Ultrazvuk u prikazu perifernih živaca

master's thesis

• Title (english): Ultrasound in peripheral nerve imaging
• Author: Goran Mileusnić
• Mentor: Gordana Ivanac (mentor)
• Committee member: Boris Brkljačić (predsjednik povjerenstva)
• Committee member: Milan Radoš (član povjerenstva)
• Committee member: Gordana Ivanac (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

Razvojem ultrazvučnih uređaja omogućena je primjena ultrazvuka u prikazu perifernih živaca. Prva opisana upotreba ultrazvuka (UZV) u prikazu perifernih živaca bila je od strane Bruna Fornagea 1988. godine. Opisao je UZV prikaz tubularne strukture živca. U prvom desetljeću 21. stoljeća upotreba UZV u prikazu perifernih živaca uglavnom je prisutna u anesteziologiji, pri navođenju igle u anestezijsko polje.
Razvoj ultrazvuka visoke rezolucije (UVR) omogućen je razvojem kristalne tehnologije UZV sondi s postignutim visokim frekvencijama te razvojem računalne obrade UZV signala. UVR je postao kvalitetan alat u prikazu perifernih živaca, te je moguća kvalitetna evaluacija stanja perifernih živaca od njihovog izlaska iz živčanih spletova do točaka inervacije na tijelu.
S obzirom na velik broj funkcija modernih UZV uređaja, nije dovoljno samo poznavati fizikalne osnove UZV valova i njihova svojstva u ljudskom tijelu, već je potrebna dugotrajna edukacija i vještina onoga koji ju izvodi. Zasad je u literaturi opisano UZV prikazivanje četiri kranijalna živca (ostali su nedostupni zbog većinskog intrakranijalog toka, te su za njihovu evaluaciju potrebni magnetska rezonanca ili kompjutorizirana tomografija), periferni živci prsne i trbušne stjenke, te skoro pa svi periferni živci ruku i nogu. Opisani su detaljni postupci izvođenja, od odabira UZV sondi za prikaz perifernih živaca prema obliku, smještaju i kliničkoj situaciji, do anatomskih orijentacijskih točaka za prvotno nalaženje živca, tehnike prikaza i načine raščlambe od okolnih struktura. Također, s obzirom na visoku osjetljivost i specifičnost UZV prikaza u određenim bolesnim stanjima perifernih živaca u literaturi se počinju opisivati UZV dijagnostički kriteriji kao samostalni pri dijagnosticiranju.

Abstract (english)

Use of ultrasound in depiction of peripheral nerves was made possible by advances and development of ultrasonic devices. First described use of ultrasound in depiction of peripheral nerves was made in 1988 by Bruno Fornage. He described tubular nerve structure. Within first decades of 21 century ultrasound depiction of peripheral nerves was mainly used in anesthesiology as a means of needle navigation during application of anesthetics. High-resolution ultrasound (HRU) was made possible due to technological advancements in crystal technology, high-frequency ultrasound transducer and computer enhanced imaging. Furthermore, high-resolution ultrasound was made to be an invaluable tool in depiction of peripheral nerves from their point of origin to the target anatomical area. Considering high number of functions that modern ultrasonic devices possess, basic understanding of ultrasonic waves physics and their interaction with the human body is not enough in every-day use and requires long term education and skill. Today, US is used to depict four cranial nerves (the rest can not be shown due to their intracranial placement; magnetic resonance imaging or computed tomography scan are used for their depiction), peripheral nerves of the thoracic and abdominal wall alongside almost all of the peripheral nerves for the arms and legs.
There are detailed descriptions of procedures used for depiction of peripheral nerves ranging from ultrasonic probe selection, nerve shape, location, anatomical markers, clinical characteristics, imaging techniques and ways of differentiating nerves form surrounding structures. Moreover, in some conditions ultrasonic examination has provided high specificity and sensitivity, this enabled formation of standalone ultrasonic diagnostic criteria for diseases.

• Keywords: ultrazvuk; periferni živci; ultrazvuk visoke rezolucije; ultrazvučna sonda visokih frekvencija; evaluacija; dijagnostičko sredstvo
• Keywords (english): ultrasound; peripheral nerves; high-resolution ultrasound; high-frequency ultrasound transducer; evaluation; diagnostic tool
• Language: croatian
• URN:NBN: urn:nbn:hr:105:687876
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-03-02 16:14:07