Karaciğer hidatid kistlerinin sınıflandırılmasında, basit kist ve abselerden ayrımında difüzyon ağırlıklı MR incelemenin tanı değeri
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Date
2007
Authors
Oruç, Esra
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Publisher
Uludağ Üniversitesi
Abstract
Amaç: Karaciğer hidatid kistlerinin sınıflandırılmasında, basit kistler ve abselerden ayrımında difüzyon MR incelemenin tanıya katkısının araştırılması. Gereç ve yöntem :Hidatid kist ya da abse ön tanısıyla US, BT ya da MR istemiyle gönderilen ve yaşları 22 ile 72 arasında değişen 27 olgu, 1.5 Tesla’lık MR cihazı ile T1 ağırlıklı hızlı Gradient eko, T2 ağırlıklı aksiyel HASTE ve DW single shot EP puls sekansı ile (üç farklı b değeriyle) incelendi. ADC haritaları eldeki yazılım ile yeniden yapılandırıldı. Hidatid kistlerin, abselerin ve basit kistlerin ADC değerleri formülle hesaplandı. Bulgular: Tüm hastalarda elde edilen histopatoloji ve seroloji sonuçları 27 hastada hidatid kisti, 5 hastada abseyi, 5 hastada basit kisti destekler nitelikteydi. Hidatid kistli olgularda lezyonların 10’u Tip1, 1’i Tip2, 5’i Tip3, 5’i Tip4 ve 6’sı Tip5 olarak sınıflandırıldı. Tip1, 3, 5 hidatid kistlerin ADC değerleri arasında anlamlı farklılık bulunmadı. Tip1, 3, 5 hidatid kistlerin ADC değerleri Tip4 ile karşılaştırıldı. ADC`si 2,17’den küçük olan olgular Tip4 kabul edildi. Tip1 hidatid kistler basit kistlerin ADC değerleri arasında anlamlı farklılık bulunmadı.
Hidatid kistler (Tip1, 3, 5) ve basit kistler abseler ile karşılaştırıldığında ADC değeri 1,76’dan küçük olan olgular abse kabul edildi ancak Tip4 hidatid kist ve absenin ADC değerleri arasında anlamlı farklılık bulunmadı. Tip2 hidatid kistli bir tek olgu olduğundan, analiz edilemedi. Sonuç: Karaciğer hidatid kistlerinin tiplendirilmesinde diffüzyon MR inceleme ile sadece Tip 4 hidatid kistler diğer tiplerden ayrılabilmiş, Tip1, 3 ve 5 hidatid kistler birbirinden ayrılamamıştır. Basit kistlerin Tip 1 hidatid kistlerden ayrımı diffüzyon inceleme ile yapılamamıştır. Karaciğer abseleri bu yöntemle Tip 4 hidatid kistlerden ayrılamamış, sadece Tip 1,3,5 ve basit kistlerden ayrılabilmiştir. Karaciğer hidatid kistlerinin tiplendirilmesinde, basit kistler ve abseden ayrımında halen ultrasonografi gold standart yöntem gibi görünmektedir.
Object: Searching of supplement of diffusion weighted MR imaging for the classification of liver hydatic cyst, differantial diagnosis from simple cysts and liver abscesses. Materials and method: 27 patients, ages between 22 to 72, who were sent to our department with the prediagnosis of hydatid cyst or abcess for US, CT or MR imaging were evaluated. MR (1.5 Tesla) was used for T1 weighted fast Gradient echo, T2 weighted axial HASTE and diffusion weighted (DW) single shot echoplanar (EP) pulse sequence (three different b values). ADC maps were rebuilted with the software. ADC values of the hydatid cysts, abscess and simple cysts were calculated with the formula. Results: Hystopathologic and serologic diagnosis of the cases showed hydatid cysts in 27 patients, abscess in 5 patients, basic cyst in 5 patients. In hydatid cyst group, 10 lesions were Type1, 1 lesion was Type2, 5 were Type3, 5 were Type4 and 6 were Type5. There was no statistically differance between ADC values of the Type1,3,5 hydatid cysts. ADC values of Type1, 3 and 5 hydatid cysts were compared to Type4. When ADC value was smaller than 2,17, it was accepted as Type4. There was no statistically differance between ADC values of Type1 hydatid cycts and simple cysts. Comparing those with hydatid cysts (Type1,3,5) to those simple cysts, ADC values of abscess were lower. Cases of ADC value smaller than 1,76 were accepted as abscess, but there was no statistically differance between ADC values of Type4 hydatid cyst and abscess. Due to there was only one Type2 hydatid cyst case, it could not be analysed. Conclusion: Only Type4 hydatid cysts could be differentiated from other types by diffusion MR imaging. Type1, Type3 and Type5 hydatid cysts could not be differantiated from each other. Simple cysts couldn’t be differentiated from Type1 with diffusion MR imaging. With this methodology, liver absesses couldn’t be differentiated from Type4, only differentieted from Type1,3,5 and simple cysts. In classification of liver hydatid cysts and differentiation from simple cysts and absesses, ultrasonography is still accepted as gold standard method.
Object: Searching of supplement of diffusion weighted MR imaging for the classification of liver hydatic cyst, differantial diagnosis from simple cysts and liver abscesses. Materials and method: 27 patients, ages between 22 to 72, who were sent to our department with the prediagnosis of hydatid cyst or abcess for US, CT or MR imaging were evaluated. MR (1.5 Tesla) was used for T1 weighted fast Gradient echo, T2 weighted axial HASTE and diffusion weighted (DW) single shot echoplanar (EP) pulse sequence (three different b values). ADC maps were rebuilted with the software. ADC values of the hydatid cysts, abscess and simple cysts were calculated with the formula. Results: Hystopathologic and serologic diagnosis of the cases showed hydatid cysts in 27 patients, abscess in 5 patients, basic cyst in 5 patients. In hydatid cyst group, 10 lesions were Type1, 1 lesion was Type2, 5 were Type3, 5 were Type4 and 6 were Type5. There was no statistically differance between ADC values of the Type1,3,5 hydatid cysts. ADC values of Type1, 3 and 5 hydatid cysts were compared to Type4. When ADC value was smaller than 2,17, it was accepted as Type4. There was no statistically differance between ADC values of Type1 hydatid cycts and simple cysts. Comparing those with hydatid cysts (Type1,3,5) to those simple cysts, ADC values of abscess were lower. Cases of ADC value smaller than 1,76 were accepted as abscess, but there was no statistically differance between ADC values of Type4 hydatid cyst and abscess. Due to there was only one Type2 hydatid cyst case, it could not be analysed. Conclusion: Only Type4 hydatid cysts could be differentiated from other types by diffusion MR imaging. Type1, Type3 and Type5 hydatid cysts could not be differantiated from each other. Simple cysts couldn’t be differentiated from Type1 with diffusion MR imaging. With this methodology, liver absesses couldn’t be differentiated from Type4, only differentieted from Type1,3,5 and simple cysts. In classification of liver hydatid cysts and differentiation from simple cysts and absesses, ultrasonography is still accepted as gold standard method.
Description
Keywords
Karaciğer, Hidatid kist, Manyetik rezonans, Difüzyon ağırlıklı görüntüleme, Liver, Hydatid cyst, Magnetic resonance, Diffusion weighted imaging
Citation
Oruç, E. (2007). Karaciğer hidatid kistlerinin sınıflandırılmasında, basit kist ve abselerden ayrımında difüzyon ağırlıklı MR incelemenin tanı değeri. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.