Polycystic Kidney Disease Radiology: Overview

• Plain film or digital X-ray imaging

The older ways of capturing an x-ray involves an intermediate cassette. At our hospital we use the contemporary way of digital or plain film radiography. In this procedure, x-ray–sensitive plates are used directly in the machine to capture data during the patient examination. This is then immediately transferred to a computer system giving almost immediate access to the doctor.

• Magnetic resonance imaging (MRI)

While an x-ray works to capture inside images of the body, a magnetic resonance imaging (MRI) goes even deeper. It forms pictures of the anatomy and the physiological processes of the body using scanners that have strong magnetic fields, magnetic field gradients, and radio waves. These pass through the body to generate images of the organs inside.

• Computed tomography (CT) scans

A computer-processed combination of many X-rays is known as a CT scan or computed tomography scan. It uses the measurements taken from different angles to create a cross-sectional image of specific areas of the body part. This allows seeing inside the body without cutting.

• Fluoroscopy

Fluoroscopy is a process in which an X-ray beam is passed through the body, and the final image on the computer shows a continuous X-ray image on a monitor, much like an X-ray movie. This helps get an in-depth understanding of the patient’s body.

• Breast imaging

This is a subspecialty of diagnostic radiology which includes mammography, breast ultrasound, breast MRI and digital imaging of the breast. The most common is mammography that is used to detect breast cancer via a low-dose X-ray. This helps check for cancer in advance, before any symptoms are evident.

• Nuclear medicine procedures

This is a process in which radioactive materials also known as radiopharmaceuticals are used for diagnosis. This includes positron emission tomography [PET] and single-photon emission computed tomography [SPECT] scans.

• Imaging of the colon

To get a complete picture of the colon, virtual CT colonography and barium enema are done. Computed tomography (CT) colonography, the former, uses special x-ray equipment to examine the large intestine for cancer and growths called polyps. In case of the latter, a small tube is inserted a short distance into the rectum and is inflated with gas. During this time CT images of the colon and the rectum are taken.

• Ultrasonography

Ultrasonography is a diagnostic imaging technique that uses high-frequency waves to produce an image for medical analysis. It is used to create an image of structures such as tendons, muscles, joints, blood vessels, and internal organs.

• Narrowing of arteries
• If the arteries seem to be narrow because of blockages or infection, interventional radiologists can treat it. They use balloons to stretch the vessel (balloon angioplasty, PTA) and in some cases, even small metal springs called stents to hold them open.  Additionally, these experts can resolve a minor clot by busting drugs directly into the artery via small catheters, thus saving many limbs.
• Aneurysms
• Aneurysms or a bubble can occur in the aorta, brain, back of the knee, intestine or spleen leading to internal bleeding or stroke. Especially if the aneurysm is ruptured. It can even be fatal or paralysing. IR treat these by relining the vessel with a tube called a stent graft.

• Haemorrhage

Haemorrhage means bleeding in simple terms, especially heavy bleeding because of an injury. In this, the blood escaped from the circulatory system via damaged blood vessels. IR helps treat this using minimally invasive surgery, and it is the most common vascular emergency treated by this department.

• Pulmonary Embolism

Pulmonary embolism is caused by one of the blood clots traveling from your lungs to other parts of the body, creating a blockage in one of the pulmonary arteries. It might even travel to deep veins in the legs sometimes. Interventional radiologists offer a special treatment for this disease wherein they place devices to capture blood clots before they reach the lung preventing further damage.

• Dilated veins

When a blood vessel wall is weakened it is dilated causing varicose veins. They appear as clusters of blue or purple veins, and often have thin red capillaries known as spider veins around them. IR helps treat these with by blocking the vein by heat treatment or by the use of irritant drugs.

• Non vascular intervention

Interventional oncology, also known as, non-vascular intervention, is ideal to treat pre-cancerous as well as benign conditions.  IR therapies are used for the following:

1. To treat tumours, ablations, embolization, and cancers
2. To stop the cancer from spreading on other systems
3. To collections fluid or pus in the chest or abdomen
4. To place feeding tubes i.e. gastrostomy, jejunostomy
5. To treat vertebroplasty or collapsed spinal bones

• Kidney stones

While filtering the waste from the body, sometimes hard deposits of minerals and acid salts are deposited. This is known as kidney stones. They can be painful when passing through the urinary tract and may cause minor infections too. Interventional radiotherapy uses techniques like placing a tube in the kidney (nephrostomy) to allow the urine to drain and removing the stones too.

• Gallstones

Solid particles that form from bile cholesterol and bilirubin can be deposited in the gallbladder leading to gallstones. Interventional radiologists remove these by placing catheter tubes through the liver.