Radiološke tehnologije

ZNAČAJ DIGITALNE STEREOTAKSIJSKE BIOPSIJE U KORELACIJI SA PATOHISTOLOŠKIM POSTOPERATIVNIM NALAZIMA

Armin Papracanin, Semra Šeper, Jasmina Bajramović, Sabina Prevljak, Ana Trogrlić — Wed, 13 Nov 2024 00:00:00 +0000

Aim : This research was conducted with the aim of analyzing the accuracy and diagnostic value of digital stereotactic breast biopsy compared to the postoperative histopathological findings.

Methods : A retrospective-prospective study was carried out over a period of 10 months, involving 30 female patients who underwent stereotactic breast biopsy. Data were collected on BI-RADS status, histopathological findings after stereotactic breast biopsy and after surgical excision, basic demographic and relevant medical history data. The patients were divided according to the degree of malignancy into three groups: patients with benign, patients with suspicious and patients with malignant pathohistological findings. The BIS and RIS systems were used for data collection, and the data were statistically analyzed using STATISTICA for Windows.

Results : All patients had a radiological finding of BI-RADS 3 or higher. Histopathological results after stereotactic biopsy showed benign findings in 17 patients (B1 and B2), borderline malignant changes were present in 4 patients (B3), one patient had a lesion suspicious for malignancy (B4), and 8 had confirmed malignant lesions (B5). Out of the total 30 patients, 13 underwent surgical treatment. Postoperative histopathological findings in 4 patients showed benign changes, 6 patients had an invasive form of carcinoma, including 5 with invasive NST breast carcinoma and one characterized as invasive ductal breast carcinoma, while three patients had Ductal Carcinoma In Situ (DCIS). A correlation test was performed between the estimated degree of malignancy from the pathohistological findings after stereotaxic biopsy and after surgical operation. Spearman's ρ test showed a significant correlation between the two methods (p < 0.001).

Conclusion : The results of histopathological analysis of samples obtained through the stereotactic biopsy method largely correlate with the postoperative histopathological diagnosis in patients who underwent surgical treatment.

Keywords : digital stereotactic breast biopsy, PHD findings, BI-RADS, NST, Ductal Carcinoma In Situ.

Diagnosis of vascular lesions in the brain – comparing T_2 and FLAIR sequences

Amina Kubat — Wed, 13 Nov 2024 00:00:00 +0000

ABSTRACT

Introduction: Vascular brain lesions refer to brain damage caused by problems with blood vessels and can include various disorders such as stroke, aneurysms, blood clots, and others. Because different brain tissues have different characteristic relaxation times, and the FLAIR sequence can also be used to deal with different tissue stresses. the sequence provides high intensity while the FLAIR sequence achieves complete saturation of cerebrospinal fluid. The objectives of this study are to compare the visualization of vascular lesions using and the FLAIR sequence and to determine which sequence provides a better depiction and additional information about vascular lesions.

Research Methods: The study was designed as a retrospective descriptive study, conducted at the Private Healthcare Institution 'Medical Center' in Travnik using an MRI machine: MRI Siemens Avanto A + Tim + Dot System, with a strength of 1.5 T. The study involved 50 patients diagnosed with vascular lesions.

Results: In the age group from 50 to 59 years, 7 patients with FAZEKAS 0 – 1 (46.66%), 4 patients with FAZEKAS 1 (26.66%), 3 patients with FAZEKAS 2 (20%) and one patient with FAZEKAS 3 (6.66%) were diagnosed. In the age group from 60 to 69 years, 6 patients with FAZEKAS 0 – 1 (28.57%), 6 patients with FAZEKAS 1 (28.57%), 6 patients with FAZEKAS 2 and 3 patients with FAZEKAS 3 (14.28%) were diagnosed. In the 70 to 79 age group, 2 patients were diagnosed with FAZEKAS 0 – 1 (14.28%), 5 patients were diagnosed with FAZEKAS 1 (35.71%), 5 patients were diagnosed with FAZEKAS 2 (35.71%) and 2 patients were diagnosed with FAZEKAS 3 (14.28%).

Discussion: Several studies have been conducted to evaluate the sensitivity of and FLAIR sequences in the diagnosis of vascular lesions in the brain. In the mentioned studies, it was found that the FLAIR sequence possesses superior capabilities in identifying and better displaying vascular lesions compared to healthy brain tissue. After measuring lesions in all 50 patients enrolled in the study, they were divided by size into three different groups:

Lesions smaller than 10 millimeters;
Lesions larger than 10 millimeters and smaller than 20 millimeters;
Lesions larger than 20 millimeters.

After statistical processing of the examined sample within this study, it was found that the FLAIR sequence provides a better representation of vascular lesions in the brain compared to the sequence in all three different groups, and it is concluded that the differences are statistically significant in favor of the FLAIR sequence in all three observed lesion sizes.

The prognostic value of FLAIR vascular hyperintensity still needs to be investigated. Future studies will determine in which settings the presence of FLAIR vascular hyperintensity can be used as valuable information for the clinician. FLAIR vascular hyperintensities indicate a risk of persistent vascular stenosis or occlusion, associated with an increased risk of future stroke. They also help identify patients with favorable collateral blood flow, who could benefit from aggressive revascularization therapy.

Conclusion: Statistically, there was a difference in the better presentation of vascular lesions on the FLAIR sequence compared to the sequence. In some cases, a sequence may be sufficient but in most cases a FLAIR sequence is preferable. Although the noise level is higher on the FLAIR sequence compared to the standard sequence, the FLAIR sequence is more useful in detecting vascular lesions.

Atrial septal defect (ASD), trans-catheter closure – case report

Haris Porobić, Darko Tomić, Sabina Prevljak, Ana Trogrlić — Wed, 13 Nov 2024 00:00:00 +0000

Atrial septal defect (ASD) is one of the most common types of congenital heart defects, occurring in about 25% of children. An atrial septal defect occurs when there is a failure to close the communication between the right and left atria. It encompasses defects involving both the true septal membrane and other defects that allow for communication between both atria. There are five types of atrial septal defects ranging from most frequent to least: patent foramen ovale, ostium secundum defect, ostium primum defect, sinus venosus defect, and coronary sinus defect. Small atrial septal defects usually spontaneously close in childhood. Large defects that do not close spontaneously may require percutaneous or surgical intervention to prevent further complications such as stroke, dysrhythmias, and pulmonary hypertension. This activity describes the evaluation, diagnosis, and management of atrial septal defect and highlights the role of team-based interprofessional care for affected patients. Atrial septal defects are frequently asymptomatic. The characteristic murmur is a soft, systolic ejection murmur over the pulmonic area (second intercostal space) combined with a wide, fixed splitting of S2. Many ASDs go undiagnosed until adulthood; therefore, treatment, especially of large defects, is often delayed. Untreated large defects can cause exercise intolerance, cardiac dysrhythmias, palpitations, increased incidence of pneumonia, pulmonary hypertension and increased mortality.

THE IMPORTANCE OF COMMUNICATION OF MEDICAL RADIOLOGY ENGINEERS AND PATIENTS THROUGH THE LENS OF EMPATHY

Darko Tomić, Ivana Stojak, Tanja Bavrka, Haris Porobić, Branislav Lovrić — Wed, 13 Nov 2024 00:00:00 +0000

_{Effective communication is essential for the quality of healthcare and patient satisfaction in medical institutions. Empathy as part of emotional intelligence plays a major role in the interaction between healthcare workers and the patient, as it helps to understand patient needs, reduce stress and improve patient experience. This paper analyzes theoretical concepts and practical aspects of empathy in the scope of medical radiology; it examines the challenges and preparations that may arise when communicating and provides guidance on how to improve the connection between medical radiology engineers and patients. Addressing this phenomenon enables the development of strategies to improve communication skills as well as compassion, which can lead to better patient outcomes and contribute to an effective working environment for medical staff.}

RADIOLOGICAL ASSESSMENT OF SPONDYLOLISTHESIS OF LUMBOSACRAL SPINE

Antonio Đopa — Wed, 13 Nov 2024 00:00:00 +0000

Introduction: One major injury or frequent minor injuries cause the vertebral body, pedicle and superior articular surfaces to slide forward. This disorder is known as spondylolisthesis and is usually accompanied by symptoms, often proportional to the degree of forward movement. Patients may complain of pain in the lower back that spreads to the thighs, and limited range of motion is possible

Objectives: The aim of this study is to determine the frequency of spondylolisthesis by age and gender in the patients studied at SKB Mostar.

Research methodology: The method of content analysis was used to retrospectively examine X-ray, CT and MRI examinations of patients with the clinical features of lumbar pain syndrome in the period from 1 January 2019 to 1 January 2020 in patients who underwent radiological examination of the LS spine at the Clinical Institute of Radiology of the University Clinical Hospital Mostar. Data were collected from IMPAX at the SKB Mostar Department of Radiology. The input parameters that were observed were: pain syndrome, diagnosis. The output parameters were the radiological findings from the X-ray, CT, and MRI scans.

Results: During the study period, 297 spinal scans were performed, and spondylolisthesis was found in 32 patients, or 11%. The youngest respondent was 8 years old, and the oldest was 85 years old. The average age of the respondents was 64.37 years. The largest number of respondents was in the age group of over 75 years old. Of the tests performed, the most common were CT scans, followed by MRI, and the rarest were X-ray scans. The highest prevalence of spondylolisthesis was found in vertebrae L4-L5 and L5-S1 at 41%. Spondylolisthesis was found bilaterally in 9% of cases at the L3-L4 and L5 vertebrae.

Conclusion: Most often, spondylolisthesis is found in L4-L5 and L5-S1 vertebrae. There was no difference according to gender, and most often subjects older than 75 years had spondylolisthesis.

Importance of CBCT diagnostics in dental implantology

Merisa Repeša-Komarica, Selma Ćosović, Selma Alić-Drina — Wed, 13 Nov 2024 00:00:00 +0000

ABSTRACT

In today's world, the aesthetic demands of patients in dentistry are very high, followed by functional requirements. CBCT diagnostics facilitate the achievement of these goals. Modern dentistry involves replacing missing teeth with dental implants. In dental implantology, precise imaging techniques are essential to accurately capture the area where implants will be placed, in order to avoid damaging adjacent vital structures during surgery. Today, radiological analysis of CBCT scans is considered the best method of choice, or the gold standard, in the pre-implantation procedure.

On CBCT scans, we can visualize the height, width, and density of the available bone for implant placement, the precise location of the maxillary sinus, mandibular canal, mental foramen, incisive canal, and diagnose certain present pathological changes.