I-radiological imaging ibalulekile ekuncediseni idatha yeklinikhi kunye nokuxhasa i-urologists ekumiseni ulawulo olufanelekileyo lwezigulane. Phakathi kweendlela ezahlukeneyo zokucinga, i-computed tomography (CT) okwangoku ithathwa njengomgangatho wesalathiso wovavanyo lwezifo ze-urological ngenxa yokufumaneka kwayo ngokubanzi, ixesha lokuskena ngokukhawuleza, kunye novavanyo olubanzi. Ngokukodwa, i-CT urography.
IMBALI
Ngaphambili, i-urography ye-intravenous (IVU), ebizwa ngokuba yi-"excretory urography" kunye / okanye "i-intravenous pyelography," yayisetyenziselwa ukuvavanya i-urinary tract. Ubuchule bubandakanya i-radiograph yokuqala ecacileyo elandelwa yinaliti ye-intravenous ye-agent echaseneyo enyibilikayo emanzini (1.5 ml / kg ubunzima bomzimba). Emva koko, uluhlu lwemifanekiso lufunyanwa ngamaxesha athile. Imida ephambili yobu buchule ibandakanya uvavanyo olumacala mabini kunye novavanyo olungekhoyo lwe-anatomy ekufutshane.
Emva kokuqaliswa kwe-computed tomography, i-IVU isetyenziswe ngokubanzi.
Nangona kunjalo, kuphela kwiminyaka yee-1990, ngokusungulwa kobuchwepheshe be-helical, amaxesha okuskena aye akhawuleza kakhulu ukuze iindawo ezinkulu zomzimba, ezifana nesisu, zifundwe ngemizuzwana. Ngokufika kweteknoloji ye-multi-detector kwi-2000s, isisombululo sendawo saphuculwa, sivumela ukuchongwa kwe-urothelium ye-urinary tract ephezulu kunye ne-bladder, kunye ne-CT-Urography (CTU) yasekwa.
Namhlanje, i-CTU isetyenziswa ngokubanzi kuvavanyo lwezifo ze-urological.
Ukusukela ngeentsuku zokuqala ze-CT, bekwaziwa ukuba i-X-reyi yamandla ahlukeneyo inokwahlula izixhobo zamanani ahlukeneyo eathom. Kwakungekho kude kube yi-2006 ukuba lo mgaqo usetyenziswe ngempumelelo ekufundeni izicubu zomntu, ekugqibeleni ukhokelela ekuqalisweni kwenkqubo yokuqala ye-CT (DECT) yamandla amabini kwi-kliniki yemihla ngemihla. I-DECT ibonise ngokukhawuleza ukufaneleka kwayo kuvavanyo lweemeko ze-urinary tract pathological, ukusuka ekuqhekekeni kwezinto eziphathekayo kwi-urinary calculi ukuya kwi-iodine efunyenwe kwi-urological malignancies.
inzuzo
Iiprothokholi ze-CT zemveli zibandakanya imifanekiso yangaphambili kunye ne-postcontrast eninzi. Izikena ze-CT zanamhlanje zibonelela ngeseti yedatha yevolumetric enokwakhiwa ngokutsha kwiinqwelomoya ezininzi kunye nobukhulu besilayi esiguquguqukayo, ngaloo ndlela igcina umgangatho obalaseleyo womfanekiso. I-CT urography (CTU) iphinda ixhomekeke kumgaqo we-polyphasic, ugxininise kwisigaba "sokukhupha" emva kokuba i-agent echaseneyo ihluze kwinkqubo yokuqokelela kunye ne-bladder, ngokuyisiseko idala i-urogram ye-IV kunye nokuphucula kakhulu ukuhlukana kwezicubu.
UMDA
Nokuba i-computed tomography eyongeziweyo eyomeleziweyo ngumgangatho wereferensi womfanekiso wokuqala wendlela yomchamo, imida yendalo kufuneka iqwalaselwe. Ukuvezwa kwemitha kunye nokuchasana kwe-nephrotoxicity kuthathwa njengemiqobo enkulu. Ukunciphisa idosi yemitha kubaluleke kakhulu, ngakumbi kwizigulana eziselula.
Okokuqala, ezinye iindlela zokucinga ezifana ne-ultrasound kunye ne-MRI kufuneka zihlale ziqwalaselwa. Ukuba ezi teknoloji azikwazi ukunika ulwazi oluceliweyo, kufuneka kuthathwe inyathelo ngokwe-CT protocol.
Uvavanyo lwe-CT oluphuculweyo luchasene nezigulane ezichasene ne-radiocontrast agents kunye nezigulane ezinokukhubazeka kwezintso. Ukunciphisa i-nephropathy eyenziwa ngokungafaniyo, izigulane ezinezinga lokuhluza i-glomerular (GFR) ngaphantsi kwe-30 ml / min akufanele zinikwe imidiya eyahlukileyo ngaphandle kokulinganisa ngononophelo ingozi kunye neenzuzo, kwaye kufuneka zisetyenziswe ngokuqaphela kwizigulane ezine-GFR kuluhlu. I-30 ukuya kwi-60 ml / min kwizigulane.
IKAMVA
Kwixesha elitsha lamayeza achanekileyo, ukukwazi ukulinganisa idatha yobuninzi kwimifanekiso ye-radiological ngumngeni wangoku kunye nexesha elizayo. Le nkqubo, eyaziwa ngokuba yi-radiomics, yaqalwa okokuqala yiLambin kwi-2012 kwaye isekelwe kwingcamango yokuba imifanekiso yeklinikhi iqulethe iimpawu ezinobungakanani obunokubonakalisa i-pathophysiology engaphantsi kwezicubu. Ukusetyenziswa kwezi mvavanyo kunokuphucula ukuthathwa kwezigqibo zonyango kunye nokufumana indawo ngokukodwa kwi-oncology, evumela, umzekelo, ukuhlolwa kwe-microenvironment yomhlaza kunye neempembelelo zonyango. Kwiminyaka embalwa edlulileyo, uphando oluninzi luye lwaqhutywa malunga nokusetyenziswa kwale ndlela, nangona kuvavanyo lwe-urothelial carcinoma, kodwa oku kuhlala kuyilungelo lophando.
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Ixesha lokuposa: Mar-20-2024
