He mea nui te whakaahua irahiko hei tāpiri i ngā raraunga haumanu me te tautoko i ngā tākuta mimi ki te whakatū i te whakahaere tika mō ngā tūroro. I roto i ngā momo whakaahua rerekē, ko te tomography rorohiko (CT) te paerewa tohutoro mō te aromatawai i ngā mate mimi nā te mea he whānui te wātea, he tere te wā matawai, ā, he whānui hoki te aromatawai. Ina koa, ko te CT urography.
HĪTORI
I ngā wā o mua, ko te urography intravenous (IVU), e kiia ana ko te "excretory urography" me/ranei te "intravenous pyelography", i whakamahia tuatahitia hei aromatawai i te ara mimi. Ko te tikanga he whakaahua X-ray tuatahi, ā, muri iho ka werohia he rongoā rerekē wairewa-wai (1.5 ml/kg te taumaha tinana). Muri iho, ka tangohia he raupapa whakaahua i ngā wā motuhake. Ko ngā herenga matua o tēnei tikanga ko te aromatawai rua-ahu me te aromatawai ngaro o te hanganga tata.
Whai muri i te whakaurunga o te tomography rorohiko, kua whānuitia te whakamahinga o te IVU.
Heoi, i te tekau tau atu i 1990 anake, me te whakaurunga mai o te hangarau porowhita, ka tere ake te wā matawai kia taea ai te ako i ngā wāhanga nui o te tinana, pērā i te puku, i roto i ngā hēkona. I te taenga mai o te hangarau maha-kitenga i te tekau tau atu i 2000, ka whakapai ake te taumira ā-wāhi, ka taea ai te tautuhi i te urothelium o te ara mimi o runga me te pūhā, ā, ka whakatūria te CT-Urography (CTU).
I ēnei rā, e whakamahia whānuitia ana te CTU hei aromatawai i ngā mate mimi.
Mai anō i ngā rā tōmua o te CT, kua mōhiotia ka taea e ngā hihi-X o ngā pūngao rerekē te wehewehe i ngā rauemi o ngā tau ngota rerekē. Nō te tau 2006 ka whakamahia angitu tēnei mātāpono ki te rangahau i ngā kiko tangata, ā, i te mutunga ka arahina ki te whakaurunga o te pūnaha CT pūngao-rua tuatahi (DECT) ki roto i ngā mahi haumanu o ia rā. Kua whakaatu tonu a DECT i tōna pai mō te aromatawai i ngā āhuatanga mate o te ara mimi, mai i te pakaru o ngā rauemi i roto i ngā konutea mimi ki te tango iodine i roto i ngā mate pukupuku mimi.
painga
Ko ngā tikanga CT tuku iho he whakaahua i mua i te whakataurite me ngā whakaahua i muri i te whakataurite maha-wāhanga. Ka whakaratohia e ngā matawai CT hou ngā huinga raraunga rōrahi ka taea te hanga anō i roto i ngā papa maha me te matotoru poro rerekē, kia mau tonu ai te kounga whakaahua pai. Ka whakawhirinaki hoki te CT urography (CTU) ki te kaupapa polyphasic, e arotahi ana ki te wāhanga "pukupuku" i muri i te tātaritanga o te kaihoko whakataurite ki roto i te pūnaha kohikohi me te pūkahukahu, ka hangaia he urogram IV me te rerekētanga kiko kua tino pai ake.
TE WHAKARERE
Ahakoa ko te tomography rorohiko whakarei ake i te rerekētanga te paerewa tohutoro mō te whakaahua tuatahi o te ara mimi, me aro atu ki ngā herenga ā-roto. Ko te pānga o te hihi me te paitini o te kiri o te hihi he ngoikoretanga nui. He mea tino nui te whakaiti i te horopeta o te hihi, inā koa mō ngā tūroro taitamariki.
Tuatahi, me whai whakaaro tonu ki ngā momo whakaahua rerekē pēnei i te ultrasound me te MRI. Mēnā kāore e taea e ēnei hangarau te whakarato i ngā mōhiohio e hiahiatia ana, me mahi he mahi e ai ki te kawa CT.
Kāore e whakaaetia te whakamātautau CT whakarei ake i te rerekētanga mō ngā tūroro e mate pāwera ana ki ngā rongoā radiocontrast me ngā tūroro e ngoikore ana te mahi a te whatukuhu. Hei whakaiti i te nephropathy i puta mai i te rerekētanga, kaua e hoatu he rongoā contrast ki ngā tūroro he iti iho i te 30 ml/min te tere tātari glomerular (GFR) ki te hunga kāore i te ata paunatia ngā mōrearea me ngā painga, ā, me tūpato te whakamahi ki ngā tūroro he GFR kei roto i te awhe 30 ki te 60 ml/min i roto i ngā tūroro.
ĀMUA
I tēnei wā hou o te rongoā tika, ko te kaha ki te whakatau i ngā raraunga tauanga mai i ngā whakaahua irahiko he wero o nāianei me ā muri ake nei. I hangaia tuatahitia tēnei tukanga, e mōhiotia ana ko te radiomics, e Lambin i te tau 2012, ā, e hangai ana ki te ariā kei roto i ngā whakaahua haumanu ngā āhuatanga tauanga e whakaata ana i te pathophysiology o te kiko. Mā te whakamahinga o ēnei whakamātautau ka taea te whakapai ake i te whakatau kaupapa hauora me te kimi wāhi, inā koa i roto i te oncology, hei tauira, ka taea te aromatawai i te taiao moroiti o te mate pukupuku me te awe i ngā kōwhiringa maimoatanga. I roto i ngā tau kua pahure ake nei, he maha ngā rangahau kua mahia mō te whakamahinga o tēnei tikanga, tae noa ki te aromatawai i te carcinoma urothelial, engari ko tēnei tonu te mana o te rangahau.
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Wā tuku: Maehe-20-2024
