Dijagnostika tromboze dubokih vena nogu i pulmonalne embolije

master's thesis

• Title (english): Diagnosis of deep vein thrombosis of the leg and pulmonary embolism
• Author: Ana Generalić
• Mentor: Gordana Ivanac (mentor)
• Committee member: Zoran Brnić (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: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

Tromboza dubokih vena (DVT) i pulmonalna embolija (PE) manifestacije su venske tromboembolije (VTE), stanja u kojem se krvni ugrušak (tromb) formira u dubokim venama te opstruira krvni protok. U PE, krvni ugrušak (embolus) se otkida i putuje krvnim žilama te se uglavljuje u plućnim arterijama. Procijenjena incidencija DVT u Hrvatskoj je 1-2 slučajeva na 1000 stanovnika godišnje, te ukoliko se ne liječi, stopa smrtnosti može biti veća od 30%. Klinički znakovi i simptomi DVT i PE često su nespecifični pa su za valjanu dijagnozu od izuzetne važnosti objektivni dijagnostički testovi. Isključivanje dijagnoze VTE određuje se prema stupnju kliničke vjerojatnosti (Wellsovi kriteriji) te prema vrijednostima D-dimera, a konačna se dijagnoza potvrđuje slikovnim metodama i vizualizacijom tromba. U prošlosti, kontrastna venografija je bila zlatni standard u dijagnosticiranju DVT, no zamijenjena kompresivnom ultrasongrafijom (CUS) i obojenim Dopplerom te su danas to metode prvog izbora u kliničkoj praksi. Slikovne metode kojima se dokazuje PE su angiografija plućne arterije, angiografija plućne arterije kompjutoriziranom tomografijom, ventilacijsko-perfuzijska scintigrafija pluća i angiografija magnetnom rezonancijom. Nakon dijagnosticiranja, bitno je što prije započeti s farmakološkim ili kirurškim liječenjem DVT i PE, kako bi se smanjila učestalost komplikacija i fatalnih ishoda.

Abstract (english)

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are manifestations of venous throboembolism (VTE), a condition in which a blood clot (thrombus) is formed in the deep veins of the body (DVT) obstructing the blood flow. In PE, the blood clot (embolus) breaks free and travels trough the bloostream, and finally lodges in the pulmonary arteries. The estimated incidence rate of DVT in Croatia is 1-2 cases per 1 000 population per year and, if untreated, the mortality rate of PE can be greater than 30%. Clinical signs and symptoms of DVT and PE are often unspecific, and objective diagnostic tests are crucial to identify the disease. Ruling out acute VTE can be achieved by using a pretest clinical probability assessment (Wells score) and a D-Dimer blood test, but a certain diagnosis can only be established by medical imaging and visualising the thrombus. In the past, contrast venography was the gold standard for diagnosing DVT, but compression ultrasonography (CUS) and Color-Doppler ultrasound (US) have become first-line methods in daily clinical practice. Imaging methods for clinically suspected PE are pulmonary angiography, computed tomographic pulmonary angiography, ventilation-perfusion lung scan and magnetic resonance angiography. Once diagnosed, DVT and PE should be treated promptly, either conservatively or surgically, to decline the rate of complications and fatal outcomes.

• Keywords: duboka venska tromboza; pulmonalna embolija; kompresivna ultrasonografija; angiografija plućne arterije kompjutoroziranom tomografijom; scintigrafija pluća
• Keywords (english): deep vein thrombosis; pulmonary embolism; compresion ultrasonography; computed tomographic pulmonary angiography; ventilation-perfusion lung scan
• Language: croatian
• URN:NBN: urn:nbn:hr:105:290040
• 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: 2017-10-26 07:26:28