Renal angiography is actively used to diagnose pathologies in adults and children. The use of this diagnostic technique is especially important in those clinical cases when other ways of revealing pathology do not provide a complete picture of the disease. The method is indispensable in the diagnosis of renal anomalies and tumor processes, internal injuries and other pathological conditions.
Angiography of renal vessels
Renal angiography is a highly informative research procedure aimed at studying the state of vessels using contrast preparations and radiography. In clinical medicine, this technique has been used for many years. And with the help of angiography of renal vessels, specialists put the most accurate diagnosis, while other methods do not give an unambiguous and clear answer.
Kidney structures are characterized by a sufficiently developed system of blood vessels, so the normal activity of the organ depends on the functionality of the vasculature. Any violation of the circulatory system has a negative effect on renal function. Angiographic examination allows to assess the functional-anatomical state of renal vessels.
Indications and diagnostic value of
Renal angiography is assigned to patients in such clinical situations:
- Cystic neoplasms;
- In order to clarify the nature of disorders occurring in the renal arteries;
- Complex kidney disorders, various functional abnormalities of the kidney structures;
- If there is a suspicion of cancer of the cortex;
- Hydronephrosis, in which the kidneys are overfilled with fluid clusters;
- In order to identify a variety of tumor process that has arisen in the abdominal cavity;
- In severe renal tuberculosis, when removal of the affected kidney is indicated;
- Hematuria of unclear etiology, in which other diagnostic methods did not help determine the cause of the appearance of blood in urine;
- In clinical cases where the diagnosis remains unclear after conducting other types of examination;
- To assess blood flow in the transplanted kidney;
- With renal arterial embolism or stenosis.
An angiographic study helps to determine the scale of vascular and tissue damage in the kidneys, can certainly determine their etiology and assess the state of vascular structures. This diagnosis is effective in oncology, when it is necessary to examine the location of blood channels.
Renal angiography is divided into several varieties, depending on the method of administration of the contrast component: transfemoral and translumural angiography. With retrograde( transfemoral) angiography, contrast is introduced through the artery on the thigh. And with transluminal angiography, the contrast medium is injected into the lower back by aortic puncture.
In addition, there is another multi-spiral computer angiography of the renal arteries( MSCT).This is a non-invasive study of blood flow in the arteries using high-speed multislice vascular scanning. Multispiral angiography after CT is necessary for the detection of vascular anomalies of a congenital nature, as well as for determining tumor pressure on the vessels, renal infarction or intraluminal arterial stenosis. CT angiography of renal vessels uses X-rays in diagnosis.
There is also an ultrasound angiography that involves several methods for obtaining ultrasound imaging of vascular courses, such as energy mapping or Doppler color mapping, artificial contrasting with intravenous contrast injection, three-dimensional vascular reconstruction, etc. Vascular angiography is often performed after CT, especially when planning angiosurgicaloperations on kidney vessels.
On video CT angiography with renal artery aneurysm:
procedure The procedure for angiographic diagnosis is not carried out without specialized training, which assumes:
- Alcohol must be excluded 14 days before the study;
- For 7 days exclude the use of blood-thinning drugs like aspirin, etc.;
- For 5 days before the planned procedure, it is necessary to perform ultrasound diagnosis of the heart and fluorography, electrocardiogram and coagulogram;
- For 2 days before the procedure, it is necessary to test for the tolerance of the contrast;
- For a day, if necessary, you need to remove hair from the specified area doctor;
- Before the procedure, you need a complete rest and a full night's sleep, so you can drink a sedative;
- In the morning you need to make an enema for cleansing the intestines, there is nothing you can not like and drink, and before research you need to go to the toilet.
The processes of angiography of renal vessels differ slightly depending on the method of administration of the contrast drug. With transluminal angiography, Omnupon and Morphine are administered before the procedure. Anesthesia is used topically, contrast is introduced with delayed breathing in the lumbar region. In the first minutes, an arteriogram and nephrogram are carried out, and then a transcript. Five minutes after the first X-ray, an excretory urogram is performed. Together with the preparation of contrast, heparin is introduced, which prevents thrombosis, and also Novocain from aortic spasm.
With transfemoral aortography, contrast is introduced into the artery on the thigh. The patient is put on his back, injected with Novocaine. In other respects, the periods of the radiograph are similar to translumbrial angiography. Stitching on the puncture site is not required, enough sterile bandages. The difference between these methods is the recovery period.
Angiographic diagnosis has a number of specific contraindications:
- Severe form of kidney failure;
- Intolerance or adverse reaction to iodine-containing drugs;
- Pulmonary tuberculosis of active form;
- Propensity to form blood clots;
- Insufficient liver or myocardium;
- Thyrotoxicosis, etc.
During 2-4 hours after the test, adverse reactions may occur, which are considered normal. They are manifested headaches and dizziness, iron taste in the mouth and light fever. But soon these reactions go by themselves.