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Diagnosis and endovascular therapy of cerebral aneurysm
SVAČINA, Igor
Summary Diagnosis and endovascular therapy of cerebral aneurysm The first part of this bachelor work is aimed at the key examination methods such as CT, MR, DSA etc., leading to the determination of diagnosis of subarachnoidal haemorrhage caused by brain aneurysms. It describes both etiology, pathogenesis, incidence of brain aneurysms and also anatomy and physiology of wessel wall and brain wessel supply {--} circle of Willisi. It explicates parametres of adjusting examination modalities for each individual procedure. Next part deals with the endovascular therapy of cerebral aneurysms. It is engaged in the embolization by coils. Detailed information was acquired from special medical literature and also by the observation of routine working procedures in radiology departments and interventional radiology departments in hospitals during scholarships. The target of the bachelors work is also to assess the role of radiographers in the process of determination of subarachnoidal haemorrhage (SAH), which is caused by brain aneurysms, and also during the endovascular therapy of brain aneurysms. The assumption, that radiographers are really necessary and important during examination and that they are useful members of operating team, came true. The further part is focused on the detection and comparison of levels of the patient{\crq}s radiation stress during the endovascular therapy of brain aneurysms. It compares total skiascopy times of these interventions and searches for differences in the amount of applied iodine contrastive solutions. The compared data come from two angio units, Siemens Multistar (2000) and new Siemens Axiom Artis (2006), that are used in the department of interventional radiology in Homolka hospital. The data of 26 patients necessary for calculation of the effective dose were obtained from the operating diaries of both angio units. Effective and organ doses were subsequently calculated by the software programme called Effdose. It was found that effective doses from both angio units are relatively low. The entrance surface doses and organ doses (thyroid, eye lens etc.) cannot cause any skin injuries and any deterministic effects. Radiation stress in Siemens Axiom Artis is almost half lower than in Siemens Multistar. The hypothesis that effective doses in the new angio unit Axiom will be lower proved true. Differences between total skiascopy times and amounts of applied contrastive solutions were slight. The hypothesis that total skiascopy times and amounts of applied iodine contrastive solutions in the new angio unit Axiom will be lower did not prove true.
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