Radiology manual in Georgian

klinikuri 



radiologii 

radiologiis 

radiologii 

radiologii s 

sax saxelmZRvanelo 

sax lmZRvanelo 

(saCxeris (saCxeris samedicino samedicino centri) centri) 

centri) 

2009 

2009 

1

mokle mokle winaTqma 

winaTqma 

klinikuri radiologiis saxelmZRvaneloSi moyvanilia 

rentgenografiis, kompiuteruli tomografiisa da 

ultrasonografiis Cvenebebi, ukuCvenebebi, TiToeuli kvlevis 

specifikacia, agreTve, personalis kvalifikaciis, xarisxis 

kontrolisa da radiaciuli usafrTxoebis moTxovnebi. 

klinikuri radiologiis saxelmZRvanelo Sedgenilia amerikis 

radiologTa kolejis Sesabamisi dokumentebis mixedviT (ACR Practice 

Guidelines) da adgilobrivi Taviseburebebis gaTvaliswinebiT. 

saxelmZRvanelos SedgenaSi monawileobdnen: 

samedicino skola “aietis”””” studentebi: 

iuri migriauli, gvanca didebuliZe, nino zavraSvili, eka 

beJaniSvili, nikoloz rusaZe, daviT xuxaSvili, giorgi 

biWiaSvili, vaxtang gurabaniZe, nuca gaxokiZe, nino 

daTiaSvili, Tamar CixraZe, Tamar pavliaSvili, sandra 

bostanjiani, diana kaWarava, Teona varSalomiZe, nato 

guguSvili, qeTi bolqvaZe 

saCxeris samedicino centris diagnostikuri departamentis 

xelmZRvaneli: eka ruxaZe 

saCxeris samedicino centris eqimi: eka kobeSaviZe 

onkologiis samedicino centris eqimi da saCxeris samedicino 

centris konsultanti: Tamar Carkviani 

gansakuTrebuli madloba gvinda gadavuxadoT onkologiis 

nacionaluri centris kompiuteruli tomografiis ganyofilebis 

xelmZRvanels, medicinis doqtors _ irakli tatiSvils, gaweuli 

daxmarebisaTvis. 

2

sarCevi 

sarCevi 

I. . 

rentgenografia 



1. Sesavali gv. 5 

2. zogadi nawili gv. 5 

3. gulmkerdis rentgenografia gv. 7 

4. abdominaluri rentgenografia gv. 8 

5. xerxemlis rentgenografia gv. 10 

6. kidurebis rentgenografia gv. 13 

7. cistografia da ureTrografia gv. 14 

8. intravenuri pieolografia gv. 15 

9. saylapavisa da zemo gastrointestinaluri 

traqtis rentgenografia gv. 16 

10. wvrili nawlavis rentgenografia bariumis 

gamoyenebiT gv. 21 

11. msxvili nawlavis rentgenografiuli 

gamokvleva bariumis oyniT gv. 23 

12. histerosalpingografia gv. 25 

II. kompiuteruli kompiuteruli tomografia 

tomografia 

tomografia 



3. Tavis tvinis kompiuteruli tomografia 

4. Tavis eqstrakranialuri nawilis da 

gv. 30 

kisris kompiuteruli tomografia gv. 32 

5. xerxemlis kompiuteruli tomografia 

6. kompiuteruli tomografia angiografiiT 

gv. 37 

(kt angiografia) gv. 39 

7. gulmkerdis kompiuteruli tomografia 

8. kompiuteruli tomografia pulmonuri 

gv. 43 

embolizmis gamosavlenad gv. 45 

9. muclisa da menjis Rrus kompiuteruli 

tomografia gv. 47 

10. kompiuteruli tomografia kolonagrafiiT 

(kt kolonografia) gv. 49 

III. ultrasonografia 

ultrasonografia 



3. abdominaluri aortis ultrasonografia 

4. eqstrakranialuri cerebrovaskuluri 

gv. 56 

sistemis ultrasonografia gv. 58 

5. transkranialuri dopleruli ultrabgeriTi 

kvleva gv. 60 

6. neirosonografia gv. 63 

7. periferiuli arteriebis ultrasonografia gv. 64 

3

8. periferiuli venebis ultrasonografia gv. 66 

9. mkerdis ultrasonografia gv. 69 

10. muclis Rrus da retroperitonealuri 

aris ultrasonografia gv. 70 

11. mcire menjis ultrasonografia gv. 75 

12. farisebri da parafarisebri jirkvlebis gv. 78 


13. sameano ultrasonografia gv. 80 

14. sonohisterografia gv. 88 

15. winamdebare jirkvlis da misi garSemomyofi 

struqturebis ultrasonogarfia gv. 89 

16. saTesle jirkvlis ultrasonografia gv. 91 

4

1. 1. Sesavali 

Sesavali 



rentgenografia informatiuli da mravalnacadi samedicino 

teqnikaa, romelic rentgenis sxivebis gamoyenebis saSualebiT 

Seiswavlis adamianis anatomiasa da fiziologias. 

rentgenografiis mizania paTologiis arsebobisa da tipis 

dadgena, an misi gamoricxva, rasac is axerxebs, rogorc uSualod 

paTologiuri procesis demonstrirebiT, aseve normalur 

anatomiaze am paTologiis zegavlenis Sedegebis vizualizaciiT. 

ansxvaveben rentgenografiuli gamokvlevis mraval saxes, 

romelTaganac zogierTs (rentgenografiuli kvlevebi, romlebic 

sruldeba saCxeris samedicino centrSi) Cven dawvrilebiT 

ganvixilavT. 

qvemoT moyvanili dokumenti Sedgenilia amerikis radiologTa 

kolejis Sesabamisi dokumentebis mixedviT (ACR Practice Guidelines). 

amasTan, zogierTi moTxovna saerToa yvela kvlevisTvis da maT 

erTad warvadgenT dokumentis zogad nawilSi. calkeuli 

rentgenografiuli kvlevebisTvis konkretuli moTxovnebi asaxulia 

dokumentis Sesabamis nawilebSi. 

2. 2. zogadi zogadi zogadi nawili nawili 

nawili 

2.1. 2.1. 2.1. personalis personalis kvalifikacia kvalifikacia da da val valdebulebebi 

val ebulebebi 

2.1.1. rentgenografiuli kvleva unda Catardes sertificirebuli 

eqimi-radiologis meTvalyureobiT, romlis kompetenciis 

donis SesanarCuneblad aucilebelia, rom is weliwadSi 

atarebdes minimum 200 rentgenografiul kvlevas. man, aseve 

monawileoba unda miiRos mudmivi samedicino swavlebis 

aqtivobebSi (axali samedicino literaturis gacnoba, 

Tematuri konferenciebi aqtualur Temebze da sxv.); 

2.1.2. rentgenografiul kvlevas asrulebs sertificirebuli 

laboranti. 

2.2. 2.2. 2.2. kvlevis kvlevis dokumentacia 

dokumentacia 

2.2.1. rentgenografiuli kvleva unda Catardes mxolod kvlevis 

SemkveTi eqimis werilobiTi moTxovnis safuZvelze, romelSic 

dadasturebuli unda iyos kvlevis samedicino saWiroeba 

(savaraudo diagnozi da gamokvlevis kodi); 

5

2.2.2. axali gamosaxulebebi unda Sedardes adre gadaRebul 

rentgenogramebs da/an sxva xelTarsebul kvlevis 

monacemebs; 

2.2.3. rentgenografiuli kvlevis pasuxi unda Seicavdes mTel 

rig aucilebel komponentebs, rogorebicaa: 

� demografiuli demografiuli demografiuli demografiuli monacemebi: monacemebi 

monacemebi 

monacemebi kvlevis Semsrulebeli 

dawesebulebis dasaxeleba, pacientis saxeli, gvari da 

saidentifikacio nomeri, kvlevis SemkveTi eqimis 

monacemebi, rentgenografiuli kvlevis tipi, kvlevis 

TariRi 

� saWiro saWiro saWiro saWiro klinikuri klinikuri klinikuri klinikuri informacia: informacia 

informacia 

informacia savaraudo diagnozi da 

gamokvlevis kodi 

� daskvniTi daskvniTi daskvniTi daskvniTi nawili: nawili nawili nawili zusti rentgenografiuli diagnozi, 

saWiroebis SemTxvevaSi, sxva diagnostikuri kvlevis 

Catarebis rekomendacia 

2.2.4. rentgenografiuli kvlevis pasuxis asli (eleqtronuli, 

an werilobiTi) unda inaxebodes kvlevis Semsrulebeli 

kabinetis arqivSi; 

2.2.5. zogierT SemTxvevebSi rentgenografiuli kvlevis pasuxi 

SeiZleba gaices arastandartuli formiT – verbaluri, an 

arasruli werilobiTi, rac mogvianebiT aucileblad unda 

Seicvalos sworad Sevsebuli pasuxiT. aseTi SemTxvevebia: 

gadaudebeli, an saswrafo situaciebi, an rodesac 

rentgenologi eqimi cvlis imave kvlevaze adre gacemul 

pasuxs (azustebs diagnozs). 

2.3. 2.3. xarisxis kontroli 

2.3.1. rentgenografiuli kvlevis pasuxi iwereba sertificirebuli 

eqimi-rentgenologis mier; 

2.3.2. araoptimaluri xarisxis gamokvlevebi unda ganmeordes; 

2.3.3. yovelTvis unda moxdes rentgenografiuli firis Sesabamisi 

markireba: pacientis saxeli, gvari, asaki, saidentifikacio 

nomeri, marjvena, an marcxena mxare, pacientis pozicia, 

gamokvlevis TariRi da dro. 

2.4. 2.4. radiaciuli usafrTxoeba 

2.4.1. rentgenografiuli kvleva unda Catardes im minimaluri 

dasxivebiT, rac sakmarisia optimaluri gamosaxulebis 

misaRebad; 

2.4.2. yvela rentgenografiuli kvleva unda Catardes Sesabamisi 

CvenebiT; 

2.4.3. orsuloba warmoadgens rentgenografiuli kvlevis 

ukuCvenebas. orsuli pacientisTvisTvis, am kvlevis Catarebis 

sakiTxis ganxilvisas yovelTvis unda iyos gaTvaliswinebuli 

6

nayofisTvis miyenebuli radiaciuli riski da kvlevis 

Sedegebis klinikuri mniSvneloba. 

3. gulmkerdis gulmkerdis rentgenografia 


gulmkerdis rentgenografia sasargeblo da informatiuli 

proceduraa haergamtari gzebis, filtvebis, pulmonuri 

sisxlZarRvebis, Suasayaris, gulis, plevris da gulmkerdis kedlis 

gamosakvlevad. Cveulebriv, gadaReba warmoebs vertikalur 

mdgomareobaSi, ukana-wina (pirdapir) da marcxena lateralur 

(gverdiT) proeqciebSi. gulmkerdis rentgenografia gvexmareba 

davadginoT gulmkerdis paTologiis arseboba, an ararseboba, 

etiologia da Tvalyuri vadevnoT mis mimdinareobas. 

3.1. 3.1. Cvenebebi: 

Cvenebebi: 

3.1.1. im simptomebis da niSnebis gamokvleva, romlebic potenciurad 

SeiZleba iyvnen dakavSirebuli respiratorul, 

kardiovaskularul, zemo gastrointestinaluri da 

gulmkerdis ZvalkunTovani sistemebis paTologiasTan; 

agreTve, im sistemuri paTologiebis kvleva, romlebmac 

meoradad SeiZleba gamoiwvion gulmkerdis paTologia. 

gulmkerdisa da gulmkerdgare simsivneebis stadiurobis 

gansazRvra. (pulmonuri metastazebis ganviTareba mravali 

neoplaziuri paTologiisaTvisaa damaxasiaTebeli); 

3.1.2. ukve diagnostirebuli gulmkerdis paTologiis dinamikaSi 

kvleva, mdgomareobis gaumjobesebis, gankurnebis, an 

daavadebis progresirebis dasadgenad; 

3.1.3. pacientebis monitoringi Torako-kardiologiuri qirurgiuli 

operaciebis, an sxva intervenciebis Semdgom; 

3.1.4. preoperaciulad, kardiologiuri da respiratoriuli 

simptomebis arsebobisas, an rodesac didia eWvi gulmkerdis 

paTologiis arsebobaze, ramac SesaZloa gavlena iqonios 

qirurgiuli Carevis Sedegze, an gazardos perioperaciuli 

sikvdilianoba, an avadoba. 

3.2. 3.2. teqnikuri moTxovnebi 

moTxovnebi: 

moTxovnebi 

3.2.1. mozrdilebSi: kanis saSualo eqspozicia ≤ 0.3 mGy; 

eqspoziciis dro ≤ 40 msec; voltaJi – 120-150 kVp 

3.2.2. axalSobilebSi, Cvilebsa da bavSvebSi (asakisa da zomis 

mixedviT: kanis saSualo eqspozicia 0,05-0.3 mGy; voltaJi – 60- 

150 kVp; minimaluri eqspoziciis dro; 

7

3. 3.3. 3. 

3. 3. rentgenologiuri rentgenologiuri pproeqci 

p proeqci 

roeqciebi 

ebi: ebi 

3.3.1. gulmkerdis standartuli rentgenografia warmoebs 

vertikalur mdgomareobaSi, ukana-wina (pirdapir) da marcxena 

lateralur (gverdiT) proeqciebSi CasunTqvis fazis bolos 

Sekavebuli sunTqvis fonze. sxvadasxva klinikur situaciebSi, 

mag. Cvilebi, an mwoliare pacientebi, gamokvleva SeiZleba 

Catardes horizontalur mdgomareobaSic. saWiroebis 

SemTxvevaSi rentgenologma gamokvleva SeiZleba Caataros 

sxva poziciebidan da sunTqvis sxvadasxva fazaSic; 

3.3.2. gulmkerdis rentgenograma unda moicavdes, rogorc 

filtvebis mwvervaloebs, aseve nekn-diafragmul kuTxeebs. 

gamosaxulebaze garkveviT unda Candes gulmkerdis malebi da 

marcxena retrokardialuri pulmonuri sisxlZarRvebi. 

pirdapir proeqciaSi (ukana-wina gamosaxuleba) beWis Zvlebi 

ar unda edebodes filtvebis gamosaxulebas, gverdiT 

proeqciaSi (lateraluri midgoma) pacients mklavebi unda 

avawevinoT. xerxemlis svetis gamosaxuleba unda iyos 

centrSi, laviwebs Soris. rentgenologiuri sxivi ise unda 

iyos mimarTuli, rom firze moeqces yvela zemoT CamoTvlili 

struqtura, amasTan, sxeulis danarCen nawilebze radiaciuli 

gamosxiveba rac SeiZleba naklebi iyos. 

4. abdominaluri rentgenografia 

abdominaluri rentgeografia gamoiyeneba kuW-nawlavis traqtis, 

abdominaluri (peritonialuri) Rrus, saSarde gzebis, 

retroperitoniumis, menjis RruSi arsebuli struqturebis da 

muclis kedlis gamosakvlevad. abdominaluri rentgenografiuli 

poziciebia: zurgze wina-ukana da/an horizontalurad mimarTuli 

rentgenologiuri sxivis (vertikaluri, dekubituri da ganivilateraluri) 

proeqciebi. muclis rentgeografia unda Catardes 

mxolod WeSmariti samedicino miznisTvis da minimaluri 

radiaciuli doziT. 

abdominaluri rentgeografia gvexmareba davadginoT muclis 

paTologiis arseboba, an ararseboba, etiologia da Tvalyuri 

vadevnoT mis mimdinaroebas. 


� muclis, ferdis, an menjis areSi tkivili 

� Rebineba 

� muclis daWimva, Seberva, garSemowerilobis momateba 

8

� gamokvleva da Semdgomi dakvirveba nawlavebis 

obstruqciuli, an araobstruqciuri gauvalobis 

SemTxvevaSi 

� Sekruloba, diarea 

� nekrozuli enterokolitis gamokvleva dRenaklul 

axalSobilebSi 

� muclis RruSi palpirebadi masa, an muclis Rrus romelime 

organos gadideba 

� Tandayolili darRvevebis gamokvleva 

� postoperaciuli pacientis dakvirveba 

� hematuria 

� moSardvis gaZneleba 

� gamokvleva da Semdgomi dakvirveba Sard-kenWovani 

daavadebis SemTxvevaSi 

� muclis daxuruli, an Semavali travma 

� ucxo sxeuli 

� sxva radiologiur kvlevaze saeWvo kalcifikatebis 

Sefaseba 

� samedicino xelsawyoebis mdebareobis dadgena 

� pnevmoperitoniumi 

� kuW-nawlavis da saSarde gzebis kontrastuli kvleva. 

4.2. 4.2. teqnikuri moTxovnebi: 

mozrdilebSi muclis standartuli rentgeografiisTvis, 

Cveulebriv, gamoiyeneba 35 X 43 sm zomis firi. Tu 

SesaZlebelia, gadaReba unda moxdes CasunTqvis fazis bolos. 

mizanSewonilia dabali kVp teqnikis da eqspoziciis 

minimaluri drois gamoyeneba. sasqeso organoebis damcavi 

fari unda gamoviyenoT mamrobiTi sqesis yvela pediatriul 

pacientSi 

4.3. 4.3. 4.3. rentgenologiuri rentgenologiuri rentgenologiuri proeqciebi: 

proeqciebi: 

abdominaluri rentgenografiuli proeqciebia: zurgze winaukana 

da/an horizontalurad mimarTuli rentgenologiuri 

sxivis (vertikaluri, dekubituri da ganivi-lateraluri) 

proeqciebi. pnevmoperitoniumis, an muclis difuzuri 

tkivilis gamosakvlevad damatebiT viyenebT ukana-wina an winaukana 

gulmkerdis proeqciebs. 

4.3.1. zurgze wina-ukana proeqcia unda moicavdes midamos boqvenis 

simfizis qveda kididan, minimum, Tirkmlebis zeda kidemde 

(idealur SemTxvevaSi, diafragmamde). gamosaxulebaze unda 

Candes orive gverdi. firis centraluri nawili unda 

emTxveodes TeZos Zvlis qeds, ise rom rentgenologiuri sxivi 

9

mas perpendikularulad kveTdes. didi zomis pacientebisTvis 

muclis Rrus srulyofili rentgenografiisTvis, SesaZloa 

dagvWirdes erTze meti firis gamoyeneba. 

4.3.2. horizontaluri proeqciebis gadasaRebad rentenologiuri 

sxivi mimarTuli unda iyos iatakis paralelurad da firis 

perpendikularulad. ZiriTadad, es proeqciebi gamoiyeneba 

pnevmoperitoniumis vizualizaciisaTvis: 

4.3.2.1. vertikalur mdgomareobaSi firi SeiZleba gadaRebul iqnas, 

rogorc wina-ukana, aseve ukana-wina proeqciebSi. firis 

centraluri nawili unda mdebareobdes TeZos Zvlis qedidan 

5 sm-iT zeviT (zrdasrul pacientSi). firi unda moicavdes 

diafragmis zeda kides. didi zomis pacientebisTvis, muclis 

qveda nawilis vizualizaciisTvis SesaZloa saWiro gaxdes 

meore firis gadaRebac; 

4.3.2.2. marcxena lateraluri dekubituri firis gadaReba xdeba 

wina-ukana proeqciaSi. firis centraluri nawili unda 

mdebareobdes TeZos Zvlis qedis gaswvriv, an mis zemoT da 

moicavdes midamos diafragmis marjvena nawilidan menjamde. 

Tu pacienti ver wveba marcxena gverdze, mis magivrad 

SeiZleba gamoviyenoT marjvena lateraluri dekubituri 

pozicia; 

4.3.2.3. ganivi lateraluri pozicia iSviaTad gamoiyeneba 

zrdasrulebsa da mozrdil bavSvebSi, mas ZiriTadad 

CvilebisTvis iyeneben 

4.3.3. saSarde sistemis paTologiebis dros (mag., Sard-kenWovani 

daavadeba) vertikaluri proeqcia ar gamoiyeneba 

4.3.4. abdominaluri rentgenografiisTvis iSviaTad gamoiyeneba 

damatebiTi proeqciebi: iribi da lateraluri (ucxo sxeulis 

lokalizaciis, an kalcifikatebis da muclis aortis 

anevrizmis dasadgenad; agreTve, Cvilebsa da bavSvebSi 

analuri atreziisa da strangulaciuri gauvalobis 

dasadgenad. 

5. xerxemlis xerxemlis rentgenografia 


xerxemlis rentgenografia sasargeblo da informatiuli 

proceduraa xerxemlis malebis, malTaSua sivrcis da 

paravertebruli rbili qsovilebis gamosakvlevad. 

am gamokvlevis mizania davadginoT, an gamovricxoT xerxemlis 

paTologia da SevafasoT daavadebis mimdinareoba. es kvleva unda 

Catardes im minimaluri dasxivebiT, rac sakmarisia optimaluri 

gamosaxulebis misaRebad. 

10


5.1.1. zogadi zogadi zogadi zogadi Cvenebebi: Cvenebebi: Cvenebebi: Cvenebebi: 

� tkivili, an moZraobis SezRudva 

� xerxemlis travma (simptomatur, an savaraudo riskis mqone 

pacientebSi) 

� qirurgiuli Carevis dagegmva 

� gadatanili operacia 

� eWvi avTvisebian procesze 

� Tandayolili anomaliebi 

� ukve dadgenili xerxemlis paTologia 

� malebis ganlagebis paTologia, skoliozis da kifozis 

CaTvliT. 

5.1.2. specifiuri specifiuri 

specifiuri 

specifiuri Cvenebebi: Cvenebebi: Cvenebebi: Cvenebebi: 

� savaraudod, kisris radikulopaTiiT ganpirobebuli 

mxris an xelis tkivili 

� tkivili kefis midamoSi 

� tkivili gulmkerdis areSi 

� tkivili sajdomis, menjis an sazardulis areSi 

� kompresiuli motexiloba 

5.2. 5.2. rentgenologiuri rentgenologiuri proeqciebi 

roeqciebi 

roeqciebi: 

roeqciebi 

5.2.1. 5.2.1. 5.2.1. 5.2.1. Kkisris Kkisris Kkisris Kkisris regionis regionis regionis regionis kvleva kvleva kvleva kvleva mozrdilebSi 

mozrdilebSi 

mozrdilebSi 

mozrdilebSi 

5.2.1.2. sruli kvleva unda moicavdes kisris mTlian regions, 

kraniocervikaluri Sesaxsrebidan gulmkerdis I malis (T1) 

zeda kidemde; 

5.2.1.2. standartuli kvleva gulisxmobs wina-ukana, gverdiT da Ria 

piris proeqciebs. Tu gaCnda aucilebloba C7-T1 segmentis 

Sefasebisa, SeiZleba gamoyenebul iqnas mocuravis gverdiTi 

proeqcia; 

5.2.1.3. rodesac didi albaTobiT, savaraudoa kisris malebis 

dazianeba (zogadi travma, nevrologiuri dazianeba, 

intoqsikacia an ugono mdgomareoba), gverdiTi, wina-ukana da 

Ria piris kbilisebri morCis proeqcia (nikapqveSa xedi) 

SegviZlia gadaviRoT yvela sxva diagnostikuri kvlevis 

Catarebamde; 

5.2.1.4. zogierT klinikur situaciaSi SesaZlebelia saWiro gaxdes 

damatebiTi proeqciebis gadaReba 

5.2.1.4.1. ormxrivi iribi proeqcia: rodesac saWiroa nervuli 

fosoebis Sefaseba 

5.2.1.4.2. moxriTi-gaSliTi gverdiTi proeqcia: saWiroa kisris 

malebis arastabilurobis Sefasebis aucileblobisas. Tumca, 

Tu pacientis moZraobebi SezRudulia, miRebuli 

11

entgenogramebi ar iqneba sakmarisi arastabilurobis 

gamosaricxad. 

5.2.2. 5.2.2. 5.2.2. 5.2.2. kisris kisris kisris kisris regionis regionis regionis regionis kvleva kvleva kvleva kvleva Cvilebsa Cvilebsa Cvilebsa Cvilebsa da da da da bavSvebSi bavSvebSi bavSvebSi bavSvebSi 

5.2.2.1. pediatrul populaciaSi umravles klinikur situaciebSi 

sakmarisia wina-ukana, kbilisebri morCis da gverdiTi 

proeqciebi, CvilebSi wina-ukana da gverdiTi proeqciebi; 

5.2.2.2. mozrdilebisgan gansxvavebiT, bavSvebSi iSviaTadaa saWiro 

damatebiTi kvlevebis Catareba. damatebiTi kvlevebis 

Catarebis aucileblobisas unda dainiSnos CT an MRI 

5.2.3. 5.2.3. 5.2.3. 5.2.3. gulmkerdis gulmkerdis gulmkerdis gulmkerdis regionis regionis regionis regionis gamokvleva 

gamokvleva 

gamokvleva 

gamokvleva 

5.2.3.1. standartulad _ wina-ukana da gverdiTi proeqciebi. 

mniSvnelovania kisris qveda da welis zeda regionebis 

vizualizaciac kisris malebis swori numeraciisTvis; 

5.2.3.2. zogierT klinikur situaciaSi saWiro xdeba damatebiTi 

proeqciebis gadaReba, rogoricaa: mocuravis gverdiTi 

proeqcia gulmkerdis zeda regionisTvis, iribi proeqcia, 

Torakolumbaluri proeqcia 

5.2.4. 5.2.4. 5.2.4. 5.2.4. gava----welis gava gava gava welis welis welis regionis regionis regionis regionis gamokvleva 

gamokvleva 

gamokvleva 

gamokvleva 

5.2.4.1. standartulad _ wina-ukana da gverdiTi proeqciebi; 

5.2.4.2. bevr zrdasrulsa da iSviaTad, mozrdil bavSvebSi 

SesaZloa saWiro gaxdes damatebiTi proeqciebis gadaReba: 

orive iribi proeqcia, gverdiTi L5-S1, kuTxiT wina-ukana L5- 

S1, moxriTi da gaSliTi gverdiTi proeqciebi. 

5.2.5. 5.2.5. 5.2.5. 5.2.5. sqoliozis sqoliozis sqoliozis sqoliozis gamokvleva 

gamokvleva 

gamokvleva 

gamokvleva 

sqoliozis gamosakvlevad saWiroa miviRoT mTliani 

Torakolumbaluri regionis ukana-wina, an wina-ukana 

proeqciebi fexze damdgar pozaSi. gamosaxuleba unda 

Seicavdes, agreTve, TeZos Zvlis qedsac. SeiZleba agreTve 

gverdiTi proeqciis gamoyenebac. Tu pacients ar SeuZlia 

fexze dogma, mjdomare pozaSi unda gadaviRoT wina-ukana 

proeqcia. 

5.2.6. 5.2.6. 5.2.6. 5.2.6. gavisa gavisa gavisa gavisa da da da da kudusunis kudusunis kudusunis kudusunis gamokvleva 

gamokvleva 

gamokvleva 

gamokvleva 

gavis zeda nawilia CarTuli standartuli lumbosakraluri 

regionis gamokvlevaSi. gava-TeZos Zvlis Sesaxsrebis 

specifiuri kvlevisTvis gamoiyeneba ormxrivi iribi 

proeqciebi. 

5.2.7. 5.2.7. 5.2.7. 5.2.7. Semofargluli Semofargluli 

Semofargluli 

Semofargluli regionis regionis regionis regionis kvleva kvleva kvleva kvleva 

zogierT klinikur situaciaSi (mag., intraoperaciulad, an 

postoperaciuli kontrolisaTvis) limitirebuli kvleva 

gvaZlevs sakmaris informacias da samagierod, amcirebs 

pacientis radiaciul dasxivebas. 

12

6. 6. kidurebis kidurebis rentgenografia 



kidurebis rentgenografia sarwmuno da sasargeblo 

proceduraa Zvlebis, saxsrebis da rbili qsovilebis 

gamosakvlevad. is xSirad pirveli meTodia kidurebis paTologiis 

diagnostirebisTvis. srulyofili diagnozis dasasmelad, 

SesaZlebelia, damatebiT saWiro gaxdes specializirebuli 

meTodebis gamoyenebac. 

6.1. 6.1. Cvenebebi Cvenebebi: Cvenebebi 

� travma 

� tkivili 

� metaboluri daavadebebi, kvebiTi deficitebi, sistemuri 

daavadebiT ganpirobebuli Zvlovani cvlilebebi 

� eWvi Cvilebis da bavSvebis mimarT Cadenil fizikur 

Zaladobaze 

� keTilTvisebiani da avTvisebiani neoplaziebi 

� Zvlis pirveladi araneoplaziuri paTologia 

� arTropaTiebi 

� infeqciebi 

� preoperaciuli, an postoperaciuli gamokvleva 

� Zvalsaxsrovani sistemis Tandayolili sindromebi da 

ganviTarebis mankebi 

� sisxlZarRvovani dazianebebi 

� kiduris rbili qsovilebis gamokvleva (mag., eWvi ucxo 

sxeulis arsebobaze) 

13

6.2. 6.2. rentgenologiuri rentgenologiuri proeqciebi 

proeqciebi 

anatomiuri anatomiuri anatomiuri are are 

proeqcia proeqcia 

proeqcia 

beWis Zvali wina-ukana (AP) da gverdiTi 

laviwis Zvali wina-ukana da wina-ukana kuTxiT 

akromioklavikuluri 

saxsari 

wina-ukana fexze mdgomi 

mxari wina-ukana Sida rotaciis da gare 

rotaciis proeqciebSi 

mxris Zvali wina-ukana da gverdiTi 

idayvi wina-ukana da gverdiTi 

wina mxari wina-ukana da gverdiTi 

maja ukana-wina (PA) gverdiTi da iribi 

mtevani Uukana-wina, iribi da gverdiTi 

(gaSlili TiTebiT) 

TiTebi ukana-wina, gverdiTi da iribi 

menji wina-ukana da gverdiTi 

barZayis Zvali wina-ukana da gverdiTi 

kvirisTavi ukana-wina, gverdiTi da mzis amosvlis 

proeqcia 

muxli ukana-wina da gverdiTi 

wvivi wina-ukana da gverdiTi 

koWi wina-ukana, gverdiTi da iribi 

quslis Zvali gverdiTi da RerZuli 

terfi wina-ukana, gverdiTi da iribi 

fexis TiTebi wina-ukana, gverdiTi da iribi 

7. cistografia istografia da da ureTrografia 

ureTrografia 

cistografia da ureTrografia radiologiuri kvlevis 

meTodebia, romlebic iZlevian informacias Sardsadenis, Sardis 

buStis da iSviaTad, SardsawveTebis Sesaxeb. 

es kvlevebi gulisxmobs Sardis buStis da Sardsadenis 

gamosaxulebebis miRebas kontrastis Seyvanamde, Seyvanisas da 

Seyvanis Semdeg. kontrastis Seyvana xdeba ureTraluri an 

cistostomuri kaTeteriT. 

cistografiis da ureTrografiis mizania qveda saSarde 

gzebis anatomiuri da funqciuri paTologiebis dadgena. 

14

7.1. 7.1. Cvenebebi 

Cvenebebi 

7.1.1. cistografiis Cvenebebi: 

� saSarde gzebis rekurentuli infeqciebi 

� vezikoureTraluri refluqsi 

� Sardis buStis konturis vizualizacia 

� Sardis buStis divertikuli 

� eWvi Sardis buStis rupturaze 

� fistula 

� postoperaciuli nakerebis an anastomozis mTlianobis 

Semowmeba 

� Sardis buStis gamosavlis obstruqcia 

� Seukavebloba 

� hematuria 

� neoplazia 

7.1.2. ureTrografiis Cvenebebi: 

� ureTras divertikuli 

� ureTras striqtura 

� Sardis buStis gamosavlis, an ureTras obstruqcia 

� travma 

� saSarde gzebis rekurentuli infeqciebi 

7.2. 7.2. kvlevis kvlevis specifika: 

specifika: 

7.2.1. cistografia da ureTrografia unda ganxorcieldes 

gamocdili samedicino personalis mier, romelic kargadaa 

ganswavluli aRniSnuli proceduris CatarebaSi 

7.2.2. ureTris, an Sardis buStis kaTeterizacia unda moxdes 

aseptikurad. kontrasti unda SeiyvanoT im raodenobiT, rac 

saWiroa im anatomiuri struqturis vizualizaciisaTvis, 

romlis gamokvlevasac vawarmoebT. kvleva SeiZleba Catardes 

fluroskopiuli kontroliTac, gansakuTrebiT, moSardvis 

Sekavebis dros; 

7.2.3. gamoyenebul unda iqnas is minimaluri radiaciuli doza, rac 

saWiroa optimaluri xarisxis gamosaxulebis misaRebad. 

8. intravenuri intravenuri pieolografia 

pieolografia 

pieolografia 

intravenuri (eqskretoruli urografia, intravenuri 

urografia) gulisxmobs Tirkmelebis da urinaruli traqtis 

rentgenologiur kvlevas kontrastis Seyvanamde da mis Semdeg. 

gamokvlevis mizania saSarde sistemis anatomiuri da 

fiziologiuri darRvevebis aRmoCena. 

15


Cvenebebi: 

� savaraudod, renaluri warmoSobis hematuria, tkivili, an 

cxeleba 

� saSarde sistemis rekurentuli infeqcia 

� eWvi renaluri masis arsebobaze 

� qvemo saSarde sistemis obstruqcia, an moSardvis Sekaveba 

8.2. 8.2. 8.2. kvlevis kvlevis kvlevis specifika: 

specifika: 

8.2.1. intravenuri pielografia unda ganxorcieldes gamocdili 

samedicino personalis mier, romelic kargadaa 

gaTviTcnobierebuli aRniSnuli proceduris CatarebaSi; 

8.2.2. pacienti gamokiTxul unda iqnas anamnezSi kontrastis mimarT, 

an raime sxva tipis alergiuli reaqciebis arsebobaze 

8.2.3. intravenuri midgomis uzrunvelyofis Semdeg kontrastis 

Seyvanas axorcielebs eqimi, an laboranti, romelic 

axorcielebs pacientis Semdgom monitoringsac SesaZlo 

gverdiTi efeqtebis droulad aRmofxvris mizniT. amisTvis, 

rentgenologiur ganyofilebaSi unda iyos gadaudebeli 

samedicino daxmarebis aRmosaCeni mowyobiloba da 

medikamentebi, saWiroa maTi gamarTulobisa da vargisianobis 

regularuli monitoringi; 

8.2.4. sawyisi rentgenografiuli gadaReba unda moxdes kontrastis 

Seyvanamde, romelmac unda gamoavlinos mniSvnelovani 

rentgenologiuri darRvevebi 

8.2.5. kontrastis Seyvanis Semdeg warmoebs TanmimdevrobiTi 

rentgenologiuri (SesaZloa, tomografiulic) gadaRebebi 

Tirkmlebis, menj-fialebis, SardsawveTebis da Sardis buStis 

gamosakvlevad. 

9. saylapavisa saylapavisa da da zemo zemo gastrointesinaluri gastrointesinaluri traqtis 

traqtis 

rentgeno rentgenografia 

rentgeno grafia 

saylapavisa da zemo gastrointestinaluri traqtis 

monofazuri da bifazuri kvleva, informatiuli da saimedo 

meTodikaa saylapavisa da zemo gastrointestinaluri traqtis 


gamokvlevis mizania saylapavisa da zemo gastrointestinaluri 

traqtis paTologiis gamoricxva, an gamovlena da aseT SemTxvevaSi, 

16

daavadebis xasiaTisa da gavrcelebis dadgena, im minimaluri 

radiaciuli dozis gamoyenebiT, rac sakmarisia xarisxiani kvlevis 

Casatareblad. 

9.1. 9.1. Cvenebebi Cvenebebi da da ukuCvenebebi: 

ukuCvenebebi: 

9.1.1. Cvenebebi saylapavisTvis: 

9.1.1.1. anamnezi da simptomebi, romlebic miuTiTeben saylapavis 

paTologiis arsebobaze: 

� savaraudod, arakardiologiuri genezis tkivili gulmkerdSi 

� simptomuri gastroezofaguri refluqsi, an eWvi mis 

arsebobaze 

� disfagia 

� odinofagia 

9.1.1.2. saylapavis iseTi paTologiebis dadgena da mdgomareobis 

Semdgomi Sefaseba, rogorebicaa: 

� saylapavis motorikis dadgenili darRveva, an eWvi mis 

arsebobaze 

� ezofagiti 

� striqturebi 

� varikozi 

� neoplaziebi 

� saylapavis obstruqcia 

� postoperaciuli Sefaseba 

9.1.2. Cvenebebi zemo gastrointestinaluri traqtisTvis: 

9.1.2.1. anamnezi da simptomebi, romlebic miuTiTeben zemo 

gastrointestinaluri traqtis paTologiis arsebobaze: 

� simptomuri gastroezofaguri refluqsi, an eWvi mis 

arsebobaze 

� abdominaluri tkivili 

� epigastriuli distresi, an diskomforti 

� dispepsia 

� Rebineba 

� gulisreva 

� zemo gastrointestinaluri traqtidan sisxldenis niSnebi, 

an simptomebi 

� anemia 

� wonaSi dakleba 

� abdominaluri masa 

9.1.2.2. zemo gastrointestinaluri traqtis iseTi paTologiebis 

dadgena da mdgomareobis Semdgomi Sefaseba, rogorebicaa: 

� dadgenili, an savaraudo gastriti, an duodeniti 

� peptiuri wyluli 

� saylapvis Tiaqari 

� varikozi 

� neoplaziebi 

17

� kuWis antraluri nawilis obstruqcia 

� postoperaciuli Sefaseba 

9.1.3. saylapavisa da zemo gastrointestinaluri traqtis 

rentgenografiuli kvleva naCvenebia naoperacieb pacientebSi, 

saylapavis, kuWisa da Tormetgoja nawlavis perforaciisa da 

nakeris mTlianobis darRvevis gamosavlenad. Tu aseTi eWvi 

klinikurad dasabuTebulia, sawyisi kvlevisaTvis unda 

gamoviyenoT wyalSi xsnadi kontrasti. Tu eWvia aspiraciis, 

ezofago-traqeuli, an ezofago-bronquli fistulis 

arsebobaze, gamoiyeneba izo-osmolaruli, an dabalosmolaruli 

kontrasti, an bariumis fafa. 

9.1.4. pacientebs, romlebsac ukanasknel periodSi aqvT gadatanili 

saylapavis, an kuWis travma, an qirurgiuli operacia, bifazuri 

kvleva ar unda CautardeT. 

9.2. 9.2. kvlevis kvlevis sp specifika: 

sp specifika: 

ecifika: 

9.2.1. Cveulebriv, saylapavis rentgenografiuli gamoklvevis win, 

pacienti, minimum, 2 saaTis ganmavlobaSi, xolo zemo 

gastrointestinaluri traqtis kvlevamde, wina Ramis 12 

saaTidan unda imyofebodes uzmoze. zogierT klinikur 

situaciaSi kvleva SesaZloa Catardes uzmod yofnis ufro 

xanmokle periodebis Semdegac; 

9.2.2. kvlevis Catarebamde aucilebelia pacientis mdgomareobis 

guldasmiT Sefaseba, maT Soris, sxva laboratoriuli da 

diagnostikuri testebis Sedegebisa da Sesabamisi qirurgiuli 

operaciis Canaweris gacnoba. xSirad, gansakuTrebiT, 

naoperacieb pacientebSi, naCvenebia, winaswari abdominaluri, 

xolo saylapavis gamoklvevisTvis, winaswari Torakaluri 

rentgenogramis gadaReba; 

9.2.3. gamokvlevis teqnika: 

9.2.3.1. saylapavi _ monofazuri teqnika: 

� gamoiyeneba dabalis simkvrivis (60 %-iani) bariumis 

suspenzia 

� gamoyenebul unda iqnas sakmarisi voltaJis radiografiuli 

teqnika, romelic saSualebas mogvcems miviRoT bariumiT 

savse saylapavis optimaluri gamosaxuleba 

� unda moxdes bariumiT gaberili (mWidro avseba) saylapavis 

sruli fluoroskopiuli kvleva 

� saylapavis lorwovanis kvleva, Tu SesaZlebelia, unda 

Sesruldes daclil mdgomareobaSic _ amisaTvis 

optimaluria guldaRma, an guldaRma marjvena wina iribi 

poziciebi. 

� saylapavis motorikis kvleva unda ganxorcieldes ylapviTi 

moZraobebis dros 

18

� kvlevis dros aucileblad unda moxdes gastroezofaguri 

kavSiris vizualizacia am midamos lokaluri paTologiis 

gamosarixcad. 

� unda moxdes gastrointestinaluri refluqsis 

fluroskopiuli Sefaseba 

� ylapviTi disfunqciis SemTxvevaSi, saylapavis farengealuri 

da cervikaluri nawilebis gadaReba unda moxdes ufro 

swrafi TanmimdevrobiT, an kvleva unda Caiweros videofirze 

9.2.3.2. saylapavi _ bifazuri teqnika: 

� kuWis gasaberad gamoiyeneba specialuri nivTiereba (Tu 

pacients ar aReniSneba am nivTierebis gadautanloba), 

romelic kuWis sanaTurSi gamoanTavisuflebs naxSirbadis 

dioqsids 

� saylapavis, kuWis kardiis da kuWis fuZis 

fluoroskopiulad gamosaklvevad gamoiyeneba maRali 

simkvrivis (210-250 %-iani) bariumis suspenzia. optimaluria 

vertikaluri iribi pozicia 

� saylapavis motorikisa da avsebuli saylapavis 

fluoroskopiuli kvleva unda ganxorcieldes monofazuri 

teqnikiT guldaRma-irib poziciaSi bariumis miRebis 

periodSi 

� unda moxdes gastrointestinaluri refluqsis 

fluroskopiuli Sefaseba 

� ylapviTi disfunqciis SemTxvevaSi, saylapavis farengealuri 

da cervikaluri nawilebis gadaReba unda moxdes ufro 

swrafi TanmimdevrobiT, an kvleva unda Caiweros videofirze 

� Tu pacients aReniSneba myari sakvebis gadaylapvis problema, 

SesaZleblobis SemTxvevaSi, sakontrastod unda gamoviyenoT 

bariumis tableti. kvleva warmoebs vertikalur poziciaSi 

9.2.3.3. zemo gastrointestinaluri traqti _ monofazuri teqnika: 

� unda moxdes saylapavis, kuWis da Tormetgoja nawlavis 

morfologiisa da funqciis fluoroskopiuli kvleva. 

amisTvis gamoiyeneba am organoebis bariumiT gaberva (mWidro 

avseba) da Tu SesaZlebelia, daclili poziciebi 


teqnika, romelic saSualebas mogvcems miviRoT am 

organoebis optimaluri gamosaxuleba, rodesac isini 

gadavsebulni arian bariumiT 

9.2.3.4. zemo gastrointestinaluri traqti _ bifazuri 

teqnika 

� kuWisa da Tormetgoja nawlavis hipotoniis gamosawvevad 

SeiZleba saWiro gaxdes hipotonuri agentis gamoyeneba 

� kuWis gasaberad gamoiyeneba specialuri nivTiereba, romelic 

kuWis sanaTurSi gamoanTavisuflebs naxSirbadis dioqsids _ 

19

unda moxdes saylapavis, kuWisa da Tormetgoja nawlavis 

adekvaturi gaberva 

� saylapavis, kuWisa da Tormetgoja nawlavis 

fluoroskopiuli gamokvleva unda Catardes bifazuri 

teqnikiT. maRali simkvrivis bariumis suspenziis miRebis 

Semdeg unda moxdes saylapavis, kuWisa da Tormetgoja 

nawlavis adekvaturi avseba. 

� saylapavis, kuWisa da Tormetgoja nawlavis 

fluoroskopiuli gamokvlevisas, dabali simkvrivis bariumis 

suspenziis miRebis Semdegac _ unda moxdes saylapavis, 

kuWisa da Tormetgoja nawlavis adekvaturi avseba 

� Tu ver moxerxda bariumiT kuWisa da Tormetgoja nawlavis 

adekvaturi avseba, an amave organoebis adekvaturi gaberva 

SesaZloa gamoviyenoT kuWisa da Tormetgoja nawlavis 

meqanikuri, an manualuri kompresiis teqnika 

9.2.3.5. gamokvleva wyalSi xsnadi kontrastiT: 

� mediastinur, an peritoniul RruebSi perforaciaze eWvis 

SemTxvevaSi SesaZloa upiratesoba mieniWos wyalSi xsnad 

kontrasts 

� aspiraciis riskis SemTxvevaSi rekomendebulia izoosmolaruli, 

an dabal-osmolaruli agentebis gamoyeneba 

� saylapavis savaraudo perforaciisa da aspiraciis riskis 

SemTxvevaSi, agreTve, SesaZlebelia bariumis gamoyeneba. 

� wyalSi xsnadi kontrasti gamoyenebul unda iqnas 

adekvaturi fluoroskopiuli da rentgenografiuli 

klvevebisTvis sakmarisi koncentraciiT 

� fluoroskopiuli kvlevebis dros gansakuTrebuli 

yuradReba unda daeTmos savaraudo perforaciis areebs 

� saylapavis perforaciaze didi klinikuri eWvis SemTxvevaSi, 

rodesac wyalSi xsnadi kontrastiT diagnozis dadastureba 

ver xdeba, an Sedegi orazrovania, SesaZlebelia monofazuri 

bariumis teqnikis gamoyenebac. gamokvlevis guldaRma 

poziciaSi Catarebam SesaZloa damatebiTi daxmarebac 

gagviwios 

9.2.4. xarisxis kontroli: 

9.2.4.1. saylapavisa da zemo gastrointestinaluri traqtis nebismieri 

fluoroskopiuli kvlevis damTavrebis Semdegac, pacienti unda 

darCes rentgenologiur ganyofilebaSi, sanam eqimi ar miiRebs 

saboloo gadawyvetilebas diagnozis Sesaxeb. zogjer, 

SesaZloa saWiro gaxdes fluoroskopiuli kvlevis 

ganmeorebiTi Catareba; 

9.2.4.2. yvela SesaZlo SemTxvevaSi unda veZeboT korelaciuri 

kavSirebi am kvlevasa da sxva radiologiur, Tu endoskopiur 

gamokvlevebs Soris; 

20

9.2.5. rentgenologiuri aparatura: 

9.2.5.1. saylapavisa da zemo gastrointestinaluri traqtis 

gamosakvlevad saWiro rentgenologiur aparaturas, unda 

SeeZlos 100 kVp maRali voltaJis producireba 

9.2.5.2. aparaturas unda SeeZlos adekvaturi 

xarisxis fluoroskopiuli gamosaxulebebis miReba 

da unda hqondes kvlevis Caweris (filmi, video, an 

cifruli) da Semdgomi Cvenebis SesaZlebloba 

9.2.5.3. xelT unda gvqondes, agreTve, kuWisa da 

Tormetgoja nawlavis calkeuli nawilebis kompresiis da 

saintereso nawilebis izolaciis mowyobilobac 

9.2.5.4. rentgenologiur ganyofilebaSi unda iyos gadaudebeli 

samedicino daxmarebis aRmosaCeni mowyobiloba da 

medikamentebi, romlebic SeiZleba dagvWirdes aspiraciis, 

alergiuli reaqciebis, refluqsis, an sxva sicocxlisaTvis 

saSiSi gadaudebeli mdgomareobebis ganviTarebisas. saWiroa 

am mowyobilobis gamarTulobisa da medikamentebis 

vargisianobis regularuli monitoringi. 

10. 10. 10. wvrili wvrili nawlavis nawlavis rentgenografia rentgenografia bariumis gamoyenebiT 

wvrili nawlavis rentgenografiuli kvleva bariumiT, 

informatiuli da saimedo meTodikaa wvrili nawlavis 


gamokvlevis mizania wvrili nawlavis paTologiis gamoricxva, 

an gamovlena da aseT SemTxvevaSi, daavadebis xasiaTisa da 

gavrcelebis dadgena, im minimaluri radiaciuli dozis gamoyenebiT, 

rac sakmarisia xarisxiani kvlevis Casatareblad. 

10.1. 10.1. Cvenebebi: 

Cvenebebi: 

10.1.1. anamnezi da simptomebi, romlebic miuTiTeben wvrili nawlavis 


� muclis tkivili 

� diarea 

� auxsneli gastro-intestinaluri sisxldena, an anemia 


� eWvi wvrili nawlavis obstruqciaze 

� temperaturis momateba 

� sefsisi 

10.1.2. wvrili nawlavis iseTi paTologiebis dadgena da mdgomareobis 

Semdgomi Sefaseba, rogorebicaa: 

21

� wvrili nawlavis dadgenili, an savaraudo obstruqcia 

� pirveladi da moereuli neoplaziebi 

� nawlavebis anTebiTi daavadeba 

� auxsneli gastro-intestinaluri sisxldena 

� malabsorbcia 

10.2. 10.2. kvlevis kvlevis specifika specifika: 

specifika 

10.2.1. Cveulebriv, wvrili nawlavis rentgenografiul kvlevamde, wina 

Ramis 12 saaTidan pacienti unda imyofebodes uzmoze. zogierT 

klinikur situaciaSi kvleva SesaZloa Catardes uzmod yofnis 

ufro xanmokle periodis Semdegac; 

10.2.2. kvlevis Catarebamde aucilebelia pacientis mdgomareobis 

guldasmiT Sefaseba, maT Soris, sxva laboratoriuli da 

diagnostikuri testebis Sedegebisa da Sesabamisi qirurgiuli 

operaciis Canaweris gacnoba. 


� Tavdapirveladve unda gamoviyenoT maRali simkvrivis 

bariumis suspenzia didi raodenobiT (minimum 500 grami). 

SesaZloa saWiro gaxdes misi Semdgomi damateba, raTa 

nawlavebis maryuJebi Tanabrad iyos avsebuli. amas yvelaze 

martivad ganvaxorcielebT, Tu mTeli proceduris manZilze 

kuWi bariumiT iqneba avsebuli 


teqnika, romelic saSualebas mogvcems miviRoT bariumiT 

savse wvrili nawlavis optimaluri gamosaxuleba 

� wvrili nawlavis fluoroskopiuli kvleva unda moxdes misi 

yvela maryuJis (misawvdomi), maT Soris, TeZos nawlavis 

terminaluri nawilis kompresiiT 

� saWiroa seriuli abdominaluri rentgenogramebis gadaReba 

bariumis gadaadgilebis mixedviT, TiToeulze gadaRebis 

drois miTiTebiT (Tu SesaZlebelia gadaReba guldaRma 

poziciaSi unda ganxorcieldes) 

10.2.4. fluoroskopiuli kvlevis damTavrebis Semdegac, pacienti unda 

darCes rentgenologiur ganyofilebaSi, sanam eqimi ar miiRebs 

saboloo gadawyvetilebas diagnozis Sesaxeb. zogjer, 

SesaZloa saWiro gaxdes fluoroskopiuli kvlevis 

ganmeorebiTi Catareba; 

22

11. 11. msxvili msxvili nawlavis nawlavis nawlavis rentgenografiuli rentgenografiuli gamokvlev 

gamokvleva 

gamokvlev 

gamokvleva 

a 

bariumis bariumis oyniT 

oyniT 

msxvili nawlavis rentgenografiuli kvleva bariumis oyniT, 

informatiuli da saimedo meTodikaa msxvili nawlavis 


gamokvlevis mizania msxvili nawlavis paTologiis gamoricxva, 

an gamovlena da aseT SemTxvevaSi, daavadebis xasiaTisa da 

gavrcelebis dadgena, im minimaluri radiaciuli dozis gamoyenebiT, 

rac sakmarisia xarisxiani kvlevis Casatareblad. 

11.1. 11.1. Cvenebebi: 

Cvenebebi: 

11.1.1. anamnezi da simptomebi, romlebic miuTiTeben msxvili nawlavis 


� muclis tkivili 

� diarea 

� yabzoba 

� gastro-intestinaluri sisxldena 

� anemia 


� nawlavis obstruqcia 

� wonis dakleba 

� cxeleba 

� sefsisi 

� anamnezSi nawlavis simsivne 

� msxvili nawlavis daavadebis memkvidreoba 

11.1.2. msxvili nawlavis iseTi paTologiebis dadgena, rogorebicaa: 

• divertikulozi 

• nawlavis anTebiTi daavadeba 

• skriningi, an eWvi msxvili nawlavis neoplaziaze 

• yvela daavadeba, an mdgomareoba, romelic azianebs msxvil 

nawlavs 


specifika 

11.2.1. msxvili nawlavis rentgenografiuli kvleva aucileblad 

saWiroebs pacientis momzadebas, rac gulisxmobs nawlavis 

maqsimalurad gawmendas fekaluri masebisagan da zedmeti 

siTxisgan da unda ganxorcieldes nebismieri qvemoT 

moyvanili meTodis, an maTi kombinaciis gamoyenebiT, 

rogorebicaa: sakvebis miRebis SezRudva, hidratacia, 

osmosuri safaRaraToebi, kontaqturi safaRaraToebi da 

gamwmendi oynebi; 


11.2.2.1. erTmagi kontrastirebis teqnika: 

23

� pacients reqtalurad unda SevuyvanoT dabali simkvrivis 

(15-25%-iani) bariumis suspenzia (sakmarisi raodenobiT, 

raTa mivaRwioT msxvili nawlavis gabervas) 

� pacientis zomis mixedviT, unda gamoviyenoT 100 kVp, an 

ufro maRali kilovoltaJis rentgenis sxivi, ise rom 

movaxerxoT msxvili nawlavis yvela segmentis penetracia 

� fluoroskopiisas unda movaxdinoT msxvili nawlavis 

yvela misawvdomi segmentis manualuri, an meqanikuri 

kompresia da movaxdinoT yvela segmentis daTvaliereba 

� sizustiT unda gadaviRoT fluoroskopiulad yvela saeWvo 

segmenti 

� zogjer saWiro xdeba bariumiT avsebuli msxvili nawlavis 

mTliani suraTis gadaRebac, rac unda vawarmooT, rogorc 

frontalur, ise irib proeqciebSi; sigmoiduri nawlavis 

gadasaRebad gamoiyeneba kuTxis, reqtaluri nawlavis 

rentgenografiisTvis ki lateraluri proeqciebi 

� garkveuli daxmarebis gaweva post-evakuaciur 

rentgenografiasac SeuZlia 

11.2.2.2. ormagi kontrastirebis teqnika: 

� gamokvleva warmoebs, specialurad am mizniT, komerciulad 

damzadebuli maRali simkvrivis (80 %-iani da meti) 

bariumis suspenziiT 

� pacientis zomis mixedviT, unda gamoviyenoT 90 kVp, an 

ufro maRali kilovoltaJis rentgenis sxivi, ise rom 

movaxerxoT msxvili nawlavis yvela segmentis penetracia 

� bariumis suspenzia da haeri Seiyvaneba fluoroskopiuli 

kontroliT, ise rom mivaRwioT msxvili nawlavis 

adekvatur daWimvasa da amovsebas 

� unda movaxdinoT msxvili nawlavis yvela segmentis 

fluoroskopiuli daTvaliereba 

� msxvili nawlavis ormag-kontrastiani yvela segmenti unda 

gadaviRoT, sul mcire, or sxvadasxva proeqciaSi. aseTi 

proeqciebia: 

1. swori nawlavis, sigmoiduri kolinjis da brma 

nawlavis damiznebiTi proeqciebi 

2. mTliani msxvili nawlavis mimoxilviTi 

rentgenogramebi gul-daRma da gul-aRma proeqciebSi, 

sigmoiduri nawlavis kuTxis da reqtaluri nawlavis 

lateraluri proeqciebi 

3. mTliani msxvili nawlavis orive lateraluri 

dekubituri proeqcia horizontaluri sxivis 

gamoyenebiT 

24

11.2.3. xarisxis kontroli 

� warmatebuli kvlevis CatarebisTvis aucilebelia msxvili 

nawlavis adekvaturi momzadeba 

� msxvili nawlavis fluoroskopiuli kvlevis damTavrebis 

Semdeg, pacienti unda darCes rentgenologiur 

ganyofilebaSi, sanam eqimi ar miiRebs saboloo 

gadawyvetilebas diagnozis Sesaxeb. zogjer, SesaZloa 

saWiro gaxdes fluoroskopiuli kvlevis ganmeorebiTi 

Catareba 

� yvela SesaZlo SemTxvevaSi unda veZeboT korelaciuri 

kavSirebi am kvlevasa da sxva radiologiur, Tu 

endoskopiur gamokvlevebs Soris 

� unda dafiqsirdes 1 sm, an meti zomis koloreqtaluri 

simsivnis, an polipebis aRmoCenis yvela SemTxveva da 

movaxdinoT maTi perioduli monitoringi 

12. 12. 12. histerosalpingografia 

histerosalpingografia 

histerosalpingografia 

histerosalpingografia kontrastuli rentgenografiuli 

kvlevaa saSvilosnos yelis, saSvilosnos Rrus, falopis milebis 

da peritonealuri Rrus gamosakvlevad. 

procedura unda Sesruldes im minimaluri radiaciuli doziT, 

rac saWiroa xarisxiani gamokvlevis Casatareblad. 

121. 121. Cvenebebi Cvenebebi da da ukuCvenebebi: 

ukuCvenebebi: 

12.1.1 histerosalpingografiis yvelaze xSiri Cvenebaa uSviloba, 

Tumca es procedura naCvenebia Semdegi Civilebis drosac: 

� tkivili menjis RruSi 

� araregularuli menstrualuri cikli 

� araregularuli vaginaluri sisxldena 

� Tandayolili anomaliebi da/an anatomiuri Taviseburebebi 

� falopis milis pre- da postoperaciuli gamokvleva, 

seleqtiuri salpingografia da milis rekanalizacia, an 

sxva intervenciebi 

� postoperaciulad saSvilosnos Rrus daTvaliereba 

� xelovnuri ganayofierebis proceduris Catarebamde 

12.1.2. histerosalpingografia unda Sesruldes menstrualuri 

ciklis folikulur fazaSi (Cveulebriv, menstruaciis 

dawyebidan me-7-10 dRis intervalSi), raTa Tavidan aviciloT 

25

SesaZlo orsuloba. gamokvleva, aseve, ukunaCvenebia menjis 

Rrus infeqciebis da aqtiuri vaginaluri sisxldenebis fonze 

12.2 kvlevis kvlevis specifika: 

specifika: 

12.2.1. histerosalpingografiis dawyebmade SesaZlebelia 

profilaqtikuri antibiotikoTerapiis Catareba. Tu es 

RonisZieba kvlevis dawyebamde ar ganxorcielda da 

gamokvlevam falopis milebis dilatacia da/an obstruqcia 

gamoavlina, maSin pacients antibiotikebi kvlevis procesSi 

unda mivceT; 

12.2.2. saSvilosnos yelis da saSvilosnos Rrus gamokvleva 

aucileblad unda moxdes aseptiuri teqnikiTa da 

fluoroskopiuli kontroliT; 

12.2.3. SesaZlebelia, rogorc cximSi xsnadi, aseve wyalSi xsnadi, 

kontrastis gamoyeneba, romelTagan TiToeuls Tavisi 

dadebiTi da uaryofiTi mxareebi aqvs. cximSi xsnadi 

kontrastis gamoyenebis SemTxvevaSi, miometriuli, an venuri 

sisxlCaqcevis gamovlenisas, kontrastis Seyvana saswrafod 

unda Sewydes 

12.2.4. Cveulebriv, gamokvleva warmoebs gulaRma frontalur 

poziciaSi, Tumca saWiroebis SemTxvevaSi SeiZleba gadaviRoT 

guldaRma da iribi proeqciebi. sakontrasto nivTierebis 

Seyvana im odenobiT unda moxdes, rac sakmarisi iqneba 

endometriumis Rrusa da falopis milebis adekvaturi 

vizualizaciisTvis. endometriuli paTologiis arsebobaze 

eWvis SemTxvevaSi, SesaZloa, saWiro gaxdes post-drenaJuli 

rentgenografiis Catarebac. Tu gamokvlevis CatarebisTvis 

dagvWirda balonuri kaTeteris gamoyeneba, endometriumis 

Rrusa da saSvilosnos yelis srulad gamosakvlevad, 

gadaReba unda moxdes proceduris bolos, daCutuli balonis 

fonze; 

26


Sesavali 

kompiuteruli kompiuteruli tomografia 

tomografia 

tomografia 

kompiuteruli tomografia (kt) (kt) radiologiuri kvlevis 

meTodia, romelic maionizirebel radiacias iyenebs ganivi ganivi ganivi ganivi 

(aqsialuri _ safexurebrivi kompiuteruli tomografia) da 

volumetruli volumetruli 

volumetruli 

volumetruli _ (spiraluri kompiuteruli tomografia) 

gamosaxulebebis misaRebad. miRebuli monacemebidan SesaZlebelia, 

agreTve, or- da sam-ganzomilebiani, an sxvadasxva sibrtyeSi 

gamosaxulebebis rekonstruireba. 

kompiuteruli tomografia mniSvnelovan klinikur 

informacias iZleva daavadebis tipisa da misi mimdinareobis 

Sesaxeb da saWiroebs adamianis anatomiisa da fiziologiis, 

agreTve, bazisuri fizikisa, kompiuteruli tomografiis teqnikis da 

radiaciuli usafrTxoebis wesebis zedmiwevniT codnas. zogjer, is 

kvlevis sawyisi meTodia, xSirad ki iniSneba sxva radiologiuri 

kvlevebis Semdgom diagnozis verificirebisTvis. 

kompiuteruli tomografiis Sesrulebisas, pacienti ganicdis 

maionizirebeli radiaciis zemoqmedebas. amitom, is unda Sesruldes 

radiaciuli usafrTxoebis wesebis zedmiwevniT dacviTa da 

xarisxiani gamosaxulebis misaRebad sakmarisi minimaluri 

dasxivebiT. 

ansxvaveben kompiuteruli tomografiis mraval saxes, 

romelTaganac zogierTs (kvlevebi, romlebic sruldeba saCxeris 

samedicino centrSi) Cven dawvrilebiT ganvixilavT. 




erTad warmovadgenT dokumentis zogad nawilSi. calkeuli 

kvlevebisTvis konkretuli moTxovnebi asaxulia dokumentis 

Sesabamis nawilebSi. 

2. 2. zogadi zogadi zogadi nawili 

nawili 

2.1. 2.1. personalis personalis kvalifikacia kvalifikacia da da val valdebulebebi 

val ebulebebi 

2.1.1. kompiuteruli tomografia unda Catardes sertificirebuli 

eqimi-radiologis meTvalyureobiT, romlis kompetenciis 

donis SesanarCuneblad aucilebelia, rom is weliwadSi 

atarebdes minimum 100 kt kvlevas. man, aseve monawileoba unda 

miiRos mudmivi samedicino swavlebis aqtivobebSi (axali 

27

samedicino literaturis gacnoba, Tematuri konferenciebi 

aqtualur Temebze da sxv.); 

2.1.2. miuxedavad imisa, rom Tanamedrove kompiuteruli 

tomografebi, ZiriTadad, avtomatur reJimSi muSaoben, 

zogierTi teqnikuri parametri kvlav rCeba operatorze 

damokidebuli. amis gamo, eqimi kargad unda iyos 

gaTviTcnoebierebuli iseT sakiTxebSi, rogorebicaa: 

� eqspoziciuri faqtorebi 

� kolimacia 

� magidis simaRle, an daxra 

� optimaluri fanjris SerCeva 

� rekonstruqciuli algoriTmebi 

� gamosaxulebis rekonstruqciis intervali 

� deteqtoris konfiguracia multideteqtoruli 

(mravalSriani) sistemebisTvis 

� Wrilis sisqe multideteqtoruli (mravalSriani) 

sistemebisTvis 

2.1.3. radiografiul kvlevas asrulebs sertificirebuli 

laboranti 

2.1.4. kompiuteruli tomografiis kabinets emsaxureba am sferoSi 

ganswavluli samedicino inJineri. 

2.2. 2.2. kvl kvlevis kvl 

evis dokumentacia 

dokumentacia 

2.2.1. 2.2.1. 2.2.1. kompiuteruli tomografia unda Catardes mxolod kvlevis 

SemkveTi eqimis werilobiTi moTxovnis safuZvelze, romelSic 

dadasturebuli unda iyos kvlevis samedicino saWiroeba 


2.2.2. 2.2.2. 2.2.2. axali gamosaxulebebi unda Sedardes adre gadaRebul 

kompiuteruli tomografiis suraTebs da/an sxva xelTarsebul 

kvlevis monacemebs; 

2.2.3. 2.2.3. kvlevis pasuxi unda Seicavdes mTel rig aucilebel 

komponentebs, rogorebicaa: 


monacemebi 

monacemebi kvlevis Semsrulebeli dawesebulebis 

dasaxeleba, pacientis saxeli, gvari da saidentifikacio nomeri, 

kvlevis SemkveTi eqimis monacemebi, radiografiuli kvlevis tipi, 

kvlevis TariRi 





� daskvniTi daskvniTi daskvniTi daskvniTi nawili: nawili nawili nawili zusti radiologiuri diagnozi, saWiroebis 

SemTxvevaSi, sxva diagnostikuri kvlevis Catarebis rekomendacia 

2.2.4. kompiuteruli tomografiis sruli Canaweri da pasuxis asli 

(eleqtronuli, an werilobiTi) mudmivad mudmivad mudmivad mudmivad unda inaxebodes 

kvlevis Semsrulebeli kabinetis arqivSi; 

28

2.2.5. zogierT SemTxvevebSi kompiuteruli kvlevis pasuxi 

SeiZleba gaices arastandartuli formiT – verbaluri, an 

arasruli werilobiTi, rac mogvianebiT aucileblad unda 

Seicvlos sworad Sevsebuli kvlevis pasuxiT. aseTi 

SemTxvevebia: gadaudebeli, an saswrafo situaciebi, an 

rodesac radiologi eqimi cvlis imave kvlevaze adre dasmul 

diagnozs (azustebs diagnozs). 

2.3. 2.3. xarisxis kontroli 

kompiuteruli tomografia moiTxovs xarisxis kontrolis 

(QC) Semdegi procedurebis gatarebas: 

2.3.1. yvela kvleva sruldeba winaswar SemuSavebuli protokolis 

mixedviT. pacientis sedacia da intravenuri kontrastis 

Seyvanac unda moxdes winaswar gansazRvruli wesebis 

mixedviT da aucileblad, eqimis TandaswrebiT. kvlevis pasuxi 

iwereba sertificirebuli eqimi-radiologis mier; 

2.3.2. kompiuteruli tomografiis kabinetSi unda iyos 

gadaudebeli samedicino daxmarebis aRmosaCeni mowyobiloba 

da medikamentebi, romlebic SeiZleba dagvWirdes alergiuli 

reaqciebis, an sxva sicocxlisaTvis saSiSi gadaudebeli 

mdgomareobebis ganviTarebisas. saWiroa am mowyobilobis 

gamarTulobisa da medikamentebis vargisianobis regularuli 

monitoringi; 

2.3.2. winaswar gansazRvruli periodulobiT da wesebiT unda 

moxdes samedicino aparaturis teqnikuri Semowmeba da 

monitoringi. aseve, winaswar unda iqnas gansazRvruli im 

piris vinaoba, vinc pasuxismgebelia aRniSnuli procesis 

Catarebaze. 

2.4. 2.4. radiaciu radiaciuli radiaciu 

li usafrTxoeba 

2.4.1. kompiuteruli tomografiuli kabinetis radiaciul 

usafrTxoebaze pasuxismgebelia eqimi da samedicino inJineri; 

2.4.2. kompiuteruli tomografia unda Catardes im minimaluri 

dasxivebiT, rac sakmarisia optimaluri gamosaxulebis 

misaRebad; 

2.4.3. yvela kvleva unda Catardes Sesabamisi CvenebiT; 

2.4.4. orsuloba warmoadgens kompiuteruli tomografiis 

ukuCvenebas. orsuli pacientisaTvis, am kvlevis Catarebis 

sakiTxis ganxilvisas, yovelTvis unda iyos gaTvaliswinebuli 

nayofisTvis miyenebuli radiaciuli riski da kvlevis 

Sedegebis klinikuri mniSvneloba. 

29

3. Tavis Tavis tvinis tvinis kompiuteruli kompiuteruli tomografia 

tomografia 

(dokumenti SemuSavebulia amerikis neiroradiologTa asociaciisa da 

amerikis radiologTa kolejis dokumentis mixedviT) 

kompiuteruli tomografia intensiurad gamoiyeneba 

neiroradiologiaSi da warmoadgens maionizirebeli radiaciis 

gamoyenebiT, organoebisa da qsovilebis gamosaxulebebis miRebas 

(koronarul, sagitalur da horizontalur WrilebSi), rac efuZneba 

maT mier rentgenuli sxivebis STanTqmas. 

E 

3.1 Cvenebebi: 

3.1.1. pirveladi: 

� Tavis mwvave travma 

� eWvi mwvave intrakranialuri hemoragiiis arsebobaze 

� kalcifikatebis aRmoCena an Sefaseba 

� sxvadasxva mizeziT (mag., simsivne, an hemoragia) 

ganxorcielebuli neiroqirurgiuli operaciis Semdgom 

(CarevisTanave) Tavis tvinis mdgomareobis Sefaseba 

� namkurnalebi an aranamkurnalebi vaskuluri dazianebebi 

� Suntirebuli hidrocefalia, an Suntis revizia 

� cnobierebis donis uecari Secvla 

� momatebuli intrakranialuri wneva 

� Tavis tkivili 

� mwvaved ganviTarebuli nevrologiuri deficitebi 

� savaraudo intrakranialuri infeqcia 

� Tavis tvinis sxvadasxva Tandayolili anomaliebi, mag.: 

kraniosinostozi, makrocefalia, mikrocefalia da a.S 

� fsiqiatriuli darRvevebi 

� tvinis Tiaqari 

� eWvi Tavis tvinis simsivneze, an masaze 

3.1.2. meoradi: 

� rodesac magnitur rezonansuli kvleva ukunaCvenebia, an 

raime mizeziT ver sruldeba 

� diplopia 

� kranialuri nervebis disfunqcia 

� krunCxva 

� apnoe 

� sinkope 

� ataqsia 

� eWvi neirodegeneraciuli daavadebebis arsebobaze 

� encefaliti 

� vaskularuli okluzia da vaskulitebi 

� anevrizma 

� neiroendokrinuli disfunqcia 

30

� ganviTarebaSi CamorCena 

� medikamenturi intoqsikacia 

� kortikaluri displazia 

� migraciuli anomaliebi, an Tavis tvinis morfologiuri sxva 

paTologiebi 

3.2. 3.2. kvlevis kvlevis kvlevis specifika: 

specifika: 

3.2.1. gamoklvevis teqnika 

3.2.1.1. kompiuterul-tomografiuli kvleva SeiZleba Catardes 

Tanmimdevruli calkeuli anaTlis teqnikiT, mravali anaTlis 

helikaluri (spiraluri) protokolis an multideteqtoruli 

mravlobiTi anaTlebis algoriTmis mixedviT; 

3.2.1.2. Tavis tvinis tomografiisas, Tanmimdevruli, an gadafarviTi 

aqsialuri Wrilebis sisqe, mozrdilebSi da 10 wlis asakis 

zeviT bavSvebSi, ar unda aRematebodes 10 mm-s, axalSobilebsa 

da 10 wlamde pacientebSi _ 5 mm-s. 

3.2.1.3. Tavis tvinis ukana fosos anu infratentorialuri ubnebis 

vizualizaciisTvis, rogorc bavSvebSi aseve mozrdilebSi, 

Sris sisqe ar unda aRematebodes 5 mm-s; 

3.2.1.4. Tavis travmuli dazianebis SemTxvevaSi, gamosaxuleba iseTi 

rakursiT unda iqnas miRebuli, rom SesaZlo dazianebebis 

dafiqsireba moxerxdes Zvlovan, rbil, subdurul da sxva 

struqturebSic; 

3.1.1.5. qalas fuZis or, an sam ganzomilebiani gamosaxulebis 

rekonstruqciisTvis, aqsialuri anaTlis sisqe, spiraluri 

teqnikis gamoyenebis SemTxvevaSi ar unda aRematebodes 3 mm-s, 

spiraluri teqnikis gamoyenebis gareSe ki 2 mm-s; 

3.1.1.6. garkveul SemTxvevebSi kompiuteruli tomografia tardeba 

intravenuri, an intraTekaluri radiokontrastuli 

nivTierebebis gamoyenebiT, Sesabamisi protokolebis zusti 

dacviT; 

3.1.1.7. specifiur klinikur situaciebSi, pirdapiri gziT miRebuli 

aqsialuri gamosaxulebidan SesaZlebelia koronaruli, 

sagitaluri da sxva ufro rTuli sibrtyeebis rekonstruqcia. 

garkveuli Cvenebebisas, kompiuteruli tomografia tardeba 

perfuziiT, angiografiiT an venografiiT. aseT 

SemTxvevebSi,Hspiraluri meTodi Zalian Txeli AanaTlebis 

safuZvelze, ukeTesi gamosaxulebis miRebis saSualebas 

iZleva, vidre tradiciuli aqsialuri meTodi. 

3.2.2. skaneris moTxovnebi: 

� skanirebis dro: minimaluri, ara umetes 2 wamisa 

� anaTalis sisqe: minimaluri, ara umetes 2 mm-isa 

� skanirebebs Soris intervali: minimaluri, araumetes 4 

wamisa, an odnav meti intravenuri kontrastis gamoyenebis 

SemTxvevaSi 

31

� sivrciTi rezolucia: > 10 lp/cm, Tu monitori < 24 cm (DFOV) 

� magidis daxra: ar unda aRematebodes 2:1 erTSriani 

spiralur-deteqtoruli skanerisaTvis. 

4. Tavis Tavis eqstrakranialuri eqstrakranialuri nawilis nawilis da da kisris kisris kompiuteruli 

kompiuteruli 

tomografia 

tomografia 

Tavis eqstrakranialuri nawilis da kisris kompiuteruli 

tomografia aris radiografiuli kvlevis meTodi, romelic 

gamoiyeneba Tavis eqstrakranialuri nawilis da kisris 

daavadebebis diagnostikaSi. igi unda Catardes mxolod 

dasabuTebuli samedicino Cvenebis SemTxvevaSi, minimaluri 

radiaciuli dozis gamoyenebiT, romelic sakmarisi iqneba 

optimaluri gamosaxulebis misaRebad. 

4.1. 4.1. Cvenebebi: Cvenebebi: 

4.1.1. Tavis eqstrakranialuri nawilis da kisris rbili qsovilebis 

kompiuteruli tomografia: 

1. Tandayolili anomaliebi 

2. keTilTvisebiani da avTvisebiani neoplaziebi 

3. infeqciuri da anTebiTi procesebi 

4. travma 

5. sisxlZarRvovani paTologiebi 

6. palpirebadi masebis gamokvleva 

7. radiaciuli TerapiiT mkurnalobis dagegmva 

8. qirurgiuli, qimioTerapiuli, an radiaciuli TerapiiT 

Catarebuli mkurnalobis Sedegebis kontroli 

9. sisxldna/epistaqsisi 

10. farisebri jirkvlis sxvadasxva paTologiebi 

4.1.2. paranazaluri sinusebis kompiuteruli tomografia: 


2. Zval-xrtilovani daavadebebi 

3. sinonazaluri keTilTvisebiani, an avTvisebiani neoplaziebi, 

rbili qsovilis, an Zvlis dazianebiT 

4. saxis travma 

5. mwvave, an qronikuli anTebiTi procesi 

6. qirurgiuli, qimioTerapiuli, an radiaciuli TerapiiT 

Catarebuli mkurnalobis Sedegebis kontroli 


8. sisxldena/epistaqsisi 

4.1.3. Tval-budis kompiuteruli tomografia: 


32

2. proftozi 

3. Zval-xrtilovani daavadebebi 

4. Tvalbudis Zvlovani nawilis da Tvalis neoplaziebi 

5. travma 

6. infeqciebi da anTebiTi procesebi 

7. farisebri jirkvlis paTologiiT gamowveuli orbitopaTia 

8. qirurgiuli, qimioTerapiuli an radiaciuli TerapiiT 

Catarebuli mkurnalobis kontroli 


10. ucxo sxeuli. 

11. diplopia 

12. mxedvelobis dakargva 

13. sinusitis, an sinusebze Catarebuli operaciebis 

garTulebebi 

4.1.4. safeTqlis Zvlis kompiuteruli tomografia: 

1. smenis dakargva 

2. neoplaziebi 

3. travma 

4. mwvave an qronikuli ostomastoiduri anTebiTi daavadeba 

5. preoperaciuli gamokvleva mastoideqtomiis Catarebamde 

6. koxlearuli implantaciis wina preoperaciuli gamokvleva 


8. eWvi Sida yuris daavadebaze 

9. qirurgiuli, qimioTerapiuli an radiaciuli TerapiiT 

Catarebuli mkurnalobis kontroli 

10. Tandayolili defeqtebi 


specifika 

4.2.1. kisris kompiuteruli tomografia: 

4.2.1.1. pacienti magidaze unda iwves gulaRma poziciaSi, kiseri 

odnav ukan unda iyos gadaxrili da sunTqavdes zedapirulad 

4.2.1.2. unda gadaviRoT gamosakvlevi regionis Tanmimdevruli, an 

gadafarviTi Wrilebi. Wrilis sisqe ar unda aRematebodes 3mms, 

Tumca pediatriul pacientebSi, Tu gvsurs radiaciuli 

dozis Semcireba, sasurvelia ufro ganieri Wrilebis 

gadaReba (≤ 5 mm); 

4.2.1.3. mTavari RerZis kuTxe unda iyos magari sasis paraleluri. 

pacientebSi, romlebsac aReniSnebaT alagamas Semcveli 

bJenebi, RerZis kuTxe Tavidan magari sasis paraleluri unda 

iyos da SeiZleba mere gadavxaroT aseTi tipis bJenebiT 

ganpirobebuli artefaqtebis Tavidan asacileblad. meore 

Wrilis kuTxe unda Seesabamebodes da iyos inis Zvlis 

sibrtyeSi; 

4.2.1.4. yvela kvleva rekonstruirebul unda iqnas rbili qsovilebis 

algoriTmSi. pacientebs, romlebsac anamnezSi aReniSnebaT 

33

infeqcia, simsivne, an travma SeiZleba CavutaroT damatebiTi 

rekonstruqciebi kideebis gamaZlierebeli algoriTmis, an 

Zvlis mkafiod gamomxatveli teqnikis saSualebiT 

4.2.1.5. intravenuri kontrastis gamoyeneba rekomendebulia misi 

ukuCvenebis ararsebobis SemTxvevaSi. ukontrasto kvleva 

SeiZleba Catarebul iqnas sanerwyve jirkvlebis kenWebis 

aRmosaCenad, an pacientebisTvis, romlebsac farisebri 

jirkvlis simsivnis gamo utardebaT radioaqtiuri iodiT 

mkurnaloba; 

4.2.1.6. Tu kvleva tardeba xmis iogebis simsivnis gamo, aqsialuri 

Wrilebi unda iyos xmis iogebis an hioiduri Zvlis 

paraleluri; 

4.2.1.7. Tu kvleva specifiurad tardeba xmis iogebis damblis 

gamosakvlevad, maSin gamosaxuleba unda moicavdes marjvena 

laviwqveSa arterias (marjvena xmis iogis damblis dros), an 

aortopulmonarul fanjaras (marcxena xmis iogis damblis 

dros); 

4.2.1.8. uSualod xorxis midamoSi Zalian Txeli Wrilebi (1.0-1.5 mm), 

gadafarviTi rekonstruqciiT SeiZleba dagvexmaros xmis 

iogebis neoplaziebis diagnostikaSi. suraTebi gadaRebuli 

fonaciis, an valsalvas manevris dros SeiZleba 

informatiuli iyos xorxis funqciis Sesafaseblad. 

4.2.2. wiaRebis kompiuteruli tomografia: 

4.2.2.1. standartuli kvleva SeiZleba Catardes koronarul WrilSi, 

an iqnas rekonstruirebuli koronarul WrilSi mravalSriani 

aqsialuri monacemebisgan. aqsialuri, an sagitaluri 

gamosaxulebebi SeiZleba informatiuli iyos radiologisa, an 

mkurnali eqimisTvis, da agreTve, SesaZlebelia maTi 

rekonstruirebac. mravalSriani mowyobilobis ararsebobis 

pirobebSi, SeiZleba gadaviRoT pirdapiri koronaruli, an 

erTdroulad, aqsialuri da koronaruli Wrilebi. 

neoplaziebis gamosakvlevad unda gamoviyenoT intravenuri 

kontrasti. kontrasti ar gamoiyeneba saxis travmis da 

sinusebis rutinuli gamokvlevis dros. kontrasti SeiZleba 

dagvexmaros iseTi sinusuri infeqciebis diagnostikaSi, 

romlebic iwveven periorbitalur, an saxis Sesiebas da aris 

eWvi abscesis, an sinonazaluri infeqciis romelime 

garTulebis arsebobaze. kvleva unda iqnas rekonstruirebuli 

Zvlovan algoriTmSi, an sxva kideebis mkafiod gamomxatvel 

algoriTmSi; 

4.2.2.2. koronaruli Wrilebis gadasaRebad pacienti unda moTavsdes 

guldaRma poziciaSi rodesac vatarebT pirdapir 

koronarul WrilSi gadaRebas _ es dagvexmareba 

gamovikvlioT wiaRebis sadinarebi. unda vecadoT mTavari 

RerZi iyos magari sasis RerZis perpendikularuli. 

34

Tanmimdevruli Wrilebi unda iyos gadaRebuli cxviris 

Rrudan Turqul kexamde. Wrilebis sisqe ar unda 

aRematebodes 3 mm-s. patara bavSvebSi, sedaciis pirobebSi, 

koronaruli Wrilebi SeiZleba miviRoT gulaRma Taviszurgis 

poziciaSi. im pacientebSi, romlebTanac SeuZlebelia 

pirdapiri koronaruli gamosaxulebis miReba, 

multideteqtoruli skaneris aqsialuri Wrilebis 

gamoyenebiT, SeiZleba Catardes koronaruli rekonstruqcia. 

Wrilebis rekomendebuli sisqea 1.0-1.5 mm; 

4.2.2.3. rutinuli multideteqtoruli skanirebisTvis, an pirdapiri 

aqsialuri gamosaxulebis misaRebad pacienti unda moTavsdes 

gulaRma poziciaSi. Tanmimdevruli an gadafarviTi Wrilebi 

unda iqnas miRebuli frontaluri sinusis zeda kididan 

magari sasis qveda kidemde. Wrilebis sisqe ar unda 

aRematebodes 3 mm-s. 

4.2.3. Tvalbudis kompiuteruli tomografia: 

4.2.3.1. standartuli kvleva unda moicavdes multideteqtoruli 

skaneriT aqsialur sibrtyeSi gadaRebul Wrilebs da 

rekonstruirebul koronarul Wrilebs. SeiZleba pirdapiri 

koronaluri da aqsialuri Wrilebis gadaRebac, Tu ar gvaqvs 

koronaruli Wrilis rekonstruirebis saSualeba, an 

gamosaricxia Znelad SesamCnevi bzaris arseboba. ukuCvenebis 

ararsebobis SemTxvevaSi, simsivneebis, anTebiTi daavadebebis 

da sisxlZarRvovani paTologiebis gamokvlevis dros, viyenebT 

intravenur kontrasts. prekontrastuli vizualizacia 

saWiroa, rodesac vcdilobT aRmovaCinoT kalciumis kerebi 

iseTi daavadebis dros, rogoricaa magaliTad, 

retinoblastoma. kvlevis Sedegebi unda iyos 

rekonstruirebuli rbili qsovilebisa da Zvlovan 

algoriTmSi. 

4..2.3.2. koronarul gamosaxulebebi: pirdapiri koronaruli Wrilis 

misaRebad pacienti unda movaTavsoT guldaRma poziciaSi. 

mTavari RerZis kuTxe Uunda iyos infraorbitalurimiataluri 

xazis perpendikularuli. Tu pacienti ver wveba 

mucelze, maSin koronaruli Wrilebi SegviZlia miviRoT 

zurgze wolisas kisris maqsimalurad ukan gadaxriT da 

ekranze mTavari RerZis SecvliT. Tanmimdevruli, an 

gadafarviTi Wrilebi unda gadaviRoT Tvalbudis wina 

kididan Turqul kexamde. Wrilis sisqe ar unda aRematebodes 

3 mm-s. rodesac veZebT mcire zomis ucxo sxeulebs, Wrilis 

sisqe ar unda aRematebodes 1.5 mm-s. pirdapiri aqsialuri 

Wrilebisgan, multideteqtorul skanerebis arsebobisas, 

SeiZleba miRebul iqnes mravalganzomilebiani 

rekonstruirebuli koronaruli Wrilebi; 

35

4.2.3.3. aqsialur Wrilebis misaRebad pacienti unda movaTavsoT 

gulaRma poziciaSi. mTavari RerZis kuTxe unda iyos 

infraorbitaluri-miataluri xazis paraleluri. 

Tanmimdevruli an gadafarviTi Wrilebi unda gadaviRoT 

frontaluri sinusis zeda kididan magar sasamde. Wrilebis 

sisqe ar unda aRematebodes 3 mm-s. mcire ucxo sxeulebis 

Ziebisas Wrilis sisqe ar unda aRematebodes 1.5 mm-s. 

4.2.4. safeTqlis Zvlis kompiuteruli tomografia: 

4.2.4.1. standartuli gamokvleva unda moicavdes gamosaxulebebs 

aqsialur da koronarul WrilebSi, an multideteqtoruli 

skaneriT gadaRebul maRali xarisxis aqsialur Wrilebs 

koronaruli rekonstruqciiT. intravenuri kontrastis 

gamoyeneba SeiZleba sasargeblo iyos mwvave mastoiditis 

arsebobisas transversuli sinusis gamtareblobis dasadgenad. 

ukuCvenebebis ararsebobis SemTxvevaSi kontrasti gamoiyeneba 

simsivnur procesebze eWvis SemTxvevaSi. yvela kvleva unda 

iyos rekonstruirebuli Zvlovan algoriTmSi. marjvena da 

marcxena mxareebi SesaZlebelia cal-calke iyos 

rekonstruirebuli. damatebiT, maRali xarisxis 

multideteqtoruli skaneriT gadaRebuli Wrilebis 

rekonstruireba Poschl (sibrtye paraleluri zeda 

naxevarrkalovani arxisa) da Stenvers (sibrtye 

perpendikularuli zeda naxevarrkalovani arxisa) sibrtyeebSi 

gvaZlevs damatebiT sasargeblo informacias, gansakuTrebiT 

zeda naxevarrklovani arxis dazianebis Sesaxeb. 

4.2.4.2. pirdapiri koronaruli Wrilebis misaRebad pacienti unda 

moTavsdes guldaRma poziciaSi. mTavari RerZi unda iyos 

infraorbitaluri-miataluri xazis perpendikularuli. 

Tanmimdevruli, an gadafarviTi Wrilebis gadaReba unda 

daviwyoT sasmeni arxis Zvlovani nawilis, daaxloebiT, 6 mm-iT 

win da davasruloT gareTa sasmeni arxis Zvlovan nawilis 6 

mm-iT ukan, mastoidis CaTvliT. Wrilis sisqe ar unda 

aRematebodes 1.5 mm-s. Tu pacientisTvis siZneles warmoadgens 

pirdapir koronarul WrilSi gamokvlevis warmoeba, maSin 

pirdapiri aqsialuri Wrilebis mravalganzomilebiani 

rekonstruirebiT SesaZlebelia koronaruli Wrilebis miReba; 

4.2.4.3. aqsialuri Wrilebis misaRebad pacienti unda moTavsdes 

gulaRma poziciaSi. mTavari RerZi unda iyos 

infraorbitaluri-miataluri xazis paraleluri. 

Tanmimdevruli, an gadafarviTi Wrilebis gadaReba unda 

daviwyoT sasmeni arxis Zvlovani nawilis, daaxloebiT, 6 mm-iT 

win da davasruloT gareTa sasmeni arxis Zvlovan nawilis 6 

mm-iT ukan, dvriliseburi morCis CaTvliT. SesaZlebelia 

saWiro gaxdes ukana fosos rekonstruqcia rbili qsovilebis 

36

algoriTmis gamoyenebiT. Wrilebis sisqe ar unda 

aRematebodes 1.5 mm-s. 


� skanirebis dro: minimaluri, ara umetes 2 wamisa 

� anaTalis sisqe: minimaluri, ara umetes 1,5 mm-isa 

� skanirebebs Soris intervali: minimaluri, ara umetes 4 

wamisa, an odnav meti intravenuri kontrastis gamoyenebis 

SemTxvevaSi 

� sivrciTi rezolucia: unda gaizomos da Seesabamebodes 

mwarmoeblis moTxovnebs 

� magidis daxra: ar unda aRematebodes 2:1 erTSriani helikalurdeteqtoruli 

(spiralur-deteqtoruli) skanerisaTvis. 

5. xerxemlis xerxemlis kompiuteruli tomografia 

xerxemlis kompiuteruli tomografia, damoukideblad, an sxva 

kvlevebTan erTad (rentgenografia, birTvul-magnituri rezonansi, 

an nuklearuli kvleva) gamoiyeneba xerxemlis mravali daavadebis 

gamosakvlevad. amasTanave, mas mniSvnelovani rolis Sesruleba 

SeuZlia invaziur diagnostikasa da TerapiaSi. 


5.1.1. xerxemlis kompiteruli tomografiis pirveladi Cvenebebia: 

anTebiTi, Tandayolili, travmuli, neoplaziuri, infeqciuri, 

depoziciuri da degeneraciuli dazianebebi. xerxemlis 

Tandayolili, an SeZenili dazianebebi moicavs 

kraniocervikalur anomaliebs, rogoricaa klipel feilis 

sindromi (Klippel Feil Syndrome) da Ciaris malformaciebi (Chiari 

malformations). xerxemlis kompiteruli tomografia 

informatiulia xerxemlis sxva dazianebebis 

diagnostikiTvisac. or da samganzomilebiani rekonstruqciebi 

SeiZleba gamoviyenoT iseTi daavadebis gamosakvlevad, 

rogoricaa sqoliozi, an spondilolizi spondilolisTesTan 

erTad, an mis gareSe. agreTve, igi gamoiyeneba zurgis tvinis 

wyalmankis gamosakvlevad; 

5.1.2. xerxemlis kompiteruli tomografia, rogorc pirveladi 

kvleva, SeiZleba dainiSnos, xerxemlis mwvave travmis dros. 

igi, agreTve, naCvenebia xerxemlis segmentebis (kisris, 

gulmkerdisa da/an welis malebi) travmis SemTxvevaSi, Tu 

xerxemlis rentgenografiuli suraTi paTologiuri, 

37

saWoWmano, an aradiagnostikuria. kompiteruli tomografia 

informatiulia xerxemlis kompresiuli motexilobis 

SemTxvevaSic; 

5.1.3. kompiuteruli tomografia gvaZlevs sakmaod Rirebul 

informacias zurgis tvinis pirveladi, an metastazuri 

neoplazmebis Sesaxeb. igi agreTve gamoiyeneba zurgis tvinSi 

mimdinare iseTi procesebis dasadgenad, rogoricaa 

mravlobiTi mieloma. kompiteruli tomografia SeiZleba 

gamoviyenoT xerxemlis paTologiuri kompresiuli 

motexilobis drosac; 

5.1.4. kompiterulma tomografiam SeiZleba Rirebuli informacia 

mogvces xerxemalSi mimdinare infeqciuri procesebis Sesaxeb. 

es meTodi, agreTve, informatiulia anTebiTi arTritebis 

(revmatoiduli arTriti, maankilozirebeli spondiliti) da 

depoziciuri daavadebebis (amiloidozi, podagra, kalcium 

pirofosfatis depoziciuri daavadeba da qronikuli 

hemodializi) gamosakvlevad. kompiuteruli tomografia 

naCvenebia lumbaluri stenozis, an diskis degeneraciuli 

daavadebis sadiagnostikod, rodesac birTvul-magnituri 

rezonansis Catareba ukunaCvenebia (mag., gulis riTmis 

xelovnuri wamyvani da sxv. kompiuteruli tomografia, 

agreTve, gamoiyeneba postoperaciul pacientebSi, romlebsac 

CautardaT Zvlis gadanergva da/an raime instrumentuli 

manipulacia xerxemalze. es ukanaskneli, zogjer, 

xorcieldeba intraTekaluri sakontrasto saSualebis 

daxmarebiT. xerxemlis kompiuteruli tomografia SeiZleba 

gamoviyenoT xerxemalze sxvadasxva manipulaciebis 

SemTxvevaSi (mielografia, biofsia, aspiracia, 

stereotaqtikuri qirurgia da xerxemlis ineqciuri 

procedurebi) _ uSualod intervenciis dros, intervenciamde 

an Semdeg; 

5.2. 5.2. kvlevis kvlevis kvlevis specifika: 

specifika: 


5.2.1.1. xerxemlis kompiuteruli skanireba iZleva Zvlis zust da 

srulyofil gamosaxulebas. xerxemlis kompiteruli 

tomografia SeiZleba warimarTos safexureobrivi erTSriani 

teqnikiT, an multideteqtoruli helikaluri protokoliT. es 

kvleva umjobesia Catardes Tanmimdevruli, an gadafarviTi, 

optimaluri sisqis (gamosakvlevi segmentis mixedviT) 

WrilebiT. xerxemlis kompiteruli tomografia SeiZleba 

moicavdes mravalganzomilebian rekonstruqciebsac, 

umjobesia, or marjvena kuTxis sibrtyeSi (mag., sagitaluri da 

koronaluri). 

38

gamosaxulebis daTvaliereba unda moxdes iseT algoriTmSi, 

rom SesaZlebeli iyos, rogorc rbili qsovilebis, aseve 

Zvlovani struqturebis daTvaliereba. amisaTvis, umjobesia 

mivdioT aparatis mwarmoeblis instruqciebs; 

5.2.1.2. kisris malebisa da kraniocervikaluri Sesaxsrebis 

gamokvleva saWiroebs Txeli Wrilebis gadaRebas _ ≤ 3mm; 

5.2.1.3. gulmkerdisa da welis malebis gamosaklvevad, garda 

malTaSorisi Sesaxsrebisa, Wrilis sisqe, aseve, ar unda 

aRematebodes 3 mm-s, saidanac SeiZleba movaxdinoT 

mravalganzomilebiani rekonstruqciebi (geometriuli 

rezoluciis gasaaumjobeseblad unda aviRoT maqsimalurad 

mcire are). malTaSoris Sesaxsrebebis gamokvleva, Tu 

SesaZlebelia, unda moxdes 1-2 mm-iani sisqis WrilebiT, rac 

ufro meti albaTobiT mogvcems davadginoT fsevdoarTrozis 

diagnozi. mravalganzomilebiani rekonstruqciebi mogvcems 

vizualizaciis damatebiTi gaumjobesebis saSualebas; 

5.2.1.4.zogierTi klinikuri Cveneba saWiroebs intravenuri, 

intraTekaluri, epiduruli, perinervuli, an intraartikularuli 

kontrastis gamoyenebas, Sesabamisi 

protokolebis zusti dacviT; 

5.2.1.5. specifikur klinikur situaciebSi, pirdapiri gziT miRebuli 

aqsialuri gamosaxulebidan SesaZlebelia or- da 

samganzomilebiani sibrtyeebis konstruireba. es procesi 

ukeTesad xorciledeba multideteqtoruli skaneriT 

miRebuli gamosaxulebebis gamoyenebiT. 


� skaneris tipi: erTSriani, mravalSriani, an eleqtronuli 

sxivis tipis 

� brunvis mTavari periodi: 1 wm, an naklebi 

� milis siTbuli tevadoba, rac uzrunvelyofs saTiTao 

gadaRebas 

� Wrilis sisqe: 1-3 mm 

� magidis daxra: ar unda aRematebodes 2:1 erTSriani 

helikalur-deteqtoruli skanerisaTvis 

� sivrciTi rezolucia: minimum 512 matriqsi 

� Tu SesaZlebelia, an es ar axdens gavlenas gamosaxulebis 

xarisxze, unda gamoviyenoT milis nakadis modulacia 

kompiuteruli kompiuteruli tomografia tomografia angiografiiT angiografiiT (kt (kt angiografia) 

angiografia) 

kt angiografia gamoiyeneba sisxlZarRvTa paTologiis 

dasadgenad, dasaxasiaTeblad an ukve dadgenili daavadebis ukeT 

Sesaswavlad, an mdgomareobis cvlilebebis dasadgenad droSi. igi, 

upirvelesad, gamoiyeneba gulis, arteriebis an venebis 

gamosakvlevad da erTdroulad saWiroebs Txel Wrilian heliakiur 

39

kompiuterul tomografiasa da iodis Semcvel sakontrasto 

nivTierebis swraf intravenur Seyvanas; bevr SemTxvevaSi 

mniSvnelovani xdeba miRebuli monacemebis samganzomilebiani da 

mravalsibrtyiani rekonstruirebac. 

kt angiografia iyenebs maionizirebel sxivebs da amitom unda 

Sesruldes daxelovnebuli eqimis meTvalyureobiT, Catardes 

mxolod Rirebuli samedicino CvenebiT da im minimaluri 

dasxivebiT, rac sakmarisi iqneba xarisxiani gamosaxulebis 

misaRebad. 


Cvenebebi: 

• arteriuli da venuri anevrizma 

• aTerosklerozuli okluziuri daavadeba 

• araaTerosklerozuli, araanTebiTi sisxlZarRvTa 

paTologia 

• arteriebis da venebis travmuli dazianeba 

• arteriis diseqcia da intramuruli hematoma 

• arteriuli da venuri Trombembolia 

• Tandayolili vaskuluri anomaliebi 

• vaskularuli anatomiuri variaciebi 

• vaskularuli Carevebi (per-kutaneuri da qirurgiuli) 

• vaskuliti da kolagenuri vaskularuli daavadebebi 

• vaskularuli infeqciebi 

6.2. 6.2. 6.2. kvlevis specifika specifika: 

specifika 

6.2.1. pacientis SerCeva da momzadeba: 

6.2.1.1. kt angiografiis kandidatebi arian is pacientebi, romelTac 

ar aReniSnebaT absoluturi ukuCveneba iodis Semcveli 

kontrastis mimarT. SedarebiTi ukuCvenebis arsebobisas, unda 

vecadoT SevamciroT kontrastis mimarT reaqciisa da 

nefrotoqsiurobis ganviTarebis albaToba, an vifiqroT sxva 

diagnostikuri kvlevis gamoyenebaze (mag. birTvul-magnituri 

rezonansi); 

6.2.1.2. rodesac es SesaZlebelia, pacienti kargad unda iyos 

hidratirebuli. aucileblad unda vuzrunvelyoT intravenuri 

midgoma. sasurvelia 20 geijiani, an ufro meti zomis 

antekubitaluri intravenuri kaTeteri; Tumca saWiroebis 

SemTxvevaSi 22 geijiani kaTeteri SeiZleba CavayenoT xelze an 

qveda kidurze. iodizirebuli kontrastis Seyvanamde, yvela 

pacients swrafi bolusiT unda SevuyvanoT fiziologiuri 

xsnari, raTa Semowmdes ramdenad saimedoa intravenuri 

midgoma, ramdenad saimedoa venuri kaTeteri; amiT vamcirebT 

kontrastis eqstravazaciis risks. garda amisa, gamokvlevis 

40

procesSi, gamocdili samedicino personalis mier, 

aucilebelia Seyvanis adgilis mudmivi monitoringi, 

eqstravazaciis sawyisi niSnebis drouli amocnobisaTvis. 

ganyofilebaSi, aseve, unda arsebobdes eqstravazaciis 

Sedegebis aRmofxvris dokumenturad dadasturebuli 

protokoli. 

6.2.2. aRWurviloba kt angiografiisTvis: 

6.2.2.1. kt angiografiisTvis upiratesoba eniWeba multideteqtoruli 

(mravalSriani) skaneris gamoyenebas, Tumca es gamokvleva 

SeiZleba Sesruldes erT-deteqtoriani skaneriTac. 

aucilebelia heliakuri gamosaxulebis miReba. brunvis 

mTavari periodi maqsimum 1 wm da sasurvelia, ufro naklebic 

iyos. skaners unda SeeZlos sisxlZarRvTa mosazRvre 

struqturebis paTologiis aRmoCena da Seswavlac; 

62.2.2. kontrastuli nivTierebis Seyvana unda moxdes specialuri 

inJeqtoris saSualebiT, programirebadi moculobiTa da 

Seyvanis siCqariT; 

6.2.2.3. miRebuli monacemebis Semdgomi damuSavebisTvis, unda 

SegveZlos gamosaxulebis sxvadasxva sibrtyeSi 

rekonstruireba, maqsimaluri intensivobis proeqciebis miReba, 

agreTve, sisxlZarRvTa diametris da saWiroebis SemTxvevaSi, 

sigrZisa da mimarTulebis uSualod gansazRvra. 


6.2.3.1. uSualod, kt angiografiuli gamosaxulebebis miRebamde, 

sanaTurSida, an eqstravaskuluri hemoragiis, arteriuli 

kalcifikacebis arsebobis, an gamosakvlevi aris anatomiuri 

Taviseburebebis dasadgenad, SesaZloa saWiro gaxdes 

aragaZlierebuli spiraluri kompiuteruli tomografiis 

Catareba, romelic idealur SemTxvevaSi unda Sesruldes 

imave sisqis WrilebiT, rogorc kt angiografia, magram ar 

unda aRematebodes 5 mm-s; 

6.2.3.2. imis gamo, rom intravenurad Seyvanili kontrasti samizne 

sisxlZarRvamde mosaxvedrad saWiroebs sxvadasxva drois 

intervals, xSirad saWiro xdeba am drois winaswar gamoTvla, 

rac SeiZleba Sesruldes 2 sxvadasxva teqnikis gamoyenebiT: 

intravenuri kontrastis mcire bolusiT (mag. 10-15 ml) 

SeyvaniT da Semdeg gamosakvlevi sisxlZarRvis 

Tanmimdevrulad gadaRebiT _ sanaTuris gadidebis 

siCqaris da intensivobis mixedviT iqmneba dro-simkvrivis 

mrudi, romlis piki gamoiyeneba skanirebis dayovnebis 

gansazRvrisaTvis 

avtomaturi gamSvebi programis gamoyenebiT, rac 

dafuZnebulia kontrastis sruli doziT Seyvanidan 

gamosakvlev sisxlZarRvSi simkvrivis monitoringze. kt 

41

angiografia avtomaturad iwyeba, roca es maCvenebeli 

miaRwevs, operatoris mier, winaswar gansazRvrul dones. 

6.2.3.3. iodis Semcveli kontrastis Seyvana unda moxdes 3 ml/wm 

minimaluri siCqariT nebismier pacientSi, romelic iwonis 50 

kg-s, an ufro mets. Warbwonian pacientebisTvis, SesaZloa 

saWiro gaxdes kontrastis ufro maRali siCqariT (5 ml/wm da 

meti) Seyvana. ase, rom kontrastis saineqcio parametrebi 

TiToeuli pacientisTvis individualurad unda SeirCes. 

bavSvebSi kontrastis dozis SerCeva xdeba sxeulis masis 

mixedviT. kontrastis moculoba unda SeirCes pacientis masis 

da im Tanmxlebi daavadebebis arsebobis gaTvaliswinebiT, 

ramac SesaZloa gazardos nefrotoqsiurobis riski. 

gulmkerdis kt angiografiis Casatareblad, umjobesia, 

kontrastis Seyvana marjvena xelidan moxdes, raTa Tavidan 

aviciloT marcxena mxarTavis venaSi araganzavebuli 

kontrastis moxvedriT gamowveuli artefaqtebi. kontrastis 

Seyvanis Semdgom fiziologiuri xsnaris bolusiT Seyvanam 

SesaZloa Seamciros sisxlZarRvebis adekvaturi 

kontrastirebisaTvis saWiro kontrastis moculoba; 

6.2.3.4. kt angiografiis Sesrulebisas Wrilis nominalulri sisqe ar 

unda aRematebodes 3 mm-s, rekonstruqcia ki unda moxdes 

Wrilis sisqeze maqsimum 50 %-iani danamatiT. gadaReba unda 

Sesruldes iseTi gaZlierebiT, rom sisxlZarRvis sanaTuri 

naTlad iyos gamoxatuli. zogjer (mag., arteriebis 

stentirebis Semdgom gaJonvis, venebis anatomiisa da 

ureTraluri da renaluri Semkrebi sistemis gamokvlevisTvis) 

gamosaxulebebis gadaReba SesaZloa dagvWirdes dayovnebiT, 

rac sruldeba maqsimum 5 mm-iani WrilebiT; 

6.2.3.5. miRebuli monacemebis damuSaveba aucilebelia mravalsibrtyiani 

da/an samganzomilebiani algoriTmebiT im 

profesionalis mier, romelic kargadaa gaTviTcnobierebuli, 

rogorc kt angiografiis teqnikaSi, aseve kardiovaskuluri 

sistemis anatomiaSi. yvela gamosaxulebaze naTlad unda 

mieTiTos gamokvlevis mxare- marjvena, an marcxena. 


• skaneris tipi: erTSriani, mravalSriani, an eleqtronuli 

sxivis tipis. kardialuri kt angiografia unda Sesruldes, 

minimum 16 Srian skanerze 

• brunvis mTavari periodi: 1 wm, an naklebi 

eqstrakardialuri da 0,5 wm, an naklebi kardialuri kt 

angiografiisTvis 

• milis siTburi tevadoba, rac uzrunvelyofs saTiTao 

gadaRebas ≥ 20 wm 

• Wrilis sisqe: araumetes, 3 mm, sasurvelia 1,5 mm 

42

7. gulmkerdis gulmkerdis kompiuteruli kompiuteruli tomografia 

tomografia 

gulmkerdis kompiuteruli tomografia gulmkerdis anatomiisa 

da fiziologiis SefasebiT adgens gulmkerdis sxvadasxva 

daavadebis xasiaTs da Seiswavlis mis mimdinareobas. igi SeiZleba 

gamoyenebul iqnas rogorc pirveladi gamokvleva, an rogorc 

damatebiTi kvleva, magaliTad, gulmkerdis rentgenografiis Semdeg. 


Cvenebebi: 

• gulmkerdis rentgenogramaze aRmoCenili cvlilebebis 

Sesafaseblad. 

• gulmkerdis paTologiis klinikuri eWvis arsebobisas. 

• filtvisa da gulmkerdis sxva pirveladi avTvisebiani 

simsivneebis diagnostirebis, Sefasebis, stadiis dadgenisa 

da Semdgomi dakvirvebisTvis. 

• dadgenili eqstraTorakaluri daavadebebis Torakaluri 

manifestaciebis Sesafaseblad 

• dadgenili an saeWvo gulmkerdis vaskuluri anomaliebis 

(Tandayolili an SeZenili) SefasebisTvis 

• dadgenili an saeWvo gulmkerdis Tandayolili 

anomaliebis SefasebisTvis 

• filtvis parenqimuli da haergamtari gzebis daavadebebis 

diagnostikisa da Semdgomi dakvirvebisTvis 

travmis Sesafaseblad 

• post-opercaiuli pacientebis da qirurgiuli 

garTulebebis SefasebisTvis 

• kompiuteruli tomografiis fonze intervenciuli 

procedurebis CatarebisTvis 

• gulmkerdis kedlis Sesafaseblad 

• plevraluri daavadebebis Sesafaseblad 

• sxivuri Terapiis mkurnalobis gegmis CamoyalibebisTvis 

7.2. 7.2. kvlevis kvlevis specifika specifika 

specifika 

7.2.1. gamoklvevis teqnika: 

7.2.1.1. gulmkerdis tipuri kompiuteruli tomografia unda 

moicavdes aqsialur gamosaxulebebs filtvebis 

mwvervaloebidan kostofrenul Rarebamde. Wrilis sisqe ar 

unda aRematebodes 5 mm-s da rekonstruqciis intervalebi 

unda udrides, an naklebi iyos Wrilis sisqeze. garkveul 

klinikur situaciebSi, magaliTad, kvanZebis arsebobis 

SemTxvevaSi, fokaluri paTologiuri ubnebi SeiZleba 

43

gadaviRoT 1-2 mm sisqis WrilebiT. kvlevis Casatareblad 

SesaZlebelia gamoyenebul iqnas safexureobrivi erTSriani 

teqnika, erTeul-deteqtoruli helikaluri (spiraluri) 

teqnika, an multi-deteqtoruli helikaluri (spiraluri) 

teqnika; 

7.2.1.2. gamokvlevebis umetesoba unda Catardes sunTqvis erTsa da 

imave fazaSi da sasurvelia, sruli CasunTqvis fonze. 

zogierTi paTologiis, magaliTad, traqeomalaciis 

Sesafaseblad kvleva sunTqvis dros tardeba. gadaReba 

SesaZlebelia Catardes amosunTqvis fazaSic, Tu gvinda 

davadginoT haeris Sekavebis arseboba. sxivuri Terapiis 

dasagegmad SeiZleba dagvexmaros skanireba sunTqvis fazebis 

TesinqronizaciiT (respiratory-gated). gamokvleva unda Cautardes 

mTlianad CvenTvis saintereso ubans; 

7.2.1.3. gamokvleva SesaZlebelia Catardes, rogorc kontrastiT, aseve 

misi gamoyenebis gareSec; 

7.2.1.4. gamosaxulebis damuSaveba unda moxdes iseT algoriTmSi, 

rom SevZloT filtvis parenqimis, Suasayarisa da gulmkerdis 

kedlis struqturebis, da Zvlebis optimaluri daTvaliereba; 

7.2.1.5. pediatriul pacientebSi gadaReba unda vawarmooT minimaluri 

dasxivebiT, rasac SesaZlebelia mivaRwioT magidis daxris 

gazrdiT da dabali energiis maionizirebeli radiaciis 

gamoyenebiT; agreTve, unda moxdes mkerdis, farisebri 

jirkvlis da Tvalis brolis radiaciisagan dacva 

specialuri damcavi saSualebebis gamoyenebiT. moZraobasTan 

dakavSirebuli artefaqtebis Semcirebas SesaZlebelia 

mivaRwioT xanmokle skanirebiT da pacientis sedaciiT. 


• skanirebis dro: ≤ 2 wm 

• Sris sisqe: ≤ 2 mm (sasurvelia, ≤ 5 mm) 

• sivrciTi rezolucia: ≥ 8 lp/cm, Tu monitori ≥ 32 cm (DFOV), an ≥ 10 lp/cm, 

Tu monitori < 24 cm (DFOV) 

• magidis daxra: ar unda aRematebodes 2:1 erTSriani helikalurdeteqtoruli 

skanerisaTvis. 

44

8. kompiuteruli kompiuteruli kompiuteruli tomografia tomografia pulmonuri pulmonuri embolizmis 

embolizmis 

gamosavlenad 

gamosavlenad 

intravenurad kontrastuli nivTierebis (iodizirebuli) ineqciis 

Semdgom, swrafi helikaluri (spiraluri) kt skanireba saSulebas 

gvaZlevs gamovikvlioT filtvis sisxlZarRvovani struqtura.Y am 

teqnikiT SesaZlebelia helikaluri kt angiografiis gamoyeneba 

pulmonuri embolizmis pirdapiri vizualizaciisaTvis. 

helikaluri kt-s mTavari mizani pulmonuri embolizmis 

dadgenaa. Bbevr pacientSi, es SedarebiT arainvaziuri testi 

anacvlebs ventilaciur\perfuziul skanirebas da kidev ufro 

invaziur, kaTeterul angiografias. 

8.1. 8.1. Cvenebebi Cvenebebi Cvenebebi da da riskebi riskebi: riskebi 

8.1.1. Cvenebebi: 

• pulmonuri embolizmis pirveladi diagnostirebisTvis, 

im pacientebSi, romelTac aReniSnebaT am diagnozis 

Sesabamisi klinikuri, laboratoriuli da 

radiografiuli monacemebi 

• pulmonuri embolizmis savaraudo diagnozis 

dasazusteblad, im pacientebSi, romelTaTvisac gulis, 

an filtvis daavadebis gamo, ventilaciur\perfuziuli 

skanirebis Catareba arainformatiuli iqneba 

• ventilaciur\perfuziuli skanirebis Semdgom, diagnozi 

arasakmarisadaa klinikurad dasabuTebuli: rodesac 

xdeba pulmonuri embolizmis swrafi diagnostireba 

• pacientebi, qronikuli pulmonuri hipertenziiT 

(SesaZlebelia, centraluri emboliis Semdgomi), 

gansakuTrebiT, pulmonuri Tromboendareqtomiis 

savaraudo kandidatebi 

• pacientebi, romelTaTvisac kaTeteruli pulmonuri 

arteriografia ukunaCvenebi. 

8.1.2. riskebi: 

• iodizirebuli kontrastuli nivTierebis SeyvanasTan 

dakavSirebuli riskebia: hipermgrZnobelobiTi reaqciebi, 

Tirkmlis toqsiuroba da rbil qsovilebSi 

eqstravazacia. pacientebs, romelTac kontrastuli 

nivTierebis mimarT aReniSnebaT hipermgrZnobelobiTi 

reaqcia an Tirkmlis ukmarisobaGwarmoadgenen 

gansakuTrebul risk jgufs da maT mimarT 

gaTvaliswinebuli unda iyos profilaqtikuri 

45

RonisZiebebis gatareba (maT Soris, medikamenturic), 

raTa SevamciroT ganmeorebiTi alergiuli reaqciebi da 

nefrotoqsiuroba; 

• Tu pacients aReniSneba taqipnoe, man SesaZloa ver 

SeZlos sunTqvis Sekaveba, an mSvidad sunTqva, rac 

gamoiwvevs arainformatiuli gamosaxulebis miRebas. 

aseTi pacientebisTvis rekomendebulia sxva 

diagnostikuri kvlevis Catareba 

• aRsaniSnavia, rom pulmonuri kompiuteruli 

tomografiis dros sarZeve jirkvalze dasxiveba Zalian 

maRalia (SesaZloa 10-jer aRematebodes mamografiisas); 

amitom, es teqnika gansakuTrebuli sifrxiliT unda 

gamoviyenoT axalgazrda gogonebSi, radgan am asakSi 

gansakuTrebuladaa gamoxatuli radiaciis 

karcinogenuli efeqtebi. Tu kvlevis Catareba 

aucilebelia, maSin aucileblad unda gamoviyenoT 

mkerdis damcavis fari. rogorc qalebSi, aseve 

mamakacebSi, aucilebelia farisebri jirkvlis dacvac 

8.2. 8.2. kvlevis specifika specifika: 

specifika 


• Wrilis sisqe ≤ 3 mm 

• ganakveTebs Soris daSoreba ≤ Wrilis sisqeze 

• sigrZivi dafarva _ mTliani gulmkerdi (Tu es 

SesaZlebelia mocemuli xelsawyosTvis) 

• skanirebis dayovneba ineqciis dawyebis Semdgom: empiriuli 

dayovneba 10-12 wm arteriuli gaZlierebisTvis da 15-25 wm 

arteriuli da venuri gaZlierebisTvis. SesaZlebelia. 

agreTve, individualuri dayovnebis gamoTvla, 

gansakuTrebiT, Tu savaraudoa, rom igi gaxangrZlivebulia 

• ganivi gamosaxuleba _ neknis gareTa zedapiridan gareTa 

zedapiramdeE gulmkerdis maqsimaluri siganis doneze 

• xedis sigane da done _ modificirebuli Suasayris 

xedebi emboliis dasadgenad; filtvis xedebi sasunTqi 

gzebis, filtvis parenqimisa da pnevmoToraqsis dasadgenad 

• gamosaxulebis damuSaveba _ rbili qsovilebis 

rekonstruqciis algoriTmi 

• kontrastuli nivTierebis Seyvana _ kontrastis 

koncentracia, ineqciis siCqare da moculoba ise unda 

iqnas SerCeuli, rom vuzrunvelyoT filtvis 

sisxlZarRvebis vizualizacia (80-150 ml, minimum 300 mg% 

dabali, an izo-osmolaruli kontrasti 3-5wv\wm-Si dabali, 

an izo-osmolaruli kontrastis gamoyeneba amcirebs 

Rebinebis albaTobas da kontrastis kanqveSa 

46

eqstravazaciiT gamowveul gverdiT efeqtebs. 

sisxlZarRvebis vizualizaciisTvis aucilebelia, rom 

kontrastis Seyvana moxdes maRali siCqariT, rac unda 

ganxorcieldes intravenuri kaTeteriT (Cveulebriv, 

gamoiyeneba 20 an met geijiani, idayvis doneze, an ufro 

zemoT. 


• skaneris tipi: erT_rigiani, mraval-rigiani helikaliri, an 

eleqtronuli sxivis tipis 

• brunvis mTavari periodi: 1 wm, an naklebi 

• milis siTbuli tevadoba, rac uzrunvelyofs saTiTao 

gadaRebas 

• Wrilis sisqe: ≤ 3 mm 

• magidis daxra: ar unda aRematebodes 2:1 erT-rigiani 

helikalur-deteqtoruli skanerisaTvis 

• sivrciTi rezolucia: minimum 512 matriqsi 

• Tu SesaZlebelia, an es ar axdens gavlenas gamosaxulebis 

xarisxze, unda gamoviyenoT milis nakadis modulacia. 

9. muclisa uclisa da da menjis menjis Rrus Rrus kompiuteruli kompiuteruli tomografia 

tomografia 

tomografia 

muclisa da menjis Rrus kompiuteruli tomografia aris 

radiografiuli kvlevis meTodi, romelic gamoiyeneba muclisa da 

menjis Rrus daavadebebis diagnostikaSi. igi unda Catardes 

mxolod dasabuTebuli samedicino Cvenebis SemTxvevaSi, minimaluri 

radiaciuli dozis gamoyenebiT, romelic sakmarisi iqneba 

optimaluri gamosaxulebis misaRebad. 

9.1. 9.1. 9.1. Cvenebebi: Cvenebebi: 

Cvenebebi: 

• tkivili muclis, ferdisa da menjis areSi 

• muclis, an menjis masebi, an siTxis dagroveba (dadgenili, 

an savaraudo) 

• muclis, an menjis pirveladi, an metastazuri simsivneebi 

• muclis, an menjis anTebiTi procesebi 

• muclis, an menjis vaskuluri paTologiebi 

• muclis, an menjis travma 

• sxva instrumentul-laboratoriuli klevebiT dadgenili 

diagnozis dazusteba 

47

• muclis, an menjis Tandayolili paTologiebi (dadgenili, 

an savaraudo) 

• muclis, an menjis areSi intervenciuli, an Terapiuli 

procedurebis warmarTvisaTvis 

• radiaciuli Terapiis win mkurnalobis dasagegmavad 

9.2. 9.2. kvlevis kvlevis specifika specifika. 

specifika 


9.2.1.1. muclis kompiuteruli tomografia unda moicavdes 

transaqsialur ganiv Wrilebs diafragmis TaRidan gava-TeZos 

saxsrebamde, romelTa sisqe ar unda aRematebodes 8 mm-s. 

menjis kompiuteruli tomografia unda moicavdes Wrilebs 

TeZos qedidan sajdom borcvamde, romelTa sisqe aseve ar 

unda aRematebodes 8 mm-s. xSirad, klinikuri situaciidan 

gamomdinare orive gamokvleva erTdroulad unda Catardes. 

muclisa da menjis kompiuteruli tomografia SeiZleba 

warimarTos safexureobrivi erT-Sriani teqnikiT, an 

multideteqtoruli helikaluri protokoliT; 

9.2.1.2. garda, pirdapiri gziT miRebuli aqsialuri gamosaxulebebisa, 

am monacemebisagan specifiur klinikur kiTxvebze sapasuxod, 

diagnozis dasazusteblad, an intervenciuli Tu qirurgiuli 

procedurebis warmarTvisaTvis SesaZlebelia koronaluri, 

sagitaluri da sxva ufro rTuli iribi sibrtyeebis miRebac. 

damatebiT, SesaZlebelia specifiuri struqturebis 

seleqtiuri warmodgenac, rac xorcildeba kompiuteruli 

angiografiiT, urografiiT, virtualuri kolonografiiT da 

sxv.. es procesi ukeTesad xorcieldeba multideteqtoruli 

skaneriT miRebuli gamosaxulebebis gamoyenebiT; 

9.2.1.3. muclis da/an menjis zogierTi kompiuteruli kvlevisTvis 

SesaZlebelia saWiro gaxdes mravali gamosaxulebis gadaReba, 

rac, Tu SesaZlebelia, umjobesia moxdes Sekavebuli sunTqvis 

fonze. radiaciuli Terapiis dasagegmavad gamokvleva tardeba 

normaluri sunTqvis fonze; 

9.2.1.4. intraluminaluri gastrointestinuri kontrasti, ukuCvenebis 

ararsebobis SemTxvevaSi, SeiZleba SeviyvanoT peroralurad, 

reqtalurad, an nazogastraluri zondis saSualebiT, raTa 

movaxdinoT gastrointestinuri traqtis ukeTesi 

vizualizacia. am mizniT SeiZleba mravali tipis kontrastis 

gamoyeneba, rogorebicaa: ganzavebuli bariumi, wyalSi xsnadi 

iodizirebuli xsnari, neitraluri kontrasti (wyali, an 

araabsorbirebadi agenti), an negatiuri kontrasti (haeri, an 

naxSirorJangi); 

9.2.1.5. zogierTi klinikuri Cveneba saWiroebs intravenuri 

kontrastis gamoyenebas, rac unda moxdes Sesabamisi 

protokolis zusti dacviT; 

48

9.2.1.6. gamosaxulebis daTvaliereba unda moxdes iseT algoriTmSi, 

rom SesaZlebeli iyos visceraluri organoebis, intraabdominaluri 

cximis, filtvebis fuZis parenqimis da 

Zvlovani struqturebis optimaluri daTvaliereba. 


� skanirebis dro: ara umetes 2 wamisa 

� anaTalis sisqe: ara umetes 2 mm-isa 

� skanirebebs Soris intervali: 1 wm, Tumca SesaZloa iyos 

odnav meti, Tu ar gamoiyeneba intravenuri kontrasti 

� sivrciTi rezolucia: ≥ 8 lp/cm, Tu monitori ≥ 32 cm 

(DFOV), an ≥ 10 lp/cm, Tu monitori < 24 cm (DFOV) 

10. 10. 10. kompiuteruli kompiuteruli tomogr tomografia tomogr afia kolonagrafiiT (kt 

kolonografia) 

kolonografia) 

kt kolonografia kvlevis metad informatiuli meTodia 

msxvili nawlavis gamosakvlevad da SeiZleba gamoyenebul iqnas, 

rogorc kvlevis sawyisi meTodi, an kolonoskopiis alternatiulad, 

rodesac am ukanasknelis gamoyeneba ukunaCvenebia an dakavSirebulia 

mniSvnelovan samedicino riskTan, magaliTad antikoagulaciur 

Terapiaze myof pacientebisTvis, an im SemTxvevaSi Tu sedacia ar aris 

mizanSewonili. am radiologiuri gamokvlevis mizania, daadginos 

koloreqtaluri neoplaziis arseboba, an ararseboba im minimaluri 

radiaciuli dozis gamoyenebiT, rac uzrunvelyofs optimaluri 

xarisxis gamosaxulebis miRebas. 

kt kolonografia SeiZleba Catardes sami sxvadasxva mizeziT: 

skriningis, monitoringisa da diagnostikisTvis. 

skrininguli miznebisTvis am gamokvlevis gamoyeneba efuZneba 

mtkicebaze dafuZnebul ramdenime dokuments, romelTa mixedviT, 

usimptomo adamianebidan SeiZleba moxdes im jgufebis identificireba, 

romelTac sxvebze metad aqvT gamoxatuli koloreqtaluri simsivnis, 

an adenomatozuri polipis ganviTarebis Sansi: magaliTad, 50 wels 

gadacilebuli adamianebi, yovelgvari sxva risk-faqtorebis gareSec, 

ganxilulni arian, rogorc saSualo riskis mqoneni.; is adamianebi, 

romelTac pirveli rigis (deda, mama, Zma an Svili) erT naTesavs, 60 

wlamde asakSi, an ramdenimes, nebismier asakSi daesva koloreqtaluri 

neoplaziis diagnozi, ganixilebian rogorc gazrdili an saSualoze 

maRali riskis mqone pirebi; pacientebi nawlavis anTebiTi daavadebis 

xangrZlivi, an genetikuri daavadebis istoriiT, ganixilebian rogorc 

maRali riskis mqoneni. 

49

monitoringi gulisxmobs ukve diagnostirebuli koloreqtaluri 

simsivnis an nawlavis anTebiTi daavadebis mqone pacientebis Semdgom 

dakvirvebas. riskis xarisxi SeiZleba damokidebuli iyos mimdinare an 

adre gadatanil paTologiaze. 

sadiagnostiko gamokvleva sruldeba simptomebis mqone 

pacientebSi, romelTac aqvT koloreqtaluri neoplaziis aRmoCenis 

maRali Sansi. 

10.1. 10.1. Cvenebebi: Cvenebebi: 

Cvenebebi: 

� im adamianebis skrininguli kvleva, romelTac aReniSnebaT 

koloreqtaluri simsivnis ganviTarebis saSualo, an 

gazrdili riski, an hyavT pirveli rigis naTesavi 

koloreqtaluri neoplaziis istoriiT 

� im pacientebis monitoringi, romelTac aqvT msxvili nawlavis 

keTilTvisebiani, an avTvisebiani simsivnis istoria 

� sadiagnostiko gamokvleva dadgenili, an adre gadatanili 

koloreqtaluri simsivnis mqone pacientebSi da agreTve, 

iseTi simptomebis mqone pacientebSi, rogorebicaa: 

abdominaluri tkivili, diarea, Sekruloba, 

gastrointestinaluri sisxldena, anemia, nawlavis 

obstruqcia, wonis daqveiTeba da sxv. 

� skrininguli, monitoringis, an sadiagnostiko mizniT 

Catarebuli arasruli kolonoskopiis Semdgom 

� pacientebi romlebic saWiroeben kolonoskopias, magram 

imyofebian antikoagulaciur Terapiaze. 


specifika 

10.2.1. msxvili nawlavis momzadeba: 

msxvili nawlavis momzadebisaTvis aucilebelia Semdegi 

RonisZiebebis Catareba: sakvebis SezRudva, hidracia, osmosuri 

da kontaqturi safaRaraToebis gamoyeneba. msxvili nawlavis 

momzadebis mizania moxdes nawlavis gawmenda fekaluri 

masebisa da zedmeti siTxisagan. SesaZlebelia pacients 

Cautardes lavaJi polieTilenis glikolis xsnariT, Tumca 

amas SeiZleba mohyves zedmeti rezidualuri siTxis darCena 

nawlavSi. ar arsebobs sakmarisi mtkicebuleba peroraluri 

kontrastis rutinulad gamoyenebis rekomendirebisTvis; 


� reqtaluri milis Cadgmamde unda SevkriboT Sesabamisi 

anamnezi da gavsinjoT pacienti 

� reqtaluri milis Cadgma unda moxdes eqimis, an 

trenirebuli asistentis (radiologiis laborantis, eqTnis 

an eqimis asistentis) mier. Tu swor nawlavSi Seyvanilia 

retenciuli baloni, misi gaberva unda Sewydes tkivilis 

dawyebisTanave, radganac tkivilis ganviTareba SeiZleba 

miuTiTebdes perforaciis riskis gazrdaze 

50

� mniSvnelovani spazmis, an pacientis diskomfortis 

mosaxsnelad SesaZlebelia antispazmuri agentis, 

magaliTad, glukagonis gamoyeneba 

� nawlavis srulyofilad gabervisaTvis nawlavebSi oTaxis 

haeris, an naxSirorJangis Seyvana SeiZleba moxdes 

meqanikurad, an eleqtronulad 

� kt kolonografiis dawyebamde unda davrwmundeT, rom 

msxvili nawlavi srulyofiladaa gadaberili (gadaviRoT 

suraTi) 

� msxvili da swori nawlavebis sruli anatomiuri suraTis 

misaRebad, gadaReba unda vawarmooT guldaRma poziciaSi 

� saskriningo gamokvlevebi unda Sesruldes dabali dozis, 

aragaZlierebuli kt teqnikis saSualebiT _ Cveulebriv, 

kVp=120, da mAs ≤ 100. pirveladi organzomilebiani 

interpretaciisaTvis sakmarisia iseTi dabali dozac, 

rogoricaa 10 mAs , magram pirveladi samganzomilebiani 

gamokvleva saWiroebs 50-100 mAs dozas. optimaluri 

gamosaxulebis misaRebad, didi zomis, an metalis 

inplantebis mqone pacientebi saWiroeben ufro maRal 

dozebs 

� ukuCvenebis ararsebobis SemTxvevaSi, diagnostikuri 

gamokvleva unda Sesruldes intravenuri kontrastuli 

nivTierebis SeyvaniT da standartuli kt parametrebiT 

(kVp=120, mAs > 200). diagnostikuri kvlevebisas, didia 

koloreqtaluri simsivnis aRmoCenis albaToba da aseT 

SemTxvevaSi, erTdroulad unda moxdes daavadebis stadiis 

dadgena 

� optimalur SemTxvevaSi, kt kolonografia unda Sesruldes 

multideteqtorul skanerze (MDCT), 3 mm-ze naklebi Sreebs 

Soris dacilebiTa da 1,5 mm-ian rekonstruqciuli 

intervaliT. sunTqvis Sekavebam ar unda gadaaWarbos 25 

wams (maqsimum, Sreebs Soris dacileba 5 mm, 

rekonstruqciuli intervali 2,5 mm) 

� unda arsebobdes qseluri uzrunvelyofa raTa moxdes 

gamosaxulebaTa monacemebis gadagzavna samuSao oTaxSi da 

specialuri programa kt kolonografiis 

interpretaciisTvis; 

10.2.3. monacemebis interpretireba 

kt kolonografiis mizania, rom moxdes msxvili nawlavis 

gamokvleva klinikurad mniSvnelovani neoplazmebis 

arsebobis, an ararsebobis dasadastureblad. SesaZlo 

paTologiebi moicavs, rogorc lorwovanis diskretul 

amoburcvebs (avTvisebiani, an avTvisebianad gardaqmnis 

riskiT), aseve infiltraciul simsivneebs. 

51

polipebis zomebi unda ganisazRvros, sul mcire, or 

sibrtyeSi mravalsibrtyiani rekonstruqciiT da/an 

samganzomilebiani gamosaxulebiT (zomad unda CaiTvalos 

udidesi Sedegi). unda dafiqsirdes warmonaqmnis morfologia 

(umoZrao, fexiani, brtyeli) da segmentaluri mdebareoba 

10.2.3.1. kt kolonografiuli monacemebis intepretireba unda moxdes 

specialuri programiT, romelic saSualebas iZleva 

erTdroulad miviRoT aqsialuri, mravalsibrtyiani 

reformatuli da samganzomilebiani endoluminaluri 

gamosaxuleba. unda iyos vertikalur da guldaRma 

poziciebSi gadaRebuli gamosaxulebebis erTdrouli 

daTvalierebis da fanjris siganisa da donis swrafi cvlis 

saSualeba. monacemebis interpretaciisTvis SeiZleba 

gamoviyenoT pirveladi organzomilebiani, an pirveladi 

samganzomilebiani teqnika 

10.2.3.2.pirveladi organzomilebiani teqnika: 

msxvili nawlavis ganivi gamosaxulebebis daTvaliereba xdeba 

filtvebisa da rbili qsovilis algoriTmiT mTel sigrZeze _ 

anoreqtaluri SeerTebidan brma nawlavamde _ sanaTursSida 

polipebis da kedlebis gasqelebis aRmosaCenad. 

� aqsialuri daTvalierebiT, paTologiaze eWvis mitanis 

SemTxvevaSi, dazianebis morfologiis Sefaseba unda 

moxdes mravalsibrtyiani rekonstruirebiT da 

endoluminaluri gamosaxulebebiT 

� paTologiis mobilurobis Sesafaseblad (narCeni fekaluri 

masala, fexiani polipi, an msxvili nawlavis segmenti 

grZeli jorjliT) unda SeviswavloT, rogorc 

vertikalur, aseve guldaRma poziciaSi gadaRebuli 

gamosaxulebebi 

� gamosaxulebis damuSaveba iseTi algoriTmiT unda moxdes, 

rom SegveZlos gansazRvra, dazianeba homogenuria, Tu 

heterogenuri 

10.2.3.3.pirveladi samganzomilebiani teqnika: 

samganzomilebiani teqnikiT msxvili nawlavis zedapiris 

srulyofili vizualizaciisTvis misi daTvaliereba unda 

movaxdinoT ori mimarTulebiT: anterogradulad (brma 

nawlavidan swor nawlavamde) da retrogradulad (swori 

nawlavidan brma nawlavamde). endoluminalur gamosaxulebaze 

polipisTvis damaxasiaTebeli morfologiuri Tvisebebis 

(mrgvali, ovaluri, an wilovani) mqone darRvevis aRmoCenis 

SemTxvevaSi, unda moxdes monacemTa organzomilebiani 

interpretaciac paTologiis hetero, Tu homogenurobisa da 

mobilurobis Sesafaseblad. 

10.2.4. xarisxis kontrolis moTxovnebi: 

52

� unda moxdes msxvili nawlavis adekvaturi gawmenda da 

gadaberva, rac sakmarisi unda iyos 1 sm-iani, an ufro didi 

zomis polipis aRmosaCenad 

� unda moxdes msxvili da swori nawlavis yvela nawilis 

srulyofili vizualizacia 

� yvela orazrovan radiografiul kiTxvaze pasuxi unda 

gaices manam, sanam pacienti datovebs ganyofilebas. 

saWiroebis SemTxvevaSi unda gadaviRoT damatebiTi 

fokusirebuli gamosaxulebebi, Tavidan unda gadaviRoT is 

ubnebi, romelTa gamosaxuleba araoptimaluria, an 

gadaRebebi vawarmooT dekubitus poziciaSi 

� SesaZleblobis SemTxvevaSi unda veZeboT korelacia 

radiologiur, endoskopiur da paTologiur monacemebs 

Soris 

� unda ganisazRvros da periodulad monitorirdes 

koloreqtaluri simsivnis, an 1 sm an meti polipebis 

dadgenis sixSire (aseTi zomis polipebis mosalodneli 

gavrceleba 3-10%-ia). polipis aRmoCenis yvela SemTxvevaSi 

unda dokumentirdes cru dadebiTi pasuxis sixSire. 

53


Sesavali 



ultrasonografia kvlevis informatiuli da mravalnacadi 

meTodia, romelic maRali sixSiris ultrabgeras iyenebs, rogorc 

gamosaxulebis misaRebad, aseve dopleruli gazomvebisTvis. 

miuxedavad imisa, rom mravalwliani gamocdilebiT 

dadgenilia ultrabgeriTi kvlevis usafrTxoeba (diagnostikuri 

kvlevebisTvis sakmarisi Zalis ultrabgeris SemTxvevaSi), xarisxis 

kontrolis moTxovnebis Sesabamisad, is unda Catardes mxolod 

Sesabamisi CvenebiT, am dargSi trenirebuli samedicino personalis 

mier, gamarTuli samedicino aparaturis gamoyenebiT da xarisxiani 

kvlevis Casatareblad sakmarisi umciresi eqspoziciiT. 

ansxvaveben ultrasonografiis mraval saxes, romelTaganac 

zogierTs (kvlevebi, romlebic sruldeba saCxeris samedicino 

centrSi) Cven dawvrilebiT ganvixilavT. 




erTad warmovadgenT dokumentis zogad nawilSi. calkeuli 

kvlevebisTvis konkretuli moTxovnebi asaxulia dokumentis 

Sesabamis nawilebSi. 

2. 2. zogadi zogadi zogadi nawili 

nawili 

2.1 personalis personalis kvalifikacia kvalifikacia da da val valdebulebebi 

val ebulebebi 

2.1.1. ultrasonografia unda Catardes sertificirebuli eqimiradiologis 

mier, romlis kompetenciis donis 

SesanarCuneblad aucilebelia, rom is weliwadSi 

atarebdes minimum 100 sxvadasxva ultrasonorafiul 

kvlevas. man, aseve monawileoba unda miiRos mudmivi 

samedicino swavlebis aqtivobebSi (axali samedicino 

literaturis gacnoba, Tematuri konferenciebi aqtualur 

Temebze da sxv.); 

2.1.2. eqimi kargad unda iyos gaTviTcnoebierebuli iseT 

sakiTxebSi, rogorebicaa: 

� utrabgeris fizikis ZiriTadi principebi 

� sxvadasxva tipis ultrabgeriTi kvlevis Cvenebebi 

� gamosakvlevi organoebis anatomiis, fiziologiis da 

paTofiziologiis sakiTxebi 

54

� ultrabgeriTi kvlevis teqnologia: mowyobilobis 

kalibracia, ultrabgeris Zalis da eqspoziciis Secvla 

da sxv. 

2.2. 2.2. kvlevis kvlevis dokumentacia 

dokumentacia 

2.2.1. 2.2.1. ultrasonografia unda Catardes mxolod kvlevis SemkveTi 

eqimis werilobiTi moTxovnis safuZvelze, romelSic 

dadasturebuli iqneba kvlevis samedicino saWiroeba 


2.2.2. 2.2.2. axali gamosaxulebebi unda Sedardes adrindel Sedegebs 

da/an sxva xelTarsebul kvlevis monacemebs; 

2.2.3. 2.2.3. kvlevis pasuxi unda Seicavdes mTel rig aucilebel 

komponentebs, rogorebicaa: 


monacemebi 

monacemebi kvlevis Semsrulebeli dawesebulebis 

dasaxeleba, pacientis saxeli, gvari da saidentifikacio nomeri, 

kvlevis SemkveTi eqimis monacemebi, ultrasonografiuli kvlevis 

tipi, kvlevis TariRi 





� daskvniTi daskvniTi daskvniTi daskvniTi nawili: nawili nawili nawili zusti ultrasonografiuli diagnozi, 

saWiroebis SemTxvevaSi, sxva diagnostikuri kvlevis Catarebis 

rekomendacia 

2.2.4. sasurvelia, rom ultrasonografiuli kvlevis pasuxis 

asli (eleqtronuli, an werilobiTi) inaxebodes kvlevis 

Semsrulebeli kabinetis arqivSi; 

2.2.5. zogierT SemTxvevebSi kvlevis pasuxi SeiZleba gaices 

arastandartuli formiT – verbaluri, an arasruli 

werilobiTi, rac mogvianebiT aucileblad unda Seicvlos 

sworad Sevsebuli pasuxiT. aseTi SemTxvevebia: gadaudebeli, 

an saswrafo situaciebi, an rodesac radiologi eqimi cvlis 

imave kvlevaze adre dasmul diagnozs (azustebs diagnozs). 

2.3. 2.3. 2.3. xarisxis kontroli 

ultrasonografia moiTxovs xarisxis kontrolis (QC) Semdegi 

procedurebis gatarebas: 

2.3.1. yvela kvleva sruldeba winaswar SemuSavebuli protokolis 

mixedviT. kvlevis pasuxi iwereba sertificirebuli eqimiradiologis 

mier; 

2.3.2. winaswar gansazRvruli periodulobiT da wesebiT unda 

moxdes samedicino aparaturis teqnikuri Semowmeba da 

monitoringi. aseve, winaswar unda iqnas gansazRvruli im 

piris vinaoba, vinc pasuxismgebelia aRniSnul procesis 

Catarebaze. 

55

2.4. 2.4. radiaciuli usafrTxoeba 

2.4.1. ultrasonografia unda Catardes im minimaluri eqspoziciiT, 

rac sakmarisia optimaluri gamosaxulebis misaRebad; 

2.4.2. yvela kvleva unda Catardes Sesabamisi samedicino CvenebiT; 

3. abdominaluri abdominaluri aortis ultrasonografia 

abdominaluri aortis ultrasonografia SesaZlebelia 

Catardes, rogorc sadiagnostiko, aseve skrininguli miznebisTvis. 

E 

3.1 3.1 Cvenebebi da da ukuCvenebebi: 

3.1.1. abdominaluri aortis anevrizmis diagnostika: 

• palpirebadi mopulsire abdominaluri masa. 

• zurgis qveda nawilis, an muclis auxsneli tkivili. 

• kidurebis dadgenili anevrizmuli daavadeba. 

• im pacientebis ganmeorebiTi kvleva, romelTac ukve 

dadgenili aqvT abdominaluri aortis anevrizmis 

diagnozi. 

• im pacientebis kvleva, romelTac Catarebuli aqvT 

aortis, an TeZos arteriis endoluminaluri Suntireba. 

3.1.2. abdominaluri aortis anevrizmis skrininguli kvleva: 

� 65 wlis, an ufro xandazmuli mamakacebi. 

� 65 wlis, an ufro xandazmuli qalebi gul-sisxlZarRvTa 

daavadebis risk-faqtorebiT (arteriuli hipertenzia, 

mwevelebi da sxv.) 

� aortis an periferiuli sisxlZarRvebis anevrizmuli 

daavadebis ojaxuri istoria, gansakuTrebiT aortis 

anevrizmis mqone pirTa pirveli rigis naTesavebi. 

muclis aortis ultrasonogarfiuli kvlevis absoluturi 

ukuCveneba ar arsebobs, Tumca, rodesac eWvia aortis 

rupturasa, an ganSrevebaze, ultrasonografia ar iTvleba 

oqros standartad. 

3.3. 3.3. kvlevis kvlevis kvlevis specifika specifika. 

specifika specifika 

3.2.1. abdominaluri aortis anevrizmis diagnostika 

3.2.1.1. muclis aorta 

56

3.2.1.1.1. ganivi gamosaxulebebi 

proqsimaluri (diafragmasTan axlos). 

Sua 

distaluri. 

sigrZivi gamosaxulebebi wina-ukana gazomvebiT 

proqsimaluri (diafragmasTan axlos) 

Sua 

distaluri 

3.2.1.2. TeZos arteriebi 

� marjvena da marcxena saerTo TeZos arteriebis 

proqsimaluri ganivi gamosaxulebebi bifurkaciasTan. 

� marjvena da marcxena saerTo TeZos arteriebis 

proqsimaluri sigrZivi gamosaxulebebi bifurkaciasTan 

wina-ukana gazomvebTan erTad 

3.2.1.3. dopleruli kvleva (feradi da/an speqtruli dopleriT), 

gansakuTrebiT im pacientebisTvis, romelTac Catarebuli aqvT 

aortis, an TeZos arteriis endoluminaluri Suntireba 

3.2.1.4. muraluri Trombozis dokumentireba misi arsebobis 

SemTxvevaSi 

3.2.1.5. yvela gazomva unda Sesruldes aortis sigrZivi RerZis 

perpendikularulad gareTa kedlidan gareTa kedlamde. 

anevrizmis aRmoCenis SemTxvevaSi fiqsirdeba misi 

maqsimaluri AP diametri _ unda moxdes am gamosaxulebis 

Cawerac. Tu sigrZiv gamosaxulebaze ver xerxdeba anevrizmis 

kideebis zustad verificireba, unda gaizomos misi ganivi 

diametric. SesaZleblobis SemTxvevaSi, unda ganisazRvros 

urTierTdamokidebuleba dilatirebul segmentsa da 

Tirkmlis arteriebs Soris. 

3.2.1.6. sxvadasxva mkvlevarebs Soris gazomvebis sxvaoba SesaZloa 

meryeobdes 5 mm-s farglebSi. amis gamo, imisaTvis, rom 

ganvszRvroT Seicvala Tu ara, an ramdenad mniSvnelovnad 

Seicvala zomebi, aucilebelia wina kvlevebis monacemebTan 

Sedareba 

3.2.2. abdominaluri aortis anevrizmis skrininguli kvleva: 

3.2.2.1. muclis aorta 

3.2.2.1.1. ganivi gamosaxulebebi 


Sua 

distaluri 

sigrZivi gamosaxulebebi wina-ukana gazomvebiT 


57

Sua 

Ddistaluri 

3.2.2.1.2. yvela gamosaxuleba da daskvnis nawili unda iqnas 

Senaxuli da saWiroebis SemTxvevaSi (Semdgomi 

gasinjvebi) xelmisawvdomi pacientisTvis. 

3.2.2.1.3. skrininguli tipis daskvna SeiZleba iyos: 

� dadebiTi: (muclis aortis anevrizmis diametri 

tolia, an aRemateba 3 sm-s) 

� uaryofiTi: (muclis aortis anevrizma ar aRiniSneba) 

� ganusazRvreli: zusti daskvnis gamotana 

gaZnelebulia, 

araoptimaluri vizualizaciis gamo. 

4. eqstrakranialuri eqstrakranialuri cerebrovaskuluri cerebrovaskuluri sistemis 

sistemis 



eqstrakranialuri cerebrovaskuluri sistemis 

ultrasonografia gulisxmobs eqstrakranialuri karotiduli 

arteriebis gamosaxulebebis miRebas da doplerul (feradi da 

speqtruli) gamokvlevas. 

Cvenebebi: 

• hemisferuli nevrologiuri simptomebis (insultis, 

tranzitoruli iSemiuri Setevis, gardamavali sibrmavis) 

mqone pacientTa gamokvleva 

• kisris areSi sisxlZarRvovani Suilis mqone pacientTa 

gamokvleva 

• pulsirebadi kisris ZarRvebis Sefaseba 

• preoperaciuli Sefaseba didi gegmiuri 

kardiovaskularuli qirurgiuli operaciebis win 

• arahemisferuli, an auxsneli nevrologiuri simptomebis 

mqone pacientTa Sefaseba 

• saZile arteriis ukve dadgenili daavadebis mqone 

pacientTa monitoringi 

• saZile arteriaTa revaskulizaciis (maT Soris, 

stentirebis) Semdgomi monitoringi 

• vaskularuli qirurgiis intraoperaciuli monitoringi 

• eWvi laviwqveSa moparvis sindromis arsebobaze 

58

kvlevis kvlevis specifika specifika. 

specifika specifika 

4.2.1. karotiduli arteriebi 

4.2.1.1. unda miviRoT da CaviweroT saerTo saZile arteriis, misi 

bifurkaciis, SigniTa da gareTa saZile arteriebis sigrZivi 

da ganivi gamosaxulebebi. aTerosklerozuli folaqis 

aRmoCenis SemTxvevaSi damatebiT unda ganvsazRvroT folaqis 

zoma, mdebareoba da sxva maxasiaTeblebi (mag, moZravi Tu 

uZravi) da movaxdonoT maTi dokumentireba rogorc sigrZiv, 

aseve ganiv poziciaSi. calke unda aRiweros da 

dokumentirdes sxva vaskuluri, Tu perivaskuluri 

paTologiebi. sisxlZarRvebis gamosaxulebebi unda miviRoT 

SeZlebisdagvarad srulad _ laviwzeda areSi transduseris 

qveviT, qveda ybis areSi ki zemoT daxriT 

4.2.1.2. feradi dopleri gamoiyeneba sisxlZarRvis Seviwroebuli 

ubnebis da aCqarebuli nakadis aRmosaCenad, sadac SemdgomSi 

unda Catardes gazomvebi speqtruli dopleriT. is aseve 

gamoiyeneba sisxlZarRvis zomasa da speqtrul doplerul 

monacemebs Soris aSkara Seusabamobis mizezebis dasadgenad 

4.2.1.3. gazomvebi speqtruli dopleriT unda Catardes Semdeg 

ubnebSi: saerTo saZile arteria (erT adgilas), gareTa saZile 

arteria (erT adgilas), SigniTa saZile arteria (2 adgilas). 

unda Caiweros da dokumentirdes TiToeul adgilas gazomili 

maqsimaluri siCqare _ sistoluri da diastoluri saerTo da 

orive SigniTa karotiduli arteriebisTvis. unda moxdes 

TiToeuli stenozis lokalizaciis dokumentireba 

4.2.1.4. saZile arteriebis 50 %-ze metad gamoxatuli stenozis 

dadgenis SemTxvevaSi unda moxdes misi ricxobrivi Sefaseba, 

mag., stenozis xarisxia 60%, an stenozis xarisxi 50% - 69% 

farglebSia 

4.2.2. vertebraluri arteriebis gamosaxuleba miiReba sigrZiv 

poziciSi, sadac unda gaizomos sisxlis nakadis siCqare da 

gamovlindes sisxlis dinebis mimarTuleba 

4.2.3. stentis arsebobis SemTxvevaSi unda gaizomos nakadis siCqare 

uSualod stentSi, mis distalurad da proqsimalurad 

4.2.4. speqtruli dopleriT gazomvebi tardeba sigrZiv poziciaSi 

kuTxis koreqciis gamoyenebiT, rac Zalian mniSvnelovania. 

rodesac ultrabgeriTi signalsa da sisxlis nakadis 

mimarTulebas Soris kuTxe aRemateba 60 graduss, dopleruli 

gazomvebis Catareba arakoreqtulia 

4.2.5. gamoklvevis Catareba umjobesia xazovani transduseriT, 

romelsac aucileblad unda hqondes dopleruli kvlevis 

Sesrulebis SesaZlebloba. Sav-TeTri gamosaxulebis 

misaRebad unda gamoviyenoT maqsimalurad maRali sixSiris 

transduseri (5 mgh da meti), dopleruli kvlevisTvis 

transduseris sixSire unda iyos 3 mgh, an ufro maRali. 

59

SedarebiT dabali sixSireebis gamoyeneba SesaZloa saWiro 

gaxdes didi masis sxeulis mqone pacientebSi, mniSvnelovnad 

kalcificirebuli sisxlZarRvebiT, an rodesac raime sxva 

mizeziT ver xdeba sisxlZarRvis adekvaturi vizualizacia. 

5. transkranialuri transkranialuri dopleruli dopleruli ultrabgeriTi ultrabgeriTi kvleva 

kvleva 

transkranialuri dopleruli kvleva arainvaziuri teqnikaa, 

romelic saSualebas gvaZlevs SeviswavloT viliziis wris da 

vertebrobazilaruli sistemis sisxlis mimoqceva. 


5.1.1. zrdasrulebi: 

• viliziis wris da vertebrobazilaruli sistemis 

mTavari qalasSida arteriebis stenozis, an okluziis 

aRmoCena, maT Soris, mwvave insultis Trombolizuri 

Terapiis monitoringisTvisac. 

• im pacientebis monitoringi, romelTac dadgenili aqvT 

viliziis wris da vertebrobazilaruli sistemis 

mTavari qalasSida arteriebis stenozi, an okluzia. 

• subaraqnoidaluri hemoragiis fonze ganviTarebuli 

vazospazmis gamovlena da monitoringi 

• viliziis wris da vertebrobazilaruli sistemis mTavar 

qalasSida arteriebSi mocirkulire embolebis aRmoCena 

• marjvnidan marcxniv Suntis dadgena (kontrastuli 

kvleva izotonuri xsnaris gamoyenebiT) 

• vazomotoruli reaqtiulobis Sefaseba 

• Tavis tvinis sikvdilis klinikuri diagnozis 

dadastureba cerebraluri sisxlis mimoqcevis sruli 

Sewyvetis demonstrirebiT. 

• intraoperaciuli da periproceduruli monitoringi 

embolizaciis, Trombozis, hipo- da hiperperfuziis 

aRmosaCenad. 

60

B5.1.2. bavSvebi: 

� viliziis wris da vertebrobazilaruli sistemis 

mTavari qalasSida arteriebis stenozis, an okluziis 

aRmosaCenad namgliseburi anemiis mqone pacientebSi, 

sisxlis transfuziis saWiroebis da xangrZlivobis 

gansazRvra. 

� namgliseburi anemiis mqone pacientebis monitoringi, 

romelTac aReniSnebaT viliziis wris da 

vertebrobazilaruli sistemis mTavari qalasSida 

arteriebis stenozi, an okluzia 

� sisxlZarRvovani paTologiebis aRmoCena (mag. moiamoia 

da sxva) 

� arteriovenozuri malformaciebis Sefaseba 

� 6 Tveze ufros CvilebSi Tavis tvinis sikvdilis 

klinikuri diagnozis dadastureba cerebraluri 

sisxlis mimoqcevis sruli Sewyvetis demonstrirebiT. 

5.2. 5.2. kvlevis specifika specifika 

5.2.1. yvela tipis ultrabgeriTi kvlevisas (Sav-TeTri, feradi da 

speqtruli dopleri/transkranialuri dupleqsi/) pacienti 

unda iwves zurgze. viliziis wresa da vertebrobazilarul 

sistemaSi unda daTvalierdes Tavis tvinis wina, Sua da 

ukana arteriebi. yiflibandis daxurvis Semdeg, qalasSida 

sisxlZarRvebis dasaTvaliereblad SeiZleba gamoyenebuli 

iqnas Semdegi ori fanjara: safeTqlis Zvali da Tavis qalas 

didi xvreli. 

5.2.2. transtemporaluri fanjara ewodeba adgils safeTqlis 

Zvalze yvrimalis Zvlis rkalis zeviT da yuris win. Sav-TeTr 

gamosaxulebaze saorientacio struqturebia: gulis formis 

hipoeqogenuri Tavis tvinis fexebi da varskvlavis formis 

eqogenuri bazilaruli cisterna. cisternis win mdebareobs 

Tavis tvinis Sua arteria, romelic unda daTvalierdes 

rogorc feradi, ise speqtruli dopleris gamoyenebiT. Tavis 

tvinis Sua arteria unda daTvalierdes 2 mgh, an 

mravalsixSiriani transduseriT (2 MHz speqtruli dopleris 

gamoyenebiT) 2-5 mm-iani intervalebiT misi yvelaze 

zedapiruli wertilidan qvemoT A1 segmentis bifurkaciamde. 

Tavis tvinis wina arteriis vizualizacia unda moxdes 

maqsimalurad (SesaZleblobis farglebSi) medialurad 

5.2.3. ukana cerebraluri arteria mdebareobs gulis formis Tavis 

tvinis fexebis win; mis P1 segmentSi dineba mimarTulia 

transduserisken, xolo P2 segmentSi sawinaaRmdego 

mimarTulebiT. marjvenamxrivi sisxlZarRvebis daTvalierebis 

61

Semdeg igive wesiT ikvleven marcxenamxriv transkranialur 

sistemas 

5.2.4. Tavis qalas didi xvreli SeiZleba gamoviyenoT bazilaruli 

da fuZis arteriebis gamosakvlevad. amisaTvis pacientma ise 

unda miatrialos da daxaros Tavi, rom nikapi Seexos gulmkerds. 

2 mgh-iani transduseri unda moTavsdes kisris zeda 

nawilSi qalas fuZeze da mivmarToT cxvirisaken. am 

SemTxvevaSi saorientacio struqturas warmoadgens 

hipoeqogenuri mogrZo tvini, an cxviris xrtili. xerxemlis 

arteriebi unda daTvalierdes 2-5 mm-iani intervalebiT. 

feradi dopleruli ultrabgeriT miRebul gamosaxulebaze 

xerxemlis arteriebs aqvT inglisuri aso V-s forma 

bazilaruli arteriis Sesaqmnelad maTi SeerTebis adgilas. 

xerxemlis da bazilarul arteriebSi dineba mimarTulia 

transduseridan da unda Seswavlil iqnas bazilaruli 

arteriis distalur daboloebamde 

5.2.5. im pacientebSi, romlebsac SesaZloa hqondeT saZile 

arteriebis stenozi, an okluzia, karotiduli sifonis da 

Tvalis kaklis arteriis daTvaliereba SesaZloa movaxdinoT 

transorbitaluri fanjridan dabali simZlavris 

ultrabgeris gamoyenebiT (10% an 17 mW). subaraqnoidaluri 

sisxlCaqcevis da vazospazmis niSnebis mqone pacientebSi, Sida 

saZile arteriis kisris segmentis gamosakvlevad SeiZleba 

gamoviyenoT qveda ybis midgoma, raTa gamoviTvaloT Tavis 

tvinis Sua da Sida saZile arteriebs Soris sisxlis dinebis 

saSualo siCqaris Tanafardoba (e.w. hemisferuli ineqsi). 

orive midgoma sruldeba 2 mgh speqtruli doplerografiiT 

kuTxis koreqciis gareSe. 

5.2.6. namglisebr-ujredovani anemiis mqone bavSvebSi damatebiT unda 

Sesruldes Tavis tvinis arteriebis talRovani analizi, 

romelic moicavs drois erTeulSi saSualo maqsimalur 

siCqaris gamoTvlas. zrdasrulebSi izomeba dinebis saSualo, 

an pikuri sistoluri siCqare pulsur indeqsTan erTad, 

sisxlZarRvis mTel sigrZeze 2-5 mm-is intervalebiT. siCqare 

SeiZleba ganisazRvros rogorc avtomaturi, aseve manualuri 

Semoxazvis meTodiT kuTxis koreqciis gareSe 

5.2.7. transkranialuri ultrasonografia SeiZleba Sesruldes 2-4 

mgh transduseriT, romelsac aqvs Sav-TeTri gamosaxulebis 

miRebis unari, an 2 mgh-iani, mxolod dopleruli kvlevis 

Catarebis SesaZleblobis mqone transduseriT. 

62

6. 6. neirosonografia 

neirosonografia 

neirosonografiis Catareba SesaZlebelia axalSobilebSi da 

CvilebSi didi yiflibandis daxurvamde. 

6.1. 6.1. Cvenebebi Cvenebebi 

Cvenebebi 

axalSobilebSi sonografiuli gamokvlevis Catareba unda 

moxdes raTa davadasturoT, an gamovricxoT: 

� hemoragia 

� parenqimuli darRvevebi 

� parkuWovani dilatacia 

� Tandayolili paTologia 

� sisxlZarRvovani darRvevebi 

kvlevis kvlevis specifika 

specifika 

6.2.1. koronaruli gamosaxulebebi 

� sxvadasxva koronaruli gamosaxulebebis miReba warmoebs 

didi yiflibandis midamodan. koronalur gamosaxulebebze 

marjvena/marcxena orientacia igivea, rac kompiuterul 

tomografiasa, an magnitur rezonansul suraTebze 

(pacientis marjvena gamosaxulia suraTis marcxena mxares) 

� wina koronaluri xedi unda moicavdes Sublis wils da 

lateraluri parkuWebis Sublis rqebs, frontalur, 

parietalur da temporalur wilebs; agreTve, bazalur 

ganglias da lateraluri parkuWebis sxeuls 

� ukana koronaluri xedi unda moicavdes temporaluri 

wilebis ukana nawils, kefis wils, ukana fosos ubans da 

agreTve, parkuWovani sistemis ukana nawilebs. 

transdiuseri ise unda gadavxar-gadmovxaroT, rom 

davinaxoT tvinis naxevarsferoebis rac SeiZleba meti 

periferiuli zedapiri 

6.2.2. sagitaluri gamosaxulebebi 

� sagitaluri xedi unda moicavdes silviis wyalsadens, 

TiToeul gverdiT parkuWs da mis qorioidul wnuls, maT 

garSemo TeTr nivTierebas da Canasaxovan matriqsul ubans, 

maT Soris, kaudoTalamur Rars. 

� Sua sagitaluri xedi moicavs zolian sxeuls, gamWvirvale 

Zgidis auzs, verges Rrus anu mexuTe parkuWs (Tu is 

arsebobs), mesame parkuWs, silviis wyalsadens, me-4 parkuWs, 

naTxemis Wiisebr sxeuls da did cisternas. Cveulebriv, 

sagitalur gamosaxulebebze wina tvini gamosaxulebis 

marcxena mxaresaa 

� damatebiTi xedebis miReba SesaZlebelia ukana an, 

mastoiduri yiflibandebidan, didi xvrelidan, nebismieri 

Ria nakeridan, an temporoparietaluri Zvlis Txeli 

63

ubnebidan. transtemporaluri midgoma, saSualebas gvaZlevs 

movaxdinoT viliziis wris da misi ZiriTadi totebis 

vizualizacia 

6.2.3. neirosonografiuli kvlevis Catareba umjobesia 

seqtoraluri, an konveqsuri transduseriT. xazovani 

transduseris gamoyeneba SesaZlebelia zeda sagitaluri 

sinusis da zedapiruli centraluri struqturebis 

vizualizaciisTvis. ultrabgeris sixSire 

SeZlebisdagvarad maRali unda iyos _ Cveulebriv, 

gamoiyeneba 5,0-7,5 mgh sixSiris ultrabgera (iSviaTad, 10 

mgh). zogierT SemTxvevaSi intrakranialuri 

sisxlismimoqcevis Sesaswavlad SesaZlebelia feradi, an 

speqtruli dopleris gamoyeneba, rac SeiZleba dabali 

simZlavris. 

7. periferiuli periferiuli periferiuli arteriebis arteriebis ultrasonografia 


arteriis okluziuri daavdebis dasadgenad, uSualod 

ultrasonografiuli kvlevis Catarebamde unda moxdes Sesaswavli 

kidurebis sisxlis wnevis gazomva. sxvadasxva doneze gazomili 

wnevis cifrebi, Tu es SesaZlebelia, unda dafiqsirdes 

Tanafardobis saxiT (mag. koW/braqialuri indeqsi.) sonografiuli 

gamokvleva moicavs gamosakvlevi arteriuli segmentebis Sav-TeTri 

gamosaxulebebis miRebasa da doplerul (speqtruli da feradi 

dopleriT) Sefasebasac. Cvenebis SemTxvevaSi safuZvlianad unda 

gamovikvlioT arteriuli segmentis mimdebare rbili qsovilebic. 


Cvenebebi 

7.1.1. simptomuri pacientebis gamokvleva hemodinamikurad 

mniSvnelovani stenozis, an okluziis aRmosaCenad 

periferiuli arteriebis specifikur segmentebSi. am 

pacientebs SesaZloa aReniSnebodeT Semdegi klinikuri 

niSnebi: koWloba, tkivili mosvenebul mdgomareobaSi, 

qsovilis iSemiuri ganleva, an saeWvo arteriuli embolizacia 

7.1.2. postoperaciuli monitoringi, maT Soris Suntirebis Semdgomi 

(xelovnuri, Tu auto venuri Suntebis gamoyenebiT) 

7.1.3. kanqveSa intervenciebis Semdgomi monitoringi, maT Soris, 

angioplastikis, Trombolizis/Trombeqtomiis, aTereqtomiis 

da stentirebis Semdgom 

7.1.4. saeWvo vaskularuli da perivaskularuli anomaliebis 

dadgena, maT Soris, masebi, anevrizmebi, fsevdoanevrizmebi, an 

sxvadasxva arterio-venuri paTologiuri komunikaciebi 

64

7.1.5. qirurgiuli operaciis, an dializis win arteriis 

topografiis dadgena 

kvlevis kvlevis specifika 

specifika 

7.2.1. arteriuli okluziuri daavadeba 

7.2.1.1. feradi da pulsuri dopleriT Sesabamis arterias ikvleven 

mTel sigrZeze da axdenen hemodinamikurad mniSvnelovani 

yvela stenozuri nakadis speqtruli gamosaxulebis Caweras 

(2-4 sm-iT stenozis proqsimalurad). rutinulad unda moxdes 

stenozuri segmentis diametris gazomva. unda aRiniSnos yvela 

im segmentis adgilmdebareoba da sigrZe, romelTa 

vizualizacia ver moxerxda. speqtruli dopleriT sisxlis 

nakadis siCqaris SefasebisTvis Zalian mniSvnelovania, rom 

ultrabgeriT signalsa da sisxlis nakadis mimarTulebas 

Soris kuTxe ar aRematebodes 60 graduss. winaaRmdeg 

SemTxvevaSi dopleruli gazomvebis Catareba arakoreqtulia. 

qvemoT ganvixilavT, Tu rogor unda moxdes konkretuli 

arteriebis Sefaseba, rodesac specifiuri sakiTxebis 

gadasawyvetad limitirebuli kvlevis Catarebac sakmarisia. 

7.2.1.2. TeZos arteriebi 

calmxrivi gamokvlevisas sruli moculobiT unda Sefasdes 

TeZos saerTo da gare arteriebi. ormxrivi kvlevis 

SemTxvevaSi ki TirkmelqveSa muclis aortac unda 

daTvalierdes. Canaweri aseve unda Seicavdes gamosakvlev 

sisxlZarRvebSi sisxlis dinebis siCqaris speqtrul 

doplerul maxasiaTeblebsac 

7.2.1.3. barZayisa da muxlqveSa arteriebi 

kvleva iTvaliswinebs barZayis saerTo, barZayis zedapiruli 

da muxlqveSa arteriebis Sefasebas mTel sigrZeze. unda 

gamovikvlioT barZayis Rrma arteriis gamosvlis adgilic. 

Canaweri aseve unda Seicavdes gamosakvlev sisxlZarRvebSi 

sisxlis dinebis siCqaris speqtrul doplerul 

maxasiaTeblebsac 

7.2.1.4. wvivis arteriebi 

unda vecadoT, rom aRniSnuli arteriebi SeviswavloT mTel 

sigrZeze. Seswavla/Canaweri aseve unda Seicavdes gamosakvlev 



7.2.1.45. laviwqveSa, iRliisa da mxris arteriebi 

unda vecadoT, rom aRniSnuli arteriebi SeviswavloT mTel 

sigrZeze. Seswavla/Canaweri aseve unda Seicavdes gamosakvlev 



7.2.2. qirurgiuli operaciebis da kanqveSa intervenciebis Semdgomi 

monitoringi 

65

7.2.2.1. Suntis Sefaseba unda movaxdinoT anastomozis mTel sigrZeze, 

SeZlebisdagvarad srulad. unda gaizomos transplantTan 

anastomozis proqsimaluri arteriis, proqsimaluri 

anastomozis, transplantis yoveli 10-20 sm-is, distaluri 

anastomozis da anastomozis distaluri arteriis siCqaris 

maCveneblebi, agreTve, ferad-doplerul an Sav-TeTr 

gamosaxulebaze arsebuli yvela saeWvo ubani 

7.2.2.2. unda vecadoT SevafasoT rogorc uSualod kanqveSa 

intervenciis ubani, aseve mimdebare proqsimaluri da 

distaluri segmentebi. Canaweri aseve unda Seicavdes sisxlis 

dinebis siCqaris speqtrul doplerul maxasiaTeblebsac 

7.2.3. sxva 

7.2.3.1. arteriebis mimdebare rbili qsovilebis savaraudo 

dazianebebis gamosakvlevad unda miviRoT am midamos Sav- 

TeTri gamosaxuleba. am areSi sisxlis dinebis arsebobis 

dasadgenad da misi xasiaTis gamosakvlevad gamoiyeneba 

pulsuri da feradi dopleri. speqtrul-dopleruli 

maxasiaTeblebi unda Caiweros vizualurad dafiqsirebul 

paTologiur ubnebSi, maTTan dakavSirebul arteriebsa da 

venebSi da maT Soris arsebul komunikaciebSi. aseve unda 

dokumentirdes dazianebis zoma da masSi Trombis arseboba. 

7.2.3.2. fsevdoanevrizmebis arsebobis SemTxvevaSi ultrasonografia 

gamoiyeneba, rogorc Terapiruli intervenciis msvlelobisas, 

aseve am proceduris efeqtianobis Sesafaseblad. 

7.2.3.3. arteriebsa da venebs Soris paTologiuri komunikaciebis 

dasadgenad gamoiyeneba feradi da pulsuri dopleri. unda 

Caiweros, rogorc Tavad am komunikaciis, aseve paTologiuri 

anastomozis proqsimaluri da distaluri sisxlZarRvebis 

speqtrul-dopleruli maxasiaTeblebi. feradi dopleri 

sasargebloa paTologiuri komunikaciis donis dasadgenad da 

rbil qsovilebze am komunikaciis gavlenis dasadgenad. 

7.2.4. periferiuli arteriebis ultrasonografiisTvis gamoiyeneba 

xazovani, an konveqsuri transduseri, pulsuri da feraddopleruli 

reJimebiT. Sav-TeTri gamosaxulebis misaRebad 

gamoyenebuli ultrabgeris sixSire ≥ 3.5 mgh-ze, dopleruli 

kvlevebisTvis ki ≥ 2.5 mgh-ze. 

8. periferiuli periferiuli periferiuli venebis venebis venebis ultrasonografia: 

ultrasonografia: 


• simptomur pacientebSi, an maRali riskis asimptomatur 

individebSi saeWvo venuri obstruqciis an Trombis Zieba 

• venuri ukmarisobis Sefaseba 

66

• dializisTvis gankuTvnili venuri Suntirebis Sefaseba 

• arteriuli Suntirebis an rekonstruqciuli qirurgiuli 

operaciebis win venuri sistemis Sefaseba 

• venebze manipulaciebis Catarebamde maTi mdgomareobis 

Sefaseba 

• pulmonur embolizmze eWvis SemTxvevaSi, gamokvleva Rrma 

venebis Trombozis Sesafaseblad 

• venuri Trombozis mqone pacientebis monitoringi 

8.2. 8.2. Ggamokvlevebis specifika: 

8.2.1. venuri Trombemboliuri daavadeba 

• qvemo kidurebis venuri sistemis SefasebisaTvis dupleqs 

teqnikiT unda gamovikvlioT Semdegi venebi: barZayis 

saerTo vena, barZayis zedapiruli vena, barZayis 

proqsimaluri Rrma vena, proqsimaluri didi saCino vena, 

da muxlqveSa vena. 

• dopleruli Sefaseba saWiroa paTologiis arsebobis 

dasamtkiceblad, an gamosaricxad, 

• asimetriulobis, pulsurobis an sunTqviTi fazurobis 

dakargvis gamosavlenad, sul mcire, ormxrivad unda 

Sesruldes barZayis saerTo venebis speqtrul-dopleruli 

analizi. 

• venuri Trombozebis diagnozis mTavar kriteriums 

arakompresirebadi venuri ubnebis gamovlena warmoadgens. 

venebis arakompresirebadi ubnebi, maTSi sisxlis nakadis 

arsebobis, an ararsebobis gamosavlenad, unda 

daTvalierdes speqtruli, an feradi dopleris 

gamoyenebiT. 

• kanWis adgilobivi tkivilis dros saWiroa lokaluri 

ubnis gamokvleva 

• barZayis da muxlqveSa venebis gamokvlevisas unda movicvaT 

maTi sigrZis maqsimaluri nawili, amasTan unda vawarmooT 

Semdegi ubnebis gamosaxulebebis Cawera: barZayis saerTo 

vena, barZayis saerTo venis da didi saCino venis SeerTebis 

adgili, barZayis Rrma proqsimaluri, barZayis zedapiruli 

venis proqsimaluri, Sua da distaluri monakveTebi da 

muxlqveSa vena. aseve unda dafiqsirdes yvela aRmoCenili 

vaskuluri, Tu aravaskuluri paTologia, Tumca diagnozis 

dasazusteblad SesaZloa saWiro gaxdes damatebiTi 

gamosaxulebebis miReba. Tu standartuli gamoklveviT 

diagnozis verificireba ver moxerxda, rogorc wesi saWiro 

xdeba simptomuri ubnebis gamokvleva damatebiTi 

fanjrebidan. rodesac Rrma venebis Trombozebis 

sadiagnostiko kriteriumad viyenebT kompresias, barZayis 

67

da muxlqveSa venebi mTel sigrZeze unda daTvalierdes 

ganiv WrilSic, kanze zewoliT, am mis gareSe, da 

movaxdinoT Canaweri orive mdgomareobaSi. zustad unda 

iqnas dokumentirebuli im ubnebis lokalizacia da 

gavrceleba, romelTa venebis kompresiac ver moxerxda 

• pacientis Civilebis, klinikuri Cvenebebis da mkurnalobis 

taqtikis Sesabamisad SeiZleba saWiro gaxdes protokolis 

modifikacia, magaliTad zedapiruli venuri sistemis, 

kanWis Rrma venebis ufro Rrma Seswavla, an ormxrivi 

gamokvleva. 

8.2.2. venuri ukmarisoba 

• venuri ukmarisobis diagnozi ismeva sisxlis reversiuli 

dinebis gamovlinebiT. yvela SemTxvevaSi unda moxdes am 

dinebis lokalizaciis da xangrZlivobis dadgena. 

dopleruli kvleva unda Catardes klinikur Cvenebaze 

dafuZnebiT yvela saWiro doneze 

• SesaZloa saWiro gaxdes iseTi manevrebis gamoyeneba, 

rogorebicaa: barZayze an kanWze zewola, valsavas manevri 

an Rrma sunTqva 

• pacienti ar unda gamovikvlioT mxolod zurgze wolisas, 

aramed Sebrunebul trendelenburgis da vertikalur 

poziciebSic (im fexs, romelzec sruldeba 

ultrasonografia, gamokvlevis procesSi ar unda 

awvebodes sxeulis wona). 

8.2.3. zeda kidurebi 

• zeda kidurebis dupleqsuri gamokvleva moicavs 

laviwqveSa, mxar-Tavis, sauRle da iRliis venebis 

daTvalierebas. Cvenebis SemTxvevaSi unda daTvalierdes 

Sevardnis, salmis, mxris da wina mxris venebi, aseve 

simptomaturi ubnebis venebic 

• dupleqsuri, an feradi dopleruli gamokvlevebi 

gamoiyeneba venebis kompresiis unaris, Trombebis, kedlis 

gasqelebis, spontanuri kontrastirebis, dinebis pulsuri, 

an respiraciuli fazurobis da venuri avsebis defeqtebis 

gamosavlenad da Sesafaseblad. 

8.2.4. venebis topografiuli Seswavla 

zeda an qveda kidurebis zedapiruli venebis tofografiuli 

Seswavla gulisxmobs maTi zomis, gamavlobis da 

mimarTulebis dadgenas SuntirebisTvis maTi Semdgomi 

gamoyenebis mizniT. SesaZloa miRebuli monacemebi kanzec 

gamoisaxos 

8.2.5. periferiuli venebis ultrasonografiisTvis umjobesia 

xazovani, an konveqsuri transduseris gamoyeneba, Tumca 

xarisxiani gamosaxulebebis miReba SesaZlebelia seqtoruli 

transduseriTac. Sav-TeTri gamosaxulebis misaRebad 

68

gamoyenebuli ultrabgeris sixSire, Cveulebriv, unda 

aRematebodes 5 mgh-s, Tumca zogjer saWiro xdeba ufro 

dabali sixSireebis gamoyeneba. dopleruli kvlevebisTvis 

gamoyenebuli ultrabgeris ki ≥ 2.5 mgh-ze. 

9. mkerdis mkerdis ultrasonografia 



Cvenebebi 

• palpacirebadi mkerdis masa, an mkerdTan dakavSirebuli sxva 

niSnebi an simptomebi 

• sxva kvlevebiT (mag. mamografiiT, an birTvul-magnituri 

rezonansiT) gamovlenili, an saeWvo paTologia 

• 30 wlamde qalebSi, an laqtaciisa da orsulebis periodSi 

aRmocenebuli palpirebadi masis pirveladi kvleva 

• mkerdis implantebTan asocirebuli problemebi 

• mamografiulad gamovlenili mikrokalcifikatebi, da/an 

mkerdis struqturuli cvlilebebi, rac am warmonaqmnebis 

gazrdili simkvrivis gamo SesaZloa malavdes simsivnur 

warmonaqmnebs 

• mkerdis biofsia da sxva intervenciuli procedurebi 

• sxivuri Terapiis dagegmva 

am etapze sabolood ar aris dadgenili ultrasonogarfiis 

efeqtianoba axlad gamovlenili mkerdis simsivnis dros, 

iRliis limfur kvanZebSi faruli metastazebis dasadgenad da 

maRali riskis qalebis skriningisTvis 

9.2 kvlevis kvlevis specifika specifika: 

specifika 

9.2.1. ultrasonografiis Sedegebi unda ganvixiloT klinikur 

suraTTan, pacientis simptomebTan, adre Catarebul 

mamografiul, ultrasonografiul da sxva radiologiuri 

kvlevebis monacemebTan korelaciaSi 

9.2.2. gamosaxulebebis miReba warmoebs, sul mcire, 2 

perendikularul proeqciaSi. unda dafiqsirdes paTologiuri 

warmonaqmnis maqsimaluri zomebi (sul mcire, ori, mag., sigrZe 

da sigane) maqsimaluri zomebis gansazRvra umjobesia 

orTogonalur sibrtyeSi 

9.2.3. aucilebelia moxdes miRebuli gamosaxulebebis Cawera da 

sworad markireba, marjvena Tu marcxena ZuZus, paTologiis 

lokalizaciis, ZuZusTan mimarTebaSi transduseris 

69

orientaciis (ganivi, Tu sigrZivi, radialuri, Tu 

antiradialuri) miTiTebiT 

9.2.4. lokalizaciis miTiTeba unda moxdes saaTis ciferblatis da 

dvrilidan manZilis mixedviT da/an daskvnis furcelze 

dafiqsirebul unda iqnas ZuZus diagramaze 

9.2.5. mkerdis masis sonografiuli maxasiaTeblebia: zoma, forma, 

orientacia, kideebi, eqogenoba, dazianebis sazRvrebi, bgeris 

Sesusteba (mag, distanciuri Crdili, an gaZliereba) da 

mimdebare qsovilis mdgomareoba 

9.2.6. mkerdis ultrasonografiisTvis, Cveulebriv, gamoiyeneba 

xazovani transduseri, SeZlebisdagvarad, maRali 

ultrabgeriTi sixSiriT (10 mgh da ufro maRali). garda amisa, 

didi mniSvneloba aqvs, rom pacienti ise movaTavsoT, rom 

maqsimalurad Semcirdes gamosakvlevi aris sisqe. 

10. 10. 10. muclis muclis Rrus Rrus da da retroperitonealuri retroperitonealuri aris 

aris 




Cvenebebi 

• tkivili muclis, ferdis, da/an zurgis areSi 

• simptomebi da niSnebi, romlebic SesaZloa dakavSirebuli 

iyos muclis Rrus da/an retroperitonealuri aris 

paTologiebTan, mag., siyviTle, hematuria 

• muclis Rrus palpirebadi paTologia, rogorebicaa: masebi 

muclis RruSi an organomegalia 

• laboratoriuli, an sxva radiologiuri kvlevebis 

Sedegebi, romlebic migvaniSneben muclis da/an 

retroperitonealur paTologiaze 

• muclis da/an retroperitonealuri aris ukve dadgenili, 

an saeWvo paTologiis dinamikaSi kvleva. 

• ultrasonografiuli kvleva metastazebis, an pirveladi 

simsivnuri warmonaqmnebis gamosavlenad 

• eWvi Tandayolili paTologiis arsebobaze 

• muclis Rrus travma 

• pre-transplantaciuri da post-transpalantaciuri 

gamokvleva 

� ultrasonografiuli kvleva invaziuri procedurebis 

dasagegmad da sameTvalyureod 

� peritoniumsa da/an retroperitoniumSi Tavisufali, an 

Semofargluli siTxis dadgena 

70

10.1. 10.1. kvlevis kvlevis kvlevis specifika specifika: 

specifika 

10.1.1. RviZli 

10.1.1.1. unda miviRoT RviZlis sigrZivi da ganivi Wrilebi. RviZlis 

parenqimis gamokvleva unda moxdes misi kerovani da/an 

difuzuri paTologiis gamosavlenad. Tu SesaZlebelia, 

RviZlis eqogenoba unda SevadaroT marjvena Tirkmlis 

eqogenobas 

10.1.1.2. unda miviRoT ZiriTadi sisxlZarRvebis gamosaxulebebi, 

rogorebicaa: qveda Rru vena. RviZlis venebi, karis mTavari 

vena, da Tu SesaZlebelia, karis venis marjvena da marcxena 

totebi 

10.1.1.3. cal-calke unda davaxasiaToT RviZlis wilebi (marjvena, 

marcxena da kaudaluri) da Tu SesaZlebelia, marjvena 

subdiafragma da masTan mimdebare plevris Rru 

10.1.1.4. dopleruli kvleva gamoiyeneba RviZlis sisxlZarRvebSi 

sisxlis dinebis mimarTulebisa da siCqaris dasadgenad. 

unda gamovikvlioT: RviZlis arteriebi, RviZlis venebi, 

karis venebi, qvemo Rru venis intrahepaturi nawili, 

kolateraluri venebi da RviZlSida porto-sistemuri 

Suntebi (maTi arsebobis SemTxvevaSi). 

10.2.2. naRvlis buSti da sanaRvle gzebi 

10.2.2.1. naRvlis buStis sigrZivi da ganivi gamosaxulebebi unda 

miviRoT zurgze mwoliare poziciaSi, Tumca zogierT 

SemTxvevaSi, kerZod, naRvlis buStSi kenWebis da/an naleqis 

arsebobisas, am organos da misi mimdebare qsovilebis 

gamosakvlevad, SesaZloa kvlevis Catareba dagvWirdes 

marcxena lateralur, vertikalur, an guldaRma 

poziciebSic. unda ganisazRvros naRvlis buStis kedlis 

sisqe, zogjer amisTvis SesaZloa dagvWirdes misi gazomva. 

Tu pacients aReniSneba tkivili, unda SevafasoT ramdenad 

mgrZnobiarea igi transduseriT zewolisadmi 

10.2.2.2. RviZlSida sanaRvle sadinrebis Sesafaseblad unda 

miviRoT RviZlis sxvadasxva Wrilebi. RviZlSida da 

RviZlgare sanaRvle sadinrebis dasaxasiaTeblad unda 

Sevafasod maTi zoma (aris Tu ara dilatirebuli), da 

kedlis sisqe, agreTve, aRvweroT sxva paTologiuri 

cvlilebebi. unda movaxdinoT RviZlis karSi sanaRvle 

sadinris zomis da paTologiuri cvlilebis (arsebobis 

SemTxvevaSi) dokumentacia. Tu SesaZlebelia, unda 

71

gamovikvlioT pankreasis Tavis areSi viziualizirebadi 

distaluri saerTo sadinaric. sanaRvle sadinrebis 

diferenciisaTvis RviZlis arteriebisa da karis venebisgan, 

SesaZloa dopleris gamoyeneba. 

10.2.2.3. naRvlis buStis rutinuli ultrasonografiuli kvleva 

unda Catardes adekvaturad gadaWimul naRvlis buStze _ 

umetesoba mozrdilebisa da bavSvebisaTvis, normalurad 

mofunqcionire naRvlis buStis SemTxvevaSi, uzmod yofna 

sakmarisia kvlevamde 8 saaTis ganmavlobaSi. Cvilebsa da 

zogierT mozrdilebSi naRvlis buStis adekvaturi 

gaWimvisTvis SesaZloa naklebi droc iyos sakmarisi. 

10.2.3. pankreasi 

10.2.3.1. Tu SesaZlebelia, unda daTvalierdes pankreasis yvela 

nawili: Tavi, kaviseburi morCi, sxeuli da kudi. 

peroralurad miRebulma wyalma, an sakontrasto 

nivTierebam SeiZleba xeli Seuwyos vizualizaciis 

gaumjobesebas 

10.2.3.2. pankreasis gamokvlevisas unda SevafasoT: 

� parenqimuli dazianebebi 

� distaluri saerTo sanaRvle sadinari pankreasis Tavis 

nawilSi 

� pankreasis sadinari _ dilataciis (gazomviT 

dadasturebuli), an raime sxva paTologiis gamovlenis 

mizniT 

� peripankreasuli are adenopaTiis da/an siTxis 

gamovlenis mizniT. 

10.2.4. elenTa 

10.2.4.1. unda miviRoT elenTis sigrZivi da ganivi Wrilebi. 

dopleruli kvleva gamoiyeneba elenTis venasa da 

arteriaSi sisxlis dinebis arsebobisa da mimarTulebis 

dasadgenad. splenomegaliis dasadastureblad dagvexmareba 

elenTis gazomva. Tu SesaZlebelia, elenTis eqogenoba 

unda SevadaroT marcxena Tirkmlis eqogenobas da vecadoT 

marcxena subdiafragmuli sivrcis da masTan mimdebare 

plevris Rrus vizualizacias. 

72

10.2.5. nawlavi 

10.2.5.1. nawlavis gamokvleva SesaZloa Catardes nawlavis kedlis 

gasqelebis (SesaZloa dagvWirdes kedlis sisqis gazomva), 

dilataciis, kunTovani hipertofiis, masebis da sxva 

paTologiuri procesebis gamosavlenad. kuWis piloruli 

nawilisa da misi mimdebare nawilebis utrasonografia 

SeiZleba dainiSnos CvilebSi, Rebinebisas. apendiqsis da 

sxva nawlavuri maryuJebis vizualizaciisTvis SesaZloa 

dagvWirdes kompresiuli ultrasonografiis Catareba. 

dopleruli kvleva gamoiyeneba sisxlis dinebis arsebobis 

dasadgenad. 

10.2.6. peritonealuri siTxe 

10.2.6.1. unda moxdes nebismieri Semofargluli Tu Tavisufali 

peritonealuri siTxis lokalizaciis da gavrcelebulobis 

dokumentacia. travmuli dazianebis, kerZod daxuruli 

travmis SemTxvevaSi, sisxldenis gamosavlenad awarmoeben 

fokusirebul abdominur ultrasonografias 

10.2.6.2. muclis RruSi Tavisufali siTxis gamosavlenad sigrZiv 

da ganiv poziciebSi aTvaliereben: 

� marjvena zeda kvadrats (RviZlis saproeqcio are, 

gansakuTrebiT RviZlis periferiulad da 

subhepaturad) 

� marcxena zeda kvadrats (elenTis saproeqcio are, 

gansakuTrebiT elenTis periferiulad) 

� muclis marjvena da marcxena lateralur arxebs 

� mcire menjs (vizualizaciis gasaumjobeseblad, savse 

Sardis buStis fonze, romelic saWiroebis da 

SesaZleblobis SemTxvevaSi, xelovnurad unda gavavsoT 

folis kaTeteris gamoyenebiT). 

10.2.7. muclis kedeli 

10.2.7.1. muclis Rrus kedlis ultrasonografia aucileblad unda 

moicavdes simptomuri ubnebis gamokvlevas. unda 

demonstrirdes nebismieri abdominaluri masisa da 

peritoniumis urTierTdamokidebuleba. unda moxdes 

peritoniumis, an muclis kedlis kunTebis nebismieri 

defeqtis dokumentireba da aRiniSnos am defeqtis areSi 

nawlavis, siTxis, Tu sxva qsovilis arseboba, an 

ararseboba. zogjer saWiro xdeba vertikalur poziciaSi, 

73

an valsalvas manevris fonze Catarebuli gamokvleva. 

dopleruli gamokvleva SeiZleba dagvexmaros aRmoCenil 

masasa da sisxlZarRvebs Soris urTierTkavSiris 

dadgenaSi. 

10.2.8. Tirkmelebi 

10.2.8.1. sigrZiv da ganiv proeqciebSi unda miviRoT orive 

Tirkmlis zeda, Sua da qveda wilebis, parenqimis, 

kortikaluri nawilis da Tirkmlis menjis gamosaxulebebi. 

unda ganisazRvros orive Tirkmlis maqsimaluri sigrZivi 

zoma. vizualizaciis gasaumjobeseblad SesaZlebelia 

kvleva CavataroT dekubitur, guldaRma da wamomjdar 

poziciebSic. Tu SesaZlebelia, Tirkmlebis eqogenoba 

unda SevadaroT Sesabamisad, RviZlis da elenTis 

eqogenobas. unda davaTvalieroT perirenaluri areebic 

10.2.8.2. Tirkmlis sisxlZarRvebis gamosakvlevad dopleruli 

kvleva gamoiyeneba: 

� Tirkmlis venisa da arteriis gamavlobis dasadgenad 

� zrdasrulebSi Tirkmlis arteriis stenozze eWvis 

SemTxvevaSi, risTvisac, rodesac es SesaZlebelia, 

Tirkmlis mTavari arteriebis eqstrarenalur nawilSi 

proqsimalurad, centralurad da distalurad (kuTxis 

koreqciiT) unda ganisazRvros sisxlis nakadis 

maqsimaluri siCqareebi. aseve, unda gaizomos Tirkmlis 

arteriebTan mimdebare aortis (transplantantis 

SemTxvevaSi, TeZos arteriis) maqsimaluri siCqare da 

Tanafardoba am siCqaresa da Tirkmlis arteriebis 

siCqareebs Soris (aorto-renaluri Tanafardoba). 

pulsuri dopleriT Tirkmlis zeda da qveda wilebis 

intrarenalur arteriebSi maqsimaluri siCqaris gazomva, 

SesaZloa iribad miuTiTebdes Tirkmlis mTavari 

arteriis stenozis arsebobaze. 

10.2.9. Sardis buSti da momijnave struqturebi 

10.2.9.1. srulyofili ultrasonografiuli kvlevis Catarebis 

SemTxvevaSi unda miviRoT gadavsebuli Sardis buStis 

da misi kedlebis ganivi da sigrZivi gamosaxulebebi. 

unda dafiqsirdes da dokumentirdes buStis sanaTuris, 

an misi kedlebis nebismieri cvlileba. aseve, 

SardsawveTebis dilatacia. agreTve, SeiZleba 

74

dafiqsirdes narCeni Sardis arseboba da moxdes misi 

raodenobis daTvla. 

10.2.10. Tirkmelzeda jirkvali 

10.2.10.1. rodesac SesaZlebelia, Cveulebriv, isinjeba 

axalSobilebSi, ganiv da sigrZiv proeqciebSi. 

zrdasrul adamianebSi maTi vizualizacia iSviaTadaa 

SesaZlebeli da Tu amis gakeTeba moxerxda, unda 

dokumentirdes rogorc jirkvlebis zoma, aseve maTSi 

hemoragiis, masebis, an sxva paTologiis arseboba. 

10.2.11. aorta 

10.2.11.1.1. aortis vizualizacia unda moxdes ganiv da sigrZiv 

proeqciebSi. aortis specifiuri gamokvlevis wesebi 

ixileT me-3 TavSi. 

10.2.12. qveda Rru vena 

10.2.12.1.1. qveda Rru venis vizualizacia unda moxdes ganiv da 

sigrZiv proeqciebSi. misi gamavlobisa da paTologiebis 

dasadgenad SesaZloa dopleris gamoyenebac. 

10.2.13. muclis Rrus ultrasonografiisTvis umjobesia 

seqtoruli, an xazovani transduseris gamoyeneba, 

SeZlebisdagvarad, maRali ultrabgeriTi sixSiriT 

(pediatriul pacientebSi 5 mgh, an ufro maRali, 

mozrdilebSi, ki 2-5 mgh). dopleruli kvlevebisTvis 

gamoiyeneba sxvadasxva sixSiris ultrabgera. 

11. 11. mcire mcire menjis menjis ultrasonografia 



Cvenebebi 

� tkivili mcire menjis areSi 

� dismenorea (mtkivneuli menstruacia) 

� menoragia (menstruaciuli sisxldena) 

� metroragia (araregularuli sisxldena saSvilosnodan) 

� menometroragia (Zlieri araregularuli sisxldena) 

� ukve dadgenili paTologiis (magaliTad, hemoragiuli 

cista) ganmeorebiTi kvleva 

� unayofo pacientebis gamokvleva da monitoringi 

� dagvianebuli menzesi, an naadrevi momwifeba 

75

� postmenopauzuri sisxldena 

� fizikuri gasinjvisas gamovlenili mcire menjis 

paTologia 

� sxva radiologuri kvlevebiT, magaliTad, kompiuteruli 

tomografiiT, an magnituri rezonansiT gamovlenili 

paTologiis Semdgomi kvleva 

� Tandayolili paTologiebis gamokvleva 

� Zlieri sisxldena, tkivili, an temperaturis momateba 

mcire menjze qirurgiuli Carevis, an mSobiarobis Semdeg 

� saSvilosnosSida kontraceptivebis lokalizacia 

� im pacientebis skrininguli kvleva, romelTac simsivnis 

ganviTarebis gazrdili riski aqvT 

11.2. 11.2. kvle kvlevis kvle vis specifika specifika: 

specifika 

11.2.1. mcire menjis transabdominaluri kvleva, Cveulebriv, 

tardeba savse Sardis buStiT, rac uzrunvelyofs 

mxedvelobis aredan airis Semcveli wvrili nawlavis 

gadawevas. iSviaTad, zedmetad gadavsebulma Sardis buStma 

SeiZleba xeli SeuSalos gamokvlevis Catarebas _ aseT 

SemTxvevaSi gamokvleva ganmeorebiT unda Catardes 

nawilobriv daclili Sardis buStiT 

11.2.2. transvaginaluri ultrasonografiia, umjobesia Catardes 

daclili Sardis buStiT. transvaginaluri transduseris 

Seyvana SeiZleba moaxdinos, rogorc eqimma, aseve Tavad 

pacientma 

11.2.3. saSvilosno 

11.2.3.1. saSvilosnos gamokvlevisas unda moxdes Semdegi monacemebis 

Sekreba da dokumentireba: 

� saSvilosnos zoma, forma da mdebareoba 

� endometriumi 

� miometriumi 

� saSvilosnos yeli 

11.2.3.2. saSvilosnos sigrZe izomeba sigrZiv RerZze saSvilosnos 

fuZidan saSvilosnos yelamde (Tu SesaZlebelia, unda 

gaizomos gareTa zoma. 

saSvilosnos siRrme (wina-ukana zoma), aseve, izomeba sigrZiv 

RerZze saSvilosnos wina kedlidan ukana kedlamde, sigrZivi 

RerZis perpendikularulad. 

saSvilosnos sigane izomeba transaqsialuri, an koronaruli 

poziciebidan. 

saSvilosnos sxeulis moculobis gansazRvrisas, gazomvebSi 

ar unda SevitanoT cervikaluri nawili 

11.2.3.3. endometriumis Sefasebisas unda gaizomos misi sisqe, 

aRiniSnos fokaluri dazianeba da masis, an siTxis arseboba 

endometriumis RruSi. monacemebis Sefasebisas unda 

76

gaviTvaliswinoT ciklis romel fazaSi xdeba gamokvleva, an 

iRebs Tu ara pacienti hormonalur preparatebs. Tu 

endometriumis suraTi ar ikveTeba, an cudad ikveTeba, es 

aucileblad unda mieTiTos eqimis daskvnaSi 

11.2.3.4. miometriumis da saSvilosnos yelis gamokvlevisas, unda 

SevafasoT maTi konturebi, eqogenuroba da warmonaqmnebis 

arseboba, an ararseboba. masebis dafiqsirebis SemTxvevaSi unda 

gaizomos, sul mcire, maTi ori zoma da dokumentirdes maTi 

lokalizacia. 

11.2.4.saSvilosnos danamatebi (sakvercxeebi da falopis milebi) 

11.2.4.1. saSvilosnos danamatebis Sefasebisas jer unda vecadoT 

sakvercxeebis gamosaxulebis miRebas. sakvercxeebis 

gamoklveva xdeba or orTogonalur sibrtyeSi. unda gaizomos 

maTi 3 zoma _ sigane, sigrZe da siRrme. cnobilia, rom 

zogierT SemTxvevaSi, magaliTad, menopauzis an didi, 

leiomiomatozuri saSvilosnos arsebobisas, sakvercxeebis 

vizulizacia ar xerxdeba 

11.2.4.2. Cveulebriv, aseve ar xerxdeba normaluri falopis milebis 

(aradilatirebuli) vizualizacia 

11.2.4.3. saSvilosnos danamatebSi simsivnuri warmonaqmnebis 

gamovlenisas unda aRniSnos da dokumentirdes maTi 

damokidebuleba sakvercxeebTan da saSvilosnosTan; aseve 

ganisazRvros masebis lokalizacia, zoma, eqogenoba da 

struqtura (cisturi, soliduri, Tu kompleqsuri). zogjer, 

danamatis vaskularizaciis dasadgenad, SesaZloa dopleris 

an feradi dopleris gamoyeneba dagvWirdes. 

11.2.5. duglasis foso (Cul-De-Sac) 

duglasis fosos da saSvilosnos ukan mdebare nawlavis 

mkafio gamosaxulebis danaxva SesaZloa ver moxerxdes. 

aRniSnuli midamo unda gamovikvlioT siTxis an masebis 

arsebobaze. simsivnuri warmonaqmnis dafiqsirebis SemTxvevaSi 

unda SevafasoT misi zoma. lokalizacia, forma, eqogenoba, da 

struqturuli maxasiaTeblebi (cisturi, soliduri, Tu 

kompleqsuri) da agreTve, maTi kavSiri saSvilosnosTan da 

sakvercxeebTan. nawlavis siTxisa da fekaluri masebisagan 

simsivnuri warmonaqmnis diferencirebaSi SesaZloa 

dagvexmaros transvaginaluri ultrasonografia. 

11.2.6. mcire menjis ultrasonografiisTvis gamoiyeneba seqtoruli, 

xazovani da transvaginaluri transduserebi, 

SeZlebisdagvarad, maRali ultrabgeriTi sixSiriT _ 

transabdominaluri kvlevebisTvis 3,5 mgh, an ufro maRali, 

transvaginaluri kvlevebisTvis, ki 5 mgh, an ufro maRali. 

77

12. 12. farisebri farisebri da da parafarisebri parafarisebri jirkvlebis 

jirkvlebis 


ltrasonografia 

12.1. 12.1. Cvenebebi Cvenebebi 

� kisris areSi palpirebadi warmonaqmnebis lokalizaciisa 

da struqturuli maxasiaTeblebis gamokvleva 

� sxva gamosaxulebiTi, an laboratoriuli kvlevebiT 

(magaliTad, farisebri jirkvlis radioizotopuri kvleviT 

gamovlenili paTologiebis Semdgomi kvleva 

� farisebri jirkvlis arsebobis dadgena da zomisa da 

lokalizaciis Sefaseba 

� avTvisebiani simsivnis gazrdili riskis mqone pacientebis 

gamokvleva 

� farisebri jirkvlis kvanZebis monitoringi 

� dadgenili, an saeWvo Tiroiduli karcinomis fonze 

daavadebis recidivis, an regionalur kvanZebSi 

metastazebis gamovlena 

� saeWvo pirveladi an meoradi hiperparaTiroidizmis fonze 

parafarisebri jirkvlebis paTologiebis kvleva 

� parafarisebr jirkvalze qirurgiuli Carevis, an 

ablaciuri Terapiis Semdgom hiperTireodizmis simptomebis 

ganmeorebiT ganviTarebisas gadidebuli paraTireoiduli 

jirkvlebis raodenobisa da zomis dadgena. 

� biofsiis, ablaciis, an sxva intervenciuli procedurebis 

win farisebri da parafarisebri jirkvlebis, an maTTan 

mimdebare kisris limfuri kvanZebis lokalizaciis dadgena 

� paraTiroiduli jirkvlis implantebis lokalizaciis 

dadgena. 

12.2. 12.2. gamoklvevis gamoklvevis specifika: 

specifika: 

12.2.1. farisebri jirkvali 

12.2.1.1. farisebri jirkvlis gamokvleva sruldeba horizontalur 

poziciaSi, daWimuli kisris fonze (gadaweuli Tavi). 

farisebri jirkvlis marjvena da marcxena wilebi unda 

daTvalierdes, sul mcire, or proeqciaSi, sigrZiv da ganiv 

WrilebSi 

12.2.1.2. unda CaviweroT orive wilis zeda, Sua da qveda nawilebis 

ganivi gamosaxulebebi; orive wilis medialuri, Sua da 

lateraluri nawilebis sigrZivi gamosaxulebebi da 

yelis, sul mcire, ganivi gamosaxuleba 

12.2.1.3. farisebri jirkvlis TiToeuli wili unda gavzomoT sam 

sibrtyeSi (wina-ukana, ganivi da sigrZivi). . izomeba yelis 

wina-ukana zoma (sisqe) 

78

12.2.1.4. unda moxdes aRmoCenili cvlilebebis dokumentireba 

(Cawera) da maTi adgilmdebarebis, zomebis (sul mcire 2 

sibrtyeSi, Tumca umjobesia samSi), raodenobis da 

struqturuli maxasiaTeblebis aRwera 

12.2.1.5. unda dokumentirdes da aRiweros mimdebare rbili 

qsovilebis (magaliTad, paTologiuri limfuri jirkvlebi, 

an Trombozuli venebi) paTologiuri cvlilebebi 

12.2.1.6. farisebri jirkvlisa da misi warmonaqmnebis 

vaskularizaciis dasadgenad SesaZlebelia speqtruli da 

feradi dopleris gamoyeneba 

12.2.1.7. SesaZleblobis SemTxvevaSi, farisebri jirkvlis 

ultrasonografiuli kvlevis Sedegebi unda Sedardes sxva 

gamokvlevebis monacemebs 

12.2.2. parafarisebri jirkvali 

12.2.2.1. parafarisebri jirkvlebis gamokvleva sruldeba 

horizontalur poziciaSi, daWimuli kisris fonze 

(gadaweuli Tavi), sigrZiv da ganiv WrilebSi orive mxares 

karotiduli arteriebidan Suaxazamde da karotiduli 

arteriebis bifurkaciidan zemoT gulmkerdis Sesavlamde 

12.2.2.2. SesaZlebelia laviwis Zvlebi faravdnen parafarisebr 

jirkvlebs da maTi ukeT vizualizaciisTvis saWiro gaxdes 

ylapviTi moZraobebis Sesruleba. zeda mediastinumSi 

lokalizebuli paraTiroiduli jirkvlebis vizualizacia 

SeiZleba moxdes sauRle fosodan. aRsaniSnavia, rom 

normaluri paraTireoiduli jirkvlebis vizualizacia 

xSirad ver xerxdeba. 

12.2.2.3. paraTireoiduli jirkvlebis vizualizaciis SemTxvevaSi, 

unda dokumentirdes maTi lokalizacia, zoma (sam 

sibrtyeSi) da raodenoba, agreTve, maTi kavSiri farisebr 

jirkvalTan 

12.2.2.4. parafarisebri jirkvlis vaskularizaciis dasadgenad 

SesaZlebelia speqtruli da feradi dopleris gamoyeneba 

12.2.2.5. SesaZleblobis SemTxvevaSi, parafarisebri jirkvlis 

ultrasonografiuli kvlevis Sedegebi unda Sedardes sxva 

gamokvlevebis monacemebs 

12.2.3. farisebri da parafarisebri jirkvlebis 

ultrasonografiisTvis gamoiyeneba xazovani transduseri, 

SeZlebisdagvarad, maRali ultrabgeriTi sixSiriT, 

Cveulebriv 10 -14 mgh. 

79

13. 13. sameano sameano ultrasonografia 


13.1. 13.1. klasifikacia 

13.1.1. pirveli trimestris kvleva 

13.1.2. meore, an mesame trimestris standartuli kvleva: 

nayofis mdebareobis dadgena, amnionuri siTxis moculobis 

dadgena, gulis aqtivobis dadgena, placentis mdebareobis 

dadgena, nayofis biometria, nayofis raodenobis dadgena da 

anatomiuri mimoxilva. garda amisa, Tu es teqnikurad 

SesaZlebelia, unda daTvalierdes dedis saSvilosnos yeli 

da misi danamatebi 

13.1.3. limitirebuli kvleva tardeba raime specifiur kiTxvaze 

sapasuxod, mag.,. sisxldenian pacientSi, nayofis gulis 

aqtivobis dasadgenad, an mSobiareSi nayofis mdebareobis 

gansasazRvrad. umravles SemTxvevaSi, limitirebuli kvleva 

tardeba adre Catarebuli sruli kvlevis Semdeg 

13.1.4. specializirebuli kvleva gulisxmobs nayofis detalur 

anatomiur daTvalierebas, rodesac anamnezis, bioqimiuri, an 

standartuli ultrasonografiuli kvlevis safuZvelze 

saeWvoa nayofis anomaliis arseboba. specializirebuli 

kvleva SeiZleba moicavdes nayofis doplerul kvlevas, 

biofizikuri profilis dadgenas, nayofis eqokardiogramas, an 

damatebiTi biometriuli gazomvebis Catarebas. 

13.2. 13.2. gamok gamokvlevis gamok gamok levis specifika specifika: 

specifika 

13.2.1. 13.2.1 13.2.1 13.2.1 pirveli pirveli pirveli pirveli trimestris trimestris trimestris trimestris kvleva kvleva kvleva kvleva 

13.2.1.1. 13.2.1.1. 13.2.1.1. Cvenebebi 

• saSvilosnoSida orsulobis dadastureba 

• saeWvo eqtopiuri orsulobis dadgena 

• vaginaluri sisxldenis mizezis dadgena 

• tkivili mcire menjis areSi 

• nayofis gestaciuri (menstrualuri) asakis Sefaseba 

• mravalnayofianobis diagnostika 

• gulis aqtivobis dadastureba 

• damxmare saSualeba qorionuli xaoebis nimuSis 

asaRebad, embrionis gadaadgilebis da mdebareobis 

Sesafaseblad da saSvilosnosSida mowyobilobis 

amosaRebad 

• maRali riskis pacientebSi nayofis zogierTi 

anomaliis, magaliTad, anencefaliiis dadgena 

80

• dedis mcire menjis, an saSvilosnos paTologiis 

gamokvleva 

• kisris naoWis (NT) sisqis gazomva, rogorc nayofis 

aneuploidiis skrining-programis nawili 

• eWvi buStnamqeris arsebobaze 

limitirebuli kvleva SeiZleba Catardes nayofis intervaluri 

zrdis da amnionuri siTxis moculobis Sesafaseblad, agreTve, 

yelis dasaTvaliereblad da gulis aqtivobis arsebobis 

dasadgenad. 

13.2.1.2. 13.2.1.2. gamosaxulebis parametrebi 

orsulobis pirveli trimestris kvleva SeiZleba Catardes, 

rogorc transabdominalurad, aseve transvaginalurad. Tu 

transabdominaluri daTvalierebiT ver xerxdeba adekvaturi 

gamosaxulebebis miReba, unda Catardes transvaginaluri an 

transperinealuri gamokvleva. 

• saSvilosno, aseve, saSvilosnos yeli da misi danamatebi unda 

daTvalierdes gestaciuri parkis aRmosaCenad. parkis 

arsebobisas, unda dadgindes misi lokalizacia da Semowmdes 

yviTris parkis, an embrionis arseboba-ararseboba. SesaZleblobis 

SemTxvevaSi, aseve, unda gaizomos Txem-kudusunis sigrZe 

Txem-kudusunis sigrZe gestaciuri (menstrualuri) asakis ufro 

zusti maCvenebelia, vidre gestaciuri parkis saSualo diametri. 

Tumca, es ukanaskneli SeiZleba gaizomos embrionis ararsebobisas. 

embrionis, an yviTris parkis ararsebobisas, sifrTxile unda 

gamoviCinoT gestaciuri parkis arsebobis dadgenisas, radgan aseT 

SemTxvevebSi, saSvilosnosSida siTxem SesaZloa datovos fsevdogestaciuri 

parkis STabeWdileba, rac Tavis mxriv, dakavSirebulia 

eqtopiur orsulobasTan. 

• unda ganisazRvros gulis aqtivobis arseboba, an ararseboba 

transvaginaluri gamokvleviT gulis aqtivobis dadgena, 

Cveulebriv, SeiniSneba roca embrionis sigrZe 5 mm, an ufro metia. 

Tu gulis aqtivoba ar SeiniSneba 5 mm-ze naklebi zomis embrionSi 

garkveuli periodis Semdeg unda Catardes ganmeorebiTi kvleva 

• nayofTa raodenobis dadgena 

81

yvela mravalnayofiani orsulobis dros unda dadgindes 

nayofis amnionebis da qorionebis xarisxi (biamnionuri, 

biqorionuli da a.S.). 

• unda Sefasdes ramdenad Seesabameba embrionis/nayofis anatomia 

pirvel trimesters. 

• unda daTvalierdes saSvilosno, saSvilosnos yeli, 

saSvilosnos danamatebi da duglasis foso 

unda Caiweros saSvilosnos danamatebis warmonaqmnebis zomebi 

da lokalizacia. unda Caiweros da gaizomos saSvilosnos yvelaze 

didi mioma. duglasis foso Semowmdes siTxis arsebobaze. 

Tu SesaZlebelia, yvela cocxali nayofis SemTxvevaSi unda 

Sefasdes kisris naoWis (NT) midamo, rogorc pirveli trimestris 

klvevis aucilebeli nawili 

im pacientebs, visTanac mizanSewonilia nayofis aneuploidiis 

riskis Sefaseba, aucilebelia Sesruldes specializirebuli 

kvleva _ specifikur asakobriv intervalSi kisris naoWis sisqis 

gazomva. (wesebi ixileT qveviT) 

kisris naoWis sisqe (Sratis bioqimiur gamokvlevasTan erTad) 

gamoiyeneba daunis sindromis, trisomia 13, trisomia 18, an nayofis 

sxva anatomiuri darRvevebis, magaliTad, gulis defeqtebis riskis 

gansasazRvrad. aseT situaciaSi, aucilebelia am struqturis 

gazomvis da xarisxis kontrolis wesebis zusti dacva, raTa 

minimumamde SevamciroT cru-dadebiTi da cru-uaryofiTi Sedegebi. 

kisris kisris kisris kisris naoWis naoWis naoWis naoWis sisqis sisqis sisqis sisqis gazomva gazomva gazomva gazomva 

• kisris kisris kisris kisris naoWi naoWi naoWi naoWi kargad kargad kargad kargad unda unda unda unda iyos iyos iyos iyos gamosaxuli 

gg 

gamosaxuli 

amosaxuli 

amosaxuli 

• nayofi nayofi nayofi nayofi unda unda unda unda iyos iyos iyos iyos Sua Sua Sua Sua sagitalur sagitalur sagitalur sagitalur sibrtyeSi 

sibrtyeSi 

sibrtyeSi 

sibrtyeSi 

• gamosaxuleba gamosaxuleba gamosaxuleba gamosaxuleba ise ise ise ise unda unda unda unda gavadidoT, gavadidoT, gavadidoT, gavadidoT, rom rom rom rom ekranze ekranze ekranze ekranze eteodes eteodes eteodes eteodes 

mxolod mxolod mxolod mxolod nayofis nayofis nayofis nayofis Tavi, Tavi, Tavi, Tavi, kiseri kiseri kiseri kiseri da da da da gulmkerdis gulmkerdis gulmkerdis gulmkerdis zeda zeda zeda zeda nawili nawili nawili nawili 

• nayofis nayofis nayofis nayofis kiseri kiseri kiseri kiseri unda unda unda unda iyos iyos iyos iyos neitralur neitralur neitralur neitralur poziciaSi poziciaSi poziciaSi poziciaSi _ _ _ _ arc arc arc arc 

moxrili moxrili moxrili moxrili arc arc arc arc gaSlili gaSlili gaSlili gaSlili 

• amnioni amnioni amnioni amnioni gamoyofili gamoyofili gamoyofili gamoyofili unda unda unda unda iyos iyos iyos iyos kisris kisris kisris kisris naoWis naoWis naoWis naoWis xazisgan xazisgan xazisgan xazisgan 

• kisris kisris kisris kisris naoWis naoWis naoWis naoWis sisqis sisqis sisqis sisqis gasazomad gasazomad gasazomad gasazomad gamoiyeneba gamoiyeneba gamoiyeneba gamoiyeneba (+) (+) (+) (+) kaliperebi 

kaliperebi 

kaliperebi 

kaliperebi 

• eleqtronuli eleqtronuli eleqtronuli eleqtronuli kaliperebi kalipere kalipere kaliperebi 

bi bi unda unda unda unda movaTavsoT movaTavsoT movaTavsoT movaTavsoT kisris kisris kisris kisris naoWis naoWis naoWis naoWis 

Sida Sida Sida Sida kideebze kideebze kideebze kideebze 

• kaliperebi kaliperebi kaliperebi kaliperebi unda unda unda unda moTavsdes moTavsdes moTavsdes moTavsdes nayofis nayofis nayofis nayofis grZeli grZeli grZeli grZeli RerZis RerZis RerZis RerZis 

perpendikularulad. 




• unda unda unda unda gaizomos gaizomos gaizomos gaizomos kisris kisris kisris kisris naoWis naoWis naoWis naoWis yvelaze yvelaze yvelaze yvelaze sqeli sqeli sqeli sqeli nawili 

nawili nawili nawili 

82

13.2.2. 13.2.2. meore meore da da mes mesame mes ame trimestris 

trimestris kvleva 

kvleva 

13.2.2.1. 

13.2.2.1. 

Cvenebebi Cvenebebi 

Cvenebebi 

• gestaciuri (menstrualuri) asakis Sefaseba 

• nayofis zrdaze dakvirveba 

• vaginaluri sisxldena 

• tkivili muclis, an mcire menjis RruSi 

• saSvilosnos yelis naklovaneba 

• nayofis mdebareobis gansazRvra 

• savaraudo mravalnayofianoba 

• amniocentezis an sxva proceduris damxmare 

saSualeba 

• mniSvnelovani gansxvaveba saSvilosnos zomasa da 

klinikur monacemebs Soris 

• menjis Rrus warmonaqmni 

• eWvi buStnamqerze 

• saSvilosnos yelis cervikaluri cirklaJi 

• saeWvo eqtopiuri orsuloba 

• eWvi nayofis sikvdilze 

• eWvi saSvilosnos paTologiaze 

• nayofis mdgomareobis Sefaseba 

• eWvi amnionuri wylebis paTologiaze 

• eWvi placentis aSrevebaze 

• damxmare saSualeba nayofis cefalur poziciaSi 

gadayvanisas 

• sanayofe buStis naadrevi gaxeva da/an naadrevi 

mSobiaroba 

• cvlileba bioqimiur markerebSi 

• ganmeorebiTi kvleva nayofis anomaliis arsebobisas 

• eWvi placentis wina mdebareobaze 

• anamnezSi, nayofi Tandayolili anomaliiT 

• nayofis mdgomareobis dadgena prenataluri movlis 

gviani registraciis SemTxvevaSi 

• im maxasiaTeblebis dadgena, ramac SesaZloa 

gazardos aneuploidiis riski 

• nayofis anomaliebis skriningi 

garkveul klinikur situaciebSi SesaZloa saWiro gaxdes 

nayofis anatomiis ufro detaluri daTvaliereba. 

83

13.2.2.2. 13.2.2.2. 13.2.2.2. gamosaxulebis gamosaxulebis parametrebi parametrebi (standartuli (standartuli kvleva) 

kvleva) 

• unda ganisazRvros nayofis gulis aqtivoba, nayofTa raodenoba 

da mdebareoba 

unda dafiqsirdes gulis cemis sixSire da/an ritmis darRveva. 

mravalnayofianobis dros saWiroa damatebiTi informaciis 

dokumentacia: qorionis xarisxi, amnionis xarisxi, nayofebis 

zomebis Sedareba, amnionuri siTxis moculobis Sefaseba 

(gazrdili, Semcirebuli, normaluri) da nayofis genitaliebi (Tu 

vizualizirdeba). 

• amnionuri siTxis moculobis xarisxobrivi an raodenobrivi 

Sefaseba 

misaRebia gamocdili ultrasonograferis mier amnionuri siTxis 

moculobis xarisxobrivi Sefaseba, Tumca SegviZlia gamoviyenoT 

naxevrad-raodenobrivi meTodebic (mag. amnionuri siTxis indeqsi, 

erTi Rrma jibe, ormagi jibe). 

• unda Sefasdes placentis mdebareoba, mdgomareoba da kavSiri 

yelis SigniTa RerZTan. unda daTvalierdes Wiplari da Tu, 

SesaZlebelia, ganisazRvros masSi gamavali sisxlZarRvebis 

raodenoba. 

placentis mdebareoba orsulobis adreul periodSi SeiZleba ar 

Seesabamebodes mis mdebareobas mSobiarobis dros. 

transabdominaluri, transperinealuri, an transvaginaluri 

daTvaliereba gvexmareba saSvilosnos yelis SigniTa RerZis 

placentasTan kavSiris vizualizaciaSi. 

transvaginaluri an transperinealuri ultrasonografia 

SeiZleba dagvWirdes, Tu yeli damoklebulia, an araadekvaturad 

vizualizdeba transabdominaluri daTvalierebiT. 

• gestaciuri (menstrualuri) asakis dadgena 

Txem-kudusunis sigrZis gansazRvra yvelaze zusti meTodia 

orsulobis vadis dasadgenad pirvel trimestrSi. mogvianebiT 

orsulobis vadis dadgena sxva sonografiuli parametrebiTacaa 

SesaZlebeli, rogoricaa: biparietuli diametri, muclis 

garSemoweriloba da barZayis diafizis sigrZe. mniSvnelovani 

84

sxvaoba gestaciur (menstrualur) asaksa da nayofis zomebs Soris 

SeiZleba miuTiTebdes nayofis zrdis darRvevaze, zrdaSi 

CamorCenasa, an makrosomiaze. 

Tu orsulobis adreul vadebSi Catarebulia detaluri 

ultrasonografiuli klveva, momdevno vadebze Sesrulebuli 

kvlevis monacemebiT ar SeiZleba orsulobis vadebis Secvla. 

o biparietuli biparietuli diametri diametri izomeba Talamusisa da gamWvirvale 

Zgidis doneze. am gamosaxulebaze ar unda 

vizualizdebodes naTxemis hemisferoebi. Gazomva warmoebs 

Tavis qalis proqsimaluri nawilis gare kidedan 

distaluri nawilis Sida kidemde. 

normaSi Tavis forma SeiZleba iyos brtyeli 

(doliqocefalia), an mrgvali (braqicefalia). amis gamo, 

gestaciuri asakis dasadgenad, biparietaluri diametris 

gansazRvraze zusti Tavis garSemowerliobis gazomvaa. 

o Tavis Tavis garSemoweriloba garSemoweriloba izomeba igive doneze rogorc 

biparietaluri diametri (Tavis qalis gare perimetri). am 

zomaze gavlenas ar axdens Tavis forma 

o barZayis barZayis barZayis diafizis diafizis sigrZe sigrZe SegviZlia gavzomoT gestaciuri 

(menstrualuri) asakis me-14 kviridan. yvelaze zustad, 

barZayis grZeli RerZi izomeba, rodesac 

ultrasonografiuli sxivi mimarTulia barZayis grZeli 

RerZis perpendikularulad (ar unda gaizomos barZayis 

distaluri epifizi) 

o muclis muclis garSemoweriloba, garSemoweriloba, garSemoweriloba, an an muclis muclis saSualo saSualo saSualo diametri diametri 

diametri 

isazRvreba kanis xazze, WeSmarit ganiv sibrtyeSi Wiplaris 

venis, portaluri sinusis da nayofis kuWis (Tu 

vizualizdeba) SeerTebis adgilas. 

muclis garSemoweriloba, an muclis saSualo diametri, sxva 

biometriul parametrebTan erTad, gamoiyeneba nayofis wonis 

dasadgenad da nayofis zrdaSi CamorCenis, an makrosomiis 

gansasazRvravad. 

• nayofis wonis Sefaseba 

nayofis wona SeiZleba ganvsazRvroT biparietuli diametriT, Tavis 

garSemowerilobiT, muclis garSemowerilobiT da barZayis 

85

diafizis sigrZiT. Sedegebi unda SevadaroT nayofis wonis 

procentebs mowodebul normogramebSi. 

nayofis zrdis Semowmeba unda moxdes, sul mcire 2-4 kviriani 

SualedebiT. ufro mokle intervalebiT skanirebisas ver viqnebiT 

darwmunebuli, rom riTaa gamowveuli anatomiuri cvlilebebi: 

namdvilad nayofis zrdiT, Tu gazomvis teqnikis variaciebiT. 

am etapze, nayofis wonis ganmsazRvrel yvelaze zust meTodsa 

da realur wonas Soris sxvaoba 15%-is farglebSia, rac SesaZloa 

gamowveuli iyos, rogorc populaciis anatomiuri TaviseburebebiT, 

aseve teqnikuri faqtorebiT. 

• dedis anatomia 

unda moxdes saSvilosnos, misi danamatebis da yelis daTvaliereba. 

Tu yelis vizualizacia gaZnelebulia, saWiroebis SemTxvevaSi 

SeiZleba Catardes transperinealuri, an transvaginaluri 

daTvaliereba. 

amiT SesaZloa moxdes klinikurad mniSvnelovani darRvevebis 

aRmoCena. unda dafiqsirdes saSvilosnos danamatebis nebismieri 

warmonaqmnis arseboba, mdebareoba da zoma; agreTve, struqturuli 

yvelaze didi, klinikurad mniSvnelovani saSvilosnos leiomioma. 

orsulobis meore da mesame trimestrebSi, xSirad ver xdeba dedis 

normaluri sakvercxeebis vizualizacia. 

• nayofis anatomiuri daTvaliereba 

nayofis anatomiis qvemoT aRwerili daTvaliereba SesaZlebelia 

daaxloebiT me-18 kviridan. ufro adreul vadebze, SesaZloa 

movaxdinoT normaluri struqturebis vizualizacia, Tumca 

zogierTi struqturebis daTvaliereba SeiZleba gaZneldes nayofis 

zomis, mdebareobis, moZraobis, dedis muclis nawiburebis da 

muclis sqeli kedlis gamo. orsulobis meore, an mesame trimestrSi 

ultrasonografiis Catarebisas SesaZloa gamovlindes akustikuri 

CrdilebiT gamowveuli teqnikuri xarvezebi, rac aucileblad unda 

dafiqsirdes. Semdgomi kvlevebi SeiZleba dagvexmaros damatebiTi 

informaciis mopovebaSi. 

nayofis anatomiis standartuli klvevis minimaluri elementebi 

CamoTvlilia qvemoT. Tu aseTi kvlevis Sedegad eWvi gaCnda, da ar 

gamovlinda raime anomalia, saWiroa ufro detaluri gamokvlevis 

Catareba. 

86

o Tavi, Tavi, saxe saxe da da da kiseri 

kiseri 

naTxemi 

qoroiduli wnulebi 

didi cisterna 

gverdiTi parkuWebi 

tvinis farda 

gamWvirvale Zgide 

zeda tuCi 

specifikur asakobriv intervalebSi kisris naoWis gazomva 

SeiZleba dagvexmaros aneuploidiis gazrdili riskis dadgenaSi. 

o gulmkerdi 

gulmkerdi 

gulis bazisuri daTvaliereba, nayofis 

oTx-kameriani gamosaxulebis miReba 

Tu teqnikurad SesaZlebelia, unda 

daTvalierdes parkuWebis gamomavali 

traqtebic 

o muceli muceli 

muceli 

kuWi (arseboba, zoma da mdebareoba) 

Tirkmelebi 

Sardis buSti 

Wiplaris SeerTeba nayofis mucelTan 

WiplarSi gamavali sisxlZarRvebis 

raodenoba 

o xerxemali 

xerxemali 

kisris, gulmkerdis, welis da gavis nawilebi 

o kidurebi 

kidurebi 

fexebi da xelebi_ arseboba an ararseboba 

o sqesi 

sqesi 

fasdeba mxolod dabali riskis orsulebSi, 

an mravalnayofianobis dros. 

13.2.3. transabdominaluri kvlevisTvis, Cveulebriv, saWiroa 3-5 mgh 

sixSiris transduseri. Warbwoniani dedebisTvis SesaZloa 

dagvWirdes ufro dabali sixSiris (2-2,25 mgh) transduseris 

gamoyeneba. orsulobis adreul vadebze SesaZloa gamoviyenoT 

5 mgh-iani transabdominaluri, an 5-10 mgh sixSiris 

transvaginaluri transduserebi. 

87

14. 14. 14. sonohisterografia 

sonohisterografia 

sonohisterografiis mizania endometriuli Rrus detaluri 

daTvaliereba. 

14.1 14.1 Cvenebebi da ukuCv ukuCvenebebi 

ukuCv 

enebebi 

14.1.1. Cvenebebi 

• saSvilosnos disfunqciuri sisxldenebi, rogorc 

premenopauzalur, ise postmenopauzalur periodSi 

(yvelaze xSiri Cveneba) 

• unayofoba da Cveuli aborti 

• saSvilosnos Rrus Tandayolili daavadebebi 

• saSvilosnos Rrus daTvaliereba, gansakuTrebiT 

saSvilosnos miomis, polipis da Sexorcebebis 

arsebobasTan mimarTebaSi 

• endovaginaluri sonografiiT aRmoCenili paTologiebi, maT 

Soris, endometriumis lokaluri an difuzuri dazianebebi 

• endovaginalur sonografiiT endometriumis gaZnelebuli 

vizualizaciis Semdeg 

14.1.2. ukuCvenebebi 

14.1.2.1. sonohisterografia ar unda Catardes orsulebSi, an 

savaraudo orsulobis dros. amis gamo, Cveulebriv, 

gamokvleva tardeba menstrualuri ciklis folikulur 

fazaSi, ciklis dasrulebis Semdeg, ovulaciamde. 

regularuli ciklis mqone pacientebSi es procedura 

umravles SemTxvevaSi unda Catardes araugvianes ciklis me-10 

dRisa 

14.1.2.2. sonohisterografiis Catareba ukunaCvenebia mcire menjis 

Rrus dadgenili, an saeWvo infeqciebis dros 

14.2.2.3. aqtiuri vaginaluri sisxldena ar warmoadgens gamokvlevis 

ukuCvenebas, magram SesaZloa gaaZnelos Sedegis 

interpretacia. 

14.2. 14.2. gamokvlevis gamokvlevis specifika specifika: 

specifika 

14.2.1 pacientis momzadeba 

proceduris dawyebamde saWiroa winaswari endovaginaluri 

sonografiis Catareba, raTa SevafasoT xom ar aris 

mtkivneuli menjis Rrus romelime organo. Tu danamatebis 

mtkivneuloba gamovlinda intrauterinul infuziamde, rac 

savaraudos xdis mwvave infeqciis arsebobas, saWiroa 

gamokvleva gadaidos Sesabamisi mkurnalobis Catarebamde. 

umtkivneulo hidrosalpingozis SemTxvevaSi, mkurnal eqimTan 

SeTanxmebiT, SesaZloa procedura Catardes 

antibiotikoTerapiis fonze. klinikuri Cvenebis SemTxvevaSi, 

88

gamokvlevamde unda Catardes orsulobis testi. aseve, 

lateqsis SaliTis gamoyenebamde, pacienti unda gamoikiTxos 

lateqsis mimarT alergiuli reaqciis arsebobaze. 

menstrualuri asakis qalebSi, sonohisterografiis Catarebis 

optimaluri droa ciklis dasrulebidan _ ovulaciis 

dadgomamde. 

14.2.2. procedura 

sonohisterogarfiis Catarebamde saWiroa Catardes winaswari 

endovaginaluri sonografia endometriumis gazomviT da 

saSvilosnos da sakvercxeebis gamokvleviT. yelis 

daTvaliereba xdeba sarkeebis gamoyenebiT. araadekvaturi 

mtkivneuloba, dazianebebis, vaginaluri, an cervikaluri 

Cirqovani gamonadenis arseboba saWiroebs proceduris 

gadadebas da damatebiTi kvlevebis Catarebas. saSvilosnos 

yelis gareTa bagis gasufTavebis Semdeg, cervikalur arxSi 

da/an saSvilosnoSi, aseptiuri teqnikiT vdgamT kaTeters da 

sonografiuli kontroliT, neli nakadiT, manualurad 

Segvyavs steriluri siTxe. 

14.2.3. sakontrasto nivTiereba 

sakontrasto nivTierebad gamoiyeneba steriluri 

fiziologiuri xsnari (salini), an wyali. 

14.2.4. gamosaxuleba 

cervikaluri arxis da saSvilosnos Rrus gamosaxulebebi 

unda miviRoT or sibrtyeSi maRali sixSiris endovaginaluri 

transduseris gamoyenebiT. kaTeterizaciamdeli 

gamosaxulebebi aucileblad unda moicavdes endometriumis 

yvelaze farTo or-Srian gamosaxulebas sagitalur WrilSi. 

saSvilosnos Rrus siTxiT avsebis Semdeg xdeba sruli 

ultrasonografiuli daTvaliereba. baloniani kaTeteris 

gamoyenebis SemTxvevaSi, endometriumis Rru, kerZod 

cervikaluri arxi da saSvilosnos qveda segmenti unda 

daTvalierdes proceduris bolos, balonis CafuSvis 

Semdegac. 

15. 15. winamdebare winamdebare jirkvlis jirkvlis da da misi misi garSemomyofi 

garSemomyofi 

struqturebis struqturebis ultrasonogarfia 

ultrasonogarfia 


Cvenebebi 

• winamdebare jirkvlis kibos, prostatis keTilTvisebiani 

simsivnis, prostatitis da mamakacuri unayofobis 

diagnostika 

• winamdebare jirkvlis kibos, abscesis da prostatis 

keTilTvisebiani simsivnis mkurnaloba 

89

• winamdebare jirkvlis kibos skriningi (manualur 

reqtalur gasinjvasa da SratSi prostat-specifiuri 

antigenis (PSA) donis gazomvasTan erTad) 

• winamdebare jirkvlis, ultrasonografiuli 

meTvalyureobiT, Sesrulebuli biofsia, Tu manualuri 

reqtaluri gasinjviT, an SratSi prostat-specifiuri 

antigenis (PSA) donis gazomviT, saeWvoa winamdebare 

jirkvlis kibo 

15.2. 15.2. gamokvlevis gamokvlevis gamokvlevis specifika specifika: 

specifika 

15.2.1. winamdebare jirkvali 

15.2.1.1. winamdebare jirkvlis vizualizaciisaTvis, 

transabdominalur, an transperinealur, midgomasTan 

SedarebiT, upiratesoba eniWeba transreqtalur midgomas. 

Tumca, transreqtaluri midgomis teqnikurad SeuZleblobis 

SemTxvevaSi, prostatis biofsiis ultrasonografiuli 

meTvalyureobisaTvis, SesaZloa gamoviyenoT 

transperinealuri midgoma. transabdominaluri gamokvleviT 

SeiZleba winamdebare jirkvlis zomis Sefaseba 

15.2.1.2. winamdebare jirkvlis gamosaxulebebi unda miviRoT, sul 

mcire, or orTogonalur: sagitalur da aqsialur, an 

sagitalur da koronalur sibrtyeebSi, jirkvlis 

mwvervalidan fuZemde WrilebSi. jirkvlis moculobis 

gamoTvla xorcieldeba sam orTogonalur sibrtyeSi 

Catarebuli gazomvebiT. SesaZloa, jirkvlis moculoba 

korelirebdes PSA-is donesTan 

15.2.1.3. jirkvali unda daTvalierdes fokaluri masis arsebobis, 

eqogenobis, simetriulobis da kideebis uwyvetobis 

Sesafaseblad. ferad-dopleruli gamokvleva gvexmareba 

gaZlierebuli vaskularizaciis ubnebis aRmosaCenad, rac 

SesaZloa gamoyenebul iqnes sabiofsio areebis mosaniSnad. 

unda Sefasdes jirkvlis garSemo arsebuli cximovani 

qsovilis da neirovaskularuli boWkoebis simetriuloba da 

eqogenoba. prostatizmis simptomebis arsebobisas, 

SesaZleblobis SemTxvevaSi, unda daTvalierdes SardsawveTis 

prostatuli nawili da marcxena da marjvena 

periureTraluri qsovilis simetriuloba, agreTve, Sardis 

buStis fuZesTan maTi SeerTebis adgili 

15.2.2. saTesle buStukebi, saTesle milakebi (Vasa Deferentia) da 

perireqtaluri sivrce 

15.2.2.1.srul sigrZeze unda gamovikvlioT saTesle buStukebis zoma, 

forma, mdebareoba, simetriuloba da eqogenoba. gansakuTrebiT 

sayuradReboa winamdebare jirkvalTan maTi dakavSirebis 

adgili. 

15.2.2.2.unayofobis gamo dagegmili ultrasonografia gulisxmobs 

saTesle milakebis gamokvlevas 

90

15.2.3. winadebare jirkvlis ultrasonografiisTvis gamoiyeneba 

transreqtaluri (endoreqtaluri) transduseri, 

SeZlebisdagvarad, maRali ultrabgeriTi sixSiriT, 

Cveulebriv 6 mgh da ufro maRali. gamokvlevis dros 

transreqtaluri gadamwodi unda moTavsdes erTjerad 

SaliTaSi, xolo gamoklvevis dasrulebisas, SaliTis 

mocilebis Semdeg, igi saWiroebs aucilebel dezinfeqcias. 

transabdominaluri da transperinealuri gamokvlevisTvis 

SesaZloa saWiro gaxdes ufro dabali sixSiris gamoyeneba. 

16. 16. saTesle saTesle jirkvlis jirkvlis ultrasonografia 


16.1. Cvenebebi Cvenebebi 

Cvenebebi 

• tkivili saTesle jirkvlis areSi 

• saTesle jirkvlis iSemia/Semogrexva 

• saTesle jirkvlis Sesieba/gadideba 

• infeqcia an anTebiTi daavadeba, rogoricaa: epididimiti, 

orqiti, an saTesle jirkvlis abscesi 

• saTesle jirkvlis asimetriulobis da jirkvlovani 

warmonaqmnebis mdebareobis (intratestikuluri, Tu 

eqstratestikuluri) da Taviseburebebis gamokvleva 

• ukve dadgenili metastazebis SemTxvevaSi, pirveladi 

simsivnis aRmosaCenad 

• pacientis monitoringi saTesle jirkvlis pirveladi 

simsivnis, leikemiis an limfomis SemTxvevaSi 

• saTeslis eqstratestikuluri Semadgenlobis gamokvleva 

• saTesle jirkvlis travma 

• kriptorxizmis SemTxvevaSi, saTesle jirkvlis 

lokalizaciis dadgena 

• unayofo mamakacebSi varikoceles aRmoCena 

16.2. 16.2. gamokvlevis specifika specifika: 

specifika 

16.2.1. saTesleebi unda daTvalierdes, sul mcire, or: grZiv da 

ganiv proeqciebSi. gamosaxulebebi unda moicavdes TiToeuli 

saTeslis rogorc zeda, Sua da qveda, ise medialur da 

lateralur wilebs da SeZlebisdagvarad, unda Sedardes 

erTmaneTs. saTesle jirkvalebi unda gamovikvlioT 

danamatebTan erTobliobaSi. unda gaizomos saTesle parkis 

sisqe 

91

16.2.2. yvela zrdasruli mamakacis saTesle jirkvlis 

ultrasonogarfiuli kvleva moicavs doplerul Sefasebasac. 

dazianebuli jirkvlis sisxlis nakadi da simetriuloba unda 

SevadaroT normalurs 

16.2.3. saTesleebis ultrasonografiisTvis umjobesia seqtoruli, an 

xazovani transduseris gamoyeneba, SeZlebisdagvarad, maRali 

ultrabgeriTi sixSiriT (pediatriul pacientebSi 7-10 mgh, 

mozrdilebSi 5 mgh, an ufro maRali,). dopleruli 

kvlevebisTvis gamoiyeneba 3,5-10 mgh sixSiris ultrabgera. 

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Radiology manual in Georgian

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