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CT angiography (CTA) is a way to examine blood vessels. It combines two types of diagnostics at once: X-ray and computed tomography. With its help, the doctor receives an accurate three-dimensional image of arteries, veins and capillaries in any part of the human body. So, CTA of the small pelvis is prescribed for the diagnosis of vascular pathologies in this particular area, confirmation of the diagnosis or its refutation. Since this method is still not widely used, many questions accumulate in patients before the procedure. The answers to them are in this article.
What is it and why is it prescribed
Computed tomographic angiography is designed to study the circulatory system. It can be applied to any part of the body or the whole organism. CTA of the pelvic vessels gives an accurate image of the arteries and small vessels located in the pelvis. With the help of a computer program, the doctor examines their structure, finds pathologies, if any, checks the patency. Based on the results, the patient is diagnosed, and a treatment regimen is determined.
This diagnostic method is based on x-rays. But the load for the subject in this case is less, since short flashes are used here, and the radiation itself is limited to beams. All received information is transmitted to a network of connected computers, which gradually reflect a 3D model of the vascular system in the pelvic region. Among the alternative examination methods, this one is preferred, since it is faster and gives a clearer result.
CTA is one of the most important achievements of modern diagnostics. The whole procedure takes no more than 20 minutes, painless, gives accurate information. Before the advent of such a technique, it was extremely difficult to consider the vascular system, and many peripheral sections were completely inaccessible. Today, CTA allows you to easily and quickly examine even the smallest details, establish a clear diagnosis and the correct tactics of therapy.
When is CTA of the pelvis needed?
The vascular network provides a constant flow of blood in the body and maintains life. Failures in its work quickly affect health, and in some cases lead to death, for example, with heart attacks. CTA of the pelvic arteries is needed to diagnose abnormalities in this area of the body. It can be:
- benign and malignant tumors of organs located in the pelvic part;
- Leriche’s syndrome in men – a disease in which an erection is blocked;
- pathology of the pelvic organs;
- diseases of the reproductive and excretory system caused by vascular disorders;
- thromboses;
- trauma;
- narrowing of the lumen of the vessels.
Computed tomography of arteries, veins and capillaries is often needed before surgery to determine the area of work to be done, the likelihood of complications, etc. Also, this procedure is sometimes prescribed after surgical interventions in women and men to control the recovery process. A surgeon, gynecologist, or other attending physician can refer you for angiography. The radiologist conducts the procedure and decodes the obtained images.
How does this happen
The whole procedure takes place in a special room, where a CT scanner is located. This is the equipment in which the patient is placed for examination, it consists of a movable table and the camera itself. Before the session, a person must change into a hospital gown, remove metal jewelry. The study is carried out using a special dye – a contrast agent, which is injected into the cubital vein.
Contrast is an iodine-based substance that is given intravenously before an angiogram. It does not transmit X-rays, due to which a more accurate picture is obtained, so blood vessels and soft tissues are better visible. Without the use of a contrast agent, CT of the pelvic arteries is not done, since the information content of such a study is insignificant. The substance is injected using a computerized injector, after which it spreads throughout the circulatory system and improves the examination.
After the injection, the movable table with the patient is moved into the chamber, while only the lower body is in the chamber to reduce radiation exposure. Here, X-rays scan the entire circumference of the pelvis, transmitting a 3D modeled image to a computer. The entire scanning procedure takes no more than 1,5 minutes, usually 30 seconds. Complete diagnosis and injection of contrast requires approximately 10-20 minutes. CTA is absolutely painless, at the time of injection of the contrast agent, a pleasant warmth can be felt throughout the body, which is a normal reaction.
During the study, the doctor is in another room in front of the monitors. Communication between him and the patient takes place through a special speakerphone. While the tomography is being performed, it is important for the subject not to move, sometimes the doctor may ask you to hold your breath. After the procedure, the patient changes clothes and waits for the decoding of the received images. It will take another 20-60 minutes for the radiologist, depending on the picture of the disease. As noted by the reviews, CT angiography of the pelvic vessels occurs quickly, without any discomfort.
How to prepare for the study
There is a small list of contraindications for this procedure, so it is important to exclude possible risks before it. Before issuing a referral to a radiologist, the attending physician must examine the patient. At the preparatory stage, the patient is subjected to allergy tests to identify possible allergies to the components of the contrast agent. After receiving all the tests and conclusions, the patient receives a referral for CT angiography.
You need to take with you for diagnostics:
- medical card;
- conclusions of previous studies;
- direction.
The examination is done only on an empty stomach, it is recommended not to eat before it for at least 6 hours. You can not drink for 4 hours before the tomography. If you feel very thirsty, you can moisten your lips with cool water. Even 2 days before the diagnosis, it is worth giving up alcohol and too fatty foods. If any medications are being taken, this should be reported to the radiologist prior to the procedure.
Where can it be done
Unfortunately, such equipment is practically inaccessible for state medical institutions. Therefore, in most cases, you have to look for private clinics. The referral can be issued by a doctor and in a regular clinic or hospital. The service of CT angiography of the pelvic vessels is provided by equipped diagnostic centers. An appointment is usually made daily, for this you only need the phone number of the selected clinic. It is even easier to use online registration on the websites of such medical centers.
The price of CTA depends on the policy of the diagnostic center. One such procedure costs between 100-150 dollars. It includes the cost of contrast, disposable clothing, radiography and the opinion of a radiologist.
Meaning of the results
Immediately after the CT scan of the arteries, the radiologist will examine the resulting image in detail. Based on these results, he will make a description and conclusion, he should not make any decisions regarding treatment. The patient receives the results of the study on electronic media, and these data can also be sent to him by e-mail. With this conclusion, he turns to the attending doctor to establish a further treatment strategy or to refute the diagnosis.
Contraindications to the procedure
People with a phobia of enclosed spaces (claustrophobia) and those whose weight is more than 200 kg undergo tomography only in an open circuit machine. Therefore, when booking by phone or online, it is worth clarifying this point. Only in extreme cases, such an examination is prescribed for:
- diabetes mellitus;
- the age of the patient is up to 14 years;
- renal failure;
- anomalies of the thyroid gland;
- myeloma.
Women in position and anyone who has an allergic reaction to the contrast component do not undergo such a diagnosis. It is prescribed to nursing mothers only in exceptional cases, when a woman’s life is in danger. In this case, it is imperative to stop feeding for two days after diagnosis, since the components of the drug can pass into breast milk.
What to do if the procedure is contraindicated
To date, there are alternative methods for diagnosing vascular diseases in the pelvis. However, CTA remains the most comfortable and accurate. If such a technique is contraindicated for a patient, MRI angiography or classical X-ray angiography may be prescribed. However, MRI is not suitable for those who have metal parts in the body, and the classical one does not have the same accuracy as CTA. All of these procedures occur in the same way for the patient, but differ in price.
Possible complications after CTA
With proper preparation and preliminary examination, the likelihood of complications is almost zero. All the consequences that can happen are due to an allergic reaction to the composition of the administered drug. At the same time, the subject experiences shortness of breath, the skin turns red and itches, and the classic allergy symptoms appear.
In addition, there is a small possibility of contrast entering the soft tissues at the injection site, this is called extravasation. In this case, the injection site may swell, redden, hurt, itch. As a rule, to eliminate side effects, a cold compress is applied to the affected area, the hand is held up. If the consequences or suspicious symptoms were found at home, you should immediately inform your doctor about this.