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ELASTOGRAFIA STRAIN

medical imaging solutions

Numar telefon0730033998

ELASTOGRAFIA STRAIN - dr.Daniela Constantin
MIERCURI , MAI 2016
ELASTOGRAFIA STRAIN - dr.Daniela Constantin
Metoda palparii este o tehnica de diagnosticare folosita din antichitate, lucru mentionat in papirusurile datand din secolul XVII i.e.n. si confirmat in scrierile lui Hipocrate. Palparea este inca o tehnica valoroasa si esentiala si in zilele noastre, atat pentru examenul clinic, cat si pentru autoexaminare.
Elastografia reprezinta metoda neinvaziva de a crea imagini interpretabile, folosind caracteristicile mecanice ale tesuturilor.
Cu alte cuvinte, elastografia este o metoda imagistica total neinvaziva ce poate detecta anumite leziuni de tip tumoral, bazandu-se pe elasticitatea sau rigiditatea tesuturilor la presiunea cu transductorul, comparativ cu tesutul normal din vecinatate.
 
 
 
Fiecarui pixel din imaginea digitala elastografica din ROI (fereastra de formare a imaginii elastografice) ii este atribuit una dintre cele 256 de culori specifice, in functie de amplitudinea deformarii. Gama de culori se interpreteaza astfel: rosu - tesut cu deformare maxima (moale), albastru - tesut nedeformabil (dur/rigid), verde - tesut cu deformare medie.
 

 

Imaginea codificata color (Strain Elastography) este suprapusa peste imaginea ecografica in scara gri a leziunii urmarite, observand cu usurinta distributia nuantelor de culori, in functie de rigiditatea sau elasticitatea tesuturilor din ROI.

 

 

 Cele mai cunoscute studii, publicate in literatura de specialitate, au ca subiect utilizarea strain elastografiei (codificate color) in examinarile tiroidei si sanului. 

Doua dintre acestea (96,99), cu 309, respectiv 97 pacienti, au utilizat strain elastografia pentru a determina rigiditatea nodulilor tiroidieni, demonstrand specificitate a metodei fata de ecografia conventionala. Experienta de pana in cazul examinarilor tiroidiene evidentiaza ca prima indicatie a sonoelastografiei in orientarea punctiei-biopsie. Astfel, un nodul suspect cu un scor elastografic SR=3, va fi punctionat in zona cu rigiditatea cea mai mare (intens albastra) pentru o specificitate mai buna. (Ghiduri EFSUMB).

 

Microchist tiroidian, artefact BGR (din arhiva personala)

 

 Chist tiroidian, artefact BGR (din arhiva personala)

 

Nodul tiroidian mixt, SR=3 (din arhiva personala)

 

Pe de alta parte, rolul elastografiei mamare este in primul rand de a urmari un nodul mamar suspect (BIRADS 3), apoi de a orienta punctia-biopsie.

 

Chist mamar, artefact BGR (din arhiva personala)

 

Nodul mamar BIRADS 3, SR 2 (din arhiva personala)

 

In loc de concluzii:

- Sonoelastografia reprezinta o alta cale de “a vedea ce poti palpa” 

- este o metoda neivaziva, simpa si rapida ce completeaza examinarea ecografica conventionala

- este o metoda imagistica accesibila, ce poate influenta reducerea numarul de punctii-biopsie

 

 

* Imaginile au fost realizate cu ecograful Apogee3300