Ngati dokotala wanu akudandaula kuti muli ndi metastatic melanoma (stage III kapena IV), pali zida zingapo zomwe zimapezeka kuti zitsimikizidwe, ndikudziwitseni momwe zakhalira ndikuyang'ana ngati zafalikira kumalo am'dera kapena kutali, mapapo, ubongo, mafupa kapena zina. malo a thupi. Izi zimaphatikizapo kuyesa magazi kwa LDH (lactate dehydrogenase) mlingo, kafukufuku wamakono, kapena zojambula zamagetsi monga computed tomography (CT), imaging magnetic resonance (MRI) ndi positron emission tomography (PET).
Mawu oyambirira awa adzakuthandizani kumvetsetsa bwino nkhaniyi ndikumvetsetsa zomwe muyenera kuyembekezera nthawi zina poopseza njira zowunikira.
Computed Tomography (CT)
CT ndi njira yojambula yomwe imagwiritsa ntchito ma x-rays kuti apange zithunzi zosiyana siyana za thupi. Zing'onozing'ono zowona mkati mwazitsulo zimayesa ma x-ray omwe amachititsa kudutsa mu gawo la thupi lomwe likuphunziridwa. Kompyutayo imatenga chidziwitso ichi ndikuchigwiritsa ntchito popanga zithunzi zingapo, zomwe zimatchedwa "magawo." Ziwalo zitatu zogwiritsa ntchito zikhoza kukhazikitsidwa pophatikizapo magawo awiriwo palimodzi. Ngati muli ndi gawo lachitatu kapena lachinayi, "mutengapo" kapena kuti khansa yowonongeka, mumakhala ndi kachilombo ka TB, chifukwa mapapo nthawi zambiri ndi malo oyamba a matenda. Dokotala akhoza kuitaniranso kanema ya ubongo, mimba kapena pelvis, pogwiritsa ntchito siteji ndi zizindikiro.
Zimene muyenera kuyembekezera. Panthawi imene mwasankha, mudzafunsidwa kugona pa tebulo lochepetsetsa lomwe limalowa pakati pa CT scanner.
Mungalandire jekeseni ya IV (IV) ya dye, kapena wothandizila wa radiocontrast, omwe amathandiza mapulaneti abwino kwambiri m'thupi lanu. Malinga ndi phunziroli, mukugona pamimba, kumbuyo kapena kumbali. Mukalowa mkatikati mwajambuzi, makina a x-ray a makina akuzungulira mozungulira. (Zamakono zamakono "zowona" zingapange chiyeso mwa njira imodzi yopitilira.) Muyenera kukhala mulibe panthawi yoyezetsa chifukwa kusuntha kumayambitsa zithunzi zosaoneka.
Mutha kuuzidwa kuti mupume mpweya wanu kwa nthawi yochepa. Kawirikawiri, zolemba zonse zimatenga mphindi zochepa zokha. Mawotchi atsopano opanga makina osiyanasiyana akhoza kujambula thupi lanu lonse, mutu mpaka chala, mu masekondi osachepera 30.
Maginito Resonance Imaging (MRI)
MRI ndi njira yopanda chithunzi yojambula zithunzi za thupi. Mosiyana ndi x-rays ndi CT scans, zomwe zimagwiritsa ntchito ma radiation, MRI imagwiritsa ntchito maginito amphamvu ndi mafunde a mawudu kuti apange chithunzichi. MRI imathandiza pa mapiritsi a melanoma ndipo ikhoza kuzindikiranso zovuta zina zamtundu wautali, makamaka mu ubongo kapena msana.
Zimene muyenera kuyembekezera. Kuti muwoneke, mungafunike kuvala chovala chachipatala kapena zovala zopanda zitsulo (monga thukuta ndi T-shema). Mudzagona pagome laling'ono, lomwe limalowa pakati pa makina a MRI. Ngati mukuwopa malo omangika (claustrophobia), auzani dokotala musanayese. Mutha kuuzidwa kuti mukhale wofatsa kapena dokotala wanu angakulimbikitseni "MRI" yotseguka, yomwe makinawo sali pafupi ndi thupi. Zida zing'onozing'ono, zomwe zimatchedwa "makola," zikhoza kuikidwa pamutu, mkono, mwendo kapena malo ena omwe angaphunzire. Zida zimenezi zimathandiza kutumiza ndi kulandira mawonekedwe a wailesi ndikusintha khalidwe la zithunzi. Zitsanzo zina zimafuna tepi yapadera (kusiyana).
Dayi imaperekedwa kaye musanayese kuyesa kupyolera mu mzere wodula m'manja. Dye imathandiza radiologist kuona malo ena momveka bwino. Pa MRI, munthu amene amagwiritsa ntchito makina akuyang'anirani kuchokera ku chipinda china. Masewera angapo a mafano amafunika nthawi zonse, kutenga mphindi ziwiri mpaka 15 iliyonse. Malingana ndi malo omwe akuphunziridwa ndi mtundu wa zipangizo, mayeso angatenge ola limodzi kapena kupitirira.
Positron Emission Tomography (PET)
PET ndi chiyeso chojambula zithunzi chomwe chimagwiritsa ntchito mankhwala othandizira mankhwala kuti ayang'ane matenda m'thupi. Mosiyana ndi maselo a MRI ndi CT, omwe amavumbulutsa ziwalo za ziwalo, kujambulidwa kwa PET kumasonyeza momwe ziwalo ndi ziphuphu zimagwirira ntchito.
Njirayi yatsimikiziridwa kuti ndi yothandiza pofufuza mavitamini a malo osadziŵika, kudziŵa siteji ya khansa ya khansa, ndikupeza zotupa zowonongeka. Zimayesedwa kukhala zogwirizana kwambiri ndi njira ya CT pofuna kuona zochepa zazikulu zofanana ndi matenda a melanoma ya metast koma komabe sizingagwirizane ndi kulondola kwa tetinel lymph node biopsy kuti tipeze ma metastases mu ma lymph nodes.
Zimene muyenera kuyembekezera. Kufufuza kwa PET kumagwiritsira ntchito kachilombo koyambitsa "tracer" mu mitsempha, kawirikawiri mkati mwa golidi. Thupi limayenda kupyola mwazi ndi kusonkhanitsa mu ziwalo kapena minofu ndi ntchito zapamwamba. Mudzayesedwa pafupi mphindi 60 mutalandira mankhwala othandizira mankhwala. Mukugona patebulo lomwe limalowa mu dzenje lomwe lili pakati pa PET. Makina a PET amadziŵa mphamvu zoperekedwa ndi mankhwala opangira mavitamini ndipo amawasintha kukhala zithunzi zitatu. Zithunzizo zimatumizidwa ku makompyuta, kumene zimasonyezedwa pa zofufuzira za dokotala kuti awerenge. Muyenera kunama panthawi ya PET kuti makina apeze zithunzi zenizeni za ziwalo zanu. Mayeso amatenga pafupifupi 30 minutes.
Zotsatira:
Dancey AL, Mahon BS, Rayatt SS. Kupenda chithunzi cha matenda a melanoma. J Plast Anatulutsa Opaleshoni Yokwanira . 2008 61 (11): 1275-83. 18 November 2008.
"Kodi Melanoma Amadziwika Motani?" American Cancer Society. 18 November 2008.
"Melanoma" National Comprehensive Cancer Network. V.2.2009. 18 November 2008.