{"id":25383,"date":"2023-11-03T11:19:53","date_gmt":"2023-11-03T10:19:53","guid":{"rendered":"https:\/\/test.nemji.cz\/helpie_faq\/ct-pocitacova-tomografie\/"},"modified":"2024-05-14T08:53:40","modified_gmt":"2024-05-14T06:53:40","slug":"ct-pocitacova-tomografie","status":"publish","type":"helpie_faq","link":"https:\/\/www.nemji.cz\/en\/helpie_faq\/ct-pocitacova-tomografie\/","title":{"rendered":"CT &#8211; po\u010d\u00edta\u010dov\u00e1 tomografie"},"content":{"rendered":"<p>Jedn\u00e1 se o za\u0159\u00edzen\u00ed pracuj\u00edc\u00ed s rentgenov\u00fdm z\u00e1\u0159en\u00edm podobn\u011b jako b\u011b\u017en\u00fd RTG p\u0159\u00edstroj, u CT (computed tomography) v\u0161ak rotuje zdroj z\u00e1\u0159en\u00ed &#8211; rentgenka i detek\u010dn\u00ed syst\u00e9m okolo t\u011bla pacienta, kter\u00fd je tak oza\u0159ov\u00e1n postupn\u011b z r\u016fzn\u00fdch \u00fahl\u016f po cel\u00e9m obvodu t\u011bla. Detek\u010dn\u00ed syst\u00e9m pak vyhodnocuje mno\u017estv\u00ed z\u00e1\u0159en\u00ed proch\u00e1zej\u00edc\u00ed t\u011blem pacienta pod r\u016fzn\u00fdmi \u00fahly a z t\u011bchto dat jsou n\u00e1sledn\u011b pomoc\u00ed v\u00fdkonn\u00e9ho po\u010d\u00edta\u010de zrekonstruov\u00e1ny jednotliv\u00e9 scany \u2013 obrazy vrstev t\u011bla zpravidla v axi\u00e1ln\u00ed rovin\u011b.<\/p>\n<p>U klasick\u00e9ho RTG sn\u00edmku je v\u00fdsledkem suma\u010dn\u00ed obraz z cel\u00e9ho t\u011bla, na kter\u00e9m se st\u00edny jednotliv\u00fdch struktur p\u0159ekr\u00fdvaj\u00ed; u CT vy\u0161et\u0159en\u00ed z\u00edsk\u00e1me tenk\u00e9 vrstvy z vy\u0161et\u0159ovan\u00e9 oblasti, bez p\u0159ekr\u00fdv\u00e1n\u00ed jednotliv\u00fdch \u010d\u00e1st\u00ed t\u011bla, lze tedy zobrazit mnohem p\u0159esn\u011bji jednotliv\u00e9 org\u00e1ny, jejich strukturu a patologick\u00e9 stavy.<\/p>\n<h5><strong><a href=\"\/wp-content\/uploads\/2023\/11\/CT.bmp\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-25375 alignnone\" src=\"\/wp-content\/uploads\/2023\/11\/CT.bmp\" alt=\"\" width=\"176\" height=\"224\" \/><\/a><\/strong><\/h5>\n<h5><strong>Indikace k vy\u0161et\u0159en\u00ed<\/strong><\/h5>\n<p>Vzhledem k relativn\u011b velk\u00e9 z\u00e1t\u011b\u017ei rtg z\u00e1\u0159en\u00edm je CT indikov\u00e1no jako \u201emetoda druh\u00e9 volby\u201c \u2013 dopl\u0148uj\u00edc\u00ed vy\u0161et\u0159en\u00ed, kter\u00e9 by m\u011blo pomoci objasnit nejasn\u00fd n\u00e1lez ultrazvukov\u00e9ho vy\u0161et\u0159en\u00ed nebo klasick\u00e9ho rtg sn\u00edmku a to p\u0159edev\u0161\u00edm u posuzov\u00e1n\u00ed kost\u00ed, plic a st\u0159ev, kde ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed nelze uplatnit. U akutn\u00edch (neodkladn\u00fdch) indikac\u00ed pou\u017e\u00edv\u00e1me CT p\u0159edev\u0161\u00edm pro zobrazov\u00e1n\u00ed hlavy \u2013 mozku p\u0159i c\u00e9vn\u00edch mozkov\u00fdch p\u0159\u00edhod\u00e1ch a \u00farazech hlavy, proto\u017ee velmi dob\u0159e zobraz\u00ed nitrolebn\u00ed krv\u00e1cen\u00ed. Velmi spolehliv\u011b zobraz\u00ed i traumatick\u00e9 zm\u011bny org\u00e1n\u016f hrudn\u00edku, b\u0159icha, p\u00e1nve i zlomeniny kost\u00ed. Dal\u0161\u00ed velmi d\u016fle\u017eitou akutn\u00ed indikac\u00ed CT vy\u0161et\u0159en\u00ed je podez\u0159en\u00ed na posti\u017een\u00ed aorty (srde\u010dnice), jako je v\u00fddu\u0165 nebo dissekce (odtr\u017een\u00ed v\u00fdstelky) aorty. V dan\u00e9m p\u0159\u00edpad\u011b se prov\u00e1d\u00ed CT angiografie (vy\u0161et\u0159en\u00ed c\u00e9v pomoc\u00ed CT), hlavn\u011b pro zobrazen\u00ed velk\u00fdch tepen (aorty, ren\u00e1ln\u00ed tepny, p\u00e1nevn\u00ed tepny, karotidy) a tak\u00e9 pro zobrazen\u00ed mozkov\u00fdch tepen (circulus arteriosus Willisi). V n\u011bkter\u00fdch p\u0159\u00edpadech m\u016f\u017ee zcela nahradit klasick\u00e9 angiografick\u00e9 vy\u0161et\u0159en\u00ed.<\/p>\n<h5><strong><a href=\"\/wp-content\/uploads\/2023\/11\/CT5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-25380\" src=\"\/wp-content\/uploads\/2023\/11\/CT5.jpg\" alt=\"\" width=\"183\" height=\"220\" srcset=\"\/wp-content\/uploads\/2023\/11\/CT5.jpg 675w, \/wp-content\/uploads\/2023\/11\/CT5-250x300.jpg 250w, \/wp-content\/uploads\/2023\/11\/CT5-10x12.jpg 10w, \/wp-content\/uploads\/2023\/11\/CT5-580x697.jpg 580w\" sizes=\"auto, (max-width: 183px) 100vw, 183px\" \/><\/a><\/strong><\/h5>\n<h5><strong>Kontraindikace vy\u0161et\u0159en\u00ed<\/strong><\/h5>\n<p>P\u0159ed vy\u0161et\u0159en\u00edm je nutno c\u00edlen\u011b p\u00e1trat a vylou\u010dit \u010di potvrdit p\u0159\u00edtomnost kontraindikac\u00ed. Ka\u017ed\u00fd pacient je o\u0161et\u0159uj\u00edc\u00edm l\u00e9ka\u0159em pou\u010den o rizic\u00edch nitro\u017eiln\u00edho pod\u00e1n\u00ed kontrastn\u00ed l\u00e1tky a v p\u0159\u00edpad\u011b jej\u00edho p\u0159edpokl\u00e1dan\u00e9ho pod\u00e1n\u00ed b\u011bhem CT vy\u0161et\u0159en\u00ed si o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159 vy\u017e\u00e1d\u00e1 a spolupodep\u00ed\u0161e pacient\u016fv p\u00edsemn\u00fd informovan\u00fd souhlas s jej\u00edm nitro\u017eiln\u00edm pod\u00e1n\u00edm.<\/p>\n<p>P\u0159i relativn\u00edch kontraindikac\u00edch je nutno zv\u00e1\u017eit pom\u011br rizika a zisku vy\u0161et\u0159en\u00ed.<\/p>\n<h5><strong>Nativn\u00ed vy\u0161et\u0159en\u00ed<\/strong><\/h5>\n<p>Gravidita &#8211; pouze ve v\u00e1\u017en\u00e9m ohro\u017een\u00ed \u017eivota.<\/p>\n<h5><strong>Vy\u0161et\u0159en\u00ed s kontrastn\u00ed l\u00e1tkou<\/strong><\/h5>\n<p>Vy\u0161et\u0159en\u00ed nesm\u00ed b\u00fdt provedeno u pacient\u016f alergick\u00fdch na jodov\u00e9 kontrastn\u00ed l\u00e1tky.<\/p>\n<p>V n\u00ed\u017ee uveden\u00fdch p\u0159\u00edpadech m\u016f\u017ee b\u00fdt kontrastn\u00ed CT vy\u0161et\u0159en\u00ed provedeno pouze v mimo\u0159\u00e1dn\u00fdch p\u0159\u00edpadech (vit\u00e1ln\u00ed indikace \u2013 vy\u0161et\u0159en\u00ed je nutno prov\u00e9st pro z\u00e1chranu \u017eivota pacienta) a za mimo\u0159\u00e1dn\u00fdch opat\u0159en\u00ed specifick\u00fdch pro dan\u00fd p\u0159\u00edpad (d\u016fkladn\u00e1 a roz\u0161\u00ed\u0159en\u00e1 antialergick\u00e1 p\u0159\u00edprava, asistence anesteziologick\u00e9ho t\u00fdmu, zaji\u0161t\u011bn\u00ed hemodial\u00fdzy, nutn\u00e1 hospitalizace atd.):<\/p>\n<p>\u2022 gravidita,<br \/>\n\u2022 jatern\u00ed a ledvinov\u00e1 insuficience, n\u00e1sledn\u011b nutn\u00e1 dial\u00fdza,<br \/>\n\u2022 hypertyre\u00f3za (zv\u00fd\u0161en\u00e1 funkce \u0161t\u00edtn\u00e9 \u017el\u00e1zy),<br \/>\n\u2022 feochromocytom (n\u00e1dor produkuj\u00edc\u00ed katecholaminy),<br \/>\n\u2022 nespolupracuj\u00edc\u00ed pacient.<\/p>\n<h5><strong>Rizika vy\u0161et\u0159en\u00ed<\/strong><\/h5>\n<p>CT p\u0159\u00edstroj vyu\u017e\u00edv\u00e1 rentgenov\u00e9 z\u00e1\u0159en\u00ed, a proto doch\u00e1z\u00ed k jist\u00e9 radia\u010dn\u00ed z\u00e1t\u011b\u017ei pacienta viz. sekce &#8222;Ionizuj\u00edc\u00ed z\u00e1\u0159en\u00ed&#8220;.<\/p>\n<p>Pod\u00e1n\u00ed kontrastn\u00ed l\u00e1tky (nitro\u017eiln\u011b pop\u0159. peror\u00e1ln\u011b) &#8211; m\u016f\u017ee m\u00edt ne\u017e\u00e1douc\u00ed \u00fa\u010dinky: n\u00e1valy horka, pocen\u00ed, nevolnost, zarudnut\u00ed, sv\u011bd\u011bn\u00ed, vyr\u00e1\u017eka a ve zcela v\u00fdjime\u010dn\u00fdch p\u0159\u00edpadech se m\u016f\u017ee objevit i t\u011b\u017ek\u00e1 alergick\u00e1 reakce charakteru anafylaktick\u00e9ho \u0161oku, vy\u017eaduj\u00edc\u00ed l\u00e9ka\u0159skou p\u00e9\u010di a zcela v\u00fdjime\u010dn\u011b i hospitalizaci pacienta.<\/p>\n<p><strong>Objednat \/ informovat se na vy\u0161et\u0159en\u00ed m\u016f\u017eete telefonem na \u010d\u00edsle:\u00a0567 157 561<\/strong><\/p>\n<h5><strong>P\u0159\u00edstrojov\u00e9 vybaven\u00ed a uk\u00e1zkov\u00e9 sn\u00edmky:<\/strong><\/h5>\n<ul>\n<li>CT Siemens SOMATOM DEFINITION AS+ 128CT p\u0159\u00edstroj Somatom Definition AS+ zna\u010dky Siemens umo\u017e\u0148uje sou\u010dasn\u00e9 sn\u00edm\u00e1n\u00ed 128 vrstev na jednu oto\u010dku rentgenky. V\u00fdjime\u010dn\u00e9 prostorov\u00e9 rozli\u0161en\u00ed nab\u00edz\u00ed zobrazen\u00ed tk\u00e1\u0148ov\u00fdch struktur od velikosti 0,24 mm, rozsah sn\u00edm\u00e1n\u00ed obrazu 200 cm v kombinaci s t\u00edmto rozli\u0161en\u00edm zase umo\u017e\u0148uje vy\u0161et\u0159en\u00ed cel\u00e9ho t\u011bla pacienta b\u011bhem 10 vte\u0159in. To je obzvl\u00e1\u0161\u0165 d\u016fle\u017eit\u00e9 p\u0159i vy\u0161et\u0159en\u00ed pacient\u016f s t\u011b\u017ek\u00fdmi \u00farazy, v bezv\u011bdom\u00ed nebo u nespolupracuj\u00edc\u00edch pacient\u016f. Tyto v\u00fdjime\u010dn\u00e9 parametry jsou vyu\u017eiteln\u00e9 zejm\u00e9na v traumatologii, kdy se jedn\u00e1 o co nejrychlej\u0161\u00ed stanoven\u00ed diagn\u00f3zy, a v kardiologii, kde umo\u017e\u0148uj\u00ed vy\u0161et\u0159en\u00ed funkce srdce a hodnocen\u00ed koron\u00e1rn\u00edch tepen v\u010detn\u011b anal\u00fdzy kalcifikac\u00ed v jejich st\u011bn\u00e1ch.Rychlost a kvalita obraz\u016f je v\u00fdhodn\u00e1 pro kvalitativn\u00ed vaskul\u00e1rn\u00ed diagnostiku a pl\u00e1nov\u00e1n\u00ed interven\u010dn\u00edch z\u00e1krok\u016f na c\u00e9v\u00e1ch. Pln\u011b automatick\u00e1 funkce objemov\u00e9ho zobrazen\u00ed (3D) usnad\u0148uje vyhodnocen\u00ed prokrven\u00ed mozku. Sn\u00edmky z tohoto p\u0159\u00edstroje jsou generov\u00e1ny ve form\u00e1tu DICOM, co\u017e umo\u017e\u0148uje jejich okam\u017eit\u00e9 p\u0159ed\u00e1n\u00ed do syst\u00e9mu PACS a prohl\u00ed\u017een\u00ed odeslan\u00fdch CT obraz\u016f na klinick\u00fdch pracovi\u0161t\u00edch.<div class=\"pgc-sgb-cb wp-block-pgcsimplygalleryblock-grid \" data-gallery-id=\"36328962\"><div class=\"sgb-preloader\" id=\"pr_36328962\">\n\t<div class=\"sgb-square\" style=\"background:#d4d4d4\"><\/div>\n\t<div class=\"sgb-square\" style=\"background:#d4d4d4\"><\/div>\n\t<div class=\"sgb-square\" style=\"background:#d4d4d4\"><\/div>\n\t<div class=\"sgb-square\" style=\"background:#d4d4d4\"><\/div><\/div><div class=\"simply-gallery-amp pgc_sgb_slider \"><noscript><div class=\"sgb-gallery\"><div class=\"sgb-item\"><a href=\"https:\/\/test.nemji.cz\/ct6\/\" target=\"_blank\"><img decoding=\"async\" alt=\"\" width=\"300\" height=\"300\" loading=\"lazy\" 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