{"id":10570,"date":"2020-12-24T21:35:50","date_gmt":"2020-12-25T02:35:50","guid":{"rendered":"https:\/\/cornflowerblue-rail-980953.hostingersite.com\/?p=10570"},"modified":"2020-12-24T22:08:07","modified_gmt":"2020-12-25T03:08:07","slug":"whats-new-in-gastrointestinal-imaging-turkish-december-2020","status":"publish","type":"post","link":"https:\/\/staging-hub.acoredu.com\/tr\/whats-new-in-gastrointestinal-imaging-turkish-december-2020\/","title":{"rendered":"What’s new in Gastrointestinal Imaging (Turkish) – December 2020"},"content":{"rendered":"
G\u00fcd\u00fck Apandisit: Klinik ve BT Bulgular\u0131<\/strong><\/span><\/h5>\n

Enzerra ve ark.<\/p>\n

AJR<\/p>\n

Bu makale, apandektomi sonras\u0131 rezid\u00fc apendiksin enflamasyonu ve obstr\u00fcksiyonuyla karakterize nadir bir olgu olan g\u00fcd\u00fck apandisitin incelenmesi amac\u0131yla yaz\u0131lm\u0131\u015ft\u0131r. Radyolog ve klinisyenlerin olguya yabanc\u0131l\u0131\u011f\u0131 nedeniyle , g\u00fcd\u00fck apandisitle alakal\u0131 olgu sunumlar\u0131 k\u0131smen say\u0131ca azd\u0131r. Bu kapsamda haz\u0131rlanan ilgili vaka serisinde demografik, klinik ve g\u00f6r\u00fcnt\u00fcleme sonu\u00e7lar\u0131 a\u00e7\u0131s\u0131ndan ele alan 14 hastan\u0131n bilgileri yer almaktad\u0131r. Apendektomi ile g\u00fcd\u00fck apandisit tan\u0131s\u0131 aras\u0131ndaki ortalama s\u00fcre 5.1 y\u0131l olarak hesaplanm\u0131\u015f, veriler 1 ay ile 17 y\u0131l aras\u0131nda bir da\u011f\u0131l\u0131m g\u00f6stermi\u015ftir. BT\u2019de ya\u011f dokuda \u00e7izgilenme, \u00a0peri\u00e7ekal s\u0131v\u0131 ve g\u00fcd\u00fckde inflamatuar de\u011fi\u015fiklikler gibi apandisitin tipik bulgular\u0131 saptanm\u0131\u015ft\u0131r. \u0130nflame g\u00fcd\u00fc\u011f\u00fcn ortalama boyutu 3.2 cm boyunda ve 1.1 cm \u00a0enindedir. Tan\u0131ya yard\u0131mc\u0131 olacak ek bulgular aras\u0131nda apendikolit ve inflame g\u00fcd\u00fck taban\u0131nda s\u00fctur varl\u0131\u011f\u0131 say\u0131labilir. Vakalar\u0131n en az \u00fc\u00e7te birinde perforasyon ve baz\u0131 hastalarda abse drenaj\u0131, ek apendektomi ya da ileum ve \u00e7ekumun \u00e7\u0131kar\u0131lmas\u0131 \u00a0gibi gereksinimler g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Makaleye g\u00f6re, yaratt\u0131\u011f\u0131 g\u00f6r\u00fc\u015f alan\u0131 engellerinden dolay\u0131 g\u00fcd\u00fc\u011f\u00fcn g\u00f6zden ka\u00e7mas\u0131na sebep olabilece\u011finden, laparoskopik apendektomi, riski artt\u0131ran bir durumdur. \u00a0Ek olarak ilk apandisitte perforasyon, nekroz veya abse olu\u015fumu gibi komplikasyonlar da varsa bunlar ameliyat\u0131 zorla\u015ft\u0131raca\u011f\u0131ndan subtotal rezeksiyon ve buna ba\u011fl\u0131 geli\u015fen luminal okl\u00fczyon da g\u00fcd\u00fck apandisitine sebep olabilir.<\/p>\n

 <\/p>\n

HCC Taramas\u0131: Ultrasona Hala \u0130htiyac\u0131m\u0131z Var m\u0131? Art\u0131lar ve Eksiler<\/strong><\/span><\/h5>\n

Kamaya A, Rodgers SK. HCC Screening: Is Ultrasound Still Needed at Transplant Centers?\u2014Point: Yes, Ultrasound Remains First Line. AJR August 19, 2020.<\/p>\n

Olson MC, Venkatesh SK. HCC Screening: Is Ultrasound Still Needed at Transplant Centers?\u2014Counterpoint: No, CT\/MR is the Way to Go. AJR 8\/5\/2020.<\/p>\n

Bu yaz\u0131, hepatosell\u00fcler karsinom (HCC) i\u00e7in y\u00fcksek riskli hastalarda ultrason ile taraman\u0131n ve takibin faydas\u0131 \u00fczerine ilgin\u00e7 bir tart\u0131\u015fma i\u00e7ermekte. G\u00fcn\u00fcm\u00fczde, ultrason primer bir g\u00f6r\u00fcnt\u00fcleme arac\u0131 olarak yayg\u0131nca kullan\u0131lmakta ve sadece baz\u0131 \u00f6zel durumlar\u0131 olan hastalar ba\u015fka g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemlerine sevk edilmektedir. Kontrast veya sedasyon gerektirmemesi, yayg\u0131nl\u0131\u011f\u0131, ucuzlu\u011fu ve uygulama kolayl\u0131\u011f\u0131, ultrason kullan\u0131m\u0131n\u0131 destekleyen fakt\u00f6rler aras\u0131ndad\u0131r. Ultrasonun sensitivitesi %80 kadar y\u00fcksek, spesifisitesi de %90\u2019un \u00fczerinde olarak saptanm\u0131\u015ft\u0131r. Her ne kadar yazarlar, kesitsel g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemlerinin do\u011fruluk oranlar\u0131n\u0131n daha y\u00fcksek oldu\u011funu belirtse de, bu kriter tek ba\u015f\u0131na daha iyi bir tarama tekni\u011fini belirtmez ve bu kapsamda ultrason, bir\u00e7ok a\u00e7\u0131dan daha uygun bir y\u00f6ntem tan\u0131m\u0131na uymaktad\u0131r. Ayr\u0131ca doppler ultrasonografinin karaci\u011fer nakli sonras\u0131 takip a\u015famalar\u0131nda hepatik kanlanmay\u0131 g\u00f6sterme avantaj\u0131n\u0131n da oldu\u011fu unutulmamal\u0131d\u0131r. Duruma kar\u015f\u0131t g\u00f6r\u00fc\u015fler aras\u0131nda, BT ve MR tekniklerinin HCC\u2019nin erken tan\u0131s\u0131nda avantajl\u0131 oldu\u011fu ve ultrasonun bu a\u00e7\u0131dan, tedavisi daha olas\u0131 erken hastal\u0131k a\u015famalar\u0131n\u0131 ka\u00e7\u0131rd\u0131\u011f\u0131 yer al\u0131r. Bu durumda \u00f6zellikle MR g\u00f6r\u00fcnt\u00fclemenin genel anlamda ve erken safhalar\u0131nda kanserleri saptamakta ultrasona k\u0131yasla \u00fcst\u00fcnl\u00fc\u011f\u00fcne dair yazarlar da referans sunmaktad\u0131r. Kesitsel g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemlerinin pahal\u0131l\u0131\u011f\u0131 ve inceleme s\u00fcreleri g\u00f6z \u00f6n\u00fcnde bulunduruldu\u011funda ise yazarlar k\u0131salt\u0131lm\u0131\u015f MR protokollerini \u00f6nermektedir. Kesitsel g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemlerinin bir ba\u015fka temel avantaj\u0131 ise lezyonlar\u0131 tek g\u00f6r\u00fcnt\u00fcleme ile \u00a0karakterize ederlerke, ultrasonda pozitif bulgulara rastlanan hastalar\u0131n BT veya MR\u2019a y\u00f6nlendirilmeleridir.<\/p>\n

 <\/p>\n

\u00d6zefagustan Endoskopik \u00a0Olarak D\u00fc\u011fme Pil \u00c7\u0131kar\u0131lmas\u0131 Sonras\u0131 Seri MR Bulgular\u0131<\/strong><\/span><\/h5>\n

Riedesel ve ark.<\/p>\n

AJR<\/p>\n

Bu makalede, \u00e7ocuklarda d\u00fc\u011fme pillerin endoskopik \u00e7\u0131kar\u0131lmas\u0131 sonras\u0131 ortaya \u00e7\u0131kan MR bulgular\u0131n\u0131n bir derlemesi yer almakta ve belli kriterleri kar\u015f\u0131layan 19 vaka ele al\u0131nmaktad\u0131r. Endoskopide, 19 hastan\u0131n her birinde ya mukozal erozyona ya da doku nekrozuna rastlanm\u0131\u015f ama tam kat hasara ya da perforasyon bulgular\u0131na rastlanmam\u0131\u015ft\u0131r. Bu 19 hastada, pil al\u0131m\u0131ndan sonraki ilk 48 saat i\u00e7erisinde toplam 48 adet MR g\u00f6r\u00fcnt\u00fcs\u00fc elde edilmi\u015f ve bu g\u00f6r\u00fcnt\u00fclerde yayg\u0131n \u00f6dem ve mediastinal ya\u011f dokuda sinyal art\u0131\u015f\u0131 izlenmi\u015ftir. \u00d6dem t\u00fcm vakalarda persistan bir bulgu olarak ortaya \u00e7\u0131km\u0131\u015f, operasyondan sonraki en az 22 g\u00fcn i\u00e7erisinde bile ger\u00e7ekle\u015ftirilen 4 MR g\u00f6r\u00fcnt\u00fclerinin hepsinde saptanm\u0131\u015ft\u0131r. \u0130lk g\u00f6r\u00fcnt\u00fclemede t\u00fcm vakalarda mukozal irreg\u00fclerite bulgusu da saptanm\u0131\u015ft\u0131r. Proksimal \u00f6zefagus hasar\u0131 olan hastalar\u0131n %40\u2019\u0131nda, alt \u00f6zefagus hasar\u0131 olan hastalar\u0131n da %43\u2019\u00fcnde \u00f6zefageal divertikul bulgular\u0131 ortaya \u00e7\u0131km\u0131\u015ft\u0131r. Bu bulgular proksimal hasar olan hastalarda takip MR g\u00f6r\u00fcnt\u00fclemelerde d\u00fczelmi\u015f ama alt \u00f6zefagus hasar\u0131 olan hastalarda devam etmi\u015ftir. Her hastaya floroskopi de yap\u0131lm\u0131\u015ft\u0131r ve bu kapsamda, 19 vakan\u0131n 4\u2019\u00fcnde s\u0131n\u0131rlanm\u0131\u015f s\u0131z\u0131nt\u0131lar, 16\u2019s\u0131nda mukozal irreg\u00fclerite ve 8\u2019inde \u00fclserasyon saptanm\u0131\u015ft\u0131r. Yazarlar, BT de yap\u0131labilece\u011fini belirtse de, hastada radyasyon maruziyeti ve MR g\u00f6r\u00fcnt\u00fclemenin yumu\u015fak dokular\u0131n de\u011ferlendirilmesindeki \u00fcst\u00fcnl\u00fc\u011f\u00fcnden dolay\u0131 kendi kurumlar\u0131nda yaln\u0131zca MR g\u00f6r\u00fcnt\u00fcleminin kontrendike oldu\u011fu durumlarda (metalik par\u00e7a \u015f\u00fcphesi bulunan hastalar vs.) BT\u2019nin kullan\u0131ld\u0131\u011f\u0131ndan s\u00f6z etmi\u015flerdir.<\/p>\n

 <\/p>\n

Postop BT G\u00f6r\u00fcnt\u00fclerde Enfekte ve Steril Abdominal S\u0131v\u0131 Koleksiyonlar\u0131nda Kar\u015f\u0131la\u015ft\u0131rma: Klinik ve G\u00f6r\u00fcnt\u00fcleme Bulgular\u0131na Dayal\u0131 bir Skorlama Sistemi<\/strong><\/span><\/h5>\n

Radosa ve ark.<\/p>\n

Abdominal Radiology<\/p>\n

Bu makale ameliyat sonras\u0131 hastalarda intraabdominal s\u0131v\u0131 koleksiyonlar\u0131n\u0131n karakterize edilmesinde bir skorlama sisteminin kullan\u0131m\u0131 amac\u0131yla yaz\u0131lm\u0131\u015ft\u0131r. Makalede \u00f6nce ameliyat sonras\u0131 g\u00f6r\u00fclen \u00e7e\u015fitli s\u0131v\u0131 koleksiyonlar\u0131 tan\u0131mlanmakta (seromlaar, hematomlar, abseler vb.) ve temiz yaralarda %5\u2019i, septik yaralarda %27\u2019yi bulan enfeksiyon oranlar\u0131n\u0131n, tedavi edilmedik\u00e7e %80\u2019e varan bir motaliteye sebep olabilecekleri belirtilmektedir. Yazarlar, a\u015fa\u011f\u0131da belirtilen de\u011fi\u015fkenleri, azalan \u00f6nemlerine g\u00f6re kullanarak bir skorlama sistemi tan\u0131mlam\u0131\u015flard\u0131r:<\/p>\n

    \n
  • Serum CRP \u2265150 mg\/L \u2013 4 puan<\/li>\n
  • Koleksiyon i\u00e7erisinde gaz \u2013 3 puan<\/li>\n
  • Koleksiyonun BT\u2019de 20 HU \u00fczeri atenuasyonu \u2013 2 puan<\/li>\n
  • Koleksiyonun BT\u2019de kontrastlanmas\u0131\u2013 2 puan<\/li>\n<\/ul>\n

    E\u011fer elde edilen toplam puan 5\u2019in \u00fczerindeyse, yazarlar bu durumu %85 sensitivite ve %79 spesifisite oranlar\u0131yla enfeksiyon varl\u0131\u011f\u0131 g\u00f6stergesi olarak tan\u0131mlamaktad\u0131r ve \u00e7al\u0131\u015fmada kullan\u0131lan s\u0131v\u0131 \u00f6rnekleri bu kapsamda laboratuvara g\u00f6nderilmi\u015ftir. Yazarlar bu ve buna benzer skorlama sistemlerinin hastaya yakla\u015f\u0131m konusunda yard\u0131mc\u0131 olaca\u011f\u0131n\u0131 belirtmektedirler.<\/p>\n

     <\/p>\n

    Duodenal Acillerin G\u00f6r\u00fcnt\u00fcleme \u00c7e\u015fitlilikleri<\/strong><\/span><\/h5>\n

    Gosangi ve ark.<\/p>\n

    Radiographics<\/p>\n

    Bu makale, duodenumdan kaynaklanan ve duodenumu sekonder olarak etkileyen acil durumlardan bahsetmektedir. \u00d6nce duodenumun 4 segmentli anatomisi tan\u0131mlanmakta ve bu yap\u0131lar\u0131n intraperitoneal ve retroperitoneal konumu tan\u0131mlanmaktad\u0131r. Peptik \u00fclser hastal\u0131klar\u0131 duodenumun genelde ilk segmentini etkiler ancak distal segmentlerde g\u00f6r\u00fcld\u00fc\u011f\u00fcnde Zollinger \u2013 Ellison Sendromu varl\u0131\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclmelidir. Komplike olmayan duodenal \u00fclserlerin g\u00f6r\u00fclmesi zordur ancak \u00a0bulgular\u0131 aras\u0131nda mukozal kontrastlanmada devams\u0131zl\u0131k ve luminal \u00e7\u0131k\u0131nt\u0131lar g\u00f6zlenebilir. indirekt bulgular\u0131 aras\u0131nda periduodenal ya\u011f \u00e7izgilenmesi, kom\u015fu lenfadenopati ve submukozal \u00f6dem yer almaktad\u0131r. Yazarlar aktif kanayan \u00fclser \u015f\u00fcphesi halinde trifazik BT anjiografi \u00f6nermektedir. Bu g\u00f6r\u00fcnt\u00fclemede, kanaman\u0131n prekontrast faz\u0131nda y\u00fcksek aten\u00fcasyonlu intraluminal materyal, arteryal faz\u0131nda intraluminal kontrast s\u0131z\u0131nt\u0131s\u0131 ve ven\u00f6z fazda s\u0131z\u0131nt\u0131 \u015feklinde de\u011fi\u015fiklikler g\u00f6zlenir. Ekstraluminal gaz varl\u0131\u011f\u0131nda perforasyon \u015f\u00fcphesi bulunmaktad\u0131r. Pankreatit, pankreatik enzimlere sekonder ya da pankreas ba\u015f k\u0131sm\u0131nda geni\u015fleme, peripankreatik s\u0131v\u0131 koleksiyonun bas\u0131s\u0131 sonras\u0131 ortaya \u00e7\u0131kabilen, duodenumu da etkileyen bir patolojidir. Akut kolesistit, duodenumu etkileyen di\u011fer bir patolojidir. Safra ta\u015f\u0131\u00a0 duodenum duvar\u0131n\u0131 erode edip safra ta\u015f\u0131 ileusuna da yol a\u00e7abilir. Duodenal travma nadirdir, s\u0131kl\u0131kla penetran travma ya da deselerasyon yaralanmalar\u0131 sebebiyle olur. \u0130lgili makalede gibi, ikinci k\u0131tada g\u00f6r\u00fclen Bouveret Sendromu, \u00fc\u00e7\u00fcnc\u00fc k\u0131tada g\u00f6r\u00fclebilen aortoduodenal fistuller ve d\u00f6rd\u00fcnc\u00fc k\u0131tada malrotasyon vb. nadir durumlar\u0131 da ele alan, duodenal patolojileri k\u0131talara g\u00f6re s\u0131ralayan kapsaml\u0131 bir tablo da yer almaktad\u0131r.<\/p>\n

     <\/p>\n

    MR Kolanjiopankreatografi: Her Radyoloji Uzmanl\u0131k \u00d6\u011frencisinin Bilmesi Gerekenler<\/strong><\/span><\/h5>\n

    Vidal ve ark.<\/p>\n

    Radiographics<\/p>\n

    Bu k\u0131sa makale MRCP uygulamalar\u0131n\u0131n iyi bir \u00f6zetini sunmaktad\u0131r. MRCP, pankreatobilier hastal\u0131klar\u0131 de\u011ferlendirmek i\u00e7in geli\u015ftirilen, invaziv olmayan bir y\u00f6ntem olarak, obstr\u00fcksiyonlar\u0131n ilerisini g\u00f6r\u00fcnt\u00fcleyemeyen ERCP y\u00f6ntemine k\u0131yasla, t\u00fcm safra sisteminin g\u00f6r\u00fcnt\u00fcs\u00fcn\u00fc sa\u011flayabilmesiyle \u00f6ne \u00e7\u0131kmaktad\u0131r. Y\u00f6ntemin dezavantajlar\u0131 aras\u0131nda maliyeti, uzaysal \u00e7\u00f6z\u00fcn\u00fcrl\u00fc\u011f\u00fcn d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc, hasta kooperasyonu gerektirmesi say\u0131labilir. 2D radyal ve 3D sekanslar gibi farkl\u0131 protokollerle uygulanabilmektedir. Makale, okuyucuyu bu protokolleri detayl\u0131 bir \u015fekilde tan\u0131tan; kullan\u0131lan teknikleri, avantajlar\u0131, dezavantajlar\u0131 ve tuzaklar\u0131 anlatan\u00a0 Radiographics web sitesine y\u00f6nlendirmektedir. Internet sitesi, safra yollar\u0131 anatomisinin normal ve varyasyonlu hallerini detayland\u0131r\u0131rken malign ve benign safra kanallar\u0131 patolojilerine de\u011finmekte, safra ta\u015flar\u0131, kolanjit, biliyer atrezi ve iatrojenik\/travmatik problemleri i\u00e7ermektedir. Bu kapsamda a\u00e7\u0131klanan malign durumlar aras\u0131nda kolanjiyokarsinom, amp\u00fcller, pankreas ve safra kesesi karsinomlar\u0131 yer almaktad\u0131r. De\u011finilen tuzaklar aras\u0131nda artefaktlar\u0131n yanl\u0131\u015f yorumlanmas\u0131ndan ve baz\u0131 varyantlar\u0131n patolojik durumlar\u0131 taklit etmesinden bahsedilmi\u015ftir.<\/p>\n

     <\/p>\n

    Pankreatik Duktal Adenokarsinom ve Varyantlar\u0131: \u0130nciler ve Tuzaklar<\/strong><\/span><\/h5>\n

    Schawkat ve ark.<\/p>\n

    Radiographics<\/p>\n

    Bu kapsaml\u0131 derleme makalesi, solid pankreatik t\u00fcm\u00f6rlerin %90\u2019\u0131n\u0131 olu\u015fturan en yayg\u0131n primer pankreas kanseri pankreatik adenokarsinomun g\u00f6r\u00fcnt\u00fclemesi ve detaylar\u0131n\u0131 anlatmaktad\u0131r. Hastal\u0131\u011f\u0131n epidemiyolojisinden bahseden makale, 5 y\u0131ll\u0131k sa\u011f kal\u0131m oran\u0131n\u0131n %7 kadar d\u00fc\u015f\u00fck oldu\u011fundan s\u00f6z etmekte ve g\u00f6r\u00fcnt\u00fcleme teknikleri anlat\u0131m\u0131na ge\u00e7meden \u00f6nce hastal\u0131\u011f\u0131n histolojisi ve klini\u011fine de\u011finmektedir. Pankreatik kitlelerin de\u011ferlendirilmesinde ince kesitli BT\u2019nin en optimal se\u00e7enek oldu\u011funa de\u011finen makale, pankreatik adenokarsinomlar\u0131n g\u00f6r\u00fcnt\u00fclemede belirsiz, az kontrastlanan ve kom\u015fu pankreas ve safra kanallar\u0131n\u0131 t\u0131kayan bir kitle \u015feklinde ortaya \u00e7\u0131kt\u0131\u011f\u0131ndan bahseder. T\u00fcm\u00f6ral dokunun kanlanmas\u0131 az oldu\u011fu i\u00e7in bilindik adenokarsinom tipleri g\u00f6r\u00fcnt\u00fclemede az kontrastlan\u0131r ve %10\u2019u \u00e7evre parankime g\u00f6re izodenstir, bu durum ise BT\u2019nin etkinli\u011fini azalt\u0131r. Yine de unutulmamal\u0131d\u0131r ki, bu izodens lezyonlar genelde iyi prognozludur ve daha az dezmoplastik stromal doku bar\u0131nd\u0131rmalar\u0131yla bilinirler.\u00a0 Duktal dilasyon ve koledok\u00a0 dilasyonu pankreatik kitlelerin indirekt bulgular\u0131 aras\u0131ndad\u0131r. Pankreatik adenokarsinom, MR\u2019da genelde T1\u2019de hipointensitesi g\u00f6sterir, T2 sinyali de\u011fi\u015fkendir, dif\u00fczyon k\u0131s\u0131tl\u0131l\u0131\u011f\u0131 vard\u0131r. Pankreatik adenokarsinomun di\u011fer benign ve malign fokal pankreatik lezyonlarla kar\u0131\u015fabilen bulgular\u0131 vard\u0131r. Klinik bulgular\u0131n detayl\u0131 de\u011ferlendirilmesi, g\u00f6r\u00fcnt\u00fcleme bulgular\u0131 laboratuvar verileri do\u011fru bir tan\u0131 i\u00e7in kullan\u0131lmal\u0131d\u0131r. Makalede pankreatik adenokarsinomun adenoskuam\u00f6z, undiferansiye, hepatoid, med\u00fcller, signet \u2013 ring ve kolloid gibi daha az yayg\u0131n histolojik alt tipleri de betimlenmektedir.<\/p>\n

     <\/p>\n

    Abdominopelvik Kur\u015fun Yaralanmalar\u0131n G\u00f6r\u00fcnt\u00fclenmesi ve \u0130ncelemesi<\/strong><\/span><\/h5>\n

    Sodagari ve ark.<\/p>\n

    Radiographics<\/p>\n

    Bu Radiographics makalesi,\u00a0 penetran balistik tavmalarda g\u00f6r\u00fcnt\u00fclemenin \u00f6nemini vurgulamaktad\u0131r. Yaz\u0131da balistik fizi\u011fi ve yaralanma mekanizmalar\u0131 gibi konular ayd\u0131nlat\u0131lmaktad\u0131r. En s\u0131k hasar paternleri laserasyon, kavitasyon ve \u015fok dalga etkileridir. \u00a0Ate\u015fli silah yaralanmalar\u0131nda g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemlerine stabil hastalarda ba\u015fvurulmal\u0131 ve hemodinamik a\u00e7\u0131dan stabil olmayan hastalar ameliyathaneye y\u00f6nlendirilip m\u00fcdahale sa\u011fland\u0131ktan sonra g\u00f6r\u00fcnt\u00fclenmeye al\u0131nmal\u0131d\u0131r. G\u00f6r\u00fcnt\u00fclemede kontrastl\u0131 protokoller ele al\u0131n\u0131rken, birden fazla yakla\u015f\u0131m protokol\u00fc oldu\u011fu unutulmamal\u0131, ultrason ile MRG\u2019nin, de\u011ferlendirmede etkinli\u011finin s\u0131n\u0131rl\u0131 oldu\u011fu ve BT\u2019nin genellikle birincil metod kabul edildi\u011fi de bilinmelidir. Makalede sonra solid organ hasar\u0131 tart\u0131\u015f\u0131lm\u0131\u015f ve her organ i\u00e7in AAST skalas\u0131na de\u011finilmi\u015ftir. Muskuloskeletal, n\u00f6rolojik ve diafragmatik hasarlardan da k\u0131saca bahsedilmektedir. Son olarak, makalede takip g\u00f6r\u00fcnt\u00fcleme ve g\u00f6r\u00fcnt\u00fcleme s\u0131ras\u0131nda hastan\u0131n pozisyonlanmas\u0131 ve kooperasyonu, metal par\u00e7ac\u0131klar\u0131n\u0131n yaratabilece\u011fi artefaktlar ve bir an \u00f6nce g\u00f6r\u00fcnt\u00fcleme sonucu \u00f6\u011frenmek isteyen klinisyenler taraf\u0131ndan s\u0131k s\u0131k\u00a0 rahats\u0131z edilmek gibi zorluklar tart\u0131\u015f\u0131lmaktad\u0131r.<\/p>\n

     <\/p>\n

    Abdominal Kistik Lenfanjiomlar\u0131n G\u00f6r\u00fcnt\u00fcleme \u00d6zellikleri, Komplikasyonlar\u0131 ve Ay\u0131r\u0131c\u0131 Tan\u0131lar\u0131<\/strong><\/span><\/h5>\n

    Tistet ve ark.<\/p>\n

    Abdominal Radiology<\/p>\n

    Bu makalede, g\u00f6rece nadir bir vaka olarak bilinen abdominal kistik lenfanjiomlar (AKL) ele al\u0131nmaktad\u0131r. %5\u2019i abdominal tipte g\u00f6r\u00fclen kistik lenfanjiomlar, genelde boyun ve koltuk alt\u0131 b\u00f6lgelerinde saptansa da lenf damarlar\u0131n\u0131n g\u00f6r\u00fcld\u00fc\u011f\u00fc her yerde ortaya \u00e7\u0131kabilir. Abdomende en s\u0131k olarak s\u0131ras\u0131yla mezenterde, omentum majus\u2019da, mezokolon ve retroperitonda g\u00f6r\u00fcl\u00fcrler. AKL g\u00f6r\u00fcnt\u00fclemelerde, ince duvar ve septal\u0131, homojen ser\u00f6z s\u0131v\u0131 i\u00e7eren multilok\u00fcle lezyon olarak g\u00f6r\u00fcl\u00fcrler. Ultrasonda anekoik, BT\u2019de s\u0131v\u0131 aten\u00fcasyonunda ve MR\u2019da d\u00fc\u015f\u00fck T1, y\u00fcksek T2, sinyalindedir. Kontrast sonras\u0131 g\u00f6r\u00fcnt\u00fclerde, kistin duvarlar\u0131 ve septalar, hafif progresif kontraslanma g\u00f6sterebilir. \u0130nce duvar, homojen s\u0131v\u0131 ve \u00e7evre organlara bas\u0131n\u0131n yoklu\u011fu, AKL tan\u0131s\u0131nda gerekli bulgulardand\u0131r. Genelde soliter olan kistler, multiple olarak da g\u00f6r\u00fclebilir. Enfeksiyonlar en s\u0131k komplikasyon olup BT ve MR\u2019da heterojen g\u00f6r\u00fcn\u00fcmdedirler. AKL, ayn\u0131 zamanda intestinal intususepsiyona da yol a\u00e7abilir. Bunun d\u0131\u015f\u0131nda AKL ile g\u00f6r\u00fcnt\u00fclenme bulgular\u0131 benzer olan bir\u00e7ok ay\u0131r\u0131c\u0131 tan\u0131 d\u00fc\u015f\u00fcn\u00fclebilir: lok\u00fcle asit, cisterna chylii, ekstrapankreatik duvarl\u0131 nekroz, duplikasyon kistleri ve kistik teratomlar bunlar aras\u0131ndad\u0131r. Hastan\u0131n anamnezi de kesin tan\u0131da yard\u0131mc\u0131 olacakt\u0131r. Genelde benign ve asemptomatik olan AKL, semptomatik olmas\u0131 halinde cerrahi rezeksiyon gerektirebilir. Vakalar\u0131n %27\u2019sine kadar\u0131nda rek\u00fcrrens olmaktad\u0131r ve perk\u00fctan skleroterapi, alternatif bir tedavi metodu olarak de\u011ferlendirilebilir.<\/p>\n

     <\/p>\n

    Abdominal ve Pelvik Yap\u0131larda Ortaya \u00c7\u0131kan \u201c- sel\u201dlerin Tan\u0131sal \u0130pu\u00e7lar\u0131, Tuzaklar\u0131 ve G\u00f6r\u00fcnt\u00fcleme \u00d6zellikleri<\/strong><\/span><\/h5>\n

    Srisajjakul ve ark.<\/p>\n

    Abdominal Radiology<\/p>\n

    \u201c- sel\u201d eki, antik Yunanca\u2019dan \u201ct\u00fcm\u00f6r\u201d ya da \u201ckavite\u201d anlam\u0131na gelen ektir. Bu makale, abdomen ve pelviste g\u00f6r\u00fclen \u201c- sel\u201dlerin \u00e7e\u015fitlerini, her birinin g\u00f6r\u00fcnt\u00fcleme karakteristiklerini ve tan\u0131sal ipu\u00e7lar\u0131n\u0131 tart\u0131\u015fmaktad\u0131r. Genelde\u00a0 insidental yakalansalar da bazen semptomatik olan \u00a0bu<\/p>\n

    \u201c-sel\u201dlerin daha yayg\u0131n olan tipleri aras\u0131nda hidroseller, varikoseller ya da mukoseller say\u0131labilir ama santorinisel, hematosel ve siringosel \u00a0gibi daha az yayg\u0131n tipleri de makale i\u00e7eri\u011fine dahildir. K\u0131saca s\u00f6z etmek gerekirse, santorinisel, genelde pankreas divisumu olan hastalarda dorsal pankreatik kanal\u0131n (Santorini Kanal\u0131) terminal k\u0131sm\u0131nda g\u00f6r\u00fclen fokal kistik dilatasyonlar olarak tan\u0131mlan\u0131r. MRCP, \u00a0santorinisellere benzeyen Wirsung kanal\u0131ndan \u00e7\u0131kan wirsingosellerden ay\u0131rt edilmelerini sa\u011flar. Siringoseller prostata kom\u015fu bulbo\u00fcretral bezlerden geli\u015fen kistlerdir ve perineal ultrason ya da bulbomembran\u00f6z \u00fcretran\u0131n arka k\u0131sm\u0131ndaki T2 \u2013 hiperintens sinyaller sayesinde MR g\u00f6r\u00fcnt\u00fcleme ile de tan\u0131mlanabilirler. Makalede ayn\u0131 zamanda koledokoseller, \u00fcreteroseller, lenfoseller, spermatoseller ve pyoloseller de tart\u0131\u015f\u0131lmaktad\u0131r.<\/p>\n

     <\/p>\n

    Translated by: Umut Y\u00fccel, Hakan Do\u011fan<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"G\u00fcd\u00fck Apandisit: Klinik ve BT Bulgular\u0131 Enzerra ve ark. AJR Bu makale, apandektomi sonras\u0131 rezid\u00fc […]","protected":false},"author":3,"featured_media":3037,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[209],"tags":[],"class_list":["post-10570","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-tr"],"yoast_head":"\nWhat's new in Gastrointestinal Imaging (Turkish) - December 2020 - ACORE<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/staging-hub.acoredu.com\/whats-new-in-gastrointestinal-imaging-december-2020\/\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What's new in Gastrointestinal Imaging (Turkish) - December 2020 - ACORE\" \/>\n<meta property=\"og:description\" content=\"G\u00fcd\u00fck Apandisit: Klinik ve BT Bulgular\u0131 Enzerra ve ark. 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