From Big Medical Encyclopedia

FLEBOGRAFYYa (Greek phleps, phlebos a vein - f-grapho to write, represent; a synonym a venografiya) — a method of X-ray inspection of veins by their artificial contrasting.

T. apply with a research objective of structure and function of veins, assessment of a venous blood-groove and venous blood circulation, and also to diagnosis patol. conditions of veins. T. produce in a complex with other diagnostic procedures — a flebotonometriya, and r t of ER and, about ra f to it

(see), fleboskogshy (see Angioskopiya), etc.

Indications to carrying out F. thrombophlebitis (see) and tromboflebiticheskiye changes of veins, thromboembolisms (see), disturbance of passability of large venous collectors, wounds of veins, wasps of beds-neniya of a varicosity (see), internal bleeding from veins, a state after vein operations, disturbance of venous blood circulation, anomaly and malformations of veins serve post-(see Vienna). T. are used also for diagnosis and differential diagnosis of tumors, volume educations and nek-ry other diseases.

Contraindications are the serious general condition of the patient, acute feverish conditions, severe forms of heart failure (see), a renal failure (see), a liver failure (see), intolerance of X-ray contrast agents for intravenous administration, etc.

F. make in the rentgenoangio-graphic office equipped with the special x-ray equipment and other devices for a research of vessels, Nek-ry techniques F. carry out in usual X-ray department (see).

Depending on a way of administration of rentgeiokontrastny substance in a venous bed distinguish the following techniques F.: direct, indirect (returnable), visceral, chrez-organ kateterizatsionny, chres-bone (intra bone), etc.

At a straight line F. radiopaque substance enter into superficially located vein by its puncture or by means of transdermal catheterization of veins on Seldingera (see Seljdipger a method). Sometimes apply a venosektion to administration of radiopaque substance (see). At F. radiopaque substance mixes up with blood and spreads its current that allows to receive consecutive contrasting of small peripheral veins, veins of average caliber and large veins, including venas cava.

Indirect contrasting of veins can be received in a venous phase of an angiography (see): at introduction to an artery of radiopaque substance it passes at first an arterial, then capillary bed and in 6 — 8 sec. reaches veins (returnable F.). On time of emergence in veins of radiopaque substance and speed of its «washing» (disappearance) from veins judge a regional hemodynamics in the studied body.

At visceral F. make a direct puncture of body (a liver, a spleen, a kidney) and enter radiopaque substance into its parenchyma (or. e.g., in a myometrium).

Chrezorganny kateterizatsionny F. includes catheterization of an intraorganic vein, then catheterization inside - and extra organ veins of this system. E.g., at transhepatic catheterization of veins of portal system (see. Portal krovoob-

Fig. The phlebogram of a left kidney is normal:

1 — the main trunk of the left renal vein,

2 — interlobar veins, 3 — arc veins.

a rashcheniye) the catheter is entered through a parenchyma of a liver into a large vnutripe-chenochny branch of a portal vein, then retrogradno carried out to a portal vein and its branches (mesenteric veins, a splenic vein, veins of a pancreas and a stomach, etc.). This technique is applied also to various X-ray surgical manipulations (embolization of varicose veins of a stomach and a gullet, sampling of blood from veins of a pancreas for hormonal testing, a chreska-teterny biopsy, etc.).

At chreskostny F. radiopaque substance is entered into spongy substance of bones (see Medullogra-fiya). Special needle make a puncture of a bone in that place where it is covered with a thin coat of compact substance (a calcaneus, a big spit of a femur, pubic bones, a breast, a body of a vertebra, etc.); the end of a needle is established in the thickness of spongy substance of a bone at a depth of 5 — 8 mm and enter radiopaque substance, a cut from spongy substance gets into small intra bone veins, and then and into deep extra bone veniplexes — a venospondilografiya.

Names of techniques F. reflect not only a way of contrasting of veins, but also specify area of a research and the studied body: a flebografiya of kidneys (fig.) and a liver, a flebografiya of a basin (see. A pelvic angiography), the lower kavografiya (see), an azigografiya (see), etc. Nek-ry complex techniques of a flebografiya received special names (e.g., the ascending functional flebografiya of the lower extremities — a technique of a functional research of deep, superficial and kommunikantny veins of legs with use of a fleboskopiya, flebotonometriya and functional trials).

Bibliography: A clinical angiography,

under the editorship of M. I. Kuzin, etc., M., 1973; The Guide to an angiography, under the editorship of. And. X. Rabkina, M., 1977; Burri C. and. A h n e f e 1 d F. W. Cava-Katheter, B.

u. a., 1977. A. P. Savchenko.