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Varnost diagnostičnega ultrazvoka in smernice za uporabo : magistrsko delo
ID Pišek, Manca (Author), ID Fošnarič, Miha (Mentor) More about this mentor... This link opens in a new window, ID Arnuga, Sašo (Comentor), ID Žibert, Janez (Reviewer)

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Abstract
Uvod: Stranske učinke diagnostičnega ultrazvoka razdelimo v dve skupini: termične in netermične/mehanične. Do slednjih pride predvsem zaradi plina znotraj mehkih tkiv (zrak v alveolih, črevesju in kontrastnih sredstvih). Ko so mehurčki takšnega plina izpostavljeni ultrazvočnemu valovanju, lahko zanihajo, pri čemer se lahko spreminja položaj in velikost mehurčka. Takšne oscilacije lahko povzročijo poškodbe celic. K netermičnim učinkom prištevamo še možnost nastanka novih prostih radikalov in sevalno silo, ki pa ne povzroči nobenih poškodb. Pri termičnih učinkih pride do poškodbe celic zaradi segrevanja tkiv – del energije ultrazvočnega snopa se med preiskavo pretvori v toploto. Za nadzor nad varno uporabo ultrazvoka sta definirana termični indeks (standard, ki uporabniku omogoča oceno nevarnosti segrevanja tkiva) in mehanični indeks (indikator sposobnosti UZ snopa, da povzroči kavitacijo). Upoštevamo smernice in priporočila za varno uporabo: priporočila o tem, kakšen je lahko dvig temperature, opozorila za uporabo različnih tehnik preiskave, pregledovanju tkiv, kjer je prisoten plin in možnost kavitacije. Namen: Opisati osnovno načelo ultrazvoka, raziskati varnost diagnostičnega ultrazvoka in varnostne smernice. Metode dela: Uporabili smo deskriptivno metodo in metodo sistematičnega pregleda literature. Iskanje je potekalo od decembra 2021 do februarja 2023 v različnih podatkovnih bazah. Iz prvotnih 3045 zadetkov smo s pomočjo vključitvenih in izključitvenih kriterijev rezultate omejili na 23 virov, ki smo jih vključili v magistrsko delo. Rezultati: Rezultate smo predstavili v dveh tabelah: v prvi so podani avtorji, leto raziskave in tehnični parametri raziskave (frekvenca, jakost ultrazvoka, čas skeniranja, način zajemanja podatkov, tarča oz. tkiva v snopu, termični in mehanični indeks ter drugi tehnični podatki o raziskavi), v drugi pa namen in ugotovitve raziskav. Razprava in zaključek: Ugotovili smo, da diagnostični ultrazvok v mnogih primerih povzroči dvig temperature od 1 °C do 2 °C, lahko tudi do 5 °C. Kadar so med preiskavo v tkivu prisotni plinski delci, pride zaradi akustične kavitacije do rupture kapilar in drobnih žil, poškodb mišičja, maščevja in sprememb v delovanju srčne mišice. Prav tako so vrednosti termičnega in mehaničnega indeksa velikokrat presegle dovoljene. Pomembno je poznavanje ozadja delovanja ultrazvoka, stranskih učinkov, smernic in priporočil. Preiskava se naj izvede le, kadar je to potrebno in je korist večja od možne škode, med preiskavo spremljamo vrednost termičnega in mehaničnega indeksa ter jima prilagajamo ekspozicijske parametre, še posebej smo previdni pri pregledavanju nosečnic, v pediatriji, uporabi kontrastnih sredstev; zmeraj pa sledimo načelu ALARA.

Language:Slovenian
Keywords:magistrska dela, radiološka tehnologija, diagnostični ultrazvok, stranski učinki ultrazvoka, termični indeks, mehanični indeks, varnost, smernice
Work type:Master's thesis/paper
Typology:2.09 - Master's Thesis
Organization:ZF - Faculty of Health Sciences
Place of publishing:Ljubljana
Publisher:[M. Pišek]
Year:2023
Number of pages:62 str.
PID:20.500.12556/RUL-152215 This link opens in a new window
UDC:616-07
COBISS.SI-ID:171834115 This link opens in a new window
Publication date in RUL:11.11.2023
Views:932
Downloads:102
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Secondary language

Language:English
Title:Diagnostic ultrasound safety and guidelines for ultrasound practice : master thesis
Abstract:
Introduction: Biological side effects of diagnostic ultrasound are primarily via two main mechanisms: thermal and nonthermal/mechanical. The last refer to damage caused by oscillation of small gas bubbles within the ultrasound field (lung, intestines and ultrasound contrast agents). The change in size and location of the bubble can cause tissue damage. Other mechanical effects of ultrasound are formation of free radicals and radiation force. During ultrasound exposure, acoustic energy is absorbed by tissue and converted into heat – thermal effects of the ultrasound cause damage with tissue heating. Control of the safe use of ultrasound is provided by thermal (standard that allows user to assess the risk of tissue heating) and mechanical (indicator of the ability of the ultrasound to cause cavitation) index. We take into the account guidelines and recommendations for safe use: what the temperature rise can be, we are extra careful with using Doppler and examining tissues with gas bodies present and/or using ultrasound contrast agents. Purpose: Purpose of master thesis is to describe basic principle of diagnostic ultrasound, ultrasound safety, recommendations and guidelines for safe use of diagnostic ultrasound. Methods: We used descriptive method and systematic review of literature. We acquired literature from December of 2021 to February of 2023 from different database. From initial 3045 results we narrowed it down to 23 articles using inclusion and exclusion criteria. Results: We have organized articles in two separate tables: authors, year of the research and technical parameters (frequency, time of the examination, target, thermal and mechanical index and other technical information about the research) in one and purpose with main findings in other table. Discussion and conclusion: Diagnostic ultrasound can cause temperature rise from 1 to 2 °C, sometimes up to 5 °C. When there are gas bubbles present during the exam, acoustic cavitation causes rupture of capillaries and small vessels, damage on the muscle, fat and abnormal heart function. Also, the values of thermal and mechanical index exceeded the permissible ones many times. It is important to know how ultrasound works, what are the side effects, guidelines and recommendations for safe use. The examination is carried out only when it is necessary and the benefit is greater than the possible harm, during the examination we monitor the value of thermal and mechanical index and adjust the exposure parameters according to them, we are especially careful when examining pregnant women, performing examinations in pediatrics and when we use contrast agents; also always follow the ALARA principle.

Keywords:master's theses, radiologic technology, diagnostic ultrasound, biological effects of ultrasound, thermal index, mechanical index, safety, guidelines

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