The picture that the doctor sees on the images of x-rays after angiography is specific for different types of vessels.
The norm for all types of vessels are considered smooth contours, measured narrowing of the lumen, “branching, as in trees.”
X-rays penetrate the body in different ways, it all depends on the density of the tissue. In the pictures, the density of body tissues is shown in white, black colors and various shades of gray.
So, bone tissue is white, blood vessels and cerebrospinal fluid are black, and the substance of the brain is gray.
Angiography, regardless of the type and area of diagnosis, is carried out according to a single scheme. First, the doctor intramuscularly introduces a tranquillizer and an antihistamine. They are necessary for the general decrease in anxiety, prevention of pathogenic reaction to a contrast agent. The skin area (under which the necessary vessel is located) is treated with an antiseptic preparation, anesthetic is administered subcutaneously, and then a small incision is made.
Introducer and catheter are inserted into the incision. Preliminarily, a special solution is injected into the vessel to prevent a spasm and to minimize the irritant effect of the contrast agent. The catheter is advanced through the introducer to the desired vessel under the control of an x-ray apparatus. Once the goal is reached, a contrast agent is injected through the catheter and the image is taken. In some cases, this step is repeated 2-3 times.
After collecting information, the catheter and introducer are removed from the body. Then the doctor stops the bleeding (opens due to injury of the vessels with a tube), applies a sterile pressure bandage and instructs. During the next 6-10 hours after the procedure, bed rest should be observed to minimize the risk of thrombosis.
The interpretation of the images obtained as a result of cerebral angiography of the cerebral vessels, as well as the diagnosis can be carried out exclusively by a specialist, as it requires special knowledge.
The principles of decoding are based on the fact that the amount of radiation penetrating through tissue directly depends on its density. In the pictures, this indicator is expressed in different colors: black, white and different shades of gray. The bone, as the densest tissue, will be white in the images, the cerebrospinal fluid and subarachnoid space will be black, and the substance will be gray in varying degrees of intensity.
Assessment of the state of brain tissue and the presence of possible pathologies is made based on their density, location and shape. To get a clearer picture, the blood vessel network can be examined dynamically.
The normal picture is as follows: all blood vessels have normal sizes, lumens and branches, there are no neoplasms in the tissues, signs of bleeding and fluid accumulation.
What complications can there be?
Complications during this procedure are extremely rare. More often they are associated with violations in the course of the performed actions, as well as reactions to the coloring matter. In analyzes without contrast, there are no complications. The following are side effects that occur during angiography:
- Vomiting, nausea, stomach discomfort, disturbances in the gastrointestinal tract.
- Allergic reactions to contrast liquid: redness, swelling, itching, rash, urticaria. Places of localization of allergies: neck, back, limbs, face.
- Shortness of breath, arrhythmia. In some cases, anaphylactic shock is observed.
- Disturbed blood circulation in the brain. Hemorrhages, stroke, spasms of blood vessels.
- Convulsions, disorders of the nervous system.
- In the case of penetration of the coloring matter into the human soft tissues, inflammatory processes develop on the skin and in the subcutaneous fat layer, fiber.
- Bleeding from a vessel that is used for analysis.
Procedures and analyzes related to the brain require a highly qualified doctor and radiologist. If the alarming symptoms are ignored, the further procedure is dangerous.
According to statistics, about 95% of people undergo the procedure without any negative effects. The remaining 5% may still encounter complications, and this is primarily due to the individual characteristics of the body and to the state of health.
Of the side effects, you can distinguish an allergic reaction to contrast, or an antiseptic that was used for research. Bleeding associated with a puncture of the vessel may also open. Severe heart damage such as stroke and heart attack are rare.
Angiography is considered an effective and in-depth study that allows you to assess the state of the vascular system of the brain. They direct her to it only if there is a serious pathology, it is impossible to undergo examination without clear indications. According to the results, the doctor will be able to clearly say whether a person has vasodilation, brain tumors and aneurysms, or if there are no pathologies.
Possible deviations from the norm
- Changes in the diameter of the vessel and its lumen. May be a consequence of developing arteriosclerosis, the presence of atherosclerotic plaque, arteriovenous malformation or fistula, as well as vascular spasm.
- Impairment of blood flow. Most often, it indicates the development of intracranial hypertension in a patient.
- Displacement of blood vessels. Lets talk about the presence of neoplasm, cerebral edema or impaired outflow of cerebrospinal flu >
Features of preparation for the procedure
The specified procedure is rotational computed tomography, with a 3D image illustrating the flow and movement of blood through the vessels, the state of the tissues. For research, a contrast fluid is injected into the blood artery of the brain or vessel. The modern method is spiral tomography, with which it is possible to track blood circulation in small arteries and vessels, to fix minor deviations from the norm.
How does the technique differ from the classical method of examination:
- The dose of radio waves is less.
- It is carried out permanently, in a clinical setting, on an outpatient basis, which guarantees timely assistance.
- The coloring liquid is injected into the vein, which does not pose an increased danger, as in the case of an artery puncture.
- Pictures of the examination results are distinguished by increased clarity.
- The rehabilitation process does not take a long period of time, the patient soon returns to his usual life.
Computed tomography diagnostics with contrast is safer: the artery is not damaged, the radiation dose is lower.
For clarity, the scanner is tuned to the purity of the patient’s heartbeat. For evenness of the pulse, a person is given medications that normalize the heartbeat. In some cases, drugs that dilate blood vessels are injected into a vein. The patient is placed on a couch, hands and feet are fixed with straps to restrict movement. Extra human actions can bring down the procedure, disrupt the clarity of the resulting image.
Moving into the tomograph, the couch performs circular movements, stopping at the moment of fixation. The doctor conducting the examination may ask the patient to hold his breath at the time of shooting. Further, the results obtained are converted into 3D images showing the state of the vessels of the brain, blood circulation, possible pathologies, as well as deviations from the norm.
Before diagnosing exclude the presence of contraindications, conduct x-rays, electrocardiography, to track the patient’s condition. Two weeks before the angiography, it is necessary to completely eliminate alcohol, so as not to distort the overall result. In some cases, the doctor conducts hydration (saturation of the body with fluid) in order to dilute the contrast agent, facilitate its elimination from the body and minimize the harmful effects on the liver.
To reduce the risk of an allergic reaction, the doctor prescribes antiallergic drugs immediately before the procedure. 4 hours before angiography should not eat food and various liquids. Before the examination, the patient must remove the jewelry, remove all metal objects, as they prevent the free passage of x-rays. Then the specialist determines the area of passage, shaves the hair on it and cleans the zone of intervention.
Before starting angiography, the doctor must obtain written consent from the patient for the procedure.
The cost of the procedure
The price of cerebral angiography lies in the range of 3000-5000 rubles, depending on the specific type of study.
The price of angiography of veins and arteries of the brain, performed using CT or MRI, may differ depending on the features of the procedure, therefore, the exact cost is best clarified individually.
In medical institutions in Russia, the average price of CT angiography is 6500 p., And MR-angiography – 7500 p. Carrying out such procedures in foreign clinics will cost the patient $ 500-600 (computer angiography) or $ 1000-2000 (MR angiography).
CT and MR angiography of cerebral vessels are safe, painless and accurate diagnostic procedures with virtually no contraindications. They are recommended for almost all patients with vascular pathologies or suspected brain diseases, since they allow timely detection of the slightest disturbances and begin appropriate treatment.
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