RESUMO
Implementing in our clinical practice multispiral CT angiography (MSCTA) of the brachiocephalic arteries into the diagnostic algorithm has made it possible to somewhat deviate from the "golden standard", i.e., the conventional contrast-enhanced angiography, in determining the indications for surgical interventions in a total of 328 patients presenting with chronic cerebral circulatory insufficiency (CCCI). All the patients diagnosed as having multifocal atherosclerosis are subjected to duplex scanning of the brachiocephalic arteries Detecting haemodynamically significant stenoses of the carotid arteries is immediately followed by MSCTA with bolus-mediated intravenous contrasting, which makes it possible to specify the degree of the stenosis and anatomical variants of the major arteries of the neck and brain at all levels, to reveal complicated atherosclerotic plaques and to carry out an objective densimetric analysis of their morphological structure, as well as to diagnose extravasal compression, diffuse and focal cerebral lesions, to also determine the presence of venous dysfunction and to detect concomitant pathology of the cervical and mediastinal organs. Presented herein is a comparative analysis of multispiral CT angiography and MRT angiography in diagnosis of brachiocephalic arteries pathology in the patients involved. The use of the algorithm referred to above makes it possible to determine the indications for surgical correction of CCCls at a qualitatively novel level.
