#1
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ÊÒ èëè ÌÐÒ?
Çäðàâñòâóéòå. Ïîìîãèòå ìíå ïîæàëóéñòà ïîíÿòü, êàêîå îáñëåäîâàíèå ìíå íóæíî ïðîâåñòè.  àíàìíåçå ñ 2000 ã. õðîíè÷åñêèé ãíîéíûé äâóõñòîðîííèé ãàéìîðèò. Çà 10 ëåò èìåþ îêîëî 70-80 ïðîêîëîâ ñ îáåèõ ñòîðîí.  äåêàáðå 2008 ãîäà, ïîñëå î÷åðåäíîãî îáîñòðåíèÿ ìíå âðà÷îì áûëî ñêàçàíî î íåîáõîäèìîñòè ñàíàöèè ãàéìîðîâûõ ïàçóõ, è áûëî âûäàíî íàïðàâëåíèå íà ÊÒ âåðõíåé ÷åëþñòè, ãàéìîðîâûõ è ëîáíûõ ïàçóõ. ÊÒ íå ñîñòîÿëîñü â ñâÿçè ñ áåðåìåííîñòüþ.  àïðåëå 2009 íà 4 ìåñÿöå áåðåìåííîñòè ãîäà ÿ ëåæàëà â Áîòêèíñêîé áîëüíèöå, áåç ðåíòãåíà, åñòåñòâåííî ïðîêîëàìè è àíòèáèîòèêàìè áûëà âûëå÷åíà.
Ìåñÿö íàçàä íà÷àëèñü ãíîéíûå âûäåëåíèÿ èç íîñà, â ñàìîì íà÷àëå çàáîëåâàíèÿ ïðîëå÷èëàñü ñèíóôîðòå è àóãìåíòèíîì, ãíîéíûå âûäåëåíèÿ óøëè. Íî, ñ òåõ ïîð ó ìåíÿ íåìåþò âåðõíèå ïåðåäíèå çóáû è âñÿ âåðõíÿÿ ÷åëþñòü èñïûòûâàåò îùóùåíèå äàâëåíèÿ, êàê áóäòî ìåæäó âñåìè çóáàìè çàñòðÿëè îñòàòêè ïèùè, ïðè ñæèìàíèè çóáîâ âåðõíÿÿ ÷åëþñòü êàê áóäòî òðàâìèðîâàíà äîëãèì æåâàíèåì æåñòêîé ïèùè. Ó ìåíÿ ïàïà ËÎÐ, íî íå ïðàêòèêóþùèé óæå ìíîãî ëåò. Îí ãîâîðèò, ÷òî íåîáõîäèìî ÊÒ ñ êîíòðàñòîì. Ñîáñòâåííî ïîéòè ñåé÷àñ ê âðà÷ó ó ìåíÿ íåò âîçìîæíîñòè, íî åñòü âîçìîæíîñòü áåç çàïèñè ñäåëàòü ÌÐÒ ñ êîíòðàñòîì. Ñîáñòâåííî âîïðîñ, ïîêàæåò ëè ÌÐÒ íàëè÷èè êèñò èëè ïîëèïîâ (çíàþ, ÷òî íîâîîáðàçîâàíèå ïîêàæåò) â ãàéìîðîâûõ ïàçóõàõ, èëè âñå òàêè íóæíî äåëàòü ÊÒ? Ñïàñèáî. |
#2
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 ñëó÷àÿõ ïîäîáíîìó Âàøåìó, ðåêîìåíäóåòñÿ ïðîâåñòè ÊÒ (áåç êîíòðàñòà) ïî ïðîòîêîëó äëÿ ïðîöåäóðû, íàçûâàåìîé ÔÅÑÑ.
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#3
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Ñïàñèáî. Ïðîñòèòå çà ìîþ íàçîéëèâîñòü, íà ÊÒ ÿ ìîãó çàïèñàòüñÿ òîëüêî óæå ïîñëå ÍÃ. Ìåíÿ íàïóãàëà ìàìà, ñêàçàâ, ÷òî îáñëåäîâàíèå íàäî ïðîâåñòè ñðî÷íî. Ïîòîìó ÷òî åñëè òàì âäðóã åñòü çëîêà÷åñòâåííîå íîâîîáðàçîâàíèå, òî ÿ ïîòåðÿþ êàê ìèíèìóì 2 íåäåëè. Âñå òàêè, åñëè ÿ ñäåëàþ ÌÐÒ ñåé÷àñ, ïåðåä ÍÃ, òî ýòî îáñëåäîâàíèå áóäåò íå èíôîðìàòèâíûì, ïî ñðàâíåíèþ ñ ÊÒ ïî ïðîòîêîëó ÔÅÑÑ?
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#4
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Çàïèñàëàñü íà ÊÒ â äâóõ ïðîåêöèÿõ. Ñïàñèáî!
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#5
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Äëÿ óòî÷íåíèÿ õàðàêòåðà èçìåíåíèé â ïàçóõàõ ÌÐÒ áóäåò âåñüìà èíôîðìàòèâíûì, êèñòû è ïîëèïû ÌÐÒ ïîêàæåò, êàê è äðóãèå èçìåíåíèÿ. Íî åñëè âåñòè ðå÷ü î ïåðñïåêòèâàõ ýíäîñêîïè÷åñêîãî õèðóðãè÷åñêîãî ëå÷åíèÿ, òî ïîòðåáóåòñÿ è âûïîëíåíèå ÊÒ.
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Ñ óâàæåíèåì, ×åðåáèëëî Âëàäèñëàâ Þðüåâè÷ |
#6
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Âëàä, áóäó÷è ðàäèîëîãè÷åñêèì ïåäàíòîì ( ), ïðèäåðæèâàþñü íàèáîëåå ïîïóëÿðíîé ïàðòèéíîé ëèíèè, âêðàòöå ñðàâíèòåëüíî íåäàâíî ñôîðìóëèðîâàííîé âîò êàêèì îáðàçîì:
- Imaging Techniques Computer Tomography. Computed tomography (CT) scanning is the best method for viewing the paranasal sinuses. There is little relationship, however, between symptoms in most patients and findings of abnormalities on a CT scan. CT scans are recommended for acute sinusitis only if there is a severe infection, complications, or a high risk for complications. CT scans are useful for diagnosing chronic or recurrent acute sinusitis and for surgeons as a guide during surgery. They show inflammation and swelling and the extent of the infection, including in deeply hidden air chambers missed by x-rays and nasal endoscopy. Often, they can detect the presence of fungal infections. ...... Magnetic Resonance Imaging. Magnetic resonance imaging (MRI) is not as effective as CT in defining the paranasal anatomy and therefore is not typically used to image the sinuses for suspected sinusitis. MRI is also more expensive than CT. However, it can help rule out fungal sinusitis and may help differentiate between inflammatory disease, malignant tumors, and complications within the skull. It may also be useful for showing soft tissue involvement. •Reviewed last on: 5/19/2009 •Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. >>>>>><<<<<<< The role of CT and MRI in the diagnosis of chronic rhinosinusitis. Chronic rhinosinusitis (CRS) is one of the most common chronic disease conditions in the United States. Currently, diagnosis is based initially on clinical symptomatology and signs, but the final diagnosis of CRS should be confirmed by objective measures. CT of the paranasal sinuses is the most commonly obtained test to confirm or exclude a diagnosis of CRS. CT has been shown to be reliable, accurate, and effective in diagnosing CRS, but it also imparts radiation exposure. More recently, MRI of the paranasal sinuses has been explored as a diagnostic modality in CRS. Initial data suggest it may be a viable alternative to CT in the diagnosis of CRS. As clinicians are likely to begin to use MRI as a diagnostic modality in CRS, further studies are warranted with respect to its particular diagnostic validation. Created Date: 2010-05-05 Completed Date: 2010-08-16 Division of Otolaryngology, Brigham and Women's Hospital, 45 Francis Street, Boston, MA 02115, USA. Current allergy and asthma reports Volume: 10 |
#7
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Èìåþ àíàëîãè÷íóþ ïàðòèéíóþ ëèíèþ.
À â öåëîì, ìåòîäû â ÷åì òî äîïîëíÿþò äðóã äðóãà, â ÷åì òî ìîãóò è çàìåíèòü îäèí äðóãîé. ÌÐÒ ìîæåò è ïðîèãðàåò ÷óòü-÷óòü ÊÒ â îöåíêå ñîñòîÿíèÿ êîñòåé, äèôôåðåíöèðîâêå ñòåíîê ÿ÷ååê ïàçóõ, âíóòðèïàçóøíûõ ïåðåãîðîäîê, ÷òî èìååò çíà÷åíèå äëÿ FESS, íî çàòî âûèãðàåò â îòíîøåíèÿ òî÷íîé äèàãíîñòèêè ìÿãêîòêàííîãî ñîäåðæèìîãî.
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Ñ óâàæåíèåì, ×åðåáèëëî Âëàäèñëàâ Þðüåâè÷ |