From Big Medical Encyclopedia

PELVIC ANGIOGRAPHY (Greek angeion a vessel + grapho to write, represent) — a method of contrast X-ray inspection of vessels of a basin.

The greatest distribution of T. and. received in diagnosis of vascular and tumoral defeats. However T. and. it is used as well at catheterization of pelvic arteries, plastics and chreskateterny embolization of vessels (see. X-ray endovascular surgery ). Special contraindications to T. and. no, they are the general for methods angiography (see).

Distinguish pelvic arteriography and a flebografiya.

Pelvic arteriogramma at a horionepitelioma of a uterus: and — an arterial phase (1 — an expanded uterine artery, 2 — a uterine vein); — a venous phase (1 — large, richly vaskulyarizirovanny tumor of a uterus, 2 — sharply expanded uterine vein).

Pelvic arteriography it is used for the purpose of specification of localization, character and extent of damage of ileal arteries and their branches; definitions of localization and prevalence of a tumor (fig.); differential diagnosis of tumoral and inflammatory processes, diagnosis of an extrauterine pregnancy, and also for assessment of a condition of the replaced kidney at its connection to the general ileal artery (see. Renal transplantation ).

Performance of pelvic arteriography is begun with a puncture of a femoral artery and retrograde catheterization of ileal arteries and an aorta by Seldinger's technique (see. Seldingera method ). Depending on a diagnostic task or are limited to the general pelvic arteriography, entering a contrast agent into a belly part of an aorta over its bifurcation, or enter a contrast agent at the same time or consistently into the general ileal arteries from two parties. Then carry out the selection (selective) arteriography of a basin: contrasting of an internal ileal artery, uterine artery, ovarian artery, etc.

The selection arteriography of internal ileal arteries (one - or bilateral) and superselek-tivny arteriography of its branches is carried out for the purpose of obtaining the image of small intraorganic vessels of a uterus and its appendages, a prostate, a bladder, a penis, etc. For this purpose enter into the general ileal artery the special probe with a tip of a special form (e.g., loop-shaped) that facilitates purposeful selection catheterization of the necessary vessel. Enter 10 — 20 ml of 65% of solution triyodirovanno-go a contrast agent (rate of administering of drug depends on its temperature) and do pictures in a direct projection; serial shooting is made with a speed of 1 — 2 shot in sec., during 5 — 8 sec.

Pelvic flebografiya began to apply in clinic since the beginning of the 50th of 20 century. It is shown for the purpose of diagnosis of diseases of veins of a basin (malformations, thrombosis, varicosity, etc.); diagnoses of a tumor; definitions of extent of local spread of malignant tumors of bodies of a small pelvis; specifications of existence of metastasises of a tumor in limf, the nodes located on the course of pristenochny veins and the main trunks of ileal veins; control of efficiency of radiation therapy of tumoral defeats ileal limf, nodes.

The pelvic flebografiya can be carried out by means of several ways: by chreskostny administration of contrast medium in spongy substance of pubic, sciatic, ileal bones, etc. (a chreskostny flebografiya); intravenous administration of a contrast agent in femoral, big saphenas of a hip, vein of a penis (see. Catheterization of veins puncture ); administrations of contrast medium in a muscular layer of a wall of a uterus, cavernous (cavernous) bodies of a penis (a penalny flebografiya), a clitoris (a visceral flebografiya).

Special contraindications to a visceral flebografiya are: existence of cancer or suspicion of endometrial cancer, pregnancy, acute and subacute inflammatory diseases of genitalias, the conditions of genitalias interfering a research (virginity, atrophic or hypoplastic processes).

See also Angiography , Flebografiya .

Bibliography: Gryaznova of I. M. Rentge-nopelveografiya, a flebografiya, endoscopy in gynecology, M., 1965; The Clinical angiography, under the editorship of M. I. Kuzin, etc., page 148, M., 1973; Pytel A. Ya. and M of and l about l and sh in and l and G. I. Pelvic flebografiya and its diagnostic value, Tashkent, 1965; The Guide to an angiography, under the editorship of. And. X. Rabkina, page 259, M., 1977; Burri C. u. A h n e-f e 1 d F. W. Cava-Katheter, B. u. a., 1977, Bibliogr.

A. P. Savchenko.