The effectiveness of treatment depends on the correct diagnosis. Diagnosis using modern devices helps to rule out medical errors. Angiography of the neck vessels is a safe method for determining the pathology for the patient. For the doctor, the diagnosis carries information about changes in the vessels of the neck in the patient.
What is angiography?
Angiography allows you to determine what happens to the vessels of the neck. Using this technique, the doctor sees the veins, arteries, capillaries, which are responsible for the saturation of the brain with oxygen. Depending on the device, the image can be in two or three dimensions. For examination, a contrast agent is administered to the patient. At the same time, it is clear whether there are neoplasms in the cervical spine.
Depending on the volume, angiography of the vessels of the neck is divided into three types:
- in general, the state of the brain is determined, a special substance is introduced through the aorta;
- superselective determines the activity of small vessels;
- a selective method is required to determine pathologies, a contrasting fluid is injected into cerebral vessels.
Angiography occurs in two types:
- CT angiography uses x-rays;
- MRI angiography detects changes using a magnetic field.
Indications for examination
To undergo an examination, angiography of the neck vessels requires a doctor's direction. A physician or a neurologist can prescribe a diagnosis based on patient complaints and suspected abnormalities. There are a number of cases in which it is advisable to undergo an examination:
- after operations to detect deviations;
- before surgery related to brain activity;
- if you suspect a lack of brain activity;
- after head injuries, bruises, extensive hematomas;
- with epilepsy;
- with suspected swelling in the head;
- after a stroke or microstroke;
- if there are congenital pathologies of the brain;
- hearing impairment;
- with atherosclerosis;
- to exclude pathologies of blood vessels or thrombosis;
- with ringing in the ears, nausea, vomiting;
- with constant pain in the neck;
- frequent headaches;
- severe pain or loss of consciousness.
Contraindications
When conducting angiography of the vessels of the neck, it is almost impossible to harm the patient's health. But, like any procedure, this method has contraindications. Women carrying a child and breastfeeding, this type of diagnosis is not recommended. The fact is that no studies have been conducted in this area. Do not perform the procedure for small children. With increased sensitivity to components included in the contrast medium, diagnosis should be abandoned. With caution, a study is prescribed to people with a mental disorder.
Absolute contraindications for conducting are:
- thyroid disease;
- obesity with complications;
- some heart diseases;
- a person is in a coma;
- bleeding disorders;
- malfunction of the kidneys, liver;
- with infectious diseases in acute form;
- diabetes;
- the presence of metal implants;
- thrombophlebitis.
How is the examination done?
CT and MRI angiography of the neck vessels with contrast is done in the direction of the doctor. The nurse will tell the patient what to do, but it is better to know how the procedure goes:
- The patient lies on the couch.
- The place where it is planned to inject a special solution is treated with an antiseptic drug.
- A puncture of the vessel is made, into which the probe is inserted into the artery.
- A catheter, which enters a vein or artery, is launched through a probe.
- Next, a colored liquid is introduced into the catheter.
- Liquid is required in order to visually image as clear as possible, therefore, using a catheter, the contrast fluid is brought to the right place.
- The device takes a series of shots.
- The catheter and probe are removed, the puncture site is treated and sealed.
The whole procedure takes from 15 minutes to an hour, depending on the method. Most often it takes up to 40 minutes. The probe may cause inconvenience to the patient. During the procedure, it is important to lie still.
Diagnostics has a high degree of reliability. Identifies the following deviations:
- consequences of a stroke;
- predisposition to stroke;
- the presence of a tumor;
- consequences of head injuries;
- atherosclerosis;
- the presence of blood clots;
- blockage of blood vessels;
- narrowing of blood vessels;
- consequences of surgery.
How to prepare for a diagnosis?
In preparation for the diagnosis of CT or MRI angiography of the neck vessels, a consultation with the therapist is required. In case of contraindications, the procedure is postponed or canceled.
During the diagnosis, there is a risk of damage to the vessel, so you need to visit a neurologist before the examination. Take blood and urine tests, a blood coagulation test. The functioning of the kidneys is checked, an ECG is done.
12 hours before the procedure, you should refuse food. Exclude alcohol for a few days. It is better to refuse water 2 hours before the procedure. A solution injected into the blood can cause an attack of nausea. Jewelry must be removed, clothing should not hamper movement.
A few hours before the procedure, a test for sensitivity to a contrast medium is performed. 2 ml of the solution is injected into a vein and the condition of the patient is monitored. If a reaction is detected, the procedure is carried out without liquid.
Distinguish the classic method of diagnosis, magnetic resonance angiography of the vessels of the neck and computed tomographic angiography.
Traditional diagnostics
An x-ray is used for this procedure. A tinted liquid is injected into the patient's blood. You can enter in 2 ways: using a catheter or through a puncture. To visually determine the state of the vessels, several successive images are created that allow you to see a picture of the changes in the vessels.
CT angiography of vessels
CT angiography of the neck vessels is considered the most modern and high-precision method for diagnosing pathologies. The stained fluid is introduced via a catheter. The puncture method is not applied. With the help of a tomograph, the image is superimposed in layers. In order to translate into a form convenient for perception, an angioprogram is used. In the picture that the apparatus gives out, the vessels and capillaries of the cervical region are clearly visible.
A similar method determines blood flow disorders and changes in blood vessels. When using a three-dimensional image, such nuances are visible that cannot be seen with ultrasound examination.
When using a tomograph, you can see some advantages:
- high accuracy of the information received;
- minimum x-ray exposure;
- the least number of complications due to the lack of a puncture method with the introduction of the solution.
MSCT is a more accurate method of CT angiography of the neck vessels.
Angiography MR
To determine the state of the walls of the vessels using the MRI method. In this case, X-ray irradiation is completely absent. It is based on electromagnetic radiation.
What does MR angiography of the neck vessels show?
- The appearance or germination of neoplasms in the walls of blood vessels. Reliability will not depend on the benignness of the tumor.
- Injuries to the neck and their consequences.
- The condition of the veins and arteries, their integrity.
This method will not be sufficiently informative in case of traumatic brain injury. The state of bone tissue or cerebral fluid cannot be examined. The method is used only for the diagnosis of the vascular system of the body.
A contrast agent is not always necessary for research. The degree of visualization is quite high. This allows you to conduct a study for those patients who have identified an allergy to the composition of the contrast medium.
MRI of the neck vessels is often used together in head MRI. This allows the doctor to get the most informative picture of the patient's condition.
MRI is used more often than CT. Computed tomography is necessary if the MRI did not show something.
Angiography in children
To detect vascular lesions, angiography of the vessels of the neck is used in children. Reviews about the procedure are positive. The method allows to detect vascular aneurysms in the early stages. It clearly defines the degree of damage, shape, location. This allows neurosurgical intervention to be applied. A contrast agent based on iodine is injected into the carotid artery using puncture. The volume injected into the blood depends on the age and weight of the child. A preliminary test for sensitivity to iodine.
The fluid is injected under pressure and a series of shots are taken. This allows you to quickly take clear pictures. The procedure is easier for the child than for adults. Before staging a puncture, the child is given anesthesia.
Indications for the diagnosis of the child are:
- suspected hemorrhage;
- aneurysms;
- vascular lesions;
- hematomas and bruises of the brain;
- brain tumors;
- epilepsy;
- cyst, brain abscess;
- hydrocephalus.
In infants who have been injured during childbirth, a violation of cerebral circulation and prolonged elimination of contrast medium are detected.
What is visible in the pictures?
The images obtained as a result of magnetic resonance angiography of the neck vessels allow the doctor to make the correct diagnosis and prescribe treatment. The main direction for diagnosis is the identification of disorders in the vascular system. You can see where the violation is localized, at what stage of development it is. The examination will help in time to identify and prevent circulatory disorders.
Vascular deformity will tell the doctor that the patient started atherosclerosis. If the blood flow is reduced, then this indicates hypertension. Enlarged vascular walls make it possible to diagnose aneurysms. Vascular displacement indicates a tumor.
Complications
During the diagnosis, complications may appear:
- ingress of contrast medium outside the blood vessel;
- disturbances in the work of the heart;
- failure of the kidneys;
- catheter discomfort;
- swelling of tissues with improper puncture;
- the appearance of an allergy to a contrast fluid;
- in rare cases, a stroke.
Within 2 days, all complications and discomfort pass. In order to avoid unforeseen situations, it is necessary to adhere to the following rules in the first day:
- do not remove the bandage;
- relax;
- exclude physical activity;
- do not carry out water procedures;
- drink plenty of fluids.
Where to get tested?
Where to do MRI angiography of the neck vessels? To do this, you need to contact any clinic in which there is equipment. In free organizations, the device is located in large regional centers. Many paid clinics have related services. The cost may vary from the distance from the city center and the number of free places.