{"id":8231,"date":"2020-09-10T16:08:18","date_gmt":"2020-09-10T21:08:18","guid":{"rendered":"https:\/\/cornflowerblue-rail-980953.hostingersite.com\/?p=8231"},"modified":"2020-09-10T16:10:30","modified_gmt":"2020-09-10T21:10:30","slug":"whats-new-in-ultrasonography-turkish-september-2020","status":"publish","type":"post","link":"https:\/\/staging-hub.acoredu.com\/tr\/whats-new-in-ultrasonography-turkish-september-2020\/","title":{"rendered":"What’s new in Ultrasonography (Turkish) – September 2020"},"content":{"rendered":"

Abdominal G\u00f6r\u00fcnt\u00fcleme<\/strong><\/span><\/h3>\n

 <\/p>\n

Primer Ara\u015ft\u0131rma<\/u><\/em><\/strong><\/p>\n

Akut fokal bakteriyel nefrit (akut lober nefroni) ve akut piyelonefrit aras\u0131ndaki g\u00f6r\u00fcnt\u00fcleme bulgular\u0131n\u0131n kar\u015f\u0131la\u015ft\u0131r\u0131lmas\u0131: akut fokal bakteriyel nefrit tan\u0131s\u0131 i\u00e7in ultrasonun yeterlili\u011finin bir \u00f6n de\u011ferlendirmesi<\/strong><\/span><\/h5>\n

Hosokawa T, Tanami Y, Sato Y, Oguma E.<\/p>\n

Emerg Radiol. 2020;27(4):405-412.<\/p>\n

https:\/\/doi.org\/10.1007\/s10140-020-01771-8<\/a><\/p>\n

Arka plan: <\/strong>Akut fokal bakteriyel nefrit (AFBN) i\u00e7in tedavi s\u00fcresi akut piyelonefritten farkl\u0131d\u0131r ve bu nedenle do\u011fru tan\u0131 klinik bir fark yaratabilir.<\/p>\n

Soru: <\/strong>Ultrasonografi, BT ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda AFBN’yi akut piyelonefritten ay\u0131rt edebilir mi?<\/p>\n

Konum: <\/strong>Saitama, Japonya<\/p>\n

Kat\u0131l\u0131mc\u0131lar ve dahil olma kriterleri: <\/strong>24 saatlik s\u00fcre i\u00e7inde kontrastl\u0131 BT ve USG\u2019si bulunan idrar yolu enfeksiyonu olan 11 \u00e7ocuk<\/p>\n

Tasar\u0131m: <\/strong>BT \u00f6zelliklerini (fokal azalm\u0131\u015f kontrastlanma) ultrasonografi \u00f6zellikleriyle (fokal hiperekojenite, apse olu\u015fumu ve diff\u00fcz nefromegali) kar\u015f\u0131la\u015ft\u0131ran retrospektif tasar\u0131m. Analiz i\u00e7in Fisher’\u0131n kesin testi (Fisher\u2019s exact test) kullan\u0131ld\u0131.<\/p>\n

Bulgular: <\/strong>8 hastada AFBN ve 3 hastada akut piyelonefrit (toplam n = 11) vard\u0131. Ultrasonografide kortikomed\u00fcller ayr\u0131mda istatistiksel olarak anlaml\u0131 bir farkl\u0131l\u0131k bulundu, AFBN vakalar\u0131n\u0131n 8’inde (%100) kortikomed\u00fcller ayr\u0131mda kay\u0131p izlenirken ve akut piyelonefrit hastalar\u0131n\u0131n hi\u00e7birinde (%0) kortikomed\u00fcller farkl\u0131la\u015fmada kay\u0131p izlenmedi (P = 0.01). Bu alanlar her durumda BT’de az kontrastlanan alanlara kar\u015f\u0131l\u0131k geldi. \u0130ki hastada BT’de birden fazla lezyon varken ultrasonografide yaln\u0131zca bir fokal anormallik tespit edildi. Ultrasonografide fokal hiperekojenite, apse olu\u015fumu ve yayg\u0131n (dif\u00fcz) nefromegali iki grup aras\u0131nda istatistiksel olarak farkl\u0131 de\u011fildi.<\/p>\n

Sonu\u00e7lar ve a\u00e7\u0131klamalar: <\/strong>Tek ba\u015f\u0131na ultrason, bu k\u00fc\u00e7\u00fck retrospektif \u00e7al\u0131\u015fmadan elde edilen sonu\u00e7lara dayanarak akut fokal bakteriyel nefrit te\u015fhisinde faydal\u0131 olabilir.<\/p>\n

 <\/p>\n

Primer Ara\u015ft\u0131rma<\/u><\/em><\/strong><\/p>\n

Kontrastl\u0131 Ultrasonunun Belirsiz Renal Kitlelerin Klinik Y\u00f6netimi \u00dczerindeki Etkileri: \u0130ki Kurumdan Retrospektif Analiz<\/strong><\/span><\/h5>\n

Eisenbrey JR, Kamaya A, Gummadi S, Bird K, Burrowes D, Arias D, Lallas CD, Trabulsi EJ, Lyshchik A.<\/p>\n

Journal of Ultrasound in Medicine (2020).<\/p>\n

https:\/\/doi.org\/10.1002\/jum.15383<\/a><\/p>\n

Arka plan: <\/strong>Rastlant\u0131sal olarak saptanan b\u00f6brek lezyonlar\u0131 yayg\u0131nd\u0131r ve \u00f6nceki \u00e7al\u0131\u015fmalar, kontrastl\u0131 ultrasonografinin (CEUS-contrast enhanced US) renal kitle karakterizasyonunda etkili bir ara\u00e7 oldu\u011funu g\u00f6stermi\u015ftir.<\/p>\n

Soru:<\/strong> CEUS, belirsiz b\u00f6brek kitlelerini de\u011ferlendirmek i\u00e7in kullan\u0131ld\u0131\u011f\u0131nda uzun vadeli klinik y\u00f6netimi nas\u0131l etkiler?<\/p>\n

Konum: <\/strong>\u0130kili enstit\u00fc: Stanford \u00dcniversitesi; Palo Alto, CA and Thomas Jefferson \u00dcniversitesi, Philadelphia, PA<\/p>\n

Kat\u0131l\u0131mc\u0131lar ve dahil olma kriterleri:<\/strong> Kronik b\u00f6brek hastal\u0131\u011f\u0131 veya nefrektomi ge\u00e7irdi\u011fi belgenen ve herhangi bir tedaviden \u00f6nce CEUS olmu\u015f 157 hastada 215 b\u00f6brek lezyonu.<\/p>\n

Tasar\u0131m:<\/strong> Kontrastl\u0131 ultrason sonras\u0131 lezyonlar\u0131n malignite ve cerrahi oranlar\u0131n\u0131 kar\u015f\u0131la\u015ft\u0131ran retrospektif tasar\u0131m.<\/p>\n

Bulgular: <\/strong>Toplam 215 lezyondan 154’\u00fcn\u00fcn (% 71,6) ya cerrahi olmas\u0131 ya da takip olmamas\u0131, 61’inin (% 28,4) takibi \u00f6nerildi. Bu 154 lezyon i\u00e7inde, 118’inin kontrastl\u0131 ultrason ile iyi huylu oldu\u011fu d\u00fc\u015f\u00fcn\u00fcld\u00fc ve bu nedenle m\u00fcdahale edilmedi. 24\u2019\u00fcne (% 15.6) cerrahi giri\u015fim uyguland\u0131 ve 21\/24 (% 87.5) \u00f6rnekte cerrahi giri\u015fim sonras\u0131 malignite kan\u0131tland\u0131. CEUS’da iyi huylu olarak kabul edilen lezyonlar\u0131n hi\u00e7birinde daha sonra RCC veya RCC \u015f\u00fcphesi saptanmam\u0131\u015ft\u0131r..<\/p>\n

Sonu\u00e7lar ve a\u00e7\u0131klamalar:<\/strong> Kontrastl\u0131 ultrason, belirsiz b\u00f6brek kitlesi olan hastalarda \u00f6nemli bir uzun vadeli klinik etkiye sahip olabilir.<\/p>\n

 <\/p>\n

Primer Ara\u015ft\u0131rma<\/u><\/em><\/strong><\/p>\n

\u201cErken Birinci Trimester Ultrasonunda Yalanc\u0131 Gebelik Kesesi (Pseudogestational Sac)\u201d ve Di\u011fer 1980’ler-D\u00f6nemi Kavramlar\u0131: Bug\u00fcn Hala Ge\u00e7erli mi?<\/strong><\/span><\/h5>\n

Phillips CH, Benson CB, Durfee SM, Heller HT, Doubilet PM.<\/p>\n

Journal of Ultrasound in Medicine. 2020 Feb 11.<\/p>\n

https:\/\/doi.org\/10.1002\/jum.15243<\/a><\/p>\n

Arka plan: <\/strong>\u0130lk trimester obstetrik US’deki bir\u00e7ok klasik \u00f6zellik, 1980’ler de dahil olmak \u00fczere Ultrasonografinin ilk g\u00fcnlerinde tan\u0131mland\u0131. Son y\u0131llarda ultrasonografi ile \u00f6nemli \u00f6l\u00e7\u00fcde iyile\u015ftirilmi\u015f \u00e7\u00f6z\u00fcn\u00fcrl\u00fck dahil \u00e7ok \u015fey de\u011fi\u015fti.<\/p>\n

Soru:<\/strong> Klasik olarak tan\u0131mlanan birinci trimester sonografik \u00f6zellikler bug\u00fcn hala ge\u00e7erli mi?<\/p>\n

Konum: <\/strong>Brigham and Women\u2019s Hospital, Boston, MA<\/p>\n

Kat\u0131l\u0131mc\u0131lar ve dahil olma kriterleri:<\/strong> Vitell\u00fcs kesesi (yolk sac) veya embriyo i\u00e7ermeyen, ekstraovaryan adneksiyal kitlesi olmayan ve gebeli\u011fin yerini belirleyen takip bilgileri olan rahim-i\u00e7i kese benzeri yap\u0131ya sahip 649 sonogram<\/p>\n

Tasar\u0131m: <\/strong>Retrospektif tasar\u0131m. Sonogramlar g\u00f6zden ge\u00e7irildi ve intrauterin koleksiyon etraf\u0131ndaki ekojenik halka, \u00e7ift kese i\u015fareti (DSS- double sac sign) ve intradesidual i\u015faret (IDS- intredecidual sign) dahil olmak \u00fczere \u00f6zellikler var veya yok olarak kaydedildi. Ortalama kese \u00e7ap\u0131 da kaydedildi.<\/p>\n

Bulgular: <\/strong>598 (% 92) intrauterin koleksiyonda ekojenik halka, 182\u2019sinde (% 28) DSS ve 347\u2019sinde (% 54) IDS vard\u0131. 649 hastan\u0131n tamam\u0131nda (daha sonra teyit edilmi\u015f) bir rahim-i\u00e7i gebelik vard\u0131, bu nedenle s\u0131v\u0131 birikimlerinin hi\u00e7birinin yalanc\u0131 bir kese (pseudogestational sac) olmad\u0131\u011f\u0131 ortaya \u00e7\u0131kt\u0131<\/p>\n

Sonu\u00e7lar ve a\u00e7\u0131klamalar: <\/strong>Pozitif bHCG’si olan ve ektopik gebeli\u011fin sonografik bulgusu olmayan hastalarda, intrauterin s\u0131v\u0131 birikiminin bir gebelik kesesi oldu\u011fu hemen hemen kesindir. \u0130ncelenen tarihsel i\u015faretler, ultrasonografi \u00e7\u00f6z\u00fcn\u00fcrl\u00fc\u011f\u00fcndeki art\u0131\u015flar g\u00f6z \u00f6n\u00fcne al\u0131nd\u0131\u011f\u0131nda bug\u00fcn yararl\u0131 olmayabilir.<\/p>\n

 <\/p>\n

Primer Ara\u015ft\u0131rma<\/u><\/em><\/strong><\/p>\n

Kontrastl\u0131 Ultrason LI-RADS 2017: BT \/ MRI LI-RADS ile kar\u015f\u0131la\u015ft\u0131rma<\/strong><\/span><\/h5>\n

Ding J, Long L, Zhang X, Chen C, Zhou H, Zhou Y, Wang Y, Jing X, Ye Z, Wang F.<\/p>\n

European Radiology. 2020 Aug 15:1-8.<\/p>\n

https:\/\/doi.org\/10.1007\/s00330-020-07159-z<\/a><\/p>\n

Arka plan: <\/strong>ACR, 2016 y\u0131l\u0131nda kontrastl\u0131 ultrason (CEUS) karaci\u011fer g\u00f6r\u00fcnt\u00fcleme raporlama ve veri sistemini (LI-RADS) geli\u015ftirdi ve BT ve MRI ile birlikte 2017 s\u00fcr\u00fcm\u00fcne ekledi.<\/p>\n

Soru:<\/strong> CEUS, 2017 LI-RADS s\u00fcr\u00fcm\u00fcn\u00fc kullan\u0131larak BT ve MRI ile nas\u0131l kar\u015f\u0131la\u015ft\u0131r\u0131l\u0131r?<\/p>\n

Location: <\/strong>Tianjin, \u00c7in<\/p>\n

Kat\u0131l\u0131mc\u0131lar ve dahil olma kriterleri:<\/strong> CEUS ve kontrastl\u0131 BT veya MRI yap\u0131lan hepatosel\u00fcler karsinom (HCC) i\u00e7in y\u00fcksek riskli 273 nod\u00fcl\u00fc olan 239 hasta dahil edilme kriterlerini kar\u015f\u0131lad\u0131. T\u00fcm hastalar\u0131n patolojileri mevcuttu.<\/p>\n

Tasar\u0131m: <\/strong>Retrospektif tasar\u0131m. T\u00fcm g\u00f6r\u00fcnt\u00fcleme \u00f6zellikleri en az iki radyolog taraf\u0131ndan g\u00f6zden ge\u00e7irildi ve LI-RADS 2017 versiyonuna g\u00f6re kategorize edildi. Bulgular, alt\u0131n standard olarak patoloji ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131. Modaliteler aras\u0131 uyum Cohen’in kappas\u0131 ile hesapland\u0131.<\/p>\n

Bulgular:<\/strong><\/p>\n

CEUS ve BT \/ MRI aras\u0131ndaki anla\u015fma 0.319 kappa ile adildi (P <0.001).<\/u><\/p>\n\n\n\n\n\n\n
\u00a0<\/strong><\/td>\nPozitif \u00f6ng\u00f6rme de\u011feri<\/strong><\/td>\n<\/tr>\n
\u00a0<\/strong><\/td>\nLR-5<\/strong><\/td>\nLR-4<\/strong><\/td>\nLR-3<\/strong><\/td>\nLR-M<\/strong><\/td>\n<\/tr>\n
CEUS<\/strong><\/td>\n98.3%<\/td>\n60%<\/td>\n25%<\/td>\n33.9%<\/td>\n<\/tr>\n
CT\/MRI<\/strong><\/td>\n95.9%<\/td>\n65.7%<\/td>\n48.1%<\/td>\n93.3%<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/strong><\/p>\n\n\n\n\n\n\n
\u00a0<\/strong><\/td>\nLR-5<\/strong><\/td>\nLR-M<\/strong><\/td>\n<\/tr>\n
\u00a0<\/strong><\/td>\nDuyarl\u0131l\u0131k<\/strong><\/td>\n\u00d6zg\u00fcll\u00fck<\/strong><\/td>\nDuyarl\u0131l\u0131k<\/strong><\/td>\n\u00d6zg\u00fcll\u00fck<\/strong><\/td>\n<\/tr>\n
CEUS<\/strong><\/td>\n75.6%<\/td>\n93.8%<\/td>\n90.9%<\/td>\n84.5%<\/td>\n<\/tr>\n
BT\/MRI<\/strong><\/td>\n83.6%<\/td>\n83.3%<\/td>\n63.6%<\/td>\n99.6%<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Sonu\u00e7lar ve a\u00e7\u0131klamalar:<\/strong> LI-RADS kullan\u0131larak CEUS ve BT\/MRI aras\u0131ndaki modaliteler aras\u0131 uyum sadece adildi, ancak LR-5 lezyonlar\u0131n\u0131n belirlenmesi i\u00e7in kar\u015f\u0131la\u015ft\u0131r\u0131labilir pozitif \u00f6ng\u00f6r\u00fc de\u011ferlerine sahipti. BT\/MRI, LR-M (HCC olmayan) maligniteyi te\u015fhis etmek i\u00e7in daha iyiydi.<\/p>\n

 <\/p>\n

Primer Ara\u015ft\u0131rma:<\/u><\/em><\/strong><\/p>\n

T\u00fcm\u00f6r Biyobelirte\u00e7leri ile Geleneksel ve Kontrastl\u0131 Ultrasonun \u00d6zelliklerinin Kombinasyonuyla Gastrointestinal Stromal T\u00fcm\u00f6rlerin Karaci\u011fere Metastaz\u0131n\u0131n Kolorektal Kanser Metastazklar\u0131ndan Ay\u0131r\u0131c\u0131 Tan\u0131lar\u0131<\/span> <\/strong><\/h5>\n

Yang D, Zhuang B, Wang W, Xie X, Xie X.<\/p>\n

Abdominal Radiology (New York) (2020).<\/p>\n

https:\/\/doi.org\/10.1007\/s00261-020-02592-6<\/a><\/p>\n

Arka plan:<\/strong> Gastrointestinal stromal t\u00fcm\u00f6rler (GIST) yakla\u015f\u0131k \u2155\u2019inin k\u00f6t\u00fc huylu olmas\u0131yla beraber en yayg\u0131n mezenkimal GI t\u00fcm\u00f6rleridir. Karaci\u011fere metastaz yayg\u0131n g\u00f6r\u00fcl\u00fcr ve zaman zaman ilk ke\u015ffedilen abnormalitedir. Karaci\u011fere metastaz\u0131n en yayg\u0131n tipi kolorektal kanserdendir (KRK).<\/p>\n

Soru:<\/strong> Laboratuvar biyobelirte\u00e7lerini kullanarak, US ve CEUS GIST\u2019in karaci\u011fere metastaz\u0131n\u0131 KRK\u2019den tam olarak ay\u0131rt edebilir mi?<\/p>\n

Konum: <\/strong>Guangzhou, \u00c7in<\/p>\n

Kat\u0131l\u0131mc\u0131lar ve dahil edilme kriterleri: <\/strong>Toplamda 160 hasta; 80 GIST\u2019in karaci\u011fere metastazl\u0131 ve 80 KRK\u2019nin karaci\u011fere metastazl\u0131. Hastalar\u0131n analiz i\u00e7in mevcut CEUS\u2019a\u00a0 sahip olmalar\u0131 gerekiyordu.<\/p>\n

Tasar\u0131m:<\/strong> Prospektif tasar\u0131m. Sonografik \u00f6zellikler ve laboratuvar biyomarkerlar\u0131 (CA125 ve CEA) kaydedildi ve \u00e7ok de\u011fi\u015fkenli analizle \u00e7\u00f6z\u00fcmlendi.<\/p>\n

Bulgular: <\/strong>US\u2019da, hipoekojenite, kar\u0131\u015f\u0131k ekojenite ve anekoik alan\u0131n her biri GIST metastaz\u0131 (P<0.05) ile ili\u015fkilendirilmi\u015ftir. CEUS ile ,kaps\u00fcller kontrastlanma, y\u0131kanman\u0131n >40 saniyede ba\u015flamas\u0131 ve kontrastlanmayan alan\u0131n oran\u0131n >%20 olmas\u0131 GIST metastazlar\u0131nda g\u00f6r\u00fclm\u00fc\u015ft\u00fcr (P<0.05). Laboratuvar biomarkerlar\u0131yla sonografik \u00f6zellikler kombinlendi\u011finde duyarl\u0131l\u0131k %70\u2019e, \u00f6zg\u00fcll\u00fck %97.5\u2019e y\u00fckseldi.<\/p>\n

Sonu\u00e7 ve g\u00f6r\u00fc\u015f: <\/strong>GIST\u2019in karaci\u011fere metastaz\u0131, \u00f6zellikle laboratuvar biomarkerlar\u0131yla (CA125 ve CEA) kombine edildi\u011finde, KRK\u2019nin karaci\u011fere metastaz\u0131ndan ay\u0131rt edilmesine yard\u0131mc\u0131 olabilecek sonografik \u00f6zelliklere sahiptir.<\/p>\n

 <\/p>\n

Primer Ara\u015ft\u0131rma<\/u><\/strong><\/em><\/p>\n

Y\u00fcksek Riskli Bireylerde Hepatosell\u00fcler Karsinom Tan\u0131s\u0131 i\u00e7in K\u00fck\u00fcrt Ekzaflor\u00fcr ve Perflorb\u00fctan ile Kontrastl\u0131 US<\/strong><\/span><\/h5>\n

Kang HJ, Lee JM, Yoon JH, Lee K, Kim H, Han JK.<\/p>\n

Radiology, 200115.<\/p>\n

https:\/\/doi.org\/10.1148\/radiol.2020200115<\/a><\/p>\n

Arka plan: <\/strong>K\u00fck\u00fcrt hekzaflor\u00fcr (SHF) yayg\u0131n bir \u015fekilde kullan\u0131lan tamam\u0131yla intravask\u00fcler bir US kontrast ajan\u0131d\u0131r. Perflorb\u00fctan (PFB)\u00a0 Kuppfer faz\u0131nda kontrast\u0131n Kupffer h\u00fccrelerine al\u0131m\u0131yla karaci\u011fer parankiminin de\u011ferlendirmesine izin veren daha az yayg\u0131n kullan\u0131lan bir kontrast ajan\u0131d\u0131r.<\/p>\n

Soru: <\/strong>LI-RADS\u00a0 2017 versiyonu kullan\u0131larak yap\u0131lan HCC de\u011ferledirmesinde SHF ve PFB\u2019nin k\u0131yaslanmas\u0131.<\/p>\n

Konum: <\/strong>Seul,Kore<\/p>\n

Kat\u0131l\u0131mc\u0131lar ve dahil edilme kriterleri: <\/strong>\u00a0HCC i\u00e7in y\u00fcksek risk ta\u015f\u0131yan ve LR-3 veya daha y\u00fcksek LI-RADS katergorilerine sahip daha \u00f6nce tedavi edilmemi\u015f 59 kat\u0131l\u0131mc\u0131.<\/p>\n

Tasar\u0131m:<\/strong> Prospektif tasar\u0131m. Hastalar ayn\u0131 g\u00fcn i\u00e7inde SHF ve PFB kullan\u0131lan CEUS\u2019a girdiler. Arteriyel fazda yo\u011fun kontrastlanma (APHE), y\u0131kanma s\u00fcresi ve derecesi ve Kupffer s\u00fcrecinde ekojenite PFB i\u00e7in kaydedildi. McNemar testi analiz i\u00e7in kullan\u0131ld\u0131.<\/p>\n

Bulgular: <\/strong>HCC\u2019nin hafif ve ge\u00e7 y\u0131kanmas\u0131 (\u2265 60 saniye) PFB (79%) kullan\u0131m\u0131nda SHF (53%) kullan\u0131m\u0131na g\u00f6re daha s\u0131k g\u00f6r\u00fclm\u00fc\u015ft\u00fcr (P=0.04). PFB kullanarak Kupffer fazda yo\u011fun kontrastlanma malign (92%) lezyonlarda benign (33%) lezyonlara g\u00f6re daha yo\u011fundu. PFB kullan\u0131m\u0131nda duyarl\u0131l\u0131k 79%, SHF ile 54% iken, \u00f6zg\u00fcll\u00fck ikisinde de 100%\u2019d\u00fc.<\/p>\n

Sonu\u00e7 ve g\u00f6r\u00fc\u015f: <\/strong>LI-RADS\u2019\u0131n 2017 versiyonu kullan\u0131larak perflorb\u00fctan CEUS k\u00fck\u00fcrt hekzaflor\u00fcrden daha y\u00fcksek tan\u0131 performans\u0131na sahip oldu.<\/p>\n

 <\/p>\n

Giri\u015fimsel Radyoloji<\/strong><\/span><\/h3>\n

 <\/p>\n

Primer Ara\u015ft\u0131rma<\/u><\/strong><\/em><\/p>\n

US k\u0131lavuzlu\u011funda portal vene ula\u015f\u0131m ve portal vene perk\u00fctan tel yerle\u015ftirme, TIPS yerle\u015ftirme s\u00fcrecinde daha k\u0131sa prosed\u00fcr s\u00fcreleri ve daha d\u00fc\u015f\u00fck radyasyon dozlar\u0131 ile ili\u015fkilendirildi.<\/strong><\/span><\/h5>\n

Cam I, Gencturk M, Shrestha P, Golzarian J, Flanagan S, Lim N, Young S.<\/p>\n

AJR Am J Roentgenol. 2020.<\/p>\n

https:\/\/doi.org\/10.2214\/AJR.20.23846<\/a><\/p>\n

Arka plan: <\/strong>Transjuguler \u0130ntrahepatik Portosistemik \u015eant (TIPS) portal hipertansiyonun komplikasyonlar\u0131n\u0131n \u00e7o\u011funu etkili bir bi\u00e7imde tedavi edebilir ve birka\u00e7 farkl\u0131 yolla uygulanabilir.<\/p>\n

Soru: <\/strong>TIPS\u2019i uygularken hangi tedavi y\u00f6ntemi en etkilidir?<\/p>\n

Konum: <\/strong>Minnesota \u00dcniversitesi,Minneapolis, MN<\/p>\n

Kat\u0131l\u0131mc\u0131lar ve dahil edilme kriterleri: <\/strong>TIPS\u2019in a\u015fa\u011f\u0131daki 3 yolundan 1\u2019ini tamamlam\u0131\u015f 264 hasta:<\/p>\n

Grup 1 (G1): Transabdominal-US rehberli\u011finde<\/p>\n

Grup 2 (G2): Floroskopibi rehberli\u011finde wedge hapatik portografi<\/p>\n

Grup 3 (G3): Floroskopi ile k\u0131lavuz telle perk\u00fctan yoldan portal vene ula\u015f\u0131m<\/p>\n

Tasar\u0131m: <\/strong>Floroskopi zaman\u0131n\u0131, anestezi zaman\u0131n\u0131, kullan\u0131lan kontrast hacmini ve intrahepatik i\u011fne ge\u00e7i\u015fleri say\u0131s\u0131n\u0131 de\u011ferlendiren retrospektif tasar\u0131m.<\/p>\n

Bulgular: <\/strong>\u00a0De\u011ferler ve \u00f6nemli farkl\u0131l\u0131klar i\u00e7in tabloya bak\u0131n\u0131z. (Listelenmeyen farkl\u0131l\u0131klar P\u22640.005\u2019ye dayanarak anlaml\u0131 de\u011fildir.)<\/p>\n

G1 ve G3\u2019den komplikasyonlar topland\u0131\u011f\u0131nda, G2 daha fazla komplikasyona sahipti (p=0.013).\u00a0<\/strong><\/p>\n\n\n\n\n\n\n\n
\u00a0<\/strong><\/td>\nGrup 1 (n=54)<\/strong><\/td>\nGrup 2 (n=172)<\/strong><\/td>\nGrup 3 (n=38)<\/strong><\/td>\n\u00d6nemli Farkl\u0131l\u0131klar (P-de\u011feri)<\/strong><\/td>\n<\/tr>\n
Floroskopi zaman\u0131 (ortalama)<\/strong><\/td>\n34.8 dakika<\/td>\n38.9 dakika<\/td>\n29.5 dakika<\/td>\nG2, G3\u2019ten daha uzun<\/u> (P=0.005)<\/td>\n<\/tr>\n
Total anestezi s\u00fcresi (ortalama)<\/strong><\/td>\n190.2 dakika<\/td>\n199.7 dakika<\/td>\n162.6 dakika<\/td>\nG3, G1 <\/u>(p=0.003) ve G2<\/u> (P=0.005)\u2019den daha k\u0131sa<\/td>\n<\/tr>\n
Kontrast hacmi<\/strong><\/td>\n67.9 mL<\/td>\n87.1 mL<\/td>\n—<\/td>\nG1, G2\u2019den daha d\u00fc\u015f\u00fck<\/u> (p=0.005)<\/td>\n<\/tr>\n
Intrahepatik \u0130\u011fne\u00a0 ge\u00e7i\u015fi (ortalama)<\/strong><\/td>\n2<\/td>\n4<\/td>\n2<\/td>\nG2, G1<\/u> (p=0.004) ve G3<\/u> (p=0.039)\u2019ten daha b\u00fcy\u00fck<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Sonu\u00e7 ve g\u00f6r\u00fc\u015f: <\/strong>US-rehberli (grup 1) ve k\u0131lavuz tel ile perk\u00fctan yoldan portal vene ula\u015f\u0131m (grup 3) TIPS i\u00e7in daha k\u0131sa floroskopi ve anestezi s\u00fcrelerine sahip oldu\u011fu gibi potansiyel olarak daha az komplikasyona sebep olur.<\/p>\n

 <\/p>\n

Toraks Radyolojisi<\/strong><\/span><\/h3>\n

 <\/p>\n

Coronavir\u00fcs (COVID-19)\u00a0 Hastalar\u0131nda Akci\u011fer Ultrason Bulgular\u0131<\/strong><\/span><\/h5>\n

Zhang Y, Xue H, Wang M, He N, Lv Z, Cui L.<\/p>\n

AJR Am J Roentgenol. 2020;1-5.<\/p>\n

https:\/\/doi.org\/10.2214\/AJR.20.23513<\/a><\/p>\n

Arka Plan: <\/strong>COVID-19 pn\u00f6monisinin BT bulgular\u0131 \u00e7ok tan\u0131mland\u0131 ancak akci\u011fer US \u00fczerine bulgular daha az belgelenmi\u015ftir.<\/p>\n

Soru: <\/strong>COVID-19 pn\u00f6monisindeki tipik akci\u011fer sonografisi bulgular\u0131 nelerdir ve hastal\u0131\u011f\u0131n \u015fiddeti, s\u00fcresi ile aras\u0131nda bir ili\u015fki var m\u0131d\u0131r?<\/p>\n

Konum: <\/strong>Beijing, \u00c7in<\/p>\n

Kat\u0131l\u0131mc\u0131lar ve dahil edilme kriterleri: <\/strong>SARS-CoV-2 pozitif PCR testine ve akci\u011fer US\u2019nuna sahip 28 hasta (14 kad\u0131n ve 14 erkek).<\/p>\n

Tasar\u0131m: <\/strong>Retrospektif tasar\u0131m ile akci\u011fer sonogrofik \u00f6zellikleri de\u011ferlendirildi ve belgelendi. Fisher\u2019\u0131n Kesin Olas\u0131l\u0131k Testi hastal\u0131k s\u00fcresini ve \u015fiddetini kar\u015f\u0131la\u015ft\u0131rmak i\u00e7in kullan\u0131ld\u0131.<\/p>\n

Bulgular: <\/strong>28 hastan\u0131n t\u00fcm\u00fc (%100) US\u2019da anormal akci\u011fer bulgular\u0131na sahipti. En yayg\u0131n bulgular; 28 hastan\u0131n hepsinde (%100) B-\u00e7izgileri, 19 hastada (%67.9) konsolidasyon ve 17 hastada (%60.7) kal\u0131nla\u015fm\u0131\u015f plevral \u00e7izgilerdi. Kal\u0131nla\u015fm\u0131\u015f plevral \u00e7izgiler hastal\u0131\u011f\u0131n uzun s\u00fcresiyle ili\u015fkilendirildi ve konsolidasyon \u015fiddetli vakalarda daha s\u0131kt\u0131 (ikisi de p\u22640.05).<\/p>\n

Sonu\u00e7 ve g\u00f6r\u00fc\u015f: <\/strong>B-\u00e7izgileri, konsolidasyon ve kal\u0131nla\u015fm\u0131\u015f plevral \u00e7izgiler COVID-19 pn\u00f6monisinin yayg\u0131n sonografik bulgular\u0131d\u0131r. Konsolidasyon ve kal\u0131nla\u015fm\u0131\u015f plevral \u00e7izgiler hastal\u0131\u011f\u0131n s\u0131ras\u0131yla \u015fiddetini ve s\u00fcresini tahmini olarak g\u00f6sterebilir.<\/p>\n

 <\/p>\n

Yayg\u0131n K\u0131saltmalar<\/strong><\/p>\n

US:<\/strong> Ultrason<\/p>\n

CEUS:<\/strong> Kontrastl\u0131 Ultrason<\/p>\n

HCC:<\/strong> Hepatosell\u00fcler Karsinom<\/p>\n

BT:<\/strong> Bilgisayarl\u0131 Tomografi<\/p>\n

MRI:<\/strong> Manyetik Rezonans G\u00f6r\u00fcnt\u00fcleme<\/p>\n","protected":false},"excerpt":{"rendered":"Abdominal G\u00f6r\u00fcnt\u00fcleme   Primer Ara\u015ft\u0131rma Akut fokal bakteriyel nefrit (akut lober nefroni) ve akut piyelonefrit […]","protected":false},"author":3,"featured_media":2490,"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-8231","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-tr"],"yoast_head":"\nWhat's new in Ultrasonography (Turkish) - September 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-ultrasonography-september-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 Ultrasonography (Turkish) - 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