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Abstract(s)
A colangio-pancreatografia por ressonância magnética (CPRM), mais conhecida por Colangio-RM, é uma técnica que tem vindo a evoluir nas últimas décadas e que tem demonstrado ser uma escolha de primeira linha no estudo das patologias do sistema bílio-pancreático (SBP). A utilização de contrastes orais negativos, como o chá preto, pode representar uma alternativa aos contrastes comerciais e proporcionar uma melhoria da qualidade das imagens obtidas. Este estudo quasi-experimental teve como objetivo principal avaliar a qualidade de imagens obtidas utilizando a técnica de Colangio-RM, após a ingestão do chá preto, através da quantificação de dois parâmetros fundamentais, a saber, a visibilidade e a detetabilidade do SBP e do sistema
gastrointestinal (SGI). Para a realização deste estudo foi seleccionada uma amostra composta por três grupos: o grupo de voluntários, o grupo de controlo (que não ingeriu chá preto) e o grupo experimental (que ingeriu chá preto). O grupo dos voluntários foi constituído por cinco indivíduos, todos saudáveis, com idades compreendidas entre os 27 e 44 anos. Para os membros deste grupo realizou-se a aquisição de imagens utilizando a técnica de Colangio-RM, antes e cinco minutos após o consumo de 300ml de chá preto. Os grupos de controlo e experimental foram compostos por 19 pacientes cada um, com idades compreendidas entre os 45 e 80 anos, com queixas e alguns com cirurgias do SBP. A técnica de Colangio-RM foi realizada aos dois grupos de pacientes. Todos os exames foram realizados num equipamento Siemens 1.5 T. A visibilidade e a detetabilidade dos SBP e SGI foram avaliados através de uma escala de Likert. No grupo de voluntários, a estrutura anatómica do SBP que melhor visualização apresentou após a ingestão do chá preto foi o Canal intra-hepático. Em relação ao SGI, o estômago foi a estrutura anatómica completamente suprimida após a toma do chá preto. Entre o grupo de controlo e o grupo experimental registaram-se diferenças estatisticamente significativas nas estruturas anatómicas Canal Pancreático de Wirsung e Colédoco, do SBP (p-value<0,05). Após a toma de chá preto, estas estruturas anatómicas ficaram completamente visíveis. Em relação ao SGI, observaram-se diferenças estatisticamente significativas em todas as estruturas (p-value<0,05), o que significa que o chá preto suprime o hipersinal. O chá preto reúne as condições para ser usado como contraste oral negativo em exames de Colangio-RM, pois reduz a intensidade do hipersinal emitido pelo SGI, melhorando a visualização do SBP.
ABSTRACT - Magnetic resonance cholangiopancreatography, or MRCP, better known as cholangio MRI, is a technique that has evolved in recent decades and proven to be the first-line choice in the study of pathologies of the biliopancreatic system. The use of negative oral contrasts, such as black tea, may represent an alternative to the commercial contrasts and an improvement in image quality. The main objective of this quasi-experimental study was to evaluate the quality of images obtained using the cholangio MRI technique, after the ingestion of black tea, through the quantification of two fundamental parameters, namely, the visibility and the detectability of the biliopancreatic and gastrointestinal systems. For this study, three groups were composed: the volunteer group, the control group (whose members did not drink black tea) and the experimental group (whose members drank black tea). The volunteer group consisted of five healthy individuals, aged 27 to 44 years old. The acquisition of images using a cholangio MRI was held to this group before and 5 minutes after the intake of 300ml of black tea. The control group and the experimental group consisted of 19 patients each, aged between 45 and 80 years old, some with complaints and others who had undergone biliopancreatic surgeries. All the acquisitions were performed on a Siemens 1.5 T equipment. The visibility and detectability of the biliopancreatic and gastrointestinal systems were evaluated according to a Likert scale. In the volunteer group, the anatomical structure in the biliopancreatic system that presented the best visualization, after the ingestion of black tea, was the main hepatic duct. In relation to the gastrointestinal system, the stomach was the anatomical structure that has been completely suppressed after the intake of black tea. There were statistically significant differences amongst the control group and the experimental group in the anatomical structures main pancreatic duct and common bile duct, of the biliopancreatic system (p-value<0.05). After the intake of black tea, these anatomical structures were completely visible. In relation to the gastrointestinal system, there were statistically significant differences in all structures (p-value<0.05), which means that black tea suppresses the hyper signal arising from them. Black tea meets the conditions to be used as a negative oral contrast in MR-cholangio examinations, reducing the intensity of the hypersignal emitted by the structures of the gastrointestinal system, improving the visualization of the biliopancreatic system.
ABSTRACT - Magnetic resonance cholangiopancreatography, or MRCP, better known as cholangio MRI, is a technique that has evolved in recent decades and proven to be the first-line choice in the study of pathologies of the biliopancreatic system. The use of negative oral contrasts, such as black tea, may represent an alternative to the commercial contrasts and an improvement in image quality. The main objective of this quasi-experimental study was to evaluate the quality of images obtained using the cholangio MRI technique, after the ingestion of black tea, through the quantification of two fundamental parameters, namely, the visibility and the detectability of the biliopancreatic and gastrointestinal systems. For this study, three groups were composed: the volunteer group, the control group (whose members did not drink black tea) and the experimental group (whose members drank black tea). The volunteer group consisted of five healthy individuals, aged 27 to 44 years old. The acquisition of images using a cholangio MRI was held to this group before and 5 minutes after the intake of 300ml of black tea. The control group and the experimental group consisted of 19 patients each, aged between 45 and 80 years old, some with complaints and others who had undergone biliopancreatic surgeries. All the acquisitions were performed on a Siemens 1.5 T equipment. The visibility and detectability of the biliopancreatic and gastrointestinal systems were evaluated according to a Likert scale. In the volunteer group, the anatomical structure in the biliopancreatic system that presented the best visualization, after the ingestion of black tea, was the main hepatic duct. In relation to the gastrointestinal system, the stomach was the anatomical structure that has been completely suppressed after the intake of black tea. There were statistically significant differences amongst the control group and the experimental group in the anatomical structures main pancreatic duct and common bile duct, of the biliopancreatic system (p-value<0.05). After the intake of black tea, these anatomical structures were completely visible. In relation to the gastrointestinal system, there were statistically significant differences in all structures (p-value<0.05), which means that black tea suppresses the hyper signal arising from them. Black tea meets the conditions to be used as a negative oral contrast in MR-cholangio examinations, reducing the intensity of the hypersignal emitted by the structures of the gastrointestinal system, improving the visualization of the biliopancreatic system.
Description
Mestrado em Radiações Aplicadas às Tecnologias da Saúde. Ramo de especialização: Imagem por Ressonância Magnética.
Keywords
Ressonância magnética Colangiografia Sistema bílio-pancreático Contraste oral negativo Magnetic resonance Cholangiography Biliopancreatic system Negative oral contrasts
Citation
Carvalho MJ. Qualidade de imagem na colangio-pancreatografia em ressonância magnética após consumo de chá preto [dissertation. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2018.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa