Interventional procedures involve the treatment of a variety of conditions in a minimally invasive manner. The best known of these procedures is the dilatation or placing of a stent (coil) in a narrowed artery, to re-establish good circulation. For example, narrowed arteries of the legs that are causing pain in the legs upon exercise or walking, can potentially be treated this way.
Angiography is a common interventional radiology procedure that can help doctors diagnose blockages, bleeding or other disorders in blood vessels throughout the body. During an angiogram, the radiologist inserts a tiny catheter into a blood vessel using a minute puncture in your skin, then injects a dye to make the blood vessels visible during a special type of X-ray called fluoroscopy.
A biopsy is a procedure to remove a piece of tissue or a sample of cells from a patient’s body so that it can be analysed in a laboratory.
- In fine-needle aspiration (FNA), a small gauge needle is used to remove cells or fluid from the area of concern using mammographic ultrasound or CT guidance. The samples are placed on slides and interpreted by a cytologist or pathologist under a microscope.
- A core biopsy is the process whereby several small cylindrical samples (cores) of breast tissue are removed from the area of concern found on a mammogram or ultrasound, using an appropriate gauge needle. The tissue samples are then sent to a pathologist for evaluation.
What are the different types of core biopsy procedures?
- Ultrasound-guided spring-loaded core biopsy: The abnormality is best seen on ultrasound. A spring-loaded biopsy needle is used to perform the biopsy under ultrasound guidance.
- Ultrasound-guided vacuum-assisted biopsy: The abnormality is best seen on ultrasound. A vacuum-assisted needle/device is used to perform the biopsy under ultrasound guidance.
- Stereotactic/tomosynthesis-guided vacuum-assisted biopsy: The abnormality is best seen on mammogram or tomosynthesis. A vacuum-assisted needle/device is used to perform the biopsy under mammographic or tomosynthesis guidance.
Fine needle aspiration
Ultrasound-guided core biopsy
Stereotactic/tomosynthesis-guided core biopsy
A facet block involves injection of the facet joints which are on each side of and connect the vertebrae. This is usually performed in the lower back but occasionally also in the neck.
A facet block provides pain relief but may also be used to distinguish between back pain originating from the facet joints vs other causes such as a pinched nerve.
The procedure is performed under imaging guidance, either with CT or dynamic real-time X-rays (fluoroscopy).
A myelogram is a diagnostic imaging examination used to evaluate diseases of the spine and spinal cord. It involves a lumbar puncture and the injection of contrast material (dye) into the spinal canal, around the spinal cord and nerve roots. This is usually followed by a CT (CT myelography) or occasionally MR (MR myelography).
MR and CT myelography are diagnostic examinations of the spine which are now rarely performed due to the high-quality images produced by conventional MR imaging. However, it is still used in patients who cannot undergo MR imaging, including patients with certain pacemakers or medical implants.
Myelography, with or without CT/MR imaging, is also used to find the site of spinal fluid leakage when this is suspected clinically, or on brain imaging.