Advanced Body and Neurological Intervention

Neuro Interventional Radiologists offer treatment and management of disorders which includes aneurysms, arteriovenous malformations (AVMs), dural fistulas and acute stroke. The comprehensive approach to managing the emergency care of brain trauma victims increases the options available to patients. Advanced CT and MRI techniques allow Alliance Radiologists to more quickly identify the source and extent of brain trauma for quick, appropriate treatments.

Interventional radiologists (IR) use their expertise in reading X-rays, ultrasound and other medical images to guide small instruments such as catheters through blood vessels to treat disease. These procedures are typically less invasive and much less costly then surgery. Here are just a few of the most common procedures preformed by Alliance IR physicians:

• Angiography is an x-ray exam of the arteries and veins to diagnose blockage and other blood vessel problems.
  
  
• Balloon Angioplasty helps open blocked or narrowed blood vessels by inserting a very small balloon in the vessel and inflating it.
  
  
• Embolization allows us to deliver a clotting agent directly to an area that is bleeding or to block blood flow to an aneurysm or fibroid tumor in the uterus.
  
  
• Needle biopsy is a diagnostic test for breast, lung and other cancers, which is an alternative to surgical biopsy.

Bone Density Studies

Bone density is a key indicator in the diagnosis of osteoporosis, a preventable disease that causes millions of fractures every year. Bone density studies allow for early detection and treatment of osteoporosis, sparing patients pain and debility due to bone degeneration and fractures. Fast and accurate studies are available.

Breast Imaging and Diagnosis

Breast health awareness is an important element for a woman’s well-being, and we encourage all women to seek services that take control of their breast health. The following outlines basic and advanced breast health services that Alliance Radiology offers:

Mammography is a low dose, specialized x-ray examination of a woman’s breast. It is divided into two types: Screening and Diagnostic.

• Screening mammograms are an annual routine exam. The goal of a screening mammogram is to detect breast cancer at its earliest stage in patients without symptoms. The American College of Radiology, Society of Breast Imaging, and American Society of Breast Surgeons recommend routine annual screening mammography in average risk women beginning at age 40. It is now also recommended that annual screening mammography in high risk (greater than or equal to 20% lifetime percent risk of breast cancer) women should begin at age 30.
  
  
• Diagnostic mammograms are for problem solving. Situations where a diagnostic mammogram might be ordered include patient symptoms such as a palpable lump, focal pain, or nipple discharge as well as an abnormality on a screening mammogram.

All examinations are performed on a state-of-the-art system accredited by The American College of Radiology. A sophisticated computer tracking system allows us to keep patients informed of the need for additional evaluation or follow-up. Patients are also sent automatic reminder notices for routine and diagnostic mammograms.

Ultrasound of the breast is another imaging tool used for problem solving. It uses soundwaves to identify lesions of various types, including cysts, solid masses, distortions, and normal tissue. This examination is useful in assessing areas found on mammography, MRI, or palpable findings which are not readily seen on mammography. As a result, it is often used as a guidance method for many biopsies.

Magnetic Resonance Imaging (MRI) is another imaging examination that can aid in the detection of breast disease as well as problem solving. This imaging tool uses magnetic waves and no radiation is involved. It is often used for women with a recently diagnosed breast cancer, both to evaluate the known cancer and to look for additional cancers in the same or opposite breast as well as for women who are high risk and require supplemental screening. Any detection of lesions or abnormalities may require additional “second look” evaluation with ultrasound and or mammography which can lead to ultrasound or stereotactic biopsy. Alternatively, MRI biopsy may be recommended of subtle findings from the MRI examination which are not seen or have a low likelihood of being identified on ultrasound or mammography.

Core Needle Biopsy is the primary technique used to diagnose most breast lesions in a minimally invasive fashion to determine if the patient requires further surgical intervention. The majority of breast biopsies are benign, but some patients are found to have breast cancer and surgery/oncology treatment are planned. Biopsies can be performed with 2D or 3D mammographic (stereotactic), ultrasound, or MRI guidance. The procedure is performed with local anaesthetic and is well tolerated by most patients.

Wire/Seed Localization is performed by the radiologist prior to surgery using mammographic, ultrasonographic, radioactive seed, or MRI guidance. This procedure identifies the area that allows the surgeon to localize and remove the correct area of breast tissue.

CT Scan

CT is one of the most useful diagnostic examinations available and allows for the visualization of organs, bone and blood vessels. A rotating x-ray device and advanced computer create detailed cross-sectional images of regional anatomy. All exams are tailored by the radiologist to evaluate a given problem and are conducted by technologists with advanced certification in CT.

Diagnostic Radiology

X-ray imaging has been performed for over 100 years and is still an excellent tool for assessing skeletal trauma and pain as well as for thoracic imaging for evaluation of the heart and lungs.

Fluoroscopy

Fluoroscopy is an imaging technique commonly used by physicians to obtain real-time moving images of the internal structures of a patient through the use of a fluoroscope. In its simplest form, a fluoroscope consists of an x-ray source and fluorescent screen between which the patient is placed.

Interventional Radiology

Interventional Radiology (abbreviated IR or sometimes VIR for vascular and interventional radiology) is a subspecialty of radiology in which minimally invasive procedures are performed using image guidance. Some of these procedures are done for purely diagnostic purposes (e.g., angiogram), while others are done for treatment purposes (e.g., angioplasty). Pictures (images) are used to direct these procedures, which are usually done with needles or other tiny instruments like small tubes called catheters. The images provide road maps that allow the Interventional Radiologist to guide these instruments through the body to the areas of interest.

Mammography

Mammography is the primary screening examination for the early detection of breast cancer and can detect cancer up to several years before a lump can be felt. Along with ultrasound, it is also used to evaluate palpable abnormalities. All examinations are performed on a state-of-the-art system accredited by The American College of Radiology. A sophisticated computer tracking system allows us to keep patients informed of the need for additional evaluation or follow-up. Patients are also sent automatic reminder notices for routine mammograms.

MRI

Magnetic resonance imaging (MRI) uses radio waves and a strong magnetic field instead of diagnostic (x-ray) to create sharp detailed pictures that show different types of tissue within the same organs. The parts of the musculoskeletal system that are most often imaged with MRI are the hips, knees and shoulders, but MRI is also used to study almost every joint in the body, including the ankles, wrists and hands. An MRI allows the review of some body parts that may not be as easy to see with other methods of imagining.

This type of procedure typically consists of 2 to 6 sequences of pictures with each lasting 2 to 15 minutes, and each sequence showing a cross-section of the body part. The MRI causes no pain but the patient may notice a warm feeling in the target area, which is normal. If a contrast injection is needed, you may feel discomfort at the injection site, and you may have a cool sensation at the site during the injection. The procedure creates loud tapping or knocking noises heard at certain phases of the exam, so patients are typically offered earplugs or headphones with music to stay relaxed during the exam.

Results from an MRI that may need pre-surgical planning are immediately discussed with your physician.

Stroke and Vascular Disease Prevention

An estimated 20 to 30 million Americans are at risk for various vascular diseases, including stroke, peripheral arterial disease, carotid artery disease and aortic aneurysms. Vascular disease outside the heart causes almost as much death and disability as heart disease, and more than any cancer.

If you are over age 50 and have one or more of the following known risk factors for vascular disease, you should consult your physician about radiology procedures that may be beneficial to you.

• Diabetes
• Hypertension (High blood pressure)
• Smoking
• High cholesterol
• Family history of vascular and/or circulatory problems

Stroke is the leading cause of serious, long-term disability, and the third leading cause of death in the U.S. People with peripheral vascular disease are 4-5 times more likely to die of a heart attack or stroke. Early detection of vascular disease is your best opportunity to prevent serious, life-threatening complications.

Watch for these stroke symptoms if you think you or someone else is having a stroke:

• Trouble walking. If you’re having a stroke, you may stumble or have sudden dizziness, loss of balance or loss of coordination.
  
  
• Trouble speaking. If you’re having a stroke, you may slur your speech or may not be able to come up with words to explain what is happening. Try to repeat a simple sentence. If you can’t, you may be having a stroke.
  
  
• Paralysis or numbness on one side of your body. If you’re having a stroke, you may have sudden numbness, weakness or paralysis on one side of the body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke.
  
  
• Trouble seeing. If you’re having a stroke, you may suddenly have blurred or blackened vision or may see double.
  
  
• Headache. A sudden, severe headache or an unusual headache, which may be accompanied by a stiff neck, facial pain, pain between your eyes, vomiting or altered consciousness, sometimes indicates you’re having a stroke.

Ultrasound

Ultrasound is an excellent non-invasive method for examining organs and blood vessels with fine anatomical detail and real-time images. Ultrasound is utilized extensively in abdominal and pelvic imaging, including obstetrics. Venous, carotid, and extremity vascular studies are also routinely performed by our registered diagnostic medical sonographers with advanced vascular certification.

Uterine Fibroid Embolization (UFE)

Uterine fibroid embolization provides a new alternative to hysterectomies for many women who suffer from the pain and heavy bleeding of uterine fibroids. Through endovascular techniques, Alliance physicians are able to localize and eliminate the blood supply to the fibroids, decreasing their size while leaving the uterus intact. The procedure has a very high success profile as a treatment for bulk-related symptoms and bleeding related to fibroids.

Varicose Veins

Venous disease, including spider and varicose veins, is not simply a cosmetic problem. It is a real medical problem, with real symptoms that impact patient’s lives. If left untreated, varicose veins can progress and lead to significant complication, such as chronic swelling, vein inflammation, skin discoloration and ulcers. Alliance offers treatments that provide a safe, effective and virtually pain-free way to treat painful and unsightly varicose veins, without surgical vein stripping, which was the primary treatment option in the past.

Vertebroplasty and Kyphoplasty

Vertebroplasty and kyphoplasty are minimally invasive procedures for vertebral compression fractures (VCF), which are fractures in vertebra, the small bones that make up the spinal column.

When a vertebra fractures, the usual rectangular shape of the bone becomes compressed and distorted, causing pain. These compression fractures, which may involve the collapse of one or more vertebrae in the spine, are a common symptom and result of osteoporosis. Osteoporosis is a disease that results in a loss of normal bone density, mass and strength, leading to a condition in which bones are increasingly porous or full of small holes and vulnerable to breaking. Vertebrae can also become weakened by cancer.

In vertebroplasty, physicians use image guidance to inject a special cement mixture through a hollow needle into the fractured bone. In kyphohplasty, a balloon is first inserted through the needle into the fractured bone to restore the height and shape of the vertebra. Then the balloon is removed and the cement mixture is injected into the cavity created by the balloon.