Neurological Advanced Studies

Mushure mokuongorora kushaya mishonga, kuongorora mumuviri, nhoroondo yevarwere, x-rays uye chero ipi zvayo yekuongorora kuongororwa, chiremba anogona kuraira imwe kana zvimwe zvezvinotevera kuongororwa mutsva kuti atarise midzi yeanokwanisa / yekufungidzirwa neurological disorder kana kukuvara. Izvi zvinowanzobatanidza neuroradiology, iyo inoshandisa zvishoma zvinyorwa zve-radioactive kuti zviongorore chimi chebasa uye sarudzo uye ordiagnostic imaging, iyo inoshandisa magetsi nemagetsi ekuongorora chimi chebasa.

Neurological Studies

Neuroradiology

• MRI
• MRA
• MRS
• fMRI
• CT inoongorora
• Myelograms
• PET inoongorora
• Vamwe vazhinji

Magnetic Resonance kuri (MRI)

Inoratidza nhengo kana zvinyoro zvinyoro zvakanaka

• Kwete mazai eoni

Kusiyana kweMRI

• Magnetic resonance angiography (MRA)
• Ongorora ropa richiyerera mumariti
• Tsvaga zvinyorwa zvisingabatsiri uye kusagadzikana kwepascular

Magnetic resonance spectroscopy (MRS)

• Chengetedza kukanganisa kwemakemikari mune hutachiona hweHIV, kurohwa, kuora musoro, coma, chirwere cheAlzheimer, tumor, uye multiple sclerosis

Inoshandiswa magnetic resonance imaging (fMRI)

• Sarudza nzvimbo chaiyo yeuropi iyo basa rinoitika

Computed Tomography (CT kana CAT Scan)

• Inoshandisa kuwirirana kwe-X-rays nekombiyuta yekombiyuta kuti ibudise zvitsvene, kana axial, mifananidzo
• Anoratidza mapfupa zvakanyanya zvakanaka
• Inoshandiswa apo kuongororwa kweuropi kunoda kukurumidza zvakadai sekufungidzirwa ropa uye fractures

Myelogram

Kusiyanisa dhayi pamwe chete neC CT kana Xray

Yakawanda inobatsira pakucherechedza rwonzi rwomusana

• Stenosis
• Tumor
• Nerve root injury

Positron Emission Tomography (PET Scan)

Radiotracer inoshandiswa kuongorora metabolism yemaviri kuti ione kuchinja kwezvinhu zvipenyu kune imwe nguva kupfuura dzimwe dzidzo dzokudzidza

Yakashandiswa kuongorora

• Chirwere cheAlzheimer
• Chirwere chePalinson
• Chirwere cheHuntington
• pfari
• Cerebrovascular accident

Electrodiagnostic Studies

• Electromyography (EMG)
• Nerve Conduction Velocity (NCV) Studies
• Zvakavhiringidzika Zvimwe Zvidzidzo

Electromyography (EMG)

Kuziva zviratidzo zvinokonzerwa nekudengenyeka kwemakumbo emasumbu

Inogona kuyerwa kuburikidza ne:

• Ganda kumusoro electrodes
• Haana kushandiswa pakuongorora zvirongwa, zvimwe zve rehab uye biofeedback

Nyeredzi dzakaiswa zvakananga mukati memusuru

• Kazhinji kumakiriniki / kuongororwa EMG

Ndozi Inoshandiswa EMG

Zvinyorwa zverepolarizations zvinogona kuva:

• Zvinowanzoitika
• Basa rekusimudzira
• Mugumisiro wekuzvidira musimba kuputika

Misungo inofanira kunge iine magetsi yanyarara pazororo, kunze kwepombi yekupedzisira

• Mushandi anofanira kudzivisa kuiswa mumupfuti wemagetsi

Zvichida 10 pfungwa dzakasiyana mumusumbu dzinotaridzirwa nenzira yakarurama

nzira

Nyore inopindirwa mumusungo

• Basa rekusimudzira rakanyorwa
• Kunyarara kwegetsi kwakanyorwa
• Voluntary muscle contraction yakanyorwa
• Kunyarara kwegetsi kwakanyorwa
• Maitiro makuru ekudzivirira akanyorwa

Samples Akaunganidza

tsandanyama

• Inotarisirwa nehutano hwakafanana asi yakasiyana nemidzi yemidzi
• Inotarisirwa nehutano humwechete asi hutano hwakasiyana
• Nzvimbo dzakasiyana-siyana pamwe chete nematambudziko

Inobatsira kusiyanisa hutachiona chechionda

Motor Unit Potential (MUP)

Amplitude

• Kuwanda kwehutundu hwemisumbu inosungirirwa kune iyo motokari yemukati
• Kunyoresa kweMUP

Nzira yekudzidzira inogona kuongororwawo

• Kurambidza kubhadhara kunogona kuratidzira kurasikirwa kwezvitima mukati memutsipa
• Kutanga kushanyira kunoonekwa mune myopathy, uko MUPs inowanzove yakaderera nguva shoma

MUPS yePolphasitiki

• Kuwedzerwa kwemamita uye nguva inogona kuva mugumisiro we reinnervation mushure mekuregererwa kwekugara

Complete Potential Blocks

• Kuderedza kuwanda kwezvikamu zvakasiyana-siyana mumutsara kunogona kukonzera chizere chakazara chekuita mutsara uye naizvozvo hakuna kuunza MUP kuverenga, zvisinei kuchinja kukuru muMUPs kunongowanikwa nekukuvadza kune axon, kwete myelin
• Kukuvadza kunheyo yenheyo yepamusoro pamusoro pehupamhi yemotokari yeururoni (yakadai nemukomana wepervical cord trauma or stroke) kunogona kukonzera kuora muviri kwakakwana zvishoma zvisina kumira painete reEG

Yakasvibiswa Muscle Fibers

Zvicherechedza sechiratidzo chemagetsi chisina kujairika

• Kuwedzera kwekuita basa rekunyora kunogona kuverengwa mumavhiki mashomanana ekutanga, sezvo inowedzera kunyanya kugadziriswa

Sezvinoita mishonga yemasikironi inowedzera makemikari anononoka inotanga kubudisa basa rekuita zvekupora

• Kufunganya kunogona

Kufara Kwezvakaitika

• HAKASI kuitika mumasikironi akafanana
• Kukwikwidza hakugone kuonekwa neziso rakashama asi kunoonekwa pa EMG
• Kazhinji inokonzerwa nehutachiona hwehutachiona, asi inogona kubudiswa nehutachiona hwehutachiona hwakanyanya kana pane kukanganisa kumakumbo emotokari

Positive Sharp Waves

• HASI kuitika mumasikirini anowanzoshanda
• Kurasikirwa kwepachivande kunokonzerwa nekuwedzera kwemuviri wechipfuva

Abnormal Findings

• Zviwanikwa zvefibrillations uye majeko akanaka akasimba ndiyo chiratidzo chinonyatsovhiringidza chekuvhiringidzika kune motokisi yemotokisi kusvika mushure mushure mevhiki imwe kusvika kumwedzi 12 mushure mekuparadzwa
• Kazhinji inonzi acute mumishumo, kunyangwe ingangove mwedzi inoonekwa mushure mekutanga
• Ichazonyangarika kana kune kukwana kwakakwana kana kuti kusagadzikana kwehutachiona

Nerve Conduction Velocity (NCV) Studies

motokari

• Miitiro inowanikwa muscle action potential (CMAP)

Sensory

• Nzira sensory nerve action potential (SNAP)

Nerve Conduction Studies

• Velocity (Speed)
• Terminal latency
• Amplitude
• Tables ezvakanaka, yakagadziridzwa kwezera, urefu uye zvimwe zvinhu zvinowanika kuvaridzi kuti vaenzanise

Terminal Latency

• Nguva pakati pekukurudzira uye kuonekwa kwekupindura
• Kushungurudzwa kwemavara neuropathies
• Kuwedzera kwechigumira latency kune imwe nzira yenzira

Velocity

Yakayerwa maererano ne latency uye zvipembenene zvakadai semakiromita

Ichitenderera pamadziro eadon

Uyewo unofanirwa nehupamhi hwe myelin sheath

• Focal neuropathies yakatetepa myelin sheaths, inononoka conduction velocity
• Mamiriro ezvinhu akafanana neCharcot Marie Tooth Disease kana Guillian Barre Syndrome inokuvadza myelin muhombe huru, kufambisa fiber

Amplitude

• Axonal utano
• Dhiyabhorosi neuropathies
• CMAP uye SNAP amplitude yakavhiringidzwa

Diabetes Neuropathy

Yakawanda inowanikwa Neuropathy

• Distal, symmetric
• Kuodzwa kwemhepo uye kukuvadza kwe-axonal saka kukurumidza uye kukura kwekutengesa zvose zvakabatwa

Zvakavhiringidzika Zvimwe Zvidzidzo

Somatosensory yakabviswa zvinogona (SSEPs)

• Yakashandiswa kuedza nhungurudzo dzemakumbo mumakumbo

Kuonekwa kunokonzerwa nemikana (VEPs)

• Yakashandiswa kuedza nhungurudzo dzemanzwiro ezvioni

Brainstem auditory yakavhiringidza mikana (AEPs)

• Yakashandiswa kuedza nhungurudzo dzenheyo dzemabhuku ekuongorora

Nzvimbo dzepamusoro dzakanyorwa kuburikidza ne-low-impedance surface electrodes

Zvinyorwa zvinyorwa mushure mekunge zvadzokerazve kune zvinokonzerwa nemanzwiro

• Inobvisa kumashure noise
• Inogadzirisa mitsva sezvo zvigone zviduku uye zvakaoma kuona kunze kwebasa rekuita
• Maererano naDr. Swenson, munyaya yeSSEPs, zvishoma ne256 zvinowanzodiwa kuitira kuwana mhinduro dzakatendeka, dzinogadziriswa

Somatosensory Akavhiringidza Maitiro (SSEPs)

Kunzwa kubva mumasumbu

• Kubata uye kukurira zvinogadziriswa paganda uye mukati maviri

Zvishoma kana zviripo marwadzo Mupiro

• Miganhu yekugona kushandisa kuongororwa kwemarwadzo ekurwadziwa

Velocity uye / kana matanho ekuchinja zvinogona kuratidza hutachiona

• Kuchinja kukuru chete kunokosha kubvira SSEPs inowanzosiyana zvikuru

Inobatsira pakushandura kwepraoperative uye kuongorora kufungidzira kwevarwere vane chirwere chakakomba chinokonzerwa neuropi

• Hazvibatsiri pakuongorora radiculopathy semunhu mumwe musinga midzi haigoni kuonekwa nyore nyore

Zuva Rekushandisa

Ita zvinopfuura 10-20 milliseconds mushure mekusimudzirwa kwemagetsi

Mhando mbiri

• H-Reflex
• F-Mhinduro

H-Reflex

Anonzi ainzi Dr. Hoffman

• Chokutanga chakatsanangura izvi zvinyorwa mu1918

Electrodiagnostic manifestation ye myotatic stretch reflex

• Motokari inopindurwa yakanyorwa mushure mekushandisa magetsi kana kuti kutowedzera kushandiswa kwemisungo yakabatana

Chechipiki chete inobatsira pakucherechedza S1 radiculopathy, sezvo kufungidzira kubva mumutsipa we-tibial kutarisa surae kunogona kuongororwa kuti velocity uye amplitude

• Zvimwe zvinyorwa zvekuti Achilles reflex kuedza
• Inokundikana kudzoka nayo mushure mekukuvadza uye naizvozvo kwete semakiriniki anobatsira mumakororo anowanzobuda radiculopathy

F-Mhinduro

Saka akatumidzwa nokuti yakatanga kunyorwa mutsoka

Inoitika 25 -55 milliseconds mushure mekutanga kwekusimudzira

Pamusana pekudzivirira kuderedza dutu remhepo, inoita kuti zviratidzo zvemagetsi zvinyorwa

• Haisi chokwadi chechokwadi
• Migumisiro mune zviduku zvinokonzera musimba
• Amplitude inogona kunge yakasiyana zvikuru, saka haisi yakakosha sevelocity
• Kuderedza velocity kunoratidza kunonoka kwekutengesa

Inobatsira pakucherechedza hutachiona hwehutano hwehutano

• Radiculopathy
• Guillian Barre Syndrome
• Chronic Inflammatory Demyelinating Polyradiculopathy (CIDP)

Inobatsira pakuongorora demyelinative peripheral neuropathies

Sources

1. Alexander G. Reeves, A. & Swenson, R. Kukanganiswa kweNervous System. Dartmouth, 2004.
2. Zuva, Jo Ann. �Neuroradiology | Johns Hopkins Radiology.� Johns Hopkins Medicine Health Library, 13 Oct. 2016, www.hopkinsmedicine.org/radiology/specialties/ne uroradiology/index.html.
3. Swenson, Rand. Electrodiagnosis.