How is angiography of cerebral vessels performed?

Angiography is an effective technique for diagnosing various vascular lesions, including those located in the brain.

In modern medicine, innovative equipment is used to carry out this research, which allows solving several problems at once: it allows the patient to be accurately diagnosed and at the same time not to harm his health. Similar procedures are called CT and MR angiography.

Contents

  • 1 The essence of the procedure
  • 2 CT and MR techniques
  • 3 Indications and contraindications
  • 4 Preparation and implementation of
  • 5 Recommendations for patients
  • 6 Principles of interpretation of results
  • 7 Possible deviations from the norm
  • 8 Average cost of

The essence of the procedure


By contrast CT and MR angiography visualization of venous andarterial blood flow of the brain on a three-dimensional image. It can be used to judge the state of the vascular ring of the cerebral hemispheres, regional arteries in the cerebral cortex, cranial sinuses and veins.

This allows to estimate the prevalence of a particular pathological process and based on the accompanying symptoms and diseases to provide the patient with an accurate diagnosis and prescribe the timely treatment.

The study allows the determination of cerebral vascular pathologies of the brain, such as:

  • developmental pathology;
  • stenosis and narrowing of the aortic lumen;
  • excessive crimp and looseness of the vascular network;
  • asymmetry in the branching of vessels;
  • malformation, etc.

CT and MR techniques

For the diagnostic angiography of vessels, computer( CT) or magnetic resonance imaging( MRI) of the brain can be used together with it. Both methods differ in accuracy and high efficiency, but they have their own peculiarities and are assigned in different cases.

MRA has the minimum number of contraindications to and does not harm the patient's health, since in most cases it allows to do without the introduction of contrast. In addition, it allows you to explore not only the state of cerebral vessels, but also nearby soft tissues.

However, with craniocerebral injuries this technique is not effective enough. In such cases, it is very important to identify possible cranial fissures, vascular ruptures, as well as abnormalities in the ventricular system, and MR angiography is not intended for studying bones and fluid structures.

That is, the best option for such patients is the computed tomography .It should be noted that CT also shows the best result in the diagnosis of aneurysms, and allows you to determine not only the extent of the affected area, but also to detect thrombi or clots inside it, as well as assess the operability of the patient.

Indications and contraindications

In the number of indications for angiography of cerebral vessels:

  • cerebral atherosclerosis of cerebral vessels;
  • congenital heart disease;
  • thromboses and vasculitis;
  • stenosis of renal, carotid, coronary and other arteries;
  • vessel occlusion;
  • vascular malformations;
  • headaches, syncope, and other similar symptoms of unexplained origin;
  • stroke( for example, lacunar stroke) and a microstroke in the anamnesis;
  • suspected brain tumor;
  • preparation for surgical operations, as well as monitoring of the performed treatment in the post-operation period;
  • craniocerebral trauma.

Like any other medical procedure, the angiography of has a number of contraindications, including:

  • allergic reactions to local anesthetics and contrast agent;
  • bleeding disorder;
  • cardiac, hepatic, renal failure during decompensation;
  • a number of psychological illnesses( eg, claustrophobia);
  • thyroid disorders;
  • venereal diseases;
  • presence of implants, pacemakers and prostheses( in the case of MRI);
  • pregnancy and lactation.

Preparation and implementation of

Before conducting the study, the patient should undergo a series of tests of , including blood tests( general, biochemical) and urine, determination of the Rh factor, blood coagulation, etc., and to collect a complete history and symptomatology.

Unlike conventional angiography, a procedure that is performed with CT or MR, does not require special preparation of ( in some cases, the patient will need to give up some medicines and meals 8-12 hours before the procedure).

The only thing that has to be done before a visit to the clinic is to remove metal objects and jewelry .Hospitalization in the hospital in this case is also not needed, so the patient can leave the medical institution immediately after the end of the study.

In the first stage, approximately 100 ml of contrast agent is injected into the elbow or forearm of the patient .This manipulation is absolutely painless, and the only thing that a patient can feel is a feeling of heat. After this, the patient is changed and placed on a mobile table, which during the procedure will be in the ring part of the tomograph.

After the device is turned on, the ring will begin to rotate around the table, and it will move slightly in the horizontal plane - it is very important for a person to maintain complete immobility.

Diagnosis also does not bring any discomfort to patients, and if there are any problems about them, it is necessary to inform the medical staff through the internal communication. The procedure takes about 30 minutes, and after receiving pictures of the investigated area the patient can go home.

Recommendations to patients

In most cases, CT and MR angiography of does not cause any side effects of , and the only complication may be an allergy to a contrast agent.

Normally the contrast is excreted through the kidneys for about 1-1.5 days - to accelerate the process it is recommended that the patient use more liquid. In the rest, a person can continue to lead a habitual way of life.

Principles for decoding the results of

The interpretation of images obtained as a result of cerebral angiography of cerebral vessels and the diagnosis can be carried out exclusively by a specialist, since requires special knowledge of .

The principles of deciphering are based on the fact that the amount of radiation penetrating through the tissues directly depends on its density. In the pictures, this indicator is expressed in different colors: black, white and different shades of gray. Bone, as the most dense tissue, will have white color on the images, spinal fluid and subarachnoid space - black, and matter - gray of varying intensity.

Evaluation of the state of brain tissue and the presence of possible pathologies is made based on their density, location and shape. To obtain a clearer picture of the , the blood vessel network can be examined in the dynamic mode of the .

The normal picture is as follows: all blood vessels have normal dimensions, lumens and branches, in the tissues there are no neoplasms, signs of bleeding and fluid accumulation.

Possible deviations from the norm

  • Changes in the diameter of the vessel and its lumen .It can be a consequence of developing arteriosclerosis, the presence of atherosclerotic plaque, arteriovenous malformation or fistula, as well as vascular spasm.
  • Blood flow impairment .Most often, the patient develops intracranial hypertension.
  • Displacement of vessels .Allows to speak about the presence of neoplasm, cerebral edema or disorders of outflow of cerebrospinal fluid. The image of the vascular network, which feeds the tumor with blood, makes it possible to clarify its location and origin, as well as to judge whether surgical intervention is possible or impossible.
  • Changes in the general structure of the of the external carotid artery and the relationship of its structures. It is a sign of extra-cerebral neoplasms( in particular, meningiomas), which is located outside or within the large hemispheres.
  • Bulge or widening of the vessel wall .A similar phenomenon is observed in the presence of an aneurysm( the image obtained as a result of angiography makes it possible to measure the extent of the damaged area and other parameters).

Average cost of


The price of angiography of veins and arteries of the brain, conducted with CT or MRI, may differ depending on the features of the procedure, so the exact cost is better specified individually.

In the medical institutions of Russia the average price of CT angiography is 6500 rubles, and MR angiography is 7500 rubles. Conducting similar procedures in foreign clinics will cost the patient 500-600 dollars( computer angiography) or 1000-2000 dollars( MR-angiography).

CT and MR angiography of cerebral vessels - safe, painless and accurate diagnostic procedures of , practically without contraindications. They are recommended to almost all patients with vascular pathologies or suspicions of brain diseases, since they allow timely detection of the slightest violations and begin appropriate treatment.