38 Medical Imaging and Radiotherapy Journal (MIRTJ) 41 (Suppl. 1) Medical Imaging and Radiotherapy Journal (MIRTJ) 41 (Suppl. 1) INTRAVENSKA UPORABA SPAZMOLITIKOV MED PREISKAVO MEDENICE Z MAGNETNO RESONANCO INTRAVENOUS USE OF SPASMOLYTICS DURING MAGNETIC RESONANCE EXAMINATION OF THE PELVIS Janković Božidarka Oddelek za klinično radiologijo, Univerzitetni klinični center Republike Srbske, Dvanaest beba bb, 78000 Banja Luka/ Department of Clinical Radiology, University Clinical Centre of Republika Srpska, Dvanaest beba bb, 78000 Banja Luka Korespondenca / Corresponding author: bozidarka.jankovic@kc-bl.com Prejeto/Recived: 28. 1. 2024 Sprejeto/Accepted: 17. 4. 2024 IZVLEČEK Uvod in namen: MR preiskava medenice se pogosto uporablja v vsakdanji klinični praksi in je postala rutinski diagnostični postopek. Med slikanjem z MR se neizogibno pojavlja veliko različnih vrst artefaktov. Razdelimo jih lahko na artefakte, ki jih povzroči bolnik, in artefakte, povezane z zaporedjem MR. Za zmanjšanje peristaltičnih artefaktov se intravensko aplicirajo antiperistaltična sredstva (spazmolitiki). V radiološki praksi v Evropi se najpogosteje uporablja Buscopan, ki deluje spazmolitično (hioscinijev butilbromid, HBB). Metode: Klinična prospektivna študija z randomiziranim kontroliranim preskušanjem. Raziskava je bila izvedena v Univerzitetnem kliničnem centru v Banja Luki. Obdobje raziskave je trajalo od marca do junija 2023. Preučevani vzorec so sestavljali bolniki, napoteni na MR preiskavo medenice. V raziskavo je bilo vključenih 60 preiskovancev; 30 žensk in 30 moških. Magnetnoresonančne preiskave za raziskavo so bile opravljene na MR napravi 1,5 Magnetom Avanto Fit (Siemens Ag 2015, Erlangen, Nemčija) z uporabo 18-kanalne tuljave za telo in 32-kanalne tuljave za hrbtenico. Uporabljen je bil standardni protokol, ki se uporablja za preiskave medenice. V tem protokolu so bile uporabljene standardne sekvence T2W FSE (ang. fast spin echo) v transverzalni, koronalni in sagitalni ravnini, sekvence T1W z in brez nasičenja maščobe (FS) v transverzalni ravnini, sekvenca DWI v transverzalni ravnini (difuzijsko obteženo slikanje) in T1W FS v transverzalni, koronalni in sagitalni ravnini po uporabi kontrastnega sredstva. Za zmanjšanje peristaltičnih artefaktov med magnetno resonanco medenice je priporočljivo neposredno pred začetkom preiskave intravensko odmeriti 2 ml Buscopana (40 mg HBB). Klinični učinki Buscopana so kratkotrajni, normalna črevesna peristaltika pa se vzpostavi od 15 do 40 minut po odmerku. Predvideno skupno trajanje MR preiskave je približno 25 minut. Rezultati: Raziskava je pokazala, da intravensko apliciranje spazmolitikov zmanjša peristaltične artefakte, prispeva k izboljšanju splošne kakovosti slike pri MR preiskavi medenice ter ne vpliva na trajanje MR preiskave. Razprava in zaključek: Uporaba spazmolitikov vodi k zmanjšanju peristaltičnih artefaktov, s čimer se poveča splošna kakovost slike, medtem ko ne vpliva na trajanje preiskave in ne povzroča neželenih reakcij. Ključne besede: magnetna resonanca, medenica, Buscopan, artefakt ABSTRACT Introduction: MR examination of the pelvis is widely used in everyday clinical practice and has become a routine diagnostic procedure. Many diff erent types of artifacts inevitably occur during MR imaging. They can be categorized as patient-induced artifacts and MR sequence-related artifacts. In order to reduce peristaltic artifacts, antiperistaltic agents (spasmolytics) are administrated intravenously. The most commonly used antispasmodic in radiological practice in Europe is Buscopan (hyoscine N-butylbromide(HBB)). Methods: Clinical prospective study randomized controlled trial. The research was conducted at the University Clinical Centre of Banja Luka. The research period was from March to June 2023. The examined sample consisted of patients referred for an MR examination of the pelvis. The study included 60 respondents (30 female and 30 male). MR examinations for the study were performed on a 1.5 Magnetom Avanto Fit MR system (Siemens Ag 2015, Erlangen, Germany) using both an 18-channel body coil and a spine 32-channel coil. The protocol used to perform this examination was the standard protocol used for pelvic examinations. Used in this protocol were standard T2W FSE (fast spin echo) sequences in transversal, coronal and sagittal planes, T1W sequences with and without fat saturation (FS) in a transversal plane, DWI sequence in a transversal plane (diff usion weighted imaging) and T1W FS in transversal, coronal and sagittal planes after contrast agent. In order to reduce peristaltic artifacts during pelvic MRI, it is recommended to administer 2 ml of Buscopan (40 mg HBB) intravenously, immediately before the start of the examination. The clinical eff ects of Buscopan are short-lived, while normal intestinal peristalsis is established between 15 and 40 minutes after administration. The expected total duration of the MR examination is approximately 25 minutes. Results: This research showed us that the intravenous administration of spasmolytics reduces peristaltic artifacts and contributes to an increase in the overall quality of the image in an MR examination of the pelvis, and that the administration of spasmolytics has no eff ect on the time of an MR examination. Conclusion: The use of spasmolytics leads to a reduction in peristaltic artifacts, thereby increasing the overall quality of the image, while it does not aff ect the examination time and cause unwanted reactions. Keywords: magnetic resonance, pelvis, Buscopan, artifact Medical Imaging and Radiotherapy Journal (MIRTJ) 41 (Suppl. 1) 39 Medical Imaging and Radiotherapy Journal (MIRTJ) 41 (Suppl. 1) LITERATURA / REFERENCES Slough R.A. et al. (2018). 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