Endovascular embolization: review of currently available embolization agents.

Percutaneous vascular embolization is one of the major applications of interventional radiology. A wide variety of embolization agents are currently available for clinical use. The interventional radiologist needs to be up to date with the newer and different types of embolic agents available along with their biopharmaceutical characteristics, strengths, and weaknesses that have been reviewed. For the purpose of this review, we have classified embolization agents into mechanical occlusion devices, particulate agents, and liquid agents, with some degree of overlap between some of the agents.

Pelvic congestion syndrome.

Pelvic congestion syndrome (PCS) is an important cause of chronic pelvic pain in female patients. Chronic pelvic pain, defined as lower abdominal or pelvic pain for a duration of 6 months or more, causes significant morbidity and results in a large number of diagnostic laparoscopies. It is of utmost importance to identify treatable causes of chronic pelvic pain, one of which is PCS. The etiology, clinical features, investigations, and treatment options in PCS have been discussed in this paper.

A comparative analysis of noncontrast flow-spoiled versus contrast-enhanced magnetic resonance angiography for evaluation of peripheral arterial disease.

PURPOSE: This feasibility study aimed to obtain initial data to assess the performance of a novel noncontrast spoiled magnetic resonance (MR) angiography technique (fresh-blood imaging [FBI]) compared to gadolinium-enhanced MR (Gd-MR) angiography for evaluation of the aorto-iliac and lower extremity arteries. MATERIALS AND METHODS: Thirteen patients with suspected lower extremity arterial disease that had undergone Gd-MR angiography and FBI at the same session were randomly included in the study. FBI was performed using an ECG-gated ow-spoiled T2-weighted half-Fourier fast spin-echo sequence. For analysis, the aortoiliac and lower limb arteries were divided into 18 anatomical segments. Two blinded readers individually graded image quality of FBI and also assessed the presence and severity of any stenotic lesions. A similar analysis was performed for the Gd-MR angiography images. RESULTS: A total of 385 arterial segments were analyzed; 34 segments were excluded due to degraded image quality (1.3% of Gd- MR vs. 8% of FBI-MR angiography images). FBI-MR angiography had comparable accuracy to Gd-MR angiography for assessment of the above knee vessels with high kappa statistics (large arteries, 0.91; small arteries, 0.86) and high sensitivity (large arteries, 98.1%; small arteries, 88.6%) and specificity (large arteries, 97.2%; small arteries, 97.6%) using Gd-MR angiography as the gold standard. CONCLUSION: Initial results show good agreement between FBI-MR angiography and Gd-MR angiography in the diagnosis of peripheral arterial disease, making FBI a potential alternative in patients with renal impairment. FBI showed highest accuracy in the above knee vessels. Technological refinements are required to improve accuracy for assessing the calf and pedal vessels.