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Be on the lookout if your family has history of high blood pressure or diabetes [고혈압·당뇨 가족력 있다면 서두르세요]

The four most serious types of diseases that everyone has heard of are cancer, heart disease, cerebrovascular disease, and rare  and obstinate diseases. In particular, heart and cerebrovascular diseases include ischemic heart disease and cerebral aneurysm that can cause acute but sudden death, so important medical examinations that can be find them in advance is emerging.
In particular, people with a family history of these diseases, such as high blood pressure or diabetes, are advised to take cerebrovascular and cardiac tests from their 40s and late 50s. Nasaret International Hospital diagnoses coronary arteries using MRI and MRA for brain overhaul and CT angiography.

# Magnetic resonance angiography (MRA) to detect cerebrovascular disease

Magnetic resonance imaging (MRI), unlike CT (computed tomography), has the advantage of imaging the composition of human tissue using a magnetic field that is harmless to the human body.

There are two types of MRI, MRI focused on brain evaluation and MRA focused on cerebrovascular disease.

MRI scans can be used to assess brain tissue abnormalities, such as cerebral infarction, cerebral hemorrhage, and brain tumors. Deformities and the like can be confirmed as well.

The MRA test also includes TOF-MRA, which does not use contrast agents, and CE-MRA, which uses contrast agents.

The TOF-MRA test has the advantage of not using contrast agents, and reconstructs the image in various projection directions to increase the diagnosis rate. Diagnosis of cerebral aneurysms, the time bomb of our most feared cerebrovascular system, is mostly done by MRA.

Cerebral aneurysm is a disease of the cerebral blood vessels in which a weak part of the wall of the vessel swells like a small balloon. This swollen vascular wall does not cause symptoms in most small cases, but can cause subarachnoid hemorrhage if it is ruptured due to the large size of the lesion or a variety of other causes.

In the case of TOF-MRA, the accuracy is reported to be 90%, similar to the accuracy of CT angiography.

The CE-MRA technique, in which a contrast agent is injected into a blood vessel and images of the cerebral vessels are taken, is also widely used for the evaluation of the carotid as well as the cerebral artery. By using the contrast agent, signal reduction due to slow blood flow or vortex is not generated, and artifacts caused by foreign substances such as dental prosthesis are reduced, which enables more accurate vascular evaluation.

In addition, CE-MRA is a widely used non-invasive test for evaluating coil therapy, which is often used as a treatment for cerebral aneurysm.

Coronary artery-CTA (CT-angiography) is used to detect stenosis, obstruction, and malformations of the coronary heart.

Coronary arteries are blood vessels that supply oxygen and nutrients to the heart muscle. They are important blood vessels that maintain heart function, and narrowing of the coronary arteries can cause ischemic heart disease such as angina pectoris and myocardial infarction.

Coronary artery-CTA can visualize coronary arteries using CT to diagnose the causes of chest pain such as angina pectoris and to assess whether the vessels are well opened after coronary angioplasty (balloon angioplasty, stent insertion, coronary artery bypass grafting).

The captured images are subjected to post-processing to accurately evaluate blood vessels, and various 3D images can be obtained using VR techniques to identify the overall structure of the heart and blood vessels.

In addition, by measuring the coronary artery calcification index, the degree of calcification in the coronary wall can be analyzed to indirectly predict cardiovascular disease.

Cardiac CT obtained with coronary artery evaluation can evaluate various cardiac diseases, including myocardial abnormalities, cardiac dilatation, structural malformations, valve diseases, pericarditis, and pericardial effusion.

# Cerebrovascular disease and heart disease are important for early detection through examination

In order to prevent cerebral aneurysm, it is important to correct one's lifestyle as common practices such as smoking, stress, poor diet, and lack of exercise increases the risk of hypertension, diabetes, hyperlipidemia, and obesity. In addition, even if there are no symptoms, after one reaches the age of fifty, it is necessary to prepare a position to accurately assess and prepare for cerebrovascular condition through examination and imaging examination by a specialist.

Likewise, regular medical check-ups are needed to prevent coronary heart disease that come without notice. Coronary artery stenosis is mainly caused by hyperlipidemia and arteriosclerosis, so if you have risk factors for cardiovascular disease such as family history of hypertension, diabetes, heart disease, are aged 55 or older, smoking, abdominally obese, coronary artery-CTA and a heart CT test can help.

First of all, if you have symptoms such as chest pain, palpitations, and difficulty breathing, it is necessary to make an evaluation through a doctor's examination and accurate imaging.

Written with the help of Dr. Kim Seung Hyun, Radiology Dept. of Nasaret International Hospital
Original article by Kiho Ilbo, published 2019 May 01


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