{"id":2562,"date":"2023-02-09T10:42:30","date_gmt":"2023-02-09T10:42:30","guid":{"rendered":"https:\/\/www.karotidnahirurgija.com\/?page_id=2562"},"modified":"2023-02-24T12:20:25","modified_gmt":"2023-02-24T12:20:25","slug":"6-1-multislice-computed-tomography-angiography-msct","status":"publish","type":"page","link":"https:\/\/www.karotidnahirurgija.com\/?page_id=2562","title":{"rendered":"6.1 MULTISLICE COMPUTED TOMOGRAPHY ANGIOGRAPHY (MSCT)"},"content":{"rendered":"

\"\"<\/a><\/p>\n

<\/p>\n

ARTERIOGRAFIJA SUPRAAORTALNIH GRANA<\/h1>\n

<\/a><\/h1>\n

\n

\n

6.1 MULTISLICE COMPUTED TOMOGRAPHY
ANGIOGRAPHY (MSCT)<\/p>\n

<\/h3>\n<\/div>\n
\n

Arteriografija je indikovana ako: postoje kontroverze izme\u0111u nalaza ili dileme (globalna simptomatologija, malformacije itd.), dolazi u obzir endovaskularna procedura, ima indikacija za vizualiziranje drugih supraaortalnih grana (brahiocefali\u010dni trunkus, vertebralna i subklavijalna arterija), postoji potreba da se analiziraju intrakranijalne cerebralne arterije.<\/h4>\n

Arteriogra<\/b><\/span>fi<\/b><\/span>ja<\/b><\/span> <\/b><\/span>se<\/span> <\/span>smatra<\/span> <\/span>\u201dzlatnim<\/span> <\/span>standardom\u201d<\/span> <\/span>u<\/span> <\/span>dijagnostici<\/span> <\/span>supraaort-<\/span> <\/span>alnih<\/span> <\/span>grana<\/span> <\/span>za<\/span> <\/span>planiranje<\/span> <\/span>terapijskih<\/span> <\/span>alternativa<\/span> <\/span>i<\/span> <\/span>klju\u010dni<\/span> <\/span>faktor<\/span> <\/span>indikacionog<\/span> <\/span>odlu\u010divanja<\/span> <\/span>(<\/span>decision<\/i><\/span> <\/i><\/span>making<\/i><\/span> <\/i><\/span>process<\/i><\/span>).<\/span> <\/span>Dobra<\/span> <\/span>karotidna<\/span> <\/span>arteriogra<\/span>fi<\/span>ja<\/span> <\/span>ne<\/span> <\/span>sme<\/span> <\/span>biti<\/span> <\/span>jednodimenzionalna,<\/span> <\/span>da<\/span> <\/span>se<\/span> <\/span>ne<\/span> <\/span>bi<\/span> <\/span>previdele<\/span> <\/span>lezije<\/span> <\/span>(obi\u010dno<\/span> <\/span>na<\/span> <\/span>zadnjem<\/span> <\/span>zidu).<\/span> <\/span>Neophodan<\/span> <\/span>je<\/span> <\/span>arteriografski<\/span> <\/span>prikaz:<\/span><\/p>\n

    \n
  • intratorakalnog,<\/span> <\/span>ekstrakranijalnog<\/span> <\/span>i<\/span><\/li>\n
  • intrakranijalnog<\/span> <\/span>arterijskog<\/span> <\/span>segmenta.<\/span><\/li>\n<\/ul>\n

    Arteriogra<\/span>fi<\/span>ja<\/span> <\/span>je<\/span> <\/span>\u010desto<\/span> <\/span>neizbe\u017ena<\/span> <\/span>u<\/span> <\/span>slu\u010daju<\/span> <\/span>globalne<\/span> <\/span>cerebralne<\/span> <\/span>ishemije.<\/span> <\/span>Arteriogra<\/span>fi<\/span>ja<\/span> <\/span>luka<\/span> <\/span>aorte<\/span> <\/span>treba<\/span> <\/span>da<\/span> <\/span>prika\u017ee<\/span> <\/span>proksimalne<\/span> <\/span>i<\/span> <\/span>distalne<\/span> <\/span>arterije<\/span> <\/span>u<\/span> <\/span>odnosu<\/span> <\/span>na<\/span> <\/span>karotidnu<\/span> <\/span>bifurkaciju,<\/span> <\/span>jer<\/span> <\/span>stanje<\/span> <\/span>ovih<\/span> <\/span>arterija<\/span> <\/span>ne<\/span> <\/span>mo\u017ee<\/span> <\/span>se<\/span> <\/span>uvek<\/span> <\/span>pouzdano<\/span> <\/span>utvrditi<\/span> <\/span>ehografski.<\/span> <\/span>U<\/span> <\/span>bolesnika<\/span> <\/span>sa<\/span> <\/span>globalnom<\/span> <\/span>simptomatologijom<\/span> <\/span>neophodan<\/span> <\/span>je<\/span> <\/span>prikaz<\/span> <\/span>Williso-ovog<\/span> <\/span>poligona.<\/span> <\/span>Ako<\/span> <\/span>je<\/span> <\/span>on<\/span> <\/span>o\u010duvan<\/span> <\/span>karotidna<\/span> <\/span>endarterektomija,<\/span> <\/span>ako<\/span> <\/span>je<\/span> <\/span>indikovana,<\/span> <\/span>mo\u017ee<\/span> <\/span>pru\u017eiti<\/span> <\/span>dobar<\/span> <\/span>rezultat<\/span> <\/span>\u010dak<\/span> <\/span>i<\/span> <\/span>ako<\/span> <\/span>postoje<\/span> <\/span>simultane<\/span> <\/span>lezije<\/span> <\/span>drugih<\/span> <\/span>supraaortalnih<\/span> <\/span>i<\/span> <\/span>intracerebralnih<\/span> <\/span>arterija.<\/span> <\/span>Hemodinamski<\/span> <\/span>zna\u010dajnim<\/span> <\/span>se<\/span> <\/span>arbitrerno<\/span> <\/span>smatraju<\/span> <\/span>stenoze<\/span> <\/span>preko<\/span> <\/span>75%<\/span> <\/span>lumena.<\/span><\/p>\n

    U<\/span> vreme uvo\u0111enja minimalno invazivnih procedura <\/span>u<\/span> <\/span>hirurgiju<\/span> <\/span>o\u010dekuje <\/span>se<\/span> <\/span>da<\/span> <\/span>bi<\/span> <\/span>i<\/span> <\/span>dijagnostika<\/span> <\/span>morala<\/span> <\/span>da<\/span> <\/span>bude<\/span> <\/span>manje<\/span> <\/span>invazivna.<\/span> <\/span>Danas<\/span> <\/span>od<\/span> <\/span>neinvazivnih<\/span> <\/span>metoda<\/span> <\/span>za<\/span> <\/span>detekciju<\/span> <\/span>karotidne<\/span> <\/span>bolesti<\/span> <\/span>koristimo<\/span> <\/span>kolor<\/span> <\/span>Duplex<\/span> <\/span>ultrasonogra<\/span>fi<\/span>ju,<\/span> <\/span>MR<\/span> <\/span>angiogra<\/span>fi<\/span>ju<\/span> <\/span>i<\/span> <\/span>MSCT<\/span> <\/span>angiogra<\/span>fi<\/span>ju.<\/span><\/p>\n

    Multislice<\/b><\/span> <\/b><\/span>Computed<\/b><\/span> <\/b><\/span>Tomography<\/b><\/span> <\/b><\/span>Angiography<\/b><\/span> <\/b><\/span>(<\/span>MSCT<\/b><\/span>)<\/span> <\/span>ili<\/span> <\/span>Multidetector<\/span> <\/span>Computed<\/span> <\/span>Tomography<\/span> <\/span>(MDCT)<\/span> <\/span>karotidnih<\/span> <\/span>arterija<\/span> <\/span>zna\u010dajno<\/span> <\/span>skra\u0107uje<\/span> <\/span>vreme <\/span>trajanja pregleda, koli\u010dinu zra\u010denja i kontrastnog sredstva, daje manje artefakata i pru\u017ea mogu\u0107nost kvalitetne 3D rekonstrukcije. Danas, posle vi\u0161e generacija MSCT aparata mo\u017eemo re\u0107i ovi nalazi imaju brojne prednosti u poredjenju sa konvencionalnom angiografijom.<\/p>\n

    <\/multicol><\/p>\n

    MSCT angiografija pokazuje stepen stenoze i prirodu plakova, ali i morfologiju karotidnih arterija i odnos sa ostalim strukturama vrata, kao i Willisov<\/i> <\/i>poligon. Neophodno je planiranje rekonstruktivnih zahvata trastorakalnim putem. MSCT 3D tehnikom se prikazuju morfolo\u0161ke promene karotidnih arterija u vidu angulacija, elongacija, kinkinga i coilinga. Prisustvo prizidne tromboze se mo\u017ee naslutiti arteriografski, a videti Duplex-sonografski i MSCT-om.<\/p>\n<\/p>\n

    Kompletna okluzija se dijagnostikuje sa ve\u0107om specifi\u010dno\u0161\u0107u i senzitivno\u0161\u0107u nego prilikom Duplex-ultrasonografije. Precizna je u odredijivanju prohodnosti distalnog arterijskog segmenta, \u0161to diktira operabilnost lezije. Ulceracija karotidnog plaka se zapa\u017ea kao iregularnost konture zida arterije, sa \u00bbplusom u senci kontrasta\u00ab, ili kao penetrantna ni\u0161a sa kraterom. La\u017eno negativni nalazi se javljaju kada je ulceracija suvi\u0161e mala da bi mogla biti vi\u0111ena. Ulkusni krater mo\u017ee biti ispunjen koagulumom ili prekriven fibroznom kapom.<\/p>\n

    Mana MSCT-a je primena jonizuju\u0107eg zra\u010denja i kontrastnog sredstva koje je nefrotoksi\u010dno.<\/p>\n<\/div>\n

    \"\"<\/p>\n

    \n

    Visokostepena stenoza karotidne <\/em>bifurkacije (80%) heterogenim plakom sa <\/em>ulceracijom prema unutra\u0161njoj karotidnoj <\/em>arteriji. MSCT potvrdjuje subokluziju <\/em>karotidne bifurkacije i isklju\u010duje <\/em>proksimalne i distalne lezije.<\/em><\/p>\n<\/div>\n

    \"\"
    \n\"\"<\/p>\n

    \n

    Krataka segmentna ateroskleroti\u010dna okluzija unutra\u0161nje karotidne arterije. Prikazuje se spolja\u0161nja karotidna arterija sa svojim granama i plakom na orificijumu<\/em><\/p>\n<\/div>\n


    \n<\/p>\n","protected":false},"excerpt":{"rendered":"

    ARTERIOGRAFIJA SUPRAAORTALNIH GRANA 6.1 MULTISLICE COMPUTED TOMOGRAPHY ANGIOGRAPHY (MSCT) Arteriografija je indikovana ako: postoje kontroverze izme\u0111u nalaza ili dileme (globalna simptomatologija, malformacije itd.), dolazi u obzir endovaskularna procedura, ima indikacija za vizualiziranje drugih supraaortalnih grana (brahiocefali\u010dni trunkus, vertebralna i subklavijalna arterija), postoji potreba da se analiziraju intrakranijalne cerebralne arterije. Arteriografija se smatra \u201dzlatnim standardom\u201d u […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-2562","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"\n6.1 MULTISLICE COMPUTED TOMOGRAPHY ANGIOGRAPHY (MSCT) - KAROTIDNA HIRURGIJA<\/title>\n<meta name=\"description\" content=\"Arteriografija je indikovana ako: postoje kontroverze izme\u0111u nalaza ili dileme (globalna simptomatologija, malformacije itd.), dolazi u obzir endovaskularna procedura, ima indikacija za vizualiziranje drugih supraaortalnih grana (brahiocefali\u010dni trunkus, vertebralna i subklavijalna arterija), postoji potreba da se analiziraju intrakranijalne cerebralne arterije.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.karotidnahirurgija.com\/?page_id=2562\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"6.1 MULTISLICE COMPUTED TOMOGRAPHY ANGIOGRAPHY (MSCT) - 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