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If it is necessary to obtain reliable information about the state of the vessels supplying blood to the lungs and mediastinum, for example, if heart disease, aortic aneurysm, pathological processes in the main vessels of the chest are suspected, specialists prescribe computed tomography of the aorta and pulmonary artery to patients.
During this examination, layer-by-layer scanning of the necessary areas of the body with x-rays takes place with the issuance of images. Thanks to XNUMXD images of the vascular system, doctors can diagnose even the smallest changes in the aorta and pulmonary branches.
Benefits of this survey
These vessels are very difficult to assess using ultrasound or magnetic resonance imaging, since the direction of these techniques is not designed to consider such structures throughout their entire length. That is why CT of the aorta and pulmonary trunk provides the most accurate and effective results that can be used to make accurate diagnoses and subsequent therapeutic measures. Some semblance of CT results can be provided by X-ray angiography for vascular pathologies, but in order to obtain more accurate data, specialists always insist on undergoing CT.
In addition, in order to perform high-quality angiography, it is necessary to inject a contrast agent directly into the study area, and since an injection cannot be made into the aorta, doctors have to pierce the femoral artery and pass a long probe through it to the aortic orifice, which makes the angiography procedure highly invasive. Whereas when performing computed tomography of this area, it is enough to introduce a contrast agent into the cubital vein. Because of this sophisticated contrast technology, X-ray angiography takes much longer than CT scans, creating another competitive advantage for the latter.
The main disadvantage of angiography is the fact that the entire process from the beginning of the contrast injection takes place under fluoroscopic control, which greatly increases the patient’s radiation dose. When performing computed tomography, such an effect of X-rays is not required, they affect a person for a limited time, and, moreover, they are low-dose, ensuring the absolute safety of patients.
Indications and contraindications for use
Among the main medical indications for computed tomography of the aorta and pulmonary artery, doctors distinguish the following diagnosed diseases:
- exfoliating aneurysm or aneurysm of the aorta;
- pulmonary embolism;
- coarctation of the aorta;
- stenotic changes in the pulmonary artery or aortic orifice;
- pathological conditions of the aorta or pulmonary artery;
- opening of the Botallov duct;
- vascular atherosclerosis.
However, when prescribing this examination, it is important to understand that CT scans cannot be performed on pregnant women, although this category of patients may rarely need such a diagnosis, since women with pathologies of the cardiovascular system must be examined for the possibility of becoming pregnant even before planning the unborn child.
Since this type of CT is not done without contrast, it cannot be used in a group of patients who are allergic to the contrast agent or iodine, which is the basis of the contrast. After the contrast is injected into the bloodstream, the iodine base of this substance stains the walls of the vessels, making the gaps between them more visible on tomography images. Such staining details the relief surface of the endothelium and makes it possible to assess its smallest defects.
Also, a contraindication to this diagnostic method is renal failure, severe thyroid dysfunction, severe forms of diabetes mellitus, and some forms of multiple myeloma. All these conditions cannot be a reason to refuse an x-ray examination, but a contrast agent for any of the above forms of diseases can be dangerous.
Contraindications for computed tomography are identified at an appointment with the attending physician, however, even in cases where this was not done for some reason, specialists conducting tomography in research centers always talk to patients before conducting studies and sometimes require the provision of some tests in order to make sure the diagnosis is completely safe for a particular person.
Preparing and conducting diagnostics
No special training is required for performing computed angiography using modern equipment. 5 hours before the proposed examination, you must refuse to eat, and about an hour before the procedure, experts recommend not drinking anything. Contrast-enhanced CT requires such limitations.
The patient must have a referral from the attending physician for a study, an extract or a medical record, the results of previous studies, if any, and tests. Before the start of the diagnosis, the patient is injected with a contrast agent. He is laid on the table of the tomograph and warned that with all the movements of the tomograph itself, the person must remain motionless. The table itself will move horizontally, and the annular part of the apparatus will rotate around it.
During computed tomography, the patient is left alone in the room, and the X-ray technician observes him through X-ray-tight glass from an adjacent room. If necessary, you can always contact the staff by two-way communication. For patients, imaging is completely painless.
Sometimes patients are interested in why the doctor prescribes for them the passage of computed tomography, and not magnetic resonance imaging. The fact is that the pulmonary artery and aorta are large vessels, in some areas reaching 3 centimeters in diameter, so for specialists they are more likely not soft tissues, but structures filled with liquids. Magnetic resonance imaging is not able to clearly visualize objects in motion, and in the case of vessels, it is important to understand that they pulsate, thus creating artifacts in MRI images.
At the same time, computed tomography makes it possible to obtain images in this area instantly and with high accuracy of the depicted objects. Also, the diagnostic technique makes it possible to build 3D models from the obtained images and examine the necessary vessel from all sides. At the same time, during the CT scan, the specialist can also see other neighboring human organs, which helps to determine the cause of the disease in more detail.
The results of computed tomography are usually given to the patient in the form of a written conclusion and all the obtained images within half an hour after the end of the study. The patient must provide all these documents to his doctor, who gave him a referral for examination, in order to make the correct diagnosis and prescribe appropriate therapy.