Cerebral angiography

ʻO Cerebral angiography kahi hana e hoʻohana ai i kahi kala kūikawā (ʻokoʻa mea) a me nā x-ray e ʻike pehea e kahe ai ke koko ma o ka lolo.

Hana ʻia ʻo Cerebral angiography i ka haukapila a i ʻole kikowaena radiology.

• Moe ʻoe ma ka papa ʻaina x-ray.
• Mālama ʻia kou poʻo me ka hoʻohana ʻana i kahi kaula, lipine, a ʻeke ʻeke paha, no laila ʻaʻole ʻoe e neʻe iā ia i ke kaʻina hana.
• Ma mua o ka hoʻomaka ʻana o ka hoʻāʻo, hāʻawi ʻia ʻoe i kahi lāʻau hoʻomālie mālie e kōkua ai iā ʻoe e hoʻomaha.
• Nānā kahi electrocardiogram (ECG) i kāu hana puʻuwai i ka wā o ka hoʻāʻo. E kau ʻia nā pākuʻi paʻa, i kapa ʻia kēpau, ma luna o kou mau lima a me kou mau wāwae. Hoʻopili nā uea i nā alakaʻi i ka mīkini ECG.

Hoʻomaʻemaʻe ʻia kahi ʻāpana o kou kino, ʻo ka maʻa mau, a hoʻomaʻemaʻe ʻia me kahi lāʻau numbing kūloko (anesthetic). Hoʻokomo ʻia kahi ʻōiwi lahilahi a hollow i kapa ʻia he catheter ma o ke aʻa. Hoʻoneʻe maikaʻi ʻia ka catheter ma o nā kīʻaha koko nui i loko o ka ʻōpū a me ka umauma i loko o ka ʻāʻī. Kōkua nā kukuna X i ke kauka e alakaʻi i ka catheter i ke kūlana kūpono.

Aia a paʻa ka catheter, hoʻouna ʻia ka kala ma o ka catheter. Lawe ʻia nā kiʻi X-ray e ʻike pehea e neʻe ai ke kala ma o ke aʻa a me nā kīʻaha koko o ka lolo. Kōkua ka wai kala i kahi kahakaha ʻana i ke kahe o ke koko.

I kekahi manawa, hoʻoneʻe kahi kamepiula i nā iwi a me nā kinakona ma nā kiʻi e nānā ʻia ana, i ʻike wale ʻia nā kīʻaha koko piha i ka wai kala. Kapa ʻia kēia ʻo digital angiography subtraction digital (DSA).

Ma hope o ka lawe ʻia o nā kukuna x, huki ʻia ka catheter. Hoʻohana ʻia ke kaomi ma ka wāwae ma ke kahua o ka hoʻokomo no 10 a 15 mau minuke e hooki i ke kahe ʻana a i ʻole hoʻohana ʻia kahi mea e pani ai i ka lua liʻiliʻi. Hoʻopaʻa ʻia kahi kaula paʻa. Pono e mālama pololei ʻia kou wāwae no 2 a 6 mau hola ma hope o ke kaʻina hana. E nānā i ka wahi no ke kahe ʻana no ka liʻiliʻi ma ka hola 12 e hiki mai ana. I nā hihia kakaikahi, hoʻohana ʻia kahi aʻa lima lima ma kahi o ke aʻa ʻūhā.

Hoʻohana pinepine ʻole ʻia ka Angiography me kahi catheter i kēia manawa. ʻO kēia no ka mea MRA (magnetic resonance angiography) a me CT angiography e hāʻawi i nā kiʻi ʻoi aku ka maopopo.

Ma mua o ke kaʻina hana, e nānā ana kāu mea hāʻawi iā ʻoe a kauoha i nā hoʻokolohua koko.

E haʻi i ka mea hāʻawi inā ʻoe:

• Loaʻa i ka moʻaukala o nā pilikia kahe ʻana o ke koko a i ʻole lawe i nā lāʻau e lahilahi ai ke koko
• Ua loaʻa i kahi hopena maʻi ʻaʻai i ka pena hoʻoliʻiliʻi x-ray a i ʻole kekahi iodine waiwai
• Hāpai paha
• Loaʻa nā pilikia i ka hakuʻala

ʻ toldlelo ʻia ʻoe ʻaʻole e ʻai a inu paha i kekahi mea no 4 a 8 mau hola ma mua o ka hoʻāʻo.

Ke hōʻea ʻoe i ka pūnaewele hoʻāʻo, e hāʻawi ʻia ʻoe i kapa komo no ka haukapila e komo ai. Pono ʻoe e hemo i nā mea hoʻonaninani āpau.

ʻIke paha ka pākaukau x-ray i ke anuanu a anuanu. Hiki iā ʻoe ke noi i kahi kapa moe a uluna paha.

Manaʻo kekahi poʻe i ka ʻūpē ke hāʻawi ʻia ka lāʻau numbing (anesthetic). E ʻike ʻoe i kahi pōkole, ʻehaʻeha a me ke kaomi ke hoʻoneʻe ʻia ka catheter i loko o ke kino. Ke pau ke kau mua, ʻaʻole ʻoe e ʻike hou i ka catheter.

Hiki i ka ʻokoʻa ke hoʻomehana i ka ʻili o ka maka o ke poʻo a poʻo paha. He maʻamau kēia a hele mau i loko o kekona kekona.

Hiki paha iā ʻoe ke palupalu a palupalu hoʻi ma ka pūnaewele o ka hoʻopili ʻana ma hope o ka hoʻāʻo.

Hoʻohana pinepine ʻia ʻo Cerebral angiography e ʻike a hōʻoia paha i nā pilikia me nā kīʻaha koko i ka lolo.

E kauoha paha kāu mea hāʻawi i kēia hoʻāʻo inā loaʻa nā ʻōuli a i ʻole nā ​​hōʻailona o:

• Nā kīʻaha koko kūpono ʻole i ka lolo (malformation vascular)
• ʻO ke kīʻaha ʻana o ke koko i ka lolo (aneurysm)
• ʻO ka hoʻoliʻiliʻi o nā aʻa i ka lolo
• ʻO ka hoʻohaunaele o nā kīʻaha koko i ka lolo (vasculitis)

Hoʻohana ʻia ia i kekahi manawa i:

• E nānā i ke kahe o ke koko i kahi tumo.
• Loiloi i nā aʻa o ke poʻo a me ka ʻāʻī ma mua o ke kaha ʻana.
• E ʻike i kahi ʻōpala i loaʻa i kahi maʻi kī.

I kekahi mau hihia, hiki ke hoʻohana i kēia kaʻina hana e kiʻi i ka ʻike kikoʻī ma hope o ka ʻike ʻia ʻana o kahi mea ʻino e ka MRI a i ʻole CT scan o ke poʻo.

Hiki ke hana ʻia kēia hōʻike i ka hoʻomākaukau no ka lāʻau lapaʻau (nā hana radiology intervenal) e ke ala o kekahi mau moku koko.

ʻO ke kala ʻokoʻa e kahe ana mai loko o ke kīʻaha koko he hōʻailona ia o ke kahe ʻana.

E ʻōlelo paha nā aʻa ʻapiʻī a paʻa paha:

• Waihona Cholesterol
• ʻO kahi spasm o kahi lolo o ka lolo
• Nā maʻi i hoʻoili ʻia
• Hoʻopili ke koko i ka maʻi hahau

Ma kahi o nā kīʻaha koko e pili ana i:

• ʻOrspala lolo
• Kahe ʻana o loko o ka iwi poʻo
• ʻO Aneurysm
• ʻO ka pilina maʻamau ma waena o nā aʻa a me nā uaua i ka lolo (malteration arteriovenous)

ʻO nā hopena kūpono ʻole ma muli o ka maʻi ʻaʻai i hoʻomaka i kekahi ʻāpana o ke kino a ua pālahalaha ʻia i ka lolo (tumor lolo lolo metastatic).

Komo pū nā pilikia:

• ʻO ka hopena āpau i ka kala ʻokoʻa
• Koko koko a hoʻokahe paha kahi i hoʻokomo ʻia ai ka catheter, kahi hiki ke ālai hapa i ke kahe o ke koko i ka wāwae a i ʻole ka lima (rare)
• Ka poino i ka aʻa a i ʻole ka paia artery mai ka catheter, hiki ke ālai i ke kahe o ke koko a hana i kahi hahau (kākaʻikahi)
• Poino i nā puʻupaʻa mai ka ʻokoʻa IV

E haʻi koke i kāu mea hāʻawi inā loaʻa iā ʻoe:

• Nāwaliwali i nā mākala o kou alo
• Pōpō i kou wāwae i ka manawa a ma hope paha o ke kaʻina hana
• ʻ speechlelo kūleʻa i ka wā a ma hope paha o ke kaʻina hana
• Nā pilikia o ka hihiʻo ma hope a ma hope paha o ke kaʻina hana

Vertebral angiogram; Angiography - poʻo; Carotid angiogram; Cervicocerebral catheter-based angiography; Angiography hoʻoemi kikohoʻe Intra-arterial; IADSA

• Lolo
• Carotid stenosis - X-ray o ke aʻa hema
• Carotid stenosis - X-ray o ke aʻa pono

ʻO Adamczyk P, Liebeskind DS. Kiʻi vascular: angiography tomographic i hoʻopili ʻia, angiography resonance magnet, a me ultrasound. I: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 40.

Barras CD, Bhattacharya JJ. Ke kūlana o kēia manawa o ke kiʻi ʻana o ka lolo a me nā hiʻohiʻona anatomical. I: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. ʻO Grainger & Allison's Diagnostic Radiology. ʻEpekema 7 Piladelapia, PA: Elsevier; 2021: chap 53.

Chernecky CC, Berger BJ. Cerebral angiography (cerebral angiogram) - hōʻikeʻike. I: Chernecky CC, Berger BJ, hua. Nā Hoʻokolohua Laboratory a me nā kaʻina hana Diagnostic. ʻElua huaʻōlelo St Louis, MO: Elsevier Saunders; 2013: 309-310.