ʻO ka hoʻohana ʻana o ke scan CT i ka urology

He mea koʻikoʻi ke kiʻi ʻana i ka radiological e hoʻopiha i ka ʻikepili lapaʻau a kākoʻo i nā urologists i ka hoʻokumu ʻana i ka hoʻokele kūpono o ka mea maʻi. Ma waena o nā ʻano kiʻi like ʻole, ua manaʻo ʻia ka computed tomography (CT) i kēia manawa ke kūlana kuhikuhi no ka loiloi ʻana i nā maʻi urological ma muli o kona loaʻa ākea, ka manawa scan wikiwiki, a me ka loiloi piha. ʻOi aku hoʻi, ʻo CT urography.

MOʻOLELO

I ka wā ma mua, ʻo ka intravenous urography (IVU), i kapa ʻia hoʻi ʻo "excretory urography" a/a i ʻole "intravenous pyelography," i hoʻohana nui ʻia e loiloi i ke ala mimi. Hoʻokomo ka ʻenehana i kahi radiograph maʻamau mua a ukali ʻia e kahi inikini intravenous o kahi mea hoʻohālikelike wai-hoʻoheheʻe ʻia (1.5 ml/kg ke kaumaha o ke kino). Ma hope iho, loaʻa kahi moʻo o nā kiʻi i nā manawa kikoʻī. ʻO nā palena nui o kēia ʻenehana e pili ana i ka loiloi ʻelua-dimensional a me ka loiloi nalowale o ke anatomy pili.

Ma hope o ka hoʻolauna ʻia ʻana o ka computed tomography, ua hoʻohana nui ʻia ʻo IVU.

Eia nō naʻe, i nā makahiki 1990 wale nō, me ka hoʻolauna ʻana o ka ʻenehana helical, ua wikiwiki loa nā manawa scan i hiki ai ke aʻo ʻia nā wahi nui o ke kino, e like me ka ʻōpū, i kekona. Me ka hiki ʻana mai o ka ʻenehana multi-detector i nā makahiki 2000, ua hoʻomaikaʻi ʻia ka hoʻonā spatial, e ʻae ana i ka ʻike ʻana i ka urothelium o ke ala urinary luna a me ka ʻōpū mimi, a ua hoʻokumu ʻia ka CT-Urography (CTU).

I kēia lā, hoʻohana nui ʻia ʻo CTU i ka loiloi ʻana i nā maʻi urological.

Mai nā lā mua o CT, ua ʻike ʻia e hiki i nā spectra X-ray o nā ikehu like ʻole ke hoʻokaʻawale i nā mea o nā helu atomika like ʻole. ʻAʻole a hiki i ka makahiki 2006 i hoʻopili pono ʻia ai kēia kumumanaʻo i ke aʻo ʻana i nā ʻiʻo kanaka, a ma hope iho ua alakaʻi ʻia i ka hoʻolauna ʻana o ka ʻōnaehana dual-energy CT (DECT) mua i ka hana lapaʻau o kēlā me kēia lā. Ua hōʻike koke ʻo DECT i kona kūpono no ka loiloi ʻana i nā kūlana pathological urinary tract, mai ka haki ʻana o nā mea i loko o nā calculi urinary a hiki i ka iodine uptake i nā malignancies urological.

pōmaikaʻi

ʻO ka maʻamau, hoʻokomo nā protocol CT kuʻuna i nā kiʻi precontrast a me multiphase postcontrast. Hāʻawi nā scanner CT hou i nā ʻikepili volumetric hiki ke hana hou ʻia ma nā mokulele he nui a me ka mānoanoa o ka ʻāpana like ʻole, no laila e mālama ana i ka maikaʻi o ke kiʻi. Hilinaʻi pū ka CT urography (CTU) i ke kumumanaʻo polyphasic, e kālele ana i ka pae "excretion" ma hope o ka kānana ʻana o ka mea hoʻohālikelike i loko o ka ʻōnaehana hōʻiliʻili a me ka ʻōpū mimi, e hana ana i kahi urogram IV me ka hoʻohālikelike ʻana o nā ʻiʻo i hoʻomaikaʻi nui ʻia.

PALENA

ʻOiai inā ʻo ka tomography computed i hoʻonui ʻia me ka hoʻohālikelike ke kūlana kuhikuhi no ke kiʻi mua ʻana o ke ala mimi, pono e hoʻoponopono ʻia nā palena kūlohelohe. ʻO ka hōʻike ʻana i ka radiation a me ka nephrotoxicity contrast he mau hemahema nui ia. He mea nui loa ka hoʻemi ʻana i ka nui o ka radiation, ʻoi aku hoʻi no nā poʻe maʻi ʻōpio.

ʻO ka mea mua, pono e noʻonoʻo mau ʻia nā ʻano hana kiʻi ʻē aʻe e like me ka ultrasound a me ka MRI. Inā ʻaʻole hiki i kēia mau ʻenehana ke hāʻawi i ka ʻike i noi ʻia, pono e hana ʻia nā hana e like me ke kaʻina hana CT.

ʻAʻole kūpono ka hoʻokolokolo CT i hoʻonui ʻia i ka hoʻohālikelike ʻana i nā poʻe maʻi i maʻi i nā mea radiocontrast a me nā poʻe maʻi me ka hana renal i hoʻopilikia ʻia. No ka hōʻemi ʻana i ka nephropathy i hoʻokumu ʻia e ka hoʻohālikelike ʻana, ʻaʻole pono e hāʻawi ʻia nā mea maʻi me ka glomerular filtration rate (GFR) ma lalo o 30 ml/min i nā mea hoʻohālikelike me ka ʻole o ke kaupaona pono ʻana i nā pilikia a me nā pono, a pono e hoʻohana ʻia me ke akahele i nā poʻe maʻi me ka GFR ma ka pae 30 a 60 ml/min i nā poʻe maʻi.

WĀ E HIKI MAI ANA

I ke au hou o ka lāʻau lapaʻau pololei, ʻo ka hiki ke hoʻoholo i ka ʻikepili quantitative mai nā kiʻi radiological he pilikia o kēia manawa a me ka wā e hiki mai ana. ʻO kēia kaʻina hana, i ʻike ʻia ʻo radiomics, ua hana mua ʻia e Lambin i ka makahiki 2012 a ua hoʻokumu ʻia ma ka manaʻo e loaʻa i nā kiʻi lapaʻau nā hiʻohiʻona quantitative e hōʻike ana i ka pathophysiology kumu o ka ʻiʻo. Hiki i ka hoʻohana ʻana i kēia mau assays ke hoʻomaikaʻi i ka hoʻoholo ʻana i ka lāʻau lapaʻau a loaʻa kahi ākea ma ka oncology, e ʻae ana, no ka laʻana, i ka loiloi ʻana i ka microenvironment cancer a me ka hoʻohuli ʻana i nā koho lapaʻau. I nā makahiki i hala iho nei, ua hana ʻia nā haʻawina he nui ma ka hoʻohana ʻana i kēia ʻano hana, ʻoiai i ka loiloi ʻana o ka urothelial carcinoma, akā ʻo kēia ke kuleana o ka noiʻi.

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ʻO LnkMed kahi mea hoʻolako i nā huahana a me nā lawelawe no ke kahua radiology o ka ʻoihana lapaʻau. ʻO nā syringes kiʻekiʻe-kaomi i hoʻomohala ʻia a hana ʻia e kā mākou hui, meMea hoʻokomo CT hoʻokahi,ʻO ka mea hoʻokomo poʻo pālua CT,Mea hoʻokomo MRIa memea hoʻokomo pāpaho angiography contrast, ua kūʻai ʻia aku i kahi o 300 mau ʻāpana ma ka home a me nā ʻāina ʻē, a ua lanakila i ka mahalo o nā mea kūʻai aku. I ka manawa like, hāʻawi pū ʻo LnkMed i nā nila kākoʻo a me nā paipu e like me nā mea hoʻopau no kēia mau lama: Medrad, Guerbet, Nemoto, etc., a me nā hui kaomi maikaʻi, nā mea ʻike ferromagnetic a me nā huahana lapaʻau ʻē aʻe. Ua manaʻoʻiʻo mau ʻo LnkMed ʻo ka maikaʻi ke kihi o ka hoʻomohala ʻana, a ua hana ikaika e hāʻawi i nā mea kūʻai aku me nā huahana a me nā lawelawe kiʻekiʻe. Inā ʻoe e ʻimi nei i nā huahana kiʻi lapaʻau, e ʻoluʻolu e kūkākūkā a kūkākūkā paha me mākou.