Interventional Radiology

The field of Radiology has expanded in the last 50 years. Technology is increasing and we are finding many different radiologic ways to make diagnosis and provide many treatments. I work in a modality of Radiology called Interventional Radiology and we are considered a service for other departments at Northwestern Medicine. I consider our department the clean-up crew for the hospital for the reason that other departments come to us when an error is made. For example, during surgery when a surgeon accidentally lacerates an artery they come to us to stop the bleeding. Interventional Radiology uses image guided minimally invasive procedures where a small needle is used to get access into a vein or an artery. Afterwards, a guide wire, and catheter are used to maneuver through the vessels to get to the destination to inject some dye to see what is going on. In simple terms, it is surgery through a pinhole! We also put in dialysis and drainage catheters (catheters that drain out infection from the body), all sorts of lines such as chest ports and picc lines (fancy IV's). Our department is one of the biggest in the country and we are divided into 2 main sections Neuro (Brain and spine) and Vascular (Body). Below are all the types of rooms we have with a description of what kind of cases we do in those rooms.

Myelogram Room

In this room we do Lumbar Punctures (collection of cerebral spinal fluid), Myelograms (injection of contrast into the spinal canal), and epideral steroid Injections (injection of a steroid into the epideral space around the spinal chord to relieve pain). All these procedures are done with a small spinal needle.

Biopsy Room

In this room we do all kinds of biopsies. With biopsies we use ultrasound and small needles to capture tissue anywhere in the body the service wants us to. The most common biopsies are liver, thyroid, and kidney. With the help of a pathologist we make sure we get the best samples possible for lab testing. The picture below is where we take the samples to have the pathologist observe.

Room 1

We have 6 other rooms like these and we do over 200 minimally invasive procedures from venograms (pictures of veins using dye) and angiograms (pictures of arteries using dye) to placing dialysis and drainage catheters.

Bi-plane Neuro Radiology Room

Bi-plane means 2 carms working at the same time to get different views of the body part we are looking at. In this room we mainly do procedures that revolve around the vessels of the brain. Procedures such as cerebral angiograms, and emergent cases such as strokes.

Room 5

This room where we mainly do radioembolization cases. This is a treatment that we do for patients with liver cancer. We basically are injecting radioactive beeds into the main vessel that is feeding the tumor. To make it easier to understand it is localized chemotherapy.

Pathologist station

This is where the pathologist sit and observe the biopsy samples our physicians take to make sure the samples are adequate. This room is located next door to our biopsy room.

Minor Procedure Room

This room is for cases that will not require any live radiation. The type of cases we do here are very basic yet effective. Examples include Paracentesis (removal of excess fluid from the abdomen) Thoracentesis (removal of fluid around the lung) We use an ultrasound to stick a small needle in either the lung or abdomen. Once were in the pocket we remove the needle and aspirate the fluid out through a catheter.

Power Injector

We use this machine to inject contrast dye into the vessels of the body so we can see what is going on. How this works, we have along tubing that connects at the tip of the syringe and the tip of the catheter. We select a flow rate and volume of contrast. when we hit the button we get the image below.

Supplies & Implants

Mobile C-Arm

This machine is used for surgery. I have used this machine during spine, orthopedics, and urinary, surgeries.

Central Pod

This area is where all the communication and action happens. The staff that sit are the captains of the ship. We schedule patients, call patients to remind them of their appointments, and work with the on-call team to coordinate the day to efficiently. The electric board is our schedule of cases. We add, cancel, and move patients from room to room to try to get the patients in and out.

Subtraction Run

This is a subtraction run of the main arteries in the liver. In this image we see the contrast starting off in the celiac artery (artery that branches off the aorta) and dispersing to the rest of the liver arteries on right side of the image. On the left side of the image the contrast disperses to the arteries of the spleen.

Portable X-ray Machine

This machine is used to go shoot x-rays up on the floors. The most common portable radiographs we do are chest, abdomen, and pelvis. We use a cassette and then we go process the image.

Processing Station

This is where all the images that are taken with a cassette are processed. The image pops up on the screen. The processing station allows us to make any contrast adjustments and any annotations to the image. Then the image gets sent to a archiving station where the radiologist can read it.

Digital Portable Machine

This portable is a combination of the previous two images. The technologist can take the image and it pops up right away on the screen. It saves the technologist a step and it helps for getting more portables done efficiently.

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