Title Suvremena radiološka dijagnostika upalnih crijevnih bolesti Title (english) Contemporary radiology diagnostics of inflammatory bowel disease Author Mia Matea Velenik Mentor Jelena Popić (mentor)Committee member Marko Banić (predsjednik povjerenstva)Committee member Gordana Ivanac (član povjerenstva)Committee member Jelena Popić (član povjerenstva)Granter University of Zagreb Defense date and country 2024-09-11, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Upalne crijevne bolesti (UCB) označava skupinu kroničnih bolesti koje zahvaćaju dio ili cijeli probavni trakt. Glavne kliničke entitete čine Crohnova bolest i ulcerozni kolitis, te su obje multifaktorijalne etiologije. Karakterizirane su protrahiranim tijekom s periodima remisije i relapsa, te se preklapaju u nekim simptomima gastrointestinalnog distresa, poput boli u abdomenu, čestih proljeva i umora. Obrada pacijenata uključuje klinički pregled, endoskopiju, histološku, radiološku te biokemijske pretrage. Glavna metoda za postavljanje dijagnoze je trenutno ileokolonoskopija s biopsijom za patohistološku analizu, no slojevne pretrage poput kompjutorizirane tomografije (CT) i magnetne rezonancije (MR) dobivaju na važnosti u obradi i praćenju pacijenata s UCB. Slojevne pretrage korisne su za analizu intra- i ekstraluminalnih promjena u gastrointestinalnom traktu, uz mogućnost analize ekstraintestinalnih manifestacija bolesti i stanja upale (aktivna ili kronična). Konvencionalne radiološke metode (pasaža tankog crijeva, enterokliza, irigografija) uvelike su napuštene u današnjici zbog kompleksnosti izvođenja i velike doze ionizirajućeg zračenja, a niže su osjetljivosti i specifičnosti od modernih slojevnih pretraga. CT uređaji široko su dostupni te daju slike visoke rezolucije u vrlo kratkom vremenu, što ih čini pogodnim i za hitna stanja, no kao negativna strana ostaje izlaganje pacijenta ionizirajućem zračenju. Osim snimanja CT-a abdomena i pelvisa, razvijeni su i protokoli CT enterografije, enteroklize i kolonografije. Pretrage koje uključuju MR dobivaju na većoj važnosti zbog manjka ionizirajućeg zračenja, čineći ih tako pogodnijima kod pedijatrijske populacije. Brojni modaliteti snimanja omogućuju analizu različitih mekih tkiva i procjenu upalnih stanja. MR enterografija pokazala se kao zlatni standard u procjeni Crohnove bolesti. Glavni nedostaci MR-a su visoka cijena izvođenja, vremensko trajanje pretrage, ima više respiratornih artefakata i postojanje kontraindikacije u primjeni kod prisutnih feromagnetnih stranih tijela. CT i MR omogućuju snimanje probavnog trakta u cijelosti na neinvazivan način. Ultrazvuk (UZV) se zasad manje koristi zbog varijabilnosti u osjetljivosti i specifičnosti, te ograničenih dijelova probavne cijevi koji su dostupni pregledu, no prednost su mu široka dostupnost, niža cijena, nije invazivan i ne koristi ionizirajuće zračenje.
Abstract (english) Inflammatory bowel disease (IBD) defines a group of chronic disease which affect part or the entirety of the gastrointestinal tract. The main clinical presentations are Crohn's disease and ulcerative colitis, both being of multifactorial etiology. They are characterized by a prolonged clinical course with periods of remission and relapse, overlapping in some symptoms of gastrointestinal distress, such as abdominal pain, diarrhea and fatigue. Patient workup includes physical examination, endoscopy, histological, radiological and biochemical testing. The main method of diagnosing is currently ileocolonoscopy with biopsy for patohistological analysis, but cross-sectional imaging like computerized tomography (CT) and magnetic resonance imaging (MRI) is gaining importance in diagnostics and follow-up of patients with IBD. Cross-sectional imaging is useful for analysis of both intra- and extraluminal changes in the gastrointestinal tract, with the ability of analyzing extraintestinal manifestations of disease and inflammatory status (active or chronic). Conventional radiological imaging (small bowel follow-through, enteroclysis, barium enema) are largely abandoned today because of procedural complexity and large doses of ionizing radiation, with lower sensibility and specificity than modern cross-sectional imaging. CT is widely available and give high resolution images in a very short time span, which makes them applicable in emergency situations, but their negative side is exposure to ionizing radiation. Aside from standard CT-s of the abdomen and pelvis, protocols like CT enterography, enteroclysis and colonography have also been developed. MRI imaging is gaining importance because of the lack of ionizing radiation, making it suitable for the pediatric population. Numerous imaging modalities allow for soft-tissue analysis and assessment of inflammation. MR enterography has shown to be the gold standard for Crohn's disease evaluation. The main problems with MRI are high costs, longer acquisition times, more respiratory artifacts and being contraindicated in patients with ferromagnetic foreign bodies. CT and MRI allow for imaging the entirety of the gastrointestinal tract in a noninvasive way. Ultrasound (US) is currently less used because of variability in sensitivity and specificity, and limitations on which parts of the bowel are accessible to visualize, but the main advantages are wide availability, lower costs, it is noninvasive and doesn't use ionizing radiation.
Keywords
upalne crijevne bolesti
Crohnova bolest
ulcerozni kolitis
radiološke metode
kompjutorizirana tomografija
mangetna rezonancija
ultrazvuk
Keywords (english)
inflammatory bowel disease
Crohn's disease
ulcerative colitis
radiological methods
computerized tomography
magnetic resonance imaging
ultrasound
Language croatian URN:NBN urn:nbn:hr:105:051381 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2024-08-29 08:55:40
