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Vpliv negativnih kontrastnih sredstev pri magnetno resonančni holangiopankreatografiji : magistrsko delo
ID Lapornik, Teja (Author), ID Mekiš, Nejc (Mentor) More about this mentor... This link opens in a new window, ID Breznik, Andrej (Co-mentor), ID Ključevšek, Damjana (Reviewer)

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Abstract
Uvod: Magnetno resonančna holangiopankreatografija (MRCP) je neinvazivna MR preiskava, ki nam poda informacije o anatomiji in patologiji biliarnega trakta. Temelji pretežno na T2- obteženih pulznih zaporedjih, kjer je poudarjen signal iz tekočin. Alternativa dragim kontrastnim sredstvom (KS) so pijače v prosti prodaji, ki vsebujejo višje koncentracije mangana, na primer ananasov sok, borovničev sok, črni čaj in podobno. Namen: Ugotoviti ali uporaba negativnih KS izboljša kvaliteto MRCP slik, katero negativno KS omogoča najboljšo vidljivost pankreatično-biliarnega trakta (PBT), kakšne so razlike med njimi in na katerih področjih PBT je največ razlik med uporabljenimi KS. Metode dela: V raziskavo je bilo vključenih 20 zdravih prostovoljcev. Najprej smo izvedli »nativno« slikanje PBT področja po protokolu za MRCP preiskavo, ki se uporablja v SB Celje, nato so v razmikih na vsaj 24 ur zaužili vsa tri različna negativna kontrastna sredstva (ananasov sok, borovničev sok in črni čaj). Preiskovancem smo 10 minut po zaužitju KS ponovili MRCP preiskavo. Pridobljene slika sta ocenjevala dva neodvisna radiologa, slike sta ocenila tako, da sta podala oceno izboljšanja vidljivosti slike po uporabi KS v primerjavi z nativno sliko. Rezultati: Primerjava med ananasovim sokom in borovničevim sokom je pokazala, da med njima ni statistično značilnih razlik, vendar ima ananasov sok neznačilno višje ocene glede na vse anatomske strukture. Dokazali smo statistično značilno razliko pri zasičenju signala v želodcu, dvanajstniku, pankreatičnem vodu, skupnem žolčnem vodu in papille Vateri po zaužitju ananasovega in borovničevega soka, v prid ananasovega soka. Statistična primerjava ni pokazala značilnih razlik po uporabi črnega čaja. Najboljša vidljivost v primerjavi vseh vrst uporabljenega negativnega KS je vidljivost pankreatičnega in skupnega žolčnega voda, medtem ko je najslabša vidljivost papile Vateri. Razprava in zaključek: Ugotovitve kažejo, da sta ananasov sok in borovničev sok oba enako učinkovita za izvedbo MRCP preiskave, saj najbolje zasičita signal iz gastrointestinalnega trakta in tako omogočita dobro vidljivost pankreato-biliarnega sistema, medtem ko se je črni čaj izkazal za neučinkovito negativno kontrastno sredstvo. Ananasov in borovničev sok omogočata boljšo vidljivost skupnega žolčnega voda, hepatičnega voda, pankreatičnega voda in papile Vateri.

Language:Slovenian
Keywords:magistrska dela, radiološka tehnologija, MRCP, negativno kontrastno sredstvo, ananasov sok, borovničev sok, črni čaj, vidljivost anatomskih struktur, izboljšanje kvalitete slik
Work type:Master's thesis/paper
Typology:2.09 - Master's Thesis
Organization:ZF - Faculty of Health Sciences
Place of publishing:Ljubljana
Publisher:[T. Aškerc]
Year:2020
Number of pages:48 str., [9] str. pril
PID:20.500.12556/RUL-121188 This link opens in a new window
UDC:616-07
COBISS.SI-ID:30564867 This link opens in a new window
Publication date in RUL:01.10.2020
Views:1587
Downloads:139
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Secondary language

Language:English
Title:The effect of negative contrast agents in magnetic resonance cholangiopancreatography : master thesis
Abstract:
Introduction: Magnetic resonance cholangiopancreatography (MRCP) is non-invasive MR examination procedure that provides us information about the anatomy and pathology of the biliary tract. The examination is based mainly on T2-weighted pulsed sequences where the signal from the fluids are visible. Alternatives to expensive negative contrast media are beverages over the counter that contains higher concentrations of manganese, such as blueberry juice, pineapple juice and black tea. Purpose: To determine wheter the use of negative contrast media improves the quality of MRCP examination, which of them enables better visualization of pacreato-biliary tract (PBT) area, what are the differences between them and in which areas of PTB are shown the biggest differencies. Methods: The measurements were performed on 20 healthy volunteers. We started with "native" imaging of the PBT area according to the MRCP protocol, used in Splošna bolnišnica Celje. In at least 24 hour intervals, volunteers ingested three different negative contrast agents such as pineapple juice, blueberry juice and black tea. 10 minutes after ingestion of contrast media, the MRCP examinations were repeated. The images were evaluated by two expert radiologist, they were evaluating improvement of visualization in PBT area after consuming contrast media. Results: A comparison between pineapple juice and blueberry juice showed that there was no statistically significant differences between them, but the pineapple juice has an insignificantly higher score compared to all anatomical structures. We found out a statistically significant difference in signal suppresion in the stomach, duodenum, pancreatic duct, common bile duct, and papillae Vateri after ingestion of pineapple and blueberry juice. Statistical analysis showed no significant differences after consumption of black tea. The best visualization, comparing all types of negative contrast agent used is the visibility of the pancreatic and common bile ducts, while the worst visualisation have the Vateri papilla Discussion and conclusion: We found out that pineapple juice and blueberry juice are both equally effective for performing MRCP examination, as they best suppres the signal from the gastrointestinal tract and allow better visualization of the PBT, while black tea has been shown to be an ineffective negative contrast agent. Pineapple and blueberry juice allow better visualization of the common bile duct, hepatic duct, pancreatic duct, and papillae Vateri.

Keywords:master's theses, radiologic technology, MRCP, negative contrast media, pineapple juice, blueberry juice, black tea, visualization, improving quality of image

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