He aha te Magnetic Resonance Elastography? Te Whāinga, Ngā Taumata/Tikanga & Ngā Hua

Ko te magnetic resonance elastography (MRE) he whakamātautau whakaahua motuhake e ine ana i te mārō, i te ngawari rānei o ō pūngao, ina koa tō ate. Whakaarohia he huarahi ngawari ki te "pā" i ō pūngao mai i waho, he rite ki te pēhi a te tākuta i tō puku i te wā o te whakamātautau tinana, engari he tino tika, he taipitopito ake.

Ko tēnei whakamātautau kore-whakauru e whakakotahi ana i te whakaahua MRI auau me ngā ngaru oro hei hanga mahere taipitopito o te mārō o te kiko. Ka āwhina ngā mōhiohio i ngā tākuta ki te kite i te kiko kiko, te mumura, ētahi atu rānei huringa i ō pūngao e kore e puta i ngā whakamātautau whakaahua paerewa.

He aha te Magnetic Resonance Elastography?

Ko te MRE he tikanga whakaahua matatau e whakamahi ana i ngā pānga autō me ngā ngaru oro hei ine i te ngawari o te kiko. Ka mahi te whakamātautau mā te tuku i ngā wiri ngawari mā tō tinana i a koe e noho ana i roto i te mīhini MRI, ka hopu i te nekehanga o ēnei ngaru mā ō pūngao.

Inā he hauora ngā kiko, he ngawari, he ngāwari hoki. Heoi, ka puta te kiko kiko, te fibrosis rānei, ka mārō ake ngā kiko, ka iti ake te ngawari. Ka taea e te MRE te kite i ēnei huringa i ngā wāhanga tuatahi, i mua i te whakaatu a ētahi atu whakamātautau i ngā rerekētanga.

Ko te whakamātautau e whakamahia ana ki te arotake i te hauora o te ate, engari ka taea hoki te arotake i ētahi atu pūngao pēnei i te roro, te ngākau, te tākihi, me ngā uaua. Koinei te taputapu whai hua mō te tātai i ngā momo āhuatanga me te kore e hiahia ki ngā tikanga whakauru.

He aha te take e mahia ana te Magnetic Resonance Elastography?

Ka tūtohu pea tō tākuta i te MRE hei arotake i te mārō o te pūngao me te kite i te haere whakamua o te mate. He tino whai hua te whakamātautau mō te aroturuki i ngā āhuatanga o te ate, nā te mea ka taea e ia te tautuhi i te kiko kiko (fibrosis) e puta mai ana i ngā momo mate ate.

Ko ngā take tino nui mō te MRE ko te arotake i ngā āhuatanga ate roa pēnei i te mate hepatitis, te mate ate momona, te cirrhosis rānei. Ka āwhina i ngā tākuta ki te whakatau i te nui o te kiko whara kua pā, me te whai hua o ngā rongoā.

I tua atu i te arotake ate, ka taea e te MRE te āwhina i te tātai i ngā āhuatanga roro, ngā raruraru ngākau, me ngā mate uaua. Koinei ngā āhuatanga nui e whai wāhi nui ana te MRE:

• Hepatitis B, C rānei
• Te mate ate momona kore-waipiro (NAFLD)
• Te mate ate waipiro
• Primary biliary cholangitis
• Autoimmune hepatitis
• Ngā puku roro, ngā āhuatanga neurological rānei
• Te mārō o te uaua ngākau
• Kidney fibrosis
• Ngā mate uaua

I ētahi wā, ka whakamahi ngā tākuta i te MRE ki te aroturuki i te urupare rongoā, ki te whakamahere rānei i ngā mahi pokanga. Ka āwhina hoki te whakamātautau ki te karo i ngā mahi hōhā ake pēnei i te biopsy ate i ētahi wā.

He aha te tikanga mō te Magnetic Resonance Elastography?

He rite te tikanga MRE ki te karapa MRI noa me te rerekētanga nui kotahi: he pūrere motuhake e whakaputa ana i ngā wiri ngawari i te wā o te whakaahua. Ka takoto koe ki runga i te tēpu e paheke ana ki roto i te mīhini MRI, ā, ko te katoa o te tukanga e 45 ki te 60 meneti te roa.

I mua i te tīmatanga o te karapa, ka whakatakoto te tohunga hangarau i tētahi papa iti, ngawari e kiia ana ko te "taraiwa pāhū" ki tō tinana i runga i te wāhi e tirotirohia ana. Ka hono tēnei papa ki tētahi mīhini e hanga ana i ngā ngaru oro iti-auau, he rite ki te mirimiri ngawari.

I te wā o te karapa, ka rongo koe i ngā oro MRI noa me te rongo o te pūoro, te patupatu rānei mai i ngā wiri. Kāore he mamae o ngā wiri, ā, he rite ki te pēhanga rīhitimi māmā ki tō kiri.

Koinei ngā mea e pā ana ki tō tikanga MRE:

1. Ka huri koe ki te kākahu hōhipera, ka tango i ngā mea whakarewa katoa
2. Ka whakatakotoria koe e te tohunga hangarau ki runga i te tēpu MRI
3. Ka whakatakotoria he papa taraiwa pāhihi ki tō tinana
4. Ka whiwhi koe i ngā taringa, i ngā taringa rānei hei whakaiti i te haruru
5. Ka reti te tēpu ki roto i te mīhini MRI
6. Ka tīmata ngā wiri ngawari i te wā e hopukina ana ngā whakaahua
7. Me pupuri tō manawa mō ngā wā poto (10-20 hēkona)
8. Ka oti te katoa o te tukanga i roto i te 45-60 meneti

I roto i te tukanga, ka taea e koe te kōrero ki te tohunga hangarau mā te pūnaha intercom. Ki te kore koe e pai i tētahi wā, ka taea e koe te tono kia mutu, kia okioki rānei.

Me pēhea te whakarite mō tō Magnetic Resonance Elastography?

He tika te whakarite mō te MRE, he rite ki te whakarite mō te MRI noa. Me karo koe ki te kai mō te 4-6 haora i mua i te whakamātautau mēnā kei te whakaahua koe i te ate, nā te mea ka āwhina tēnei ki te whakarato i ngā whakaahua mārama ake.

Ko te whakarite tino nui ko te tirotiro mō ngā mea whakarewa i tō tinana. I te mea e whakamahi ana te MRE i ngā aukume kaha, ka mōrearea ētahi whakarewa, ka raru rānei i ngā hua o te whakamātautau.

I mua i tō whakaritenga, me mōhio ki tō rōpū hauora mō ētahi o ēnei mea:

• Ngā kaiwhakawhiwhi manawa, ngā kaiwhakawhiwhi defibrillator rānei
• Ngā whakaurunga cochlear
• Ngā whakakapinga hononga whakarewa
• Ngā topenga pokanga, ngā tītina rānei
• Ngā pūrere o roto i te kōpū (IUDs)
• Ngā moko me te waituhi whakarewa
• Ngā whakapaipai tūturu
• Ngā werohanga tinana

I te rā o tō whakamātautau, mau i ngā kākahu pai, ngā kākahu wātea me te kore he here whakarewa. Ka huri pea koe ki te kākahu hōhipera, engari ko ngā kākahu pai ka pai ake te wheako.

Mēnā he claustrophobia tō, he āwangawanga rānei mō ngā wāhi kapi, kōrero ki tō tākuta i mua. Ka tohutohu pea rātou i tētahi rongoā ngawari hei āwhina i a koe kia okioki i te wā o te tukanga.

Me pēhea te pānui i ngā hua o tō Magnetic Resonance Elastography?

Ka inehia ngā hua MRE i roto i ngā kilopascals (kPa), e tohu ana i te mārō o te kiko. Ko te kiko noa, hauora te tikanga kei waenga i te 2-3 kPa, engari ko te kiko mārō ake, he kiko whara e whakaatu ana i ngā uara teitei ake.

Ka whakamāramahia e tō tākuta ēnei inenga me tō hītori rongoā me ētahi atu hua whakamātautau. Ka rerekē pea ngā awhe motuhake i runga i te okana i tirotirohia me te tikanga whakaahua i whakamahia.

Mō te MRE ate, koinei te tohu o ngā uara mārō rerekē:

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• Te ate noa: 2.0-3.0 kPa
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• Fibrosis ngawari: 3.0-4.0 kPa
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• Fibrosis āhua: 4.0-5.0 kPa
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• Fibrosis kaha: 5.0-6.0 kPa
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• Cirrhosis: Neke atu i te 6.0 kPa
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He mea nui kia mahara he aratohu whānui ēnei, ā, ka whakaarohia e tō tākuta tō āhuatanga takitahi i te wā e whakamārama ana i ngā hua. Ko ētahi āhuatanga ka puta te mārō rangitahi kāore e tohu ana i te kino tūturu.

Kei roto hoki i ngā hua ngā whakaahua taipitopito e whakaatu ana i ngā tauira mārō puta noa i te okana i tirotirohia. Mā ēnei pārongo ā-wāhi e āwhina ana i ngā tākuta ki te tautuhi i ngā wāhi e pā ana, me te whakamahere i ngā maimoatanga tika.

He aha te taumata pai rawa atu o te Magnetic Resonance Elastography?

Ko te

Ka whakatau tō tākuta i tō awhe whāinga i runga i ō āhuatanga motuhake. Ko te whāinga he pupuri i ngā pānui tūmau, he kite rānei i te whakapai ake i te wā, kaua ki te whakatutuki i tētahi tau motuhake.

He aha ngā āhuatanga tūpono mō ngā hua Magnetic Resonance Elastography koretake?

He maha ngā āhuatanga ka whai wāhi ki te piki o te mārō o te okana ka kitea e te MRE. Mā te māramatanga ki ēnei āhuatanga tūpono ka whakamārama he aha te take ka tūtohu pea tō tākuta i tēnei whakamātautau me te aha pea te tikanga o ngā hua.

Ko ngā āhuatanga tūpono nui rawa atu e pā ana ki ngā āhuatanga e pā ana ki te mumura, ki te kiko rānei i roto i ngā okana i te wā. Mā ēnei tukanga ka mārō haere ngā kiko, ka iti ake te ngāwari.

Ngā āhuatanga tūpono noa ka puta pea he hua MRE koretake ko:

• Te mumura ate huaketo mau tonu (B, C rānei)
• Te nui rawa o te inu waipiro
• Te momomo me te mate metabolic
• Te mate huka
• Ngā taumata cholesterol tiketike
• Ngā āhuatanga autoimmune
• Ētahi rongoā
• Ngā mate ate ira
• Ngā mate okana o mua

Ka whai wāhi anō te pakeke, i te mea ka mārō haere ngā okana i te wā. Heoi, ko te mārō nui te tikanga he āhuatanga kei raro iho, kaua ko te koroheketanga noa.

Ētahi āhuatanga onge ka pā anō ki ngā hua MRE, tae atu ki te mate a Wilson, te hemochromatosis, me te ngoikoretanga alpha-1 antitrypsin. Mā ēnei āhuatanga ira ka puta ngā momo kino okana motuhake e whakaatu ana i te pikinga o te mārō.

He aha ngā raruraru ka puta mai i ngā hua MRE koretake?

Ko ngā hua MRE koretake anō e kore e puta he raruraru, engari ka tohu pea i ngā āhuatanga kei raro iho ka puta he raruraru hauora nui ki te kore e rongoatia. Kei runga i te okana e whakaatu ana i te pikinga o te mārō me te take i raro iho ngā raruraru.

Mō ngā hē i te ate, ko te āwangawanga nui ko te haere ki te cirrhosis me te korenga o te ate. I te wā e mārō haere ana te kiko ate nā te kiko kōpiko, e kore e taea e ia te mahi i ōna mahi nui.

Ngā raruraru ka puta mai i te mārō o te ate i kitea e te MRE ko:

• Te pēhanga toto i roto i te pūkahukahu (te piki o te pēhanga i roto i ngā oko toto ate)
• Ngā varices (ngā uaua whānui ka toto)
• Ascites (te kohinga wai i roto i te puku)
• Hepatic encephalopathy (te korenga o te roro nā te raruraru ate)
• Te piki o te tūponotanga o te mate pukupuku ate
• Te korenga ate katoa e hiahia ana ki te whakawhiti

I roto i ētahi atu okana, ka taea e te mārō hē te arahi ki ngā raruraru rerekē. Ka tohu pea te mārō o te kiko roro i ngā puku, i ngā mate neurodegenerative rānei, i te wā e pā ana te mārō o te uaua ngākau ki te mahi papu.

Ko te rongo pai ko te kitenga wawe mā te MRE e āhei ana te wawaotanga i mua i te puta mai o ēnei raruraru. He maha ngā āhuatanga e pā ana ki te mārō okana ka taea te rongoā, te whakahaere rānei i te wā e mau ana i te wā.

Āhea au e kite ai i te tākuta mō te whai i te Magnetic Resonance Elastography?

Me whakarite e koe ngā hui whai i runga i ō hua MRE me ngā tohutohu a tō tākuta. Kei te whakawhirinaki te wā ki te kitea he hē, me te tere o te haere o tō āhuatanga.

Mena he noa ō hua MRE, ka tūtohu pea tō tākuta kia whakamātau anō i roto i te 1-2 tau, ina koa kei a koe ngā āhuatanga tūpono mō te mate okana. Ka āwhina te aroturuki i ngā huringa i mua i te pūngia.

Mō ngā hua hē, ka hiahia pea koe ki ngā hui whai auau. Ka waihanga tō tākuta i tētahi hōtaka aroturuki i runga i te kaha o tō āhuatanga me te tere o te huringa.

Me whakapā atu koe ki tō tākuta i mua atu mēnā ka puta mai ngā tohu hou, ahakoa ngā hua MRE:

• Te mamae puku tonu, te pupuhi rānei
• Te ngenge, te ngoikore rānei kāore i whakamāramahia
• Te kōwhai o te kiri, o ngā kanohi rānei (te kōura)
• Te mimi pouri, te tūtae koma rānei
• Te whakapairuaki, te ngaro rānei o te hiahia kai
• Te ngāwari ki te pāmu, ki te whakaheke toto rānei
• Te rangirua, te uaua rānei ki te arotahi

Kaua e tatari ki tō tūpono e whai ake nei ki te tākuta mēnā kei te pā koe i ngā tohumate e māharahara ana. Mā te wawaotanga wawe ka nui te rerekētanga ki ngā putanga maimoatanga.

Ngā pātai e pātai pinepine ana mō te Magnetic Resonance Elastography

Q.1 He pai te whakamātautau MRE mō te kite i te fibrosis ate?

Āe, he tino pai te MRE mō te kite i te fibrosis ate, ā, e kiia ana ko tētahi o ngā tikanga kore-whakawhiwhi tino tika e wātea ana. E whakaatu ana ngā rangahau ka taea e te MRE te kite i te fibrosis me te tika neke atu i te 90%, e whai mana ana i te whakamātautau toto, i te whakaahua paerewa rānei.

Ka taea e te MRE te tautuhi i te fibrosis i ōna wāhanga tuatahi, i mua i te puta mai o ngā tohumate, i te whakaatu rānei a ētahi atu whakamātautau i ngā hē. Mā tēnei kitenga wawe ka taea te maimoatanga wawe ka taea te whakaroa, te whakahuri rānei i te tukanga kōpiko i ētahi wā.

Q.2 E tohu ana te mārō ate tiketike i te cirrhosis i ngā wā katoa?

Kāore, kāore te mārō ate tiketike e tohu ana i te cirrhosis i ngā wā katoa. Ahakoa te tino uara mārō tiketike (nui ake i te 6.0 kPa) e whakaatu ana i te kōpiko matatau, he maha ētahi atu āhuatanga ka taea te whakaputa i te pikinga mārō rangitahi, whakahuri rānei.

Ka taea e te mumura koi mai i te hepatitis, te ngoikore o te ngākau, te kai rānei i mua i te whakamātautau te whakapiki i te mārō ate. Ka whakaarohia e tō tākuta tō pikitia rongoā katoa, kaua ko ngā tau MRE anake, i te wā e whakatau ana i tētahi tātaritanga.

Q.3 Kia pēhea te auau o taku whakamātau i te MRE?

E whakawhirinaki ana te auau o te whakamātau MRE ki ō hua tuatahi me ngā āhuatanga kei raro. Mēnā he noa ō hua, ā, kāore ō āhuatanga tūpono, ka nui pea te whakamātau i ia 2-3 tau.

Mō te hunga e pā ana ki ngā mate ate roa, ki ngā hua rānei kāore i te tika, ka tohutohu ngā tākuta ki te MRE ia 6-12 marama ki te aroturuki i te haere o te mate me te whai hua o te rongoā. Ka waihanga tō tākuta hauora i tētahi hōtaka aroturuki whaiaro i runga i tō āhuatanga motuhake.

Q.4 Ka taea e te MRE te whakakapi i te koiora ate?

I te nuinga o ngā wā, ka taea e te MRE te whakarato i ngā pārongo rite ki te koiora ate me te kore e raru, e kore e pai o te tikanga whakauru. Heoi, i ētahi wā ka hiahiatia tonu te koiora mō te tātaritanga whakatau, ina koa kāore i te mārama te take o te mate ate.

He pai te MRE ki te ine i te fibrosis me te aroturuki i ngā huringa i roto i te wā, engari ka taea e te koiora te whakarato i ngā pārongo atu mō ngā tauira mumura me ngā momo mate motuhake. Mā tō tākuta e whakatau ko tēhea whakamātautau te mea e tika ana mō tō āhuatanga.

Q.5 He pānga taha ētahi mai i te MRE?

He tino haumaru te MRE, kāore hoki he pānga taha e mōhiotia ana mō te nuinga o te tangata. He ngawari, he kore mamae ngā wiri e whakamahia ana i te wā o te whakamātautau, he rite ki te mirimiri māmā. He rite te kaha o ngā pānga autō ki ngā karapa MRI auau.

Ka pōuri ētahi tāngata i te takoto tonu mō te 45-60 meneti, ka pā rānei te claustrophobia i roto i te mīhini MRI. Ehara ēnei i ngā pānga taha mai i te whakamātautau tonu, engari he urupare noa ki te taiao whakamātautau ka taea te whakahaere mā te whakarite tika.