LIYENOGRAFIYA

LIYENOGRAFIYA (Latin lien a spleen + grech, grapho to write, represent) — a method of X-ray inspection of blood vessels spleens by means of contrast agents. First messages on L. appeared in 1956 and belong to F. Morino and soavt., to P. Odman. To H. Tillander.

L. it is applied for the purpose of definition of focal and diffusion processes in a spleen at an injury and various diseases (general diseases of blood, a splenomegaly and including Banti's syndrome, a disease to Gosha, Nimann's disease — Peak, cysts, primary tumors of a spleen, etc.).

The main indications to L.: establishment of the reason of a splenomegaly (thrombophlebitis of splenic or portal veins, aneurysm of a splenic artery, general diseases, germination or prelum of a splenic vein tumor, cirrhosis, etc.); differentiation of a true cyst of a spleen from a posttraumatic cyst; detection of the centers of defeat in a spleen at a lymphogranulomatosis and specification of its stage; definition of nature of injury of a spleen at the closed injuries of a stomach.

Contraindications to use of L.: serious condition of the patient, acute diseases of a liver, kidneys, pancreas and intolerance of iodide drugs.

of Fig. 1. Normal selection liyenogramma: 1 — an arterial phase (the splenic artery and arterial network of a spleen is contrasted); 2 — a parenchymatous phase (intensive contrasting of a parenchyma of a spleen, a splenic vein and a shadow of a catheter in a splenic artery are visible).

Fig. 1. Normal selection liyenogramma: 1 — an arterial phase (the splenic artery and arterial network of a spleen is contrasted); 2 — a parenchymatous phase (intensive contrasting of a parenchyma of a spleen, a splenic vein and a shadow of a catheter in a splenic artery are visible).

of Fig. 2. Tseliakogramma at an injury of a spleen. Against the background of the stomach inflated via the probe on the right the shadow of the contrasted spleen above is visible; 1 — fragmentation of an upper pole of a spleen as a result of an injury; simultaneous contrasting of a splenic artery (2) and vein (3) owing to emergence of traumatic arteriovenous shunting.

Fig. 2. Tseliakogramma at an injury of a spleen. Against the background of the stomach inflated via the probe on the right the shadow of the contrasted spleen above is visible; 1 — fragmentation of an upper pole of a spleen as a result of an injury; simultaneous contrasting of a splenic artery (2) and vein (3) owing to emergence of traumatic arteriovenous shunting.

L. make by the selection catheterization of a celiac trunk or a splenic artery. Through a catheter enter a triiodide contrast agent (76% Verografinum, Urotrastum, etc.) also make a serial X-ray analysis in a perednezadny projection at horizontal position of the patient on spin. All phases of contrasting of vascular network of a spleen — arterial, parenchymatous (fig. 1) and venous consistently are reflected in pictures.

Focal damages of a spleen cause deformation of intraorganic branchings of vessels, their expanding. In a parenchyma sites with the lowered content of contrast medium are visible. The splenomegaly of any etiology is followed by considerable expansion of a splenic artery, lengthening and narrowing of its intraorganic branches. At an injury of a spleen limited «extravasates» in a parenchyma, arteriovenous fistulas, «breaks» of intraorganic vessels and defects of contrasting are observed at small ruptures of a parenchyma. By data the Caique (G. Kaick) with sotr. (1970), at significant gaps fragmentation of body (fig. 2) is defined, and intraperitoneal hematomas lead to the shift of a spleen and the artery feeding it.

Bibliography: Pereslegin I. A., Krivenko E. V. and Filkov E. M. K to a question of diagnostic opportunities of an abdominal angiography at a lymphogranulomatosis, Vestn, rentgenol, and radio-gramophones., No. 3, page 6, 1974; Prokubo in-sky V. I., B and l and l y to and A. S's N. and Cutins A. A. Diagnosis of not parasitic cysts of a spleen, Surgery, No. 2, page 87, 1972; The Guide to an angiography, under the editorship of. And. X. Rabkina, page 214, M., 1977; Beduhn D. Der Milztumor im Angiogramm, Rontgenpraxis, Bd 26, S. 217, 1973; Ekelund L., Gothlin J. Pettersson H. Angiography in expansive lesions of the spleen, Amer. J. Roentgenol., v. 125, p. 81, 1975; K an i with

k G., W e n z W. u. B e d u h n D. Die an-giographische Diagnostik der Milzruptur, Fortschr. Rontgenstr., Bd 112, S. 633, 1970; S with a t 1 i f f J. H. a. o. The «starry night» splenic angiogram, Amer. J. Roentgenol., v. 125, p. 91, 1975.

O. B. Nestayno, A. F. Tsyb.