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Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies (such as x-ray radiography, ultrasound, computed tomography (CT), nuclear medicine, positron emission tomography (PET) and magnetic resonance imaging (MRI)) to diagnose or treat diseases. Interventional radiology is the performance of, usually minimally invasive, medical procedures with the guidance of imaging technologies.
The acquisition of medical imaging is usually carried out by the radiographer or radiologic technologist. The field of radiology is rapidly expanding due to advances in computer technology, which is closely linked to modern imaging. Radiology is an expanding field in medicine. Applying for residency positions in radiology has become increasingly competitive. Applicants are often near the top of their medical school class, with high USMLE (United States Medical Licensing Examination) scores.
Diagnostic radiologists must complete prerequisite undergraduate education, 4 years of medical school, one year of internship, and 4 years of residency training. After residency, radiologists often pursue one or two years of additional specialty fellowship training. Veterinary radiologists are veterinarians that specialize in the use of X-rays, ultrasound, MRI and nuclear medicine for diagnostic imaging or treatment of disease in animals. They are certified in either diagnostic radiology or radiation oncology by the American College of Veterinary Radiology.
Several medical schools in the US have started to incorporate radiology education into their core MD training. New York Medical College, The Wayne State University School of Medicine, the Uniformed Services University, and the University of South Carolina School of Medicine offer integrated radiology curriculum during their respective MD Programs. Peripheral vascular disease (PVD) refers to the obstruction of large arteries not within the coronary, aortic arch vasculature, or brain.
PVD can result from atherosclerosis (ath-uh-roh-skluh-roh-sis), which is when fatty substances form a deposit of plaque on the inner lining of arterial walls, inflammatory processes leading to stenosis [sti-noh-sis], which is a narrowing or stricture of a passage or vessel, an embolism, which is the occlusion of a blood vessel by an embolus (undissolved material carried by the blood and impacted in some part of the vascular system, as thrombi or fragments of thrombi, tissue fragments, clumps of bacteria, rotozoan parasites, fat globules, or gas bubbles), or thrombus (a clot that forms in and obstructs a blood vessel, or that forms in one of the chambers of the heart) formation. PVD causes either acute or chronic ischemia [ih-skee-mee-uh] (lack of blood supply). The symptoms of PVD are: ???Claudication – pain, weakness, numbness, or cramping in muscles due to decreased blood flow ???Sores, wounds, or ulcers that heal slowly or not at all Noticeable change in color (blueness or paleness) or temperature (coolness) when compared to an unaffected limb ???Diminished hair and nail growth on affected limb and digits. Upon suspicion of PVD, the first thing that is examined is the ankle brachial pressure index (ABPI/ABI). When the blood pressure readings in the ankles are lower than that in the arms, blockages in the arteries which provide blood from the heart to the ankle are suspected. An ABI ratio less than 0. 9 is consistent with PVD; values of ABI below 0. indicate moderate disease and below 0. 4 imply severe ischemic disease. If ABIs are abnormal, radiologists take action. The next step is generally a lower limb doppler ultrasound examination to look at the site and extent of atherosclerosis. Other imaging can be performed by angiography [an-jee-og-ruh-fee], where a catheter [kath-i-ter] is inserted into the common femoral artery and selectively guided to the artery in question. While injecting a radiodense contrast agent, an X-ray is taken.
Any flow limiting stenoses found in the x-ray can be identified and treated by atherectomy [ath-uh-rek-tuh-mee], which is the removal of plaque from an artery by means of a tiny rotating cutting blade inserted through a catheter, angioplasty [an-jee-uh-plas-tee], which is the repair of a blood vessel, as by inserting a balloon-tipped catheter to unclog it or by replacing part of the vessel with either a piece of the patient’s own tissue or a prosthetic device, or stenting, which is a surgical procedure or operation for inserting a small, expandable tube called a stent into an anatomical vessel.