Neuroradiology

The Neuroradiology section at the University of Maryland includes 7 full-time and 1 part-time faculty and up to 4 fellows with responsibilities at the University of Maryland Medical System, Maryland Institute of Emergency Medical Services System (also known as the Shock Trauma Center), and the Baltimore Veteran's Affairs (VA) Medical Center. We perform and interpret CT, MR, angiography, myelography, and interventional procedures. The University Hospital and the Shock Trauma Center are jointly equipped with 2 1.5T MR scanners, a 3T MR scanner, and 5 CT scanners. Two of the 5 state-of-the-art angiography suites have biplane capabilities for neurointervention. The VA Medical Center also has a fully integrated digital radiology department with a biplane neuroangiography suite.

Clinical services: The Neuroradiology Section interprets approximately 16,000 CT and 15,000 MR examinations of the head, neck, and spine and approximately 1,000 myelograms and angiographic studies each year. PET/CT evaluation with a multidetector CT scanner is used routinely in the evaluation of head and neck malignancies, and these studies are interpreted in conjunction with the department's Division of Nuclear Medicine. Active clinical services in the departments of Neurosurgery, Neurology, Ophthalmology, Pediatrics, Oncology, Orthopedics, and Otorhinolaryngology provide the opportunity for exposure to a broad array of pathologies. An additional elective rotation at Children's Hospital in Washington, DC, can be arranged as part of the training experience.

Advanced Imaging: Advances in both MR and CT applications continue to occur at a rapid pace. Our institution is committed to maintaining state-of-the-art capabilities and has a strong track record of acquiring new applications, often as beta or work-in-progress techniques through existing research agreements with manufacturers and other academic institutions. Our fellowship trainees are introduced to the same cutting-edge applications as our faculty and are given time and guidance in application for clinical use. Knowledge and skill with regard to these applications are valuable assets that our fellows acquire.

Neurointervention: Three interventional neuroradiologists, supported by a critical care nurse practitioner, provide diagnostic and therapeutic solutions to the entire spectrum of CNS disease using percutaneous and endovascular techniques. All endovascular neurointerventions at the University of Maryland are performed by neuroradiology, and more than half of the approximately 150 aneurysms seen each year at our institution are treated by endovascular means. Our faculty have led the field in the practical application of CT angiography and enhanced MR angiography for the treatment and follow-up of intracranial aneurysms. We perform diagnostic carotid, cerebral, and spinal angiography and provide emergency services as well as elective treatment of intracranial aneurysms, acute or impending stroke, carotid and vertebral artery stenosis, intracranial atherosclerosis, arteriovenous and dural vascular malformations, epistaxis, and carotid cavernous fistulas. Patients may also be scheduled for preoperative embolization of tumors, as well as head and neck chemoembolization. We have a combined experience of more than 35 years in treating these lesions with microcoils, particulate agents, liquid tissue adhesive, stents, and covered stents. All elective patients are seen in consultation by our faculty, fellows, and nurse practitioner prior to intervention. Patients are followed in our own weekly neuroradiology clinic as necessary, ensuring a thorough and proper continuum of care.

Our interventional spine service, one of the first in the country to begin offering percutaneous vertebroplasty in the 1990s, offers a wide array of diagnostic and therapeutic percutaneous spinal pain interventions. Patients may be referred for epidural steroid injection, selective nerve root block, diagnostic and therapeutic facet joint injection, and SI joint injection. We perform discography, percutaneous bone biopsy, and biopsy of head and neck and paraspinal soft tissue masses. Vertebroplasty, kyphoplasty, and related treatments are offered for benign and malignant vertebral compression fractures.

Educational activities: Teaching within the section is intensive, with regular weekly lectures and case conferences provided to residents and medical students. Additional monthly lectures are offered to attendings, fellows, residents, and students in all major referring departments. Regular educational opportunities include work rounds with the Departments of Neurosurgery (including weekly Grand Rounds), Neurology, Otorhinolaryngology, Ophthalmology, Neuropathology, and Neuro-oncology. Significant time is devoted daily to informal consults with university attendings and house staff. The fellows prepare and present cases at weekly interdisciplinary conferences with the neurosurgery, neurology, and ororhinolaryngology departments. Periodic neuroradiology journal club and interesting case conferences supplement the departmental conference schedule. These cases are then submitted to the neuroradiology digital teaching file.

Research: Research opportunities within the section are abundant, and fellow involvement is required; many degrees of commitment are possible. Current and past areas of interest include: neuroanatomic abnormalities (both congenital and acquired), percutaneous vertebroplasty, CT perfusion, cervicocerebral vascular injuries, PET/CT imaging in head and neck cancer, diffusion tensor imaging for assessment of white matter tracts in the brain, functional preoperative MR, MR spectroscopy, MR and CT angiography imaging evaluation, and laboratory research in interventional techniques and materials. A vascular research laboratory for training and research is readily available for the development of interventional procedures.

Applying for a Fellowship in Neuroradiology at Maryland

Four 1-year ACGME-accredited fellowship positions are offered each year.

We are participating in the fellowship match administered by the National Residency Match Program (NRMP) for Neuroradiology, and we will be using the universal fellowship application form designed by the Association of Program Directors in Radiology. Under the NRMP's guidelines, candidates for 2012 fellowships can submit rankings of program choices from May 11, 2011, to June 8, 2011. We will not accept external candidates outside the match.

To apply, complete the universal fellowship application form and send it to:

Dr. Andrew Steven, MD
Director, Fellowship Program in Neuroradiology
Department of Diagnostic Radiology and Nuclear Medicine
University of Maryland School of Medicine
22 South Greene Street
Baltimore, MD 21201

ATTN: Chanell Sessions
Administrative Assistant III / Fellowship Coordinator
Office: (410) 328-5112
Fax: (410) 328-3168
Email: csessions@umm.edu

Contact the NRMP office at (202)862-6077 to request application materials to the match. We will not accept external candidates outside the match. We will also be honoring the agreement among Program Directors to begin interviewing candidates only on or after Feb 21, 2011, and no later than May 20, 2011.

Applications are currently being reviewed for the remaining positions in the fellowship program beginning July 1, 2011.

PLEASE NOTE: In addition to the universal application form, we require a copy of each candidate's CV and a personal statement. One of the 3 letters of recommendation must be from the candidate's residency program director. In addition, we require copies of the dean's letter and transcript from medical school, proof of graduation from medical school, U.S. Medical Licensing Examination board scores, and Educational Commission for Foreign Medical Graduates certificate (when applicable). Effective 2016 ACGME will only accept U.S. ACGME accredited residency graduates for consideration in our fellowship programs.

For additional information on becoming a neuroradiology fellow, visit the ASNR Web site.

This page was last updated: September 16, 2014

         
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