HMI205 Image Test

good thing about hitting rock bottom: only direction left is up

what type of C-arm?

bi-plane

what type of C-arm?

floor-mounted single-plane

what type of C-arm?

ceiling-mounted single-plane

name of the common technique used for vascular access

seldinger technique

most common access sites for Seldinger technique vascular access

femoral arteries and radial arteries

label 1

inguinal ligament

label 2

inferior epigastric artery

label 3

common femoral artery

label 4

deep femoral artery

label 5

superficial femoral artery

label 6

ideal access window (inferior to inguinal ligament, superior to common femoral artery bifurcation

type of flow

retrograde (going against normal blood flow)

type of flow

antegrade (going with normal blood flow

type of guidewire

spinal guidewire

type of guidewire

cobra

type of guidewire

headhunter guidewire

type of guidewire

angled guidewire

type of catheter

pigtail (top)
modified pigtail (bottom)

what piece of equipment is this and its function?

vascular sheath

maintains vascular access open, enables convenient exchange of catheters

label 1

sheath

label 2 + function

dilator

allows a smooth, tapered transition from the guidewire to the sheath entry, prevents trauma

label 3 + function

side tube

allows injections such as heparinised saline (prevent blood clots) or contrast dye for procedures

label 4

3-way stopper

type of catheter

flush catheters used for large vessel angiography

side perforations allow for more contrast infusion to fill vessel efficiently

type of catheter

selective catheters used for specific vessels with particular shapes/curves

type of catheter

reverse-curve catheters for vessels with a secondary or tertiary curve

type of catheter

infusion catheter

side perforations allow for efficient medication administration

e.g. disperse clotting medication through length of clot

function of a cutting balloon catheter

blades can be used to cut atherosclerotic stenoses of vessels as balloon is dilated and passed through

type of catheter + function

drainage catheter (most commonly pigtail)

draining abscesses, nephrostomy

equipment + function

contrast pressure injector

deliver high volume of contrast quickly at high pressure
control rate and volume of injection

has heating device surrounding syringes to prevent reduce viscosity

program multiple phases and saline combinations

what modality of angio?

Digital Subtraction Angiography (DSA)

what modality of angio?

Computed Tomography Angiography (CTA)

what modality of angio?

Magnetic Resonance Angiography (MRA)

label 1

coeliac trunk

label 2

common hepatic artery

label 3

abdominal aorta

label 4

right renal artery

label 5

superior mesenteric artery

label 6

left gastric artery

label 7

splenic artery

label 8

left renal artery

label 9

inferior mesenteric artery

label 10

left common iliac artery

label 11

left internal iliac artery

label 12

left external iliac artery

label 1

abdominal aorta

label 2

splenic artery

label 3

left gastric artery

label 4

left inferior phrenic artery

label 5

common hepatic artery

label 6

right inferior phrenic artery

label 7

left renal artery

label 8

superior mesenteric artery

label 9

right renal artery

label 10

gastroduodenal artery

label 11

(jejunal branches) of superior mesenteric artery

label 12

ileocolic artery

label 13

inferior mesenteric artery

label 14

median sacral artery

label 15

left common iliac artery

label 16

left external iliac artery

label 17

left internal iliac artery

label 18

right common iliac artery

label 19

right external iliac artery

label 20

right internal iliac artery

what type of DSA artefact is this and why is it present?

Misregistration

Patient moved between mask image and contrast run

Fixes for misregistration

• Re-masking (post-contrast image is taken and used as mask image)

• Proper patient immobilisation and re-imaging

• Pixel shift (manual movement of mask relative to contrast run, works sometimes when movement is slight)

• Spatial enhancement

what type of DSA artefact is this?

Metal masking artefact due to tooth filling superimposing and obscuring vessel pathway

Landmarking in DSA

A small fraction of the live image is subtracted instead of entirety, leaving some bony/soft tissue landmarks visible

Roadmapping in DSA

• DSA done and frame with maximum vessel opacification used as mask image.

• Mask subtracted from live, leaves static image of vessels under live image, providing guide.

type of interventional technique?

balloon angioplasty

type of interventional technique?

balloon angioplasty stent placement of left anterior interventricular artery

type of interventional technique?

stent graft placement for abdominal aorta aneurysm

stent grafting

• Synthetic fabric tube (graft) reinforced by metallic stent/mesh.

• Bypasses blood past weakened area of aortic wall

what interventional technique has been done here?

nephrostomy

what is the visible pathology?

Right ureteric stenosis/obstruction

what interventional technique?

abcess drainage (perisigmoid diverticular abcess)

what interventional technique?

radiofrequency ablation

• Needle electrode placed in tumour

• RF current passed through electrode, heats tumour and erodes it

• Frictional heat created by ions in the tissue destroys it

• Alternative is ‘cryoablation’, AKA freezing

equipment type

infusion catheter spraying thrombolysis pulse spray

what projection is this?

PA internal carotid artery

label 1

left internal carotid artery

label 2

left middle cerebral artery

label 3

left anterior cerebral artery

label 4

resemblance of aneurysm at site of carotid siphon

what projection?

transorbital 30deg oblique ICA

what projection?

lateral internal carotid artery

what projection?

reverse transorbital 30deg oblique ICA

what projection?

PA internal carotid artery - cross compression

label 1

pericallosal artery

label 2

callosomarginal artery

label 3

anterior cerebral artery

label 4

middle cerebral artery

label 5

anterior choroidal artery

label 6

posterior cerebral artery

label 7

posterior communicating artery

label 8

opthalmic artery

label 9

ICA cavernous part

label 10

ICA petrous part

label 11

ICA cervical part

what projection?

vertebral artery PA