Neuroradiology

Our neuro-interventional group treats both pediatric and adult patients. We can take direct appointments, interview, examine patients, review any imaging, and make recommendations in our weekly outpatient clinic. We provide clinic surveillance and long-term follow-up for patients who have treatments or who are being monitored without treatment. The section also serves in a consulting role for inpatient care. We have weekly multidisciplinary meetings where potential treatments are discussed with colleagues in neurosurgery, neurology, oncology, and otolaryngology, ensuring the pooling of expert knowledge and experience in all cases. The diagnostic neuroradiologists also attend daily multidisciplinary meetings to review imaging findings with the patient’s hospital care teams.

Vascular neuro-interventional procedures are performed in our new state of the art Phillips Biplane suites including:

• Cerebral angiography
• Brain aneurysm coiling, Web embolization, Flow Diversion
• Brain arteriovenous malformation embolization
• Dural arteriovenous fistula embolization
• Caroticocavernous fistula embolization
• Brain artery mechanical thrombectomy for acute stroke
• Carotid artery stenting
• Meningioma embolization
• Selected subdural hematoma embolization
• Intracranial atherosclerosis angioplasty and stenting
• Retinoblastoma chemoembolization
• Glomus/paraganglioma tumor embolization
• Pituitary and parathyroid venous sampling
• Epistaxis (nosebleed) embolization
• Juvenile angiofibroma embolization
• Head and neck trauma embolization/stent grafting
• Venous sinus stenting for idiopathic intracranial hypertension/pseudotumor
• Venous sinus thrombectomy
• Vein of Galen malformation embolization
• Spinal angiography
• Spinal tumor embolization
• Head and neck lymphatic and venous malformation percutaneous sclerotherapy
• Pulsatile tinnitus work up and treatment

Non-Vascular neuro-interventional procedures may be performed in a biplane suite, in a dedicated CT fluoroscopy suite, or using ultrasound guidance and include:

• Spinal tumor biopsy
• Spinal tumor radiofrequency ablation
• Spinal compression fracture vertebroplasty and kyphoplasty
• Head and neck tumor FNA and biopsy
• Cervical nerve root injection
• Lumbar and cervical epidural steroid injection
• Lumbar nerve root injection
• Lumbar puncture and myelography
• Cervical puncture and myelography
• Blood or fibrin epidural patch, lumbar, thoracic and cervical
• Lumbar drain placement
• Spinraza spinal injection
• CSF leaks work up and treatment

On the diagnostic side, we cover the entire breadth of standard and advanced neuroimaging, from optimizing the image quality, then carefully examining the images to detect abnormalities, interpret their nature and significance, using expertise in radiology, neuroanatomy, neuropathology, and medical neurosciences, and communicating the findings to the patient’s medical management team. We have particularly large volumes of stroke, brain tumor, neck cancer, and epilepsy patients. We are one of the few level 1 trauma centers in the state. Advanced MR techniques include functional MRI, spectroscopy, permeability imaging, CSF flow studies, fetal MRI, cerebral perfusion, and angiography. Dual-source CT enables virtual subtraction of contrast, new CT algorithms enable better imaging through metallic hardware. CT angiography and perfusion of acute stroke are instantly available to our neuro-interventionists and stroke team through the RAPID-AI application to make immediate management decisions, with over 150 catheter stroke treatments per year.

Across the campus, we have 14 MR units including Phillips and GE, 3T, and 1.5T. A dedicated Phillips 3T MR scanner is used for research in functional imaging, spectroscopy, and clinical research trials. There are 10 CT units including dual-source technology and an interventional CT fluoroscopy machine for interventions. Two dedicated neuro-angiography suites with Philips Azurion 7 biplane system with flat panel detectors, full 3D angiography, image fusion, and guidance capability for neuro-interventional treatments.

Areas of investigation include: perfusion imaging in the evaluation of intracranial neoplasms; diffusion tensor imaging in the evaluation of intracranial neoplasms, DTI in multiple sclerosis and other white matter diseases, methods of quantification on multiple sclerosis lesions, hydrocephalus, intracranial pressure and neurocognition, intracranial vessel wall imaging to stratify stroke risk, permeability measurement in intracranial aneurysms, models of stroke to evaluate neuroprotective strategies, artificial intelligence and radiomics to detect and diagnose specific tumors, functional MRI in pre-operative planning.

The section oversees the diagnostic neuroradiology fellowship program which can be viewed through the “Education” link at the top of the screen. Diagnostic radiology residents and medical students also rotate through the section, as well as observerships offered to trainees from the clinical neurosciences including neurology and neurosurgery. Neuroradiology faculty are involved in education beyond the department and institution and are regularly invited speakers at national and international meetings.

The section of neuroradiology at The University of Chicago is comprised of eight nationally-renown full-time faculty members who are all dedicated to patient care, medical education, and advancing the forefront of medicine.