Prikaz tromboze venskih sinusov z magnetno resonanco

diplomsko delo

Matej Jurjević (Author), Nejc Mekiš (Reviewer), Janez Podobnik (Mentor), Tina Lončarič (Co-mentor)

Abstract

Uvod: Možganska venska tromboza zajema trombozo duralnih sinusov in globokih možganskih ven. Na podlagi raznolikih etioloških dejavnikov in neznačilne klinične slike je njeno diagnosticiranje oteženo. Namen: Namen diplomske naloge je ugotoviti, če lahko z brezkontrastno magnetno resonančno preiskavo venskih sinusov diagnostično zadovoljivo prikažemo trombozo le-teh. Metode dela: Uporabljena je deskriptivna oziroma opisna metoda dela, ki predstavlja teoretični del. Podatki so bili pridobljeni s preučevanjem literature. V praktičnem delu sva izvajala meritve, katerih cilj je bil prikaz venskih sinusov v celoti s pomočjo spreminjanja amplitude gradienta za kodiranje hitrosti. Pridobljeni podatki in izvedene meritve so bili opravljeni na Nevrološki kliniki v Ljubljani. Rezultati: Standardni odkloni pri meritvah venskih sinusov pri vrednosti amplitude gradienta za kodiranje hitrosti 15cm/s podkrepijo tezo, da se venski sinusi najboljše prikažejo pri le-tej hitrosti pretoka krvi. Arterije imajo v povprečju najmanjši standardni odklon pri slikanju s parametrom 70cm/s, kar nam pove, da je slikanje arterij pri tej vrednosti amplitude gradienta za kodiranje hitrosti najprimernejše za sliko z najbolj konstantnim signalom iz preiskovanega anatomskega dela.. Razprava in zaključek: Po primerjalni študiji sklepamo, da je Phase Contrast daleč najbolj zanesljiva metoda izbora pri iskanju trombotičnih sprememb v možganskem venskem sistemu in sinusih hkrati pa tudi moramo poudariti dejstvo, da se pri uporabi 3D tehnike PC izredno podaljša čas ponovitve ali tako imenovan »time repetition«, ki lahko samo preiskavo podaljša tudi za 15 minut, kar posledično privede do tega, da se zdravniki radiologi redkeje odločajo za slednjo preiskavo predvsem iz razloga časovne stiske, ki pesti javno zdravstvo. Pomembno bi bilo nadaljnje preučiti prednosti in slabosti ter samo korist tehnike Phase Contrast, ter jo predvsem iz vidika uporabe kontrastnega sredstva, ki predstavlja tveganje in škodo na človekovo telo, bolj uveljaviti v klinični praksi. Glede na teoretična izhodišča in izvedene meritve, bi morala tehnika Phase Contrast predstavljati metodo izbora za vse napotne diagnoze tromboze venskih sinusov, pri pacientih kjer težko apliciramo kontrastno sredstvo zaradi različnih dejavnikov. Rezultati kažejo na porast praktične uporabe MRV in tehnike Phase Contrast, vendar ne v klinično zaželjeni meri.

Keywords

diplomska dela;radiološka tehnologija;tromboza venskih sinusov;metoda faznega kontrasta;kodiranje hitrosti;magnetna resonanca;računalniška tomografija;venografija;

Data

Language:	Slovenian
Year of publishing:	2019
Typology:	2.11 - Undergraduate Thesis
Organization:	UL ZF - University College of Health Studies
Publisher:	[M. Jurjević]
UDC:	616-07
COBISS:	5684075
Views:	18
Downloads:	6
Average score:	0 (0 votes)
Metadata:

Other data

Secondary language:	English
Secondary title:	Magnetic resonance imaging of cerebral venous thrombosis
Secondary abstract:	Introduction: Venous sinus thrombosis includes the thrombosis of the dural sinuses and deep cerebral venous system. Due to different etymological factors and uncommon clinical states its diagnosis is harder to be stated. Purpose: The purpose of our diploma work is to find out if a non contrast MRI of the venous system diagnostically fullfils the same aspects of a contrast MRI examination. Methods: We used the descriptive method to represent the theoretical part of our diploma work. The data was gathered by studying different literature. The practical part of our work was based on signal intensity measurements done with different velocity parameters. All of the measurements were made at Nevrološka klinika in Ljubljana. Results: The standard deviation of our signal intensity measurements in the venous sinuses gave us the information that the blood flow void of 15cm/s returns the highest imaging quality results. Arteries have the smallest standrad deviation mean while using the 70cm/s velocity parameter, which tells us, that the signal is the most constant while using these imaging settings. By comparing two studies we acknowledge the fact that the Phase Contrast imaging technique is by far the most reliable when we are looking out for thrombotic changes in the cerebral venous system. Discussion and conclusion: Comparing the studies, we can rely on the facts that Phase Contrast ist the most reliable technique to choose, when we are seeking for thrombotic changes in the deep venous system. We must consider the fact that using 3D Phase Contrast technique, makes the measurment of signal intensity much longer than using other techniques with aplicated intravenous contrast. That happens due to longer time repetition parameter, which can make the measurment even to 15 minutes longer. Considering the facts, doctor radiologist usually choose the contrast methods due to time press in our public healthcare system. It would be important to study all the benefits and weaknesses of the technique and include it more in the public healthcare system. Applicated intravenous contrast is currently the method of choice, but it does damage to the body, especially kidneys. On the ground of our theoretical statements and practical measurements, the Phase Contrast imaging technique should represent the primary method for diagnosing patients with a clinical image of venous sinus thrombosis that suffer from alergies connected to applicated i.v. contrast. The results show increased use of these methods, but they are not used as frequently as wished for.
Secondary keywords:	diploma theses;radiologic technology;venous sinus thrombosis;phase contrast method;velocity parameter;magnetic resonance;computed tomography;venography;
Type (COBISS):	Bachelor thesis/paper
Study programme:	0
Thesis comment:	Univ. v Ljubljani, Zdravstvena fak., Oddelek za radiološko tehnologijo
Pages:	36 str.
ID:	11310524