catheter-based medicine delivery, medical device placement, and angioplasty of narrowed structures.
Budd–Chiari syndrome is a very rare condition, affecting one in a million adults. The condition is caused by occlusion of the hepatic veins that drain the liver. The symptoms are non-specific and vary widely, but it may present with the classical triad of abdominal pain, ascites, and liver enlargement. It is usually seen in younger adults, with the median age at diagnosis between the ages of 35 and 40, and it has a similar incidence in males and females. The syndrome can be fulminant, acute, chronic, or asymptomatic. Subacute presentation is the most common form.
Portal hypertension is abnormally increased portal venous pressure – blood pressure in the portal vein and its branches, that drain from most of the intestine to the liver. Portal hypertension is defined as a hepatic venous pressure gradient greater than 5 mmHg. Cirrhosis is the most common cause of portal hypertension; other, less frequent causes are therefore grouped as non-cirrhotic portal hypertension. When it becomes severe enough to cause symptoms or complications, treatment may be given to decrease portal hypertension itself or to manage its complications.
Gastric varices are dilated submucosal veins in the lining of the stomach, which can be a life-threatening cause of bleeding in the upper gastrointestinal tract. They are most commonly found in patients with portal hypertension, or elevated pressure in the portal vein system, which may be a complication of cirrhosis. Gastric varices may also be found in patients with thrombosis of the splenic vein, into which the short gastric veins that drain the fundus of the stomach flow. The latter may be a complication of acute pancreatitis, pancreatic cancer, or other abdominal tumours, as well as hepatitis C. Gastric varices and associated bleeding are a potential complication of schistosomiasis resulting from portal hypertension.
Intestinal varices are dilated submucosal veins in the intestine.One treatment includes a transjugular intrahepatic portosystemic shunt.
Transjugular intrahepatic portosystemic shunt is an artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein. It is used to treat portal hypertension which frequently leads to intestinal bleeding, life-threatening esophageal bleeding and the buildup of fluid within the abdomen (ascites).
A portosystemic shunt or portasystemic shunt, also known as a liver shunt, is a bypass of the liver by the body's circulatory system. It can be either a congenital or acquired condition and occurs in humans as well as in other species of animals. Congenital PSS are extremely rare in humans but are relatively common in dogs. Improvements in imaging and awareness have contributed to an increase in cases.Thus a large part of medical and scientific literature on the subject is grounded in veterinary medicine.
In medicine, a distal splenorenal shunt procedure (DSRS), also splenorenal shunt procedure and Warren shunt, is a surgical procedure in which the distal splenic vein is attached to the left renal vein. It is used to treat portal hypertension and its main complication. It was developed by W. Dean Warren.
Portal hypertensive gastropathy refers to changes in the mucosa of the stomach in patients with portal hypertension; by far the most common cause of this is cirrhosis of the liver. These changes in the mucosa include friability of the mucosa and the presence of ectatic blood vessels at the surface. Patients with portal hypertensive gastropathy may experience bleeding from the stomach, which may uncommonly manifest itself in vomiting blood or melena; however, portal hypertension may cause several other more common sources of upper gastrointestinal bleeding, such as esophageal varices and gastric varices. On endoscopic evaluation of the stomach, this condition shows a characteristic mosaic or "snake-skin" appearance to the mucosa of the stomach.
Anorectal varices are the dilation of collateral submucosal vessels due to backflow in the veins of the rectum. Typically this occurs due to portal hypertension which shunts venous blood from the portal system through the portosystemic anastomosis present at this site into the systemic venous system. This can also occur in the esophagus, causing esophageal varices, and at the level of the umbilicus, causing caput medusae. Between 44% and 78% of patients with portal hypertension get anorectal varices.
Anne Christine Roberts is an American interventional radiologist who is credited with the invention of the Roberts Uterine Catheter (RUC), a catheter designed to facilitate navigation through the uterine arteries and currently used widely for uterine artery embolization procedures. She also served as president of the Society of Interventional Radiology (SIR) (1996-1997) and was the second woman to become president of the society.
Katharine Legg Krol, M.D., FSIR, FACR, is an American interventional radiologist. She was part of the original Palmaz and Wallstent trials for the treatment of peripheral arterial disease (PAD). She served as the president of the Society of Interventional Radiology (SIR) (2006-2007) - becoming the fourth woman to have held this position.
Helen C. Redman was an American interventional radiologist, noted for being a founding member of the American Association for Women Radiologists (AAWR) in 1981 and the first female president of the Radiological Society of North America (RSNA) from 1994-1995.
Renate L. Soulen, MD, FSIR is an American physician. She is credited as one of three women co-founders of the Society for CardioVascular and Interventional Radiology, a founding member of the Philadelphia Angio Club, and the first female president of the Philadelphia Roentgen Ray Society.
Ann S. Fulcher is an American abdominal radiologist in the radiology department at Virginia Commonwealth University/Medical College of Medicine (VCU). She serves as a professor and the chair of the department of radiology at VCU.
Anna-Maria Belli, MD, FCIRSE is a British interventional radiologist known for her work in vascular interventional radiology and for holding leadership positions in interventional radiology societies in Britain and Europe.
Ali A Haydar is Lebanese physician who is an emeritus professor at the American University of Beirut and is the Chief Medical Officer at Aman Hospital, Doha, Qatar and previously the Chairman of radiology at the Clemenceau Medical Center affiliated with Johns Hopkins International since 2018. He is also a member of the Radiological Society of North America, British society of Interventional and Cardiovascular Radiology and the Cardiovascular and Interventional Radiological Society of Europe and fellow of the Pan Arab Interventional radiology society.
Congenital portosystemic shunts (PSS) is a hereditary condition in dogs and cats, its frequency varying depending on the breed. The shunts found mainly in small dog breeds such as Shih Tzus, Tibetan Spaniels, Miniature Schnauzers and Yorkshire Terriers, and in cats such as Persians, British Shorthairs, Himalayans, and mixed breeds are usually extrahepatic, while the shunts found in large dog breeds such as Irish Wolfhounds and Labrador Retrievers tend to be intrahepatic.
Balloon-occluded retrograde transvenous obliteration (BRTO) is an endovascular procedure used for the treatment of gastric varices. When performing the procedure, an interventional radiologist accesses blood vessels using a catheter, inflates a balloon and injects a substance into the variceal blood vessels that causes blockage of those vessels. To prevent the flow of the agent out of the intended site, a balloon is inflated during the procedure, which occludes.
References
- 1 2 "Jeanne LaBerge, MD, FSIR Receives SIR Gold Medal".
- ↑ "10th Annual Tegtmeyer Lecture to be Delivered by SIR Gold-Medalist Jeanne LaBerge, MD, FSIR". Radiology and Medical Imaging. 2018-08-24. Retrieved 2022-03-09.
- ↑ Publishing, BIBA (2012-09-12). "Interventional radiology in the USA now a primary specialty in medicine". Interventional News. Retrieved 2022-03-09.
- ↑ Kaufman, John A. (2014-11-01). "The Interventional Radiology/Diagnostic Radiology Certificate and Interventional Radiology Residency". Radiology. 273 (2): 318–321. doi: 10.1148/radiol.14141263 . ISSN 0033-8419. PMID 25340266.
- ↑ Rösch, Josef; Keller, Frederick S.; Kaufman, John A. (2003-07-01). "The Birth, Early Years, and Future of Interventional Radiology". Journal of Vascular and Interventional Radiology. 14 (7): 841–853. doi:10.1097/01.RVI.0000083840.97061.5b. ISSN 1051-0443. PMID 12847192.
- ↑ Ray, Charles E. (2002). "Interventional Radiology Essentials". American Journal of Roentgenology. 178 (1): 100. doi:10.2214/ajr.178.1.1780100. ISSN 0361-803X.
- ↑ Butty, Sabah (2002-03-01). "Interventional Radiology Essentials". Journal of Vascular and Interventional Radiology. 13 (3): 284. doi:10.1016/S1051-0443(07)61721-7. ISSN 1051-0443.
- ↑ "Society of Interventional Radiology - SIR 2017 SIR Awards". www.sirweb.org. Retrieved 2022-03-09.
- ↑ "Society of Interventional Radiology Foundation names Jeanne M. LaBerge 2011 Dotter Lecturer".
- ↑ LaBerge, Jeanne M. (2011). "The 27th Annual Charles T. Dotter Lecture: Data Integration in Interventional Radiology: The Pressing Challenge of Our Time". Journal of Vascular and Interventional Radiology. 22 (8): 1061–1067. doi:10.1016/j.jvir.2011.04.007. PMID 21621421.