ANGIOGRAPHY

From Big Medical Encyclopedia
by Fig. 1. Angiogram of a hip. In the lower third are defined arterio - venous aneurisms
Fig. 2. The angiogram of area of a hip joint and a hip at a myxoma. In a middle part the femoral artery is displaced medially. Contours its equal, accurate
Fig. 3. The angiogram of a forearm and a brush at a Raynaud's disease. Drying of a gleam of an elbow artery in a distal half and at the level of a brush, drying of a gleam of an elbow vein

ANGIOGRAPHY (Greek angeion — a vessel and graphu — I write, I represent; synonym vazografiya) — X-ray inspection of arteries and veins after introduction to them of a contrast agent. And. apply to diagnosis of anomalies of development and diseases of vascular system, and also tumoral, parasitic and other defeats of separate bodies. And. allows to study topografo-anatomic features of vessels, their functional condition, speed of a blood-groove, a way of roundabout blood circulation, localization and extent of pathological process (fig. 1 — 3).

With the help And. differentiate inflammatory and tumoral diseases and it promote the choice of the most rational method of treatment.

Contraindications to And. — serious condition of the patient, mental disorders, acute diseases of a liver, kidneys and hypersensitivity to iodide drugs.

For And. apply water-soluble triyodirovanny contrast mediums. At introduction to a vascular bed they are rather safe and are in a short space of time brought out of an organism.

are contrasted by Fig. 4. Sounding and the selection angiography of a celiac trunk. The intra hepatic arteries, arteries which are bending around a cyst, intra splenic and gastro and duodenal and intestinal arteries are contrasted (on the right along a backbone the catheter is visible)

And. carry out by an exposure of a vessel, a transdermal puncture or introduction to a vessel of a special X-ray contrast catheter on Seldingera (fig. 4). These catheters are elastic and keep the form of a bend given in advance in a gleam of a vessel that gives the chance to enter them into the explored area.

And. it is possible to make on a usual X-ray apparatus, carrying out a single picture with the extended endurance (from 4 to sec.) or serial pictures (serial And.) with short endurance and bystry change of cartridges by means of special adaptation — a seriograf. In a crust, time for And. use the electron-optical converter with the television device that allows to receive a sharp image of vessels in pictures; at the same time beam load of investigated considerably decreases.

Separate types And. — see. Angiocardiography , Angiopulmonografiya , Aortografiya , Arteriography , Vertebralnaya angiography , Carotid angiography , Renal angiography , Pelvic angiography , Flebografiya , Cerebral angiography .

A scintiangiography

the Scintiangiography — a research of vessels by introduction to them of radio pharmaceuticals with the subsequent registration of their radiation special devices and calculating devices. At radio isotope And. apply two main techniques: a) direct administration of radioactive drug in a cavity of large vessels and heart for obtaining their image on skanogramma or stsintifotogramma; b) administration of radioactive drug in blood in the form of the macrounit (see. Radioactive colloids ) for temporary embolization of a capillary network of body.

Radio isotope visualization of large vessels and cardial cavities on skanogramma and stsintifotogramma allows to distinguish anomalies of development of heart and large vessels, stenoses of large veins (e.g., venas cava, subclavial veins after a radical mastectomy and so forth), vascular aneurisms (see. Aortic aneurysm , radio isotope diagnosis).

The possibility of scanning is based on the phenomenon of embolization of capillaries (see) and stsintigrafiya (see) a number of bodies (brain, lungs, pancreas, intestines etc.). At the same time the image of separate vessels is impossible, but an opportunity to judge the area and the nature of distribution of a capillary network in body is created. Particles of the macrounit are late in capillaries within an hour then they break gradually up and removed in a blood flow. For a research there is enough embolization of only one of 100 capillaries therefore the procedure is safe for the patient. For scanning of lungs the radioactive drug is administered intravenously, for visualization of other bodies — in the corresponding artery.

A posthumous angiography

the Posthumous angiography at a medicolegal research, being an auxiliary method, allows to record objectively space ratios of vessels at preservation of integrity of area of a body or body, to create idea of diameter of the main and small arteries, of extent of their narrowing, anomalies, level and the nature of defeat of a vascular wall, and also of extent of development of an anastomosis and options of collateral circulation.

Posthumous And. gives the chance to purposefully conduct a section research, especially in cases of sudden death, the closed craniocereberal injury, at damages and painful changes of interiors owing to defeat of the main vessels feeding them. It can be useful even at putrefactive changes of a corpse when the arterial system and soft tissues surrounding it is not destroyed yet.

For posthumous And. the main vessels apply the stiffening contrast masses containing bismuth, lead carbonate, basic carbonate white lead etc. It is the most reasonable to use the contrast weight consisting of a suspension of red lead oxide in solution gelatin (composition of ingredients on 100 ml of weight: 4 g food gelatin, 10 ml of water, 50 ml of glycerin and 150 g of red lead oxide). Administration of contrast medium is preceded by washing of a vascular bed isotonic solution of sodium chloride. Forcing of contrast weight in the main arteries is carried out through a cannula under pressure of 120 mm of mercury.

Posthumous And. the main arterial pools in cases of sudden death allows to resolve prior to an internal research of a corpse an issue of character, a stage and extent of atherosclerotic process, of the level of stenoses and occlusion.

Fig. 5.1. Posthumous angiogram of the main arteries of the head and neck. Crimpiness of vessels is visible: 1 — a back projection
Fig. 5.2. Posthumous angiogram of the main arteries of the head and neck. Crimpiness of vessels is visible: 2 — the right slanting projection

The variety of structural manifestations of atherosclerotic process on angiograms can be found in the form of defects of filling, roughnesses of contours, irregularity of intensity of a shadow, a festonchatost or a crenation of edges, segmented expansions and the alternating narrowings, pathological crimpiness of a vascular shadow (fig. 5), and also in the form of break of contrasting in cases of thromboses.

Great diagnostic value on the angiogram at posthumous court. - a medical research in cases of a mechanical injury has a vykhozhdeniye of a contrast agent out of limits of walls of vessels. It can be in the form of small single and multiple impregnations or massive limited periarterial accumulations.

Version posthumous And., used at court. - medical researches, the microangiography allowing to study the small vessels and capillaries filled with the special stiffening contrast weight is (solution of plumbic chloride from gelatinous). By this method it is possible to reveal the nature of changes of a vascular capillary network at the closed craniocereberal injury and it is hidden the proceeding idiopathic hypertensia.


Bibliography: Vinogradov V. V., Mazayev P. N. and Shapovalyants G. G. The selection angiography of abdominal organs and retroperitoneal space, M., 1971; The Krakow N. I. and Mazayev of P. N. Angiografiya in surgery of vessels of extremities and a neck, M., 1964, bibliogr.; Kuliyeva H. D. Main vessels of a ventral aorta, Baku, 1970; Petrovsky B. V. and Milonov of O. B. Hirurgiya of aneurisms of peripheral vessels, M., 1970; Tikhonov K. B. Angiography, L., 1962, bibliogr.; Angiography, ed. by H. L. Abrams, v. 1 — 2, Boston, 1961, bibliogr.

P. N. Mazayev; G. A. Zubovsky (I am glad.), A. S. Lithuanian Jew (court.).

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