Byinshi wamenya kuri Tomodensitométrie ( CT Scan) ikoranabuhanga ryifashishwa mudasobwa hakaboneka amashusho arambuye yo mu mubiri.

Nubwo Scanneur ari igikoresho gihenze ku buryo atari henshi iboneka mu bitaro byo hirya no hino mu gihugu, ikunze kwifashishwa n’abaganga basuzuzuma cyangwa bakurikirana uburwayi bunyuranye ku buryo nko ku bitaro bya Ruhengeri naho hataboneka iki gikoresho, nta munsi w’ubusa abaganga badafata icyemezo kohereza abarwayi i Kigali ngo baje kunyuzwa muri iki cyuma ngo babashe kumenya imiterere y’ibibazo birimo iby’uburwayi ku barwayi baje babagana.

Iyi niyo mpamvu, Virunga Today yahisemo gutegura inkuru irambuye kuri iri koranabuhanga rya none, iyi nkuru ikaba ije ikurikira iyo yakozwe kuri radiographie byombi akaba ari uburyo bwifashishwa hafatwa amashusho y’imbere mu mubiri.

I. Tomodensitométrie ni iki ?

Tomodensitométrie (TDM) ni izina ry’ikoranabuhanga ryo gusuzuma indwara rizwi cyane ku izina rya scanner cyangwa CT Scan. Ni uburyo bwo gufata amashusho y’imbere mu mubiri hifashishijwe rayon X hamwe na mudasobwa  bigatanga amashusho arambuye mu buryo bwa 2D cyangwa 3D.

Ibice bigize CT Scan

Ifoto ya 2D n’ifoto ya 3D

 

Ishusho y’umutima igaragaza neza itandukaniro riri hagati y’image en 2D n’image en 3D iri hejuru.

Image en 2D (ibumoso): igaragaza umutima mu buryo bworoshye, flat, nta bujyakuzimu. Ubonamo gusa imiterere y’inyuma n’utuyoboro tw’ingenzi, ariko ntubona uko chambers n’imitsi bihagaze mu buryo burambuye.

Image en 3D (iburyo): igaragaza umutima mu buryo bufite ubujyakuzimu, texture, n’imiterere y’imbere. Ubonamo neza imitsi, amaraso, n’utugingo twose mu mpande zitandukanye, bigafasha muganga kubona uko umutima wubatanye mu mubiri.

Mu magambo arambuye: Ifoto ya 2D ni ishusho yoroheje igaragaza gusa ubugari n’uburebure, naho ifoto ya 3D ikongeraho ubujyakuzimu, ikerekana ibintu mu buryo bw’imbere kandi ikaboneka mu mpande zitandukanye. Ni yo mpamvu CT Scan itanga amakuru arambuye cyane kurusha radiographie.

II. Intambwe z’ingenzi mu mikorere ya CT Scanner

1. Kohereza rayon X mu gace k’umubiri

CT Scanner ifite tube ya X-ray, iyo tube izenguruka ku murwayi, ikohereza rayon X mu mpande zose z’ako gace k’umubiri.  Iyi tube  ya X-ray izenguruka ku murwayi ni intambwe y’ingenzi ituma CT Scan ibasha gufata amakuru mu mpande zose, ikayahuza ikerekana amashusho ya 3D y’imbere mu mubiri.

2. Kwakira amakuru n’ibimenyetso (Detection)

Ku ruhande rw’inyuma, hari  uduce bita detectors  zakira rayons zanyuze  mu mubiri. Uko utunyangingo (tissus)  dutandukanye dufata X-ray mu buryo butandukanye, detectors zibika ayo makuru.

3. Kohereza amakuru muri mudasobwa (Data transmission)

Ayo makuru yose yoherezwa muri computer,- Computer ikora ibaruramigereka (calcul numérique) ikoresheje algorithms za matematika.

4. Kurema amashusho mu bice bito bito (Slices / Coupes fines)

Computer ihindura ayo makuru  y’imbere mu mubiri mo bice bito bito bita slices

Buri slice ni ishusho y’ako gace nk’aho umubiri wagabanijwemo mu gace kamwe. Slice muri CT scan ni igice cy’umubiri gifatirwa ifoto imbere.Iyo slice iba ari section y’imbere (nko 5 mm cyangwa 10 mm z’ubugari), igaragaza uko inyama, amagufwa cyangwa ibindi bice by’umubiri bimeze muri icyo gice gusa.

5. Guhuza slices kugira ngo haboneke ishusho ya 3D

-Slices nyinshi zihuza, computer ikazikoranya ikerekana ishusho ya 3D y’imbere mu mubiri. Muganga ashobora kuyihindura akayireba mu mpande zitandukanye (rotation, zoom).

6. Kunoza amashusho (image processing):

Mudasobwa ishobora kongera ibisobanut (contrast), kugabanya urusaku (noise), no guhindura amashusho kugira ngo muganga abone neza ibice byose.

7. Kubika no gusangira amakuru:

Amashusho abitswe mu mudasobwa, ashobora koherezwa mu bindi bikoresho cyangwa gusangirwa n’abandi baganga binyuze mu sisteme za digital (PACS – Picture Archiving and Communication System).

Computer rero ni umutima wa CT Scan. Iyo  X-ray yanyuze mu mubiri, mudasobwa ni yo ikusanya amakuru, ikayahuza, ikayabika, ikayavugurura, hanyuma igatanga amashusho arambuye y’imbere mu mubiri.

Aho Computer iba muri CT Scan

• Console Room (icyumba cy’abatekinisiye): ni ho hiba computer nyirizina ikora igenzura n’isesengura ry’amakuru.
• Kure y’icyumba cy’umurwayi: iyi computer ishyirwa kure ya za radiation zituruka muri X-ray tube, kugira ngo ikorwe neza kandi irindwe kwangirika.
• Workstation: abaganga (radiologists) bakoresha indi computer yo gusuzuma no gukora raporo, nayo iba hanze y’icyumba cy’umurwayi.

Bivuze ko computer zose ziba hanze y’icyumba cy’umurwayi, mu gice cy’umutekano, kugira ngo zirindwe radiation kandi zikorere neza.

Igihe igikorwa cyo kunyura muri CT Scan kimara

CT Scan ntabwo imara igihe kinini ku murwayi, ariko byose biterwa n’ubwoko bw’isuzuma n’umutwe w’umubiri uri gusuzumwa.

Mu bihe bisanzwe:
– Gutegeka no gutegura umurwayi: 5 – 10 min (gusobanurirwa, kwambara, kwicara cyangwa kuryama neza).
– Isuzuma nyirizina (scan): akenshi bimara 5 – 15 min gusa.
– CT Scan y’umutwe cyangwa y’inda ishobora gufata iminota 5 – 10.
– CT Scan y’umubiri wose ishobora gufata iminota 10 – 15.
– Gusubiza ibisubizo: nyuma yo gusuzuma, umurwayi ategereza ko muganga asoma amafoto, bishobora gufata igihe kinini kurusha scan ubwayo.

Ibintu bishobora gutuma bimara igihe kinini
– Gukoresha contrast (dye): Iyo hakeneye gushyirwamo umuti ugaragaza neza imitsi cyangwa ingingo, bishobora kongera iminota 10 – 20.
– Umurwayi udashobora kwicara cyangwa kuryama neza: nko ku bana bato cyangwa abarwayi bafite uburibwe bukabije, bishobora gutuma bategurwa igihe kirekire.
– Ubwoko bw’imashini: Imashini nshya (64-slice, 128-slice) zikora vuba kurusha izisanzwe.
Bivuze ko umurwayi akenshi aba yamaze hagati ya iminota 10 – 30 muri CT Scan, harimo gutegurwa no gusuzumwa.

 

III.Ikoreshwa rya Contraste muri CT Scan

Contraste ni umuti (contrast agent/dye) winjizwa mu mubiri kugira ngo utange ishusho irambuye kurusha isanzwe.  CT Scan ishobora gukorwa idafite contraste cyangwa itayifite. Contraste ya CT Scan ikozwe mu miti ifite iodine (IV) cyangwa barium (oral/rectal),Iodine ikoreshwa cyane mu mitsi n’utunyangingo, naho barium ikoreshwa mu gifu n’amara.

 

Impamvu contraste ikoreshwa

– Kwerekana neza imitsi y’amaraso (blood vessels): contraste ituma imitsi igaragara neza, bigafasha gusuzuma ibibazo nk’ifunga ry’imitsi cyangwa aneurysm.

– Kwerekana neza utunyangingo (soft tissues): utunyangingo nk’umwijima, impyiko, n’umutima bigaragara neza iyo hifashishijwe contraste.

– Gusuzuma indwara zifata ingingo z’imbere: nka cancer, infections, cyangwa ibibyimba (tumors). Contraste ituma bigaragara neza ku mashusho.

– Kugenzura imikorere y’impyiko n’umwijima: uburyo contraste isohoka mu mubiri bushobora kwerekana uko impyiko n’umwijima bikora.

– Kwerekana neza ibikomere: nko kumenya aho amaraso yamenetse cyangwa aho hari ibikomere mu mubiri.

Ibigomba kwitonderwa mu ikoreshwa rya contraste

– Allergies: hari abantu bashobora kugira ikibazo kuri contraste (reaction allergique).

– Indwara z’impyiko: contraste ishobora kongera ikibazo ku bafite impyiko zikora nabi.

– Abagore batwite: bagomba kubanza kubisuzumwa neza kuko contraste ishobora kugira ingaruka ku mwana.

Mu magambo magufi: Contraste muri CT Scan ikoreshwa kugira ngo amashusho agaragaze neza imitsi, utunyangingo, n’ibibyimba, bigafasha muganga kubona amakuru arambuye kurusha CT Scan isanzwe.

IV.Ibigomba kwitonderwa mu ikoreshwa rya CT Scan

CT Scan ikoresha X-ray radiation kugira ngo ifate amashusho y’imbere mu mubiri. Kubera ko iyi mirasire ishobora kugira ingaruka ku buzima iyo ikoreshejwe nabi, hari ibintu by’ingenzi bigomba kwitonderwa.

 Ku murwayi

– Abagore batwite: CT Scan ikoresha imirasire, bityo abagore batwite bagomba kubanza kubwira abaganga kugira ngo barebe niba ari ngombwa.

– Allergies ku contrast dye: Hari abashobora kugira ikibazo ku contrast agent ikoreshwa mu bice bimwe bya CT Scan. Umurwayi agomba kubanza kubivuga.

– Indwara z’impyiko: Abafite impyiko zikora nabi bashobora kugira ikibazo mu gukoresha contrast dye, kuko ishobora kongera ikibazo.

– Kwirinda ibintu by’icyuma: Nubwo CT Scan itakurura ibyuma nka MRI, umurwayi agomba kubanza kubwira abaganga niba afite implants cyangwa ibyuma mu mubiri.

– Kwiyumvisha uko ikorwa: Umurwayi agomba gusobanurirwa ko CT Scan ari vuba, itababaza, ariko ikoresha imirasire.

Ku bakozi b’ubuzima

– Kugenzura dose y’imirasire: Bagomba gukoresha dose ntoya ishoboka ariko itanga amakuru akenewe.

– Kugenzura imashini: Imashini igomba kubungabungwa neza kugira ngo itange ibisubizo byizewe.

– Kwirinda radiation exposure: Abakozi bagomba gukoresha ubwirinzi (protective shields) kugira ngo batagerwaho n’imirasire.

– Gusobanurira umurwayi: Umurwayi agomba kumenya impamvu CT Scan ikorwa, uko ikorwa, n’ibyo agomba kwitondera

Mu magambo magufi: Mu ikoreshwa rya CT Scan, hagomba kwitonderwa abagore batwite, indwara z’impyiko, allergies ku contrast dye, kugenzura dose y’imirasire, no kubungabunga imashini.

CT Scan ikoreshwa mu gusuzuma imbere mu mubiri, cyane cyane mu gice cy’impyiko, umutima, ubwonko, amara, n’ahandi, kubera ko itanga amashusho arambuye kurusha X-ray isanzwe.

V.Ahantu CT Scan ikoreshwa

– Ubwonko (Brain): gusuzuma indwara zifata ubwonko nka stroke, ibibyimba (tumors), cyangwa ibikomere.

– Iby’umutima n’imitsi y’amaraso (Cardiovascular system): kureba imitsi y’amaraso (blood vessels), gusuzuma indwara z’umutima, cyangwa kugenzura imitsi ifunze.

– Iby’amara n’impyiko (Abdomen & pelvis): gusuzuma impyiko, umwijima, amara, n’impyiko mu gihe hari ibibyimba, ibikomere cyangwa indwara zindi.

– Iby’amagufwa (Bones): kumenya imvune, ibikomere cyangwa indwara zifata amagufwa.

– Cancer: gupima no gukurikirana uko indwara ya kanseri yifashe mu mubiri.

VI.Ibyiza byo gukoresha CT Scan n’inzitizi

Ibyiza

– Igaragaza neza kurusha X-ray isanzwe: CT Scan ikora slices (ibice bito by’ifoto) bigashyirwa hamwe kugira ngo bigaragaze ishusho ya 3D y’umubiri.

– Ifasha mu gusuzuma indwara zinyuranye: irerekana neza imitsi, ingingo z’umubiri, n’utunyangingo tworoshye (soft tissues).

– Ni vuba kandi itababaza: umuntu aryama ku meza, imashini ikazenguruka ikamufotora mu bice bitandukanye, bigatanga amakuru yihuse.

– Ifasha mu gukurikirana indwara: si ugusuzuma gusa, ahubwo ikoreshwa no kureba uko indwara ikura cyangwa uko imiti ikora.

 

Ibibazo mu gukoresha CT Scan

• Igiciro gihanitse
  Kugura no gukoresha CT Scan bisaba amafaranga menshi. Ibi bituma ibigo bito by’ubuzima bitayibona, kandi abarwayi bagasabwa kujya kure kuyikorerwa.

Imashini imwe ya CT Scan ishobora kugura hagati ya miliyoni 400 Frw – miliyoni 800 Frw, bitewe n’ubwoko bwayo (64-slice, 128-slice, n’ibindi).
– Ibikoresho byunganira: Harimo software, server yo kubika amakuru, n’ibikoresho byo gusohora raporo. Ibi bishobora kongeraho miliyoni 50 – miliyoni 100 Frw.
– Gusana no kubungabunga: Buri mwaka ikigo gikeneye gutanga amafaranga yo gusana no kubungabunga, ashobora kugera kuri miliyoni 20 – miliyoni 40 Frw.
– Amafaranga y’imisoro: Kubera ko imashini itumizwa hanze, hiyongeraho imisoro, bigatuma igiciro cyiyongera cyane.

• Dose  radiation iri hejuru
  CT Scan ikoresha imirasire ya X-ray nyinshi kurusha radiographie isanzwe. Iyo umuntu akorerwa CT kenshi bishobora kongera ibyago byo kugira ingaruka ku buzima.
• Kuboneka ahantu hihariye gusa
  CT Scan iboneka mu bitaro bikuru cyangwa mu bigo bifite ubushobozi buhanitse. Mu bice by’icyaro cyangwa mu bigo bito, abarwayi bagomba gukora ingendo ndende kugira ngo bayikorerwe.
• Imyiteguro yihariye
  Hari aho bisaba guha umurwayi “contrast agent” (ikinyabutabire cyinjizwa mu mubiri) kugira ngo amashusho agaragare neza. Ibi bishobora gutinda cyangwa bikaba ikibazo ku barwayi bafite uburwayi bwihutirwa.
• Abantu bamwe batemerewe kuyikorerwa
  • Abatwite, kubera ingaruka z’utubyare ku mwana uri mu nda
  • Abantu bafite allergie ku “contrast agent”
  • Abafite ibibazo bikomeye by’impyiko, kuko “contrast agent” ishobora kubangamira imikorere yazo.

Icyotonderwa

Nubwo CT Scan ari ikoranabuhanga rihaniste kandi ikaba ishobora gusimbura Radiographie, radiographie iracyakoreshwa kubera:

• Byihuse kandi bihendutse
  Radiographie ikorwa mu minota mike, nta gutegereza cyane, kandi igiciro cyayo kiri hasi ugereranyije na CT. Ni yo mpamvu ikiri uburyo bwa mbere bwo gusuzuma indwara nyinshi.
• Dose ya  radiation ( ubukana bwa Xray) iri hasi
  CT ikoresha dose nini y’utubyare ugereranyije na X-ray. Radiographie rero ikaba ikiri amahitamo meza mu gusuzuma ibintu bisanzwe cyangwa mu gukurikirana abarwayi kenshi.
• Kuboneka hose
  Ibitaro byinshi, ndetse n’ibigo by’ubuzima bito, bifite radiographie. CT scanner yo ikenerwa ahantu hihariye kandi ikaba igikoresho gihenda.
• Ibyo isuzuma byihariye
  • Gusuzuma amagufwa (imyivumbagatanyo, imvune, arthritis)
  • Gusuzuma ibibazo by’amaso y’imbere y’igitsina (chest X-ray ku ndwara z’ubuhumekero nka pneumonia, tuberculosis)
  • Kugenzura ibintu byoroheje mu buryo bwihuse (nk’amaso y’amenyo, kugenzura catheter cyangwa implants).

 

 

Twifashishije: www.elsan.care na www.wikipedia.com

 

 

Inkuru bifitanye isano:

Iby’ingenzi wamenya kuri Radiographie, ubuhanga bumaze imyaka 120 bukoreshwa hafatwa amashusho imbere mu mubiri w’umuntu

Umwanditsi: Musengimana Emmanuel