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IX. Благодарност На светлата памет на дядо ми, професор д-р Георги Хаджидеков......... С искрена благодарност към: - Доцент З. Тончев, мой пръв учител и научен ръководител - Доцент Г. Кирова, вдъхновила ме за тематиката - Всички колеги от Университетската болница „Лозенец”, МЦ „Провита”, Университетската болница в Безансон, за безкористното сътрудничество - Савина, Васко, родителите ми, чиято любов и обич е най-голямата подкрепа 82
X. Summary Magnetic resonance urography in children MR urography (MRU) is a new, attractive imaging modality that was introduced to paediatric uroradiology more than a decade ago and has evolved into an effective imaging tool for the evaluation of various urologic abnormalities in children. MRU provides both morphological and functional information by means of different sequences with or without injection of gadolinium. The method is most commonly applied for the evaluation of hydronephrosis and provides valuable insight into a wide range of obstructive uropathies and is also beneficial in tumors and in the diagnosis of pyelonephritis and renal scarring MRU where it has been shown to be superior to renal scintigraphy. Post processing algorithms permits the evaluation of the split renal function by generating time-intensity curves representative for the renal function, as well as many other parameters. The use of MRU for the assessment of urolithiasis, vesicoureteral reflux, renal trauma, and fetal urinary tract abnormalities is still limited and technical refinements are required. Judicious use of gadoliniumbased contrast agents in children at risk for nephrogenic systemic fibrosis should be employed with attention focused on from today so as to avoid new occurrences. Potential future applications include virtual endoscopy and MRU-guided procedures. The aim of our work is to promote the use of MRU in given paediatric queries trying to provide a safe and reliable MR protocol for anatomic imaging that is generally accepted. For this reason our ambition together with the ESPR uroradiology task force and the ESUR paediatric working is to join forces to define imaging and procedural recommendations in paediatric uroradiology. The aim of this process is not only to standardize paediatric uroradiologic imaging but also to reduce invasiveness and radiation dose. The new proposals are consensus-based, as use and indications have changed and approaches on how to perform the MRU examination in children differ in the literature. We are also describing our experience in functional MRU on the basis of recent technical innovations and post processing functional analysis tools. The lack of standardization for quantitative renal functional evaluation and urinary drainage assessment requires new studies, comparison of the different approaches as we have already started to perform and extensive interdisciplinary consultations. Classic morphometric methods have been applied to MR urography studies for overall assessment of anatomic kidney information. We also used experimental models at 7T MRI to assess new contrast agents with kidney excretion as alternative to gadolinium in cases of kidney dysfunction which we consider harmless for mammalians in selected doses. MRU has the potential to revolutionize imaging of the urinary tract and to become in future the leading diagnostic modality of the wide spectrum of pathological conditions affecting the urinary tract in newborns and children. It integrates exquisite anatomical information with a variety of functional data and avoids ionizing radiation. MRU is increasingly employed as a problem solver when conventional imaging studies remain inconclusive and its growing application will likely improve availability and cost in the future. 83
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МЕДИЦИНСКИ УНИВЕРС
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СЪДЪРЖАНИЕ Въведен
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Въведение В образн
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II. Материал и метод
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Скениранията са пр
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представени формул
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Подобни техники см
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2.5. Морфометрични м
Page 17 and 18:
Корелационен анали
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- Позиционни аномал
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17 Таблица 4. Разпред
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От общо 56 пациента
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21 Таблица 5. Разпред
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23 Първичен везикоу
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1.2.3. Трансплантиран
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L1_L3 L1_L3 80 60 80 60 40 20 40 20
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4. Бъбречни паренхи
Page 35 and 36: ImageJ-DRF-R NucMed-DRF-R ImageJ-DR
Page 37 and 38: 8.1. Операции върху б
Page 39 and 40: Фигура 17. Брой и про
Page 41 and 42: Фигура 18. Carbamoyl-PROXYL
Page 43 and 44: 1.1. Статична МР урог
Page 45 and 46: количество концент
Page 47 and 48: Фигура 23. Нормална
Page 49 and 50: заболявания в детс
Page 51 and 52: МР урография предс
Page 53 and 54: а) б) Фигура 26. Малро
Page 55 and 56: а) б) Фигура 28. МР ан
Page 57 and 58: г) д) е) Фигура 30. Лев
Page 59 and 60: RCI причина за по-вис
Page 61 and 62: секвенция целяща г
Page 63 and 64: При нормални бъбре
Page 65 and 66: за оценка на бъбреч
Page 67 and 68: бъбреците при слаб
Page 69 and 70: еднакво времетраен
Page 71 and 72: Фигура 40. Компютърн
Page 73 and 74: двустранна, левост
Page 75 and 76: Съвременния подход
Page 77 and 78: детската възраст с
Page 79 and 80: 8. Експериментален
Page 81 and 82: МР образна диагнос
Page 83 and 84: при 7Т магнитен рез
Page 85: VIII. Научни публикац
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