Tesi etd-05122016-123508 |
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Tipo di tesi
Tesi di laurea magistrale LM5
Autore
MINGHINI, REBECCA
URN
etd-05122016-123508
Titolo
Contrast-enhanced ultrasound (CEUS) nelle patologie renali del cane
Dipartimento
SCIENZE VETERINARIE
Corso di studi
MEDICINA VETERINARIA
Relatori
relatore Prof.ssa Citi, Simonetta
correlatore Dott. Mannucci, Tommaso
controrelatore Prof.ssa Guidi, Grazia
correlatore Dott. Mannucci, Tommaso
controrelatore Prof.ssa Guidi, Grazia
Parole chiave
- analisi qualitativa
- analisi quantitativa
- cane
- contrast-enhanced ultrasound
- patologie renali
Data inizio appello
31/05/2016
Consultabilità
Completa
Riassunto
Introduzione: La contrast-enhanced ultrasound (CEUS) è una tecnica ecografica innovativa che permette lo studio della perfusione degli organi e di parti di essi in tempo reale. Tale metodica prevede l’utilizzo di mezzi di contrasto costituiti da microbolle gassose rivestite da membrana che dopo somministrazione intravenosa si diffondono nel circolo ematico permettendo l’amplificazione del segnale ultrasonoro riflesso dal circolo stesso. Lo studio econcontrastografico in medicina veterinaria è ancora metodica utilizzata per la maggior parte a scopo di ricerca, anche se sono presenti in letteratura studi su organi addominali affetti da molteplici patologie. Materiali e Metodi: Nel nostro studio sono stati considerati 22 cani affetti da patologia renale con distribuzione focale o diffusa. Ogni soggetto è stato sottoposto ad esame B-mode e ad esame CEUS, i cui risultati venivano analizzati con analisi qualitativa in entrambe le distribuzioni delle lesioni e con analisi quantitativa solo in caso di patologie diffuse. Risultati e Discussione: Abbiamo applicato la metodica CEUS in tutti i pazienti con assenza di effetti collaterali e in un tempo non superiore ai 5 minuti. Tutte le lesioni focali hanno mostrato alterazioni di enhancement tali da discriminare le diagnosi differenziali emesse con ecografia B-Mode. Nelle patologie diffuse abbiamo riscontrato alterazioni delle fasi di presa di contrasto in corticale e midollare, diverse anche fra i soggetti affetti dalla stessa patologia. Quindi non si è potuta riscontrare una caratteristica presentazione in analisi qualitativa né di insufficienza renale acuta né di insufficienza renale cronica. Lo studio quantitativo mostra una differenza tra le due classi ma non è possibile confrontarla con la bibliografia per assenza di pubblicazioni riguardanti il medesimo argomento, né con articoli di soggetti sani in quanto i risultati presentano unità di misura differenti. Conclusioni: la metodica CEUS in accordo con la bibliografia ci permette di differenziare le lesioni benigne dalle maligne, ma nelle patologie diffuse renali non permette ancora di ottenere risultati in più rispetto all’indagine diagnostica eseguita su base clinica, laboratoristica ed ecografica.
Introduction: The contrast-enhanced ultrasound (CEUS) is an innovative ultrasound technique that allows the study of the perfusion of the organs and parts of them in real time. This method involves the use of contrast media consisting of gas microbubbles coated of membrane that after intravenous administration spread into the bloodstream allowing the enhancement of reflected signal from the same circle. The contrast ultrasonographic study in veterinary medicine is still the method used mostly for research purposes, although there are reports in the literature of abdominal organs suffering from multiple diseases. Materials and Methods: In our study we have considered 22 dogs with renal disease with focal or diffuse distribution. Each subject has been subjected to the B-mode test and to CEUS examination, the results of which were analyzed by qualitative analysis in both the distributions of the lesions and with quantitative analysis only in the case of common diseases. Results and Thread: We applied the CEUS in all patients with absence of side effects and in a time not exceeding 5 minutes. All focal lesions showed alterations of enhancement such as to discriminate the differential diagnosis issued with B-mode ultrasound. In diffuse diseases we found alterations in contrast taken steps in the cortex and medulla, different even among individuals with the same disease. So there not has been possible to detect a feature presentation nor qualitative analysis of acute renal failure or chronic renal failure. The quantitative study shows a difference between the two classes but it is not possible to compare it with the bibliography for the absence of publications on the same issue, nor with healthy subjects articles because the results have different units of measure. Conclusions: CEUS method in accordance with the bibliography allows us to differential benign from malignant lesions, but in kidney diffuse diseases not yet allowed to get results higher than the survey diagnostics performed on a clinical basis, clinical laboratory and ultrasound.
Introduction: The contrast-enhanced ultrasound (CEUS) is an innovative ultrasound technique that allows the study of the perfusion of the organs and parts of them in real time. This method involves the use of contrast media consisting of gas microbubbles coated of membrane that after intravenous administration spread into the bloodstream allowing the enhancement of reflected signal from the same circle. The contrast ultrasonographic study in veterinary medicine is still the method used mostly for research purposes, although there are reports in the literature of abdominal organs suffering from multiple diseases. Materials and Methods: In our study we have considered 22 dogs with renal disease with focal or diffuse distribution. Each subject has been subjected to the B-mode test and to CEUS examination, the results of which were analyzed by qualitative analysis in both the distributions of the lesions and with quantitative analysis only in the case of common diseases. Results and Thread: We applied the CEUS in all patients with absence of side effects and in a time not exceeding 5 minutes. All focal lesions showed alterations of enhancement such as to discriminate the differential diagnosis issued with B-mode ultrasound. In diffuse diseases we found alterations in contrast taken steps in the cortex and medulla, different even among individuals with the same disease. So there not has been possible to detect a feature presentation nor qualitative analysis of acute renal failure or chronic renal failure. The quantitative study shows a difference between the two classes but it is not possible to compare it with the bibliography for the absence of publications on the same issue, nor with healthy subjects articles because the results have different units of measure. Conclusions: CEUS method in accordance with the bibliography allows us to differential benign from malignant lesions, but in kidney diffuse diseases not yet allowed to get results higher than the survey diagnostics performed on a clinical basis, clinical laboratory and ultrasound.
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