He aha ka Magnetic Resonance Elastography? Ke Kumu, nā Pae/Kaʻina Hana & Nā Hōʻikeʻike

ʻO ka magnetic resonance elastography (MRE) he hoʻokolohua kiʻi kūikawā e ana i ka paʻakikī a i ʻole ka palupalu o kou mau ʻōkana, ʻo kou ate hoʻi. E noʻonoʻo iā ia he ala mālie e "manaʻo" i kou mau ʻōkana mai waho mai, e like me ke kauka e kaomi ana i kou ʻōpū i ka wā o ka hoʻokolokolo kino, akā ʻoi aku ka pololei a me ka kikoʻī.

Hoʻohui kēia hoʻokolohua non-invasive i ke kiʻi MRI maʻamau me nā nalu kani e hana i nā palapala kikoʻī o ka paʻakikī o ka ʻiʻo. Kōkua ka ʻike i nā kauka e ʻike i ka ʻōpala, ka mumū, a i ʻole nā ​​hoʻololi ʻē aʻe i kou mau ʻōkana i ʻike ʻole ʻia ma nā hoʻokolohua kiʻi maʻamau.

He aha ka Magnetic Resonance Elastography?

ʻO MRE kahi ʻenehana kiʻi kiʻekiʻe e hoʻohana ana i nā māla magnetic a me nā nalu kani e ana i ka elasticity o ka ʻiʻo. Hana ka hoʻokolohua ma ka hoʻouna ʻana i nā haʻalulu mālie ma kou kino i loko o kahi mīkini MRI, a laila hopu i ke ʻano o ka neʻe ʻana o kēia mau nalu ma kou mau ʻōkana.

Ke olakino nā ʻiʻo, he palupalu a maʻalahi lākou. Eia naʻe, i ka wā e ulu ai ka ʻōpala a i ʻole ka fibrosis, e paʻakikī a emi ka elastic nā ʻiʻo. Hiki i ka MRE ke ʻike i kēia mau loli i nā pae mua, ma mua o ka hōʻike ʻana o nā hoʻokolohua ʻē aʻe i nā mea maʻamau.

Hoʻohana pinepine ʻia ka hoʻokolohua e loiloi i ke olakino o ke ake, akā hiki nō ke loiloi i nā ʻōkana ʻē aʻe e like me ka lolo, ka puʻuwai, nā puʻupaʻa, a me nā ʻiʻo. ʻO kēia ka mea he mea hana waiwai no ka ʻike ʻana i nā kūlana like ʻole me ka ʻole o nā kaʻina hana invasive.

No ke aha e hana ʻia ai ka Magnetic Resonance Elastography?

Hiki i kāu kauka ke ʻōlelo aku iā MRE e loiloi i ka paʻakikī o ka ʻōkana a ʻike i ka holomua o ka maʻi. He mea pono ka hoʻokolohua no ka nānā ʻana i nā maʻi ate, no ka mea, hiki iā ia ke ʻike i ka ʻōpala (fibrosis) e ulu ana mai nā maʻi ate like ʻole.

ʻO nā kumu maʻamau no ka MRE e komo pū ana me ka loiloi ʻana i nā maʻi ate maʻi e like me ka hepatitis, ka maʻi ate momona, a i ʻole cirrhosis. Kōkua ia i nā kauka e hoʻoholo i ka nui o ka ʻeha i hana ʻia a inā e hana pono ana nā lapaʻau.

Ma waho aʻe o ka loiloi ate, hiki i ka MRE ke kōkua i ka ʻike ʻana i nā maʻi lolo, nā pilikia o ka naʻau, a me nā maʻi ʻiʻo. Eia nā maʻi nui kahi e hāʻawi ai ka MRE i ka ʻike waiwai:

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• Hepatitis B a i ʻole C maʻi
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• Maʻi ate momona ʻole i ka waiʻona (NAFLD)
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• Maʻi ate waiʻona
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• Primary biliary cholangitis
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• Autoimmune hepatitis
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• Nā maʻi lolo a i ʻole nā maʻi neurological
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• ʻOʻoleʻa ʻiʻo naʻau
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• Kidney fibrosis
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• Nā maʻi ʻiʻo
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I kekahi mau hihia, hoʻohana nā kauka i ka MRE e nānā i ka pane ʻana i ka lapaʻau a i ʻole e hoʻolālā i nā kaʻina hana ʻoki. Hiki nō hoʻi i ka hoʻāʻo ke kōkua i ka pale ʻana i nā kaʻina hana invasive hou e like me nā biopsies ate i kekahi mau kūlana.

He aha ke kaʻina hana no Magnetic Resonance Elastography?

Ua like ke kaʻina hana MRE me kahi scan MRI maʻamau me kahi ʻokoʻa nui: hana kahi mea hana kūikawā i nā haʻalulu mālie i ka wā o ke kiʻi. E moe ʻoe ma luna o kahi papa e paheʻe ana i loko o ka mīkini MRI, a ʻo ke kaʻina hana holoʻokoʻa e lawe maʻamau i 45 a 60 mau minuke.

Ma mua o ka hoʻomaka ʻana o ka scan, e kau kahi mea loea i kahi pad liʻiliʻi, palupalu i kapa ʻia he

1. E hoʻololi ʻoe i ka ʻaʻahu haukapila a wehe i nā mea metala a pau
2. Hoʻonoho ka mea loea iā ʻoe ma luna o ka papa MRI
3. Hoʻonoho ʻia kahi pale hoʻokele passive ma kou kino
4. E loaʻa iā ʻoe nā pepeiao pepeiao a i ʻole nā headphone e hōʻemi i ka walaʻau
5. E paheʻe ana ka papa i loko o ka mīkini MRI
6. Hoʻomaka nā haʻalulu mālie i ka wā e kiʻi ʻia ai nā kiʻi
7. Pono ʻoe e paʻa i kou hanu no nā manawa pōkole (10-20 kekona)
8. Hoʻopau ʻia ke kaʻina holoʻokoʻa ma kahi o 45-60 mau minuke

I loko o ke kaʻina hana, hiki iā ʻoe ke kamaʻilio me ka mea loea ma o kahi ʻōnaehana intercom. Inā ʻoluʻolu ʻole ʻoe i kekahi manawa, hiki iā ʻoe ke noi e hooki a i ʻole e hoʻomaha.

Pehea e hoʻomākaukau ai no kāu Magnetic Resonance Elastography?

He maʻalahi ka hoʻomākaukau ʻana no ka MRE a like me ka hoʻomākaukau ʻana no kahi MRI maʻamau. Pono ʻoe e pale i ka ʻai ʻana no 4-6 mau hola ma mua o ka hoʻāʻo inā e kiʻi ana ʻoe i nā kiʻi ate, no ka mea, kōkua kēia i ka hāʻawi ʻana i nā kiʻi maopopo.

ʻO ka hoʻomākaukau nui loa e pili ana i ka nānā ʻana i nā mea metala i loko o kou kino. No ka mea, hoʻohana ka MRE i nā magnet ikaika, hiki i kekahi mau metala ke pilikia a i ʻole ke keakea i nā hopena hoʻāʻo.

Ma mua o kāu manawa, e hōʻoia e haʻi i kāu hui mālama ola e pili ana i kekahi o kēia mau mea:

• Pacemakers a i ʻole defibrillators
• Nā mea kanu cochlear
• Nā pani hui metala
• Nā kiʻi ʻoki a i ʻole nā staples
• Nā mea hana intrauterine (IUDs)
• Nā peʻa me ka inika metala
• Makeup mau
• Nā apo kino

I ka lā o kāu hoʻāʻo, e ʻaʻahu i nā lole ʻoluʻolu, kūpono ʻole me ka ʻole o nā mea paʻa metala. E hoʻololi paha ʻoe i ka ʻaʻahu haukapila, akā ʻo nā lole ʻoluʻolu e ʻoluʻolu ai ka ʻike.

Inā he claustrophobia a i ʻole ka hopohopo e pili ana i nā wahi i hoʻopaʻa ʻia, e kamaʻilio me kāu kauka ma mua. Hiki iā lākou ke kauoha i kahi sedative māmā e kōkua iā ʻoe e hoʻomaha i ka wā o ke kaʻina hana.

Pehea e heluhelu ai i kāu mau hopena Magnetic Resonance Elastography?

Ana ʻia nā hopena MRE ma nā kilopascals (kPa), e hōʻike ana i ka paʻakikī o ka ʻiʻo. ʻO ka maʻamau, ana ʻia ka ʻiʻo olakino ma waena o 2-3 kPa, aʻo ka ʻiʻo paʻakikī a me ka ʻōpala e hōʻike ana i nā waiwai kiʻekiʻe.

E wehewehe kāu kauka i kēia mau ana me kāu mōʻaukala olakino a me nā hopena hoʻokolohua ʻē aʻe. Hiki ke loli nā pae kikoʻī ma muli o ke kino i nānā ʻia a me ke ʻano kiʻi i hoʻohana ʻia.

No ka MRE ate, eia ka mea e hōʻike ai nā waiwai paʻakikī like ʻole:

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• Ate maʻamau: 2.0-3.0 kPa
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• Fibrosis māmā: 3.0-4.0 kPa
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• Fibrosis maʻamau: 4.0-5.0 kPa
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• Fibrosis koʻikoʻi: 5.0-6.0 kPa
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• Cirrhosis: Ma luna o 6.0 kPa
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He mea nui e hoʻomanaʻo he mau alakaʻi maʻamau kēia, a e noʻonoʻo kāu kauka i kou kūlana pilikino i ka wā e wehewehe ai i nā hopena. Hiki i kekahi mau maʻi ke hoʻoulu i ka paʻakikī manawa ʻaʻole pono e hōʻike i ka pōʻino mau.

Aia pū nā hopena i nā kiʻi kikoʻī e hōʻike ana i nā hiʻohiʻona paʻakikī ma ke kino i nānā ʻia. Kōkua kēia ʻike spatial i nā kauka e ʻike i nā wahi pilikia kikoʻī a hoʻolālā i nā lāʻau lapaʻau kūpono.

He aha ke kiʻekiʻe ʻoi loa o ka Magnetic Resonance Elastography?

Aia ka

Na kāu kauka e hoʻoholo i kāu pae pahuhopu e pili ana i kāu mau kūlana kikoʻī. ʻO ka pahuhopu pinepine ka mālama ʻana i nā helu paʻa a i ʻole ka ʻike ʻana i ka hoʻomaikaʻi ʻana i ka manawa, ma mua o ka loaʻa ʻana o kahi helu kikoʻī.

He aha nā mea pilikia no nā hopena Elastography Magnetic Resonance maʻamau ʻole?

Hiki i kekahi mau mea ke kōkua i ka hoʻonui ʻana i ka paʻakikī o nā ʻōpū i ʻike ʻia e MRE. ʻO ka hoʻomaopopo ʻana i kēia mau mea pilikia e kōkua i ka wehewehe ʻana i ke kumu e ʻōlelo ai kāu kauka i kēia hoʻāʻo a me ke ʻano o nā hopena.

ʻO nā mea pilikia nui e pili ana i nā kūlana e hoʻoulu ai i ka mumū a i ʻole ka ʻeha i loko o nā ʻōpū i ka manawa. Hoʻomaʻamaʻa kēia mau kaʻina i nā ʻiʻo i ʻoi aku ka paʻakikī a me ka liʻiliʻi.

ʻO nā mea pilikia maʻamau e hiki ke alakaʻi i nā hopena MRE maʻamau ʻole e pili ana:

• Hepatitis viral maʻi (B a i ʻole C)
• Ka nui o ka inu ʻana i ka waiʻona
• Ka momona a me ka maʻi metabolic
• Diabetes
• Nā pae cholesterol kiʻekiʻe
• Nā kūlana autoimmune
• Nā lāʻau lapaʻau
• Nā maʻi ate genetic
• Nā maʻi ʻōpū mua

Hiki i ka makahiki ke pāʻani i kahi hana, no ka mea, ʻoi aku ka paʻakikī o nā ʻōpū i ka manawa. Eia naʻe, ʻo ka paʻakikī nui e hōʻike pinepine ana i kahi maʻi ma lalo o ka ʻili ma mua o ka ʻelemakule maʻamau.

Hiki i kekahi mau maʻi maʻamau ke hoʻopilikia i nā hopena MRE, me ka maʻi o Wilson, hemochromatosis, a me ka hemahema o ka alpha-1 antitrypsin. ʻO kēia mau maʻi genetic e hoʻoulu i nā ʻano pōʻino o nā ʻōpū e hōʻike ana i ka paʻakikī.

He aha nā pilikia hiki ke loaʻa i nā hopena MRE maʻamau ʻole?

ʻAʻole nā hopena MRE maʻamau ʻole i nā pilikia, akā hiki iā lākou ke hōʻike i nā kūlana ma lalo o ka ʻili e hiki ke alakaʻi i nā pilikia olakino koʻikoʻi inā ʻaʻole i mālama ʻia. Aia nā pilikia i ka ʻōpū e hōʻike ana i ka paʻakikī a me ke kumu ma lalo o ka ʻili.

No nā pilikia e pili ana i ke akepaʻa, ʻo ka mea nui e hopohopo ai, ʻo ia ka holomua ʻana i ka cirrhosis a me ka maʻi o ke akepaʻa. Ke lilo ka ʻiʻo o ke akepaʻa i mea paʻakikī ma muli o ka ʻeha, ʻaʻole hiki iā ia ke hana pono i kāna mau hana nui.

ʻO nā pilikia e hiki ke loaʻa mai ka paʻakikī o ke akepaʻa i ʻike ʻia e MRE, ʻo ia:

• Portal hypertension (hoʻonui ʻia ke kaomi i loko o nā kīʻaha koko o ke akepaʻa)
• Varices (nā veins i hoʻonui ʻia e hiki ke kahe)
• Ascites (ka hōʻiliʻili wai i loko o ka ʻōpū)
• Hepatic encephalopathy (ka hana ʻino o ka lolo ma muli o nā pilikia o ke akepaʻa)
• Hoʻonui ʻia ka pilikia o ka maʻi kanesa o ke akepaʻa
• ʻO ka maʻi o ke akepaʻa e koi ana i ka transplantation

I nā ʻōkana ʻē aʻe, hiki i ka paʻakikī ʻole ke alakaʻi i nā pilikia like ʻole. Hiki i ka paʻakikī o ka ʻiʻo lolo ke hōʻike i nā maʻi ʻaʻai a i ʻole nā maʻi neurodegenerative, aʻo ka paʻakikī o ka ʻiʻo o ka puʻuwai hiki ke hoʻopilikia i ka hana pumping.

ʻO ka lono maikaʻi, ʻo ia ka ʻike mua ʻana ma o MRE e ʻae pinepine ai i ka hana ma mua o ka ulu ʻana o kēia mau pilikia. Nui nā kūlana e hoʻoulu ai i ka paʻakikī o nā ʻōkana hiki ke mālama ʻia a i ʻole e mālama pono ʻia ke hopu ʻia i ka wā mua.

I ka manawa hea wau e ʻike ai i ke kauka no ka nānā ʻana i ka Magnetic Resonance Elastography?

Pono ʻoe e hoʻonohonoho i nā manawa nānā ma muli o kāu mau hopena MRE a me nā ʻōlelo aʻoaʻo a kāu kauka. Aia ka manawa i ka loaʻa ʻana o nā pilikia a me ka wikiwiki o ka holomua ʻana o kou maʻi.

Inā maʻamau kāu mau hopena MRE, hiki i kāu kauka ke ʻōlelo i ka hoʻāʻo hou ʻana i loko o 1-2 mau makahiki, ʻoiai inā he mau mea pilikia kāu no ka maʻi o ke kino. Ke kōkua nei ka nānā mau ʻana i ka hopu ʻana i nā loli i ka wā ma mua o ka lilo ʻana i mea koʻikoʻi.

No nā hopena maʻamau, pono paha ʻoe i nā manawa nānā pinepine. E hana kāu kauka i kahi papa hana nānā ma muli o ke koʻikoʻi o kou maʻi a me ka wikiwiki o ka loli.

Pono ʻoe e hoʻokaʻaʻike i kāu kauka i ka wā ma mua inā e loaʻa iā ʻoe nā hōʻailona hou, me ka nānā ʻole i kāu mau hopena MRE:

• He ʻeha mau i ka ʻōpū a i ʻole ka pehu
• Luhi a nāwaliwali paha i wehewehe ʻole ʻia
• Melemele o ka ʻili a i ʻole nā maka (jaundice)
• Mimi ʻeleʻele a i ʻole nā noho palapala
• Nausea a i ʻole ka nalowale o ka ʻai
• Maʻalahi ka ʻeha a i ʻole ke kahe ʻana
• Huikau a i ʻole ka paʻakikī o ka noʻonoʻo

Mai kali no kāu manawa i hoʻonohonoho ʻia inā ʻoe e ʻike nei i nā hōʻailona e pili ana. Hiki i ka hana mua ke hana i kahi ʻokoʻa nui i nā hopena lapaʻau.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka Magnetic Resonance Elastography

Q.1 He maikaʻi anei ka hoʻāʻo MRE no ka ʻike ʻana i ka fibrosis ate?

ʻAe, maikaʻi loa ʻo MRE no ka ʻike ʻana i ka fibrosis ate a ua manaʻo ʻia ʻo ia kekahi o nā hana non-invasive pololei loa i loaʻa. Hōʻike nā haʻawina hiki i ka MRE ke ʻike i ka fibrosis me ka pololei ma luna o 90%, e ʻoi aku ka hilinaʻi ma mua o nā hoʻāʻo koko a i ʻole nā kiʻi maʻamau.

Hiki i ka MRE ke ʻike i ka fibrosis i kona wā mua, pinepine ma mua o ka ʻike ʻia ʻana o nā hōʻailona a i ʻole nā hoʻāʻo ʻē aʻe e hōʻike i nā mea ʻokoʻa. ʻO kēia ʻike mua e hiki ai ke mālama wikiwiki e hiki ke hoʻolohi a i ʻole e hoʻohuli i ke kaʻina hana ʻeha i kekahi mau hihia.

Q.2 ʻO ke kiʻekiʻe o ka paʻakikī o ke ake ke manaʻo mau nei i ka cirrhosis?

ʻAʻole, ʻaʻole hōʻike mau ka paʻakikī o ke ake i ka cirrhosis. ʻOiai ʻo nā waiwai paʻakikī kiʻekiʻe loa (ma luna o 6.0 kPa) e hōʻike pinepine ana i ka ʻeha holomua, hiki i kekahi mau kūlana ʻē aʻe ke hoʻoulu i ka piʻi paʻakikī manawa a i ʻole hiki ke hoʻohuli ʻia.

Hiki i ka mumū nui mai ka hepatitis, ka maʻi puʻuwai, a i ʻole ka ʻai ʻana ma mua o ka hoʻāʻo ke hoʻonui i ka paʻakikī o ke ake. E noʻonoʻo kāu kauka i kāu kiʻi olakino piha, ʻaʻole wale nā helu MRE, i ka wā e hana ai i kahi hōʻailona.

Q.3 Pehea ka pinepine e hana hou ai au i ka hoʻāʻo MRE?

Aia ka pinepine o ka hana hou ʻana i ka hoʻāʻo MRE ma kāu mau hopena mua a me nā kūlana i lalo. Inā maʻamau kāu mau hopena a ʻaʻohe ou pilikia, lawa paha ka hoʻāʻo ʻana i kēlā me kēia 2-3 mau makahiki.

No nā kānaka me nā maʻi ate maʻi a i ʻole nā hopena maʻamau ʻole, ua ʻōlelo maʻamau nā kauka i ka MRE i kēlā me kēia 6-12 mahina e nānā i ka holomua o ka maʻi a me ka pono o ka lāʻau. E hana kāu mea mālama ola i kahi papa hana nānā pilikino e pili ana i kou kūlana.

Q.4 Hiki i ka MRE ke pani i ka biopsy ate?

I nā hihia he nui, hiki i ka MRE ke hāʻawi i ka ʻike like me ka biopsy ate me ka ʻole o nā pilikia a me ka hōʻoluʻolu ʻole o kahi kaʻina hana invasive. Eia naʻe, pono nō ka biopsy i kekahi manawa no ka hōʻoia ʻana, ʻoiai ke maopopo ʻole ke kumu o ka maʻi ate.

He maikaʻi ka MRE i ke ana ʻana i ka fibrosis a me ka nānā ʻana i nā loli i ka manawa, akā hiki i ka biopsy ke hāʻawi i ka ʻike hou e pili ana i nā ʻano mumū a me nā ʻano maʻi kikoʻī. E hoʻoholo kāu kauka i ka hoʻokolohua kūpono loa no kou kūlana.

Q.5 He hopena ʻaoʻao anei mai ka MRE?

He palekana loa ka MRE a ʻaʻohe hopena ʻaoʻao i ʻike ʻia no ka hapa nui o nā kānaka. He akahai a ʻaʻohe ʻeha nā haʻalulu i hoʻohana ʻia i ka wā o ka hoʻokolohua, e like me ka lomilomi māmā. He ikaika like nā māla magnetic me nā scans MRI maʻamau.

Hiki i kekahi poʻe ke ʻoluʻolu iki mai ka moe ʻana no 45-60 mau minuke a i ʻole ka ʻike ʻana i ka claustrophobia i ka mīkini MRI. ʻAʻole kēia mau hopena ʻaoʻao mai ka hoʻokolohua ponoʻī, akā he mau pane maʻamau i ke kaiapuni hoʻokolohua hiki ke mālama ʻia me ka hoʻomākaukau kūpono.