Медицинская литература. Новинки

 

 

 

 

 

 

Возможности магнитно-резонансной томографии в диагностике экстреннной абдоминальной патологии в условиях многопрофильной хирургической клиники

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Цель: оценить диагностическую эффективность МРТ у пациентов с острой абдоминальной патологией. Материал и методы. По экстренным показаниям 109 пациентам выполнена МРТ брюшной полости. Возраст пациентов составил от 9 до 85 лет (в среднем 53 ± 3,23 года), среди них было 57 (52,3%) мужчин и 52 (47,7%) женщины. МР'исследования проводили на томографе Signa 1,5 Тл (GE). Результаты. У большинства пациентов установлен синдром механической желтухи – 64 (58,7%). Злокачественный характер изменений диагностирован у 24 (22%) пациентов, среди них преобладал рак головки поджелу' дочной железы. Доброкачественный генез выявлен в 38 (34,8%) наблюдениях, наиболее часто был представлен холелитиазом. Воспалительные изменения визуализированы у 30 (27,5%) пациентов, из них у 11 в паренхиме поджелудочной железы. У 5 пациентов при проведении МРТ исключена органическая патология. Выводы. МРТ позволила верифицировать диагноз у 95 (87,1%) и у 31 (28,4%) пациента была изменена тактика лечения. Общая точность метода при механической желтухе составила 89%, при воспалительных заболеваниях – 98,2%.

Ключевые слова:
экстренная абдоминальная патология, магнитно-резонансная томография, механическая желтуха, холелитиаз, рак головки поджелудочной железы.

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The Possibilities of Magnetic Resonance Imaging in the Diagnosis of Emergency Abdominal Pathology in Multidisciplinary Surgical Clinic

Purpose. To assess the diagnostic efficacy of magnetic resonance imaging (MRI) in patients with acute abdominal pathology. Matherials and methods. For emergency indications 109 patients underwent MRI of the abdomen. Aged from 9 to 85 year (mean age of 53 ± 3.23 y.), 57 (52.3%) male, 52 (47.7%) female. All MR examinations were performed using 1.5 Т system GE Signa. Results. In most patients, jaundice syndrome set – 64 (58.7%). Malignant nature of the changes was diagnosed in 24 (22%), among them the predominant cancer of the pancreatic head. Benign genesis identified in 38 (34.8%) patients, the most frequently presented with cholelithiasis. Inflammatory changes visualized in 30 (27.5%) cases, of which 11 patients of pancreas. In 5 cases, MRI excluded organic pathology. Conclusion. MRI could verify the diagnosis in 95 (87.1%). In 31 (28.4%) were modified therapeutic approaches. The overall accuracy of the method when jaundice is 89.0%, with 98.2% of the inflammatory diseases.

Keywords:
emergency abdominal pathology, magnetic resonance imaging, jaundice, cholelithiasis, cancer of the head of the pancreas