Additional Information
Book Details
Abstract
This book gives a synoptic description of the practical details of how to carry out the common procedures in imaging on which a trainee in radiology and related professionals will be expected to be familiar. It does not attempt to cover rarer techniques beyond the scope of the FRCR exam or to show the resulting images. Every technique is clearly described under a set of standard headings (e.g. methods, indications, equipment, patient preparation, technique, aftercare, complications, further reading).
- The text adopts a synoptic style which makes for easy preparation for the FRCR and similar examinations
- The selectivity of the techniques covered will focus a candidate’s attention on what questions to expect.
- The use of standard headings makes the contents highly accessible for a reader.
- The new edition has been comprehensively updated throughout and will reflect the very latest equipment and practice developments.
- It will reference the key recent national and international guidelines (Royal College, Dept. Of Health, WHO)
- A new chapter on the ‘Radiographer Role and Responsibilities in Interventional Radiology’ will reflect the evolving role of the advanced practitioner radiographer (working in collaboration with the radiologist). This will add utility/appeal to the radiographer market and aid understanding and be a more accurate reflection of the modern imaging service for radiologists
- There is a new chapter on ablative therapies.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| GUIDE TORADIOLOGICAL PROCEDURES | i | ||
| GUIDE TORADIOLOGICAL PROCEDURES | iii | ||
| Copyright | iv | ||
| Contents | v | ||
| Preface | xv | ||
| Acknowledgements | xvi | ||
| List of contributors | xvii | ||
| 1 - General notes | 1 | ||
| RADIOLOGY | 1 | ||
| Methods | 1 | ||
| Indications | 1 | ||
| Contraindications | 1 | ||
| Risk due to radiation | 1 | ||
| Risk due to the contrast medium | 4 | ||
| Risks due to the technique | 5 | ||
| Contrast Medium | 5 | ||
| Equipment | 5 | ||
| Patient preparation | 5 | ||
| Preliminary Images | 7 | ||
| Technique | 7 | ||
| Images | 7 | ||
| Additional Techniques or Modifications of Technique | 7 | ||
| Aftercare | 7 | ||
| Complications | 7 | ||
| Due to the anaesthetic | 7 | ||
| Due to the contrast medium | 8 | ||
| Due to the technique | 8 | ||
| RADIONUCLIDE IMAGING | 9 | ||
| RADIOPHARMACEUTICALS | 9 | ||
| Radioactive Injections | 9 | ||
| Activity Administered | 9 | ||
| Equipment | 10 | ||
| Technique | 10 | ||
| Patient positioning | 10 | ||
| Images | 10 | ||
| Aftercare | 11 | ||
| Radiation safety | 11 | ||
| Complications | 11 | ||
| COMPUTED TOMOGRAPHY | 11 | ||
| Patient Preparation | 11 | ||
| Intravenous Contrast Medium | 13 | ||
| Oral Contrast Medium | 13 | ||
| Pelvic Scanning | 13 | ||
| Computed Tomography Colonography | 13 | ||
| MAGNETIC RESONANCE IMAGING | 13 | ||
| Patient Preparation | 13 | ||
| SAFETY IN MAGNETIC RESONANCE IMAGING | 14 | ||
| Effects Due to Magnetic Fields | 14 | ||
| Static field | 14 | ||
| Biological effects | 14 | ||
| Nonbiological effects | 15 | ||
| Gradient field | 15 | ||
| Biological effects | 15 | ||
| Nonbiological effects | 16 | ||
| Radiofrequency field | 16 | ||
| Noise | 16 | ||
| Inert Gas Quench | 17 | ||
| Intravenous Contrast Medium | 17 | ||
| Recommendations for Safety | 17 | ||
| Controlled and restricted access | 18 | ||
| Implants | 18 | ||
| Pregnancy | 18 | ||
| ULTRASONOGRAPHY | 19 | ||
| Patient Preparation | 19 | ||
| Abdomen | 19 | ||
| Pelvis | 19 | ||
| Endoscopic | 20 | ||
| Children | 20 | ||
| 2 - Intravascular contrast media | 21 | ||
| HISTORICAL DEVELOPMENT OF RADIOGRAPHIC AGENTS | 21 | ||
| ADVERSE EFFECTS OF INTRAVENOUS WATER-SOLUBLE CONTRAST MEDIA | 25 | ||
| TOXIC EFFECTS ON SPECIFIC ORGANS | 25 | ||
| Venous | 25 | ||
| Arterial | 25 | ||
| Soft-Tissue Toxicity | 25 | ||
| Cardiovascular Toxicity | 26 | ||
| Nephrotoxicity | 26 | ||
| Thyroid Function | 27 | ||
| IDIOSYNCRATIC REACTIONS | 28 | ||
| Fatal Reactions | 28 | ||
| Nonfatal Reactions | 29 | ||
| MECHANISMS OF IDIOSYNCRATIC CONTRAST MEDIUM REACTIONS | 30 | ||
| PROPHYLAXIS OF ADVERSE CONTRAST MEDIUM EFFECTS | 30 | ||
| Iodinated Contrast in Pregnancy and Lactation | 30 | ||
| CONTRAST AGENTS IN MAGNETIC RESONANCE IMAGING | 33 | ||
| HISTORICAL DEVELOPMENT | 33 | ||
| MECHANISM OF ACTION | 33 | ||
| GADOLINIUM | 34 | ||
| Dose | 35 | ||
| Adverse Reactions | 35 | ||
| Acute adverse reactions | 36 | ||
| Delayed adverse reactions | 36 | ||
| Precautions for prevention of adverse reactions | 37 | ||
| Acute adverse reactions | 37 | ||
| Delayed adverse reactions | 37 | ||
| GASTROINTESTINAL CONTRAST AGENTS | 38 | ||
| Positive Agents | 38 | ||
| Negative Agents | 38 | ||
| Magnetic Resonance Imaging Contrast Agents in Pregnancy and Lactation | 38 | ||
| CONTRAST AGENTS IN ULTRASONOGRAPHY | 39 | ||
| 3 - Gastrointestinal tract | 43 | ||
| Introduction to Contrast Media | 43 | ||
| Water-Soluble Contrast Agents | 43 | ||
| Indications | 44 | ||
| Complications | 44 | ||
| Gases | 44 | ||
| Barium | 45 | ||
| Advantages | 46 | ||
| Disadvantages | 46 | ||
| Complications | 46 | ||
| Pharmacological Agents | 46 | ||
| Hyoscine-N-Butylbromide (Buscopan) | 46 | ||
| Indications | 46 | ||
| 4 - Liver, biliary tract and pancreas | 93 | ||
| METHODS OF IMAGING THE HEPATOBILIARY SYSTEM | 93 | ||
| METHODS OF IMAGING THE PANCREAS | 93 | ||
| PLAIN FILMS | 94 | ||
| ULTRASOUND OF THE LIVER | 94 | ||
| Indications | 94 | ||
| Contraindications | 94 | ||
| Patient Preparation | 94 | ||
| Equipment | 94 | ||
| Technique | 94 | ||
| Additional Views | 95 | ||
| Hepatic veins | 95 | ||
| Portal vein | 95 | ||
| Hepatic artery | 95 | ||
| Common bile duct | 95 | ||
| Spleen | 96 | ||
| ULTRASOUND OF THE GALLBLADDER AND BILIARY SYSTEM | 96 | ||
| Indications | 96 | ||
| Contraindications | 96 | ||
| Patient Preparation | 97 | ||
| Equipment | 97 | ||
| Technique | 97 | ||
| Additional Views | 97 | ||
| Assessment of gallbladder function | 97 | ||
| Intrahepatic bile ducts | 97 | ||
| Extrahepatic bile ducts | 98 | ||
| Postcholecystectomy | 98 | ||
| ULTRASOUND OF THE PANCREAS | 98 | ||
| Indications | 98 | ||
| Contraindications | 98 | ||
| Patient Preparation | 99 | ||
| Equipment | 99 | ||
| Technique | 99 | ||
| COMPUTED TOMOGRAPHY OF THE LIVER AND BILIARY TREE | 99 | ||
| Indications | 99 | ||
| Contraindications | 100 | ||
| Technique | 100 | ||
| Single-phase (portal phase) contrast-enhanced computed tomography | 100 | ||
| Multiphasic contrast-enhanced computed tomography | 100 | ||
| COMPUTED TOMOGRAPHIC CHOLANGIOGRAPHY | 101 | ||
| Contraindications | 101 | ||
| Indications | 101 | ||
| Technique | 101 | ||
| COMPUTED TOMOGRAPHY OF THE PANCREAS | 102 | ||
| Indications | 102 | ||
| Contraindications | 102 | ||
| Technique | 102 | ||
| MAGNETIC RESONANCE IMAGING OF THE LIVER | 103 | ||
| Indications | 103 | ||
| Magnetic Resonance Imaging Pulse Sequences | 103 | ||
| Diffusion Weighted Imaging | 104 | ||
| Contrast-enhanced Magnetic Resonance Liver Imaging | 105 | ||
| Gadolinium-enhanced T1-weighted magnetic resonance imaging | 105 | ||
| Liver-specific contrast agents | 105 | ||
| Magnetic resonance angiography | 106 | ||
| MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY | 106 | ||
| 5 - Urinary tract | 127 | ||
| PLAIN FILM RADIOGRAPHY | 128 | ||
| 6 - Image guided ablation techniques for cancer treatment | 155 | ||
| TYPES OF ABLATIVE TECHNOLOGY | 155 | ||
| RADIOFREQUENCY ABLATION | 155 | ||
| Background Information | 155 | ||
| Indications | 156 | ||
| Contraindications | 156 | ||
| Patient Preparation | 156 | ||
| Equipment | 156 | ||
| Imaging Guidance Technique | 156 | ||
| Postprocedural Care/Imaging/Follow-Up | 156 | ||
| MICROWAVE ABLATION | 156 | ||
| Background Information | 156 | ||
| Indications | 157 | ||
| Contraindications | 157 | ||
| Patient Preparation | 157 | ||
| Equipment | 157 | ||
| Imaging Guidance Technique | 157 | ||
| Postprocedural Care/Imaging/Follow-Up | 157 | ||
| CRYOABLATION | 157 | ||
| Background Information | 157 | ||
| Indications | 158 | ||
| Contraindications | 158 | ||
| Patient Preparation | 158 | ||
| Equipment | 158 | ||
| Imaging Guidance Technique | 158 | ||
| Postprocedural Care/Imaging/Follow-Up | 158 | ||
| IRREVERSIBLE ELECTROPORATION | 158 | ||
| Background Information | 158 | ||
| Indications | 159 | ||
| Contraindications | 159 | ||
| Patient Preparation | 159 | ||
| Equipment | 159 | ||
| Imaging Guidance Technique | 159 | ||
| Postprocedural Care/Imaging/Follow-Up | 159 | ||
| KEY CHALLENGES | 160 | ||
| 7 - Reproductive system | 163 | ||
| Methods of Imaging in the Female Reproductive System | 163 | ||
| Methods of Imaging the Male Reproductive System (Scrotum and Testes) | 163 | ||
| HYSTEROSALPINGOGRAPHY | 163 | ||
| Indications | 163 | ||
| Contraindications | 164 | ||
| Contrast Medium | 164 | ||
| Equipment | 164 | ||
| Patient Preparation | 164 | ||
| Technique | 164 | ||
| Images | 165 | ||
| Aftercare | 165 | ||
| Complications | 165 | ||
| Due to the contrast medium | 165 | ||
| Due to the technique | 165 | ||
| ULTRASOUND OF THE FEMALE REPRODUCTIVE SYSTEM | 166 | ||
| Indications | 166 | ||
| Contraindications | 166 | ||
| Patient Preparation | 166 | ||
| Equipment | 166 | ||
| Reporting Gynaecological Ultrasound | 166 | ||
| Contrast Medium | 167 | ||
| ULTRASOUND OF THE SCROTUM | 168 | ||
| Indications | 168 | ||
| Contraindications | 168 | ||
| Patient Preparation | 168 | ||
| Equipment | 168 | ||
| Technique | 168 | ||
| COMPUTERIZED TOMOGRAPHY OF THE REPRODUCTIVE SYSTEM | 169 | ||
| 8 - Respiratory system | 177 | ||
| Methods of Imaging the Respiratory System | 177 | ||
| COMPUTED TOMOGRAPHY OF THE THORAX | 177 | ||
| Indications | 177 | ||
| Contraindications | 178 | ||
| Technique | 178 | ||
| COMPUTED TOMOGRAPHY-GUIDED LUNG BIOPSY | 179 | ||
| Indications | 179 | ||
| Contraindications | 179 | ||
| Equipment | 179 | ||
| Patient Preparation | 180 | ||
| Technique | 180 | ||
| Aftercare | 181 | ||
| Complications2–4 | 181 | ||
| METHODS OF IMAGING PULMONARY EMBOLISM | 182 | ||
| RADIONUCLIDE LUNG VENTILATION/PERFUSION IMAGING | 183 | ||
| Indications | 183 | ||
| Contraindications (To Perfusion Imaging) | 184 | ||
| Radiopharmaceuticals | 184 | ||
| Perfusion | 184 | ||
| Ventilation | 184 | ||
| Equipment | 184 | ||
| Patient Preparation | 185 | ||
| Technique | 185 | ||
| Perfusion | 185 | ||
| Ventilation | 185 | ||
| 81mKr gas | 185 | ||
| 99mTc-DTPA aerosol | 185 | ||
| Images | 186 | ||
| Additional Techniques | 186 | ||
| Aftercare | 186 | ||
| Complications | 186 | ||
| COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF PULMONARY EMBOLI | 186 | ||
| Technique | 186 | ||
| Computed Tomography Pulmonary Angiography—Enhanced Scan of Pulmonary Arterial System1 | 186 | ||
| PULMONARY ARTERIOGRAPHY | 187 | ||
| Indications | 187 | ||
| Contraindications1 | 187 | ||
| Contrast Medium | 188 | ||
| Equipment | 188 | ||
| Technique | 188 | ||
| Additional Techniques | 188 | ||
| Complications | 188 | ||
| MAGNETIC RESONANCE OF PULMONARY EMBOLI | 188 | ||
| Technique | 190 | ||
| MAGNETIC RESONANCE IMAGING OF THE RESPIRATORY SYSTEM | 191 | ||
| PET AND PET-CT OF THE RESPIRATORY SYSTEM | 192 | ||
| 9 - Heart | 193 | ||
| ANGIOCARDIOGRAPHY | 193 | ||
| Indications | 193 | ||
| Contrast Medium | 193 | ||
| Equipment | 194 | ||
| Technique | 195 | ||
| Image Acquisition | 195 | ||
| CORONARY ARTERIOGRAPHY | 195 | ||
| Indications | 195 | ||
| Contrast Medium | 196 | ||
| Equipment | 196 | ||
| Patient Preparation | 197 | ||
| Preliminary Image | 197 | ||
| Technique | 197 | ||
| Image Acquisition | 197 | ||
| Complications | 198 | ||
| CARDIAC COMPUTED TOMOGRAPHY | 198 | ||
| Indications | 199 | ||
| Contraindications | 199 | ||
| Patient Preparation | 199 | ||
| Beta-Blockers | 200 | ||
| Nitrates | 200 | ||
| Technique | 200 | ||
| Scan Protocol | 201 | ||
| Plain computed tomography heart | 201 | ||
| Contrast-Enhanced Cardiac Scan | 201 | ||
| Contrast administration | 201 | ||
| Retrospective scan | 202 | ||
| Prospective scan | 202 | ||
| Single-beat acquisition | 202 | ||
| CARDIAC MAGNETIC RESONANCE | 203 | ||
| Indications | 203 | ||
| Contraindications | 204 | ||
| Relative Contraindications | 204 | ||
| Patient Preparation | 204 | ||
| Technique | 204 | ||
| Localizer images | 204 | ||
| Thoracic overview, cardiac morphology | 204 | ||
| Functional imaging | 204 | ||
| Tissue characterization | 205 | ||
| Myocardial perfusion | 205 | ||
| Dobutamine stress imaging | 205 | ||
| Early gadolinium enhancement | 205 | ||
| Late gadolinium enhancement | 205 | ||
| Flow quantification | 206 | ||
| Magnetic resonance angiography | 206 | ||
| RADIONUCLIDE VENTRICULOGRAPHY | 206 | ||
| Indications | 206 | ||
| Gated blood-pool study1 | 206 | ||
| Contraindications | 207 | ||
| Radiopharmaceuticals | 207 | ||
| Equipment | 207 | ||
| Patient Preparation | 207 | ||
| Technique | 207 | ||
| Images | 208 | ||
| Analysis | 208 | ||
| Additional Techniques | 208 | ||
| Aftercare | 209 | ||
| Complications | 209 | ||
| RADIONUCLIDE MYOCARDIAL PERFUSION IMAGING | 209 | ||
| Indications | 209 | ||
| Contraindications | 209 | ||
| Radiopharmaceuticals1,2 | 209 | ||
| Equipment | 210 | ||
| Patient Preparation | 210 | ||
| Technique | 210 | ||
| Stress regimen | 211 | ||
| 99mTc-MIBI or tetrofosmin rest/stress test | 211 | ||
| 2-Day protocol (stress/rest) | 211 | ||
| 1-Day protocol (stress/rest) | 212 | ||
| 201Tl stress/rest test | 212 | ||
| Images | 212 | ||
| Single photon emission computed tomography | 212 | ||
| Analysis12 | 213 | ||
| Additional Techniques | 213 | ||
| Aftercare | 215 | ||
| Complications | 215 | ||
| 10 - Arterial system | 217 | ||
| NONINVASIVE IMAGING | 217 | ||
| VASCULAR ULTRASOUND | 217 | ||
| COMPUTED TOMOGRAPHIC ANGIOGRAPHY | 218 | ||
| PERIPHERAL (LOWER LIMB) COMPUTED TOMOGRAPHIC ANGIOGRAPHY | 218 | ||
| Indications | 218 | ||
| Patient Preparation | 218 | ||
| Technique | 219 | ||
| Aftercare and Complications | 219 | ||
| MAGNETIC RESONANCE ANGIOGRAPHY | 219 | ||
| VASCULAR ACCESS | 220 | ||
| Patient Preparation | 220 | ||
| Equipment for Vascular Access | 221 | ||
| Ultrasound | 221 | ||
| Needle | 221 | ||
| Guidewires | 221 | ||
| Vascular Sheaths | 222 | ||
| Catheters | 222 | ||
| Taps and Connectors | 223 | ||
| Relative Contraindications | 223 | ||
| Technique (Fig. 10.2) | 223 | ||
| Aftercare | 226 | ||
| GENERAL COMPLICATIONS OF CATHETER TECHNIQUES | 227 | ||
| Due to the Anaesthetic | 227 | ||
| Due to the Contrast Medium | 227 | ||
| Due to the Technique | 227 | ||
| Local | 227 | ||
| Distant | 228 | ||
| ANGIOGRAPHY | 229 | ||
| Indications | 229 | ||
| Equipment | 229 | ||
| Patient Preparation | 229 | ||
| Technique | 229 | ||
| Aftercare | 230 | ||
| Complications | 230 | ||
| ANGIOPLASTY | 230 | ||
| Indications | 230 | ||
| Equipment | 230 | ||
| Patient Preparation | 231 | ||
| Technique | 231 | ||
| Aftercare | 232 | ||
| Complications | 232 | ||
| STENTS | 233 | ||
| Indications | 233 | ||
| Equipment | 233 | ||
| Patient Preparation | 234 | ||
| Technique | 234 | ||
| Aftercare | 234 | ||
| Complication | 234 | ||
| CATHETER-DIRECTED ARTERIAL THROMBOLYSIS | 234 | ||
| Indications | 234 | ||
| Contraindications | 234 | ||
| Patient Preparation | 235 | ||
| Equipment | 235 | ||
| Technique | 235 | ||
| Aftercare | 236 | ||
| Complications | 236 | ||
| VASCULAR EMBOLIZATION | 236 | ||
| Indications | 236 | ||
| Equipment | 237 | ||
| Patient Preparation | 237 | ||
| Technique Principles | 237 | ||
| Aftercare | 238 | ||
| Complications | 238 | ||
| THORACIC AND ABDOMINAL AORTIC STENT GRAFTS | 238 | ||
| Indications | 238 | ||
| Equipment | 238 | ||
| Preparation | 239 | ||
| Principles | 240 | ||
| Aftercare | 240 | ||
| Complications | 241 | ||
| 11 - Venous system | 243 | ||
| ULTRASOUND | 243 | ||
| Duplex | 244 | ||
| Colour Doppler | 244 | ||
| LOWER LIMB VENOUS ULTRASOUND | 244 | ||
| Indications | 244 | ||
| Equipment | 244 | ||
| Technique | 244 | ||
| UPPER LIMB VENOUS ULTRASOUND | 245 | ||
| Indications | 245 | ||
| Equipment | 245 | ||
| Technique | 245 | ||
| COMPUTED TOMOGRAPHY | 245 | ||
| MAGNETIC RESONANCE | 246 | ||
| PERIPHERAL VENOGRAPHY | 247 | ||
| LOWER LIMB | 247 | ||
| Method | 247 | ||
| Indications | 247 | ||
| Contraindications | 247 | ||
| Contrast Medium | 247 | ||
| Equipment | 248 | ||
| Patient Preparation | 248 | ||
| Technique | 248 | ||
| Images | 248 | ||
| Aftercare | 248 | ||
| Complications | 248 | ||
| Due to the contrast medium | 248 | ||
| Due to the technique | 249 | ||
| UPPER LIMB | 249 | ||
| Method | 249 | ||
| Indications | 249 | ||
| Contrast Medium | 249 | ||
| Equipment | 249 | ||
| Patient Preparation | 249 | ||
| Technique | 249 | ||
| Aftercare | 249 | ||
| Complications | 249 | ||
| Due to the contrast medium | 249 | ||
| CENTRAL VENOGRAPHY | 250 | ||
| 12 - Radionuclide imaging in oncology and infection | 263 | ||
| POSITRON EMISSION TOMOGRAPHY IMAGING | 263 | ||
| 2-[18F]FLUORO-2-DEOXY-D-GLUCOSE POSITRON EMISSION TOMOGRAPHY SCANNING | 264 | ||
| Indications (Oncology) | 264 | ||
| General | 264 | ||
| Specific | 265 | ||
| Contraindications | 265 | ||
| Patient Preparation | 265 | ||
| Technique | 266 | ||
| Other Applications | 266 | ||
| Coronary artery disease | 266 | ||
| Neurology | 266 | ||
| Imaging of Infection and Inflammation | 266 | ||
| OTHER PET RADIOPHARMACEUTICALS | 267 | ||
| 18F-CHOLINE | 267 | ||
| Technique | 267 | ||
| 18F-FLUORIDE | 267 | ||
| 68GALLIUM-LABELLED PHARMACEUTICALS | 267 | ||
| 67GALLIUM RADIONUCLIDE TUMOUR IMAGING | 268 | ||
| RADIOIODINE METAIODOBENZYLGUANIDINE SCAN | 268 | ||
| Indications | 268 | ||
| Contraindications | 268 | ||
| Radiopharmaceuticals | 269 | ||
| Equipment | 269 | ||
| Patient Preparation | 269 | ||
| Technique | 269 | ||
| Images | 269 | ||
| Additional Techniques | 269 | ||
| Aftercare | 270 | ||
| Complications | 270 | ||
| SOMATOSTATIN RECEPTOR IMAGING | 270 | ||
| Indications | 270 | ||
| Contraindications | 271 | ||
| Radiopharmaceuticals | 271 | ||
| Equipment | 271 | ||
| Patient Preparation | 271 | ||
| Technique | 271 | ||
| Additional Techniques | 271 | ||
| Aftercare | 272 | ||
| Complications | 272 | ||
| LYMPH NODE AND LYMPHATIC CHANNEL IMAGING | 272 | ||
| RADIOGRAPHY | 272 | ||
| ULTRASOUND | 272 | ||
| 13 - Bones and joints | 279 | ||
| Imaging Modalities | 279 | ||
| MUSCULOSKELETAL MAGNETIC RESONANCE IMAGING—GENERAL POINTS | 280 | ||
| ARTHROGRAPHY—GENERAL POINTS | 282 | ||
| ARTHROGRAPHY | 283 | ||
| Indications | 283 | ||
| Contraindications | 284 | ||
| Contrast Medium | 284 | ||
| Conventional/computed tomography arthrography | 284 | ||
| Magnetic resonance arthrography | 285 | ||
| Equipment | 285 | ||
| Patient Preparation | 285 | ||
| Preliminary Images | 285 | ||
| Radiographic Views | 285 | ||
| Aftercare | 285 | ||
| Complications | 285 | ||
| Due to the contrast medium | 285 | ||
| Due to the technique | 285 | ||
| Other | 286 | ||
| ARTHROGRAPHY—SITE-SPECIFIC ISSUES | 286 | ||
| KNEE | 286 | ||
| Fluoroscopic Technique | 286 | ||
| HIP | 287 | ||
| Fluoroscopic Technique | 287 | ||
| Ultrasound Technique | 289 | ||
| Radiographic Views in the Paediatric Hip Arthrogram | 289 | ||
| SHOULDER | 289 | ||
| Technique | 289 | ||
| Anterior (fluoroscopic guided) | 290 | ||
| Posterior (fluoroscopic guided) | 291 | ||
| Posterior (ultrasound guided) | 293 | ||
| ELBOW | 294 | ||
| Technique | 294 | ||
| Single contrast | 294 | ||
| Double contrast | 295 | ||
| WRIST | 295 | ||
| Technique | 295 | ||
| Radiocarpal joint | 295 | ||
| Midcarpal joint | 297 | ||
| ANKLE | 297 | ||
| Technique | 297 | ||
| TENDON IMAGING | 298 | ||
| Methods of Imaging Tendons | 298 | ||
| GENERAL POINTS | 299 | ||
| ULTRASOUND OF THE PAEDIATRIC HIP | 299 | ||
| Indications | 299 | ||
| Technique | 299 | ||
| Developmental dysplasia of the hip | 299 | ||
| Static (Graf) method | 299 | ||
| Dynamic method | 299 | ||
| Hip-joint effusion | 300 | ||
| Slipped femoral capital epiphysis | 300 | ||
| THERMOABLATION OF MUSCULOSKELETAL TUMOURS | 300 | ||
| Introduction | 300 | ||
| Thermocoagulation | 300 | ||
| Indications | 301 | ||
| Rationale | 301 | ||
| Contraindications | 301 | ||
| Equipment | 301 | ||
| Procedure | 302 | ||
| Biopsy | 302 | ||
| Thermoablation | 302 | ||
| Post Radiofrequency Ablation Care | 303 | ||
| Complications | 303 | ||
| RADIONUCLIDE BONE SCAN | 303 | ||
| Indications | 303 | ||
| Contraindications | 304 | ||
| Radiopharmaceuticals | 304 | ||
| Equipment | 304 | ||
| Patient Preparation | 304 | ||
| Technique | 304 | ||
| Images | 304 | ||
| Standard | 304 | ||
| Three-phase | 305 | ||
| Analysis | 305 | ||
| Additional Techniques | 305 | ||
| Aftercare | 305 | ||
| Complications | 305 | ||
| Competing modalities | 305 | ||
| 14 -\rBrain | 307 | ||
| Methods of Imaging the Brain | 307 | ||
| COMPUTED TOMOGRAPHY OF THE BRAIN | 308 | ||
| Indications | 308 | ||
| Technique | 309 | ||
| MAGNETIC RESONANCE IMAGING OF THE BRAIN | 309 | ||
| Indications | 309 | ||
| Technique | 310 | ||
| IMAGING OF INTRACRANIAL HAEMORRHAGE | 311 | ||
| COMPUTED TOMOGRAPHY | 311 | ||
| MAGNETIC RESONANCE IMAGING | 312 | ||
| IMAGING OF GLIOMAS | 313 | ||
| COMPUTED TOMOGRAPHY | 313 | ||
| MAGNETIC RESONANCE IMAGING | 313 | ||
| IMAGING OF ACOUSTIC NEUROMAS | 314 | ||
| COMPUTED TOMOGRAPHY | 314 | ||
| MAGNETIC RESONANCE IMAGING | 314 | ||
| RADIONUCLIDE IMAGING OF THE BRAIN | 315 | ||
| CONVENTIONAL RADIONUCLIDE BRAIN SCANNING (BLOOD–BRAIN BARRIER IMAGING) | 315 | ||
| REGIONAL CEREBRAL BLOOD FLOW IMAGING | 315 | ||
| Indications | 315 | ||
| Contraindications | 315 | ||
| Radiopharmaceuticals | 315 | ||
| Equipment | 316 | ||
| Patient Preparation | 316 | ||
| Technique | 316 | ||
| Images | 316 | ||
| Analysis | 317 | ||
| Additional Techniques | 317 | ||
| Aftercare | 317 | ||
| Complications | 317 | ||
| POSITRON EMISSION TOMOGRAPHY | 317 | ||
| Indications | 317 | ||
| Contraindications | 317 | ||
| Radiopharmaceuticals | 317 | ||
| Patient Preparation | 317 | ||
| 15 -\rSpine | 325 | ||
| Methods of Imaging the Spine | 325 | ||
| IMAGING APPROACH TO BACK PAINAND SCIATICA | 326 | ||
| CONVENTIONAL RADIOGRAPHY | 327 | ||
| COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING OF THE SPINE | 328 | ||
| MYELOGRAPHY | 330 | ||
| CONTRAST MEDIA | 330 | ||
| CERVICAL MYELOGRAPHY | 330 | ||
| Indications | 330 | ||
| Lateral Cervical C1/2 Puncture Versus Lumbar Injection | 330 | ||
| Contrast Medium | 331 | ||
| Equipment | 331 | ||
| Patient Preparation | 331 | ||
| Technique | 331 | ||
| Radiographic Views | 332 | ||
| Aftercare | 332 | ||
| LUMBAR MYELOGRAPHY | 332 | ||
| Indications | 333 | ||
| Contraindications | 333 | ||
| Contrast Medium | 333 | ||
| Equipment | 333 | ||
| Patient Preparation | 333 | ||
| Preliminary Images | 333 | ||
| Technique | 333 | ||
| Radiographic Views | 335 | ||
| Additional Technique | 335 | ||
| THORACIC MYELOGRAPHY | 335 | ||
| CERVICAL MYELOGRAPHY BY LUMBAR INJECTION | 336 | ||
| COMPUTED TOMOGRAPHY MYELOGRAPHY | 336 | ||
| PAEDIATRIC MYELOGRAPHY | 336 | ||
| Aftercare | 337 | ||
| Complications | 337 | ||
| LUMBAR DISCOGRAPHY | 337 | ||
| Aims | 337 | ||
| Indications | 337 | ||
| Contraindications | 338 | ||
| Contrast Medium | 338 | ||
| Equipment | 338 | ||
| Patient Preparation | 338 | ||
| Preliminary Radiographs | 338 | ||
| Technique | 338 | ||
| Radiographic Views | 339 | ||
| Computed Tomography Postdiscogram | 339 | ||
| Patient Interrogation | 339 | ||
| Aftercare | 339 | ||
| Complications | 339 | ||
| INTRADISCAL THERAPY | 340 | ||
| FACET JOINT/MEDIAL BRANCH BLOCKS | 340 | ||
| Indications | 340 | ||
| Equipment | 340 | ||
| Technique | 340 | ||
| PERCUTANEOUS VERTEBRAL BIOPSY | 341 | ||
| Indications | 341 | ||
| Contraindications | 341 | ||
| Equipment | 341 | ||
| Patient Preparation | 341 | ||
| Technique | 342 | ||
| Aftercare | 342 | ||
| Complications | 342 | ||
| BONE AUGMENTATION TECHNIQUES | 343 | ||
| NERVE ROOT BLOCKS | 343 | ||
| LUMBAR SPINE | 343 | ||
| CERVICAL SPINE | 344 | ||
| 16 -\rLacrimal system, salivary glands, thyroid and parathyroids | 345 | ||
| Methods of Imaging the NasolacrimalDrainage Apparatus | 345 | ||
| DIGITAL SUBTRACTION AND COMPUTED TOMOGRAPHY DACRYOCYSTOGRAPHY | 345 | ||
| Indications | 345 | ||
| Contraindications | 345 | ||
| Contrast Medium | 345 | ||
| Equipment | 345 | ||
| Images | 346 | ||
| Aftercare | 346 | ||
| Complications | 346 | ||
| References | 346 | ||
| MAGNETIC RESONANCE IMAGING OF LACRIMAL SYSTEM | 346 | ||
| Methods of Imaging the Salivary Glands | 347 | ||
| ULTRASOUND | 347 | ||
| CONVENTIONAL AND DIGITAL SUBTRACTION SIALOGRAPHY | 348 | ||
| Indications | 348 | ||
| Contraindications | 348 | ||
| Contrast Medium | 348 | ||
| Equipment | 348 | ||
| Patient Preparation | 348 | ||
| Preliminary Images\r | 348 | ||
| Parotid gland | 348 | ||
| Submandibular gland | 348 | ||
| Technique | 349 | ||
| Images | 349 | ||
| Aftercare | 349 | ||
| Complications | 349 | ||
| MAGNETIC RESONANCE IMAGING SIALOGRAPHY | 350 | ||
| CONTRAST ENHANCED MAGNETIC RESONANCE IMAGING AND COMPUTED TOMOGRAPHY | 350 | ||
| Methods of Imaging the Thyroid andParathyroid Glands | 350 | ||
| ULTRASOUND OF THYROID | 351 | ||
| Contraindications | 351 | ||
| Patient Preparation | 351 | ||
| Equipment | 351 | ||
| Technique | 351 | ||
| ULTRASOUND OF PARATHYROID | 351 | ||
| COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING OF THYROID AND PARATHYROID | 352 | ||
| 17 -\rBreast | 357 | ||
| METHODS OF IMAGING THE BREAST | 357 | ||
| MAMMOGRAPHY | 357 | ||
| Indications | 357 | ||
| Not Indicated | 357 | ||
| Equipment | 358 | ||
| Technique | 359 | ||
| References | 359 | ||
| Further Reading | 360 | ||
| ULTRASOUND | 360 | ||
| Indications | 360 | ||
| Not Indicated | 360 | ||
| Equipment | 361 | ||
| Technique | 361 | ||
| Additional Technique | 361 | ||
| References | 361 | ||
| Further Reading | 361 | ||
| MAGNETIC RESONANCE IMAGING | 361 | ||
| Indications | 361 | ||
| Technique | 362 | ||
| References | 362 | ||
| Further Reading | 362 | ||
| RADIONUCLIDE IMAGING | 363 | ||
| Intraoperative Sentinel Node Identification | 363 | ||
| Positron Emission Tomography Scanning | 363 | ||
| Reference | 363 | ||
| Further Reading | 363 | ||
| IMAGE-GUIDED BREAST BIOPSY | 363 | ||
| Indications | 363 | ||
| Equipment | 364 | ||
| Patient Preparation | 364 | ||
| Technique | 365 | ||
| Complications | 365 | ||
| PREOPERATIVE LOCALIZATION | 365 | ||
| Equipment | 365 | ||
| Patient Preparation | 366 | ||
| Technique | 366 | ||
| Further Reading | 366 | ||
| 18 -\rRole of the radiographer and the nurse in interventional radiology | 367 | ||
| ROLE OF THE RADIOGRAPHER IN INTERVENTIONAL RADIOLOGY | 367 | ||
| Preprocedural Role | 367 | ||
| In Theatre | 368 | ||
| ROLE OF THE NURSE IN INTERVENTIONAL RADIOLOGY | 370 | ||
| References | 374 | ||
| Further Reading | 374 | ||
| 19 -\rPatient consent | 375 | ||
| INTRODUCTION | 375 | ||
| VOLUNTARINESS | 375 | ||
| INFORMATION | 376 | ||
| Who? | 376 | ||
| When? | 377 | ||
| What? | 377 | ||
| CAPACITY | 378 | ||
| ASSESSMENT OF CAPACITY | 378 | ||
| SUPPORTING PATIENTS IN DECISION MAKING | 379 | ||
| ACTING FOR A PERSON WHO LACKS CAPACITY | 380 | ||
| DOCUMENTING ASSESSMENT OF CAPACITY | 382 | ||
| SHARED DECISION MAKING | 382 | ||
| References | 382 | ||
| 20 -\rSedation and monitoring | 385 | ||
| SEDATION | 385 | ||
| Preparation | 386 | ||
| Equipment | 386 | ||
| Preassessment | 386 | ||
| Analgesic drugs | 387 | ||
| LOCAL ANAESTHESIA | 387 | ||
| INHALATIONAL ANALGESIA | 387 | ||
| INTRAVENOUS ANALGESIA | 387 | ||
| SEDATIVE DRUGS | 389 | ||
| Sedation of Children | 389 | ||
| Complications of Sedation | 391 | ||
| References | 392 | ||
| Further Reading | 392 | ||
| MONITORING | 392 | ||
| Equipment | 393 | ||
| Technique | 393 | ||
| SEDATION AND MONITORING FOR MAGNETIC RESONANCE IMAGING | 394 | ||
| RECOVERY AND DISCHARGE CRITERIA | 394 | ||
| Further Reading | 394 | ||
| 21 -\rMedical emergencies | 395 | ||
| EQUIPMENT | 395 | ||
| RESPIRATORY EMERGENCIES | 397 | ||
| RESPIRATORY DEPRESSION | 397 | ||
| LARYNGOSPASM | 397 | ||
| BRONCHOSPASM | 397 | ||
| ASPIRATION | 398 | ||
| PNEUMOTHORAX | 398 | ||
| CARDIOVASCULAR EMERGENCIES | 399 | ||
| HYPOTENSION | 399 | ||
| TACHYCARDIA | 399 | ||
| BRADYCARDIA | 400 | ||
| ADVERSE DRUG REACTIONS | 400 | ||
| CONTRAST MEDIA REACTION | 400 | ||
| LOCAL ANAESTHETIC TOXICITY | 402 | ||
| I - Average effective dose equivalents for some common examinations | 403 | ||
| II - Dose limits – the Ionising Radiation Regulations 19991 | 405 | ||
| III - The Ionising Radiation (Medical Exposure) Regulations 2000 with the Ionising Radiation (Medical Exposure) (Amendment) Regulations 2006 and the Ionising Radiation (Medical Exposure) (Amendment) Regulations 20111 | 407 | ||
| 1. Commencement | 407 | ||
| 2. Glossary of [some of the] terms | 408 | ||
| 3. These Regulations apply to the following medical exposures | 410 | ||
| 4. Duties of the employer | 410 | ||
| 5. Duties of the practitioner, operator and referrer | 411 | ||
| 6. Justification of Individual Medical Exposures | 412 | ||
| 7. Optimization | 413 | ||
| 8. Clinical audit | 414 | ||
| 9. Expert advice | 415 | ||
| 10. Equipment | 415 | ||
| 11. Training | 415 | ||
| 12. Enforcement | 416 | ||
| 13. Defence of due diligence | 416 | ||
| SCHEDULE 1 | 416 | ||
| SCHEDULE 2 | 417 | ||
| A. Radiation production, radiation protection and statutory obligations relating to ionizing radiations | 417 | ||
| B. Diagnostic radiology, radiotherapy and nuclear medicine | 418 | ||
| Index | 421 | ||
| A | 421 | ||
| B | 422 | ||
| C | 424 | ||
| D | 428 | ||
| E | 428 | ||
| F | 429 | ||
| G | 430 | ||
| H | 431 | ||
| I | 431 | ||
| J | 433 | ||
| K | 433 | ||
| L | 433 | ||
| M | 434 | ||
| N | 437 | ||
| O | 437 | ||
| P | 437 | ||
| R | 439 | ||
| S | 441 | ||
| T | 443 | ||
| U | 444 | ||
| V | 445 | ||
| W | 446 | ||
| X | 446 | ||
| IBC | ES2 |