Viktors \u013bi\u0146ovs <\/a>un rezidenti radiolo\u0123ijas specialit\u0101t\u0113 Marina Audrupe un Artis Brok\u0101ns st\u0101sta par ultrasonogr\u0101fiju.<\/strong><\/p>\n
\nUltrasonogr\u0101fisk\u0101 (USG) izmekl\u0113\u0161ana ir diagnostisk\u0101 metode, kas balst\u0101s uz ultraska\u0146as izmanto\u0161anu.<\/strong> T\u0101 ir ska\u0146a, kuras frekvence p\u0101rsniedz dzirdam\u0101s ska\u0146as frekvenci. Radiolo\u0123iskaj\u0101 diagnostik\u0101 pielietotie frekvences diapazoni sv\u0101rst\u0101s no viena l\u012bdz 30 Mhz. Lai veiktu ultrasonogr\u0101fijas izmekl\u0113jumu, nepiecie\u0161ama ultrasonogr\u0101fijas iek\u0101rta, kas ar\u012b veido att\u0113lus, pateicoties iek\u0101rtas zondei. Ultrasonogr\u0101fijas zonde var nodro\u0161in\u0101t da\u017e\u0101du izstaroto ultraska\u0146as frekven\u010du diapazonu, un t\u0101 nodro\u0161ina divas svar\u012bgas izmekl\u0113juma funkcijas \u2013 ultraska\u0146as raid\u012b\u0161anu un uztver\u0161anu. \u0160\u012bs funkcijas \u012bsteno, pateicoties zond\u0113 eso\u0161iem pjezoelektriskajiem krist\u0101liem, kam piem\u012bt sp\u0113ja konvert\u0113t elektriskos impulsus meh\u0101niskajos ultraska\u0146as vi\u013c\u0146os un otr\u0101di. Ultraska\u0146as vi\u013c\u0146i izplat\u0101s pa audiem, tie tiek absorb\u0113ti, atspogu\u013coti vai izklied\u0113ti. Tiem atstarojoties, ar iek\u0101rtas anal\u012bzes pal\u012bdz\u012bbu veido dinamisku divdimensiju pel\u0113kto\u0146u att\u0113lu, kas atspogu\u013co cilv\u0113ka \u0137erme\u0146a iek\u0161\u0113jos audus un org\u0101nus. Ska\u0146as vilnim, kas sasniedzis dzi\u013c\u0101kas \u0137erme\u0146a strukt\u016bras, ir nepiecie\u0161ams ilg\u0101ks laiks, lai atgrieztos atpaka\u013c zond\u0113. Iek\u0101rta sp\u0113j to atpaz\u012bt un veidot att\u0113lu atbilsto\u0161i \u0137erme\u0146a sl\u0101\u0146u dzi\u013cumam. Ieg\u016btais att\u0113ls sniedz pla\u0161u inform\u0101ciju par izmekl\u0113jamo org\u0101nu \u2013 t\u0101 izm\u0113ru, formu, strukt\u016bru, veselumu.<\/p>\nUltrasonogr\u0101fija pal\u012bdz noteikt ar\u012b patolo\u0123ijas, kas var b\u016bt nesaist\u012btas ar konkr\u0113to org\u0101nu, piem\u0113ram, br\u012bvu \u0161\u0137idrumu v\u0113dera dobum\u0101. Ultrasonogr\u0101fiski bie\u017e\u0101k izmekl\u0113tie apvidi ir \u2013 v\u0113dera dobums un iegurnis, kakla org\u0101ni, loc\u012btavas, asinsvadi un sirds. <\/strong>Ultrasonogr\u0101fija pal\u012bdz noteikt vair\u0101kas patolo\u0123ijas, s\u0101kot ar organiskiem audu boj\u0101jumiem un veidojumiem (v\u0113zis), beidzot ar funkcion\u0101liem trauc\u0113jumiem (ur\u012bna retence).<\/p><\/blockquote>\nAsinsvadu ultrasonogr\u0101fiju d\u0113v\u0113 par doplerogr\u0101fiju.<\/strong> T\u0101 ir pla\u0161i izmantota medic\u012bnisk\u0101s radiolo\u0123isk\u0101s diagnostikas metode, ar kuru nov\u0113rt\u0113 asins pl\u016bsmu da\u017e\u0101d\u0101s asinsvadu sist\u0113m\u0101s.<\/p>\nPielietojot doplerogr\u0101fiju, iesp\u0113jams spriest ar\u012b par org\u0101na apasi\u0146o\u0161anu, par pa\u0161iem asinsvadiem un asins pl\u016bsmu tajos. Metode ir balst\u012bta uz Doplera efektu un t\u0101 sniedz svar\u012bgu inform\u0101ciju par asins pl\u016bsmas virzienu un \u0101trumu, m\u0113rot ska\u0146as vi\u013c\u0146u frekvences izmai\u0146as, kas atspogu\u013cojas no asins pl\u016bsm\u0101 eso\u0161aj\u0101m asins \u0161\u016bn\u0101m. Pateicoties prec\u012bziem asins pl\u016bsmas m\u0113r\u012bjumiem, iesp\u0113jams noteikt patolo\u0123isk\u0101s izmai\u0146as, kas ietekm\u0113 asinsvadu diametru.<\/strong> Ar doplerogr\u0101fijas pal\u012bdz\u012bbu var prec\u012bzi noteikt asinsvadu sa\u0161aurin\u0101jumus (stenozes) vai sl\u0113gumus (okl\u016bzijas), ka ar\u012b papla\u0161in\u0101jumus (aneirismas).<\/p>\nAt\u0161\u0137ir\u012bb\u0101 no t\u0101d\u0101m att\u0113ldiagnostikas metod\u0113m k\u0101 datortomogr\u0101fija vai rentgenogr\u0101fija, ultrasonogr\u0101fija sniedz diagnostisko inform\u0101ciju bez joniz\u0113jo\u0161\u0101 starojuma iedarb\u012bbas. T\u0101 ir dro\u0161a diagnostisk\u0101 metode, kuras izmanto\u0161ana pie\u013caujama ar\u012b maziem b\u0113rniem un gr\u016btniec\u0113m.<\/strong> Ar doplerogr\u0101fijas pal\u012bdz\u012bbu var prec\u012bzi noteikt asinsvadu sa\u0161aurin\u0101jumus (stenozes) vai sl\u0113gumus (okl\u016bzijas), ka ar\u012b papla\u0161in\u0101jumus (aneirismas). Audos absorb\u0113ta ultraska\u0146a p\u0101rv\u0113r\u0161as siltum\u0101, kas ultrasonogr\u0101fijas izmekl\u0113juma laik\u0101 veidojas niec\u012bg\u0101 daudzum\u0101 bez kait\u012bguma cilv\u0113ka \u0137ermenim.<\/p>\nUltrasonogr\u0101fijas izmekl\u0113jums ir \u0101trs un vienk\u0101r\u0161s, tas ir nes\u0101p\u012bgs un nekait\u012bgs pacientam. \u0160is diagnostisk\u0101s radiolo\u0123ijas izmekl\u0113jums ir sal\u012bdzino\u0161i l\u0113ts un pieredz\u0113ju\u0161a radiologa rok\u0101s augsti informat\u012bvs.<\/p><\/blockquote>\n
\u0160\u012bs priek\u0161roc\u012bbas padara ultrasonogr\u0101fiju par vienu no att\u0113ldiagnostikas izv\u0113les metod\u0113m da\u017e\u0101du slim\u012bbu vai to seku diagnostik\u0101<\/strong>. Nereti ultrasonogr\u0101fiju izmanto, lai izsl\u0113gtu patolo\u0123iju un neveiktu papildus izmekl\u0113jumus, kam nepiecie\u0161ami papildus l\u012bdzek\u013ci, laiks un bie\u017ei apstaro\u0161ana ar joniz\u0113jo\u0161o starojumu.<\/p>\nUltrasonogr\u0101fisk\u0101 izmekl\u0113\u0161ana ir piem\u0113rota m\u012bksto audu izv\u0113rt\u0113\u0161anai, bet gaisu saturo\u0161\u0101m strukt\u016br\u0101m un kaulaudiem izmekl\u0113\u0161ana ir ierobe\u017eota, k\u0101 ar\u012b audiem, ko piesedz kauli vai gaisu saturo\u0161as strukt\u016bras, jo ultraska\u0146as vi\u013c\u0146i nesp\u0113j tos penetr\u0113t un atgriezties zond\u0113. Izmekl\u0113jot kaulus, speci\u0101lists var redz\u0113t tikai kaula virsmu un nevar izv\u0113rt\u0113t to vis\u0101 platum\u0101. K\u0101 metodes tr\u016bkumu var min\u0113t ierobe\u017eotu dzi\u013c\u0101ku audu un org\u0101nu izmekl\u0113\u0161anu, apgr\u016btin\u0101tu adipozo pacientu izmekl\u0113\u0161anu un nosac\u012bto subjekt\u012bvu att\u0113lu interpret\u0101ciju (izmekl\u0113juma rezult\u0101ts atkar\u012bgs no speci\u0101lista pieredzes). Lai ieg\u016btu maksim\u0101li informat\u012bvus un prec\u012bzus izmekl\u0113juma rezult\u0101tus, nepiecie\u0161ami augsti apm\u0101c\u012bti ultrasonogr\u0101fijas speci\u0101listi.<\/p>\n
Ultrasonogr\u0101fijas pielieto\u0161ana m\u016bsdienu medic\u012bn\u0101 neaprobe\u017eojas tikai ar diagnostisko funkciju, to pla\u0161i pielieto ar\u012b, veicot minim\u0101li invaz\u012bvas proced\u016bras, piem\u0113ram, biopsijas un aspir\u0101cijas<\/strong>. \u0160\u012bs manipul\u0101cijas ultrasonogr\u0101fijas kontrol\u0113 k\u013c\u016bst prec\u012bz\u0101kas un sal\u012bdzino\u0161i ar konvencion\u0101laj\u0101m metod\u0113m, t\u0101m ir maz\u0101ki komplik\u0101ciju riski. \u0160\u012bs proced\u016bras nereti veic ambulatori, t\u0101d\u0113j\u0101di samazinot nepiecie\u0161am\u012bbu p\u0113c ilgsto\u0161as hospitaliz\u0101cijas.<\/p>\nUltrasonogr\u0101fijas izmekl\u0113jumu iesp\u0113jams papildin\u0101t ar\u012b ar elastogr\u0101fiju.<\/strong><\/p>\nElastogr\u0101fija ir tehnolo\u0123ija kas, pateicoties ultraska\u0146as vi\u013c\u0146iem, pal\u012bdz noteikt da\u017e\u0101du audu elasticit\u0101ti, kas ir b\u016btisks faktors vair\u0101ku patolo\u0123iju diagnostikai. Piem\u0113ram, to bie\u017ei pielieto aknu cirozes vai fibrozes diagnostik\u0101, nosakot slim\u012bbas smaguma pak\u0101pi un dinamiku.<\/p><\/blockquote>\n
M\u016bsdien\u0101s iesp\u0113jams veikt ultrasonogr\u0101fijas izmekl\u0113jumus ar kontrastvielu.<\/strong> Tie p\u0113c b\u016bt\u012bbas ir gaisu saturo\u0161i mikroburbu\u013ci, kas, ievadot cilv\u0113k\u0101 asinsrit\u0113, tiek izelpoti tuv\u0101ko stundu laika p\u0113c ievad\u012b\u0161anas. Ar\u012b ultrasonogr\u0101fij\u0101 pielietot\u0101 kontrastviela ir cilv\u0113ka organismam nekait\u012bga. Kontrastviela pal\u012bdz at\u0161\u0137irt labdab\u012bgus veidojumus no \u013caundab\u012bgiem, izv\u0113rt\u0113t procesa izplat\u012bbu un smaguma pak\u0101pi.<\/p>\nUltraska\u0146as apvieno\u0161ana (FUSION) ar cit\u0101m att\u0113lveido\u0161anas metod\u0113m k\u0101 datortomogr\u0101fiju vai magn\u0113tisko rezonansi sniedz iesp\u0113ju jaun\u0101m diagnostisk\u0101s radiolo\u0123ijas metod\u0113m<\/strong>. Apvienojot to stipr\u0101s puses, tiek nodro\u0161in\u0101ta kop\u0113ja izpratne par pacienta anatomisko uzb\u016bvi un patolo\u0123ijas esam\u012bbu. Tas pal\u012bdz prec\u012bzi kontrol\u0113t procesu dinamiku, k\u0101 ar\u012b ultrasonogr\u0101fijas kontrol\u0113 prec\u012bz\u0101k veikt invaz\u012bvas proced\u016bras.<\/p>\nUltrasonogr\u0101fiju, k\u0101 ar\u012b citas radiolo\u0123ijas nozares liel\u0101 m\u0113r\u0101 uzlabo m\u0101ksl\u012bg\u0101 intelekta iek\u013cau\u0161ana.<\/strong> Lai uzlabotu USG izmekl\u0113juma diagnostiskas potenci\u0101lu, ma\u0161\u012bnm\u0101c\u012b\u0161an\u0101s algoritmu izveido\u0161anai izmanto lielus datu kopu apjomus. P\u0113t\u012bjumi apliecina, ka m\u0101ksl\u012bgais intelekts sp\u0113j uzlabot da\u017e\u0101du slim\u012bbu atpaz\u012b\u0161anu, t\u0101d\u0113j\u0101di nodro\u0161inot prec\u012bz\u0101ku un savlaic\u012bg\u0101ku diagnostiku. M\u0101ksl\u012bg\u0101 intelekta un pieredz\u0113ju\u0161a radiologa kombin\u0101cija var iev\u0113rojami uzlabot USG diagnostikas jut\u012bbu un precizit\u0101ti.<\/p>\nUz valsts apmaks\u0101tu ultrasonogr\u0101fijas izmekl\u0113jumu var nos\u016bt\u012bt jebkur\u0161 \u0101rsts, kur\u0161 ir re\u0123istr\u0113ts \u0101rstu re\u0123istr\u0101.<\/strong> J\u0101piebilst, ka ultrasonogr\u0101fijas izmekl\u0113jumu var veikt ar\u012b bez \u0101rsta nos\u016bt\u012bjuma p\u0113c pa\u0161a pacienta iniciat\u012bvas. T\u0101dos gad\u012bjumos pacients nevar pretend\u0113t uz valsts apmaks\u0101tu pakalpojumu.<\/p>\nLiel\u0101koties ultrasonogr\u0101fijas izmekl\u0113jumu izmanto k\u0101 prim\u0101ru izmekl\u0113\u0161anas metodi un atkar\u012bb\u0101 no atradnes nosaka turpm\u0101ko izmekl\u0113\u0161anas taktiku.<\/strong> Bie\u017ei\u00a0 noz\u012bm\u0113 st\u0101vok\u013ca kontroli ar ultrasonogr\u0101fiju, tas ir \u2013 izmekl\u0113jumus j\u0101atk\u0101rto noteiktos laika interv\u0101los. Vair\u0101ku slim\u012bbu profilaksei ultrasonogr\u0101fijas izmekl\u0113jumu var veikt reizi piecos gados sij\u0101jo\u0161as diagnostikas nol\u016bkos. Vair\u0101kk\u0101rt atk\u0101rtoti ultrasonogr\u0101fiskie izmekl\u0113jumi cilv\u0113ka vesel\u012bbai nav kait\u012bgie, jo tiem nav negat\u012bvas iedarb\u012bbas uz cilv\u0113ka organismu.<\/p>\nUltrasonogr\u0101fijas izmekl\u0113jumus var veikt jebkur\u0161 \u0101rsts radiologs vai cits speci\u0101lists, kur\u0161 apguvis ultrasonogr\u0101fijas metodi un ir sertific\u0113ts veikt \u0161o izmekl\u0113jumu.<\/strong><\/p><\/blockquote>\n\u0160obr\u012bd vair\u0101ku specialit\u0101\u0161u izgl\u012bt\u012bbas programmas iek\u013cauj ultrasonogr\u0101fiju, kas \u013cauj veikt \u0161o izmekl\u0113jumu, \u0146emot v\u0113r\u0101 speci\u0101lista kompetenci.<\/p>\n
\nIzmantot\u0101 literat\u016bra:<\/strong><\/p>\n1. Block, B. (2019). Abdominal Ultrasound: Step by Step (2nd ed.)<\/em>. Private Practice: Braunschweig, Germany.<\/p>\n2. Khalid, G.A. (2012b). The Effect of Doppler Phenomenon on the Speed of Blood Flow<\/em>. Al-Khwarizmi Engineering Journal, [online] 8(4), pp.26\u201339. Available at: https:\/\/alkej.uobaghdad.edu.iq\/index.php\/alkej\/article\/view\/145.<\/p>\n3. Carovac, A., Smajlovic, F. and Junuzovic, D. (2011). Application of Ultrasound in Medicine<\/em>. Acta Informatica Medica, 19(3), p.168. doi:10.5455\/aim.2011.19.168-171.<\/p>\n4. Stoll, J. (2012). Ultrasound fusion imaging. Perspectives in Medicine<\/em>, [online] 1(1), pp.80\u201381. doi:https:\/\/doi.org\/10.1016\/j.permed.2012.05.004.<\/p>\n5. Park SH. Artificial intelligence for ultrasonography: unique opportunities and challenges<\/em>. Ultrasonography. 2021 Jan;40(1):3-6. doi: 10.14366\/usg.20078. Epub 2020 Nov 3. PMID: 33227844; PMCID: PMC7758099.<\/p>\n
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