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Publikacije (37)

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F. Julardžija, A. Šehić, Esad Voloder, M. Jusufbegović, D. Bulja, Hadžan Konjo, S. Kamenjaković, S. Vegar-Zubović

Multiple sclerosis is a chronic demyelinating disease of the central nervous system, that causes permanent disabilities. Diagnostics of this disease by magnetic resonance requires the appliance of corresponding protocols with the sequences that emphasize demyelinating plaques. Standard sequences T1 and T2 sometimes cannot clearly show demyelinating plaques, and it is necessary to work on perfecting the sequences that emphasize the changes in the brain formed as demyelinating plaques. The aim of the survey: The aim of the survey was to estimate the value of MR sequence with double inversion recovery (DIR) in discovering demyelinating lesions of the brain in multiple sclerosis (MS). Patients and methods of the survey: 22 patients were included in the survey, they were of both genders and different age. The patients were with diagnosed with multiple sclerosis. The patients underwent the scanning on MR apparatus 1.5 T. Comparison of DIR sequence to FLAIR and T2 W sequences were done. Result: DIR sequence proved significantly more MS lesions compared to T2W or FLAIR sequence, including intracortical, juxtacortical and paraventricular zone of the brain. In the infratentorial zone of brain, T2W sequence proved significantly more plaques compared to DIR and FLAIR. Conclusion: DIR sequence compared to T2W and FLAIR sequences discovered more demyelinating lesions in targeted regions that were examined. DIR sequence is a tool that contributes to easier and faster diagnostics of multiple sclerosis, needs to be included into the routine MR protocol of patients with MS, in order to discover more easily intracortical and juxtacortical MS lesions of the brain.

Introduction: This study aims to explore clinical values and possibilities of heart artifact elimination for patients who underwent SPECT myocardial perfusion scintigraphy. The main focus is on nuclear medicine technologists and their knowlodge of the new technologies developed in nuclear cardiology. Methods: A qualitative descriptive study, review article has been performed for this research. Pubmed, Web of Science, and Embase were searched using a predefined electronic search strategy. Eighteen studies were deemed eligible for this systematic review. Results: Based on the literature we found average age for the patients with coronary artery disease is 59.69 years for women and 57.39 yeras for men. False positive findings, blurred images, respiratory artifacts and sinogram and linogram interruption is very often, especially with patients with irregular breathing cycles, fear of the reasults, anxiety and patients with high BMI. Many studies performed on phantoms or on patients suggest image artifacts can be reduced or even eliminated with the new scanning methodology, software application upgrade, and with right nuclear medicine technologist education. Conclusion: Coronary artery disease can affect men and women equally so the best diagnostic modality is essential for adequate treatment. Interruption of sinogram or linogram, truncation of the heart and blurred image is the first sign artifact of the image. Essential and the first step of every cardiac proccesing software is sinogram and linogram inspection combined with motion correction evaluation of the raw images. New technologies can improve image quality which can increase sensitivity and specificy of myocardial perfusion scintigraphy in all patients.

Research goal: The aim of the research is to define the possibilities of TVU and the MRI in the diagnosis of the most common benign ovarian lesions which cause pelvic pain. Patients and methods: In study were included n=74 patients with pelvic pain, who were examined with TVU and then with an MRI of pelvis. Diagnostic results of all patients (n=74) divided into two groups according to the modality that was performed (TVU results n=74 and MRI results n=74 MRI ). We compared the results of TVU and MRI, and with a pathohistological finding after surgery. TVU test sensitivity and MRI test sensitivity has been made for each pathological entity in particular. The overall sensitivity test of TVU was performed for all pathological entities together. The overall sensitivity test of MRI was performed for all pathological entities together. Results: TVU demonstrated sensitivity of 83.3% for ectopic pregnancy, 83.3% for ovarian torsion, 84% for endometriotic cyst, 88.2% for hemorrhagic cysts, 58.3% for tubo-ovarian abscesses, 62.5% for dermoid cysts. Overall sensitivity of TVU for all these pathological entities was 78.4%. MRI showed a sensitivity of 100% for ovarian ectopic pregnancy, 83.3% for ovarian torsion, 100% for endometriotic cyst, 100% of hemorrhagic cysts, 83.3% tubo-ovarian abscess, and 87.5% for dermoid cysts. Overall sensitivity of MRI in all of these pathological entities was 94.6%. The analysis using the chi square test shows that there is a significant difference in the sensitivity between the US and MRI in favor of greater overall MRI sensitivity in diagnosing ovarian pain caused by benign lesions. (χ2 = 14.352, df = 9, p = 0.0021). Conclusion: TVU is the first choice method for ovarian analysis due to the convenience and absence of radiation, and MRI is a very useful modality when TVU’s results are confusing and unspecific.

Aim: The aim of this study is to prove the advantages of combined use of T2 weighted three dimensional (T2 W 3D) and T1 weighted three dimensional contrast medium enhanced (T1 W 3D CE) magnetic resonance (MR) urography in displaying urinary tract in child population. Material and methods: Total of 120 patients were included in the study, 71 (59%) male patients and 49 (41%) female patients. The study was conducted on the Radiology clinic, University of Sarajevo Clinical Center, during the period from February to November 2016. Patients were examined on the 1.5T and 3T MRI, with standard protocol which includes T2 W 3D and T1 W 3D contrast medium enhanced MR urography. In the post procesing quantitative measurement of signal intensity and evaluation of the display quality in the area of renal pelvis, middle of ureter and the mouth of the ureter were done. Measurement was concluded on Syngo software B13. Results: Analyzing the acquired data and statistically processing them we got results which have shown higher signal intensity of measured structures on T1 W 3D contrast medium enhanced MR urography on the level p<0.01 and p<0.05 compared to T2 W 3D MR urography in patients that had normal dynamics of contrast medium secretion. However, in kidneys with decreased function, T2 W 3D MR urography provided higher signal intensity and better display compared to T1 W 3D contrast medium enhanced MR urography on the level p<0.05 and p<0.01. Conclusion: T2 W3D MR urography is useful in imaging nonfunctional kidney as well as in patients prone to allergic reactions, where as T1 W3D CE MR urography is at an advantage over T2 W 3D MR urography in imaging the kidney functionality, kidney dynamics measurement, it provides higher MRI signal intensity required for clear 3D reconstructions.

Introduction: Diffusion weighted imaging (DWI) is a form of magnetic resonance imaging (MRI) based on measuring the random Brownian motion of water molecules within a tissue. The aim of this study was to show the significance of diffusion-weighted imaging (DWI) in differentiating pancreatic cystic formations from normal pancreatic parenchyma using MRI 1.5 T.Methods: A total of 52 patients were included in the study (25 with pancreatic cystic formations and 27 with normal MRI findings of the pancreas). DWI technique was used with b values of 0.500 and 1 000 mm2/s at 1.5 T. The signal intensity was measured, as well as apparent diffusion coefficient (ADC). Visual estimation of the signal intensity of detected cystic lesions was performed and compared to the normal appearance of pancreas.Results: The highest signal intensity of the cystic lesions with hyper-signal was observed with DWI b0 value in the pancreatic head (M 185.1 ± 47.205, p 0.05.Conclusions: Differences in signal intensity and ADC values have an important diagnostic value in differentiating the cystic formations from normal pancreatic parenchyma in MRI examination.

F. Julardžija, A. Šehić, Damir Jaganjac, Esad Voloder, Srećko Mađura, D. Vrcić

The objective this study is to assess the public opinions on prostitution, STD and AIDS among various groups of population in Paseechareon District, Bangkok. The study was done by interviewing samples randomly selected from 6 different professions: district officers, subdistrict and village headmen, teachers, bank workers, policemen and entertainment businessmen. It was found that the respondents were all well awere of problems of prostitution and its related undesirable consequences  such as the rapaid spread of AIDS and the bad reputation for having a very high number of sex workers in all regions of the country. These problems could be possible controlled by enforcing the Prostitution Act and placing stronger punishment to those who offended the law. However, since it became a norm for men to buy sex services from prostitutes who engaged in the sex business because of such underlyying conditions as poverty and low education, the regular and proper use of condoms would be an effective means to urgently prevent STD and AIDS in Thailand.

Nusret Salkica, A. Begić, Adnan Beganovic, F. Julardžija, A. Šehić, Halil Čorović, Safet Hadžimusić, A. Skopljak-Beganović

Introduction: The introduction of hybrid imaging systems such as single photon emission computed tomography/computed tomography (SPECT/CT) has completely changed the scanning procedure of conventional diagnostic nuclear medicine protocols. Modern bone scintigraphy protocols include standardized uptake value quantification and whole body (WB) SPECT/CT scanning modality. The major limitation of these new technologies is the relatively long scanning time. New detector systems with modern reconstruction software have been developed for fast scanning SPECT protocols. These new technologies can produce images of reduced acquisition with the same quality as full scanning acquisition. As a result, new studies suggest that planar WB scintigraphy should be replaced with WB SPECT/CT. Methods: One hundred oncology patients performed SPECT/CT as a part of their clinical follow-up. Three different scanning and three reconstruction protocols have been evaluated. Two nuclear medicine physicians evaluated with Likert scale image sharpness, lesion visibility, and lesion background detectability. The overall image quality was determined as the sum of these three parameters. Results: In terms of scan duration reduction on image quality, Volumetrix Evolution for Bone performed during ultra-fast SPECT acquisition achieved the highest score, which is superior compared to the standard SPECT acquisition protocol. The overall image quality was the best with the Volumetrix MI Evolution for Bone protocol for ultra-fast acquisition. Conclusion: The Evolution for Bone protocol for ultra-fast acquisition showed the best results compared to other protocols. The adoption of the new acquisition SPECT protocol may offer more comfortable examinations, resulting in higher patient satisfaction. The implementation of this new protocol can lead to an improvement in SPECT sensitivity, primarily due to the reduction of SPECT motion artifacts: SPECT has significantly improved nuclear medicine diagnostics. The disadvantage of SPECT methods is the relatively low signal-to-noise ratio and contrast-to-noise ratio. The low number of image photons is a major problem with SPECT imaging, as the signal decreases as the noise (image background) increases.

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