Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Magnetna rezonancija tehnikom „zadržavanja daha“ u dijagnostici i preoperativnoj procjeni proširenosti malignih tumora bubrega [Magnetic resonance imaging in diagnosis and preoperative staging of renal cell carcinoma using “breath-hold” technique]

Špero, Martina (2011) Magnetna rezonancija tehnikom „zadržavanja daha“ u dijagnostici i preoperativnoj procjeni proširenosti malignih tumora bubrega [Magnetic resonance imaging in diagnosis and preoperative staging of renal cell carcinoma using “breath-hold” technique]. PhD thesis, Sveučilište u Zagrebu.

[img]
Preview
PDF
Download (1125Kb) | Preview

    Croatian abstract

    Karcinom bubrega je najčešća primarna maligna neoplazma bubrega i čini oko 2-3% svih malignih tumora čovjeka. Incidencija karcinoma bubrega u stalnom je porastu u protekle tri dekade. Ciljevi ovog istraživanja bili su: 1. procijeniti kliničku vrijednost magnetne rezonancije bubrega kao radiološke metode u dijagnostici i preoperativnoj procjeni proširenosti malignih tumora bubrega, 2. rezultate dobivene prilikom pregleda magnetnom rezonancijom usporediti s patohistološkim nalazom kao "zlatnim standardom", 3. utvrditi točnost, osjetljivost i specifičnost, pozitivnu i negativnu prediktivnu vrijednost magnetne rezonancije kao radiološke metode u dijagnostici i preoperativnoj proširenosti karcinoma bubrega prema TNM klasifikaciji iz 2002. godine. U okviru prospektivne studije, učinjena je magnetna rezonancija bubrega kod 55 bolesnika, srednje životne dobi 56.3 godina: postavljena je dijagnoza i učinjena preoperativna procjena proširenosti 64 tumorske tvorbe bubrega, a otkrivene tumorske tvorbe karakterizirane su kao solidni tumor 51/64, cistični tumor 7/64, komplicirana cista 3/64, dok je u slučaju 3/64 tvorbe nalaz bio nesiguran. Prema nalazu MR bubrega u okviru T kategorije tumorske tvorbe su stupnjevane: 53/64 T1 kategorija, 5/64 T2 kategorija, 6/64 T3 kategorija; 62 tumora su stupnjevana kao N0, dva kao N2; 1 tumor je stupnjevan kao M1, a 63/64 su stupnjevani M0. Prema patohistološkom nalazu 6/64 tumorske tvorbe su bile benigne, a 58/64 bile su maligne. Prema makroskopskom patološkom nalazu srednja veličina tumorske tvorbe bila je 43.7 mm. Prema patohistološkom nalazu, 51/58 malignih tumora bubrega stupnjevano je kao T1 kategorija, 3/58 kao T2 kategorija, 4/58 kao T3 kategorija; 1 tumor je stupnjevan kao N2 i jedan kao M1, ostali su stupnjevani kao N0 i M= U ovom istraživanju većina tumora je ocijenjena kao T1N0M0, odnosno TNM I stadij. Osjetljivost MR bubrega kao slikovne metode u dijagnostici malignih tumora bubrega za sve tri kategorije TNM sustava bila je 93.1%, specifičnost 100%, točnost 93.7%, pozitivna prediktivna vrijednost 100%, negativna prediktivna vrijednost 60%. U zaključku, uloga magnetne rezonancije kao moderne radiološke metode u slikovnom prikazu bolesti bubrega promijenila se tijekom vremena, pri čemu je MR, uz MDCT, postala «imaging» metodom izbora u dijagnostici i preoperativnoj procjeni proširenosti malignih tumora bubrega.

    English abstract

    Renal cell carcinoma is the most common primary malignant neoplasm of the kidney and accounts for 2-3% of all cancer diagnosed. Its incidence is constantly increasing over the last three decades. The aim of this study was to assess the sensitivity, specificity, accuracy, positive and negative and positive predictive value of MRI in diagnosis and preoperative staging of renal cell carcinoma using the 2002 TNM staging system, with pathological staging as the gold standard. Fifty-five patients, mean age 56.3 years, with 64 renal tumors underwent MRI for diagnosis and preoperative staging. MRI detected 51 solid and 7 cystic renal tumors, 3 complex cysts, 3 doubtful findings. MRI tumor mean size was 45.7 mm. MRI staged 53 tumors as T1, 5 as T2, and 6 as T3 stage: (3/6 T3a, 3/6 T3b). Sixty-two tumors were staged N0, two were staged N2. 1/64 was staged M1 (distant liver metastases), 63/64 were staged M0. Pathological findings revealed 6 benign and 58 malignant renal tumors. Pathologic tumor mean size was 43.7 mm. Pathologist staged 51 tumors as T1, 3 as T2, 4 tumors as T3 stage. One tumor was staged N2 and one was staged M1, all the rest were staged N0 and M0. In our study most of the patients were staged T1N0M0 by MRI and pathological findings, and kappa test revealed excellent agreement between all three classes of the TNM staging system. Sensitivity of the MRI in preoperative staging of renal cell carcinoma is 93.1%, specificity is 100%, accuracy is 93.7%, positive predictive value is 100%, negative predictive value is 60%. In conclusion, the role of MRI in renal imaging has changed over time and it has become an important modality for evaluating renal masses and for staging patients with RCC.

    Item Type: Thesis (PhD)
    Mentor: Marotti, Miljenko
    Divisions: Izvan medicinskog fakulteta
    Depositing User: Marijan Šember
    University: Sveučilište u Zagrebu
    Institution: Medicinski fakultet
    Number of Pages: 119
    Status: Unpublished
    Creators:
    CreatorsEmail
    Špero, Martina
    Date: 26 October 2011
    Date Deposited: 24 Nov 2011 09:36
    Last Modified: 24 Nov 2011 09:36
    Subjects: /
    Related URLs:
      URI: http://medlib.mef.hr/id/eprint/1382

      Actions (login required)

      View Item

      Document Downloads

      More statistics for this item...