Imaging in Vascular Surgery

Question 1

What are the main imaging modalities used in vascular surgery?

Answer 1

Ultrasound (US) / Doppler US

CT Angiography (CTA)

MR Angiography (MRA)

Question 2

What are the advantages of ultrasound (US) for imaging blood vessels?

Answer 2

✅ No radiation exposure
✅ Portable and widely available
✅ Real-time imaging with Doppler to assess blood flow
✅ No contrast needed

Question 3

What are the disadvantages of ultrasound (US) for imaging blood vessels?

Answer 3

❌ Operator-dependent (requires skill)
❌ Poor penetration in obese patients
❌ Limited field of view compared to CT/MR
❌ Image quality affected by gas or calcifications

Question 4

What are the advantages of CT Angiography (CTA) for imaging blood vessels?

Answer 4

✅ High-resolution, detailed images
✅ Rapid scan time
✅ Good for detecting aneurysms, dissections, & arterial disease
✅ 3D reconstruction possible

Question 5

What are the disadvantages of CT Angiography (CTA)?

Answer 5

❌ Requires ionizing radiation
❌ Requires IV contrast (risk of contrast nephropathy)
❌ Affected by arterial calcifications (can obscure vessels)
❌ Not ideal for patients with chronic kidney disease

Question 6

What are the risks associated with contrast administration?

Answer 6

☠️ Contrast-Induced Nephropathy (CIN) – Kidney damage, especially in CKD patients
☠️ Allergic Reactions – Mild (rash) to severe (anaphylaxis)
☠️ Extravasation – Contrast leaking outside the vessel causing tissue damage
☠️ Thyroid Dysfunction – Iodine-based contrast can affect thyroid function

Question 7

What are the advantages of MR Angiography (MRA)?

Answer 7

✅ No radiation exposure
✅ Can be done without contrast (useful for kidney patients)
✅ Good for soft tissue & vessel wall assessment

Question 8

What are the disadvantages of MR Angiography (MRA)?

Answer 8

❌ Expensive and less available than CT
❌ Longer scan time (patient must stay still)
❌ Cannot be used in patients with certain metal implants (pacemakers, some stents)