Primerjava magnetno resonančne angiografije in računalniško tomografske angiografije pri slikanju pacienta z anevrizmo torakalne aorte : diplomsko delo

Kuralt, Matej (avtor), Šikovec, Klemen (avtor), Podobnik, Janez (mentor), Breznik, Andrej (komentor), Starc, Tina (recenzent)

Anevrizma aorte je segmentna razširitev premera žilne svetline za več kot 50 % glede na normalni premer žile. Na torakalni aorti se največkrat pojavi v ascendentnem delu (60 %), nato v descendentnem (35 %), najredkeje pa se pojavi na aortnem loku. Za postavitev diagnoze sta najpomembnejši slikovni preiskavi magnetno resonančna angiografija (MRA) in računalniško tomografska angiografija (CTA). MRA je neinvazivna slikovna metoda, ki omogoča pregled žilja brez ionizirajočega sevanja. Znane so tri osnovne tehnike MRA slikanja, tehnika preleta, faznokontrastna angiografija in kontrastno poudarjena angiografija. CTA je neinvazivna slikovna metoda, pri kateri uporabimo jodovo kontrastno sredstvo za prikaz žilja. Pri obeh slikovnih metodah nam največ težav povzroča ritmično gibanje srca, zato uporabljamo EKG proženo slikanje. Namen: Namen diplomske naloge je predstaviti primer pacienta z diagnosticirano anevrizmo torakalne aorte in ugotoviti, katera od slikovnih metod (MRA ali CTA) je boljša pri diagnosticiranju anevrizme ter predstaviti prednosti in slabost obeh metod. Metode dela: Izvedli smo retrospektivno študijo kliničnega primera, kateremu je bila s CTA preiskavo diagnosticirana anevrizma ascendentne torakalne aorte in nato kasneje opravljena tudi MRA preiskava za kontrolo velikosti torakalne aorte. Rezultati: S CTA in MRA preiskavama smo izmerili premere različnih predelov torakalne aorte. Ugotovili smo, da so bile vse meritve obeh slikovnih preiskav enake, opazili smo odstopanje le v predelu proksimalnega aortne loka. Razprava in zaključek: Ugotovili smo, da sta CTA in MRA enako dobri za diagnosticiranje anevrizme torakalne aorte. CTA kljub uporabi ionizirajočega sevanja in kontrastnega sredstva še vedno ostaja zlati standard za prikaz torakalne aorte, predvsem zaradi nižjih stroškov preiskave, večje dostopnosti in hitrosti slikovne metode, saj lahko slikamo celotno aorto v enem vdihu bolnika. Vedno večjo vlogo pri diagnosticiranju in spremljanju anevrizem pa pridobiva brezkontrastna MRA, ker ne uporablja ionizirajočega sevanja. Njena največja slabost je čas trajanja preiskave, ampak z uporabo novejših pulznih zaporedij se čas preiskave skrajšuje in tako postaja vse boljša alternativa CTA preiskava. Obe preiskavi najbolj omejuje ritmično gibanje srca, zato uporabljamo EKG proženo slikanje, ki bistveno zmanjšuje artefakte zaradi gibanja srca.

• Jezik: Slovenski jezik
• Ključne besede: diplomska dela, radiološka tehnologija, anevrizma, torakalna aorta, magnetno resonančna angiografija, računalniško tomografska angiografija, EKG proženo slikanje
• Vrsta gradiva: Diplomsko delo/naloga
• Tipologija: 2.11 - Diplomsko delo
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [M. Kuralt ; K. Šikovec]
• Leto izida: 2022
• Št. strani: 34 str., [1] str. pril.
• PID: 20.500.12556/RUL-139392
• UDK: 616-07
• COBISS.SI-ID: 120473859
• Datum objave v RUL: 02.09.2022

KURALT, Matej in ŠIKOVEC, Klemen, 2022, Primerjava magnetno resonančne angiografije in računalniško tomografske angiografije pri slikanju pacienta z anevrizmo torakalne aorte : diplomsko delo [na spletu]. Diplomsko delo. Ljubljana : M. Kuralt ; K. Šikovec. [Dostopano 3 maj 2025]. Pridobljeno s: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=slv&id=139392

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Comparison of magnetic resonance angiography and computed tomographic angiography by imaging patient with thoracic aorta aneurysm : diploma work

Izvleček

An aortic aneurysm is a segmental enlargement of the diameter of the vascular lumen by more than 50% of the normal diameter of the vessel. In the thoracic aorta, it occurs most frequently in the ascending segment (60%), followed by the descending segment (35%), and most rarely in the aortic arch. The most important imaging tests for diagnosis are magnetic resonance angiography (MRA) and computed tomographic angiography (CTA). MRA is a non-invasive imaging method that allows the examination of the vasculature without ionising radiation. Three basic MRA imaging techniques are known, the time of flight technique, phase-contrast angiography and contrast-enhanced angiography. CTA is a non-invasive imaging method that uses an iodine contrast agent to image the vasculature. For both imaging methods, the rhythmic movement of the heart is the most difficult, which is why we use ECG gated imaging. Purpose: The aim of this thesis is to present a case of a patient diagnosed with a thoracic aortic aneurysm and to determine which of the imaging methods (MRA or CTA) is better in diagnosing the aneurysm and to present the advantages and disadvantages of both methods. Methods: We performed a retrospective study of a case who was diagnosed with an ascending thoracic aortic aneurysm by CTA and subsequently underwent MRA to control the size of the thoracic aorta. Results: The diameters of different regions of the thoracic aorta were measured by CTA and MRA. We found that all measurements were identical between the two imaging examinations, with only a deviation in the proximal aortic arch. Discussion and conclusion: We found that CTA and MRA are equally good for diagnosing thoracic aortic aneurysms. Despite the use of ionising radiation and contrast agent, CTA remains the gold standard for thoracic aortic imaging, mainly due to its lower cost, greater accessibility and speed of imaging, as the whole aorta can be imaged in one breath of the patient. However, non-contrast MRA is gaining an increasing role in the diagnosis and follow-up of aneurysms because it does not use ionising radiation. Its biggest disadvantage is the duration of the examination, but with the use of newer pulse sequences, the examination time is decreasing and thus it is becoming a better alternative to CTA. Both examinations are most limited by the rhythmic motion of the heart, which is why we use ECG gated imaging, which significantly reduces artefacts due to cardiac motion.

• Ključne besede: diploma theses, radiologic technology, aneurysm, thoracic aorta, magnetic resonance angiography, computed tomography angiography, ECG gated imaging