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Procedures are a key part of Neuroradiology. The most commonly performed procedures outside of the neurovascular realm include fluoroscopy-guided lumbar punctures and myelograms, and Fellows should become experts in performance of these procedures and be capable of teaching them to other trainees such as radiology residents. Fellows should develop a working knowledge of each of these procedures, including how they are performed, and their common risks and contraindications. Fellows should know about procedural complications including risks of bleeding, and should be able to adapt to a complex patient.
Other less common procedures performed by Diagnostic Neuroradiology Fellows include intrathecal drug delivery, biopsies, and neurovascular procedures.
In our Community Spine IR rotation, Fellows will develop basic training in the evaluation of patients with chronic spinal pain and learn to perform percutaneous fluoroscopically guided spinal interventions (including facet injections, medial branch blocks, selective spinal nerve blocks and epidural steroid injections).
Fellows should already be aware from their radiology residency training of the imaging and basic management of most common conditions, including trauma, spine degenerative disease, and vascular imaging. Fellows should focus on high-end knowledge about more specific conditions and should focus on providing a better differential diagnosis. For example, a Fellow should be able to give you information about the most likely specific subtype of brain tumor, not just tell you that a brain tumor is likely to be present.
Fellows should also know more about the details of advanced imaging techniques that offer more sophisticated imaging of brain structure and function. These advanced techniques include functional MRI, MR spectroscopy, MR perfusion, and diffusion tensor imaging. Fellows should become familiar with the general application of these techniques and how they can contribute to the diagnosis and management of certain disorders. Fellows should also know how to tweak those examinations to obtain optimal information in particular clinical scenarios.