What the radiologist should know about the role of interventional radiology in urology

Interventional radiology has been constantly developing in terms of the techniques, materials, and methods of intervention. It interacts with all areas of medicine, always with the ultimate goal of ensuring the well-being of patients. Advances in imaging techniques, especially in the last two decades, have led to a paradigm shift in the field of urological imaging interventions. Many urologic diseases that were previously treated only surgically can now be effectively managed using minimally invasive image-guided techniques, often with shorter hospital stays and requiring only local anesthesia or conscious sedation.

Keywords:
Radiology, interventional; Urology; Fluoroscopy; Tomography, X-ray computed; Ultrasonography; Magnetic resonance imaging

Authorship

Tiago Kojun Tibana

Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil.Universidade Federal de Mato Grosso do SulBrazilCampo Grande, MS, BrazilHospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil.

http://orcid.org/0000-0001-5930-1383

Vinícius Adami Vayego Fornazari

Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.Universidade Federal de São PauloBrazilSão Paulo, SP, BrazilEscola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.

http://orcid.org/0000-0002-5880-1703

Walberth Gutierrez Junior

http://orcid.org/0000-0002-9798-221X

Edson Marchiori

Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.Universidade Federal do Rio de JaneiroBrazilRio de Janeiro, RJ, BrazilUniversidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.

http://orcid.org/0000-0001-8797-7380

Denis Szejnfeld

http://orcid.org/0000-0001-8482-5955

Thiago Franchi Nunes Correspondence: Dr. Thiago Franchi Nunes. Avenida Senador Filinto Müller, 355, Vila Ipiranga. Campo Grande, MS, Brazil, 79080-190. Email: thiagofranchinunes@gmail.com.

http://orcid.org/0000-0003-0006-3725

Correspondence: Dr. Thiago Franchi Nunes. Avenida Senador Filinto Müller, 355, Vila Ipiranga. Campo Grande, MS, Brazil, 79080-190. Email: thiagofranchinunes@gmail.com.

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (11)

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Figure 1
Contrast-enhanced coronal and axial computed tomography of the abdomen (A and B, respectively), showing marked bilateral hydronephrosis, caused by a mass (sarcoma) in the prostate gland, invading both ureteral orifices and making cystoscopic JJ stenting impossible.

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Figure 2
Planning of percutaneous JJ stenting with ultrasound of the urinary tract in the hemodynamics room (A). X-ray showing adequate positioning of both ends of the JJ stent after the procedure (B).

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Figure 3
Renal angiography showing pseudoaneurysm after partial nephrectomy (A), evolving to macroscopic hematuria. Embolization with vascular coils (B).

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Figure 4
Patient with macroscopic hematuria who had been diagnosed with renal neoplasia that was refractory to treatment and were not candidates for surgery. Renal angiography showing a vascularized, poorly delimited tumor (A). The patient was treated with embolization. Follow-up renal angiography showing regression of the findings, indicating the success of the procedure (B).

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Figure 5
Pre- and post-treatment angiography with selective embolization (A and B, respectively), showing good results in patients with previously resected prostate cancer, presenting hematuria due to locoregional tumor recurrence.

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Figure 6
Sagittal and axial computed tomography angiography (A and B, respectively), showing compression of the left renal vein between the aorta and the superior mesenteric artery (nutcracker syndrome) in a patient with varicocele.

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Figure 7
Angiography showing endovascular treatment with dense foam and fibered coils (A,B) in a patient with nutcracker syndrome.

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Figure 8
In-phase gradient-echo coronal magnetic resonance imaging of the abdomen, showing renal cell carcinoma in the right mid-kidney (A). Follow-up magnetic resonance imaging after percutaneous ablation, showing regression of the tumor (B).

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Figure 9
Axial computed tomography of the abdomen, showing percutaneous ablation of a renal cell carcinoma.

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Figure 10
Primary hyperaldosteronism in a patient diagnosed with functional adrenal adenoma in a single adrenal gland (arrow), visualized on contrast-enhanced fat-saturated T1-weighted magnetic resonance imaging of the abdomen (A). Percutaneous ablation, performed as an alternative to laparoscopic treatment, provided improvement in the clinical and imaging parameters. Follow-up magnetic resonance imaging showing the success of the procedure (B).

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Figure 11
Axial computed tomography of the abdomen, showing percutaneous ablation of an adrenal adenoma.

Figure 1 Contrast-enhanced coronal and axial computed tomography of the abdomen (A and B, respectively), showing marked bilateral hydronephrosis, caused by a mass (sarcoma) in the prostate gland, invading both ureteral orifices and making cystoscopic JJ stenting impossible.

Figure 2 Planning of percutaneous JJ stenting with ultrasound of the urinary tract in the hemodynamics room (A). X-ray showing adequate positioning of both ends of the JJ stent after the procedure (B).

Figure 3 Renal angiography showing pseudoaneurysm after partial nephrectomy (A), evolving to macroscopic hematuria. Embolization with vascular coils (B).

Figure 4 Patient with macroscopic hematuria who had been diagnosed with renal neoplasia that was refractory to treatment and were not candidates for surgery. Renal angiography showing a vascularized, poorly delimited tumor (A). The patient was treated with embolization. Follow-up renal angiography showing regression of the findings, indicating the success of the procedure (B).

Figure 5 Pre- and post-treatment angiography with selective embolization (A and B, respectively), showing good results in patients with previously resected prostate cancer, presenting hematuria due to locoregional tumor recurrence.

Figure 6 Sagittal and axial computed tomography angiography (A and B, respectively), showing compression of the left renal vein between the aorta and the superior mesenteric artery (nutcracker syndrome) in a patient with varicocele.

Figure 7 Angiography showing endovascular treatment with dense foam and fibered coils (A,B) in a patient with nutcracker syndrome.

Figure 8 In-phase gradient-echo coronal magnetic resonance imaging of the abdomen, showing renal cell carcinoma in the right mid-kidney (A). Follow-up magnetic resonance imaging after percutaneous ablation, showing regression of the tumor (B).

Figure 9 Axial computed tomography of the abdomen, showing percutaneous ablation of a renal cell carcinoma.

Figure 10 Primary hyperaldosteronism in a patient diagnosed with functional adrenal adenoma in a single adrenal gland (arrow), visualized on contrast-enhanced fat-saturated T1-weighted magnetic resonance imaging of the abdomen (A). Percutaneous ablation, performed as an alternative to laparoscopic treatment, provided improvement in the clinical and imaging parameters. Follow-up magnetic resonance imaging showing the success of the procedure (B).

Figure 11 Axial computed tomography of the abdomen, showing percutaneous ablation of an adrenal adenoma.

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Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem Av. Paulista, 37 - 7º andar - conjunto 71, 01311-902 - São Paulo - SP, Tel.: +55 11 3372-4541, Fax: 3285-1690, Fax: +55 11 3285-1690 - São Paulo - SP - Brazil
E-mail: radiologiabrasileira@cbr.org.br

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What the radiologist should know about the role of interventional radiology in urology

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[1] Correspondence: Dr. Thiago Franchi Nunes. Avenida Senador Filinto Müller, 355, Vila Ipiranga. Campo Grande, MS, Brazil, 79080-190. Email: thiagofranchinunes@gmail.com.