Wyniki wyszukiwania - Biblioteka Nauki

1

Obrazowanie czynności mózgu techniką rezonansu magnetycznego

100%

Bogorodzki P.

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2009

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tom R. 85, nr 9

40-45

PL

W artykule przedstawiono podstawy obrazowania czynności mózgu metodą Jądrowego Rezonansu Magnetycznego. Obejmuje to następujące aspekty tej techniki: historię odkrycia sygnału BOLD (ang. blood oxygenation level dependent), sposoby jego detekcji, metody prezentacji map czynościowych oraz pomocnicza aparatura stosowana do stymulacji wybranych obszarów korowych mózgu.

EN

Paper presents an introduction to functional Magnetic Resonance Imaging (fMRI) methodology. This covers the following aspects of fMRI methodology: an historic overview of BOLD (ang. blood oxygenation level dependent) discovery, BOLD detection, mapping techniques used in FMRI and supporting fMRI instrumentation used for region of interest (ROI) stimulation of human brain cortex.

2

Numerical models of human breast

100%

Michałowska-Samonek J. , Miaskowski A. , Wac-Włodarczyk A.

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2009

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tom R. 85, nr 12

125-127

EN

The aim of the paper is to introduce the online repository of numerical breast models, obtained using MRI. These free available models allow to better illustrate changes setting in breast through obtained fairly accurate characteristics of tissues i.e. the models assemble the structural heterogeneity of normal breast tissues and the realistic dispersive dielectric properties in frequency range 0.5-20 GHz based on Debye’s model.

PL

Celem artykułu jest prezentacja darmowego repozytorium naturalistycznych, numerycznych modeli gruczołu piersiowego i jego krótkie omówienie. Modele te pozwalają zobrazować heterogeniczną budowę gruczołu piersiowego, a także odwzorować właściwości dyspersyjne jego tkanek w zakresie częstotliwości 0.5-10 GHz w oparciu o parametryczny model Debye’a.

3

Imaging of myocardial infarction with thermoacoustic tomography: An ex vivo study

94%

Weizhi Q. , Wei C. , Xi L. , Jian R. , Lin H.

X-Acoustics: Imaging and Sensing

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2014

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tom 1

|

nr 1

EN

In the present study, we evaluated the feasibility of thermoacoustic tomography (TAT) for imaging of ex vivo mouse hearts with myocardial infarction. A circular scanning TAT system with an unfocused transducer was used to recover the dielectric property distribution of normal andmyocardial infarcted mouse heart tissues. The applicability of this myocardial infarction imaging system was validated using a model of myocardial infarction in two Sprague-Dawley rats and verified through comparison with magnetic resonance imaging (MRI). TAT results not only indicated the location and ischemia and the extent of myocardial ischemia (MI), but also showed good imaging contrast between infarcted and normal myocardium without the use of contrast agent. The experimental results suggest that TAT may provide a unique opportunity to enable real-time precision imaging to determine the site of injury intraoperatively

4

Symptomatic multipartite patella: imaging findings and pain relief. A description of two cases

94%

Perdikakis E. , Pothitakis C.

Open Medicine

|

2013

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tom 8

|

nr 2

172-175

EN

Musculoskeletal injuries in the non-elite athletes are a clinical entity that is being seen more frequently nowadays. The term “weekend warriors” applies to amateur participants in sports activities and is related to an increasing number of musculoskeletal injuries mainly due to overuse. Concomitant skeletal variations may as well predispose to trauma. We add to the literature two cases of multipartite patella in which locally injected ropivacaine (ropivacaine hydrochloride) and steroid (betamethasone acetate-betamethasone sodium phosphate) relieved the symptoms completely. Here, we describe the clinical, imaging features and the course of treatment.

5

State of art of MRI of fetal heart

94%

Manganaro L.

Prenatal Cardiology

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2015

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tom 5

|

nr 3

9-12

EN

Congenital heart defect (CHD) is one of the most common type of fetal malformations. Tissue-Doppler imaging, dynamic threedimensional (4D) echocardiography and fetal cardiac magnetic resonance imaging (MRI) are advanced modalities for the assessment of cardiac structure and function. MRI can study the cardiac morphology using T2-weighted half-Fourier single-shot turbo spin-echo sequence (HASTE) and steady-state free precession (True FISP) sequences. Also a dynamic study can be performed, through the acquisition of cine-MR sequences with real-time steady-state free precession (SSFP) oriented according to the standard projections used in fetal echocardiographic scanning. If the challenges relating to motion and cardiac gating can be overcome, MRI has the potential to provide high-resolution imaging of the fetal heart.

6

Peginterferon beta-1a – nowa postać interferonu beta-1a

94%

Maciejek Z. , Niezgodzińska-Maciejek A.

Aktualności Neurologiczne

|

2015

|

tom 15

|

nr 3

135-138

EN

In 2014 after phase 3 ADVANCE clinical study was finished, a new, pegylated form of interferon beta-1a with less frequent dosing was accepted for treatment in relapsing-remitting multiple sclerosis. One thousand five hundred and twelve patients with relapsing-remitting multiple sclerosis were enrolled to the ADVANCE study from 183 sites in 26 countries (500 to the placebo group, 512 to the 125 μg subcutaneous peginterferon beta-1a every 2 weeks group and 500 to the 125 μg subcutaneous peginterferon beta-1a every 4 weeks group). The investigated groups were similar in terms of age, sex, duration of the disease and disability rated using the Expanded Disability Status Scale. The primary and secondary endpoints were efficacy and safety of 2-year peginterferon beta-1a treatment in patients with relapsing-remitting multiple sclerosis compared to the placebo group, which after 1 year also received peginterferon beta-1a 125 μg every 2 or every 4 weeks. The results from the 2-year ADVANCE study demonstrate efficacy of treatment with peginterferon beta-1a 125 μg administered subcutaneously every 2 weeks compared with placebo: significantly reduced annualized relapse rate (by 37%), the number of new/newly enlarged T2 lesions (by 67%), the risk of relapse (by 39%) and the risk of 12-week sustained disability progression (by 33%). The most common adverse events (94% of patients) associated with peginterferon beta-1a treatment were: injection site reactions, flu-like symptoms, pyrexia and headache. Sixteen percent of patients taking the study drug every 2 weeks and 22% of patients taking the study drug every 4 weeks reported serious adverse events; relapse, pneumonia and urinary tract infections were the most common. Interpretation: the treatment with peginterferon beta-1a with less frequent administration is effective, well tolerated and safe for patients with relapsing-remitting multiple sclerosis.

PL

W 2014 roku, po zakończeniu próby klinicznej III fazy ADVANCE, do leczenia postaci rzutowo-remisyjnej stwardnienia rozsianego wprowadzono nową pegylowaną postać interferonu beta-1a o wydłużonym czasie działania. Do badania zakwalifikowano 1512 chorych ze 183 ośrodków z 26 krajów (500 uczestników przyjmowało placebo, 512 – peginterferon beta-1a w dawce 125 μg podawany podskórnie co 2 tygodnie, 500 – peginterferon beta-1a w dawce 125 μg podawany podskórnie co 4 tygodnie). Grupy były zbliżone pod względem wieku, płci, czasu trwania choroby i niepełnosprawności ocenianej w Expanded Disability Status Scale. Cel badania stanowiła ocena skuteczności i bezpieczeństwa pegylowanego interferonu beta-1a po 2 latach terapii w porównaniu z grupą placebo, która w drugim roku również otrzymywała ten lek. Skuteczność peginterferonu beta-1a podawanego co 2 tygodnie w porównaniu z placebo przejawiała się redukcją rocznego wskaźnika rzutów (o 37%), liczby nowych lub powiększonych ognisk T2-zależnych (o 67%), ryzyka wystąpienia rzutu (o 39%) i ryzyka utrwalonej 12-tygodniowej progresji niepełnosprawności (o 33%). Najczęstsze działania niepożądane towarzyszące kuracji (94% chorych) to odczyn w miejscu wkłucia, objawy grypopodobne, gorączka i bóle głowy. U 16% osób przyjmujących lek co 2 tygodnie i 22% otrzymujących go co 4 tygodnie odnotowano poważne objawy niepożądane (rzuty, zapalenie płuc, infekcje dróg moczowych). Reasumując: leczenie peginterferonem beta-1a cechowały skuteczność, dobra tolerancja i bezpieczeństwo.

7

Spontaneous resolution of unifocal Langerhans cell histiocytosis of the skull: potential role of ultrasound in detection and imaging follow-up

94%

Vanhoenacker F. M. , Verlooy J. , De Praeter M.

Journal of Ultrasonography

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2018

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tom 18

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nr 74

265-270

EN

Langerhans cell histiocytosis is a tumor-like condition characterized by idiopathic proliferation of Langerhans cells. The disease may involve the skeleton as well as other organs systems. Bone involvement may be solitary or multifocal. Unifocal osseous Langerhans cell histiocytosis may involve virtually any bone, with the calvarium being most frequently involved. Plain radiography, computed tomography and magnetic resonance imaging are the most used techniques for detection and characterization of the lesion. The use of ultrasound is less known, although it may be a valuable technique in detection and follow-up of superficially located lesions such as calvarial lesions. This case report describes an 8-year-old girl, in whom the lesion was initially detected by ultrasound. Furthermore, ultrasound was used to evaluate spontaneous resolution of the lesion. The knowledge of ultrasound characteristics may be important to avoid unnecessary radiation and gadolinium administration, particularly in a pediatric population.

PL

Histiocytoza z komórek Langerhansa jest chorobą rozrostową charakteryzującą się idiopatyczną proliferacją komórek Langerhansa. Może ona lokalizować się zarówno w układzie kostnym, jak i innych układach narządowych. Zmiany kostne mogą być pojedyncze lub wieloogniskowe. Pojedyncze ogniska kostne histiocytozy z komórek Langerhansa mogą być zlokalizowane w dowolnej kości, jednak zazwyczaj jest to sklepienie czaszki. Najczęściej stosowanymi technikami obrazowymi w rozpoznaniu tej jednostki są radiografia konwencjonalna, tomografia komputerowa oraz rezonans magnetyczny. Badanie ultrasonograficzne jest rzadziej stosowaną metodą, jednakże może ono okazać się cennym narzędziem w rozpoznawaniu i obserwacji pojedynczych zmian, takich jak zmiany w kości sklepienia czaszki. W niniejszej pracy opisujemy przypadek 8 letniej dziewczynki, u której pojedyncze ognisko choroby rozpoznano w badaniu ultrasonograficznym. Znajomość charakterystycznych cech w obrazie ultrasonograficznym pozwala uniknąć niepotrzebnej ekspozycji pacjenta na promieniowanie oraz gadolin, co jest szczególnie istotne w populacji dziecięcej.

8

The cerebellum in children with spastic cerebral palsy: Volumetrics MRI study

94%

Gościk E. , Kułak W. , Gościk J. , Okurowska-Zawada B. , Tarasow E.

Progress in Health Sciences

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2011

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tom 1

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nr 2

67-75

EN

Purpose: To determine the volume of the cerebellum in children with spastic cerebral palsy (CP) in relation to risk factors and motor development. Material and methods: The present study included 30 children with spastic CP, aged 2-17 years. The volume of the cerebellum was examined on sagittal magnetic resonance images (MRI) of the CP patients and on 33 healthy subjects. To estimate the total cerebellum volume of each subject we used Analyze 10 Biomedical Imaging Software. Results: Children with spastic CP (129726,2 ± 26040,72 mm3) had a significantly smaller mean of the cerebellum volume compared to controls (143122,5 ± 12351,10 mm3). No significant difference between the total cerebellar volume and gender in patients with CP was found. No significant relationship between cerebellar volume and birth weight, Apgar score, gestational age, and Gross Motor Function Classification System (GMFCS) level were noted. Positive correlations between birth weight, Apgar score, gestational age, and GMFCS level, between Apgar score and gestational age, or between gestational age and GMFCS level were found. Conclusion: Our results show that children with spastic CP had smaller volumes of the cerebellum as compared to controls.

9

Pelvic Leiomyosarcoma obstructing vaginal opening - case report

83%

Terzic M. , Aksam S. , Bila J. , Maricic S. , Arsenovic N.

Open Medicine

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2012

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tom 7

|

nr 2

245-248

EN

We present a 42-year-old female admitted for a 4 month history of increasing pelvic discomfort and pain. Clinical examination revealed a large tumor obstructing the vagina. Tumor markers (CA 125, CEA, AFP and CA 19-9), white blood cells and biochemical tests were all within the normal limits. Pelvic ultrasound and magnetic resonance imaging scan confirmed the presence of a large retroperitoneal/pelvic mass. The tumor was surgically excised and pathohistologically diagnosed as a well differentiated leiomyosarcoma, staged IB. Six years after surgery the patient is well and disease free.

10

Clinical Evaluation and Instrumental Diagnostics in Acute Acromioclavicular Joint Dislocation

83%

Bezruchenko S. , Dolhopolov O. , Yarova M. , Luchko R. , Mazevych V.

Ortopedia Traumatologia Rehabilitacja

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2022

|

tom 24(1)

1-12

EN

Background. The aim was to improve the diagnosis of acromioclavicular joint dislocation by studying the capabilities and characteristics of clinical and instrumental diagnostic methods. The idea is expressed that modern clinical and instrumental diagnostic methods comprise a large number of techniques, but no single algorithm for diagnosing injury to the AC joint has been developed. A gold standard for investigating and diagnosing acute AC joint dislocation does not currently exist. Materials and Methods. A retrospective study of the characteristics and capabilities of clinical and instrumental diagnostic methods was performed in 152 patients with traumatic shoulder pathology. The patients were divided into two groups: Group I of 102 patients (67%) with acromioclavicular joint dislocation type III-VI according to Rockwood classification and Group II of 50 patients (33%) with a partial tear of the rotator cuff. Clinical and instrumental examinations involved specific provocative tests; the radiological diagnostics comprised conventional radiographs with the Zanca, axillary and Alexander views, and CT, MRI, and ultrasound examinations. Results. The characterization of examination methods was based on the records of patients in Group I and II. The most sensitive clinical test to establish Rockwood type V of acromioclavicular joint dislocation was the Paxinos test (91%). The lowest sensitivity across the tests used was observed with the active compression test to diagnose type IV of dislocation (50%). As regards the X-ray examination, the axial view was 100% sensitive for detecting type IV and VI AC joint dislocation. The Zanca view is highly sensitive for patients with Rockwood type V and Alexander view for Rockwood type III and V dislocations. The accuracy of ultrasound work-up in Group I was 95%, with 96% sensitivity and 93% specificity, while MRI accuracy was 97%, with 96% sensitivity and 98% specificity, and CT accuracy was 81%, with 83% sensitivity and 75% specificity. Conclusions. 1. Determination of the sensitivity and specificity of the X-ray examination revealed the absence of a 100% effective X-ray view for type III and V AC joint dislocation. 2. The accuracy and sensitivity of the ultrasound, MRI, and CT examinations are high. 3. There is currently no consensus on a protocol to view acute AC joint injuries. 4. Complete and timely early diagnosis of acromioclavicular dislocation allows for a differentiated approach to surgical treatment tactics, preventing possible complications and restoring the function of the injured shoulder joint to the fullest extent.

11

Paraurethral cyst: a case report

83%

Ceyhan M. , Nural M. , Oztas T. , Bayrak İ. , Rizalar R.

Open Medicine

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2010

|

tom 5

|

nr 2

243-245

EN

Paraurethral or Skene’s duct cyst is a rare cause of masses located in the inter-labial genitor-urinary region and their etiology is not fully known. These congenital cysts may be diagnosed easily by inspection in the initial physical examination of the new-borne. Radiological evaluation is helpful for differential diagnosis and in determining the proximal extension of the cystic pathology. Treatment alternatives are needle aspiration and non-surgical follow-ups leading to a spontaneous regression and surgery. In this report the radiological findings of a female newborn diagnosed with paraurethral cyst in US and MR examinations have been discussed.

12

MR Imaging of Mouse Heart in vivo Using a Specialized Probehead and Gradient System

83%

Heinze-Paluchowska S. , Skórka T. , Drelicharz Ł. , Chłopicki S. , Jasiński A.

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2006

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tom Vol. 80, nr 7

1133-1139

EN

Preliminary results of Magnetic Resonance Imaging (MRI) of cardiac function in mice in vivo, using the homebuilt gradient coils and specialized RF probehead are demonstrated. An unshielded gradient system with inner diameter of 60 mm was designed and constructed for the 4.7T/310 magnet with MARAN DRX console (Resonance Instruments). Dedicated probehead, constructed to fit the gradient system, consists of the RF birdcage coil and the animal handling system. ECG-triggered cine images of eight FVB (wild-type) and four transgenic micewith heart failure (Tg alfa q*44) were acquired at physiological temperature (37 graduate C) with a good quality of multislice images in different phases of the cardiac cycle, as well as a good contrast between myocardium and flowing blood. This technique allowed the calculation of the end-diastolic (EDV) and end-systolic (ESV) volumes of working heart that could be used to monitor the development of heart failure in vivo in Tg alfa q*44 mice.

13

Anti-granulocyte scintigraphy in early rheumatoid arthritis - does it work?

83%

Horkay E. , Kincse G. , Varga J. , Szabados L. , Garai I. , Gaál J.

Open Medicine

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2013

|

tom 8

|

nr 5

558-564

14

Research into the Value of B-Mode Ultrasound, CT and MRI Examinations in the Diagnosis of Preoperative Myometrial Infiltration of Endometrial Cancer and Lymph Node Metastasis

71%

Lu R. , Guixia S.

Open Medicine

|

2014

|

tom 10

|

nr 1

EN

This study is conducted to observe the diagnostic value of B-mode ultrasound, CT and MRI examinations in preoperative myometrial infiltration of endometrial cancer and lymph node metastasis. Retrospectively analyze 50 cases of the patients from Oct. 2010 to Aug. 2013. Before operation all the patients received dilatation & curettage to determine pathological diagnosis and clinical staging. There were 150 cases of patients who received B-mode ultrasound examination, wherein, 93 cases received CT examination and 57 cases received MRI examination as well. In the diagnosis of MIEC the diagnostic indicies of individual MRI examination were higher than that of individual B-mode ultrasound and CT examinations. Consistency of individual MRI examination with pathological diagnosis was significantly higher than that of B-mode and CT examinations. The sensitivity of CT and MRI was significantly higher than that of B-mode ultrasound examination. However, diagnostic indicators of B-mode ultrasound and CT joint examination were higher than B-mode ultrasound examination alone. The consistency of both with pathological diagnosis was significantly increased. B-mode and CT can significantly improve the diagnostic accuracy and has a good consistency with pathological diagnosis, thereby applicable to the clinical diagnosis of preoperative myometrial infiltration of endometrial cancer and lymph node metastasis.

15

A fast method of separation of the noisy background from the head-cross section in the sequence of MRI scans

71%

Kalicka R. , Lipiński S.

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tom Vol. 30, no. 2

15-27

EN

The paper presents a new method of removing the noisy background from the sequence of magnetic resonance imaging (MRl) scans. The sequence of scans is required in order to monitor a passage of a contrast agent through the brain tissue. The scans contain the noisy head-cross data and also the noisy background data. The latter has to be removed and excluded from a further analysis. It is achieved by applying some basic morphological operations to the previously binarized MRl scans. The results of separating the background from the sequence of scans are presented in the paper. The scans binarization method is described and compared with the widely used Otsu method. The proposed method of the noisy background separation is easily applicable, efficient and does not need any sophisticated calculations.

16

Diagnostyka zmian nowotworowych trzonu macicy (TK, MRI, PET)

71%

Królicki L. , Andrysiak R. , Jakuciński M.

Ginekologia Onkologiczna

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2009

|

tom 7

|

nr 1

22-24

EN

Badania obrazowe w diagnostyce raka macicy odgrywają istotną rolę, zwłaszcza w ocenie zaawansowania choroby. Ponieważ każda metoda ma pewne zalety i ograniczenia, wybór odpowiedniej metody diagnostycznej zależy od określonego problemu diagnostycznego. W artykule dokonano przeglądu możliwości wykorzystania tomografii komputerowej, tomografii rezonansu jądrowego oraz PET w diagnostyce raka trzonu macicy.

17

An object-oriented approach to simulating human gait motion based on motion tracking

71%

Tändl M. , Stark T. , Erol N. , Löer F. , Kecskeméthy A.

International Journal of Applied Mathematics and Computer Science

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2009

|

tom 19

|

nr 3

469-483

EN

Accurate bone motion reconstruction from marker tracking is still an open and challenging issue in biomechanics. Presented in this paper is a novel approach to gait motion reconstruction based on kinematical loops and functional skeleton features extracted from segmented Magnetic Resonance Imaging (MRI) data. The method uses an alternative path for concatenating relative motion starting at the feet and closing at the hip joints. From the evaluation of discrepancies between predicted and geometrically identified functional data, such as hip joint centers, a cost function is generated with which the prediction model can be optimized. The method is based on the object-oriented multibody library M ⃢ BILE, which has already been successfully applied to the development of industrial virtual design environments. The approach has been implemented in a general gait visualization environment termed Mobile Body.

18

Magnetic resonance imaging (MRI) for assessment of differences in geometrical parameters in muscles stabilizing vertebral column in young and older persons. Case study

59%

Dziuba A. , Rutkowska-Kucharska A. , Hadzik A. , Rudziński M. , Garcarek J.

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tom Vol. 12, no. 3

41-51

EN

Today non-traumatic low back pain (LBP) is a social disease being attributed to weakening the function of abdominal and back muscles. Condition of deep muscles, inaccessible to non-invasive examinations, can be assessed by means of magnetic resonance imaging (MRI). The method allows for the assessment of cross-sections, muscle girths, as well as their intensity (brightness). The aim of the investigations was to determine the opportunities to employ MRI technique for assessing the geometry of muscles which stabilize spinal column. The study covered 4 women without LBP symptoms. The cross-sectional area, thickness and brightness of abdominal and back muscles were measured at the level of L3–L4. Measurement of geometrical parameters in the positions studied was aimed at setting such measurement conditions that would force higher isometric contraction in the muscles examined. As a result of measurements it can be inferred that other conditions of the experiment affect neither an increase in cross-sectional surface area nor the thickness of the muscles examined. The differences observed in geometrical parameters of the muscles testify to different coordination of muscle activation in the positions studied, both in young and older subjects, and to the purposefulness of continuing this type of measurements.

19

Przypadek choroby Creutzfeldta-Jakoba zdiagnozowany przyżyciowo

59%

Adamkiewicz B. , Fornalska Z. , Skłodowski P. , Liberski P. P. , Klimek A.

Aktualności Neurologiczne

|

2006

|

tom 6

|

nr 1

54-57

EN

A rapidly progressing dementia, followed by focal neurological signs and evidence of periodic sharp waves complexes in the EEG may lead to the clinical suspicion of Creutzfeldt-Jakob disease (CJD). Nevertheless the cases of CJD are diagnosed seldom. Patient, a 66-year-old man was admitted to Department of Neurology with progressive disturbances of communication. There was no family history of similar diseases. In the neurological examination aphasia, behavioural abnormalities and grow of muscles tension was found. There were also periodic abnormalities in EEG. The rapidly progressive worsening of consciousness persuaded us to recognizing CJD. We diagnosed him as having CJD as we detected the 14-3-3 neuronal protein in cerebrospinal fluid. Cranial MRI showed mild cerebral atrophy with periventricular white matter hyperintensity in T2-weighted scans. During the observation the contact with patient rapidly worsened and he died after two weeks hospitalisation. The CJD was proven by the typical EEG, neuronal protein in CSF and by autopsy too. This is the one of few cases diagnosed alive.

PL

Szybko postępujące otępienie, po którym pojawiają się ogniskowe objawy uszkodzenia mózgu oraz obecność periodycznych zmian patologicznych w zapisie EEG pod postacią iglicy i fali wolnej nasuwają podejrzenie choroby Creutzfeldta-Jakoba (CJD). Tym niemniej rozpoznania tego schorzenia są rzadko spotykane. Chory 66-letni został przyjęty do Oddziału Neurologicznego WSS im. M. Kopernika w Łodzi z powodu zaburzeń zachowania i porozumiewania się. W rodzinie nie było przypadków demencji. W badaniu przedmiotowym stwierdzono zaburzenia typu afatycznego, wzrost napięcia mięśniowego z niewielką asymetrią w kończynach. W badaniu elektroencefalograficznym uwidoczniono nasilone zmiany patologiczne pod postacią iglic i fal wolnych. Szybko postępujące zaburzenia świadomości nasunęły podejrzenie CJD. Wykonano badanie pmr, w którym wykazano obecność białka neuronalnego 14-3-3. W badaniu MRI zaobserwowano zaniki korowo-podkorowe. W trakcie pobytu stan chorego ulegał szybkiemu pogorszeniu, pojawiła się śpiączka, napięcie mięśniowe narastało. Po dwóch tygodniach hospitalizacji nastąpił zgon pacjenta. Badanie sekcyjne potwierdziło rozpoznanie sporadycznej postaci CJD. Jest to jeden z nielicznych przypadków rozpoznanych przyżyciowo.

20

Anatomia diagnostyczna i diagnostyka patologii strefy entezy pierścienia rotatorów

59%

Czyrny Z.

Journal of Ultrasonography

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2012

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tom 12

|

nr 49

178-187

EN

Detailed anatomy, crucial in modern high-definition diagnostics imaging, is a base for understanding diagnostic images and the nature of the diagnosed disease. The aim of this paper is presentation of a new anatomical model of the rotator cuff, which includes definition of tendinous and capsule-ligamentous layers as equally important to rotator cuff function understanding. Schematic and diagnostic (ultrasonography, magnetic resonance imaging) anatomy of the rotator cuff based on the core tendon concept is presented. Appropriate tissue layers of the cuff are discussed in detail. In the diagnostics part some enthesal pathologies of the rotator cuff are presented. Material and methods: New anatomical data was analyzed in the context of rotator cuff layers – their presence, thickness and structure observed on magnetic resonance imaging and ultrasonographic images. Conclusions: Rotator cuff should be regarded as a multilayer structure consisting of fused fibers of tendons and capsuloligamentous complex. The thickness of these layers is comparable therefore it is important to realize that capsular pathologies may become a serious obstacle to normal shoulder joint function. Understanding of anatomical rotator cuff layers explains the formation of calcific cavities within the rotator cuff. In fact between layers of the cuff. Calcific cavities are a sequelae of chronic enthesopathy/enthesal tear with hydroxyapatite filling and probably delaminating the tendinous layer from the capsuloligamentous one.

PL

Anatomia szczegółowa, jakiej wymaga nowoczesna diagnostyka obrazowa, jest podstawą zrozumienia obrazów diagnostycznych oraz natury diagnozowanej choroby. Celem pracy jest przedstawienie nowego modelu anatomicznego struktur mięśniowo-ścięgnistych i torebkowo-więzadłowych o kompleksowej nazwie pierścień rotatorów, na podstawie schematów anatomicznych i anatomii diagnostycznej (ultrasonografia i rezonans magnetyczny) pierścienia z zastosowaniem koncepcji rdzeni ścięgnistych. Omawiane są odpowiednie warstwy tkankowe pierścienia rotatorów. W części diagnostycznej przedstawiono niektóre patologie entezy ramiennej pierścienia rotatorów. Materiał i metoda: Przeanalizowano najnowsze dane z badań anatomicznych struktury warstw pierścienia rotatorów – ich lokalizację, wymiary i strukturę w badaniach ultrasonograficznym i rezonansu magnetycznego. Wnioski: Pierścień rotatorów powinien być rozpatrywany jako wielowarstwowa struktura składająca się z przeplatających się i zespalających ze sobą włókien ścięgien i kompleksu torebkowo-więzadłowego spełniających różne funkcje statyczno- dynamiczne. Grubość tych warstw jest porównywalna, stąd duże znaczenie ma świadomość, że patologie kompleksu torebkowo-więzadłowego mogą stać się poważną przeszkodą w prawidłowym funkcjonowaniu stawu ramiennego, mając istotny wpływ na zachowanie się całego pierścienia rotatorów. Zrozumienie anatomii i funkcji warstw pierścienia rotatorów wyjaśnia część zagadki tworzenia się hydroksyapatytowych jam wapiennych pomiędzy warstwami ścięgien/kompleksu. Jamy te są konsekwencją uszkodzeń entezy pierścienia rotatorów na granicy przyczepu warstwy ścięgnistej i torebkowo- więzadłowej. Takie uszkodzenie entezy otwiera drogę do wypełniania już istniejących rozwarstwień ścięgna-kompleksu oraz aktywnego ich rozlaminowywania poprzez ciągłe wypełnianie materiałem wapiennym.