脑血管造影术

定义

脑血管造影术 is a procedure that uses a special dye (contrast material), x-rays to see how blood flows through the brain.

选择的名字

Vertebral angiogram; Angiography - head; Carotid angiogram; Cervicocerebral catheter-based angiography; Intra-arterial digital subtraction angiography; IADSA

如何执行测试

脑血管造影术 is done in the hospital or radiology center.

• 你躺在x光台上.
• Your head is held still using a strap, tape, or sandbags, so you do not move it during the procedure.
• Before the test starts, you are given a mild sedative to help you relax.
• An 心电图 心电图(ECG)在测试过程中监测你的心脏活动. Sticky patches, called leads, will be placed on your arms and legs. 导线连接到心电图机.

你身体的一部分, 通常是腹股沟, is cleaned and numbed with a local numbing medicine (anesthetic). A thin, hollow tube called a catheter is placed through an artery. The catheter is carefully moved up through the main blood vessels in the belly area and chest into an artery in the neck. X-rays help the radiologist guide the catheter to the correct position.

Once the catheter is in place, dye is sent through the catheter. X-ray images are taken to see how the dye moves through the artery and blood vessels of the brain. 这种染料有助于突出血流中的任何阻塞.

有时, a computer removes the bones and tissues on the images being viewed, so that only the blood vessels filled with the dye are seen. 这被称为数字减影血管造影(DSA)。.

After the x-rays are taken, the catheter is withdrawn. Pressure is applied on the leg at the site of insertion for 10 to 15 minutes to stop the bleeding or a device is used to close the tiny hole. 然后使用紧绷的绷带. Your leg should be kept straight for 2 to 6 hours after the procedure. Watch the area for bleeding for at least the next 12 hours. In rare cases, a wrist artery is used instead of the groin artery.

导管血管造影术现在很少使用了. 这是因为MRA (磁共振血管造影), CT血管造影术 提供更清晰的图像.

如何准备考试

Before the procedure, your health care provider will examine you and order blood tests.

如果你:

• Have a history of bleeding problems or take medicines that are blood thinners
• Have had an allergic reaction to x-ray contrast dye or any iodine substance
• 可能怀孕了
• 肾功能有问题

You may be told not to eat or drink anything for 4 to 8 hours before the test.

When you arrive at the testing site, you will be given a hospital gown to wear. 你必须摘掉所有的首饰.

考试的感觉如何

x光台可能感觉又硬又冷. 你可以要毯子或枕头.

Some people feel a sting when the numbing medicine (anesthetic) is given. You will feel a brief, sharp pain and pressure as the catheter is moved into the body. Once the initial placement is complete, you will not feel the catheter any longer.

The contrast may cause a warm or burning feeling of the skin of the face or head. This is normal and usually goes away within a few seconds.

You may have slight tenderness and bruising at the site of the injection after the test.

为什么要进行测试

脑血管造影术 is most often used to identify or confirm problems with the blood vessels in or around the brain.

Your provider may order this test if you have symptoms or signs of:

• Abnormal blood vessels in the brain (vascular malformation)
• 脑血管膨大(动脉瘤)
• 脑部动脉狭窄
• Inflammation of the blood vessels in the brain (vasculitis)

它有时用于:

• 看看流向肿瘤的血液.
• Evaluate the arteries of the head and neck before surgery.
• 找到一个可能导致 中风. 

在某些情况下, this procedure may be used to get more detailed information after something abnormal has been detected by an MRI or 头部CT扫描.

This test may also be done in preparation for medical treatment (介入放射学程序)通过某些血管. For instance, this test can be part of a treatment for a 中风 or to treat a brain 动脉瘤.

异常结果意味着什么

Contrast dye flowing out of the blood vessel may be a sign of bleeding.

狭窄或阻塞的动脉可能表明:

• 胆固醇沉积
• 脑血管痉挛脑血管痉挛
• 遗传疾病
• 引起中风的血栓

血管错位可能是由于:

• 脑部肿瘤
• 颅内出血
• 动脉瘤
• Abnormal connection between the arteries and veins in the brain (动静脉畸形)

Abnormal results may also be due to cancer that started in another part of the body and has spread to the brain (转移性脑瘤).

风险

并发症可能包括:

• 对造影剂过敏
• 导管插入处有血块或出血, which could partly block blood flow to the leg or hand (rare)
• 导管对动脉或动脉壁的损害, 会阻碍血液流动并导致中风(罕见)
• 静脉造影剂对肾脏的损害

注意事项

如果你有以下情况，请立即告知你的十大赌博平台排行榜:

• 面部肌肉无力
• 手术过程中或手术后腿部麻木
• 手术过程中或手术后言语不清
• 手术期间或手术后的视力问题

参考文献

Adamczyk P, Liebeskind DS. Vascular imaging: computed tomographic angiography, 磁共振血管造影, and ultrasound. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. 布拉德利和达洛夫的《临床实践中的神经学. 8日艾德. Philadelphia, PA: Elsevier; 2022:chap 41.

Barras CD, Bhattacharya JJ. Current status of imaging of the brain and anatomical features. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. 格兰杰 & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 7日艾德. Philadelphia, PA: Elsevier; 2021:chap 53.

陈国强，张国强. 脑血管造影术 (cerebral angiogram) - diagnostic. 见:陈国强，张国强编. 实验室测试和诊断程序. 6日艾德. St Louis, MO: Elsevier Saunders; 2013:309-310.