Centinela Radiology provides imaging and interventions for Women’s Health in Los Angeles, CA. Our radiologists focus on diagnosis, biopsy and localization of breast masses and treatment of fibroids and pelvic venous congestion.
Uterine fibroids are benign growths in the uterus, estimated to affect 30 to 40% of women. They frequently occur during the childbearing years. These benign (non-cancerous) growths often show no symptoms. Fibroids can be of any size, the larger uterine fibroids can result in heavy periods, frequent urination, bloating, pelvic pain, and constipation. In severe cases, fibroids can grow so large that a bulge is visible on the abdomen. A pelvic ultrasound detects uterine fibroids.
Chronic pelvic pain may be a result of blood pooling in the pelvic veins. A backward flow of blood into the ovarian veins is known as pelvic venous reflux. The vein swells in size, creating pressure. Pelvic pain can cause significant interference with activities of daily living. Diagnostic imaging such as a CT scan, MRI, laparoscopy, X-rays, pelvic ultrasound may be needed to rule out other causes.
Adenomyosis refers to endometrial tissue that normally lines the uterus growing abnormally into the uterine wall. During menstruation, endometrial tissue swells. When swelling occurs in the uterine wall, the patient may experience severe period pain, cramping, and heavy periods. If adenomyosis is suspected, your physician may order pelvic imaging such as an ultrasound or MRI.
Lesions in the breast tissue can be benign or malignant. Centinela Radiology offers digital mammography and percutaneous biopsy to detect and diagnose lumps. If a suspicious lesion is confirmed on a mammogram, a biopsy may be ordered.
Digital mammography uses X-ray radiation to produce a clear image of the breast tissue. Breast imaging such as a mammogram only detects if a mass is present. It does not show whether a growth is benign or cancerous. A physician may order a breast biopsy after observing a lump or abnormality on a mammogram to determine if the mass is cancerous.
Procedure: During a mammogram, the breast is placed between two firm surfaces. The breast tissue is compressed so a clear X-ray image can be taken. The X-ray captures images of the internal breast tissue. The images are then displayed on a computer screen and examined by a doctor. While conventional mammograms are stored on film, a digital mammogram is stored on a computer. This allows the image to be enhanced or magnified for further evaluation. Suspicious lesions may require a breast biopsy for further evaluation. If a patient has dense breast tissue, 3D tomosynthesis may be used instead of mammography.
A biopsy detects whether a suspicious lump is cancerous or benign.
Procedure: Under local anesthesia, a radiologist uses image guidance to locate the breast lump. A hollow needle is then inserted to collect a tissue sample. The needle is withdrawn and the skin is bandaged. The cells are examined under a microscope.
Before surgery for the removal of a breast tumor, a marker is placed for the surgeon to confirm the location of the tumor. Traditionally a wire marker was placed on the day of the surgery, which was the preferred technique for localizing breast tumors. However, the wire would be projecting outside the skin until the surgery. Centinela Radiology uses the ‘Savi Scout’ which is completely embedded into the breast using ultrasound guidance and can be performed up to 30 days before the surgery.
To treat pelvic or ovarian varicose veins, a radiologist may perform pelvic embolization. This nonsurgical procedure destroys pelvic varicose veins that lead to pelvic congestion. Embolic drugs or coils cause the vein to collapse so blood pooling can no longer occur. Recovery time is minimal. Cramping is the most commonly reported side effect of ovarian vein embolization and generally subsides in 24 to 48 hours.
Procedure: Under conscious sedation, a catheter (thin hollow tube) is passed through the skin into the femoral vein at the groin. The catheter is manipulated until it reaches the abnormal pelvic veins. Image guidance helps to guide the catheter. Embolization is performed with coils or surgical material. The equipment is withdrawn, and the skin is bandaged.
UFE is a minimally invasive technique performed by an interventional radiologist. UFE treats fibroids by restricting the blood supply that nourishes them. Embolization materials are delivered in the uterine arteries to decrease the blood flow to the uterus and the fibroids. The fibroids cannot survive without an adequate blood supply. Thus, the fibroids shrink. The uterus is not damaged or scarred in any way. This minimally invasive procedure does not involve general anesthesia, incisions, or scars. The estimated success rate of UFE is 85%. Most patients only require one treatment.
Procedure: Under conscious sedation, a catheter (thin hollow tube) is passed through the skin into the femoral artery at the groin or the radial artery at the wrist. Image guidance helps to guide the catheter. Embolic drugs or coils are placed into the artery that supplies blood to the uterus. Blood flow to the uterus is reduced. The catheter is withdrawn, and the skin is bandaged. The fibroids become malnourished and shrink over the next few months.
Centinela Radiology understands that breast biopsy results are time-sensitive. A fast turnaround time and accurate results are a top priority.
A percutaneous biopsy (“core needle biopsy”) is less invasive than surgery. It does not cause breast deformation. Scarring is minimal or absent. It is less invasive and costs less than open surgery. Percutaneous needle biopsy is 98.9% accurate in detecting whether a breast lump is cancerous.
A digital mammogram produces a 2D image taken from the front and side view of the breasts. A 3D mammogram (tomosynthesis) allows the radiologist to look at the breast from various angles.
Noticeable pain relief occurs in approximately 75% of patients that undergo embolization for pelvic venous congestion.
Nearly 85% of patients that receive UFE for fibroids find the treatment successful. Usually, only one UFE treatment is needed however if new fibroids grow in the future a second treatment can be considered.
UFE has several advantages compared to other uterine fibroids treatments. The procedure takes place while the patient is comfortable and partially sedated. There are no stitches, scars, or incisions. The uterus is not cut or removed during the procedure; Instead, the blood supply that is keeping the uterine fibroids alive is obstructed. The uterine fibroids shrink and die as a result of the treatment. It is effective as an alternative to hysterectomy or myomectomy.
It takes time for fibroid shrinking to occur. The uterine fibroids usually shrink in a few weeks following treatment. Most patients with a history of heavy periods due to uterine fibroids notice a lighter menstrual flow one month later.
It is not known exactly how UAE affects fertility, but it is possible to get pregnant after the treatment in most cases.
Cramping, mild pain, nausea, and brown or gray discharge are common for the first several days after treatment.
The procedure is performed with conscious sedation and local anesthesia. Pain after uterine artery embolization tends to peak during the first 24 hours, and occasionally patients are kept overnight in the hospital for observation and so strong pain medication can be delivered to reduce discomfort.
It is rare for fibroids to return after uterine embolization.
Schedule an appointment today to experience why Centinela Radiology is the choice for diagnostic imaging solutions for patients around the country who need the right answers, right away.
Centinela Radiology’s expert team of doctors and staff have the talent and the tools to help make sense of your health. From diagnostic imaging to interventional radiology, our minimally-invasive procedures get to the core of your concerns, so we can get you back to being the image of health.
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