Baş dönmesinin değerlendirilmesinde 1.5 teslalık manyetik rezonans görüntüleme beyin çalışmasının yararlılığı: geriye dönük 500 olguluk bir çalışma

Year 2016, , 429 - 436, 30.09.2016

Zoya İrfan Khan Sushil Ghanshyam Kachewar

https://doi.org/10.17826/cukmedj.234959

Abstract

Amaç: Bu çalışmanın amacı baş dönmesi sebeplerinin değerlendirilmesinde 1.5 tesla magnetik rezonans beyin görüntüleme çalışmasının faydasını değerlendirmektir.

Gereç ve Yöntem: Geçmişe yönelik bu analitik çalışmada baş dönmesi görülen 500 hastanın MRG beyin taramaları baş dönmesi sebeplerini belirleyebilmek için analiz edildi.

Bulgular: 500 MRG seri taramaları incelendi. Cinsiyet bilgisi yaşları 36 ile 74 arasında değişen 288 kadın ve 212 erkek olarak belirlendi. 272 tarama (%54.4) tamamen normal olarak bildirildi. Mastoiditlerin göz önünde bulundurulmadığı 52 vakada (%10.4) önemli bulgular görüldü. Mastoidit baş dönmesinin olası sebebi kabul edildiğinde önemli bulgular 284 vakada, yani vakaların %56.8'inde görülmektedir. En sık rastlanan tesadüfi bulgular; 136 taramada (%27.2) iskemik odaklar, 144 taramada (%28.8) eski infarktüsler, 177 olguda (%35.4) görülen serebral atrofilerdir. 77 taramada ise (%13.5) ileri değerlendirmeye ihtiyaç duyulan klinik olarak ciddi rastlantısal bulgular saptanmıştır.

Sonuç: Diğer çalışmalarda bahsedilen MRG’nin yüksek duyarlılık ve özgüllük; rutin ilaç tedavisine yanıt vermeyen baş dönmesi olan hastaların incelenmesinde kullanılımını doğrulamaktadır. Bu hastalarda MRG taraması direkt olarak baş dönmesine sebep olan önemli bulguları başarıyla gösterebilmektedir. Fakat bu bulguların sıklığı oldukça azdır. Çoğu zaman klinik açıdan önemli olabilen veya klinik açıdan önemli olmayan rastlantısal bulgular gösterilebir. Maliyetli bir inceleme olan MRG bu özelliği nedeniyle böylesi hastalarda sağduyulu bir şekilde kullanılmalıdır.

Keywords

Beyin, baş dönmesi

Utility of 1.5 tesla magnetic resonance imaging brain study in evaluating giddiness: a retrospective study of 500 cases

Abstract

Purpose: The purpose of this study was to evaluate the utility of 1.5 tesla magnetic resonance imaging (MRI) brain studies in evaluating the cause of giddiness.

Materials and methods: In this retrospective analytical study; MRI brain scans of 500 patients who presented with giddiness; were analysed to assess if the cause of giddiness could be found in them.

Results: Five-hundred MRI serial scans were reviewed. Gender wise total 288 females and 212 males with age ranging between 36 to 74 years were found. Two hundred and seventy two scans (54.4%) were reported as completely normal. Significant findings were seen in 52 cases (10.4%); when mastoiditis was not taken into account. When mastoiditis was included as a possible cause of giddiness, the significant findings were seen in 284 cases (56.8%) of cases. The most frequent incidental finding were cerebral atrophy in 177 cases (35.4 %), old infarcts in 144 scans (28.8%) and ischemic foci in 136 scans (27.2%). Seventy seven scans (13.5%), had clinically serious incidental findings that needed further management. 

Conclusion: High sensitivity and specificity of the MRI mentioned in other studies justifies its use in investigating patients with giddiness that do not respond to routine medications. MRI scans in such patients can successfully demonstrate the significant findings - which can directly cause giddiness. But incidence of such findings is very less. Most often, incidental findings are demonstrated which may or may not be clinical significance. MRI being a costly investigation, should therefore be used judiciously in such patients.

Keywords

Brain, dizziness

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