Articles
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22 results found
Article
Percutaneous cholecystostomy
Percutaneous cholecystostomy is the image-guided placement of a drainage catheter into the gallbladder lumen. This minimally invasive procedure can aid in patient stabilization in order to enable a more measured surgical approach with time for therapeutic planning.
A 2018 study demonstrated no ...
Article
Percutaneous transhepatic cholangiography
Percutaneous transhepatic cholangiography (PTC) is a radiographic technique employed in the visualization of the biliary tree and can be used as the first step in a number of percutaneous biliary interventions (e.g. percutaneous transhepatic biliary stent placement)
Indications
Purely diagnost...
Article
Magnetic resonance cholangiopancreatography (MRCP)
Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging technique to visualize the intra and extrahepatic biliary tree and pancreatic ductal system.
It can provide diagnostically-equivalent images to ERCP and is a useful technique in high risk patients to avoid significant ...
Article
Hepatic venous pressure gradient
Hepatic venous pressure gradient measurement is a safe and minimally invasive method to indirectly measure portal vein pressure in chronic liver disease patients suspected of developing portal vein hypertension.
This procedure is usually performed at the same time as the transjugular liver bio...
Article
Percutaneous transhepatic biliary drainage
Percutaneous transhepatic biliary drainage, also known as percutaneous transhepatic cholangial drainage (PTCD), is an interventional radiology procedure undertaken for those with biliary obstruction.
It is commonly undertaken as part of palliative biliary stent insertion. Rarely, it is used in...
Article
Liver biopsy (percutaneous)
Percutaneous liver biopsy, utilizing either ultrasound or CT guidance, allows for an accurate and reliable method of acquiring hepatic tissue for histopathological assessment. It is divided into two types:
non-focal or non-targeted liver biopsy (used in the assessment and staging of the parench...
Article
Transcatheter arterial chemoembolisation
Transcatheter arterial chemoembolisation (TACE), also known as transarterial chemoembolisation, is a minimally-invasive method of administering chemotherapy directly to a liver tumor via a catheter under digital subtraction angiography (DSA). The chemoembolic agent may be delivered as a mixture ...
Article
Selective internal radiation therapy
Selective internal radiation therapy (SIRT), also known as transarterial radioembolization (TARE) or hepatic radioembolization, is a relatively new and developing modality for treating non-resectable liver tumors. The procedure consists of a transcatheter injection of radioactive particles via t...
Article
Chemical ablation
Chemical ablation is a technique in which chemical ablative substances are used to cause cell death in neoplastic tissue. It is used as a standalone procedure or in combination with other techniques like TACE and radiofrequency ablation.
Agents
absolute ethanol (most commonly used)
acetic aci...
Article
Endoscopic retrograde cholangiopancreatography
Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic and interventional procedure technique using both endoscopy and fluoroscopy for examination and intervention of the biliary tree and pancreatic ducts. It is typically performed by doctors with endoscopic qualifications (e.g. g...
Article
Transjugular intrahepatic portosystemic shunt
Transjugular intrahepatic portosystemic shunt (TIPS or TIPSS) is a treatment for portal hypertension in which direct communication is formed between a hepatic vein and a branch of the portal vein, thus allowing some proportion of portal flow to bypass the liver. The target portosystemic gradient...
Article
Liver and biliary interventional procedures
There is a wide range of liver and biliary interventional procedures, both diagnostic and therapeutic, most commonly using CT-guidance or ultrasound-guidance.
Vascular Interventions:
transjugular intrahepatic portosystemic shunt (TIPS)
transjugular liver biopsy (TJLB)
Percutaneous...
Article
Irreversible electroporation
Irreversible electroporation (IRE), also known as non-thermal irreversible electroporation (NTIRE), is a non-invasive soft-tissue ablation technique used for tumor ablation in regions that require very high precision and preservation of surrounding collagenous structures (vessels and ducts) and ...
Article
Ultrasound-guided biopsy
Ultrasound-guided biopsy is one form of image-guided biopsy, typically performed by a radiologist. It is the most common form of image-guided biopsy, offering convenience and real-time dynamic observation with echogenic markers on cannulae allowing for precise placement.
It can potentially be u...
Article
T tube cholangiogram
T-tube cholangiograms are a fluoroscopic study performed in the setting of hepatobiliary disease. This technique has been largely superseded by MRCP and ERCP.
Typically a T-shaped tube is left in the common bile duct at the time of surgery (e.g. cholecystectomy) and allows for exploration of t...
Article
Percutaneous liver tumor ablation
Percutaneous liver tumor ablation techniques are well-established and effective therapeutic alternatives for the treatment of primary and secondary liver tumors. Hepatocellular carcinoma (HCC) and colorectal oligometastatic disease are the most common indications. There are specific indications ...
Article
Portal vein embolization
Portal vein embolization (PVE) is a technique used to selectively occlude the blood supply to one of the liver lobes, diverting portal blood flow to the other lobe, the future liver remnant (FLR).
This diversion will increase the size of the post-hepatectomy future liver remnant, which improves...
Article
Esophageal varix
Esophageal varices describe dilated submucosal veins of the esophagus, and are an important portosystemic collateral pathway. They are considered distinct from gastric varices, which are less common.
Epidemiology
Esophageal varices are present in ~50% of patients with portal hypertension 1,2. ...
Article
Radioembolization
Radioembolization is the delivery of radioactive microspheres to cancers using an endovascular approach. It is often performed as an outpatient procedure.
Indications
hepatocellular carcinoma 2
hepatic metastases from colorectal carcinoma
Contraindications
Absolute contraindications
exces...
Article
TIPS evaluation
TIPS evaluation is useful to ensure that a transjugular intrahepatic portosystemic shunt (TIPS) is working properly and that no stenosis has occurred within the stent. Ultrasound is often used as a first-line modality.
Radiographic features
Ultrasound
The normal TIPS should show color Doppler...
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