B5404 - Tecniche di imaging angiografiche ed emodinamica (BO)

Learning outcomes

Students acquire the technical, practical, and methodological knowledge necessary to perform angiographic examinations with appropriate protocols based on the patient's clinical question, the pathology, and the type of equipment available. They recognize artifacts and image quality criteria, the multidisciplinary team, and radiation protection and hygiene standards.

Course contents

The course unit introduces the main angiographic and hemodynamic imaging techniques, with particular attention to the technical and practical aspects relevant to the Medical Radiology Technician.

Main topics:

• introduction to the angiography suite, catheterization laboratory and hybrid operating room;

• role of the Medical Radiology Technician in angiographic, hemodynamic and interventional procedures;

• organization of the multidisciplinary team and integration with other healthcare professionals;

• main components of angiographic equipment;

• monoplanar and biplanar angiographic systems;

• C-arm, digital detectors, angiographic table, monitors, image acquisition and archiving systems;

• principles of fluoroscopy, pulsed fluoroscopy and digital angiographic acquisition;

• Digital Subtraction Angiography, roadmap, reference fluoroscopy and subtraction techniques;

• image quality criteria in angiographic imaging;

• recognition of the main artefacts and strategies for their prevention or correction;

• optimization of technical parameters according to anatomical district, clinical question, procedure and patient body habitus;

• main acquisition protocols in angiographic and hemodynamic procedures;

• management of projections, incidence angles, obliquities and reconstructions;

• methodology of coronary angiographic image acquisition;

• diagnostic coronary angiography: technical principles, main projections and quality criteria;

• coronary angioplasty: procedural phases, technical support and image management;

• complementary techniques in hemodynamics: OCT, IVUS and FFR;

• role of intravascular and functional imaging in the qualitative and quantitative assessment of stenosis;

• main structural heart procedures in the hybrid room;

• TAVI: general principles, procedural phases and technical-radiological support;

• main peripheral vascular and aortic procedures;

• EVAR and FEVAR: general principles, angiographic imaging, planning and intra-procedural control;

• use of image processing software;

• principles of fusion imaging in complex endovascular procedures;

• rotational protocols and cone beam CT in angiographic and interventional settings;

• main diagnostic and interventional angiographic procedures in arterial and venous districts;

• technical management of the automatic contrast medium injector;

• general characteristics of iodinated contrast media in angiography;

• use of CO₂ as a contrast medium in specific procedural contexts;

• safety, preparation and control of devices used in angiographic procedures;

• hygiene, asepsis and conduct rules in the angiography suite;

• principles of sterility, gowning, sterile field management and operator movement within the room;

• radiation protection of patients and operators;

• individual and collective protective equipment;

• correct use of lead aprons, thyroid shields, lead glasses, protective barriers, mobile shields and radiation protection drapes;

• principles of dose optimization in fluoroscopy and angiography;

• control of fluoroscopy time, distance, collimation, filtration, frame rate and low-dose modes;

• dose area product, air kerma and dosimetric indicators in interventional procedures;

• prevention of radiation-induced skin injuries during prolonged procedures;

• traceability of dosimetric data and technical-documentary quality of the procedure;

• patient management during angiographic and hemodynamic procedures;

• attention to patient safety, comfort, communication and preparation;

• selected iconographic examples and procedural videos aimed at understanding procedural phases, image quality and the technical role of the Medical Radiology Technician.

The clinical background of the procedures is presented exclusively for educational purposes, in order to understand the technical rationale of the examination, the choice of acquisition protocols, collaboration with the team, and optimization of image quality and radiation dose.

Readings/Bibliography

Teaching materials will mainly consist of lecture notes, presentations and iconographic materials provided by the teacher and made available through the Virtuale platform.

Further bibliographic references, scientific articles, guidelines or supplementary materials may be indicated during the course on the following topics:

• digital angiographic imaging;

• hemodynamics and interventional cardiology;

• vascular interventional radiology;

• hybrid room and endovascular procedures;

• radiation protection in interventional fluoroscopic procedures;

• technical management of contrast media and automatic injectors.

Teaching methods

The course unit includes lectures supported by presentations, angiographic images, fluoroscopic sequences, procedural videos and selected technical-procedural cases.

Teaching will focus on the applied understanding of the role of the Medical Radiology Technician in angiographic and hemodynamic procedures, with particular reference to equipment management, image quality, radiation protection, sterility and collaboration with the multidisciplinary team.

Group discussions of clinical-procedural cases may be proposed in order to promote technical reasoning, recognition of operational criticalities and correct application of safety and quality principles.

Assessment methods

Learning will be assessed through an oral examination.

The examination will cover the topics addressed during the lectures and will assess:

• knowledge of the main angiographic and hemodynamic equipment;

• understanding of image acquisition protocols;

• ability to describe the main hemodynamic, angiographic and hybrid room procedures;

• knowledge of the technical role of the Medical Radiology Technician in the different procedural phases;

• ability to recognize image quality criteria and main artefacts;

• knowledge of hygiene, asepsis and sterility rules;

• knowledge of radiation protection principles for patients and operators;

• ability to discuss the technical and practical aspects of angiographic and hemodynamic imaging in an appropriate, critical and coherent manner.

The assessment will take into account content accuracy, clarity of presentation, appropriate use of technical and professional terminology, and the ability to integrate procedural, radiation protection and organizational aspects.

Teaching tools

The following teaching tools will be used:

• lecture slides;

• selected angiographic images;

• videos and fluoroscopic sequences of hemodynamic and interventional procedures;

• technical diagrams of equipment and angiography suites;

• examples of acquisition protocols;

• selected procedural cases;

• teaching materials uploaded to the Virtuale platform;

• any articles, guidelines or supplementary materials indicated by the teacher.

The teaching materials covered during the lectures will be shared through the UniBO Virtuale platform.

Students with learning disorders and\or temporary or permanent disabilities: please, contact the office responsible (https://site.unibo.it/studenti-con-disabilita-e-dsa/en/for-students) as soon as possible so that they can propose acceptable adjustments. The request for adaptation must be submitted in advance (15 days before the exam date) to the lecturer, who will assess the appropriateness of the adjustments, taking into account the teaching objectives.

Office hours

See the website of Giulia Carpanelli