Department of Radiology, Vascular and Interventional Radiology

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Facilities and Equipments :

Radiology department at CIIMS is one of the oldest advanced radiology diagnostic and therapeutic unit of Nagpur city. It has the most experienced faculties and offers advanced services to the patient during both routine and emergency hours.

 

Early detection is critical in the successful treatment of disease. At CIIMS, our diagnostic radiology department offers outpatient, emergency department, fluoroscopy and inpatient radiology services in a patient-friendly environment with state-of-the-art computerized radiography technology.

 

It contains four separate subunit

  1. CT  Scan
  2. Digital X-ray and fluoroscopy
  3. Sonology unit
  4. Interventional Radiology

CT SCAN

 

Somatom ARC model is now replaced by spiral CT Scan Emotion DUO power of Siemens, installed on 10.09.2003 Dr.Shirish Deshpande Sr.Consultant in Radiology who has an outstanding experience of more than 15 years in CT Scanning and MRI is looking after the work in this department along with the expert technical staff. Services of this department are available round the clock. The charges for scanning are economical compared to the other centers of Nagpur.

 

Magic View by Siemens:

 

This is an additional attachment of CT Scan recently installed in our hospital, With the help of which three dimensional images of any part of the body is possible. The unique feature of this unit is that of editing facility i.e.. the part of 3D images which is not required can be deleted to get additional diagnostic information. Another additional feature of this unit is MPR (ie. Multi Planner Reconstruction) with the help of this one can reconstruct set of images in any plane (i.e.. orthogonal) then conventional, sagittal and corneal planes.

 

3D images and MPR images enhances diagnostic value. In the whole central India region this is available in CIIMS hospital at very reasonable charges

 

Machine Name : Siemens SOMATOM EMOTION DUO

Type Multislice Scanner (DUO Scan)

Date of Installation : 10.09.2003

Scan Time : 0.8 sec/scan

 

Procedure : Special
Perfusion (Cerebral study) Quantitative evaluation of dynamic CT Data of Brain following highly concentrated bolus contrast for differential diagnosis and management of acute ischemic stroke.

  1. Angiography : (Cerebral, carotid, lower limb, upper limb aorta) 
    4 Vessel cerebral angio and peripheral angiography
  2. 3D VRT - Volume rendering technique
    SSD - Surface shaded display
    MPR - Multiplamer reconstruction
    MIP - Maximum intensity projection and volume
  1. Possible Scanning :
    1) Head - Orbit, Sinus. 
    2) Neck
    3) Shoulder
    4) Abdomen
    5) Pelvis
    6) Spine - Cervical, Lumbar, Thoracic
    7) Extrenuties
    8) C T Guided biopsy

 

Digital X-Ray and Fluoroscopy

 

This department was started in August 1987, with 2 Siemens X-Ray machines. The 500 mA machines with image intensifier is used for conventional Radiography and special procedures like barium studies. IVP, Meyelograms etc. And the other is a mobile X-Ray unit (60 MA) for the bed side conventional plain X-Rays. 

 

Latest techniques:-

  1. Klinoskop 500MA Siemens with Fluroscopy
  2. PLddr 3E 60 MA L 100K v Siemens Portable X-ray
  3. Multimobile 2.5 KW Siemens Portable X-ray
  4. Allengers 3.5 KW high frequency Portable Unit.
  5. Fuji C.R. (Digital X-ray)
  6. Here doing all the routing x-ray from head to toe and being mainly neurology institute x-ray os spine including special view like flexon, extension in cervical and lumber spines are routinely done here. Almost all the investigation procedure including
    1. All  routine x-rays, including special view like Stenver’s and optic foramina, (except tomograms)
    2. IVP
    3. MCU
    4. Retrograde
    5. Fistulogram
    6. Sialogram
    7. Barium Swallow
    8. Barium Meal
    9. Hypotonic duodenography
    10. Barium Enema etc are performed here with use of Fluroscope as and when required.
    11. High grade Urography
    12. Retrograde and antegrade Pyelography
    13. Cystography and micturating cystourethrography
    14. Retrograde Urethrography

 

SONOLOGY UNIT :

Department of SONOLOGY is started in March 2008, Ultrasound is a common procedure at CIIMS that allows medical practitioners to visualize structures beneath the skin. The technique uses sound waves beamed into the body and reflected off of various tissues to develop a picture of the interface between solid and fluid spaces.

 

There are no known risks to ultrasound, which can be used to screen, diagnose and aid in the treatment of various diseases.


CIIMS's ultrasound department is equipped with state-of-the-art ultrasound technology. Our courteous staff is highly trained.
We provide diagnostic imaging as well as ultrasound guidance for numerous biopsies and procedures.

 

Ultrasound procedures offered (but not limited to) include:

  • Abdomen & Pelvis
  • Small part
                • Scrotum
        • Thyroid
        • Joints
  • Doppler Imaging
    • Carotid
    • Peripheral Vascular Doppler
    • Trans Cranial Doppler (TCD)
  • FNAC (Diagnostic as well as Therapeutic ascetic and pleural tapping)
  • Breast
  • Extremities (including shoulder)
  • Pelvis
  • Thyroid
  • All portable and bed side USG, Doppler as well as therapeutic procedures are done.

 

Interventionsl Radiology Unit :

 

This department was started in August 1987, with 2 Siemens X-Ray machines. The 500 mA machines with image intensifier is used for conventional Radiography and special procedures like barium studies. IVP, Meyelograms etc. And the other is a mobile X-Ray unit (60 MA) for the bed side conventional plain X-Rays.

The second phase of the development of vascular and Interventional Radiology was started first ever in Central India by Dr. Shrikant Kothekar in Oct. 1990. Interventional Radiology has now became a part of treatment of difficult situations. It can be called pin hole surgery/radiology since the procedure involves percutaneous needle puncture followed by guide wire, catheter introduction and manipulation under x-ray control.

Following is the list of indications wherein Interventional Radiology steps in to help relieve condition Non-surgically.

  • To relieve obstruction drainage and stenting in obstructive Uropathy and Jaundice.
  • Fallopian tube recanalization in tubal blocks.
  • To dilate narrowing of stenosis - Renal carotid and peripheral angioplasty.
  • To control bleeding by occluding abnormal communication as in arteriovenous malformations & fistulae. Embolization in Hemoptysis / hematuria / Bleeding PR/PV etc.
  • Carotid stenting for preventing progression of ischemic stroke.
  • IVC filter to prevent pulmonary embolism.
  • Uterine artery embolization of fibroid.


Interventional radiology represents a mix of adventure, innovation and improvisation and has certainly contributed significantly to the patient care in Central India and CIIMS both. The well-done emobilization of prostatic, uterine, bronchial, coeliac arterial bleeds that have won accolades nationally and internationally, are a testimony to this spirit. Needless is to mention our contribution to hepatic, renal, and peripheral vascular disease.

Catheterization Laboratory   Since the beginning, interventional radiology has performed a large number of different procedures briefly given below -
  • Diagnostic procedures - Cerebral angio, Aortogram and peripheral renal mesentric bronchial etc.
  • Angioplasties/Stenting - Carotid, Renal and peripheral.
  • Embolizations - Bronchial , Mesentric, Uterine, Pelvic, AVM, AVF, Neovascularization etc.
  • Percutaneous drainage - Percutaneous Nephrostomy, Uterine stenting, Biliary drainage and Biliary stenting.
  • Percutaneous nephrolithomy
Catheterization Laboratory   The Department's First
Many of these procedures have been done for the first time in Central India notably, Adrenal Transaxillary Angiograms, Embolization in superior mesenteric, Radial, Scalp and Renal artery and AVM. Bleeding uterine, Bronchial, Prostatic & mesentric vessels. Renal, subclavian, Peripheral, Angioplasties Percutaneous Nephrolithotomy, Ureteric/biliary stenting, IVC filters etc.


WHERE INTERVENTIONAL RADIOLOGY SAVES LIMB, BRAIN &LIFE

PROBLEM PRESENTATION ETIOLOGY PROCEDURE
Ischemic Stroke Hemiplegia/Hemiparesis Acute Intracerebral thrombosis LOCAL Intra-arterial Thrombolysis within 3 hours.
Venous infarct convulsions, unconsciousness, neurodeficit

 

Sagittal sinus thrombosis Local intravenous sagittal sinus thrombolysis
Brain Haemorrhage Unconsciousness,Neuro deficit AV malformation, Aneurysm Coil Embolisation or Glue injection
Carotid Artery Stenosis Transient Ischemic Attack (TIA) Atherosclerosis Angioplasty and stenting
Bronchial artery to Pulmonary artery fistulae Haemoptysis Tuberculosis/Carcinoma Bronchial Artery Embolization
Renal Artery Stenosis Hypertension
.
Atherosclerosis, Aorto arteritis Fibromuscular Dysplasia Angioplasty and Stenting
GI Bleeding Haematemesis, Malena, Bleeding PR Ulcer, Tumor, NSAID Aneurysm, A-V-M Angiodysplasia Embolization
Bleeding PV Menorrhagia, Pressure Symptoms Uterine Fibroid, Pseudoaneurysm, Pelvic A-V-M Post Operative Uterine artery Embolization
Urinary bleeding Haematuria AV Malformation,Trauma,Tumor, latrogenicf (Post TURP, Renal biopsy) Embolization
Peripheral Vascular Disease Claudication

Ulcer

Gangrene

Atherosclerosis,

Arteritis,

Coarctation of Aorta

Angioplasty and stenting, LOCAL thrombolysis in acute cases.
DVT with/without Pulmonary Embolism

Edema feet,

Pain in chest,

Breathlessness

Hypercoagulable state, Trauma,infection, Post operative Local thrombolysis and IVC filter placement
Portal Hypertension Haematemesis

Maleana

 

Cirrhosis TIPS (Trans Jugular interahepatic Portosystemic shunt)
Obstructive Jaundice Jaundice/Itching Biliary stricture/Calculus PTBD/Stenting
Obstructive Uropathy Oligouria, Anuria Malaise, Anemia, Pain Calculus, Stricture Precutaneous Nephrostomy & D-J Stenting
Female Infertility Inability to conceive Cornual block Fallopian tube recanalisation (FTR)
Osteoporosis of vertebral body Pain in back Tenderness Post menopausal, Old age, Immunosuppresion, Haemangioma Vertebroplasty
Thrombocytopenia Bleeding Hypersplenism Partial splenic embolization
Vertebro basilar insufficiency(VBI) Vertigo Stenosis at verebral or basilar artery Vertebro basilar stenting.
Absent Radial Syncope Subclavian steal syndrome (Subclavian artery stenosis) Subclavian artery stenting.

 

Pulsatile supraclavicular swelling Swelling, ischemic pain Traumatic/latrogenic Subclavian stent graft.
Swelling over head, neck, face and extrimities Disfigurement

Bleeding pain

Epistaxis

AVF, Nasopharyngioma AVM Hemangioma, Vascular tumors Embolization
Cyanosis Breathlessness Polycythemia Hemoptysis Pulmonary AVM, Aneurysm, AVF Pulmonary artery Embolization
Pulsatile abdominal/Thoracic mass Pain Thoracic aortic aneurysm Abdominal aortic aneurysm Middle aortic syndrome Stent graft/Stent
Abdominal Pain (Normal investigations) Severe pain/post prandial abdominal pain Mesentric artery stenosis/Embolic acute mesentric occlusion Mesentric artery angioplasty/Local intra arterial thrombolysis.
Male infertility/Pelvic congestion syndrome Pain Menorrhagia Spermatic/Ovarian varicocities Coil Embolization
Benign Hypertrophy of prostate Difficulty in micturation/Retention Benign prostatic hyperplasia Embolization of porstatic vessels.
Hypoglycemia Syncope Insulinoma Pancreatic artery Embolization
Malignancy Cachexia Hepato/Secondaries in Liver Chemo Embolization
Acute limb ischemia Acute pain in extrimity Absent pulsations Thrombo Embolism Local intra arterial thrombolysis
Lower motor weakness Acute neuro deficit Spinal AVM/AVF Hemangioma of vertebral body Embolization
Bowel and Ureteric stricture Constipation/Obstructive Uropathy Inflammatory/Neoplasia Dilatation and stenting
Tracheal stenosis Difficulty in breathing (Stridor) Extrinsic compression

Tumor encasement

/Tracheaomalacia

Tracheal stenting