Indications of MR arthrography What is MR arthrography, and what are its indications? Direct MR arthrography involves the injection of dilute gadolinium-based contrast material into a joint under fluoroscopic guidance followed by MR imaging. This technique is commonly employed in the shoulder and hip to evaluate the labrum and articular cartilage ( Figure 75-1 ). Wrist arthrography …
Common image guided musculoskeletal interventional procedures Musculoskeletal radiology is a subspecialty that encompasses many diagnostic and therapeutic procedures using image guidance. Some common ultrasonography-guided (US-guided) procedures in musculoskeletal radiology include: joint injections, tendon sheath injections, calcific tendinosis lavage, bursal injections, tendon fenestration, and soft tissue biopsy. Fluoroscopy is often used to guide joint injections as …
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What types of nonvascular neurointerventional procedures are available? • Vertebral augmentation: Administration of polymethylmethacrylate in acute compression vertebral fractures for pain relief • Pain injection: Transforaminal or interlaminal epidural corticosteroid injections, facet (zygapophyseal joint) injections, nerve blocks, and synovial cyst fenestration. • Biopsy: Imaging-guided biopsy of the calvarium, head and neck, and spine to assess for malignancy or …
What are the potential complications of neurointerventional procedures? • Ischemic stroke: Related to emboli secondary to dislodged atherosclerotic plaques, air bubbles, catheter-related thrombus, or arterial dissection. • Intracranial hemorrhage. • Access-related vascular injury: Hemorrhage/hematoma, pseudoaneurysm at access site, or thromboembolic complications. • Infection. • Drug reaction (to any administered medications including iodinated contrast material). • Radiation injury.
What types of vascular neurointerventional procedures are available? Diagnostic Testing • Cerebral catheter angiography: Assessment for cerebral aneurysm, stenosis (atherosclerosis or vasculitis/vasculopathy), or vascular malformation. • Cervical catheter angiography: Assessment for carotid artery stenosis or traumatic cervical vascular injury. • Inferior petrosal sinus sampling: Measurement of adrenocorticotropic hormone (ACTH) levels from the pituitary gland in selected patients with …
What are the indications and contraindications for cerebral and spinal catheter angiography? Indications for Cerebral Catheter Angiography • Cerebral artery aneurysm. • Subarachnoid hemorrhage. • Vasospasm. • Cerebral vascular malformation. • Intraparenchymal hemorrhage or intraventricular hemorrhage with suspicion for cerebral vascular malformation. • Acute ischemic stroke. • Vasculitis/vasculopathy. • Severe intracranial/extracranial vascular stenosis. • Traumatic cervical/cerebral vascular injury. • Severe epistaxis. Indications for Spinal Catheter …
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What is the basic normal arterial anatomy of the spinal cord? The spinal cord is supplied by the anterior spinal artery (ASA) and the paired posterior spinal arteries (PSA). The ASA arises from the intradural segments of the vertebral arteries and supplies the anterior two thirds of the spinal cord. The ASA receives additional contribution …