• Title/Summary/Keyword: Radiology, interventional

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Interventional radiography in management of high-flow arteriovenous malformation of maxilla: report of a case

  • Khambete, Neha;Risbud, Mukund;Mehta, Nikit
    • Imaging Science in Dentistry
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    • v.41 no.3
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    • pp.123-128
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    • 2011
  • Arteriovenous malformations are extremely rare conditions in that can result from abnormalities in the structure of blood vessels, which may be potentially fatal. A 30-year-old female patient visited our hospital with a complaint of swelling on the right maxillary posterior gingiva along with the large port-wine stain on right side of face. On clinical examination, the swelling was compressible and pulsatile. Radiographic examination revealed a lytic lesion of maxilla. Diagnostic angiography revealed a high-flow arteriovenous malformation of maxilla which was treated by selective transarterial embolization of maxillary artery using polyvinyl alcohol particles.

Dynamic Chest X-Ray Using a Flat-Panel Detector System: Technique and Applications

  • Akinori Hata;Yoshitake Yamada;Rie Tanaka;Mizuki Nishino;Tomoyuki Hida;Takuya Hino;Masako Ueyama;Masahiro Yanagawa;Takeshi Kamitani;Atsuko Kurosaki;Shigeru Sanada;Masahiro Jinzaki;Kousei Ishigami;Noriyuki Tomiyama;Hiroshi Honda;Shoji Kudoh;Hiroto Hatabu
    • Korean Journal of Radiology
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    • v.22 no.4
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    • pp.634-651
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    • 2021
  • Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD). This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.

Transarterial Chemoembolization for Hepatocellular Carcinoma: 2023 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association

  • Yuri Cho;Jin Woo Choi;Hoon Kwon;Kun Yung Kim;Byung Chan Lee;Hee Ho Chu;Dong Hyeon Lee;Han Ah Lee;Gyoung Min Kim;Jung Suk Oh;Dongho Hyun;In Joon Lee;Hyunchul Rhim;Research Committee of the Korean Liver Cancer Association
    • Korean Journal of Radiology
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    • v.24 no.7
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    • pp.606-625
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    • 2023
  • Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

The Characteristic of Radiation Exposure for Radiologist with Applying Condition in Interventional Radiology in Cardiology (심장내과의 중재적 시술시 시술조건에 따른 방사선사의 방사선 노출 특성)

  • Park, Jeong-Kyu;Cho, Euy-Hyun
    • Journal of Digital Contents Society
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    • v.13 no.3
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    • pp.421-429
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    • 2012
  • Lately, the number of interventional radiology is increased by the extension of procedure in medical radiation, and radiation exposure may be appeared differently by interventional radiologists, it is caused increase of radiation dose for radiation worker, patient, and radiologists. This study has done a comparative analysis characteristic of radiation exposure for five radiologists who executed interventional cardiology for 303 patients in S university hospital of Gyeong-Buk from Nov. 1, 2011 to Jan. 31, 2011. The average exposure time of five radiologists was 697.95sec. The average of cumulative DAP(exp) for patients was $52,730mGycm^2$ and the average of total DAP for patients was $104,875.14mGycm^2$. The average of frames for image was 855.52 frames in acquired images, and the average of frames for images was 802.2 frames in exposure images. They were statistically significant differences (p<0.05). Exposure time, cumulative DAP(fluro), cumulative DAP(exp), total DAP, acquired image, and exposure image were high correlation except cumulative DAP(exp), and acquired runs in x-ray exposure characteristics of machine. Exposure time was a great influence on radiologist. It signified that the more exposure time lead to the more radiation dose for radiologist. Radiation dose is related to ability, experience, difficulty, and precision of procedures in interventional procedure. The number of angiography and exposure time is difficult to control by radiologists. Therefore, it is in need of reasonable system which was evaluated the real dose of medical teams in interventional proceedings. We think that self education and training are required to reduce radiation dose for radiologists and radiation workers.

A Study on the Evaluation of Patient Dose in Interventional Radiology (중재적방사선검사에서 환자 피폭선량에 관한 연구)

  • Park, Hyung-Sin;Lim, Cheong-Hwan;Kang, Byung-Sam;You, In-Gyu;Jung, Hong-Ryang
    • Journal of radiological science and technology
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    • v.35 no.4
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    • pp.299-308
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    • 2012
  • To perform patient dose surveys in major interventional radiography procedures as a mean of inter-institutional comparison and of establishing reference dose levels with the ultimate goal of optimizing patient doses in the field of interventional radiography. We reviewed international patient dose survey data in the literature and measured patient dose in major interventional radiography procedures (TACE, AVF, PTBD, TFCA, GDC embolization). ESD(Entrance Skin Dose) was measured using TLD chips attached to the patient skin and ED(Effective Dose) was calculated using angiography unit-derived DAP. A survey of patient dose in interventional radiography procedures were also performed with a questionnaire for interventional radiologists and we proposed a guideline for optimizing patient doses in the field of interventional radiology. The patient dose survey data in interventional radiography procedures were very rare in literature compared with those in diagnostic radiography procedures. In TACE, the mean ED was 25.43 mSv and the mean ESD was 511.75 mGy. The mean ED of TACE was not high, but the cumulative dose should be checked, due to longer procedure TACE. In TFCA, the mean ED was 22.6 mSv and it was relatively high compared with data of other countries. In GDC embolization, the mean ED was not available, because GDC embolization was performed with old Image-Intensifier-type unit and there has no unit-installed ionization chamber. Also, the mean ESD of GDC embolization was up to 2,264 mGy and further studies are needed to calculate the net ED of GDC embolization. Patient dose occurred during interventional radiography procedures are high related with the difficulty of the procedure, fluoroscopy time, the number of angiographies and the treatment protocol. Therefore, continuous education and efforts should be made to optimize the patient dose in the field of interventional radiology.

Clinical Study on Safety and Efficacy of Microwave Ablation for Primary Hyperparathyroidism

  • Ying Wei;Lili Peng;Yan Li;Zhen-long Zhao;Ming-an Yu
    • Korean Journal of Radiology
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    • v.21 no.5
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    • pp.572-581
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    • 2020
  • Objective: To evaluate the safety, feasibility, and efficacy of microwave ablation (MWA) for the treatment of primary hyperparathyroidism (PHPT). Materials and Methods: This study enrolled 67 PHPT patients (22 men, 45 women; mean age, 56.0 ± 16.3 years; range, 18-83 years) from January 2015 to December 2018. The laboratory data, including the serum intact parathyroid hormone (iPTH), calcium, phosphorus, and alkaline phosphatase (ALP) levels, were evaluated before MWA and again 2 hours, 1 day, 7 days, 1 month, 3 months, 6 months, 12 months, 18 months, and 24 months after. Results: Complete ablation was achieved with all 72 hyperplastic parathyroid glands found on the 67 patients enrolled, 64 of whom were treated in one session and 3 were treated over two sessions. The technical success rate was 100%. The median follow-up time was 13.6 months (range, 10.0-31.1 months). The clinical success rate was 89.4%. The volume reduction rate was 79.4% at 6 months. Compared to pre-MWA, the serum iPTH, calcium, phosphorus, and ALP levels had significantly improved 6 months post-MWA (iPTH, 157.3 pg/mL vs. 39.2 pg/mL; calcium, 2.75 ± 0.25 mmol/L vs. 2.34 ± 0.15 mmol/L; phosphorus, 0.86 ± 0.20 mmol/L vs. 1.12 ± 0.22 mmol/L; ALP, 79 U/L vs. 54 U/L, respectively; all, p < 0.01). Hoarseness was a major complication in 4 patients (6.0%), but it improved spontaneously within 2-3 months. Conclusion: MWA is safe, feasible, and effective for the treatment of PHPT.

Interventional Therapy for Renal Artery Pseudoaneurysms

  • Ji, Wen-Bin;Wang, Wei-Zheng;Sun, Song;Mi, Yu-Cheng;Xu, Qiong;Chen, Yi-Er;Yang, Song;Tao, Dan;Xu, Wei;Xu, Chao
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1595-1598
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    • 2012
  • The aim of this study was to explore the angiographic diagnosis and embolization therapy for renal artery pseudoaneurysms due to acute urinary tract hemorrhage after conservative medical management failed. Seven out of ten cases had fever symptoms after the kidney surgery. The pseudoaneurysms were treated with gelatin sponge and (or) spring coil and the majority demonstrated rapid blockage of hemorrhage. Angiography diagnosis and trans catheter embolization are rapid, safe and effective methods for diagnosis and treatment of renal artery pseudoaneurysms.

Is Interventional Therapy Superior to Medical Treatment in Chronic Low Back Pain?: Yes, in Considerable Cases (만성요통의 치료에서 중재적인 치료가 보존적 치료보다 우세한가?: 긍정적인 입장에서)

  • Chang, Sang-Bum
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.3-6
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    • 2010
  • The British guideline for early management of persistent low back pain, published in 2009, indicated that physicians should offer exercise or medication, rather than radiological interventions or injections, as first choice of treatment in the patients with chronic low back pain (CLBP). However, there had been great controversies regarding the effectiveness of interventional treatment of patients with CLBP. Both somatic (discogenic, instability, etc) and psychosocial factors contribute to the pathophysiology of chronic low back pain (CLBP). Although it can be difficult in many occasions, thorough interview with the patients and specific diagnostic approaches can help us to identify which is the main etiology in individual patient. With the recent progress in medical radiology and development of new therapeutic modalities, some subgroups of patients of CLBP caused by somatic factors appear to be good candidates of interventional therapy. Interventional therapy can be considered in patients with CLBP caused by annulus rupture, facet joint degeneration, disc degeneration, and vertebral column instability. Among other subgroups of CLBP, carefully selected patients with disc degeneration show the most favorable result by interventional therapy. In this regard, discogenic pain, either as a form of CLBP or acute discogenic radiculopathy, seems to be a good indication of interventional therapy. Because many spine specialists generally consider those with radiculopathy are easier to be treated, patients with CLBP tend to be subjects of conventional conservative therapy. For these reasons, clinicians should make their best effort to identify every possible somatic cause in patients with CLBP before regarding them as hypochondriacs. In this review, some of the recent evidence on the role of interventional treatment in patients with CLBP will be discussed, and some of our cases who showed favorable results by interventional therapy will be presented.

Retroperitoneal Hematoma as a Serious Complication of Endovascular Aneurysmal Coiling

  • Murai, Yasuo;Adachi, Koji;Yoshida, Yoichi;Takei, Mao;Teramoto, Akira
    • Journal of Korean Neurosurgical Society
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    • v.48 no.1
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    • pp.88-90
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    • 2010
  • Retroperitoneal hematoma (RH) due to radiologic intervention for an intracranial lesion is relatively rare, difficult to diagnose, and can be lifethreatening. We report a case of RH that developed in a patient on anticoagulant therapy following endovascular coiling of a ruptured anterior communicating artery (AcoA) aneurysm. An 82-year-old man presented with a 12-day history of headache. Computed tomography (CT) on admission demonstrated slight subarachnoid hemorrhage, and left carotid angiography revealed an AcoA aneurysm. The next day, the aneurysm was occluded with coils via the femoral approach under general anesthesia. The patient received a bolus of 5,000 units of heparin immediately following the procedure, and an infusion rate of 10,000 units/day was initiated. The patient gradually became hypotensive 25 hours after coiling. Abdominal CT showed a huge, high-density soft-tissue mass filling the right side of the retroperitoneum space. The patient eventually died of multiple organ failure five days after coiling. RH after interventional radiology for neurological disease is relatively rare and can be difficult to diagnose if consciousness is disturbed. This case demonstrates the importance of performing routine physical examinations, sequentially measuring the hematocrit and closely monitoring systemic blood pressures following interventional radiologic procedures in patients with abnormal mental status.