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Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the

body, with particular interest in the arteries, veins and the heart chambers. This is traditionally done by injecting a radio-opaque contrast agent into the blood vessel and imaging using X-ray based techniques such as fluoroscopy. The word itself comes from the Greek words angeion, "vessel", and graphein, "to write or record". The film or image of the blood vessels is called an angiograph, or more commonly, an angiogram. The term angiography is strictly defined as based on projectional radiography; however, the term has been applied to newer vascular imaging techniques such as CT angiography and MR angiography. The term isotope angiography has also been used, although this more correctly is referred to as isotope perfusion scanning.

Access to the blood vessels is gained most commonly through the femoral artery, to look at the left side of the heart and the arterial system or the jugular or femoral vein, to look at the right side of the heart and the venous system. Using a system of guide wires and catheters, a type of contrast agent (which shows up by absorbing the x-rays), is added to the blood to make it visible on the x-ray images. The X-ray images taken may either be still images, displayed on a image intensifier or film, or motion images. For all structures except the heart, the images are usually taken using a technique called digital subtraction angiography (DSA). Images in this case are usually taken at 2 - 3 frames per second, which allows the radiologist to evaluate the flow of the blood through a vessel or vessels. This technique "subtracts" the bones and other organs so only the vessels filled with contrast agent can be seen. The heart images are taken at 15-30 frames per second, not using a subtraction technique. Because DSA requires the patient to remain motionless, it cannot be used on the heart. Both these techniques enable the radiologist or cardiologist to see stenosis (blockages or narrowings) inside the vessel which may be inhibiting the flow of blood and causing pain.

Indications
y y y y y y y y

Unstable angina or Chest pain [uncontrolled with medications or after a heart attack] Heart attack Before a bypass surgery Abnormal treadmill test results Determine the extent of coronary artery disease Disease of the heart valve causing symptoms (syncope, shortness of breath) To monitor rejection in heart transplant patients Syncope or loss of consciousness in patients with aortic valve disease

Contraindiciations
y y y y y y y y y y y

Allergy to contrast (dye) medium Uncontrolled Blood Pressure (Hypertension) Problems with blood coagulation (Coagulopathy) Kidney failure or dysfunction Severe anemia Electrolyte imbalance Fever Active systemic infection Uncontrolled rhythm disturbances (arrhythmias) Uncompensated heart failure Transient Ischemic attack

Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins and the heart chambers. Access to the blood vessels is gained most commonly through the femoral artery, to look at the left side of the heart and the arterial system or the jugular or femoral vein, to look at the right side of the heart and the venous system. A system of guide wires and catheters, a type of contrast agent is added to the blood to make it visible on the x-ray images. The X-ray images taken may either be still images, displayed on a image intensifier or film, or motion images. For all structures except the heart, the images are usually taken using a technique called digital subtraction angiography (DSA). Images in this

case are usually taken at 2 - 3 frames per second, which allows the radiologist to evaluate the flow of the blood through a vessel or vessels. This technique "subtracts" the bones and other organs so only the vessels filled with contrast agent can be seen. The heart images are taken at 15-30 frames per second, not using a subtraction technique.

INDICATIONS: Unstable angina or Chest pain [uncontrolled with medications or after a heart attack]

Heart attack

Before a bypass surgery

Abnormal treadmill test results

Determine the extent of coronary artery disease

Disease of the heart valve causing symptoms (syncope, shortness of breath)

To monitor rejection in heart transplant patients

Syncope or loss of consciousness in patients with aortic valve disease

CONTRAINDICATIONS:

Allergy to contrast (dye) medium

Uncontrolled Blood Pressure (Hypertension)

Problems with blood coagulation (Coagulopathy)

Kidney failure or dysfunction

Severe anemia

Electrolyte imbalance

Fever

Active systemic infection

Uncontrolled rhythm disturbances (arrhythmias)

Uncompensated heart failure

Transient Ischemic attack

A CT (computerized tomography) scanner is a special kind of X-ray machine. Instead of sending out a single X-ray through your body as with ordinary X-rays, several beams are sent simultaneously from different angles. The X-rays from the beams are detected after they have passed through the body and their strength is measured. Beams that have passed through less dense tissue such as the lungs will be stronger, whereas beams that have passed through denser tissue such as bone will be weaker. A computer can use this information to work out the relative density of the tissues examined. Each set of measurements made by the scanner is, in effect, a cross-section through the body. The computer processes the results, displaying them as a two-dimensional picture shown on a monitor. The technique of CT scanning was developed by the British inventor Sir Godfrey Hounsfield, who was awarded the Nobel Prize for his work. CT scans are far more detailed than ordinary X-rays. The information from the two-dimensional computer images can be reconstructed to produce three-dimensional images by some modern CT scanners. They can be used to produce virtual images that show what a surgeon would see during an operation. CT scans have already allowed doctors to inspect the inside of the body without having to operate or perform unpleasant examinations. CT scanning has also proven invaluable in pinpointing tumors and planning treatment with radiotherapy. The CT scanner was originally designed to take pictures of the brain. Now it is much more advanced and is used for taking pictures of virtually any part of the body. The scanner is particularly good at testing for bleeding in the brain, for aneurysms (when the wall of an artery swells up), brain tumors and brain damage. It can also find tumors and abscesses throughout the body and is used to assess types of lung disease. In addition, the CT scanner is used to look at internal injuries such as a torn kidney, spleen or liver; or bony injury, particularly in the spine. CT scanning can also be used to guide biopsies and therapeutic pain relieving procedures. The scanner looks like a large doughnut. During the scan the patient lies on a bed, with the body part under examination placed in the round tunnel or opening of the scanner. The bed then moves slowly backwards and forwards to allow the scanner to take pictures of the body, although it does not touch the patient. The length of the test depends on the number of pictures and the different angles taken.

A CT (computerized tomography) scanner is a special kind

of X-ray machine. Instead of sending out a single X-ray through

your body as with ordinary X-rays, several beams are sent

simultaneously from different angles.

CT scans are far more detailed than ordinary X-rays. The information from the two-dimensional computer images can be reconstructed to produce three-dimensional images by some modern CT scanners. They can be used to produce virtual images that show what a surgeon would see during an operation.

CT scans have already allowed doctors to inspect the inside of the body without having to operate or perform unpleasant

examinations. CT scanning has also proven invaluable in

pinpointing tumors and planning treatment with radiotherapy.

The scanner looks like a large doughnut. During the scan the patient lies on a bed, with the body part under examination placed in the round tunnel or opening of the scanner. The bed then moves slowly backwards and forwards to allow the scanner to take pictures of the body, although it does

not touch the patient. The length of the test depends on the

number of pictures and the different angles taken.

MRI (magnetic resonance imaging) is a fairly new technique that has been used since the beginning of the 1980s. The MRI scan uses magnetic and radio waves, meaning that there is no exposure toX-rays or any other damaging forms of radiation.
The patient lies inside a large, cylinder-shaped magnet. Radio waves 10,000 to 30,000 times stronger than the magnetic field of the earth are then sent through the body. This affects the body's atoms, forcing the nuclei into a different position. As they move back into place they send out radio waves of their own. The scanner picks up these signals and a computer turns them into a picture. These pictures are based on the location and strength of the incoming signals. Our body consists mainly of water, and water contains hydrogen atoms. For this reason, the nucleus of the hydrogen atom is often used to create an MRI scan in the manner described above.

Using an MRI scanner, it is possible to make pictures of almost all the tissue in the body. The tissue that has the least hydrogen atoms (such as bones) turns out dark, while the tissue that has many hydrogen atoms (such as fatty tissue) looks much brighter. By changing the timing of the radio wave pulses it is possible to gain information about the different types of tissues that are present. An MRI scan is also able to provide clear pictures of parts of the body that are surrounded by bone tissue, so the technique is useful when examining the brain and spinal cord. Because the MRI scan gives very detailed pictures it is the best technique when it comes to finding tumors (benign or malignant abnormal growths) in the brain. If a tumor is present the scan can also be used to find out if it has spread into nearby brain tissue. The technique also allows us to focus on other details in the brain. For example, it makes it possible to see the strands of abnormal tissue that occur if someone has multiple sclerosis and it is possible to see changes occurring when there is bleeding in the brain, or find out if the brain tissue has suffered lack of oxygen after a stroke. The MRI scan is also able to show both the heart and the large blood vessels in the surrounding tissue. This makes it possible to detect heart defects that have been building up since birth, as well as changes in the thickness of the muscles around the heart following a heart attack. The method can also be used to examine the joints, spine and sometimes the soft parts of your body such as the liver, kidneys and spleen.

With an MRI scan it is possible to take pictures from almost every angle, whereas a CT scan only shows pictures horizontally. There is no ionizing radiation (X-rays) involved in producing an MRI scan. MRI scans are generally more detailed, too. The difference between normal and abnormal tissue is often clearer on the MRI scan than on the CT scan. The scan is usually done as an outpatient procedure, which means that the patient can go home after the test. During the scan it is important to lie completely still. For this reason it might be necessary to give a child an anaesthetic before they are tested. Since you are exposed to a powerful magnetic field during the MRI scan, it is important not to wear jewellery or any other metal objects. An MRI scan is not suitable for the patient if they have electrical appliances, such an a ear implant, implantable cardioverter defibrillator or pacemaker, or have any metal in their body such as surgical clips. But orthopaedic metal ware, such as artificial hips or bone screws, are not normally a problem.

MRI (magnetic resonance imaging) is a fairly new technique

that has been used since the beginning of the 1980s.

The MRI scan uses magnetic and radio waves, meaning that

there is no exposure toX-rays or any other damaging forms of

radiation.

Radio waves 10,000 to 30,000 times stronger than the magnetic

field of the earth are then sent through the body. This affects the

body's atoms, forcing the nuclei into a different position. As

they move back into place they send out radio waves of their own.

The scanner picks up these signals and a computer turns them

into a picture.

The MRI scan gives very detailed pictures it is the best

technique when it comes to finding tumors (benign or malignant

abnormal growths) in the brain. If a tumor is present the scan

can also be used to find out if it has spread into nearby brain

tissue.

The MRI scan is also able to show both the heart and the large

blood vessels in the surrounding tissue. This makes it possible to

detect heart defects that have been building up since birth, as

well as changes in the thickness of the muscles around the heart

following a heart attack. The method can also be used to

examine the joints, spine and sometimes the soft parts of your

body such as the liver, kidneys and spleen. An MRI scan is not suitable for the patient if they have electrical

appliances, such an a ear implant, implantable cardioverter

defibrillator or pacemaker, or have any metal in their body such

as surgical clips.

But orthopaedic metal ware, such as artificial hips or bone

screws, are not normally a problem.