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İntraabominal Kistik Lezyonların Tanısında Doku Harmonik Ultrasonografi ve Bilgisayarlı Tomografinin Rolü

Yıl 2021, Sayı: 14, 302 - 322, 31.08.2021
https://doi.org/10.38079/igusabder.964865

Öz

Amaç: Batın Ultrasonografi (US) ve Bilgisayarlı Tomografi (BT) tetkikleri Radyoloji Kliniklerinde sıklıkla kullanılan görüntüleme yöntemleridir. Bu incelemeler sırasında batında sıklıkla kistik lezyonlar tespit edilmektedir. Bu kistlerin klinik önemini belirlemek ve karakterize etmek önemli bir sorundur.
Yöntem: İstanbul Eğitim ve Araştırma Hastanesi Radyoloji Kliniği US ve BT ünitelerinde abdominal görüntüleme yapılan ve kistik lezyon saptanan 145 hastanın bulguları retrospektif olarak incelendi. Abdominal organlarda veya batın boşluğunda saptanan, organlar ile ilişkisi olmayan kistik lezyonların BT bulguları gözden geçirildi ve ayrıca yeni US görüntü elde yöntemi olan Doku Harmonik Görütüleme (THI) 'nin kistik lezyonların karakterizasyonuna katkısı incelenmiştir.
Bulgular: Batında kistik lezyon tespit edilen 56 erkek (%39,3) ve 89 kadın (%60,7) olmak üzere toplam 145 hasta dahil edildi. En sık böbreklerde (n:68, %46,89) ve ikinci sıklıkta karaciğerde (n:65; %44,82) kistik lezyonlar saptadık. Ayrıca 5 olguda (%3.44) dalakta, 7 olguda (%4,82) pankreasta, 5 olguda (%3,44) karın boşluğunda kistik lezyon tespit ettik. Tüm olgularımızda hem THI görüntülemede hem de BT incelemesinde kistik lezyonlar görüntülenebildi.
Sonuç: THI inceleme özellikle kistin duvarı özelliği, internal septa ve kist içi solid komponent varlığını göstermede, BT inceleme ise özellikle duvar kalsifikasyonu ve apsede hava varlığının yanı sıra intramural solid komponenti göstererek kistik lezyonları karakterize etmede değerli bilgiler sağlar.

Kaynakça

  • Choudhry S, Gorman B, Charboneau JW. Comparison of tissue harmonic imaging with conventional US in abdominal disease. Radiographics. 2000;20:1127-1135.
  • Burns PN, Powers JE, Hope Simpson D, Uhlendorf V, Fritzsch T. Harmonic imaging: principles and preliminary results. Angiology. 1996;47:63-73.
  • Dulia O, Peter B, David HS. Tissue Harmonic imaging: Is it a benefit for bile duct sonography. AJR. 2001;176: 653-659.
  • Anvari A, Forsberg F, Samir AE. A Primer on the Physical Principles of Tissue Harmonic Imaging. Radiographics. 2015;35(7):1955-64.
  • Averkiou MA, Roundhill DR, Powers JE. A new imaging technique based on the nonlinear properties of tissues. Proc IEEE Ultrason Symp. 1997;2:1561–1566.
  • Chiristopher T, Carstensen EL. Finite amplitude distorsion and its relatinonship to linear derating formula for diagnostic ultrasound system. Ultrasound Med Bio. 1996;22:1103-1116.
  • Desser TS, Jeffrey RB. Tissue harmonic imaging techniques: physical principles and clinical applications. Semin Ultrasound CT MR. 2001;22:1-10.
  • Robert SS, Jon W, Rosaleen BP. Tissue harmonic ımaging sonography: Evaluation of ımage quality compared with conventional sonography. AJR. 1998;171:1203-1206.
  • Thomas JD, Rubin DN. Tissue harmonic imaging: why does it work? J Am Soc Echocardiogr. 1998;11:803-808.
  • Abuhamad A. Harmonics assist study of the ‘’difficlut-to-image’’. Harmonic Ultrasound, supplement to Diagnostic Imaging Europe. 1998;25-27.
  • Rals PH. Tissue Harmonics offer geater image clarity. Harmonic Ultrasound, supplement to Diagnostic imaging Europe. 1998;19-21.
  • Hann LE, Bach AM, Cramer LD. Hepatic sonography: Comprasion of tissue harmonic and standart sonography techniques. AJR. 1999;173:201-206.
  • Shapiro RS, Wagreich J, Parsons RB, Stancato-Pasik A, Yeh HC, Lao R. Tissue harmonic imaging sonography: evaluation of image quality compared with conventional sonography. AJR Am J Roentgenol. 1998;171(5):1203-6.
  • Noguera AM, Montserrat E, Torrubia S. Ultrasound of pancreas: update and controversies. Eur. Radiol. 2001;11:1594-1606.
  • Kaya T, Adapınar B, Özkan R. Temel Radyoloji Tekniği. Bursa: Güneş & Nobel Tıp Kitabevleri; 1997;333-351.
  • Wootton-Gorges SL, Thomas KB, Harned RK, Wu SR, Stein-Wexler R, Strain JD. Giant cystic abdominal masses in children. Pediatr Radiol. 2005;35:1277–88.
  • Esen, K., Özgür, A., Karaman, Y. et al. Abdominal nonparenchymatous cystic lesions and their mimics in children. Jpn J Radiol. 2014;32:623–629.
  • Vanassche T, Vanhoenacker FM, Pilate I, et al. Part 2: Answer: Haemorrhagic mesenteric cyst. British Journal of Sports Medicine. 2010;44:991.
  • Kawashima A, Goldman SM, Sandler CM. The indeterminate renal mass. Radilogic Clinics of North America. 1996;34;997-1014.
  • Bosniak MA. The use of the Bosniak classification system for renal cysts and cystic tumors. J Urol. 1997;157(5):1852-1853.
  • Curry NS, Cochran ST, Bissada NK. Cystic renal masses: accurate Bosniak classification requires adequate renal CT. AJR. 2000;175: 339-342.
  • Wilson TE, Doelle EA, Cohan RH, Wojna K, Cytic renal masses: A reevalution of the usenfullness of the Bosniak classification system. Acad Radiol. 1996;3:564-570.
  • Craig JR, Peters RL, Edmonson HA. Tumors of the Liver and intrahepatic bile ducts (second series). Atlas of Tumor Pathology. Washington DC: Armed Forces Institute of pathology;1989.
  • Oğuz M, Aksungur EH, Bıçakcı YK. ve ark. Ultrasonografi. 1. baskı: İstanbul, Nobel Tıp Kitabevleri; 1997;25-47.
  • Lee JK, Sagel SS, Stanley JP. Computed Body Tomography. Third edition, Lippincott- Raven, Phiadelphia 1998; 716-718.
  • Everson GT, Scherzinger A, Berger-Leff N. Polycystic liver disease: guantitation of parenchymal and cyst volumes from computed tomography images and correlates of hepatic cyts. Hepatology. 1998;8:1627-1634.
  • Federle MP, Filly RA, Moss AA. Cystic hepatic neoplasms: complementary roles of CT and Sonography. AJR. 1981;136:345-348.
  • Karaköse S. Böbrek ve Toplayıcı Sistem Hastalıklarında Ultrasonografinin Yeri. TRD. 1998;33:404-413.
  • Steinhart GF, Slovis TH, Perlmutter AD. Simple Renal cyts in infant. RSNA. 1985;155:349-350.
  • Bluth EI, Arger PH, Benson CB, Ralls PW, Siegel MJ. Ultrasound A Practical Approach to Clinical Problems. New York: Stuttgart, Thieme; 2000;421-422.
  • Kawashima A, Goldman SM, Sandler CM. The indeterminate renal mass. Radilogic Clinics of North America. 1996;34;997-1014.
  • Levine E, Cook LT, Grantham JJ. Liver cysts in autosomal-dominant polycystic kidney disease: clinical and computed Tomographic study. Clinical and computed tomographic study. AJR. 1985;145:229-233.
  • Rumack CM, Wilson SR, Charboneau JW. Diagnostic Ultrasound. 2nd ed, ST. Louis: Mosby; 1998;87-154.
  • Lee JK, Sagel SS, Stanley JP. Computed Body Tomography. 3rd eds. Phiadelphia: Lippincott- Raven; 1998;716-718.
  • Gharbi AH, Hassine V, Brauner MW, Dupuch K. Ultrasound Examination of the Hydatic Liver. Radiology. 1981;139:459-463.
  • Downer WR, Peterson MS. Massive splenic infarction and liquefactive necrosis complicating polycythemia vera. AJR. 1993;161:79-80.
  • Ödev K, Kılınç M, Güngör A, et al. Renal hydatid cysts and the evaluation of their radiologic images. Eur Urol. 1996;30:40-49.
  • Ödev K. Böbrek ve toplayıcı sistem hastalıklarının tanısında konvansiyonel tanı yöntemleri. TRD. 1998;33:388-403.
  • Rumack CM, Wilson SR; Charboneau JW. Diagnostic Ultrasound. 2nd ed., ST. Louis: Mosby; 1998;371-396.
  • Lewall DB, McCorkell SJ. Hepatic echinococcal cyst: Sonographic appearance and classification. Radiology. 1985;155:773-775.
  • Bosniak MA. The use of the Bosniak classification system for renal cysts and cystic tumors. J Urol. 1997;157(5):1852-1853.
  • Curry NS, Cochran ST, Bissada NK.: Cystic renal masses: accurate Bosniak classification requires adequate renal CT. AJR. 2000;175:339-342.
  • Kourtesis G, Wilson SE, Williams RA. The clincal significanse of fluid collections in acute pancreatitis. Am Surg. 1990;56:796-799.
  • McCowin MJ, Federle MP. Computed Tomography of pancreatic pseudocysts od the duodenoum. AJR 1985;145: 1003-1007.
  • Grace RR, Jordan PH Jr. Unresolved problems of pancreaticpseudocysts. Ann Surg. 1976;184:16-21.
  • Rohrmann CA, Jr, MD, Baron RL. Biliary Complications os pancreatitis. Radiologic Clinics of North America. 1989;27: 93-103.
  • Finlay DE, Letourneau JG, Longley DG. Assesment of vascular complications of renal, hepatic, and pancreatic transplantation. RadioGrafphics. 1992;12:981-996.
  • Grogan JR, Saeian K, Taylor AJ, Quiroz F, Demeure MJ, Komorowski RA. Making sense of mucin-producing pancreatic tumors. AJR. 2001;176: 921-929.
  • Lee JK, Sagel SS, Stanley JP. Computed Body Tomography. 3rd eds. Phiadelphia: Lippincott- Raven; 1998;996-998.
  • Rumack CM, Wilson SR; Charboneau JW. Diagnostic Ultrasound. 2nd eds. ST. Louis: Mosby, 1998;503-514.
  • Lee DL, Madhuvrata P, Reed MW, Balasubramanian SP: Chylous mesenteric cyst: a diagnostic dilemma. Asian J Surg. 2016, 39:182-186.

The Role of Tissue Harmonic Ultrasonography and Computerized Tomography in the Diagnosis of Intraabdominal Cystic Lesions

Yıl 2021, Sayı: 14, 302 - 322, 31.08.2021
https://doi.org/10.38079/igusabder.964865

Öz

Aim: Abdominal Ultrasonography (US) and Computed Tomography (CT) examinations are imaging methods frequently used in Radiology Clinics. During these examinations, cystic lesions are frequently detected in the abdomen. It is an important problem to identify and characterize the clinical significance of these cysts.
Methods: The findings of 145 patients who underwent abdominal imaging in the US and CT units of the Istanbul Training and Research Hospital Radiology Clinic and were found to have cystic lesions were analyzed retrospectively. The CT findings of cystic lesions detected in the abdominal organs or the abdominal cavity were reviewed, and the contribution of the new US image acquisition method, Tissue Harmonic Imaging (THI), to the characterization of cysts was examined.
Results: A total of 145 patients, 56 men (39.3%) and 89 women (60.7%) with cystic lesions in the abdomen, were included. We detected cystic lesions most frequently in the kidneys (n:68, 46.89%) and second most frequently in the liver (n:65; 44.82%). In addition, we detected cystic lesions in the spleen in 5 cases (3.44%), in the pancreas in 7 cases (4.82%), and in the abdominal cavity in 5 cases (3.44%). In all our cases, cystic lesions could be visualized in both THI imaging and CT examination.
Conclusion: THI examination provides valuable information in characterizing cystic lesions, especially by showing the wall feature of the cyst, the internal septa and the presence of intra-cystic solid component, while CT examination especially shows the wall calcification and the presence of air in the abscess, as well as the intramural solid component.

Kaynakça

  • Choudhry S, Gorman B, Charboneau JW. Comparison of tissue harmonic imaging with conventional US in abdominal disease. Radiographics. 2000;20:1127-1135.
  • Burns PN, Powers JE, Hope Simpson D, Uhlendorf V, Fritzsch T. Harmonic imaging: principles and preliminary results. Angiology. 1996;47:63-73.
  • Dulia O, Peter B, David HS. Tissue Harmonic imaging: Is it a benefit for bile duct sonography. AJR. 2001;176: 653-659.
  • Anvari A, Forsberg F, Samir AE. A Primer on the Physical Principles of Tissue Harmonic Imaging. Radiographics. 2015;35(7):1955-64.
  • Averkiou MA, Roundhill DR, Powers JE. A new imaging technique based on the nonlinear properties of tissues. Proc IEEE Ultrason Symp. 1997;2:1561–1566.
  • Chiristopher T, Carstensen EL. Finite amplitude distorsion and its relatinonship to linear derating formula for diagnostic ultrasound system. Ultrasound Med Bio. 1996;22:1103-1116.
  • Desser TS, Jeffrey RB. Tissue harmonic imaging techniques: physical principles and clinical applications. Semin Ultrasound CT MR. 2001;22:1-10.
  • Robert SS, Jon W, Rosaleen BP. Tissue harmonic ımaging sonography: Evaluation of ımage quality compared with conventional sonography. AJR. 1998;171:1203-1206.
  • Thomas JD, Rubin DN. Tissue harmonic imaging: why does it work? J Am Soc Echocardiogr. 1998;11:803-808.
  • Abuhamad A. Harmonics assist study of the ‘’difficlut-to-image’’. Harmonic Ultrasound, supplement to Diagnostic Imaging Europe. 1998;25-27.
  • Rals PH. Tissue Harmonics offer geater image clarity. Harmonic Ultrasound, supplement to Diagnostic imaging Europe. 1998;19-21.
  • Hann LE, Bach AM, Cramer LD. Hepatic sonography: Comprasion of tissue harmonic and standart sonography techniques. AJR. 1999;173:201-206.
  • Shapiro RS, Wagreich J, Parsons RB, Stancato-Pasik A, Yeh HC, Lao R. Tissue harmonic imaging sonography: evaluation of image quality compared with conventional sonography. AJR Am J Roentgenol. 1998;171(5):1203-6.
  • Noguera AM, Montserrat E, Torrubia S. Ultrasound of pancreas: update and controversies. Eur. Radiol. 2001;11:1594-1606.
  • Kaya T, Adapınar B, Özkan R. Temel Radyoloji Tekniği. Bursa: Güneş & Nobel Tıp Kitabevleri; 1997;333-351.
  • Wootton-Gorges SL, Thomas KB, Harned RK, Wu SR, Stein-Wexler R, Strain JD. Giant cystic abdominal masses in children. Pediatr Radiol. 2005;35:1277–88.
  • Esen, K., Özgür, A., Karaman, Y. et al. Abdominal nonparenchymatous cystic lesions and their mimics in children. Jpn J Radiol. 2014;32:623–629.
  • Vanassche T, Vanhoenacker FM, Pilate I, et al. Part 2: Answer: Haemorrhagic mesenteric cyst. British Journal of Sports Medicine. 2010;44:991.
  • Kawashima A, Goldman SM, Sandler CM. The indeterminate renal mass. Radilogic Clinics of North America. 1996;34;997-1014.
  • Bosniak MA. The use of the Bosniak classification system for renal cysts and cystic tumors. J Urol. 1997;157(5):1852-1853.
  • Curry NS, Cochran ST, Bissada NK. Cystic renal masses: accurate Bosniak classification requires adequate renal CT. AJR. 2000;175: 339-342.
  • Wilson TE, Doelle EA, Cohan RH, Wojna K, Cytic renal masses: A reevalution of the usenfullness of the Bosniak classification system. Acad Radiol. 1996;3:564-570.
  • Craig JR, Peters RL, Edmonson HA. Tumors of the Liver and intrahepatic bile ducts (second series). Atlas of Tumor Pathology. Washington DC: Armed Forces Institute of pathology;1989.
  • Oğuz M, Aksungur EH, Bıçakcı YK. ve ark. Ultrasonografi. 1. baskı: İstanbul, Nobel Tıp Kitabevleri; 1997;25-47.
  • Lee JK, Sagel SS, Stanley JP. Computed Body Tomography. Third edition, Lippincott- Raven, Phiadelphia 1998; 716-718.
  • Everson GT, Scherzinger A, Berger-Leff N. Polycystic liver disease: guantitation of parenchymal and cyst volumes from computed tomography images and correlates of hepatic cyts. Hepatology. 1998;8:1627-1634.
  • Federle MP, Filly RA, Moss AA. Cystic hepatic neoplasms: complementary roles of CT and Sonography. AJR. 1981;136:345-348.
  • Karaköse S. Böbrek ve Toplayıcı Sistem Hastalıklarında Ultrasonografinin Yeri. TRD. 1998;33:404-413.
  • Steinhart GF, Slovis TH, Perlmutter AD. Simple Renal cyts in infant. RSNA. 1985;155:349-350.
  • Bluth EI, Arger PH, Benson CB, Ralls PW, Siegel MJ. Ultrasound A Practical Approach to Clinical Problems. New York: Stuttgart, Thieme; 2000;421-422.
  • Kawashima A, Goldman SM, Sandler CM. The indeterminate renal mass. Radilogic Clinics of North America. 1996;34;997-1014.
  • Levine E, Cook LT, Grantham JJ. Liver cysts in autosomal-dominant polycystic kidney disease: clinical and computed Tomographic study. Clinical and computed tomographic study. AJR. 1985;145:229-233.
  • Rumack CM, Wilson SR, Charboneau JW. Diagnostic Ultrasound. 2nd ed, ST. Louis: Mosby; 1998;87-154.
  • Lee JK, Sagel SS, Stanley JP. Computed Body Tomography. 3rd eds. Phiadelphia: Lippincott- Raven; 1998;716-718.
  • Gharbi AH, Hassine V, Brauner MW, Dupuch K. Ultrasound Examination of the Hydatic Liver. Radiology. 1981;139:459-463.
  • Downer WR, Peterson MS. Massive splenic infarction and liquefactive necrosis complicating polycythemia vera. AJR. 1993;161:79-80.
  • Ödev K, Kılınç M, Güngör A, et al. Renal hydatid cysts and the evaluation of their radiologic images. Eur Urol. 1996;30:40-49.
  • Ödev K. Böbrek ve toplayıcı sistem hastalıklarının tanısında konvansiyonel tanı yöntemleri. TRD. 1998;33:388-403.
  • Rumack CM, Wilson SR; Charboneau JW. Diagnostic Ultrasound. 2nd ed., ST. Louis: Mosby; 1998;371-396.
  • Lewall DB, McCorkell SJ. Hepatic echinococcal cyst: Sonographic appearance and classification. Radiology. 1985;155:773-775.
  • Bosniak MA. The use of the Bosniak classification system for renal cysts and cystic tumors. J Urol. 1997;157(5):1852-1853.
  • Curry NS, Cochran ST, Bissada NK.: Cystic renal masses: accurate Bosniak classification requires adequate renal CT. AJR. 2000;175:339-342.
  • Kourtesis G, Wilson SE, Williams RA. The clincal significanse of fluid collections in acute pancreatitis. Am Surg. 1990;56:796-799.
  • McCowin MJ, Federle MP. Computed Tomography of pancreatic pseudocysts od the duodenoum. AJR 1985;145: 1003-1007.
  • Grace RR, Jordan PH Jr. Unresolved problems of pancreaticpseudocysts. Ann Surg. 1976;184:16-21.
  • Rohrmann CA, Jr, MD, Baron RL. Biliary Complications os pancreatitis. Radiologic Clinics of North America. 1989;27: 93-103.
  • Finlay DE, Letourneau JG, Longley DG. Assesment of vascular complications of renal, hepatic, and pancreatic transplantation. RadioGrafphics. 1992;12:981-996.
  • Grogan JR, Saeian K, Taylor AJ, Quiroz F, Demeure MJ, Komorowski RA. Making sense of mucin-producing pancreatic tumors. AJR. 2001;176: 921-929.
  • Lee JK, Sagel SS, Stanley JP. Computed Body Tomography. 3rd eds. Phiadelphia: Lippincott- Raven; 1998;996-998.
  • Rumack CM, Wilson SR; Charboneau JW. Diagnostic Ultrasound. 2nd eds. ST. Louis: Mosby, 1998;503-514.
  • Lee DL, Madhuvrata P, Reed MW, Balasubramanian SP: Chylous mesenteric cyst: a diagnostic dilemma. Asian J Surg. 2016, 39:182-186.
Toplam 51 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Makaleler
Yazarlar

Mehmet Ali Nazlı 0000-0003-4605-7822

Abdullah Yüksel Barut Bu kişi benim 0000-0002-7861-0736

Özgür Kılıçkesmez Bu kişi benim 0000-0003-4658-2192

Yayımlanma Tarihi 31 Ağustos 2021
Kabul Tarihi 17 Ağustos 2021
Yayımlandığı Sayı Yıl 2021 Sayı: 14

Kaynak Göster

JAMA Nazlı MA, Barut AY, Kılıçkesmez Ö. The Role of Tissue Harmonic Ultrasonography and Computerized Tomography in the Diagnosis of Intraabdominal Cystic Lesions. IGUSABDER. 2021;:302–322.

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