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Awareness of Radiologists and Radiographers toward Patient Care in the interventional radiology department

Open Journal of radiology 2022年第3期12卷 142-154页

作者： Mazin A. Hassib Taif T. Hejji Maryh Y. Qaisi Rozan M. Alharbi Lujain A. Fati Ghadi S. Alahmadi Mjdoleen M. Alshabihi Medical Imaging Technology department Al-Gahd International College for Medical Applied Sciences Jeddah Kingdom of Saudi Arabia

Background: The hospitals and health care centres are organized around the patient, a model in which healthcare providers partner with patients and families to identify and satisfy patients’ needs and preferences. Providers respect patients’ values and preferences, address their emotional and social needs, and involve them and their families in decision making. According to the best of our knowledge, there is no evidence to prove, radiologists and radiographers are aware enough about the patient safety, care, and code of conduct with their patients in the interventional radiology department. Objective: This article aims to measure the awareness of radiologists and radiographers toward care and safety in an interventional radiology department. Material and Method: This study was carried in period from 15 February to 20 April 2022. One hundred sixty-four radiographers and radiologists participating in this study completed the questionnaire, which equals a response rate of approximately 82%. The questionnaire was fully completed by almost all responders;only a few of them gave partial answers. Results: The first question for radiographers and radiologists was “the sufficient awareness about the patient safety and care during the interventional radiology procedure. Also, the majority of the radiographers and radiologists are providing the patients with sufficient information when he/she ask for help or queries. A large number of radiographers and radiologists were participating in this study explaining the procedures to patients before starting the examinations in a structured way. Finally, the result shows both radiographers and radiologists respect the patient’s rights, privacy, and dignity and also kept the radiation protection during the interventional radiology procedures. Conclusion: This article summarizes the key categories of awareness of patient care issues in the provision of interventional radiology services, from the joint perspectives of radiographers and

关键词： interventional radiology Patients Care Awareness in interventional radiology

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Variability in Fluoroscopic Time during interventional Non-Cardiac Procedures Performed Outside of the radiology department

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2018年第4期7卷 464-471页

作者： Murdhi A. Al Harbi Abdullah H. Al Malki Saeed A. Al Ahmari Khaled Soliman Diagnostic radiology and Medical Imaging department Prince Sultan Military Medical City Riyadh KSA Medical Physics department Prince Sultan Military Medical City Riyadh KSA

Purpose: Increasing physician awareness of patient exposure to radiation is an important step towards the reduction of potentially harmful effects of radiation. Published studies demonstrated that providing physicians with feedback regarding their fluoroscopy time leads to a reduction in average fluoroscopy times. The aim of this work was to analyze and publish our medical center data observed during the past year;fluoroscopy time (FT), Dose Area Product (DAP) and cumulative dose (CD) were monitored for radiation protection purposes. Methods: Fluoroscopy time is one of multiple radiation dose indices used in radiation safety auditing. Such auditing is nowadays turning into requirement of patient care safety and quality improvement;as indicated by accreditation bodies both nationally and internationally. All non-cardiac procedures performed outside radiology department by surgeons and interventionists are viewed. FT, DAP and CD are extracted for analysis. Results: a total of 846 cases were studied (643 orthopedic, 99 others, 73 urology, 17 chest, 7 vascular and 4 ERCP cases). Mean FT was 1.3 minutes, mean CD to the patient was 12.98 mGy and the mean DAP was 4.53 Gy/cm2. The longest FT noted was 55 min. The maximum CD was 904 mGy and the maximum DAP was 689 Gy/cm2. Using spearman’s correlation test we found out that there is a significant correlation between FT and DAP (correlation coefficient = 0.615, p. value 0.001). There is a significant correlation between FT and CD (correlation coefficient = 0.628, p. value 0.001). Conclusion: Information about FT that used in each procedure can be used as a tool for patient dose optimization. As we found a significant correlation between DAP as well as CD. Reducing fluoroscopic time (FT) is a radiation protection goal, since it serves the purpose of protection for both the patient and the workers.

关键词： Fluoroscopy Time interventional radiology Cumulative Dose Dose Area Product

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Doppler ultrasonography in living donor liver transplantation recipients: Intra- and post-operative vascular complications

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World Journal of Gastroenterology 2016年第27期22卷 6145-6172页

作者： Omar Abdelaziz Hussein Attia department of Diagnostic and interventional radiology Cairo University Hospitals department of Diagnostic and interventional radiology National Cancer Institute Cairo University

Living-donor liver transplantation has provided a solution to the severe lack of cadaver grafts for the replacement of liver afflicted with end-stage cirrhosis, fulminant disease, or inborn errors of metabolism. Vascular complications remain the most serious complications and a common cause for graft failure after hepatic transplantation. Doppler ultrasound remains the primary radiological imaging modality for the diagnosis of such complications. This article presents a brief review of intra- and post-operative living donor liver transplantation anatomy and a synopsis of the role of ultrasonography and color Doppler in evaluating the graft vascular haemodynamics both during surgery and post-operatively in accurately defining the early vascular complications. Intra-operative ultrasonography of the liver graft provides the surgeon with useful real-time diagnostic and staging information that may result in an alteration in the planned surgical approach and corrections of surgical complications during the procedure of vascular anastomoses. The relevant intraoperative anatomy and the spectrum of normal and abnormal findings are described. Ultrasonography and color Doppler also provides the clinicians and surgeons early post-operative potential developmental complications that may occur during hospital stay. Early detection and thus early problem solving can make the difference between graft survival and failure.

关键词： Doppler Ultrasound Living donor Liver transplantation Intraoperative Postoperative Vascular Complications

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Transcatheter arterial chemoembolization followed by immediate radiofrequency ablation for large solitary hepatocellular carcinomas

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World Journal of Gastroenterology 2013年第26期19卷 4192-4199页

作者： Zhi-Jun Wang Mao-Qiang Wang Feng Duan Peng Song Feng-Yong Liu Zhong-Fei Chang Yan Wang Jie-Yu Yan Kai Li department of interventional radiology PLA General Hospital

AIM: To assess the technical safety and efficacy of transcatheter arterial chemoembolization (TACE) combined with immediate radiofrequency ablation (RFA) for large hepatocellular carcinomas (HCC) (maximum diameter ≥ 5 cm). METHODS: Individual lesions in 18 patients with HCCs (mean maximum diameter: 7.5 cm; range: 5.1-15.5 cm) were treated by TACE combined with percutaneous RFA between January 2010 and June 2012. All of the patients had previously undergone one to four cycles of TACE treatment. Regular imaging and laboratory tests were performed to evaluate the rate of technical success, technique-related complications, local-regional tumor responses, recurrence-free survival time and survival rate after ***: Technical success was achieved for all 18 visible HCCs. Complete response (CR) was observed in 17 cases, and partial response was observed in 1 case 1 mo after intervention. The CR rate was 94.4%. Local tumors were mainly characterized by coagulative necrosis. During follow-up (2-29 mo), the mean recurrencefree survival time was 16.8 ± 4.0 mo in 17 cases of CR. The estimated overall survival rate at 6, 12, and 18 mo was 100%. No major complications were observed. Levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the blood of 17 patients transiently increased on the third day after treatment (ALT 200.4 ± 63.4 U/L vs 24.7 ± 9.3 U/L, P < 0.05; AST 228.1 ± 25.4 U/L vs 32.7 ± 6.8 U/L, P < 0.05). Severe pain occurred in three patients, which was controlled with morphine and fentanyl. CONCLUSION: TACE combined with immediate RFA is a safe and effective treatment for large solitary HCCs. Severe pain is a major side effect, but can be controlled by morphine.

关键词： Large hepatocellular carcinoma Transcatheter arterial chemoembolisation Radiofrequency ablation Combination therapy Synchronism

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Transjugular intrahepatic portosystemic shunt with covered stents for hepatocellular carcinoma with portal vein tumor thrombosis

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World Journal of Gastroenterology 2014年第6期20卷 1602-1607页

作者： Jian-Bo Zhao Chao Feng Qiao-Hua Zhu Xiao-Feng He Yan-Hao Li Yong Chen department of interventional radiology Nanfang Hospital Southern Medical University department of interventional radiology People’s Hospital Southern Medical University

AIM: To evaluate transjugular intrahepatic portosystemic shunt (TIPS) with covered stents for hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (PVTT).

关键词： Transjugular intrahepatic portosystemic shunt Covered stent Portal hypertension Main portal vein tumor thrombus Hepatocellular carcinoma

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Passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts and assessment of clinical outcomes

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World Journal of Hepatology 2017年第12期9卷 603-612页

作者： Michael C Hsu Charles N Weber S William Stavropoulos Timothy W Clark Scott O Trerotola Richard D Shlansky Goldberg Michael C Soulen Gregory J Nadolski department of radiology Division of Interventional RadiologyMount Sinai Hospital department of radiology Division of Interventional RadiologyHospital of the University of Pennsylvania

AIM To assess for passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts(TIPS) and compare outcomes with maximally dilated *** Polytetrafluoroethylene covered TIPS(Viatorr) from July 2002 to December 2013 were retrospectively reviewed at two hospitals in a single institution. Two hundred and thirty patients had TIPS maximally dilated to 10 mm(m TIPS), while 43 patients who were at increased risk for hepatic encephalopathy(HE), based on clinical evaluation or low pre-TIPS portosystemic gradient(PSG), had 10 mm TIPS sub-maximally dilated to 8 mm(sm TIPS). Group characteristics(age, gender, Model for End-Stage Liver Disease score, post-TIPS PSG and clinical outcomes were compared between groups, including clinical success(ascites or varices), primary patency,primary assisted patency, and severe post-TIPS HE. A subset of fourteen patients with sm TIPS underwent follow-up computed tomography imaging after TIPS creation, and were grouped based on time of imaging( 6 mo). Change in diameter and crosssectional area were measured with 3D imaging software to evaluate for passive *** Patient characteristics were similar between the sm TIPS and m TIPS groups, except for pre-TIPS portosystemic gradient, which was lower in the sm TIPS group(19.4 mm Hg ± 6.8 vs 22.4 mm Hg ± 7.1, P = 0.01). Primary patency and primary assisted patency between sm TIPS and m TIPS was not significantly different(P = 0.64 and 0.55, respectively). Four of the 55 patients(7%) with sm TIPS required TIPS reduction for severe refractory HE, while this occurred in 6 of the 218 patients(3%) with m TIPS(P = 0.12). For the 14 patients with follow-up computed tomography(CT) imaging, the median imaging follow-up was 373 d. There was an increase in median TIPS diameter, median percent diameter change, median area, and median percent area change in patients with CT follow-up greater than 6 mo after TIPS placement compared to follow-up within 6 mo(

关键词： Variceal hemorrhage Portal hypertension Transjugular intrahepatic portosystemic shunts Ascites Sub-maximal dilation Underdilated Passive expansion Hepatic encephalopathy

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Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy

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World Journal of Gastroenterology 2017年第10期23卷 1735-1746页

作者： Murad Feroz Bandali Anirudh Mirakhur Edward Wolfgang Lee Mollie Clarke Ferris David James Sadler Robin Ritchie Gray Jason Kam Wong department of radiology Foothills Medical Centre University of Calgary Division of interventional radiology Department of Radiology UCLA Medical Center

Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hypertension, is in part due to morphological changes occurring in chronic liver diseases. This results in rerouting of blood flow away from the liver through collateral pathways to low-pressure systemic veins. Through a variety of computed tomographic, sonographic, magnetic resonance imaging and angiographic examples, this article discusses the appearances and prevalence of both common and less common portosystemic collateral channels in the thorax and abdomen. A brief overview of established interventional radiologic techniques for treatment of portal hypertension will also be provided. Awareness of the various imaging manifestations of portal hypertension can be helpful for assessing overall prognosis and planning proper management.

关键词： Portal hypertension Diagnostic imaging Portosystemic collaterals Image-guided therapy

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Extensive calcifications in portal venous system in a patient with hepatocarcinoma

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World Journal of Gastroenterology 2014年第43期20卷 16377-16380页

作者： Cheng-En Wang Cheng-Jian Sun Shuai Huang Yan-Hua Wang Ling-Ling Xie department of interventional radiology Affiliated Hospital of Qingdao University

Calcification of the portal venous system is a rare entity that can be incidentally discovered during computed tomography (CT). We describe a case of extensive calcifications in the portal venous system in a middle-aged male patient with hepatocellular carcinoma (HCC). This patient presented with epigastric pain that had no obvious origin prior to admission. Laboratory examinations were positive for hepatitis B surface antigen and α-fetoprotein, and severe esophageal and gastric varices were detected during gastroscopy. Abdominal X-ray plain film showed well-defined linear and track-like calcification, with irregular margins directed along the course of the portal venous system. CT revealed extensive calcifications along the course of the portal, splenic, superior mesenteric and gastroesophageal veins. He underwent splenectomy 22 years ago due to splenomegaly and partial hepatectomy seven months before because of HCC of low-grade differentiation, confirmed by pathology. Finally, the patient was diagnosed with postoperative recurrent HCC and extensive portal venous system calcification after selective hepatic angiography under digital subtraction angiography.

关键词： Portal vein Calcification Portal hypertension Hepatocarcinoma Hepatocellular carcinoma

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Acute extensive portal and mesenteric venous thrombosis after splenectomy:Treated by interventional thrombolysis with transjugular approach

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World Journal of Gastroenterology 2009年第24期15卷 3038-3045页

作者： Mao-Qiang Wang Han-Ying Lin Li-Ping Guo Feng-Yong Liu Feng Duan Zhi-Jun Wang department of interventional radiology Chinese PLA General Hospital Beijing 100853 China

AIM:To present a series of cases with symptomatic acute extensive portal vein(PV)and superior mesenteric vein(SMV)thrombosis after splenectomy treated by transjugular intrahepatic approach catheter-directed thrombolysis. METHODS:A total of 6 patients with acute extensive PV-SMV thrombosis after splenectomy were treated by transjugular approach catheter-directed thrombolysis. The mean age of the patients was 41.2 *** access to the portal system via the transjugular approach,pigtail catheter fragmentation of clots, local urokinase injection,and manual aspiration thrombectomy were used for the initial treatment of PV-SMV thrombosis,followed by continuous thrombolytic therapy via an indwelling infusion catheter in the SMV,which was performed for three to six days. Adequate anticoagulation was given during treatment, throughout hospitalization,and after discharge. RESULTS:Technical success was achieved in all 6 *** improvement was seen in these patients within 12-24 h of the *** complications were *** 6 patients were discharged 6-14 d(8±2.5 d)after *** mean duration of follow-up after hospital discharge was 40±16.5 *** and contrast-enhanced computed tomography confirmed patency of the PV and SMV,and no recurrent episodes of PV-SMV thrombosis developed during the follow-up period. CONCLUSION:Catheter-directed thrombolysis via transjugular intrahepatic access is a safe and effective therapy for the management of patients with symptomatic acute extensive PV-SMV thrombosis.

关键词： Mechanical thrombectomy Portal vein Splenectomy Superior mesenteric vein Thrombolysis Thrombosis

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Fine needle aspirating and cutting is superior to Tru-cut core needle in liver biopsy

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Hepatobiliary & Pancreatic Diseases International 2013年第5期12卷 508-511页

作者： Guo-Ping Li Gao-Quan Gong Xiao-Lin Wang Yi Chen Jie-Min Cheng Chang-Yu Li department of interventional radiology Zhongshan HospitalFudan University

BACKGROUND:Liver biopsy is the "gold standard" for evaluating liver disorders,but controversies over the potential risk of complications and patient discomfort still *** a 21G fine needle,we developed a new biopsy procedure,fine needle aspirating and cutting(FNAC).Our procedure obtains enough tissue for pathological examination and meanwhile,reduces the risk of biopsy *** present study was to determine the safety and efficiency of 21G FNAC compared with 18G Tru-cut core needle(TCN) in liver tumor ***:Ninety-four patients with unresectable malignant tumors were included in this *** were divided into 2 groups:18G TCN and 21G *** total positive rate(TPR) and safety of both groups were ***:TPR was not different between the two *** puncture track subcapsular hemorrhage and arteriovenous shunt were reported with 18G TCN but not with 21G *** incidence of pain caused by biopsy was higher for the 18G TCN group compared to the 21G FNAC group(P0.5 cm,but 52.1% in the 21G FNAC group(P<0.05).More than 50% of patients in both groups had sufficient tissue for immunohistochemical ***:TPR is not different between the 21G FNAC and 18G TCN biopsy procedures,but the safety of 21G FNAC is superior to that of 18G *** obtained by either of these two procedures are sufficient for a pathological diagnosis.

关键词： biopsy tumor chemoembolization diagnostic liver

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