Radiološke tehnologije

KOMPJUTERIZIRANA TOMOGRAFIJA MOZGA KOD PACIJENATA SA SUMNJOM NA CEREBROVASKULARNI INZULT

2023-09-14T06:51:42+00:00

Uvod: Cerebrovaskularni inzult (CVI), poznatiji kao moždani udar, predstavlja jedno od najznačajnijih zdravstvenih pitanja suvremenog društva. To je ozbiljno neurološko stanje koje nastaje zbog oštećenja moždanih krvnih žila, što rezultira poremećenim dotokom krvi u određene dijelove mozga. Taj poremećaj može izazvati brzu smrt moždanih stanica i uzrokovati ozbiljne posljedice za pacijenta. Kako bi se pravovremeno prepoznale i adekvatno liječile promjene u moždanom tkivu, ključno je kliničko procjenjivanje pacijenata s sumnjom na cerebrovaskularni inzult. Kompjuterizirana tomografija (CT) mozga neinvazivna metoda igra iznimno važnu ulogu u dijagnostici i praćenju ovog stanja.

Materijal i metode: Podatci koji su bili potrebni za provedbu istraživanja prikupljeni su u Zavodu za radiologiju Sveučilišne kliničke bolnice Mostar iz bolničkih programskih sustava BIS i IMPAX. Pretraživanje podataka obuhvaćalo je pacijente koji su bili podvrgnuti CT-u mozga u razdoblju od 1. 1. 2021. do 31. 12. 2021. Za statističku analizu podataka korišteni su programi SPSS Statistics, inačica 25 i Microsoft Excel 2016. Za testiranje statističke značajnosti razlika korišten je Hi-kvadrat test. Granica statističke značajnosti postavljena je na p=0,05. P vrijednosti koje se nisu mogle iskazati do tri decimale, prikazane su kao p<0,001.

Rezultati: U istraživanju je sudjelovalo 37 ispitanika. Od ukupnog broja ispitanika pacijenata ženskog spola bilo je 46 %, a muškog spola 54 %. Prosječna životna dob pacijenata bila je 77 godina. Najveći udio ispitanika bio je u dobnoj skupini od 80-90 godina, njih 54 %. Od ukupnog broja pacijenata koji su bili podvrgnuti CT-u zbog sumnje na CVI, 3 pacijenta ili 8,1 % su imali uredan CT nalaz bez znakova ishemijskog moždanog udara ili hemoragijskih promjena. Pacijentima kojima je u CT nalazu opisana akutna ishemijska lezija bilo je 16 ili 43,2 %, s opisom subakutne ishemijske lezije bilo je 3 ili 8,1 %, zatim sa svježom ishemijskom lezijom bio je 1 (2,7 %), u pacijenata s intracerebralnim krvarenjem bilo je 4 ili 10,8 %, i oni koji su bili izloženi CT pregledu radi kontrole bilo je 10 ili 27 %. Dosta manji broj pacijenata upućen na CT dijagnostiku iz razloga što je istraživanje vršeno u doba pandemije SARS-CoV-2 virusa, jer su tad pacijenti upućivani pod strogom sumnjom na CVI.

Zaključak: CT mozga je ključna metoda snimanja za pacijente sa sumnjom na CVI. Brza dostupnost i vizualizacija moždanog tkiva omogućuju promptnu dijagnozu i terapijske odluke. Unatoč ograničenjima, CT ostaje nezamjenjiv alat u ranom otkrivanju ovog ozbiljnog stanja, a nadamo se daljnjem tehnološkom napretku.

3D intravascular endoscopy using CT

2023-09-23T19:51:27+00:00

Coronary CT angiography can be used to characterize coronary plaques based on both morphology and composition.

Coronary plaques are typically evaluated with 2D axial and multiplanar reformatted images. However, these visualization tools are limited to observing extraluminal changes in coronary arteries. The presence of plaque precludes visual visualization of the coronary artery wall within the lumen.

Since its invention in 2000, coronary fly-through or virtual angioscopy (VA) has been widely studied. However, its application has been limited by the need for optimal computed tomography (CT) acquisition and time-consuming post-processing.

In recent years, advances in post-processing software have simplified his VA design, but until recently, image quality was insufficient for most patients.

3D angioscopy visualization (3DIE) is used to visualize the different coronary artery linings and plaque appearances associated with different plaque types.

ZNAČAJ KLASIČNE RADIOGRAFIJE PLUĆA U OTKRIVANJU TUBERKULOZE PLUĆA

2023-10-08T11:24:07+00:00

ABSTRACT

Diagnostic radiology provides a non-invasive insight into the anatomy and physiology of the human body and is one of the most useful tools in modern medicine. Accelerated technological development has led to improved image quality and the ability to obtain additional diagnostic information necessary for accurate and rapid diagnostics. As in other fields of medicine, in diagnostic radiology, all elements of risk must be balanced against the benefits arising from the use of a given diagnostic method.

Aim: study is to determine the age and gender structure of the subjects who came for radiographs, to prove whether the X-ray has a significant role in detecting lung tuberculosis, whether the radiological record matches the findings of a pneumophysiologist or whether a microbiological analysis is needed, and to determine whether tuberculosis detected by classical radiography is also proven.

Prospective method included 50 adult respondents from the Public Health Center of the Canton of Sarajevo, of different age and gender structures, who performed radiographic pulmonary imaging and processing of pneumophysiological findings in the period from 01.01.2018. do 30.05.2019. years. X-rays were taken from the classic Siemens Multix X-ray machine. Patients' medical records, microbiological examination of sputum on BC, pneumophysiological findings, radiographs and radiological findings from the radiological information system and the PACS system were used for the data. We used a retrospective study that included descriptive statistics, standard deviation, arithmetic mean, and correlation coefficient.

Results: show that there is no significant statistical difference by gender, the average age of the respondents was 50, 52 years.

X-ray imaging as a diagnostic procedure is of great importance in the detection of pulmonary tuberculosis, and 72% of the subjects had pulmonary tuberculosis first compared with the findings of pneumophysiologists, and bacteriological analysis was used in 28% subjects due to suspected pneumophysiologists in the diagnosis. By comparing the correlation of the pneumophysiologist and the bacteriological analysis, the X-ray showed 100% lung tuberculosis.

Uloga hepatospecifičnog kontrastnog sredstva dinatrijev gadoksetat u dijagnostici žarišnih lezija jetre na magnetnoj rezonanci

2023-10-08T18:00:00+00:00

Abstract

Hepato-specifična kontrastna sredstva omogućavaju sveobuhvatno snimanje jetre jer, zahvaljujući svojim farmakokinetičkim osobinama, pružaju mogućnost snimanja ne samo u dinamičkoj fazi već i u fazi u kojoj je kontrastno sredstvo akumulirano u hepatocitima, osiguravajući na taj način dodatni set informacija koji može biti od pomoći u dijagnostici žarišnih lezija jetre.

Dinatrijev gadoksetat, hepato-specifično kontrastno sredstvo, je indikovan za otkrivanje fokalnih lezija jetre i pruža informacije o tipu lezija pri snimanju u T1 tehnici magnetne rezonance (MR). Aplicira se isključivo intravenski.

Nakon primjene dinatrijevog gadoksetata u bolusu, dinamičko snimanje u arterijskoj fazi, portalnoj fazi i fazi ravnoteže iskorištava različite vremenske obrasce pojačanja signala u različitim lezijama jetre, na temelju čega nastaje radiološki opis lezije.

ASL( Arterial Spin Labeling) perfuzija

2023-09-28T19:18:19+00:00

SAŽETAK

Perfuzija se odnosi na isporuku kiseonika i hranljive materije u tkiva putem protok krvi i jedan je od najosnovnijih fiziološki parametri. Poremećaji perfuzije takođe čine većinu vodeći uzroci medicinskog invaliditeta i mortalitet. Dok mjerenja od perfuzije imaju direktnu dijagnostičku vrijednost u vaskularni poremećaji, mjerenja perfuzije takođe služe kao biomarkeri za a širi spektar fizioloških i patofizioloških funkcije. Bliska sprega između cerebralnog krvotoka i metabolizma omogućava regionalnu funkciju mozga biti procijenjen mjerenjima od cerebralnu perfuziju i povećanu vaskularnost neoplazmi omogućava perfuziju tumora da se koristi kao mjera tumora stepena i za praćenje odgovora na tumor terapija.

U oblasti MRI, najviše ljudi povezuju pojam perfuzije snimanje s dinamičkim kontrastom osjetljivosti snimanje pomoću kontrasta za opuštanje agent.

ASL Perfuzija je tehnika MR perfuzije koja ne zahtjeva intravensku primjenu kontrastnog sredstva ( za razliku od DSc I DCE perfuzije). Umjesto toga, koristi sposobnost MRI-a da magnetski označi arterijsku krv. Parametar koji se najčešče izvodi je cerebralni protok krvi (CBF).

ASL je vrlo pogodna tehnika za upotrebu u pedijatriji, u kojoj upotreba radioaktivnih tragova moze biti ograničena. Također je sigurna metoda za primjenu kod pacijenata sa oštečenom bubrežnom funkcijom.

Alcohol ablation of the heart – Case report

2023-10-08T17:45:51+00:00

Abstract

Alcohol septal ablation (ASA) is a minimally invasive, non-surgical treatment for hypertrophic cardiomyopathy. This condition causes the heart tissue to thicken, restricting blood flow. Reduced blood flow causes symptoms such as shortness of breath and fatigue. Alcohol septal ablation restores normal blood flow by damaging and shrinking the thickened tissue. The procedure does not damage normal tissue. Providers perform this procedure on people who have HCM and, despite medication, have symptoms of shortness of breath and/or fatigue with exertion.¹

Alcohol ablation has been successfully used in the ablation of ventricular tachycardiaventricular fibrillation, and atrial fibrillation. ²

Material and Methods

The procedure is performed under the control of the Toshiba Infinix discoscope, in the coronary angiography program. Diascopy parameters are 86 kVp, 800 mA, fluoroscopy: 5 fr/sec, radiography 10 fr/sec, pulse width 12 bit, matrix size 1024x1024. The procedure was performed in the RAO 30° CRANIAL 30° projection, and with a magnification of 20 cm. Visipaque 320 contrast agent was used, which was injected via the MEDRAD Avanta automatic injector. Contrast injection parameters were flow rate 2 ml/s and volume 4 ml. A total of 120 ml of contrast agent was given. To confirm the results of AA, ultrasound contrast agent SONOVIEW was used. Monitoring of contrast flow through the myocardium was done with a SIEMENS ultrasound device.

Case study

The patient, 65 years old, is hospitalized at the Department of Interventional Cardiology for an invasive cardiac procedure under the diagnosis of hypertrophic obstructive cardiomyopathy. Echocardiography after the procedure: The left atrium is dilated and elongated. Mitral valve morphologically sclerotically changed, functionally mild to moderate MR 2+ (VC 4 min) Left ventricle of regular dimensions, concentrically hypertrophic walls. Type 3 SAM is being verified. Preserved left ventricular systolic function (EF 60%).

Conclusion

We present the case of an elderly patient with symptomatic obstructive hypertrophic cardiomyopathy. Despite the modification of drug therapy, significant obstructive pressure in the outflow tract of the left ventricle still persisted. After adequate preparation, septal alcohol ablation is performed with echo control of the procedure. Postprocedurally, the dynamics of cardioselective enzymes are monitored with ultrasound verified hypokinesis of the S2 irrigation area. Due to intermittent complete AV block, a permanent electrostimulator is implanted. At the