Chapman & Nakielny's Guide to Radiological Procedures : Chapman & Nakielny's Guide to Radiological Procedures E-Book

Chapman and Nakielny’s Guide to Radiological Procedures has become the classic, concise guide to the common procedures in imaging on which a radiology trainee will be expected to be familiar. Now fully revised and updated in line with current practice, it will also prove invaluable to the wider clinical team that now delivers modern imaging services, including radiographers and radiology nurses, as well as a handy refresher for radiologists at all levels. The highly accessible format has been retained, with every technique described under a set of standard headings, making it ideal for quick reference and exam preparation. \* Comprehensively reviewed and updated throughout – incorporating the very latest techniques, clinical practice developments and key recent national and international guidelines \* New chapter on the important roles of the radiographer and nurse in procedural radiology – reflecting the delivery of modern radiological practice by multi-professional teams \* New chapter on ablative therapies – outlining the various radiological techniques and indications for non-surgical treatment of tumours \* Complementary access to the complete, enhanced eBook version - including new, interactive MCQs to check understanding and aid those preparing for the FRCR and similar examinations Previous edition review comments: "The book provides a comprehensive and well-referenced guide to a wide range of imaging techniques and the imaging modalities employed...Overall, an excellent book... " Rad Magazine \* Comprehensively reviewed and updated throughout – incorporating the very latest techniques, clinical practice developments and key recent national and international guidelines \* New chapter on the important roles of the radiographer and nurse in procedural radiology – reflecting the delivery of modern radiological practice by multi-professional teams \* New chapter on ablative therapies – outlining the various radiological techniques and indications for non-surgical treatment of tumours \* Complementary access to the complete, enhanced eBook version - including new, interactive MCQs to check understanding and aid those preparing for the FRCR and similar examinations Front Cover GUIDE TORADIOLOGICAL PROCEDURES GUIDE TORADIOLOGICAL PROCEDURES Copyright Contents Preface Acknowledgements List of contributors 1 - General notes RADIOLOGY Methods Indications Contraindications Risk due to radiation Risk due to the contrast medium Risks due to the technique Contrast Medium Equipment Patient preparation Preliminary Images Technique Images Additional Techniques or Modifications of Technique Aftercare Complications Due to the anaesthetic Due to the contrast medium Due to the technique RADIONUCLIDE IMAGING RADIOPHARMACEUTICALS Radioactive Injections Activity Administered Equipment Technique Patient positioning Images Aftercare Radiation safety Complications COMPUTED TOMOGRAPHY Patient Preparation Intravenous Contrast Medium Oral Contrast Medium Pelvic Scanning Computed Tomography Colonography MAGNETIC RESONANCE IMAGING Patient Preparation SAFETY IN MAGNETIC RESONANCE IMAGING Effects Due to Magnetic Fields Static field Biological effects Nonbiological effects Gradient field Biological effects Nonbiological effects Radiofrequency field Noise Inert Gas Quench Intravenous Contrast Medium Recommendations for Safety Controlled and restricted access Implants Pregnancy ULTRASONOGRAPHY Patient Preparation Abdomen Pelvis Endoscopic Children 2 - Intravascular contrast media HISTORICAL DEVELOPMENT OF RADIOGRAPHIC AGENTS ADVERSE EFFECTS OF INTRAVENOUS WATER-SOLUBLE CONTRAST MEDIA TOXIC EFFECTS ON SPECIFIC ORGANS Venous Arterial Soft-Tissue Toxicity Cardiovascular Toxicity Nephrotoxicity Thyroid Function IDIOSYNCRATIC REACTIONS Fatal Reactions Nonfatal Reactions MECHANISMS OF IDIOSYNCRATIC CONTRAST MEDIUM REACTIONS PROPHYLAXIS OF ADVERSE CONTRAST MEDIUM EFFECTS Iodinated Contrast in Pregnancy and Lactation CONTRAST AGENTS IN MAGNETIC RESONANCE IMAGING HISTORICAL DEVELOPMENT MECHANISM OF ACTION GADOLINIUM Dose Adverse Reactions Acute adverse reactions Delayed adverse reactions Precautions for prevention of adverse reactions Acute adverse reactions Delayed adverse reactions GASTROINTESTINAL CONTRAST AGENTS Positive Agents Negative Agents Magnetic Resonance Imaging Contrast Agents in Pregnancy and Lactation CONTRAST AGENTS IN ULTRASONOGRAPHY 3 - Gastrointestinal tract Introduction to Contrast Media Water-Soluble Contrast Agents Indications Complications Gases Barium Advantages Disadvantages Complications Pharmacological Agents Hyoscine-N-Butylbromide (Buscopan) Indications Adult dose Advantages Side effects Contraindications Aftercare Glucagon Indications Adult dose Advantages Side effects Contraindications Aftercare Metoclopramide (Maxolon)3 Indications Adult dose Advantages Side effects Contraindications Aftercare Contrast Swallow Indications: Suspected Oesophageal Pathology Contraindications Contrast Medium Equipment Patient Preparation Technique Aftercare Complications Barium Meal Methods Indications Contraindications Contrast Medium Patient Preparation Preliminary Image Technique Images Modification of Technique for Young Children Aftercare Complications Small Bowel Follow-Through Methods Indications Contraindications Contrast Medium Patient Preparation Preliminary Image Technique Images Additional Images Aftercare Complications Small-Bowel Enema Advantage Disadvantages Indications and Contraindications Contrast Medium Equipment Patient Preparation Preliminary Image Technique Images Modification of Technique Aftercare Complications Barium Enema Methods Indication Contraindications Absolute Relative Contrast Medium Equipment Patient Preparation For 3 days prior to examination On the day prior to examination On the day of the examination Technique Exposures Aftercare Antibiotic Prophylaxis in Barium Enema5 Complications (All Are Rare) Enema Variants The ‘Instant’ Enema Indications Contraindications Contrast Medium Preliminary Image Technique Images Air Enema Indications Technique Reduction of an Intussusception Methods Contraindications Patient Preparation Preliminary Investigations Contrast Medium Technique Pneumatic reduction Ultrasound reduction10 Barium reduction (no longer recommended) Images Aftercare Complications Contrast Enema in Neonatal Low Intestinal Obstruction Contraindications Patient Preparation Contrast Medium Technique Sinogram Retrograde Ileogram Indications Technique Colostomy Enema Indications Technique Loopogram Indications Contrast Technique Images Herniogram Indications Contraindications Patient Preparation Contrast Medium Technique Images Complications Evacuating Proctogram Indications Contraindications Contrast Medium Technique Films Coeliac Axis, Superior Mesenteric and Inferior Mesenteric Arteriography Indications Contrast Medium Equipment Technique Coeliac axis Superior mesenteric artery Late-phase visceral arteriography Inferior mesenteric artery Ultrasound of the Gastrointestinal Tract Indications Equipment Patient Preparation Technique Aftercare Transabdominal Examination of the Lower Oesophagus and Stomach Indications Hypertrophic Pyloric Stenosis Equipment Technique Small Bowel Indications Technique Appendix Indications Equipment Patient Preparation Technique Large Bowel Indications Endoluminal Examination of the Anus Indications Patient Preparation Equipment Technique Aftercare Endoluminal Examination of the Rectum Indications Patient Preparation Equipment Technique Computed Tomography of the Gastrointestinal Tract Indications Intraluminal Contrast Agents Intravenous Contrast Bolus timing Computed Tomographic Colonography Indications Bowel Preparation Technique Complications Aftercare Magnetic Resonance Imaging of the Gastrointestinal Tract Indications Contraindications Contrast Agents Motion Artefacts Pulse Sequences Techniques Suspected perianal fistula Local staging of anorectal cancer Small-bowel magnetic resonance enteroclysis Small-bowel magnetic resonance enterography Radionuclide Gastro-Oesophageal Reflux Study Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Physiological test1: adults and older children Milk scan1: infants and younger children Provocation with abdominal compression2: adults and older children Analysis Additional Technique: Oesophageal Transit Aftercare Complications Radionuclide Gastric-Emptying Study Indications Contraindication Radiopharmaceuticals Equipment Patient Preparation Technique Analysis Additional Techniques Aftercare Complications Radionuclide Meckel’s Diverticulum Scan Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Aftercare Complications Radionuclide Imaging of Gastrointestinal Bleeding Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Aftercare Complications Alternative Investigative Imaging Modalities Labelled White Cell Scanning in Inflammatory Bowel Disease 4 - Liver, biliary tract and pancreas METHODS OF IMAGING THE HEPATOBILIARY SYSTEM METHODS OF IMAGING THE PANCREAS PLAIN FILMS ULTRASOUND OF THE LIVER Indications Contraindications Patient Preparation Equipment Technique Additional Views Hepatic veins Portal vein Hepatic artery Common bile duct Spleen ULTRASOUND OF THE GALLBLADDER AND BILIARY SYSTEM Indications Contraindications Patient Preparation Equipment Technique Additional Views Assessment of gallbladder function Intrahepatic bile ducts Extrahepatic bile ducts Postcholecystectomy ULTRASOUND OF THE PANCREAS Indications Contraindications Patient Preparation Equipment Technique COMPUTED TOMOGRAPHY OF THE LIVER AND BILIARY TREE Indications Contraindications Technique Single-phase (portal phase) contrast-enhanced computed tomography Multiphasic contrast-enhanced computed tomography COMPUTED TOMOGRAPHIC CHOLANGIOGRAPHY Contraindications Indications Technique COMPUTED TOMOGRAPHY OF THE PANCREAS Indications Contraindications Technique MAGNETIC RESONANCE IMAGING OF THE LIVER Indications Magnetic Resonance Imaging Pulse Sequences Diffusion Weighted Imaging Contrast-enhanced Magnetic Resonance Liver Imaging Gadolinium-enhanced T1-weighted magnetic resonance imaging Liver-specific contrast agents Magnetic resonance angiography MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY Indications Contraindications Technique MAGNETIC RESONANCE IMAGING OF THE PANCREAS Indications Technique ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY Indications Contraindications Contrast Medium Pancreas Bile Ducts Equipment Patient Preparation Preliminary Image Technique Images Pancreas (using fine focal spot) Bile ducts Aftercare Complications Due to the contrast medium Due to the technique Local Distant INTRAOPERATIVE CHOLANGIOGRAPHY Indications Contraindications Contrast Medium Equipment Patient Preparation Technique Images POSTOPERATIVE (T-TUBE) CHOLANGIOGRAPHY Indications Contraindications Contrast Medium Equipment Patient Preparation Preliminary Image Technique Images Aftercare Complications Due to the contrast medium Due to the technique PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY Indications Contraindications Contrast Medium Equipment Patient Preparation Preliminary Imaging Technique Images Delayed Images Aftercare Complications Due to the contrast medium Due to the technique Local Generalized INTERNAL BILIARY DRAINAGE Indications Contraindications Contrast Media Equipment Patient Preparation Technique Transhepatic Endoscopic Aftercare Complications PERCUTANEOUS EXTRACTION OF RETAINED BILIARY CALCULI (BURHENNE TECHNIQUE) Indications Contraindications Contrast Medium Equipment Patient Preparation Technique Aftercare Complications Due to the contrast medium Due to the technique ANGIOGRAPHY COELIAC AXIS, SUPERIOR MESENTERIC AND INFERIOR MESENTERIC ARTERIOGRAPHY Indications Contrast Medium Equipment Technique Coeliac axis Superior mesenteric artery Late-phase visceral arteriography Inferior mesenteric artery RADIONUCLIDE IMAGING OF LIVER AND SPLEEN Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Aftercare Complications Alternative Investigative Imaging Modalities RADIONUCLIDE HEPATOBILIARY AND GALLBLADDER RADIONUCLIDE IMAGING Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Images Additional Techniques Cholecystokinin and morphine provocation Quantitative analysis Aftercare Complications INVESTIGATION OF SPECIFIC CLINICAL PROBLEMS THE INVESTIGATION OF LIVER TUMOURS Investigation Ultrasound Computed Tomography Magnetic Resonance Imaging THE INVESTIGATION OF JAUNDICE Investigations Obstructive jaundice Nonobstructive jaundice THE INVESTIGATION OF PANCREATITIS PANCREATIC PSEUDOCYSTS 5 - Urinary tract PLAIN FILM RADIOGRAPHY Indications Technique INTRAVENOUS EXCRETION UROGRAPHY Indications Contraindications Contrast Medium Adult dose Paediatric dose Patient Preparation Preliminary Images Technique Images Additional Images Variation ULTRASOUND OF THE URINARY TRACT Indications Contraindications Patient Preparation Equipment Technique COMPUTED TOMOGRAPHY OF THE URINARY TRACT Indications Techniques Standard diagnostic computed tomography Renal lesion characterization computed tomography Adrenal lesion characterization computed tomography Computed tomography kidneys, ureters, bladder Computed tomography urogram (CTU) Variations Computed tomography angiography Indications Technique MAGNETIC RESONANCE IMAGING OF THE URINARY TRACT Technique MAGNETIC RESONANCE IMAGING OF THE PROSTATE Technique/Example Protocol MAGNETIC RESONANCE UROGRAPHY Indications Technique MAGNETIC RESONANCE IMAGING OF THE ADRENALS Indications Technique MAGNETIC RESONANCE RENAL ANGIOGRAPHY MICTURATING CYSTOURETHROGRAPHY Indications Contraindications Contrast Medium Equipment Patient Preparation Preliminary Image Technique Aftercare Complications ASCENDING URETHROGRAPHY IN THE MALE Indications Contraindications Contrast Medium Equipment Patient Preparation Preliminary Image Technique Aftercare Complications Due to the Technique RETROGRADE PYELOURETEROGRAPHY Indications Contraindications Contrast Medium Equipment Patient Preparation Preliminary Image Technique In the operating theatre In the x-ray department Aftercare Complications CONDUITOGRAM Indications Contrast Technique PERCUTANEOUS RENAL CYST PUNCTURE AND BIOPSY Indications Contraindications Equipment Patient Preparation Technique Complications PERCUTANEOUS ANTEGRADE PYELOGRAPHY AND NEPHROSTOMY Indications Contraindications Contrast Medium Equipment Patient Preparation Technique Patient position Identifying the collecting system prior to the definitive procedure Site/plane of puncture Techniques of puncture and catheterization Aftercare Complications PERCUTANEOUS NEPHROLITHOTOMY Indications Contraindications Contrast Medium Equipment Patient Preparation Technique Patient position Methods of opacification of the collecting system Puncture of the collecting system Dilatation Removal/disintegration Aftercare Complications Immediate Delayed RENAL ARTERIOGRAPHY Indications Contrast medium Flush aortic Selective renal artery injection Equipment Technique Femoral artery puncture STATIC RENAL RADIONUCLIDE SCINTIGRAPHY Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Images Analysis Additional Techniques Aftercare Complications DYNAMIC RENAL RADIONUCLIDE SCINTIGRAPHY Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Images Analysis Additional techniques Aftercare Complications DIRECT RADIONUCLIDE MICTURATING CYSTOGRAPHY Indications Contraindications Radiopharmaceuticals Equipment Technique Aftercare Complications Alternative 6 - Image guided ablation techniques for cancer treatment TYPES OF ABLATIVE TECHNOLOGY RADIOFREQUENCY ABLATION Background Information Indications Contraindications Patient Preparation Equipment Imaging Guidance Technique Postprocedural Care/Imaging/Follow-Up MICROWAVE ABLATION Background Information Indications Contraindications Patient Preparation Equipment Imaging Guidance Technique Postprocedural Care/Imaging/Follow-Up CRYOABLATION Background Information Indications Contraindications Patient Preparation Equipment Imaging Guidance Technique Postprocedural Care/Imaging/Follow-Up IRREVERSIBLE ELECTROPORATION Background Information Indications Contraindications Patient Preparation Equipment Imaging Guidance Technique Postprocedural Care/Imaging/Follow-Up KEY CHALLENGES 7 - Reproductive system Methods of Imaging in the Female Reproductive System Methods of Imaging the Male Reproductive System (Scrotum and Testes) HYSTEROSALPINGOGRAPHY Indications Contraindications Contrast Medium Equipment Patient Preparation Technique Images Aftercare Complications Due to the contrast medium Due to the technique ULTRASOUND OF THE FEMALE REPRODUCTIVE SYSTEM Indications Contraindications Patient Preparation Equipment Reporting Gynaecological Ultrasound Contrast Medium ULTRASOUND OF THE SCROTUM Indications Contraindications Patient Preparation Equipment Technique COMPUTERIZED TOMOGRAPHY OF THE REPRODUCTIVE SYSTEM Indications Technique MAGNETIC RESONANCE IMAGING OF THE REPRODUCTIVE SYSTEM Indications Artifacts Pulse Sequences Scrotal Magnetic Resonance GYNAECOLOGICAL MALIGNANCY CERVICAL CANCER Staging Magnetic Resonance Imaging Sequences Follow-Up UTERINE CARCINOMA Magnetic Resonance Imaging Staging Follow-Up OVARIAN CANCER OMENTAL BIOPSY Patient Preparation Technique Aftercare PET COMPUTERIZED TOMOGRAPHY UTERINE ARTERY EMBOLIZATION Clinical Indications Contraindications Consent, Counselling and Communication Procedure Complications Follow-Up 8 - Respiratory system Methods of Imaging the Respiratory System COMPUTED TOMOGRAPHY OF THE THORAX Indications Contraindications Technique COMPUTED TOMOGRAPHY-GUIDED LUNG BIOPSY Indications Contraindications Equipment Patient Preparation Technique Aftercare Complications2–4 METHODS OF IMAGING PULMONARY EMBOLISM RADIONUCLIDE LUNG VENTILATION/PERFUSION IMAGING Indications Contraindications (To Perfusion Imaging) Radiopharmaceuticals Perfusion Ventilation Equipment Patient Preparation Technique Perfusion Ventilation 81mKr gas 99mTc-DTPA aerosol Images Additional Techniques Aftercare Complications COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF PULMONARY EMBOLI Technique Computed Tomography Pulmonary Angiography—Enhanced Scan of Pulmonary Arterial System1 PULMONARY ARTERIOGRAPHY Indications Contraindications1 Contrast Medium Equipment Technique Additional Techniques Complications MAGNETIC RESONANCE OF PULMONARY EMBOLI Technique MAGNETIC RESONANCE IMAGING OF THE RESPIRATORY SYSTEM PET AND PET-CT OF THE RESPIRATORY SYSTEM 9 - Heart ANGIOCARDIOGRAPHY Indications Contrast Medium Equipment Technique Image Acquisition CORONARY ARTERIOGRAPHY Indications Contrast Medium Equipment Patient Preparation Preliminary Image Technique Image Acquisition Complications CARDIAC COMPUTED TOMOGRAPHY Indications Contraindications Patient Preparation Beta-Blockers Nitrates Technique Scan Protocol Plain computed tomography heart Contrast-Enhanced Cardiac Scan Contrast administration Retrospective scan Prospective scan Single-beat acquisition CARDIAC MAGNETIC RESONANCE Indications Contraindications Relative Contraindications Patient Preparation Technique Localizer images Thoracic overview, cardiac morphology Functional imaging Tissue characterization Myocardial perfusion Dobutamine stress imaging Early gadolinium enhancement Late gadolinium enhancement Flow quantification Magnetic resonance angiography RADIONUCLIDE VENTRICULOGRAPHY Indications Gated blood-pool study1 Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Images Analysis Additional Techniques Aftercare Complications RADIONUCLIDE MYOCARDIAL PERFUSION IMAGING Indications Contraindications Radiopharmaceuticals1,2 Equipment Patient Preparation Technique Stress regimen 99mTc-MIBI or tetrofosmin rest/stress test 2-Day protocol (stress/rest) 1-Day protocol (stress/rest) 201Tl stress/rest test Images Single photon emission computed tomography Analysis12 Additional Techniques Aftercare Complications 10 - Arterial system NONINVASIVE IMAGING VASCULAR ULTRASOUND COMPUTED TOMOGRAPHIC ANGIOGRAPHY PERIPHERAL (LOWER LIMB) COMPUTED TOMOGRAPHIC ANGIOGRAPHY Indications Patient Preparation Technique Aftercare and Complications MAGNETIC RESONANCE ANGIOGRAPHY VASCULAR ACCESS Patient Preparation Equipment for Vascular Access Ultrasound Needle Guidewires Vascular Sheaths Catheters Taps and Connectors Relative Contraindications Technique (Fig. 10.2) Aftercare GENERAL COMPLICATIONS OF CATHETER TECHNIQUES Due to the Anaesthetic Due to the Contrast Medium Due to the Technique Local Distant ANGIOGRAPHY Indications Equipment Patient Preparation Technique Aftercare Complications ANGIOPLASTY Indications Equipment Patient Preparation Technique Aftercare Complications STENTS Indications Equipment Patient Preparation Technique Aftercare Complication CATHETER-DIRECTED ARTERIAL THROMBOLYSIS Indications Contraindications Patient Preparation Equipment Technique Aftercare Complications VASCULAR EMBOLIZATION Indications Equipment Patient Preparation Technique Principles Aftercare Complications THORACIC AND ABDOMINAL AORTIC STENT GRAFTS Indications Equipment Preparation Principles Aftercare Complications 11 - Venous system ULTRASOUND Duplex Colour Doppler LOWER LIMB VENOUS ULTRASOUND Indications Equipment Technique UPPER LIMB VENOUS ULTRASOUND Indications Equipment Technique COMPUTED TOMOGRAPHY MAGNETIC RESONANCE PERIPHERAL VENOGRAPHY LOWER LIMB Method Indications Contraindications Contrast Medium Equipment Patient Preparation Technique Images Aftercare Complications Due to the contrast medium Due to the technique UPPER LIMB Method Indications Contrast Medium Equipment Patient Preparation Technique Aftercare Complications Due to the contrast medium CENTRAL VENOGRAPHY Indications Contrast Medium Equipment Patient Preparation Technique Images Aftercare Complications Due to the contrast medium INFERIOR VENA CAVOGRAPHY Indications Contrast Medium Technique Aftercare Complications Due to the contrast medium Due to the technique PORTAL VENOGRAPHY Methods Indications Contrast Medium Equipment Patient Preparation Technique Superior mesenteric angiography For trans-splenic approach Images Aftercare Complications Due to the contrast medium Due to the technique Due to the catheter TRANSHEPATIC PORTAL VENOUS CATHETERIZATION Indications Contraindications Contrast Medium Technique VENOUS INTERVENTIONS VENOUS ANGIOPLASTY AND STENTS Indications Patient Preparation Equipment Technique Aftercare Complications Indications GONADAL VEIN EMBOLIZATION Patient Preparation Equipment Technique Aftercare Complications INFERIOR VENA CAVA FILTERS Indications Patient Preparation Equipment Technique Aftercare Complications THROMBOLYSIS Indications Patient Preparation Equipment Technique1 Aftercare Complications PULMONARY EMBOLISM Indications Patient Preparation Equipment Technique Aftercare Complications 12 - Radionuclide imaging in oncology and infection POSITRON EMISSION TOMOGRAPHY IMAGING 2-[18F]FLUORO-2-DEOXY-D-GLUCOSE POSITRON EMISSION TOMOGRAPHY SCANNING Indications (Oncology) General Specific Contraindications Patient Preparation Technique Other Applications Coronary artery disease Neurology Imaging of Infection and Inflammation OTHER PET RADIOPHARMACEUTICALS 18F-CHOLINE Technique 18F-FLUORIDE 68GALLIUM-LABELLED PHARMACEUTICALS 67GALLIUM RADIONUCLIDE TUMOUR IMAGING RADIOIODINE METAIODOBENZYLGUANIDINE SCAN Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Images Additional Techniques Aftercare Complications SOMATOSTATIN RECEPTOR IMAGING Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Additional Techniques Aftercare Complications LYMPH NODE AND LYMPHATIC CHANNEL IMAGING RADIOGRAPHY ULTRASOUND Advantages Disadvantages COMPUTED TOMOGRAPHY Advantages Disadvantages MAGNETIC RESONANCE IMAGING Advantages Disadvantages RADIOGRAPHIC LYMPHANGIOGRAPHY RADIONUCLIDE LYMPHOSCINTIGRAPHY Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Analysis Aftercare Complications Other Techniques—Magnetic Resonance Lymphangiography5 RADIONUCLIDE IMAGING OF INFECTION AND INFLAMMATION Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Additional Techniques Aftercare Complications 13 - Bones and joints Imaging Modalities MUSCULOSKELETAL MAGNETIC RESONANCE IMAGING—GENERAL POINTS ARTHROGRAPHY—GENERAL POINTS ARTHROGRAPHY Indications Contraindications Contrast Medium Conventional/computed tomography arthrography Magnetic resonance arthrography Equipment Patient Preparation Preliminary Images Radiographic Views Aftercare Complications Due to the contrast medium Due to the technique Other ARTHROGRAPHY—SITE-SPECIFIC ISSUES KNEE Fluoroscopic Technique HIP Fluoroscopic Technique Ultrasound Technique Radiographic Views in the Paediatric Hip Arthrogram SHOULDER Technique Anterior (fluoroscopic guided) Posterior (fluoroscopic guided) Posterior (ultrasound guided) ELBOW Technique Single contrast Double contrast WRIST Technique Radiocarpal joint Midcarpal joint ANKLE Technique TENDON IMAGING Methods of Imaging Tendons GENERAL POINTS ULTRASOUND OF THE PAEDIATRIC HIP Indications Technique Developmental dysplasia of the hip Static (Graf) method Dynamic method Hip-joint effusion Slipped femoral capital epiphysis THERMOABLATION OF MUSCULOSKELETAL TUMOURS Introduction Thermocoagulation Indications Rationale Contraindications Equipment Procedure Biopsy Thermoablation Post Radiofrequency Ablation Care Complications RADIONUCLIDE BONE SCAN Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Images Standard Three-phase Analysis Additional Techniques Aftercare Complications Competing modalities 14 - Brain Methods of Imaging the Brain COMPUTED TOMOGRAPHY OF THE BRAIN Indications Technique MAGNETIC RESONANCE IMAGING OF THE BRAIN Indications Technique IMAGING OF INTRACRANIAL HAEMORRHAGE COMPUTED TOMOGRAPHY MAGNETIC RESONANCE IMAGING IMAGING OF GLIOMAS COMPUTED TOMOGRAPHY MAGNETIC RESONANCE IMAGING IMAGING OF ACOUSTIC NEUROMAS COMPUTED TOMOGRAPHY MAGNETIC RESONANCE IMAGING RADIONUCLIDE IMAGING OF THE BRAIN CONVENTIONAL RADIONUCLIDE BRAIN SCANNING (BLOOD–BRAIN BARRIER IMAGING) REGIONAL CEREBRAL BLOOD FLOW IMAGING Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Images Analysis Additional Techniques Aftercare Complications POSITRON EMISSION TOMOGRAPHY Indications Contraindications Radiopharmaceuticals Patient Preparation Technique 201THALLIUM BRAIN SCANNING Indications Contraindications Radiopharmaceutical Equipment Technique Analysis Aftercare DOPAMINE TRANSPORTER LIGANDS Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Images Analysis Aftercare ULTRASOUND OF THE INFANT BRAIN Indications Equipment Patient Preparation Methods Technique Coronal Sagittal CEREBRAL ANGIOGRAPHY Indications Contraindications Equipment Preparation Technique Contrast Medium Contrast Medium Volume Projections Films Aftercare 15 - Spine Methods of Imaging the Spine IMAGING APPROACH TO BACK PAINAND SCIATICA CONVENTIONAL RADIOGRAPHY COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING OF THE SPINE MYELOGRAPHY CONTRAST MEDIA CERVICAL MYELOGRAPHY Indications Lateral Cervical C1/2 Puncture Versus Lumbar Injection Contrast Medium Equipment Patient Preparation Technique Radiographic Views Aftercare LUMBAR MYELOGRAPHY Indications Contraindications Contrast Medium Equipment Patient Preparation Preliminary Images Technique Radiographic Views Additional Technique THORACIC MYELOGRAPHY CERVICAL MYELOGRAPHY BY LUMBAR INJECTION COMPUTED TOMOGRAPHY MYELOGRAPHY PAEDIATRIC MYELOGRAPHY Aftercare Complications LUMBAR DISCOGRAPHY Aims Indications Contraindications Contrast Medium Equipment Patient Preparation Preliminary Radiographs Technique Radiographic Views Computed Tomography Postdiscogram Patient Interrogation Aftercare Complications INTRADISCAL THERAPY FACET JOINT/MEDIAL BRANCH BLOCKS Indications Equipment Technique PERCUTANEOUS VERTEBRAL BIOPSY Indications Contraindications Equipment Patient Preparation Technique Aftercare Complications BONE AUGMENTATION TECHNIQUES NERVE ROOT BLOCKS LUMBAR SPINE CERVICAL SPINE 16 - Lacrimal system, salivary glands, thyroid and parathyroids Methods of Imaging the NasolacrimalDrainage Apparatus DIGITAL SUBTRACTION AND COMPUTED TOMOGRAPHY DACRYOCYSTOGRAPHY Indications Contraindications Contrast Medium Equipment Images Aftercare Complications References MAGNETIC RESONANCE IMAGING OF LACRIMAL SYSTEM Methods of Imaging the Salivary Glands ULTRASOUND CONVENTIONAL AND DIGITAL SUBTRACTION SIALOGRAPHY Indications Contraindications Contrast Medium Equipment Patient Preparation Preliminary Images Parotid gland Submandibular gland Technique Images Aftercare Complications MAGNETIC RESONANCE IMAGING SIALOGRAPHY CONTRAST ENHANCED MAGNETIC RESONANCE IMAGING AND COMPUTED TOMOGRAPHY Methods of Imaging the Thyroid andParathyroid Glands ULTRASOUND OF THYROID Contraindications Patient Preparation Equipment Technique ULTRASOUND OF PARATHYROID COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING OF THYROID AND PARATHYROID Indications RADIONUCLIDE THYROID IMAGING Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Images Analysis Additional Techniques Aftercare Complications Other Techniques RADIONUCLIDE PARATHYROID IMAGING Indications Contraindications Radiopharmaceuticals Equipment Patient Preparation Technique Additional Techniques Aftercare Complications 17 - Breast METHODS OF IMAGING THE BREAST MAMMOGRAPHY Indications Not Indicated Equipment Technique References Further Reading ULTRASOUND Indications Not Indicated Equipment Technique Additional Technique References Further Reading MAGNETIC RESONANCE IMAGING Indications Technique References Further Reading RADIONUCLIDE IMAGING Intraoperative Sentinel Node Identification Positron Emission Tomography Scanning Reference Further Reading IMAGE-GUIDED BREAST BIOPSY Indications Equipment Patient Preparation Technique Complications PREOPERATIVE LOCALIZATION Equipment Patient Preparation Technique Further Reading 18 - Role of the radiographer and the nurse in interventional radiology ROLE OF THE RADIOGRAPHER IN INTERVENTIONAL RADIOLOGY Preprocedural Role In Theatre ROLE OF THE NURSE IN INTERVENTIONAL RADIOLOGY References Further Reading 19 - Patient consent INTRODUCTION VOLUNTARINESS INFORMATION Who? When? What? CAPACITY ASSESSMENT OF CAPACITY SUPPORTING PATIENTS IN DECISION MAKING ACTING FOR A PERSON WHO LACKS CAPACITY DOCUMENTING ASSESSMENT OF CAPACITY SHARED DECISION MAKING References 20 - Sedation and monitoring SEDATION Preparation Equipment Preassessment Analgesic drugs LOCAL ANAESTHESIA INHALATIONAL ANALGESIA INTRAVENOUS ANALGESIA SEDATIVE DRUGS Sedation of Children Complications of Sedation References Further Reading MONITORING Equipment Technique SEDATION AND MONITORING FOR MAGNETIC RESONANCE IMAGING RECOVERY AND DISCHARGE CRITERIA Further Reading 21 - Medical emergencies EQUIPMENT RESPIRATORY EMERGENCIES RESPIRATORY DEPRESSION LARYNGOSPASM BRONCHOSPASM ASPIRATION PNEUMOTHORAX CARDIOVASCULAR EMERGENCIES HYPOTENSION TACHYCARDIA BRADYCARDIA ADVERSE DRUG REACTIONS CONTRAST MEDIA REACTION LOCAL ANAESTHETIC TOXICITY I - Average effective dose equivalents for some common examinations II - Dose limits – the Ionising Radiation Regulations 19991 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 1. Commencement 2. Glossary of [some of the] terms 3. These Regulations apply to the following medical exposures 4. Duties of the employer 5. Duties of the practitioner, operator and referrer 6. Justification of Individual Medical Exposures 7. Optimization 8. Clinical audit 9. Expert advice 10. Equipment 11. Training 1