Myra P. Evangelista BSRT 4 Assignment CLUSTER 3: Radiologic Contrast Examination Define each following terms: 1 - 3 sentences only (direct to the point) 1. Myelography - A myelogram is a diagnostic imaging test generally done by a radiologist. It uses a contrast dye and X-rays or computed tomography (CT) to look for problems in the spinal canal. A myelogram may be done to assess the spinal cord, subarachnoid space, or other structures for changes or abnormalities. 2. Vascular and Interventional Procedures -Vascular and interventional radiology is a cutting-edge medical specialty that encompasses image-guided minimally invasive procedures which minimize hospital stays and patient recovery time. It is a leading and innovative partner in the minimally invasive procedural trend of medicine and surgery. 3. Vertebroplasty and Kyphoplasty -are ways of treating vertebral body compression fractures, which are small breaks in the thick mass of bone that makes up the front part of your spinal column (the vertebral body). Vertebral body fractures lead to the collapse or compression of a vertebra, causing your spine to shorten and curve forward. This can result in pain and a kyphotic (hunched-over) deformity 4. Diskography (Provocative Diskography) -is a diagnostic test meant to confirm or exclude the intervertebral disc(s) as a source of back pain. This technique involves puncture of the disc with a fine-gauge needle under fluoroscopic guidance and pressurization of the disc via the injection of contrast media. 5. Interventional Pain Management -Interventional pain management is a method which utilizes pain blocking techniques to help make day-to-day activities less difficult, and effectively restore quality of life for patients. Surgery, electrostimulation, nerve blocks or implantable drug delivery systems may be used as part of the treatment process. Definition of Terms: * angiography - radiographic examination of the blood vessels after the injection of contrast medium * arachnoid -a thin delicate membrane surrounding the brain and spinal cord brain the portion of the central nervous system contained within the cranium * brain - the portion of the central nervous system contained within the cranium * cauda equina - a collection of nerves located in the spinal canal inferior to the spinal cord * cerebellum - the part of the brain located in the posterior cranial fossa behind the brainstem * cerebral aqueduct - an opening between the third and fourth ventricles * cerebrospinal fluid - the fluid that flows through and protects the ventricles, sub-arachnoid space, brain and spinal cord * cerebrum -the largest uppermost portion of the brain * conus medullaris - the most inferior portion of the spinal cord * cortex -the outer surface layer of the brain * dura mater -the tough outer layer of the meninges which lines the cranial cavity and spinal canal * epidural space -outside or above the dura mater * falx cerbri -a fold of dura mater that separates the cerebral hemi spheres * filum terminale -a threadlike structure which extends from the distal end of the spinal cord * gadolinium - an IV contrast medium used in MR * hindbrain - the portion of the brain within the posteriot fossa; it includes the pons, medulla oblongata and cerebellum * interventional radiology - a branch of radiology that uses catheters to perform therapeutic procedures * intrathecal injection -an injection into the subarachnoid space of the spinal canal * kyphoplasty -kyphoplasty injects special cement into your vertebrae — with the additional step of creating space for the treatment with a balloon-like device (balloon vertebroplasty). Kyphoplasty can restore a damaged vertebra's height and may also relieve pain. * pons -an oval-shaped area of the brain anterior to the medulla oblongata * slices -sectional images of the body produced with either computed tomography or magnetic resonance imaging * spinal cord -an extension of the medulla oblongata that runs through the spinal canal to the upper lumbar vertebrae * stereotactic surgery -a radiographic procedure performed during neurosurgery to guide needle placement into the brain * tentorium - the layer of dura that separates the cerebrum and cerebellum * vermis - a wormlike structure that connects the two cerebellar hemispheres * vertebroplasty -Vertebroplasty is an outpatient procedure for stabilizing compression fractures in the spine. Bone cement is injected into back bones (vertebrae) that have cracked or broken, often because of osteoporosis. The cement hardens, stabilizing the fractures and supporting your spine. 6. Angiographic Studies -Angiography is a type of X-ray used to check blood vessels. Blood vessels do not show clearly on a normal X-ray, so a special dye needs to be injected into your blood first. This highlights your blood vessels, allowing your doctor to see any problems. 7. Digital Subtraction Angiographic Procedures -Provides an image of the blood vessels in the brain to detect a problem with blood flow. The procedure involves inserting a catheter (a small, thin tube) into an artery in the leg and passing it up to the blood vessels in the brain. 8. Three-Dimensional Intraarterial Angiography -is a true technical revolution that allows improvement in the quality and safety of diagnostic and endovascular treatment procedures. 3D angiography images are obtained by reconstruction of a rotational angiography acquisition done on a C-arm (GE Medical Systems) spinning at 40 degrees per second. Define each Angiographic Supplies and Equipment: *needles -Vascular access needles are necessary when performing percutaneous cardiovascular procedures. Needle size is based on the external diameter of the needle and is assigned a gauge size. The most commonly used access needle for adult cardiovascular procedures is a 18-gauge needle that is 2.75 inches long. This particular needle is compatible with a 0.035 guidewire, which is the most frequently used guidewire in cardiovascular procedures. * guidewires -Guidewires; also commonly referred to as a spring guide or wire guide are used in angiography and other special procedures as a platform for the catheter to be advanced over. To decrease the possibilities of complications the guidewire should be advanced into the vasculature ahead of the catheter. * introducer sheaths -Introducer sheaths are frequently utilized on angiographic procedures when multiple catheters will be utilized. A variation of the previously described Seldinger technique allow the introducer sheath to be placed in lieu of the catheter during percutaneou entry of the vascular system. Typically, most introducer sheaths range in length from 10 to 25 cm. * catheterization -angiographic catheters whose main purpose is as a conduit for contrast media, right heart catheters are typically flow directed catheters, which utilize an inflated balloon on the tip of the catheter to ease passage through the various chambers of the heart. Moreover various types of flow directed catheters are capable of performing more tasks than the standard angiographic catheter. Depending on the type of procedure to be performed the physician will decide which catheter to use. REFERENCES Anxionnat, R., Bracard, S., Macho, J., Da Costa, E., Vaillant, R., Launay, L., Trousset, Y., Romeas, R., & Picard, L. (1998). 3D angiography. Clinical interest. First applications in interventional neuroradiology. Journal of neuroradiology = Journal de neuroradiologie, 25(4), 251–262. Ballinger P. W and Frank E. D. (2003) Volume Three Merrill’s Atlas of Radiographic Positions and Radiographic Procedures 10th Edition. Cleveland Clinic (2020) kyphoplastyvertebroplasty https://my.clevelandclinic.org/health/treatments/11277- FLORIDA MEDICAL CLINIC (2018) HTTPS://WWW.FLORIDAMEDICALCLINIC.COM/BLOG/WHATIS-INTERVENTIONAL-PAIN-MANAGEMENT/ Johns Hopkins University (2022) https://www.hopkinsmedicine.org/health/treatment-testsand-therapies/myelogram Johns Hopkins University (2022) https://www.hopkinsmedicine.org/health/treatment-tests-and therapies/kyphoplasty MAYO CLINIC (2020) HTTPS://WWW.MAYOCLINIC.ORG/TESTSPROCEDURES/VERTEBROPLASTY/ABOUT/PAC-20385207 NHS (2020) HTTPS://WWW.NHS.UK/CONDITIONS/ANGIOGRAPHY/ STANFORD MEDICINE ( 2022) HTTPS://STANFORDHEALTHCARE.ORG/MEDICALTESTS/A/ANGIOGRAM-ARTERIOGRAM/TYPES/DIGITAL-SUBTRACTION-ANGIOGRAPHY.HTML University of Michigan Health Michigan Medicine (2022) https://www.uofmhealth.org/conditions-treatments/vascular-and-interventional-radiology/ Zachary L McCormick, MD, Fred DeFrancesch, MD, Vivek Loomba, MD, Maxim Moradian, MD, Ramesh Bathina, MD, George Rappard, MD, on behalf of the Standards Division of the Spine Intervention Society, Diagnostic Value, Prognostic Value, and Safety of Provocation Discography, Pain Medicine, Volume 19, Issue 1, January 2018, Pages 3– 8, https://doi.org/10.1093/pm/pnx034
