Introduction to Neuroradiology Department

1. Previous department directors:

The first term: Dr. Zhang Zun (August 1964 to January 1969)
1. Developed intracerebral air injection photography.
2. Develop cerebral angiography to diagnose intracranial diseases.

Second term: Dr. Li Renjie (January 1969 to July 1974)

1. Develop pre-operative embolization for head and neck tumors to reduce blood loss during surgery.

2. Detachable balloon for the treatment of carotid-cavernous sinus fistula (March 1974).

The third term: Dr. Deng Muhuo (August 1974 to July 1995)

1. Transorbital puncture into the cavernous sinus was used in our hospital to treat recurrent carotid cavernous sinus fistula (June 1976).

2. Intracranial aneurysm was successfully treated with embolization (combined with detachable balloon and liquid suppository) (September 1977).

3. Promote the use of vascular supports to treat intravascular clot dissolution in head and neck artery stenosis and acute ischemic stroke.

Fourth term: Dr. Guo Wanyou (since August 1995)

1. WYGuo, HC Pan, HM Wu, WY Chung, CY Shiau, LW Wang, HJ Chiou, MY Yen, MMH Teng, 1998, Radiosurgery as a treatment alternative for dural arteriovenous fistulas of cavernous sinus. AJNR 19:1081-1087

2. WY Guo, S. Ono, S. Oi; SH Shen, TT Wong, HW Chung, JH Hung, 2006 Dynamic Motion Analysis of Fetuses with Central Nervous System Disorders by Cine Fetal MR Using Fast Imaging Employing Steady-State Acquisition with Parallel Imaging Technique -A Preliminary Result. J Neurosurgery (Pediatrics) 105:94-100 Some videos of this study are excerpted for viewing. (This video is only for viewing in the hospital, and the copyright belongs to Director Guo Wanyou)

3. Relevant articles have been published in several medical journals 

The fifth term: Dr. Luo Zhaobao (from February 105 of the Republic of China)

Current: Dr. Zhang Fengji (since April 110, Republic of China)

2. The most outstanding undergraduate medical technology

Outstanding technology of neuroradiology department 1:

"Treatment of cavernous sinus vascular disease by puncture through the orbit through the superior orbital fissure" technique

In June 1976, a case of recurrent carotid cavernous sinus was treated. This is a technique that directly punctures the cavernous sinus through a complete orbit to achieve the purpose of treatment. This case was published in the American Journal of Neurosurgery in 1988 [1]. In 1989, he won the Taipei Medical Technology Innovation Award. This technique continued to accumulate cases and was published in Radiology in 1995 [2]. This technology was demonstrated on a computer at the Neuroradiological Society of America conference and exhibition held in San Diego in 1999, and was awarded the Cum Laude Award.

1. Teng MMH , Guo WY, Lee LS, Chang T. 1988. Direct puncture of the cavernous sinus for obliteration of a recurrent carotid-cavernous fistula. Neurosurg. 23:104-107.

2. Teng MMH,Lirng JF,Chang T,Chen SS,Guo WY,Cheng CC,Shen WC,Lee LS. 1995. Embolization of Carotid Cavernous Fistula by Means of Direct Puncture through the Superior Orbital Fissure. Radiology 194:705-711

Outstanding Technology in Neuroradiology 2:

" Endovascular treatment of cerebral aneurysms (embolization)"

An aneurysm is caused by a defect in the artery wall that cannot withstand the pressure of blood, causing a local bulge. The overall mortality rate from a ruptured brain aneurysm is high, and many survivors are left with stroke symptoms such as paralysis. The typical treatment for an aneurysm is for the neurosurgeon to use a "microvascular clip" to clamp the junction of the aneurysm and the normal artery (here called the neck of the aneurysm). However, some aneurysms do not have good surgical treatments or are not suitable for general anesthesia, so endovascular treatment can be considered. Because an aneurysm is like a time bomb, it can rupture at any time and cause a stroke. Without this treatment material and embolization technology, once a neurosurgeon declares it inoperable, it is almost like a death sentence. Therefore this technology and material are extremely important.

Three outstanding technologies in the Department of Neuroradiology:

" Embolization Treatment of Carotid Cavernous Fistula"

Carotid cavernous fistulas mostly occur after trauma. There are also cases where aneurysm ruptures in the internal carotid artery in the cavernous sinus. The symptoms are: hearing murmurs, proptosis of the eye, conjunctival congestion or edema, high intraocular pressure (glaucoma), pain behind the eyes, bleeding (retrobulbar hemorrhage, intracranial hemorrhage, nose or nasopharyngeal hemorrhage), visual impairment or loss of vision , Restriction of eye movement (compression of the third, fourth or sixth cranial nerves), cerebral ischemia. The best treatment currently is embolization. Detachable balloons are commonly used. The technique of angiography is used to send the balloon to the cavernous sinus through the fistula under the control of the angiography X-ray machine screen. The balloon is then filled to an appropriate size and left in the cavernous sinus. . This seals the fistula and preserves the internal carotid artery. Since the first case was performed in March 1974, our hospital has accumulated more than 200 cases by 1988, and has always been the domestic referral and treatment center for this disease.

" One-stop development of quantitative X-ray angiography"

The undergraduate team is led by Director Guo Wanyou to integrate various modules of the X -ray digital flat-panel angiography system, including quantitative angiography ( Quantitative DSA ), flat-panel computer tomography (Flat Detector CT) , perfusion imaging (Parenchymal blood volume measurement) , and metal artifacts. It improved the cutting-edge functions of Metallic artifacts reduction and took the lead in proposing the concept of one-stop blood flow imaging diagnosis and treatment evaluation. Several related papers have been published in internationally renowned (SCI) academic journals. The clinical applications of this one-stop blood flow imaging diagnosis and treatment assessment include diagnosis and endovascular treatment of various cerebrovascular diseases, gamma knife radiosurgery and craniotomy treatment, and endovascular treatment of peripheral vascular, aortic and carotid artery diseases.

1. CJ Lin, SC Hung, WY Guo*, FC Chang, CB Luo, J. Beilner, M. Kowarschik, WF Chu, CY Chang. Monitoring Peri-Therapeutic Cerebral Circulation Time: A Feasibility Study Using Color-Coded Quantitative DSA in Patients with Steno-Occlusive Arterial Disease. AJNR Am J Neuroradiol. 2012, 33:1685-1690 (SCI), .Responsible author*

2. CJ Lin, M. Yu, SC Hung, MMH Teng, WY Guo*, FC Chang, CB Luo, WF Chu, CY Chang. In-Room Assessment of Cerebral BloodVolume for Guidance During Intra-Arterial Thrombolytic Therapy. Interventional Neuroradiology 2012 ,18:497-502 (SCI), Responsible author*

3. SC Hung, CJ Lin, WY Guo*, FC Chang, CB Luo, MM Teng, CY Chang. Toward the era of a one-stop imaging service using an angiography suite for neurovascular disorders. Biomed Res Int. 2013;2013: 873614. (SCI) Responsible author*

4. CJ Lin, CB Luo, SC Hung, WY Guo*, FC Chang, J. Beilner, M. Kowarschik, WF Chu, CY Chang. Application of color-coded digital subtraction angiography in treatment of indirect carotid-cavernous fistulas: Initial experience. J Chin Med Assoc. 2013 (SCI), responsible author*

5. SC Hung, CC Wu, CJ Lin, WY Guo*, CB Luo, FC Chang, and CY Chang. Artifacts Reduction of Different Metallic Implants in Flat Detector C-Arm CT. AJNR Am J Neuroradiol. 2014, in press, ( SCI), responsible author*

6. WF Chu, CJ Lin, WS Chen, SC Hung, CF Chiu, TH Wu, and WY Guo*. Radiation Doses of Cerebral Blood Volume Measurements Using C-Arm CT: A Phantom Study. AJNR Am J Neuroradiol. 2014, in press, (SCI), responsible author*

3. Neuroradiology service items

1. Provide imaging diagnosis of nervous system, head and neck, and spinal cord diseases, such as plain films, magnetic resonance imaging, computer tomography, and spinal photography, for clinicians to use as a basis for treatment.

2. Angiography is used to diagnose head and neck vascular lesions, including aneurysms, arteriovenous malformations, arteriovenous fistulas, arterial stenosis and vascular tumors.

3. Endovascular embolization is used to treat head and neck aneurysms, arteriovenous malformations, and arteriovenous fistulas.

4. Treatment of carotid-cavernous sinus fistulas.

5. Balloon dilatation is used to treat stenosis of arteries in the head and neck.

6. Use of vascular supports to treat stenosis of arteries in the head and neck.

7. Use balloon dilatation and vascular supports to treat subclavian artery steal.

8. Intravascular clot lysis for acute ischemic stroke.

9. Endovascular treatment of major bleeding from the mouth and nose.

10. Blood flow reduction embolization before surgery for head and neck tumors.

11. Tissue biopsy under computer tomography guidance

12. Intravascular catheter draws blood to measure hormone levels

13. Embolization of head and neck hemangiomas.

4. Future prospects of neuroradiology department

1. In the field of diagnostic neuroradiology, our department has been working hard to benefit patients.

2. The introduction and improvement of new technologies have increased the diagnosis rate and treatment possibilities of diseases, such as the development of fluoroscopy-guided pain treatment.

3. Electronicization and computerization of image data.

5. Development goals:

Use advanced neuroimaging technology to detect and diagnose various neurological diseases early and develop non-invasive imaging-guided diagnosis and therapy.

6. Development plan:

(1) Short-term (1-2 years)

1. Neurography teaching data file.

2. Develop various interventional diagnosis and treatment technologies.

3. Developing cross-platform integrated neuroimaging technology.

4. Retire old machines and upgrade machines with insufficient functions.

5. Select outstanding young doctors to study abroad to directly learn new knowledge and introduce new concepts of diagnosis and treatment.

(2) Medium term (3-4 years)

1. Actively cultivate neurological diagnosis and treatment talents at all levels.

2. Establish a research physician system.

3. Improve the quality and connotation of research, and break through the quality and quantity of published papers.

4. Based on the country and looking at the world, based on the existing international academic achievements, we strive for international research cooperation and exchange programs and host world-class academic conferences.

(3) Long-term (more than 5 years)

1. Construct a high-quality image-guided non-invasive medical center for diagnosis and treatment.

2. Create postmodern diagnosis and treatment with imaging medicine as the core