Interventional radiology belongs to micro-trauma surgery, an emerging discipline with the development of modern high technology, which is guided by radiological images and accomplishes various diagnoses and treatments with the help of a puncture needle and a 1 to 2 mm thin catheter. Intervention makes the diagnosis to the degree of histological and cytological accuracy. Intervention makes the treatment more effective, less side effects and less invasive. Interventional techniques are suitable for both young and old people.
Interventional treatment is suitable for all kinds of patients, and it is also suitable for patients who cannot undergo surgery or have difficulties in surgery, and it can achieve good results when combined with clinical medical and surgical treatment or interventional treatment alone.
Interventional radiology is divided into two categories: intravascular interventional radiology and extravascular interventional radiology.
1, intravascular interventional radiology
(1) Intravascular specimen extraction: diagnosis of complex congenital heart disease, liver disease and various types of micro endocrine adenoma (such as parathyroid adenoma, islet cell tumor, adrenal adenoma, paraglomerular cell tumor, etc.), renal arterial hypertension, endomyocardial/myocardial biopsy, liver biopsy, etc.
(2) Angiography.
①Arteriography
Cardiac angiography to diagnose various complex congenital cardiovascular malformations, coronary angiography to diagnose coronary heart disease, Kawasaki disease, coronary arteriovenous fistula, etc.
Cerebral angiography to diagnose cerebrovascular diseases such as cerebral infarction, cerebral thrombosis, venous sinus thrombosis, cerebral hemorrhage, cerebral arteriovenous fistula, cerebral aneurysm
Cerebral arteriovenous malformation, cerebrovascular occlusion, intracranial tumors, metastases, etc.
macroangiography to diagnose aneurysm, arterial stenosis, vascular malformation, thrombosis, vascular stenosis, various unexplained hemorrhage and ischemia, benign and malignant tumors, metastases, etc.
(2) Venography to diagnose Bu-ga syndrome, inferior vena cava stenosis, hepatic vein stenosis, superior vena cava stenosis, portal hypertension and its causes, large and small venous thrombosis, esophagogastric fundic varices, varicose veins of the lower extremities, varicose veins of the spermatic cord, etc.
(3) Intravascular drug perfusion.
①Target vessel perfusion of hemostatic drugs for visceral hemorrhage, such as hemoptysis, vomiting blood, blood in stool, blood in urine, gynecological hemorrhage, traumatic liver rupture, spleen rupture, kidney rupture, fracture hemorrhage, etc.; or combined with embolic agents for hemorrhage.
(ii) infusion of thrombolytic drugs to treat intravascular thrombosis in various places, such as cerebral thrombosis, coronary artery thrombosis, extremity artery thrombosis, extremity vein thrombosis, mesenteric artery thrombosis, portal vein thrombosis, pulmonary artery thrombosis, etc.; it can be combined with thrombus aspiration or thrombus crushing to treat thrombosis.
(3) Infusion of chemotherapy drugs for malignant tumors, such as brain metastases, glioma, nasopharyngeal cancer, maxillary sinus cancer, lung cancer, esophageal cancer, cardia cancer, stomach cancer, liver cancer, liver metastases, pancreatic cancer, bile duct cancer, intestinal cancer, kidney cancer, adrenal tumors, bladder cancer, cervical cancer, ovarian cancer, choriocarcinoma, osteosarcoma, etc., with the application of embolization or continuous infusion of chemotherapy is more effective, especially for highly differentiated type of insensitive tumors.
(4) Perfusion of antibiotics for treatment of various intractable infections, through the intervention of high concentration of antibiotics directly on the lesion, the anti-infection effect is very satisfactory.
(4) Intravascular embolization.
Treatment of various malignant tumors mentioned above.
Treatment of cerebral arteriovenous malformation, cerebral aneurysm, carotid cavernous sinus fistula, meningioma, nasopharyngeal fibrovascular aneurysm, rhinorrhea and spinal and spinal vascular malformation and hemangioma, aneurysm, entrapment aneurysm, pseudoaneurysm, etc.
Treatment of various types of hemorrhage, arteriovenous catheterization, patent foramen ovale, atrial and ventricular septal defect, pulmonary arteriovenous fistula, hemoptysis, and pre-surgical embolization to prevent surgical hemorrhage. For example, embolization of cervical hemangioma for surgical resection, percutaneous hepatic penetration of coronary vein embolization of the stomach or treatment of gastroesophageal variceal bleeding via spontaneous splenic-renal or gastric-renal shunt route, splenic artery embolization for hypersplenism, arterial embolization for spontaneous rupture and traumatic bleeding of the liver, kidney, and spleen, and varicose veins of the spermatic cord.
(5) Angioplasty: Treatment of various types of arterial and venous stenosis, heart valve stenosis, etc. using balloon catheters and/or stents. Such as coronary angioplasty, mitral valvuloplasty, aortoplasty, inferior vena cava angioplasty, cephalobrachial angioplasty, renal arterioplasty, limb arterioplasty, venoplasty, and interventions for Bou-ga syndrome, vascular impotence, etc.
(6) Endovascular stent implantation: treatment of intractable stenosis, stenosis of vascular anastomosis such as stenosis after liver transplantation and kidney transplantation, aneurysm, entrapment aneurysm, pseudoaneurysm, large vessel rupture, etc. For example, PTA and endoprosthesis for iliac artery stenosis, PTA and endoprosthesis for renal artery stenosis.
(7) Intravascular foreign body removal: removal of all types of intravascular foreign bodies. Such as limb arteriovenous thrombosis aspiration, cardiovascular foreign body removal, etc.
(8) Vena cava filter placement: treatment of peripheral venous thrombosis, prevention of fatal pulmonary embolism, etc.
2.Extravascular interventional radiology
(1) Extravascular lumpectomy, such as percutaneous transhepatic cholangiography, paracentesis of renal pelvis, nasolacrimal ductography, selective tubal angiography, etc. to diagnose various types of luminal stenosis.
(2) Puncture biopsy: Diagnosis of various inflammatory pseudotumors and benign and malignant tumors is a great advancement in diagnostic imaging, replacing surgical incisional biopsy. Such as lung biopsy, mediastinal biopsy, liver biopsy, hepatobiliary tract pancreatic biopsy, breast biopsy, musculoskeletal biopsy, prostate biopsy, bone biopsy, joint synovial biopsy, etc.
(3) Puncture aspiration: diagnosis and treatment of various types of fluid, cysts, abscesses and herniated discs. Such as lung abscess, liver abscess, brain abscess, retroperitoneal abscess, perirenal abscess, lumbar disc herniation, cervical disc herniation, bone cyst, etc.
(4) Puncture drainage: treatment of various types of abscesses, pancreatic pseudocysts, obstructive jaundice, hydronephrosis, intractable pleural fluid, ascites, etc., such as abdominal abscess, hematoma drainage, liver abscess drainage, drainage of pus accumulation in kidney and perinephric kidney, etc.
(5), puncture sclerotherapy: there are simple cyst sclerotherapy, malignant tumor sclerotherapy, nerve destruction treatment for intractable pain of upper abdominal tumor, compression fracture or vertebral metastases vertebroplasty, etc. It can be used to treat thyroid cysts, mediastinal cysts, lung cysts, liver cysts, kidney cysts, adrenal cysts, ovarian cysts, bone cysts, pulmonary alveoli with spontaneous pneumothorax, functional adenoma of thyroid, parathyroid adenoma, adrenal adenoma, peripheral lung cancer and pulmonary metastases, small hepatocellular carcinoma, small residual cancer foci after treatment by other methods, and interventional treatment of tubal pregnancy, etc.
(6) Physiological lumpectomy: treatment of stenosis of nasolacrimal duct, esophagus, cardia, stomach, duodenum, colon, rectum, trachea, bronchus, bile duct, ureter, urethra and fallopian tube.
(7) Stoma and fistula: such as percutaneous nephrostomy, percutaneous gastrostomy, percutaneous pelvic puncture fistula, ureteral endotracheal tube, percutaneous suprapubic cystostomy for each luminal stricture or obstruction.
(8) Endoluminal stenting: treatment of stubborn stenosis, malignant stenosis, scar stenosis and endoluminal fistulas such as esophagotracheal fistula, esophageal mediastinal fistula, esophagothoracic fistula and esophagogastric anastomotic fistula.
(9) Foreign body and stone removal: ureteral, renal pelvis, urinary tract stones bile duct stones and foreign body removal treatment. Trans-T-tubular bile duct lithotomy percutaneous urinary tract stone removal.
(10) Plexus block and other treatments: such as abdominal plexus block, lumbar sympathetic nerve stem block for intractable pain, interventional treatment for lacrimation, intravenous diversion of ascites, interventional treatment for chronic fistula, interventional treatment for lymphatic cysts, medullary nucleus melting treatment, tubal mucosal block, etc.