{"id":9688,"date":"2020-11-14T13:12:58","date_gmt":"2020-11-14T18:12:58","guid":{"rendered":"https:\/\/cornflowerblue-rail-980953.hostingersite.com\/?p=9688"},"modified":"2020-11-15T01:08:14","modified_gmt":"2020-11-15T06:08:14","slug":"whats-new-in-liver-imaging-turkish-november-2020","status":"publish","type":"post","link":"https:\/\/staging-hub.acoredu.com\/tr\/whats-new-in-liver-imaging-turkish-november-2020\/","title":{"rendered":"What’s new in Liver Imaging (Turkish) – November 2020"},"content":{"rendered":"

HCC<\/strong><\/span><\/h3>\n

 <\/p>\n

Karaci\u011fer G\u00f6r\u00fcnt\u00fcleme Raporlama Ve Veri Sistemi Damar-\u0130\u00e7i-T\u00fcm\u00f6r Kategorisi: Sistematik Bir \u0130nceleme Ve Meta-Analiz.<\/strong><\/span><\/h5>\n

Kim DH, Choi Sh, Park SH ve ark. Eur Radiol<\/em>. Springer; 2020; 1-10.<\/p>\n

\u015eu adresten temin edilebilir: http:\/\/link.springer.com\/10.1007\/s00330-020-07282-x<\/a>.<\/p>\n

Anahtar kelimeler:<\/strong> LI-RADS, MRG, BT, HCC<\/p>\n

Klinik soru: <\/strong><\/p>\n

    \n
  1. LR-TIV vakalar\u0131nda altta yatan etiyoloji nedir?<\/li>\n
  2. LR-TIV kategorisini kullanan raporlarda heterojenli\u011fin nedeni nedir?<\/li>\n<\/ol>\n

    Ne yap\u0131ld\u0131:<\/strong> HCC ve HCC olmayanlar\u0131n y\u00fczdeleri, LR-TIV’li vakalar\u0131n birle\u015ftirilmi\u015f meta-analitik verilerinden hesapland\u0131.<\/p>\n

    Nas\u0131l yap\u0131ld\u0131:<\/strong> MEDLINE ve EMBASE ile bulunan \u00f6nceki 16 \u00e7al\u0131\u015fman\u0131n meta-analizi. Bunlar\u0131n aras\u0131nda, 98’i (%65) HCC’ye ve 52’si (%35) HCC olmayan t\u00fcm\u00f6rlere ba\u011fl\u0131 olan 150 LR-TIV vakas\u0131 vard\u0131.<\/p>\n

    Bulgular ve sonu\u00e7lar:<\/strong> Birle\u015ftirilmi\u015f meta-analitik y\u00fczdeler, LR-TIV vakalar\u0131n\u0131n %70.9’unun HCC’ye ba\u011fl\u0131 oldu\u011funu, %29.2’sinin HCC olmayan t\u00fcm\u00f6rlere ba\u011fl\u0131 oldu\u011funu g\u00f6stermi\u015ftir. Hepatit C’li vakalar, LR-TIV nedeni ile daha y\u00fcksek birle\u015ftirilmi\u015f HCC y\u00fczdelerine sahipti. \u0130lgin\u00e7 bir \u015fekilde, referans standart olarak sadece patolojik tan\u0131n\u0131n kullan\u0131ld\u0131\u011f\u0131 6 \u00e7al\u0131\u015fmada (di\u011fer 10 \u00e7al\u0131\u015fmada patolojik tan\u0131 ve g\u00f6r\u00fcnt\u00fcleme takibinin bir kombinasyonunu kulland\u0131), HCC’nin birle\u015ftirilmi\u015f y\u00fczdeleri ortalamadan daha d\u00fc\u015f\u00fckt\u00fc.<\/p>\n

    Karar: <\/strong>HCC, referans standard\u0131na, co\u011frafi farkl\u0131l\u0131klara ve \u00e7al\u0131\u015fma tasar\u0131m\u0131na ba\u011fl\u0131 olarak HCC olmayanlara g\u00f6re LR-TIV i\u00e7in daha yayg\u0131n altta yatan bir etiyolojiydi.<\/p>\n

    Anlamlar\u0131:<\/strong> HCC en s\u0131k bildirilen etiyoloji olmas\u0131na ra\u011fmen, herhangi bir malignite damar i\u00e7i t\u00fcm\u00f6rlere neden olabilir. Tan\u0131 i\u00e7in kullan\u0131lan referans standart, LR-TIV’de HCC ve HCC olmayanlar\u0131n y\u00fczdesini etkileyebilir. \u00c7al\u0131\u015fma tasar\u0131m\u0131n\u0131n rapor heterojenli\u011fine neden olan \u00f6nemli bir fakt\u00f6r oldu\u011fu bulunmu\u015ftur.<\/p>\n

     <\/p>\n

    LI\u2013RADS Kategori 5 Hepatosell\u00fcler Karsinom: K\u00fcratif Rezeksiyon Sonras\u0131 Erken N\u00fcks Riski Stratifikasyonu \u0130\u00e7in Preoperatif Gadoksetik Asitli MRG<\/strong><\/span><\/h5>\n

    Wei H, Jiang H, Zheng T ve ark. Eur Radiol<\/em>. Springer; 2020; 1-14.<\/p>\n

    \u015eu adresten temin edilebilir:\u00a0 https:\/\/www.sciencedirect.com\/science\/article\/pii\/S1665268120300685?via%3Dihub<\/a>http:\/\/link.springer.com\/10.1007\/s00330-020-07303-9<\/a>.<\/p>\n

    Anahtar kelimeler:<\/strong> LI-RADS, risk stratifikasyonu, Gadoksetik asit, MRG, HCC<\/p>\n

    Klinik soru:<\/strong> LR-5 HCC’nin (v2018) k\u00fcratif rezeksiyonundan sonra erken n\u00fcks risk stratifikasyonunda preoperatif gadoksetatl\u0131 MRG’nin rol\u00fc nedir?<\/p>\n

    Ne yap\u0131ld\u0131:<\/strong> K\u00fcr ama\u00e7l\u0131 rezeksiyondan sonra erken n\u00fcks (ameliyattan sonraki 2 y\u0131l i\u00e7inde) olan 103 HCC’li (LR-5) hastada gadoksetik asitli MRG’yi de\u011ferlendiren prospektif bir \u00e7al\u0131\u015fma.<\/p>\n

    Nas\u0131l yap\u0131ld\u0131:<\/strong> K\u00fcratif rezeksiyondan \u00f6nceki 2 hafta i\u00e7inde gadoksetatl\u0131 3.0 T MRG yap\u0131lan HCC (siroz veya kronik hepatit B enfeksiyonu) geli\u015fme riski y\u00fcksek 207 hasta (Child-Pugh A) 2 y\u0131la kadar takip edildi. Sadece patolojik olarak do\u011frulanm\u0131\u015f intra- veya ekstra-hepatik HCC’ye sahip olanlar dahil edildi. Erken n\u00fcks i\u00e7in olas\u0131 belirleyicileri saptamak i\u00e7in Cox (oransal risk) regresyon analizi yap\u0131ld\u0131.<\/p>\n

    Bulgular ve sonu\u00e7lar:<\/strong> 103 hastan\u0131n 53’\u00fcnde erken n\u00fcks vard\u0131. Erken n\u00fcks ile anlaml\u0131 olarak ili\u015fkili MRG bulgular\u0131 aras\u0131nda korona kontrastlanmas\u0131, hepatobiliyer fazda perit\u00fcm\u00f6ral hipointensite ve satelit nod\u00fcl\u00fc vard\u0131. Hastalar LR-5a’ya (yukar\u0131da belirtilen MR belirleyicilerinin hi\u00e7biri), LR-5b’ye (bir belirleyiciye) veya LR-5c’ye (iki veya \u00fc\u00e7 belirleyiciye) ayr\u0131ld\u0131 ve s\u0131ras\u0131yla %65, %39 ve %6’l\u0131k 2 y\u0131ll\u0131k hastal\u0131ks\u0131z sa\u011f kal\u0131ma sahip bulundu. AFP > 400 ng\/mL de bir risk fakt\u00f6r\u00fc olarak bulundu.<\/p>\n

    Karar:<\/strong> LR-5 HCC’nin cerrahi rezeksiyonundan sonra erken hastal\u0131k n\u00fcks\u00fcn\u00fcn preoperatif tahmini, korona kontrastlanmas\u0131, hepatobiliyer fazda perit\u00fcm\u00f6ral hipointensite ve satelit nod\u00fcl\u00fcn\u00fc i\u00e7eren MR \u00f6zellikleri kullan\u0131larak yap\u0131labilir.<\/p>\n

    Anlamlar\u0131:<\/strong> Korona kontrastlanmas\u0131, HBP’de perit\u00fcm\u00f6ral hipointensite ve satelit nod\u00fcllerinin varl\u0131\u011f\u0131 gibi gadoksetat ile geli\u015ftirilmi\u015f MRG bulgular\u0131, hastal\u0131ks\u0131z sa\u011fkal\u0131m\u0131n tahmin edilmesine yard\u0131mc\u0131 olabilir.<\/p>\n

     <\/p>\n

    KARAC\u0130\u011eER G\u00d6R\u00dcNT\u00dcLEME TEKN\u0130KLER\u0130<\/strong><\/span><\/h3>\n

     <\/p>\n

    Karaci\u011fer Dif\u00fczyon A\u011f\u0131rl\u0131kl\u0131 G\u00f6r\u00fcnt\u00fclemede, Kardiyak Hareket Artefakt\u0131n\u0131n Solunum D\u00f6ng\u00fcs\u00fcne Ba\u011f\u0131ml\u0131l\u0131\u011f\u0131 \u00dczerine<\/strong><\/span><\/h5>\n

    Riexinger A, Laun FB, bickelhaupt S, ve ark. Baltzer Pat, edit\u00f6r. PLoS One<\/em>. Public Library of Science; 2020;15(10): e0239743.<\/p>\n

    \u015eu adresten temin edilebilir: https:\/\/dx.plos.org\/10.1371\/journal.pone.0239743<\/a>.<\/p>\n

    Anahtar kelimeler:<\/strong> MRG, hareket artefakt\u0131, DAG<\/p>\n

    Klinik soru:<\/strong> \u0130nspirasyonda elde edilen dif\u00fczyon a\u011f\u0131rl\u0131kl\u0131 g\u00f6r\u00fcnt\u00fcleme, sol hepatik lob \u00fczerindeki kardiyak hareket artefakt\u0131n\u0131 azaltabilir mi?<\/p>\n

    Ne yap\u0131ld\u0131:<\/strong> Bilinen veya \u015f\u00fcphelenilen fokal karaci\u011fer lezyonlar\u0131 olan 43 hastada inspirasyon ve ekspirasyonda elde edilen MRG DAG taramalar\u0131nda kardiyak hareket artefakt\u0131n\u0131n prospektif kar\u015f\u0131la\u015ft\u0131rmal\u0131 \u00e7al\u0131\u015fmas\u0131.<\/p>\n

    Nas\u0131l Yap\u0131ld\u0131: <\/strong>T\u00fcm hastalar nefes kontroll\u00fc \u015fekilde1.5T taray\u0131c\u0131da \u00e7ekildi. Diff\u00fczyon a\u011f\u0131rl\u0131kl\u0131 g\u00f6r\u00fcnt\u00fcleme (DAG) sekanslar\u0131, hasta nefesini tutarken inspirasyonda ve ekspirasyonda b = 50 s\/mm2 ve 800 s\/mm2 i\u00e7in elde edildi. Likert \u00f6l\u00e7e\u011fi kullan\u0131larak sekanslar\u0131n kalitatif analizi 2 okuyucu taraf\u0131ndan ger\u00e7ekle\u015ftirildi. Normalize sinyal, her hastan\u0131n DAG sekanslar\u0131 i\u00e7in her iki b de\u011ferinde sol hepatik lob \u00fczerinde bir ilgi b\u00f6lgesi \u00e7izilerek hesapland\u0131. Wilcoxon i\u015faretli s\u0131ralar testi, her hasta i\u00e7in inspirasyon ve ekspirasyon aras\u0131ndaki kantitatif analiz i\u00e7in kullan\u0131ld\u0131.<\/p>\n

    Bulgular ve sonu\u00e7lar: <\/strong>\u0130nspirasyondaki normalle\u015ftirilmi\u015f sinyal, herhangi bir istatistiksel \u00f6nemi olmaks\u0131z\u0131n ekspirasyondakinden biraz daha y\u00fcksekti. Kalitatif de\u011ferlendirme hi\u00e7bir farkl\u0131l\u0131k g\u00f6stermedi.<\/p>\n

    Sonu\u00e7<\/strong>: Sol hepatik lobdaki pulsasyon artefakt\u0131nda DAG sekanslar\u0131nda inspirasyon s\u0131ras\u0131nda ekspirasyon ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda \u00f6nemli bir fark yoktur.<\/p>\n

    \u00c7\u0131kar\u0131mlar:<\/strong> Karaci\u011ferde DAG sekans\u0131 s\u0131ras\u0131nda hastan\u0131n nefesini tutmas\u0131 kardiyak hareket artefakt\u0131n\u0131 azaltabilirken, DAG sekans\u0131n\u0131n inspirasyon veya ekspirasyon s\u0131ras\u0131nda al\u0131nmas\u0131 aras\u0131nda \u00f6nemli bir fark yoktur.<\/p>\n

     <\/p>\n

    MRG’de Karaci\u011fer Y\u00fczey Nod\u00fclaritesinin Yar\u0131 Otomatik \u00d6l\u00e7\u00fcm Y\u00f6ntemiyle Karaci\u011fer Fibrozisinin Evrelendirilmesi<\/strong><\/span><\/h5>\n

    Kim SW, Kim YR, Choi KH, et al. Am J Roentgenol<\/em>. American Roentgen Ray Society; 2020;215(3):624\u2013630<\/p>\n

    \u015euradan ula\u015f\u0131labilir: https:\/\/www.ajronline.org\/doi\/10.2214\/AJR.19.22041<\/a>.<\/p>\n

    Anahtar Kelimeler: <\/strong>MRG, Karaci\u011fer Fibrozisi, yar\u0131 otomatik<\/p>\n

    Klinik soru:<\/strong> Karaci\u011fer fibrozisinin evrelendirilmesi i\u00e7in kontrastl\u0131 MRG’de karaci\u011fer y\u00fczey nod\u00fcleritesini (LSN) \u00f6l\u00e7mek i\u00e7in yar\u0131 otomatik y\u00f6ntem kullan\u0131lmas\u0131n\u0131n do\u011frulu\u011fu nedir?<\/p>\n

    Ne yap\u0131ld\u0131:<\/strong> Yar\u0131 otomatik LSN kantifikasyon yaz\u0131l\u0131m\u0131 geli\u015ftirilmi\u015f ve bu yaz\u0131l\u0131m hesaplanan Metavir skoruna kar\u015f\u0131 do\u011fruluk a\u00e7\u0131s\u0131ndan de\u011ferlendirilmi\u015ftir.<\/p>\n

    Nas\u0131l yap\u0131ld\u0131: <\/strong>Kronik karaci\u011fer hastal\u0131\u011f\u0131 evrelemesi i\u00e7in histopatoloji ile biyopsi yap\u0131lmadan 6 ay \u00f6nce veya sonra gadoksetatl\u0131 karaci\u011fer MRG yap\u0131lan 132 hastan\u0131n retrospektif \u00e7al\u0131\u015fmas\u0131. T\u00fcm hastalarda ayr\u0131ca AST ve trombosit serum seviyeleri ve fibrozis-4 indeksi bulunuyordu.<\/p>\n

    Bulgular ve sonu\u00e7lar:<\/strong> LSN i\u00e7in e\u011fri alt\u0131nda kalan alanlar F0-F1’e kar\u015f\u0131 F2-F4, F0-F2’ye kar\u015f\u0131 F3-F4 ve F0-F3\u2019e kar\u015f\u0131 F4 i\u00e7in s\u0131ras\u0131yla 0.93, 0.98 ve 0.83’e e\u015fitti. Bu sonu\u00e7larda LSN skoru ve Metavir skoru y\u00fcksek korelasyona sahipti (Spearman katsay\u0131s\u0131 0.713).<\/p>\n

    Sonu\u00e7:<\/strong> Yazarlar taraf\u0131ndan geli\u015ftirilen algoritmaya g\u00f6re yar\u0131 otomatik olarak hesaplanan LSN skoru, y\u00fcksek do\u011frulu\u011fa sahiptir ve patolojik fibrozis evresi ile ili\u015fkilidir.<\/p>\n

    \u00c7\u0131kar\u0131mlar:<\/strong> MRG \u00f6zelliklerine g\u00f6re yar\u0131 otomatik olarak LSN’yi hesaplama y\u00f6ntemi, karaci\u011fer fibrozisinin evrelendirilmesi i\u00e7in invaziv olmayan, uygulanabilir bir y\u00f6ntem olabilir.<\/p>\n

     <\/p>\n

    KARAC\u0130\u011eER: D\u0130\u011eER<\/strong><\/span><\/h3>\n

     <\/p>\n

    Kolorektal Karaci\u011fer Metastaz\u0131n\u0131n Periferindeki Karaci\u011fer Parankiminin MRG Bulgular\u0131: Uzun D\u00f6nem Prognozun Potansiyel Bir Predikt\u00f6r\u00fc<\/strong><\/span><\/h5>\n

    Nakai Y, Gonoi W, Kurokawa R, et al. Radiology<\/em>. Radiological Society of North America ; 2020;202367.<\/p>\n

    \u015euradan Ula\u015f\u0131labilir: http:\/\/pubs.rsna.org\/doi\/10.1148\/radiol.2020202367<\/a>.<\/p>\n

    Anahtar kelimeler:<\/strong> MRG, kolorektal metastaz, prognoz<\/p>\n

    Klinik soru: <\/strong>Gadoksetatla g\u00fc\u00e7lendirilmi\u015f MRG kullanarak, kolorektal karaci\u011fer metastazlar\u0131n\u0131n (KKM’ler) periferindeki karaci\u011fer parankiminin g\u00f6r\u00fcnt\u00fcleme bulgular\u0131yla uzun vadeli prognozu tahmin edebilir miyiz?<\/p>\n

    Ne yap\u0131ld\u0131:<\/strong> KKM’lerin periferindeki\u00a0 karaci\u011fer parankim MRG bulgular\u0131 ile patolojik damar ve safra kanal\u0131 invazyonu aras\u0131ndaki ili\u015fki de\u011ferlendirildi.<\/p>\n

    Nas\u0131l Yap\u0131ld\u0131:<\/strong> Neoadjuvan kemoterapi olmaks\u0131z\u0131n KKM i\u00e7in k\u00fcratif cerrahiden \u00f6nce -gadoksetik asit uygulanan 106 hastan\u0131n retrospektif \u00e7al\u0131\u015fmas\u0131. 3 abdominal radyolog, KKM’lere periferik alandaki erken kontrastlanmay\u0131, azalm\u0131\u015f kontrast tutulumunu ve safra kanal\u0131 dilatasyonunu MRG’de de\u011ferlendirdi. T\u00fcm t\u00fcm\u00f6r \u00f6rnekleri, \u00e7evreleyen damarlar\u0131n ve safra kanallar\u0131n\u0131n invazyonu a\u00e7\u0131s\u0131ndan yeniden de\u011ferlendirildi. Cox orant\u0131l\u0131 tehlike modeli ve Bayesian bilgi kriteri, rek\u00fcrrenssiz sa\u011fkal\u0131m ve genel sa\u011fkal\u0131m\u0131n predikt\u00f6rlerini belirlemek i\u00e7in kullan\u0131ld\u0131.<\/p>\n

    Bulgular ve sonu\u00e7lar:<\/strong> 106 hastada 148 KKM de\u011ferlendirildi. T\u00fcm\u00f6r\u00fcn periferindeki safra kanal\u0131 dilatasyonu, patolojik portal ven ve safra kanal\u0131 invazyonunun yan\u0131 s\u0131ra k\u0131sa rek\u00fcrrenssiz ve genel sa\u011fkal\u0131m ile de ili\u015fkiliydi. T\u00fcm\u00f6r\u00fcn periferindeki alanda erken kontrastlanma, azalm\u0131\u015f gadoksetik asit al\u0131m\u0131 ve safra kanal\u0131 dilatasyonunun kombinasyonu, k\u0131sa genel sa\u011fkal\u0131m\u0131n predikt\u00f6r\u00fcyd\u00fc.<\/p>\n

    Sonu\u00e7 \/ \u00c7\u0131kar\u0131mlar: <\/strong>KKM’lerin periferindeki MRG bulgular\u0131 k\u00fcratif cerrahi sonras\u0131 uzun d\u00f6nem prognozun predikt\u00f6r\u00fcd\u00fcr.<\/p>\n

     <\/p>\n

    Translated by: G\u00f6rkem Ayas, Ahmet Umur Top\u00e7u, Duygu Cengiz<\/p>\n","protected":false},"excerpt":{"rendered":"HCC   Karaci\u011fer G\u00f6r\u00fcnt\u00fcleme Raporlama Ve Veri Sistemi Damar-\u0130\u00e7i-T\u00fcm\u00f6r Kategorisi: Sistematik Bir \u0130nceleme Ve Meta-Analiz. […]","protected":false},"author":3,"featured_media":2955,"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-9688","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-tr"],"yoast_head":"\nWhat's new in Liver Imaging (Turkish) - November 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\/9342\/\" \/>\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 Liver Imaging (Turkish) - November 2020 - ACORE\" \/>\n<meta property=\"og:description\" content=\"HCC   Karaci\u011fer G\u00f6r\u00fcnt\u00fcleme Raporlama Ve Veri Sistemi Damar-\u0130\u00e7i-T\u00fcm\u00f6r Kategorisi: Sistematik Bir \u0130nceleme Ve Meta-Analiz. 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