Abstract:

Aim: was to improve diagnostics of neck vessels' damage, by methods of traditional and CT-angiography

Material and methods: 65 injured patients with suspected damage of neck major vessels underwent examination. 52 persons had open traumas of the neck, 13 persons had closed traumas of the neck. Radiological diagnostics included CT-angiography and traditional angiography Main aim of examination was in determination of damage including both vessels and other structures of the neck, their localization and the nature of damage.

Results: CT-angiography gave possibilities:

•           to give exact characterictics of all traumatic injures of the neck and to choose the group of patients with vessel traumas (23 patients)

•           to define exactly the nature of the damage of neck vessels (aneurysm, thrombosis, rupture);

•           to control the effectiveness of the surgical intervention.

Traditional angiography was applied in 10 observations of the traumatic aneurysm of neck vessel, for search of the additional diagnostic information. In comparison with results of CT- angiography any other precise information was not received.

Conclusions: analysis of the traditional and CT-angiography diagnostic possibilities of vessels damage, accompanying cervical trauma demonstrated high effectiveness of both methods. Traditional angiography should be used in absence of CTA in diagnostic arsenal. 

Referenses

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Abstract:

Purpose. Was to define the capability of multi-slice computed tomography angiography (MSCT-angiography) in diagnostics of arteriove-nosus conflict in patients with primary and recurrent varicocele.

Materials and methods. 46 patients with left-side varicocele were underwent MSCT-angiography: 36 had firstly diagnosed disease, 10 had recurrent types. Capability of MSCT-angiography in the zone of possible arteriovenosus conflicts was estimated on the base of imaging analysis: axial, multiplanar and 3D-imaging of left renal vein (LRV), a.mesenterica superior (AMS) in aortomesenterical zone, and crossing place of left iliaca communis vein(LICV) and right iliaca communis artery (LICA). We have investigated structure features of left testiculars vein (LTV) in patients with primary and recurrent varicocele.

Results. All the patients during axial imaging analysis we have investigated the crossing place of LRV and LICV with conflict arteries - AMS and LICA. We have revealed featured of LRV, compressed by AMS, on the base of axial and multiplanar imaging changes. Analysis of axial multiplanar and 3D-reconstruction has showed high capability in diagnostics of arteriovenosus conflict on the level LICV Study of multiplanar and CT-imaging in case of LICV valve insufficiency and different types of anatomy is possible

Conclusions. Taking into consideration diagnostic capability, technical simplicity and high sensitivity of MSCT-angiography in diagnostics of arteriovenosus conflicts in varicocele, this methodic must be included in algorithm of patients examination in case of primary and recurrent varicocele. MSCT-angiography in definition of haemodynamic types of disorders can promote the right choice of surgical correction.

References 

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3.    Бавильский В.Ф., Суворов А.В., Иванов А.В. и др. Выбор метода оперативного лечения варикоцеле.  Урология. 2003; 6: 40-43.

4.    Гарбузов Р.В., Поляев Ю.А., Петрушин А.В. Артериовенозный конфликт и варикоцеле у подростков. Диагностическая и итервенционная радиология. 2010; 4 (3): 31-36.

5.    Мазо Е.Б., Тирси К.А., Андранович С.В., Дмитриев Д.Г. Ультразвуковой тест и скротальная допплер-эхография в предоперационной диагностике гемо-динамического типа варикоцеле. Урология и нефрология. 1999; 3: 22-26.

6.    Лопаткин Н.А., Морозов А.В., Житникова Л.Н. Стеноз почечной вены. М.: Медицина. 1984.

7.    Коган М.И., Афоко А., Тампуори Д., Асанти-Асамани А., Пипченко О.И. Варикоцеле: противоречия проблемы. Урология. 2009; 6: 67-72.

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Abstract:

Ischemic strokes are still the worldwide problem with high mortality and morbidity. Carotid endarterectomy that is used for revascularization of changed artery required precise visualization of carotid arteries at extra- and intracranial level, assessment of intracranial circulation.

References

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Abstract:

Aim: was to estimate changes in architectonic and hemodynamics of left common iliac vein (lCIV), caused by its crossing with right common iliac artery (rCIA), in patients with varicocele according to data of computed tomography angiography (CTA) and contrast venography.

Materials and methods: we analyzed results of CTA and contrast venography in the area of arte-riovenous crossing: 37 patients with newly diagnosed and 45 with recurrent varicocele. Analysis of topical changes was made on data of axial tomography, multiplanar and 3D reconstructions. Hemodynamic changes in lCIV, were determined by dynamic venogram and results of mesurement of pressure gradient between lCIV and vena cava inferior (VCI).

Results: it was found that CTA is the most informative for visualizing of lCIV narrowing caused by its compression by rCIA. This is due to the possibility of obtaining a same contrasting imaging of vessels involved in arteriovenous «conflict». Multiple view scanning reconstruction revealed a correlation between size of the lumbosacral angle and the degree of compression of lCIV caused by arteriovenous conflict. CT angiography with the use of utility model, allowed to change the state of the arteriovenous crossing, showed compression instability Dynamic contrast venography showed angiographic features typical for lCIV compression, and also visualized venous collaterals that compensate blood-flow disorders. Conducting direct measurement of venous pressure gradient in compression area allowed us to estimate the degree of hemodynamic changes in lCIV and explore the mechanism of compression generated by pulsating blood flow of rCIA.

Conclusions: severity of compression of lCIV at arteriovenous «conflict» is affected by constitutionally-static angle between L5-S1 vertebral bodies. Compression degree of lCIV is not constant and may vary depending on the patient's body position. Compression of lCIV promotes collateral blood flow through veins of sacral and external lumbar drainage. The more expressed compression of lCIV the more developed collateral blood flow in both drainage systems. Developed collaterals compensate hypertension caused by compression of lCIV Estimation of venous blood flow disorders, in case of varicocele, and choice of method of surgical treatment should be based on data from X-ray contrast studies and results of tensometry conducted at the area of arteriovenous «conflict» of lCIV.  

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