Ese ufite ibibazo by'agasabo k'inkari? Reka tuvuge kuri HIDA Scan!

Ese wigeze wumva ububabare mu gice cyo hejuru cy'iburyo cy'inda yawe? Cyangwa se muganga yakubwira ko ufite ikibazo runaka ku gasabo k'inkari? Icyo gihe, ushobora kuba warasabwe gukora "HIDA scan" (Hepatobiliary Immunodiacetic Acid Scan). Rero, ushobora kumva ufite ubwoba gato iyo ubyumvise, ariko ntugahangayike. Uyu munsi, turaganira kuri iyi "HIDA scan" mu buryo bworoshye, mu buryo ushobora kumva.

Gupima HIDA ni iki?

Muri make, scan ya HIDA ni ikizamini cyihariye kireba uko agasabo k'inkari gakora. Muri iki gikorwa, haterwa ingano nto y'ikinyabutabire cyitwa radioactive tracer mu mubiri wawe. Hanyuma, hakoreshwa kamera yihariye kugira ngo harebwe uko kigenda mu mubiri wawe. Iki kizamini gikorerwa mu ishami ry'ubuvuzi bwa kirimbuzi mu bitaro.

Kugira ngo dusobanure birambuye, iyi "HIDA scan" ireba uburyo inyo itembera mu mwijima wawe igana mu mara mato. Iyi nzira y'inyo tuyita "système del biliary".

Tekereza nawe, umwijima wawe ukora aya mazi yo mu gifu yitwa inyo. Iyi nyo idufasha gusya ibinure biri mu byo turya. Hanyuma, inyo ikorwa inyura mu miyoboro yihariye (imiyoboro y'inyunganiramirire) ikabikwa mu gasabo k'inyunganiramirire. Inyo ni agafuka gato kari munsi y'umwijima wawe, iburyo, hafi y'imbavu zawe zo hepfo. Iyo uriye, iyi nyoni irafungana (igapfunyika) maze yohereza inyoni ibitsemo binyuze mu miyoboro ikagera mu gice cya mbere cy'amara yawe mato (duodenum), kugira ngo ifashe gusya ibinure.

Urabyumva ubu? Niba hari ikibazo gito muri iki gikorwa, ushobora kubona ibimenyetso bitandukanye. Ni bwo iyi "HIDA scan" ishobora gufasha kubona impamvu. Ibi byitwa kandi "cholescintigraphy" na "hepatobiliary scintigraphy".

Ni izihe ndwara zishobora kugaragara hakoreshejwe HIDA scan?

Abaganga bakoresha ubu buryo bwa `HIDA scan` kugira ngo bamenye kandi basuzume ingano y'izi ndwara:

• Indwara ya cholecystete ikabije: Iyi ni indwara ihita igutera. Ushobora kugira ububabare bukomeye mu gice cyo hejuru cy'iburyo cy'inda yawe ndetse n'ibimenyetso nk'umuriro. Akenshi (hafi 90%) biterwa n'amabuye y'agahinda afunga umuyoboro w'indyo.
• Kolecystite idakira: Iki ni cyo gihe agasabo k'inkari kawe kabyimba kandi kakabyimba buri gihe. Ububabare burakabije cyane ugereranyije no mu gihe cy'ububabare bukabije, ariko ububabare bushobora kuza bugashira. Ibi akenshi biterwa n'uko amabuye y'inka aziba umuyoboro w'inka (cystic duct).
• Imikorere mibi ya sphincter ya Oddi: Iki ni igihe sphincter ya Oddi, imitsi ikora nk'irembo ry'umutobe w'inyongo n'umutobe wa pancreas (enzymes), idafunguka neza. Ibi bitera gusubira inyuma kw'imitobe y'igogora. Ibi bishobora gutera ububabare bukomeye.
• Kugabanuka kw'imitsi y'amenyo:Iyi ni indwara ibaho ku bana bavutse. Ibuza imyuka iva mu mwijima w'umwana ijya mu mara mato. Iyi ni impamvu ikomeye, ariko idakunze kugaragara, itera indwara y'umuhondo ku bana bavutse. Iyo ibi bidakosowe no kubagwa mu mezi abiri cyangwa atatu ya mbere y'ubuzima, bishobora kwangiza umwijima.
• Kuva kw'inkari: Aha niho inkari iva mu miyoboro y'inkari. Iyo ibi bibaye, ingingo ziyikikije zishobora kubyimba, kubabara, ndetse no kwandura. Ibi bikunze kubaho nyuma yo kubagwa injangwe, gukomereka, cyangwa guterwa umwijima.

Ni ryari ukeneye gupimwa HIDA?

Abaganga basaba ko habaho isuzuma rya HIDA kugira ngo barebe niba hari ibibazo biri mu turemangingo tw’umwijima, mu nzira y’imyakura, no mu gasabo k’inkari. Muganga ashobora gusaba ko habaho isuzuma rya HIDA niba ufite kimwe muri ibi bimenyetso:

• Kubabara mu nda cyane cyane ku ruhande rw'iburyo: Ibi bishobora guterwa no kubyimba k'agasabo k'inkari (cholecystite). Iyi ni yo mpamvu ikunze kugaragara yo gupimwa HIDA.
• Ububabare cyangwa umuriro nyuma yo kubagwa bimwe na bimwe: Niba warabazwe gukuraho agasabo k'inkari, kubagwa inda yo hejuru, cyangwa guterwa umwijima, ushobora gukenera gupimwa HIDA niba ufite umuriro n'ububabare nyuma yaho.
• Umuhogo ukabije mu bana bavutse: Ibi bishobora guterwa n'indwara ishobora gushyira ubuzima mu kaga yitwa biliary atresia.

Nanone, niba ufite stent y'inkondo y'umura ishyizwe mu muyoboro w'inkondo y'umura, ushobora gupimwa HIDA kugira ngo urebe niba ikora neza. Stent y'inkondo y'umura ni umuyoboro muto kandi udafite icyobo ushyirwa mu muyoboro w'inkondo y'umura kugira ngo igume ifunguye niba ifunze. Niba waratewe umwijima, ushobora gupimwa inshuro nyinshi za HIDA kugira ngo urebe uko umwijima wawe ukora nyuma yo kubagwa.

Ni nde ukora isuzuma rya HIDA?

Hari abaganga batatu bakora isuzuma rya HIDA. Bafasha mu gushyiraho ibikoresho byo gupima, gutanga imiti ivura indwara hakoreshejwe imirasire, no gusobanura ibisubizo bya scan. Abo ni:

• Umuganga w’inzobere mu `ubuvuzi bwa kirimbuzi` cyangwa `radiyoloji ya kirimbuzi`.
• Impuguke mu ikoranabuhanga rya kirimbuzi.
• Umuhanga mu bya fiziki mu by'ubuvuzi.

Isuzuma rya HIDA rikora rite?

Isuzuma rya HIDA (isuzuma rya aside hepatobiliary immunodiacetic) rikoresha ibintu bike bya radioactive byitwa radiopharmaceuticals cyangwa radiotracers. Ibi bikunze guterwa mu mitsi yawe.

Iyi 'radiotracer' inyura mu mwijima wawe, mu gasabo k'inkari no mu mara mato. Iyi 'radiotracer' itanga ubwoko bw'ingufu zitwa 'gamma rays'. Kamera zidasanzwe zipima izi ngufu, kandi mudasobwa izikoresha kugira ngo igaragaze neza uko ingingo zawe n'ingingo bikora.

Ni gute nakwitegura gupima HIDA?

Itsinda ry'abaganga bawe rizaguha amabwiriza yihariye y'uburyo bwo kwitegura HIDA scan. Ni ingenzi cyane gukurikiza ayo mabwiriza neza. Dore amabwiriza rusange yo kwitegura:

• Niba utwite, utekereza ko utwite, cyangwa urimo konsa , ni ngombwa ko ubibwira muganga wawe mbere yo gupimwa HIDA.
• Bwira itsinda ry'abaganga bawe imiti yose ufata, harimo na vitamine n'inyongeramusaruro z'ibimera. Muganga wawe ashobora kugusaba guhagarika gufata imiti imwe na imwe mbere yo kuyisuzuma, kuko ishobora kugira ingaruka ku bisubizo by'isuzuma.
• Iyo uje gupimwa , kuramo imitako cyangwa ibikoresho byose ubishyire mu rugo, cyangwa ubikuremo mbere yo gupimwa. Ibi bishobora kubangamira isuzuma.
• Niba ufite ubwoba bw'aho hantu hafunganye (`claustrophobia`), tubwire mbere yuko ikizamini gitangira. Ibi biterwa nuko kugira ngo ubone amashusho meza, kamera isuzuma igomba gufatwa hafi gato y'umubiri wawe. Ariko, iyi kamera ntabwo imeze nk'umuyoboro ufunze impande zose, ahubwo ifunguye ku mpande zombi. Akenshi ishyirwa hejuru y'inda yawe, kandi ntipfuka mu maso.
• Kugira ngo upime HIDA , ugomba kwiyiriza ubusa nibura amasaha ane (nta biryo cyangwa ikinyobwa keretse amazi). Niba ukeneye kwiyiriza ubusa igihe kirenze icyo, muganga azakubwira.
• Abana bavutse bashobora gukenera ubuvuzi bwihariye iminsi itatu kugeza kuri itanu mbere yo gupimwa. Abakozi bo mu cyumba cy’abana bazakugira inama kuri ibi.

Ese ugomba gusinzira mu gihe cyo gupima HIDA?

Ntabwo ukunze guhabwa ikinya cyo gusinzira mu isuzuma rya HIDA. Mu by'ukuri, hari uburyo bwo gusimbuza busaba ko wimukira mu myanya itandukanye.

Ariko, niba ufite ingorane zo kuguma uhagaze mu gihe cyo gupimwa, cyangwa niba umwana wawe arimo gupimwa, wowe cyangwa umwana wawe mushobora guhabwa umuti utuma aruhuka kandi akumva afite ibitotsi. Ariko, ntabwo bizagutera gusinzira burundu, uzakomeza kuba maso.

Gupima HIDA bifata igihe kingana iki?

Ubusanzwe, scan ya HIDA ishobora gufata hagati y'isaha imwe n'enye . Hari igihe ushobora gusabwa kugaruka mu masaha 24 uhereye igihe scan ya mbere yakorewe kugira ngo ubone andi mashusho.

Ni iki wakwitega mu gihe cyo gupima HIDA?

Hashobora kubaho impinduka nto mu buryo bwo gupima HIDA, bitewe n'igice cy'imiyoboro y'amaraso yawe kirimo gusuzumwa. Ariko muri rusange, dore icyo ushobora kwitega:

• Uzakenera gukuramo imyenda itwikiriye igifu cyawe. Ibitaro bizaguha ikanzu yo kwambara.
• Uzakenera kuryama ureba hejuru ku meza yo gupimisha.
• Umuforomo cyangwa umutekinisiye azashyira catheter yo mu mitsi (IV) mu mutsi uri mu kuboko kwawe cyangwa mu kiganza cyawe, hanyuma agatera radiotracer.
• Umutekinisiye azashyira kamera yo gupima hejuru y'inda yawe, hafi y'umubiri wawe.
• Iyo utangiye gufata amafoto, kamera ikoresha scanning ifata amafoto menshi. Kamera ishobora kuzenguruka hirya no hino yawe cyangwa ikaguma ahantu hamwe.
• Mu gufata amafoto, ni ngombwa cyane kugumana kamera ahantu hamwe nta kwimuka. Icyo gihe ni bwo ushobora kubona amafoto meza cyane.
• Ushobora kandi gusabwa guhinduranya imyanya hagati yo gufata amafoto. Inzobere mu ikoranabuhanga izabikubwira.
• Nyuma yo gufata amafoto, umuhanga mu ikoranabuhanga ashobora kuguha umuti wo gukuramo agasabo k'inkari. Ibi bishobora gutera ububabare buto mu nda yo hejuru. Uko agasabo k'inkari kagenda gasohora, bazafata andi mafoto.
• Iyo amashusho yose akenewe amaze gufatwa (ibi bishobora gufata amasaha ane), gushakisha biba byarangiye.

Ese scan ya HIDA irababaza?

Gupima HIDA ntabwo bibabaza cyane. Iyo radiotracer itanzwe binyuze muri IV, ushobora kumva urimo gushyuha gato iyo urushinge rwinjijwe mu mitsi, ni byo gusa.

Ariko, niba urimo gupimwa HIDA kugira ngo umenye niba ufite ikibazo cy’uburwayi, ushobora kugira ububabare buterwa n’iyo ndwara. Urugero, indwara nka cholecystitis na sphincter ya Oddi zishobora gutera ububabare bukomeye. Nanone, ntugomba gufata imiti imwe n’imwe igabanya ububabare mbere yo gupimwa, kuko iyi miti ishobora kugira ingaruka ku mikorere y’urusobe rw’inkari rwawe ndetse ikagira ingaruka ku buryo ikizamini gikoreshwa.

Urugero, imiti igabanya ubukana (nka morphine na codeine) igomba guhagarikwa nibura amasaha atandatu mbere yo gupimwa HIDA.

Bigenda bite nyuma yo gupima HIDA?

Bitewe n'impamvu yatumye ukorerwa isuzuma rya HIDA, ushobora gutaha, cyangwa ugasabwa gusubira mu cyumba cy'ibitaro.

Ugomba kunywa amazi menshi mu masaha 24 ari imbere nyuma yo gupimwa. Ibi bizafasha `radiotracer` kuva mu mubiri wawe vuba. Kenshi na kenshi, `radiotracer` izasohoka mu mubiri wawe mu munsi umwe, haba mu nkari cyangwa mu mwanda.

Sukura umusarani neza nyuma yo kuwukoresha, kandi woge intoki zawe neza n'isabune. Ingano y'imirasire iri muri tracer ni nto cyane, bityo nta ngaruka zishobora guterwa n'abandi bari hafi yawe nyuma yo gupimwa.

Niba uri umubyeyi wonsa, ugomba kwirinda gusohora amashereka mu masaha 24 nyuma yo gupimwa. Ibi biterwa nuko icyuma gipima amashereka gishobora kongeramo imirasire mu mashereka yawe, ibi bikaba byagira ingaruka mbi ku mwana wawe. Kubwibyo, ni byiza gusohora amashereka y'inyongera mbere yo gupimwa no kuyarinda, cyangwa ugashaka ubundi buryo bwo konsa umwana wawe umunsi ukurikiyeho.

Ni izihe ngaruka n'ingaruka mbi zo gupima HIDA?

Ingaruka zo gupimwa na HIDA ni nke cyane. Ni izi zikurikira:

• Agace katewemo radiotracer gashobora kuba karimo gukomereka gato.
• Hari ingano nto y'imirasire. Ingano y'imirasire uhura nayo mu gihe cyo gupima HIDA isanzwe ni nk'iyo umuntu usanzwe ahura nayo mu gihe cy'umwaka.
• Birashoboka kugira ubwivumbure ku bikoresho bya radiotracers byakoreshejwe muri scan. Ariko, ibi ni gake cyane .

Ni ingenzi cyane kubwira muganga wawe niba utwite, utekereza ko utwite, cyangwa urimo konsa. Kenshi na kenshi, ibizamini by'imiti ya kirimbuzi, nka HIDA scan, ntibikorerwa abagore batwite kuko bishobora kwangiza umwana uri mu nda.

Isuzuma ry’imiti ya kirimbuzi, harimo na HIDA scan, ritanga amakuru adasanzwe andi masuzuma, nka ultrasound, adashobora. Kubwibyo, niba utari utwite, inyungu zo gupima HIDA ziruta kure ingaruka ntoya.

Bitwara igihe kingana iki kugira ngo umenye ibisubizo bya HIDA scan?

Umuganga w’inzobere mu by’imirasire azareba amashusho yo muri HIDA scan, yandike raporo, hanyuma abwire muganga wawe ibisubizo. Hanyuma muganga wawe azakubwira ibisubizo. Ibi akenshi bifata amasaha ari munsi ya 24 .

Ni izihe ngaruka zavuye mu gupima HIDA?

Amakuru ari muri raporo y'ibyavuye mu isuzuma rya HIDA ashobora gutandukana bitewe n'impamvu yatumye usuzuma. Ubusanzwe, raporo izasobanura uburyo imashini ipima amaraso yanyuze mu nzira y'imiyoboro y'amaraso.

Abaganga basuzuma indwara ya nyuma bahuza ibyavuye mu isuzuma rya HIDA n'ibindi bipimo, nko gupima amaraso.

Ibisubizo bya scan ya HIDA bishobora kuba birimo:

• Ibisanzwe: Imashini ipima umwijima yavuye mu mwijima wawe ijya mu gasabo k'inkari no mu mara mato nta kibazo na kimwe cyayibangamiye.
• Kugenda buhoro kwa radiotracer: Ibi bishobora gusobanura ko hari ahantu runaka hafunganye cyangwa habuze ikintu mu muyoboro w'indyo yawe, cyangwa ko umwijima wawe udakora neza.
• Nta radiotracer igaragara mu gasabo k'inkari: Ibi bishobora gusobanura ko ufite cholecystite ikabije, kuziba kw'imiyoboro y'inkari.
• Igice cyo gusohora agahu gake mu buryo budasanzwe: Ibi bigaragazwa n'ingano y'inkondo y'umurambo ishobora gusohora (igice cyo gusohora) nyuma yo gukangurwa n'imiti. Igice cyo gusohora agahu ka 30% kugeza kuri 35% ni ibisanzwe. Niba uyu mubare uri hasi mu buryo budasanzwe, bishobora kugaragaza ko umuntu afite indwara idakira ya cholecystite.
• Udukoresho two gupima imirasire twabonetse mu tundi duce:Iyo scan igaragaje ko radiotracer iri hanze y’imikorere y’indyo yawe, bishobora kugaragaza ko hari aho indyo iva.

Wibuke ko ibisubizo byawe byose, muganga wawe azabigusobanurira, bityo ntutinye kumubaza ibibazo.

Hanyuma, icyo ugomba kumenya

`HIDA scan` (Hepatobiliary Immunodiacetic Acid Scan) ni ikizamini cy'ingenzi cyo kumenya ibibazo bimwe na bimwe mu mwijima wawe, imiyoboro y'amaraso n'agasabo k'inkari. Bishobora kukugora cyane gukora ikizamini nk'icyo. Ariko menya ko `HIDA scan` ari ikizamini kidababaza na gato. Ushobora kubaza muganga wawe ikibazo cyangwa impungenge ufite. Ntugahangayike, abaganga bari hano kugufasha.

` Isuzuma rya HIDA, agasabo k'inkari, umwijima, inyo, ibikoresho bifite imirasire, gusuzuma, ububabare bwo mu nda