Izifundo eziPhakamileyo zeNewlogical

Emva kokuvavanywa kwengqondo, ukuhlolwa ngokomzimba, imbali yesigulane, i-ray-ray kunye nayo nayiphina imvavanyo yokuhlola, udokotela unokuyalela omnye okanye ngaphezulu kwezi zilandelayo zivavanyo zokuhlola ukufumana ingcambu yesifo okanye ukulimala okunokwenzeka. Ezi zifo ziquka ngokubanzi neuroradiology, esebenzisa ubuncinci bezinto ezichithwa ngama-radioactive ukufunda umsebenzi wesigqeba kunye nesakhiwo kunye ukucinga ngomntu, esebenzisa amatshini kunye neendleko zombane ukuze afunde umsebenzi wequmrhu.

Studies Neurological Studies

Neuroradiology

• MRI
• MRA
• NKS
• fMRI
• CT scans
• IMyelograms
• PET ihlola
• Abanye abaninzi

Ukujonga umfanekiso weMagnetic Resonance (MRI)

Ibonisa iziko okanye izicubu ezincinci kakuhle

• Ayikho imisebe ye-ionizing

Utshintsho kwiMRI

• I-magnetic resonance angiography (MRA)
• Ukuphonononga ukuphuma kwegazi kwimithambo
• Fumana i-aneurysms ne-malformations

I-spectroscopy ye-magnetic resonance (MRS)

• Hlola ukungaqhelekanga kweekhemikhali kwi-HIV, ukubetha, ukulimala kwentloko, i-coma, isifo se-Alzheimer, i-tumor, kunye ne-multiple sclerosis

Ukucatshulwa kwemifanekiso emaganetic (fMRI)

• Misela indawo ethile yengqondo apho kwenzeka khona umsebenzi

I-Tomography eComputer (CT okanye i-CAT Scan)

• Usebenzisa umxube we-X-ray kunye nobuchwepheshe bekhompyutha ukuvelisa imifanekiso engqambileyo, okanye i-axial
• Ubonisa amathambo ngokukhethekileyo
• Isetyenziswe xa uvavanyo lwengqondo lufuneka ngokukhawuleza njengokuba kukhankanywa ukuphuma kwegazi kunye neentambo

IMyelogram

Idayi yokungafani kunye ne-CT okanye i-Xray

Uninzi luncedo ekuhloleni intambo yomthambo

• Stenosis
• Izidumbu
• Ukulimala kwengcambu

I-Positron Ukuchithwa kwe-Tomography (i-PET Scan)

I-Radiotracer isetyenziselwa ukuvavanya i-metabolism of tissue ukufumana utshintsho lwezinto eziphilayo ngaphaya kwezinye iintlobo zezifundo

Ukusetyenziswa ukuhlola

• Isifo se-Alzheimer
• Isifo sikaParkinson
• Isifo sikaHuntington
• sokuwa
• Ingozi yeCerebrovascular

Studiodagnostic Studies

• I-Electromyography (EMG)
• Iingcali zokuPhathwa kweMigudu yeVelocity (NCV)
• Ukukhutshwa kwezifundo

I-Electromyography (EMG)

Ukufumanisa izibonakaliso ezibangelwa ukugqithiswa kwemisipha yomzimba

Inokulinganiswa nge:

• I-electrodes ebusweni
• Ayisetyenziselwa iinjongo zokuxilonga, ngaphezulu kwe-rehab ne-biofeedback

Iinaliti ezibekwe ngqo kwi-muscle

• Eqhelekileyo kwi-EMG yekliniki / yokuxilonga

ISigineshana seNgcaciso EMG

Ukugqithiswa kokurekhodwa kuku:

• Ngokukhawuleza
• Umsebenzi wokufaka
• Isiphumo sokuqhawula ngokuzithandela kwemisipha

Imisipha kufuneka ibe yombane ngokuphumla, ngaphandle kwesiphelo semoto

• Umsebenzi kufuneka agweme ukufakwa kwisitya sokugqibela

Ubuncinane ubunzima be-10 kwiimisipha zilinganiswa ngokuchazwa kakuhle

Procedure

Inaliti ifakwe kwisisipha

• Umsebenzi obhalisiweyo oqoshiwe
• Ukuthuliswa kombane kubhalwe
• Ukuqhekeka kwemizimba ngokuzithandela kubhalwe
• Ukuthuliswa kombane kubhalwe
• Umgudu wokuqhawula umphezulu oqoshiwe

Iisampula eziqokelelwayo

izihlunu

• Iyalondolozwa ngentshontsho efanayo kodwa iingcambu zentliziyo ezahlukileyo
• Iyalondolozwa yinkomo yesondlo efanayo kodwa imiqobo eyahlukileyo
• Iindawo ezahlukeneyo kunye neentambo

Unceda ukuhlukanisa izinga lesilonda

I-Motor Unit Ingenzeka (MUP)

Amplitude

• Ubuninzi beemfayili zomsila ezixhomekeke kuloo moto we-neuron
• Ukukhawulelwa kweMUP

Iprotration yokubambisa ingahlolwa kwakhona

• Ukuqeshiswa kwexesha elichanekileyo kunokubonisa ukulahlekelwa kweenjini eziphakathi kweesistim
• Ukuqashwa kwangaphambili kubonakala kwi-myopathy, apho ii-MUPs zihlala ziphantsi kwexesha elifutshane

Polyphasic MUPS

• Ukwandiswa kwe-amplitude kunye nobude bungaba ngumphumo we-reinnervation emva kokuchaswa okungapheliyo

Gcwalisa i ziBloko

• Ukuxutywa kwemimoya yamacandelo amaninzi ngokulandelelana kunokubangela ibhloko epheleleyo yokuqhutyelwa kwentsholongwane kwaye ngoko akukho miphumo efundwayo ye-MUP, nangona kunjalo iinguqu eziguqukayo kwi-MUPs zibonwa nje ngengozi kwi-axon, kungekhona i-myelin
• Ukulimala kwinkqubo yomnatha ephakathi kwinqanaba le-neuron yemoto (njengentlungu yomlomo wesibeletho okanye isisu) kungabangela ukukhubazeka okupheleleyo okungaqhelekanga kwi-needle EMG

I-Denervated Muscle Fibers

Kufunyenwe njengempawu zombane ezingavamile

• Ukwandiswa komsebenzi wokunyusa kuya kufundwa kwiiveki zokuqala zeveki, njengoko kuqhutyiswa kancinci

Njengoko iimbumba ze-muscle ziba neengqondo ezininzi ziza kuqaliswa ukuvelisa umsebenzi wokuphoxeka ngokukhawuleza

• Iimfibrillation

Iifabrillation Potentials

• NGAKHO kwenzeke kwiimpawu zomzimba eziqhelekileyo
• Izibhakabhaka azikwazi ukubonwa ngelihlo kodwa zibonakala kwi-EMG
• Ngokuqhelekileyo kubangelwa zizifo zesibindi, kodwa kunokuveliswa zizifo ezinzima zomzimba xa kukho umonakalo kwiinqwelo zeemoto

Iimpawu eziPhezulu eziPhambili

• AWAKHO kwenzeke kwiifayili eziqhelekileyo zokusebenza
• Ukugqithiswa ngokukhawuleza ngenxa yokunyuka kweembrane

Iziphumo ezingavumelekanga

• Ukufunyanwa kweefayili kunye namaza abukhali angumqondiso onokuthenjelwa kwimonakalo yemoto ukuya kwisisipha emva kweveki enye ukuya kwiinyanga ze-12 emva komonakalo
• Rhoqo ibizwa ngokuba yi- acute kwiingxelo, ngaphandle kokuba zibonakala kwiinyanga emva kokuqala
• Kuya kutshabalala ukuba kukho ukuguqulwa okupheleleyo okanye ukuchithwa kwemibhobho yesibindi

Iingcali zokuPhathwa kweMigudu yeVelocity (NCV)

imoto

• Iimilinganiselo zibandakanya izakhono zamathambo (CMAP)

Efanelekileyo

• Imilinganiselo yezinyathelo zentshukumo yezinzwa zesifo (SNAP)

Izifundo zokuPhathwa kweMigudu

• Velocity (Speed)
• Ukuphela kwekota
• Amplitude
• Iifayili eziqhelekileyo, ezilungelelaniswa ubudala, ubude kunye nezinye izinto zifumaneke kwiingcali ukuba zenzele uqhathaniso

Terminal Latency

• Ixesha phakathi kwe-stimulus nokubonakala kwempendulo
• Ukungena kwendawo neuropathies
• Ukwandisa i-latency yesigxina kwindlela ethile yomgca

Velocity

Ukubalwa ngokusekelwe kwi-latency kunye neziguquko ezifana nomgama

Ixhomekeke kumgama we-axon

Kwakhona kuxhomekeke ekubunjeni kwe-myelin sheath

• I-neuropathies egxile kwi-myelin sheaths, iyanciphisa ukuqhubela phambili
• Imiqathango efana neCharcot Marie Tooth Disease okanye i-Guillian Barre Syndrome yonakalisa i-myelin ngobubanzi obukhulu, iimbombo ezihamba ngokukhawuleza

Amplitude

• Impilo yeAxonal
• Nexicopathies ezinobuthi
• I-CMAP kunye ne-SNAP amplitude ethintekile

I-Diabetes Neuropathy

Ezixhaphake kakhulu neuropathy

• Ukwahlula, umlinganiso
• Ukutshatyalaliswa kwemimoya kunye nomonakalo we-axonal ngoko ke ukukhawuleza kunye nokuphakama kwe-conduction zichaphazelekayo

Ukukhutshwa kwezifundo

I-Somatosensory evoked potentials (SSEPs)

• Kusetshenziselwa ukuvavanya imisipha yamalungu

Iimpawu ezikhutshwayo ezibonakalayo (VEPs)

• Kusetshenziselwa ukuvavanya imisipha ye-visual system

I-Brainstem yokuphicothwa kwezinto ezinokukhupha iziphumo (AEPs)

• Isetshenziselwa ukuvavanya imizwa yengqondo yenkqubo yokuhlola

Amandla afakwe kwi-electrodes ephezulu ye-impedance

Ukurekhoda ngokulinganayo emva kokuphindaphindiweyo kokuvakala kwintliziyo

• Isusa imvelaphi
• Ihlaziya iziphumo kuba izakhono zincinci kwaye kunzima ukuzibona ngaphandle komsebenzi oqhelekileyo
• Ngokutsho kukaDkt. Swenson, kwimeko ye-SSEP, ubuncinane i-256 stimuli zidla ngokufunekayo ukwenzela ukufumana iimpendulo ezinokwethenjelwa, ezizalisekayo

I-Somatosensory Evoked Potentials (SSEPs)

Ukuvalelwa kwiimisipha

• Ukuthintela kunye neengxaki zokufumana uxinzelelo kwesikhumba kunye nezicubu ezinzulu

Incinci ukuba ikho intlungu Negalelo

• Amandla okunciphisa ukusebenzisa uvavanyo lweengxaki zentlungu

I-Velocity kunye / okanye iinguqulelo ze-amplitude zingabonisa ukugula

• Kukho utshintsho olukhulu oluphawulekayo kuba i-SSEP ziqheleke kakhulu

Ukunceda ukubeka iliso kwi-intraoperative kunye nokuvavanya ukugxekwa kwezigulane ezinobungozi obunobungozi obuchotshozayo

• Akukho luncedo ekuhloleni i-radiculopathy njengengcambu yesondlo somntu ngamnye ayikwazi ukufumaneka lula

Iimpawu ezizayo

Zenzeke ngaphezu kwe-10-20 millisecond emva kokuvuselelwa kweemoto

Ezimbini iindidi

• H-Reflex
• F-Response

H-Reflex

Ebizwa ngokuba nguDkt. Hoffman

• Okokuqala ichaza le ngcamango kwi-1918

Ukubonakalisa i-Electrodiagnostic ye-reflex stretch stretch

• Impendulo yeemoto ezirekhodwa emva kokuvuselelwa kombane okanye ukunyusa ngokomzimba we-muscle edibeneyo

Kuphela kuphela luncedo ekliniki ekuhloleni i-radioxpathy ye-S1, njengoko i-reflex evela kwi-nervous nerve to triceps surae inokuhlolwa ngokukhawuleza kunye ne-amplitude

• Uninzi olunokuthi uvavanyo lwe-Achilles reflex
• Ihluleka ukubuyela kunye nomonakalo kwaye ngoko kungengokuthi luncedo olusesikliniki kwiimeko zengxubevange ze-radiculopathy

F-Response

Ngaloo nto ibizwa ngokuba ibhalwe kuqala ngenyawo

Ivela kwi-25 -55 i-millisecond emva kokuvuselelwa kokuqala

Ngenxa yokugqithiswa kwe-antidromic depolarization ye-nerve ye-motor, okubangele uphawu lwombane lwama-orthodromic

• Ayikho ingqiqo yeqiniso
• Iziphumo kwintambo encinci yemisipha
• Ubungakanani buyahlukahluka kakhulu, ngoko kungabalulekanga nje ngexabiso
• Ukunciphisa ukunyuka kwembonakalo kubonisa ukuqhuba okucothayo

Uncedo ekuhloleni i-nerve pathology

• Radiculopathy
• Guillian Barre Syndrome
• I-Polyidculophyphism Demyelinating Polyradiculopathy (Chronicle Inflammatory Demyelinating Polyradiculopathy)

Uncedo ekuhloleni i-demyelinative peripheral neuropathies

imithombo

1. UAlexander G. Reeves, A. kunye noSwenson, R. Ukuphazamiseka kwenkqubo yeNervous. UDartmouth, 2004.
2. Usuku, Jo Ann. EI-Neuroradiology | Johns Hopkins Radiology. Johns Hopkins Medicine Health Library, 13 Okt. 2016, www.hopkinsmedicine.org/radiology/specialties/ne uroradiology / index.html.
3. Swenson, iRandi. Electrodiagnosis.