Bağırsağın benign-malign hastalıklarının ayrımında dijital floroskopi, ultrasonografi ve renkli doppler sonografi bulgularının karşılaştırılması
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Dosyalar
Tarih
2010
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Haziran 2009-Şubat 2010 tarihleri arasında Radyoloji Anabilim Dalı'na diğer kliniklerden refere edilen 14`ü kadın, 18'i erkek toplam 32 olgunun elde edilen dijital floroskopik, ultrasonografik ve renkli doppler sonografik bulguları yapılan prospektif çalışma neticesinde değerlendirildi. Gastrointestinal sistem şikayetleri mevcut olan olgulara yapılan tetkikler, işlem sonrasında hastaların endoskopik ya da cerrahi patoloji sonuçlarıyla karşılaştırıldı. Benign bağırsak hastalığı tespit edilen hasta popülâsyonun yaş ortalaması malign olanlara göre daha az iken cinsiyetlere göre hastalıklar arasında anlamlı farklılık saptanmadı. Benign ya da malign bağırsak hastalığı tanısı alan olguların dijital floroskopik görüntüleri incelendiğinde 9 Crohn hastasının 6'sında (%66), 5 ülseratif kolit vakasının tümünde (%100) ve 18 malignite hastasının 15'inde (%83,3) floroskopik bulgular saptandı. Tutulan segment uzunlukları benign patolojilerde malign gruba göre daha uzun olarak tespit edildi. Bağırsak duvar kalınlık artışı ise malign hasta grubunda benign patolojilere göre daha fazlaydı. Aynı hasta grubun yapılan ultrasonografik incelemesinde ise hastalıktan etkilenen bağırsak segmentinin morfolojik özellikleri asimetrik ya da diffüz uniform olarak ortaya konuldu. Renkli doppler sonografik analiz neticesinde kadın popülasyonun süperior mezenterik arterden elde edilen pulsatilite indeksi değerleri klinik yönden anlamlı olmamakla beraber istatiksel olarak daha fazla tespit edildi. Bunla beraber benign bağırsak patolojilerinde hastalıktan etkilenen segment duvarından ölçülen spektral verilere göre, malign patolojilerdeki rezistif indeks değerleri benign hastalıklara göre istatiksel yönden anlamlı 54 olarak fazlaydı. Geçiş değeri olarak rezistif indeks değeri %81,3 duyarlılık, %61,5 özgüllük değeriyle 0,63 olarak belirlendi. Bu çalışmamızda klinik olarak benign ya da malign proçeslerde ilk tercih edilen tetkik olarak floroskopik incelemelerde kullanılan radyasyonun ileri dönemdeki komplikasyonları göz önüne alındığında, ultrasonografik incelemenin hastalıkların tanı aşamasında floroskopiye göre ilk basamakta seçilmesi faydalı olmakla birlikte yeterli değildir. Bununla beraber renkli doppler ultrasonografi verilerinden elde edilen sonuçlar henüz dar bir popülasyonda ortaya konulduğundan, bu veriler tartışmalı olarak yorumlanabilmekte ama ileride yapılacak geniş serilerde tekrar irdelenmesi gereken bir konu olarak karşımıza çıkmaktadır.
Abstract
Between June 2009-February 2010 in our deparment to other clinics, was referred to 14 female, 18 males in total 32 patients obtained a digital fluoroscopy, ultrasound and color doppler sonographic findings of the prospective study results were assessed. Patients with gastrointestinal complaints made avaliable investigations compared with patients endoscopic or surgical pathology results after operations. Detected in patients with benign bowel disease population, the mean age was less than those with malignant disease according to gender did not differ significantly between. Benign or malignant bowel disease patients with a diagnosis of digital fluoroscopic images were examined; Crohn's patients, 6 of 9 (66%), five cases of ulcerative colitis in all (100%) and 15 of 18 malignant patients' cases (83,3%) has fluoroskopic findings. İn affected segments with benign pathology in length were found to be longer than the malignant group. İncreased bowel wall thickness in patients with malignant pathology than in benign pathology. In the ultrasonographic examination of the same group of patients, affected bowel segment morphology was exposed as a asymmetric or extent uniform. Color doppler sonographic analysis as a result, pulsatilite index values of female populations superior mesenteric artery obtained, although not clinically significant were found 56 to be statistically more. Gloat with in benign pathologies, according to the measured spectral data from affected bowel wall segment, resistive index values in malignant disease compared with benign disease direction was statistically significantly more. resistive index values of the transition as 81,3% sensitivity, 61,5% with specificity values were determined as 0.63. In our study, clinically benign or malignant process in fluoroscopic examination as the first choice tests used in the forward-term complications of radiation is taken into consideration, fluoroscopic diagnosis of diseases by ultrasound during the first steps to be selected to be beneficial is not sufficient. Nevertheless, the results of color doppler sonography data not yet been put forward in a narrow population, these data are interpreted as controversial and larger series will be repeated in the future should be analyzed as an issue is encountered.
Abstract
Between June 2009-February 2010 in our deparment to other clinics, was referred to 14 female, 18 males in total 32 patients obtained a digital fluoroscopy, ultrasound and color doppler sonographic findings of the prospective study results were assessed. Patients with gastrointestinal complaints made avaliable investigations compared with patients endoscopic or surgical pathology results after operations. Detected in patients with benign bowel disease population, the mean age was less than those with malignant disease according to gender did not differ significantly between. Benign or malignant bowel disease patients with a diagnosis of digital fluoroscopic images were examined; Crohn's patients, 6 of 9 (66%), five cases of ulcerative colitis in all (100%) and 15 of 18 malignant patients' cases (83,3%) has fluoroskopic findings. İn affected segments with benign pathology in length were found to be longer than the malignant group. İncreased bowel wall thickness in patients with malignant pathology than in benign pathology. In the ultrasonographic examination of the same group of patients, affected bowel segment morphology was exposed as a asymmetric or extent uniform. Color doppler sonographic analysis as a result, pulsatilite index values of female populations superior mesenteric artery obtained, although not clinically significant were found 56 to be statistically more. Gloat with in benign pathologies, according to the measured spectral data from affected bowel wall segment, resistive index values in malignant disease compared with benign disease direction was statistically significantly more. resistive index values of the transition as 81,3% sensitivity, 61,5% with specificity values were determined as 0.63. In our study, clinically benign or malignant process in fluoroscopic examination as the first choice tests used in the forward-term complications of radiation is taken into consideration, fluoroscopic diagnosis of diseases by ultrasound during the first steps to be selected to be beneficial is not sufficient. Nevertheless, the results of color doppler sonography data not yet been put forward in a narrow population, these data are interpreted as controversial and larger series will be repeated in the future should be analyzed as an issue is encountered.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Radyoloji, Nükleer Tıp, Radiology, Nuclear Medicine, Tıp, Tıp Bilimleri
