Computed tomography - a method of studying the structure of the human body. With its help, soft tissues, the skeleton, the circulatory system are examined, pathologies are detected. CT of blood vessels in medicine is called angiography - CTA. This method examines the arteries, capillaries, veins, find places of narrowing or blockage. To identify leg abnormalities, angiography of the lower extremities is prescribed. How it happens, how to prepare, how much it will cost and whether there is a risk to health - all this can be learned right now.
Description of the CTA method
The circulatory system spreads throughout the body and ensures the life of every cell. Therefore, failures in its work quickly affect the human condition. It was extremely difficult to diagnose vascular diseases before the invention of computed tomography. Today, using this method, doctors can examine in detail even small capillaries without a single incision. The essence of CTA is x-ray scan of the body. The images created during this process form a 3D model of the circulatory system on a computer monitor.
The innovativeness of angiography is due to even greater accuracy of the results than that of a simple X-ray or conventional CT. For clear images using a special amplifier - a contrast agent. This is a solution based on iodine, which is injected test in a vein. The contrast does not let the x-rays pass, so the pictures show the circulatory system more precisely, with the smallest nuances. This solution is also called a dye.
Unlike other diagnostic methods, CTA of the vessels of the lower extremities allows to reduce the proportion of radiation. This technology uses beams collected in a beam, while the exposure time is as short as possible. For examination, only the lower part of the body is placed in the tomograph chamber, which also reduces the level of X-ray exposure. The procedure consists of several stages: preparation, introduction of contrast, taking pictures and decoding the results.
For the patient, the session is absolutely painless, the only invasion is the administration of the drug. The process of radiography lasts no more than a minute, then the doctor examines the 3D model in detail and writes a conclusion based on it. The patient receives the results in written and electronic form, according to which the attending physician will determine the treatment regimen or further examination.
When CTA is prescribed
Due to the fact that the technique is based on irradiation, albeit minimal, this procedure is prescribed only by a doctor. That is, it is impossible to pass it simply at will, for this there should be a referral from a vascular surgeon or a doctor in attendance. Indications for such a diagnosis are abnormalities in the legs, suspected vascular pathology, and patient complaints.
A doctor can write a referral if the patient experiences:
- pain and lameness after physical exertion, weakness in limbs, trembling;
- unreasonable pain in the muscles of the legs;
- numbness of the fingers, feet, or parts of the limbs;
- feet cold even when warm.
Also, if the doctor does not feel the pulsation while feeling, this is the reason for the CTA. Any suspicion of vascular occlusion requires computed tomography, as they often lead to serious complications, such as a heart attack.
During the procedure, the radiologist may see different vascular pathologies. Examines the diameter of the passage, the presence of a lumen or thrombus, finds the places of narrowing. Volumetric images of the patient show inflammatory processes in the vessels and adjacent tissues. Due to this, most diseases, even those not related to the circulatory system, can be detected in CTA of the lower extremities.
Such a detailed diagnosis is needed before operations, to confirm the diagnosis or to refute it. With the identified disease, tomography allows you to monitor the healing process and correct treatment in time. Angiography of the legs is prescribed for:
- varicose veins;
- injury to arteries or veins;
- inflammation of the aorta (Takayasu disease);
- malignant and benign vascular tumors;
- chronic venous insufficiency;
- edema of the legs of undetected nature;
- arterial thrombosis;
- phlebothrombosis and thrombophlebitis;
- angiopathy in diabetes mellitus.
During the course of treatment, the doctor may prescribe one or more tomography procedures. After surgical interventions, they are also sent to KTA, this allows you to review the results of the operation after some time, prescribe treatment or finish it.
Where can I get this diagnosis?
If the patient is treated in a private clinic, they can also provide a similar service here. In this case, it remains only to assign a date and pass the session. In public medical institutions, computer tomographs are almost non-existent, since they are very expensive equipment. If a doctor from a regular hospital or clinic prescribed CTA of the vessels of the lower limbs, you need to look for a diagnostic center.
You can do this without leaving home, using the Internet. Such private medical centers always have websites describing services. It also sometimes indicates the cost and there is the possibility of online recording. The price of one procedure ranges from 100-200 dollars, depending on the clinic and the scanner itself.
Preparation for the procedure
The study of the circulatory system is a very painstaking process, it can be influenced by a number of factors that distort the data. Therefore, reviews of doctors recommend to prepare in advance. Upon discharge of the referral, the doctor must warn his ward about the prohibition of drugs that reduce blood clotting. Two days before admission, it is advisable to refuse alcohol, since ethyl alcohol sometimes leads to blockage of small capillaries. For 6 hours you need to refuse to eat, the session is held on an empty stomach. At the reception with you need to take:
- referral to the procedure from your doctor;
- pictures and results of all previous diagnostics;
- discharge from an ambulatory card;
- other documents that may be relevant to the studied disease;
- simple drinking water (it will be necessary after diagnosing).
Upon arrival at the radiologist's office, he must be informed about the associated diseases and medications that are being taken. So, it must be warned if there is diabetes, pregnancy, allergy to mollusks (iodine), the presence of prostheses and implants in the legs.
How would this happen
In the office where the procedure will take place, the tomograph is located. It consists of a special camera that scans the body, and a movable table on which the patient will lie. Before the procedure, the patient is given a change of clothes, just take off all metal jewelry. The doctor himself during the diagnosis will be in the next room with a window. Communication is maintained through the speakerphone: the researcher hears the doctor and vice versa.
Then the patient lies down on the table and a contrast is administered to him. The dye is injected through the injector into the ulnar vein, at which time heat can be felt all over the body - this is a normal reaction that passes quickly. After the introduction of iodine-containing substance begins the process of tomography. The table smoothly enters the chamber, where x-rays pass through the entire circumference through the lower limbs. The obtained data is immediately transferred to a computer and form a 3D model of the circulatory system in the legs.
For the subject being examined, the whole procedure ends; it remains only to change into his clothes and wait for the conclusion of the radiologist. Also, for quick removal of contrast from the body, it is recommended to drink plenty of fluids. Decoding results takes 15-30 minutes. The entire session will require no more than 40-50 minutes. The data is given to the patient in his hands in the form of a photo and a written conclusion, 3D modeling is transferred to an electronic medium: a DVD or a flash card. These results can be sent by email at the request of the patient.
When CTA is contraindicated
As with all methods of exposure, computed tomography has its limitations. Almost all contraindications for angiography due to the presence of contrast. This substance contains iodine, which can adversely affect the internal organs and systems. In addition, iodine is excreted from the body with liquid, including breast milk, so for nursing mothers, this procedure is prescribed only in extreme cases.
CT of vessels of the lower extremities is not carried out in such situations:
- the patient is in serious condition;
- with renal failure;
- if you are allergic to iodine (checked before discharge appointment);
- keratin levels are elevated in the blood (checked before discharge);
- during pregnancy;
- with diabetes mellitus type II.
Women during lactation may require CTA, in this case, feeding is stopped for two days after undergoing the procedure. Children up to 14 years old are prescribed such a study only in severe cases, usually replacing it with other types. In case of kidney failure, such a survey is also avoided, since iodine adversely affects the kidneys. But if the patient’s life is threatened, the doctor may prescribe CTA under strict supervision.
People weighing more than 200 kg will need a session in an open type tomograph. Sometimes the equipment is designed for a weight of not more than 150 kg. During the recording by phone or online, this nuance is better to clarify immediately.
Similar diagnostic methods
If CT is contraindicated, use an alternative examination method. Replace tomography can be on MRI - magnetic resonance imaging. Its advantage is that it does not require irradiation. Images are taken using the electromagnetic response. But this method is absolutely not suitable for those who have metal implants. In addition, the price of such a service is higher than that of KTA. One session will cost 150-250 dollars.
Another new technology is MSCT (multispiral computed tomography). It is also based on x-rays and a contrast agent. However, the level of irradiation and the amount of dye is less than that of angiography. The results are equally informative, in the form of a 3D image of the circulatory grid. Among all the research options, this one is the most expensive. For one reception you will have to pay 300-350 dollars. Reviews show that in different clinics this price may be higher.
Is CTA dangerous?
Any type of radiation does not have a positive effect on the human body. Similarly, the effect of CT on a person has not been sufficiently studied, although there are no critically negative responses. Radiation, which is used in angiography, does not exceed the permissible thresholds. But scientists still do not recommend abusing such sessions. At one time, a person receives such amount of background radiation, which he receives for 2 years from the external environment. However, this amount does not cause visible damage to health, if between procedures maintain intervals of 3-6 months. To reduce the level of radiation the patient is placed in the chamber is not completely, so the risk is further reduced.
There is a small chance of contrast entering the soft tissues outside the vessels. This is accompanied by redness and swelling at the injection site, and sometimes painful sensations. But in this case, side effects occur quickly enough and the patient can immediately seek help. If the patient was tested for allergies before the examination, all possible contraindications are taken into account - the session will pass without complications, quickly and comfortably.