{"id":5137,"date":"2015-12-18T12:05:54","date_gmt":"2015-12-18T12:05:54","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=5137"},"modified":"2016-01-20T11:47:53","modified_gmt":"2016-01-20T11:47:53","slug":"evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/","title":{"rendered":"Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE"},"content":{"rendered":"<p style=\"text-align: justify;\"><em>Acumularea de fier \u00een ficat este un factor de risc important pentru ciroz\u0103 \u0219i cre\u0219te riscul de carcinom hepatocelular (CHC). Detectarea depozitelor hepatice de Fe prin biopsie prezint\u0103 dezavantajul c\u0103 metoda este invaziv\u0103 \u0219i are, prin urmare, o reproductibilitate sc\u0103zut\u0103 pentru evalu\u0103rile periodice. Evaluarea imagistic\u0103 neinvaziv\u0103 prin m\u0103sur\u0103torile T2* ponderate \u0219i mai recent, prin SWI 2D GRE poate monitoriza implicarea acumul\u0103rilor de Fe \u00een dezvoltarea carcinomului hepatocelular pornind de la stadiul de nodul displazic premalign.<\/em><\/p>\n<p style=\"text-align: justify;\"><strong>Aplica\u021biile IRM \u00een patologia hepatic\u0103:<\/strong><\/p>\n<ul style=\"text-align: justify;\">\n<li>depisteaz\u0103 \u0219i caracterizeaz\u0103 leziunile focale solide intrahepatice: leziuni primare (hiperplazia focal\u0103 nodular\u0103, adenom, hepatocarcinom, colangiocarcinom intrahepatic etc.) \u0219i leziuni secundare (metastaze cu diferite puncte de plecare);<\/li>\n<li>este util\u0103 \u00een evaluarea ficatului cirotic (aprecieri morfologice asupra ficatului);<\/li>\n<li>diferen\u021biaz\u0103 nodulii regenerativi hepatici de nodulii displazici;<\/li>\n<li>caracterizeaz\u0103, \u00een patologia hepatic\u0103 difuz\u0103, steatoza hepatic\u0103, hemosideroza \u0219i hemocromatoza;<\/li>\n<li>diferen\u021biaz\u0103 leziunile chistice hepatice: chiste simple, abcese, hamartoame biliare, determin\u0103ri secundare chistice;<\/li>\n<li>caracterizeaz\u0103 leziuni hepatice vasculare: \u0219unturi arterio-venoase, sindrom Budd<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong>SWI 2D GRE<\/strong> este o tehnic\u0103 imagistic\u0103 recent\u0103 care folose\u0219te diferen\u021bele de susceptibilitate magnetic\u0103 dintre \u021besuturi \u0219i care ofer\u0103 un contrast net superior fa\u021b\u0103 de imaginile PD, T1, T2, T2*W GRE.\u00a0 SWI (Susceptibility Weighted Imaging) depistez\u0103 depozitele de fier din \u021besuturi, microcalcific\u0103rile \u0219i microhemoragiile intraprenchimatoase. Se compune din patru seturi de imagini: de faz\u0103, de magnitudine, SWI (prin compunerea imaginilor de magnitudine \u0219i de faz\u0103) \u0219i MIP. T2* W GRE a fost considerat\u0103 cea mai sensibil\u0103 tehnic\u0103 pentru vizualizarea nodulilor hepatici care con\u021bin Fe. Susceptibility-weighted imaging -SWI este mai sensibil\u0103 \u00een detectarea leziunilor focale bogate \u00een Fe prin ad\u0103ugarea informa\u021biilor din ,,imaginile de faz\u0103\u201d la contrastul oferit de T2* W GRE.<\/p>\n<p style=\"text-align: justify;\">Dac\u0103 pentru investiga\u021biile\u00a0 neuroimagistice SWI presupune o achizi\u021bie 3D GRE cu TE lung, pentru investiga\u021biile abdominale versiunea SWI este 2D GRE, cu scurtarea timpului de ecou (pentru evitarea artefactelor de mi\u0219care date de respira\u021bie \u0219i de mi\u0219c\u0103rile peristaltice) \u0219i achizi\u021bie \u00een apnee \u0219i cu folosirea imaginilor de faz\u0103 pentru evaluarea cantitativ\u0103 a depunerilor de Fe \u0219i SWI pentru detectarea acestora.<\/p>\n<p style=\"text-align: justify;\">Utilizarea SWI \u00een investiga\u021biile abdominale este recent\u0103 \u0219i este folosit\u0103 pentru evaluarea nodulilor hepatici, pentru detectarea \u0219i evaluarea cantitativ\u0103 a depozitelor de Fe din ficat, pentru detectarea hemoragiei intratumorale (CHC) \u0219i a vasculariza\u021biei venoase (leziuni hepatice hipervascularizate).<\/p>\n<p style=\"text-align: justify;\"><em>Acumularea de Fe \u00een ficat este un factor de risc important pentru ciroz\u0103 \u0219i cre\u0219te riscul de hepatocarcinom. <\/em><\/p>\n<p style=\"text-align: justify;\"><strong>Ciroza hepatic\u0103<\/strong> reprezint\u0103 distruc\u021bia \u021besutului normal prin fibroz\u0103 \u0219i \u00eenlocuirea acestuia de noduli benigni de regenerare \u0219i de noduli displazici premaligni care \u00een 80-90% dintre cazuri se pot transforma carcinom hepatocelular. Chiar \u00een absen\u021ba unei boli sistemice precum hematocromatoza, Fe se poate acumula \u00een nodulii de regenerare sau \u00een nodulii displazici \u00een ficatul cirotic. Chiar dac\u0103 un num\u0103r mic de noduli cu acumulare de Fe sunt displazici, 25% dintre ace\u0219tia din urm\u0103 prezint\u0103 depozite de Fe. <em>Nodulii\u00a0 displazici cu con\u021binut ridicat de Fe sunt considera\u021bi leziuni premaligne, \u00een timp ce nodulii de regenerare care prezint\u0103 acumul\u0103ri de Fe sunt markeri pentru ciroze virale sau alcoolice.<\/em><\/p>\n<p style=\"text-align: justify;\">\u00cen hepatite, depozitele de fier apar, de obicei, \u00een celulele reticuloendoteliale din cauza migr\u0103rii feritinei din hepatocitele distruse. \u00cen stadiul de studiu exist\u0103 supozi\u021bia c\u0103 acumularea hepatic\u0103 de fier este implicat\u0103 \u00een progresia fibrozelor hepatice \u0219i \u00een rezisten\u021ba la terapia cu interferon.<\/p>\n<p style=\"text-align: justify;\"><strong>Carcinomul hepatocelular (CHC)<\/strong> este al 5-lea cel mai frecvent cancer ca inciden\u021b\u0103 \u0219i apare la pacien\u021bii cu boli hepatice cronice. Cei mai frecven\u0163i factori de risc sunt hepatitele cronice virale B \u015fi C, ciroza hepatic\u0103, consumul de alcool \u015fi expunerea la afla-toxine. Printre al\u0163i factori se num\u0103r\u0103: hemocromatoza, boala Wilson, ciroza biliar\u0103 primitiv\u0103, deficitul de \u03b11-anti tripsin\u0103, obezitatea, hormonii estrogeni, diabetul zaharat, fumatul \u015fi hepatosteatoza non-alcoolic\u0103.<\/p>\n<p style=\"text-align: justify;\">Dezvoltarea tehnicilor imagistice prin rezonan\u021b\u0103 magnetic\u0103 conduce la \u00eembun\u0103t\u0103\u021birea acurate\u021bei diagnostic\u0103rii CHC. Caracteristicile morfologice ale CHC, detectabile prin IRM \u0219i confirmate histopatologic sunt: capsula fibroas\u0103 \u0219i tiparul mozaicat al capt\u0103rii de contrast MR. Dintre leziunile mai mari de 2 cm, 60-80% prezint\u0103 capsul\u0103 fibroas\u0103. Tiparul mozaicat este prezent \u00een 63% dintre cazurile de CHC \u0219i reprezint\u0103 arii de cre\u0219tere tumoral\u0103 combinate cu arii de necroz\u0103 \u0219i cu arii de \u021besut hepatic de regenerare. Prezen\u021ba invaziei vasculare este un factor important de prognostic CHC.<\/p>\n<p style=\"text-align: justify;\">SWI este folosit pentru evaluarea nodulilor \u00een ficatul cirotic, pentru detectarea cu acurate\u021be a microhemarogiilor intratumorale \u0219i a vasculariza\u021biei venoase \u00een CHC. Exist\u0103 \u0219i leziuni benigne care prezint\u0103 necroz\u0103 \u0219i hemoragie intratumoral\u0103 \u0219i pentru a face diferen\u0163ierea malign vs benign metoda indicat\u0103 este examinarea IRM cu administrare de contrast. DCE <em>(Dynamic Contrast Enhanced) <\/em>implic\u0103 achizi\u021bia de imagini secven\u021biale \u00een timpul trecerii substan\u0163ei de contrast prin \u021besuturile de interes. Intensitatea capt\u0103rii agentului de contrast este corelat\u0103 cu densitatea vascular\u0103 din \u021besut, \u00een timp ce rata \u0219i wash-out-ul substan\u0163ei de contrast este corelat\u0103 cu factori angiogenici precum densitatea capilar\u0103 \u0219i factorul de cre\u0219tere vascular\u0103 endotelial\u0103. Oferind informa\u021bii despre perfuzia tumoral\u0103 \u0219i despre permeabilitatea capilar\u0103, DCE are capacitatea de a caracteriza noninvaziv vasculariza\u021bia \u021besutului tumoral, inclusiv r\u0103spunsul la terapia antiangiogenic\u0103.<\/p>\n<p style=\"text-align: justify;\">\u00cens\u0103, pentru pacien\u021bii cu insuficien\u021b\u0103 renal\u0103, administrarea substan\u021bei de contrast este un factor de risc. SWI poate diferen\u021bia leziunile hepatice hipervascularizate \u00een absen\u021ba administr\u0103rii substan\u021bei de contrast. SWI ofer\u0103 informa\u021bii mult mai detaliate dec\u00e2t IRM conven\u021bional despre marginile tumorii, vasculariza\u021bie, hemoragiile intratumorale \u0219i invazia vascular\u0103, tiparul mozaicat al CHC \u0219i pseudocapsul\u0103.<\/p>\n<p style=\"text-align: justify;\">SWI este mai sensibil\u0103 la modific\u0103rile substan\u0163elor paramagnetice induse de un proces patologic (precum prezen\u0163a con\u0163inutului de fier, hemoragiei, calcific\u0103rilor sau a modific\u0103rilor de nivel de oxigenare) fa\u0163\u0103 de restul tehnicilor IRM conven\u0163ionale, inclusiv fa\u0163\u0103 de m\u0103sur\u0103torile T2* ponderate, deoarece utilizeaz\u0103 informa\u0163ii de faz\u0103 pentru a cre\u015fte efectele de susceptibilitate de la nivelul imaginilor.<\/p>\n<p style=\"text-align: justify;\">Capsulele tumorale \u00een carcinomul hepatocelular au un strat fibros interior \u0219i un strat exterior bogat \u00een con\u0163inut de ap\u0103, ce con\u0163ine vase mici \u015fi c\u0103i biliare. Prezen\u0163a acestora creaz\u0103 apari\u0163ia unui inel unic hipointens pe m\u0103sur\u0103torile T1 ponderate \u015fi un inel dublu cu un strat intern hipointens, cu strat extern hiperintens pe m\u0103sur\u0103torile T2 ponderate, sau un inel unic hipointens pe m\u0103sur\u0103torile T2 ponderate \u00een cazul capsulelor sub\u0163iri din cauza prezen\u0163ei reduse a vaselor \u015fi a c\u0103ilor biliare din stratul extern. Pseudocapsula este responsabil\u0103 \u015fi pentru inelul periferic hiperintens vizibil frecvent pe imaginile IRM cu substan\u0163\u0103 de contrast. Depistarea pseudocapsulei CHC este important\u0103 nu doar pentru caracterizarea tumorilor hepatice, dar \u015fi pentru tratamentul clinic. Pseudocapsulele au o microvasculariza\u0163ie bogat\u0103, iar s\u00e2ngele de la nivelul acestor vase au o concentra\u0163ie sc\u0103zut\u0103 a oxigenului, av\u00e2nd ca rezultat o diferen\u0163\u0103 de faz\u0103 \u00eentre vase \u015fi parenchimul \u00eenvecinat. Prin urmare, SWI (care atenueaz\u0103 diferen\u0163ele de faz\u0103 cu contrast crescut al imaginilor) \u00eembun\u0103t\u0103\u0163e\u015fte vizualizarea clar\u0103 a pseudocapsulei comparativ cu m\u0103sur\u0103torile conven\u0163ionale T1 \u015fi T2 ponderate.<\/p>\n<p style=\"text-align: justify;\">Invazia vascular\u0103: la examenul histopatologic, CHC poate fi observat la nivelul venelor suprahepatice \u015fi\/sau venei porte. Pe imaginile T2* ponderate \u015fi SWI, invazia vascular\u0103 a fost caracterizat\u0103 printr-un defect de umplere al lumenelor hiperintense ale venelor suprahepatice \u015fi\/sau venei porte. SWI poate eviden\u0163ia trombi veno\u015fi secundari invaziei tumorale.<\/p>\n<p style=\"text-align: justify;\">Protocol IRM cu administrare de contrast i.v. (Gadolinium):<\/p>\n<ul style=\"text-align: justify;\">\n<li>localizer \u00een 3 planuri<\/li>\n<li>T1W 3D dual echo GRE axial<\/li>\n<li>T2 W 3D FSE axial\u2013 cu timp de ecou (TE) mediu, cu rezolu\u021bie \u00eenalt\u0103<\/li>\n<li>T2W 2D ssFSE axial\u2013 cu TE lung,<\/li>\n<li>DWI Echo Planar axial cu 3 b-values (b50, b400, b800)<\/li>\n<li>Dyn fat-sat T1W 3D GRE axial, cu substan\u021b\u0103 de contrast<\/li>\n<li>T1W 3D GRE fat-sat, coronal, cu rezolu\u021bie \u00eenalt\u0103<\/li>\n<li>op\u021bional: <strong>SWI<\/strong> 2D axial<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Examinarea dinamic\u0103 folosind drept substan\u0163\u0103 de contrast Gadolinium include trei sau mai multe faze; consecutiv inject\u0103rii substan\u0163ei de contrast se disting: faza arterial\u0103 (20-35s), venoas\u0103 (60- 90s), intersti\u0163ial\u0103 (120-150s) \u015fi tardiv\u0103 (5 minute).<\/p>\n<p style=\"text-align: justify;\">Protocol cu administrare de contrast i.v. specific\u0103 hepatocitar\u0103 (Primovist):<\/p>\n<ul style=\"text-align: justify;\">\n<li>localizer \u00een 3 planuri<\/li>\n<li>T1W 3D dual echo GRE, axial<\/li>\n<li>DWI Echo Planar Imaging 3 b-values, axial<\/li>\n<li>Dyn fat-sat T1W 3D GRE, axial, cu injectare de Primovist<\/li>\n<li>T2w 3D FSE axial, TE mediu, rezolu\u021bie \u00eenalt\u0103,<\/li>\n<li>T1W3D GRE axial,fat-sat cu rezolu\u021bie \u00eenalt\u0103,<\/li>\n<li>T1W 3D GRE fat-sat ce-MRC, coronal, cu rezolu\u021bie \u00eenalt\u0103.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Pentru protocolul dinamic se fac achizi\u0163ii \u00een faza arterial\u0103 (20-35s), venoas\u0103 (60- 90s), intersti\u0163ial\u0103 (120-150s) \u015fi tardiv\u0103 (5 minute), similar examin\u0103rii cu Gadolinium \u015fi o achizi\u0163ie suplimentar\u0103 la 20 de minute, specific\u0103 hepatocitar\u0103.<\/p>\n<p style=\"text-align: justify;\">Echipa medicala\u00a0MEDINST Diagnostic<br \/>\nRom\u00e2no-German<\/p>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/02\/MEDinst-logograma-claim_4c_P2945.jpg\" rel=\"attachment wp-att-4113\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-4113\" src=\"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/02\/MEDinst-logograma-claim_4c_P2945-300x90.jpg\" alt=\"MADinst\" width=\"300\" height=\"90\" srcset=\"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/02\/MEDinst-logograma-claim_4c_P2945-300x90.jpg 300w, https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/02\/MEDinst-logograma-claim_4c_P2945.jpg 800w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p style=\"text-align: justify;\"><strong>Medinst Diagnostic Rom\u00e2no-German func\u021bioneaz\u0103 din anul 1997 \u00een cadrul Institutului Na\u021bional de Neurologie \u0219i Boli Neurovasculare Bucure\u0219ti.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Acumularea de fier \u00een ficat este un factor de risc important pentru ciroz\u0103 \u0219i cre\u0219te riscul de carcinom hepatocelular (CHC). Detectarea depozitelor hepatice de Fe prin biopsie prezint\u0103 dezavantajul c\u0103 [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":5243,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[33,445],"tags":[442],"class_list":["post-5137","post","type-post","status-publish","format-standard","has-post-thumbnail","category-articole","category-imagistica","tag-medinst"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE - Jurmed - Medici<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE - Jurmed - Medici\" \/>\n<meta property=\"og:description\" content=\"Acumularea de fier \u00een ficat este un factor de risc important pentru ciroz\u0103 \u0219i cre\u0219te riscul de carcinom hepatocelular (CHC). Detectarea depozitelor hepatice de Fe prin biopsie prezint\u0103 dezavantajul c\u0103 [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/\" \/>\n<meta property=\"og:site_name\" content=\"Jurmed - Medici\" \/>\n<meta property=\"article:published_time\" content=\"2015-12-18T12:05:54+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2016-01-20T11:47:53+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/12\/MEDinst-900x-450.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"900\" \/>\n\t<meta property=\"og:image:height\" content=\"609\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"costelv\" \/>\n<meta name=\"twitter:label1\" content=\"Scris de\" \/>\n\t<meta name=\"twitter:data1\" content=\"costelv\" \/>\n\t<meta name=\"twitter:label2\" content=\"Timp estimat pentru citire\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/\"},\"author\":{\"name\":\"costelv\",\"@id\":\"https:\/\/jurmed.ro\/medici\/#\/schema\/person\/d32bd0fe3243bb12082045e5e5635d2d\"},\"headline\":\"Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE\",\"datePublished\":\"2015-12-18T12:05:54+00:00\",\"dateModified\":\"2016-01-20T11:47:53+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/\"},\"wordCount\":1493,\"commentCount\":0,\"image\":{\"@id\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/12\/MEDinst-900x-450.jpg\",\"keywords\":[\"Medinst\"],\"articleSection\":[\"Articole\",\"Imagistica\"],\"inLanguage\":\"ro-RO\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/\",\"url\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/\",\"name\":\"Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE - Jurmed - Medici\",\"isPartOf\":{\"@id\":\"https:\/\/jurmed.ro\/medici\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/12\/MEDinst-900x-450.jpg\",\"datePublished\":\"2015-12-18T12:05:54+00:00\",\"dateModified\":\"2016-01-20T11:47:53+00:00\",\"author\":{\"@id\":\"https:\/\/jurmed.ro\/medici\/#\/schema\/person\/d32bd0fe3243bb12082045e5e5635d2d\"},\"breadcrumb\":{\"@id\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#breadcrumb\"},\"inLanguage\":\"ro-RO\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"ro-RO\",\"@id\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#primaryimage\",\"url\":\"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/12\/MEDinst-900x-450.jpg\",\"contentUrl\":\"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/12\/MEDinst-900x-450.jpg\",\"width\":900,\"height\":609},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/jurmed.ro\/medici\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/jurmed.ro\/medici\/#website\",\"url\":\"https:\/\/jurmed.ro\/medici\/\",\"name\":\"Jurmed - Medici\",\"description\":\"JURMED \u2013 Jurnal de Sanatate este o publicatie lunara de informare si preventie medicala. Revista si site-ul au un continut bogat de articole si informatii cu adresabilitate catre publicul larg.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/jurmed.ro\/medici\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"ro-RO\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/jurmed.ro\/medici\/#\/schema\/person\/d32bd0fe3243bb12082045e5e5635d2d\",\"name\":\"costelv\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"ro-RO\",\"@id\":\"https:\/\/jurmed.ro\/medici\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/562bbd538aef9094eff6466c34ed9504fe82c1cb144e421d853e80c3b3d5a9f8?s=96&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/562bbd538aef9094eff6466c34ed9504fe82c1cb144e421d853e80c3b3d5a9f8?s=96&r=g\",\"caption\":\"costelv\"},\"url\":\"https:\/\/jurmed.ro\/medici\/author\/costelvoicu\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE - Jurmed - Medici","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/","og_locale":"ro_RO","og_type":"article","og_title":"Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE - Jurmed - Medici","og_description":"Acumularea de fier \u00een ficat este un factor de risc important pentru ciroz\u0103 \u0219i cre\u0219te riscul de carcinom hepatocelular (CHC). Detectarea depozitelor hepatice de Fe prin biopsie prezint\u0103 dezavantajul c\u0103 [&hellip;]","og_url":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/","og_site_name":"Jurmed - Medici","article_published_time":"2015-12-18T12:05:54+00:00","article_modified_time":"2016-01-20T11:47:53+00:00","og_image":[{"width":900,"height":609,"url":"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/12\/MEDinst-900x-450.jpg","type":"image\/jpeg"}],"author":"costelv","twitter_misc":{"Scris de":"costelv","Timp estimat pentru citire":"7 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#article","isPartOf":{"@id":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/"},"author":{"name":"costelv","@id":"https:\/\/jurmed.ro\/medici\/#\/schema\/person\/d32bd0fe3243bb12082045e5e5635d2d"},"headline":"Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE","datePublished":"2015-12-18T12:05:54+00:00","dateModified":"2016-01-20T11:47:53+00:00","mainEntityOfPage":{"@id":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/"},"wordCount":1493,"commentCount":0,"image":{"@id":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#primaryimage"},"thumbnailUrl":"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/12\/MEDinst-900x-450.jpg","keywords":["Medinst"],"articleSection":["Articole","Imagistica"],"inLanguage":"ro-RO","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/","url":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/","name":"Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE - Jurmed - Medici","isPartOf":{"@id":"https:\/\/jurmed.ro\/medici\/#website"},"primaryImageOfPage":{"@id":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#primaryimage"},"image":{"@id":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#primaryimage"},"thumbnailUrl":"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/12\/MEDinst-900x-450.jpg","datePublished":"2015-12-18T12:05:54+00:00","dateModified":"2016-01-20T11:47:53+00:00","author":{"@id":"https:\/\/jurmed.ro\/medici\/#\/schema\/person\/d32bd0fe3243bb12082045e5e5635d2d"},"breadcrumb":{"@id":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#breadcrumb"},"inLanguage":"ro-RO","potentialAction":[{"@type":"ReadAction","target":["https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/"]}]},{"@type":"ImageObject","inLanguage":"ro-RO","@id":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#primaryimage","url":"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/12\/MEDinst-900x-450.jpg","contentUrl":"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2015\/12\/MEDinst-900x-450.jpg","width":900,"height":609},{"@type":"BreadcrumbList","@id":"https:\/\/jurmed.ro\/medici\/evaluarea-depunerilor-de-fier-hepatice-prin-secventa-de-rezonanta-magnetica-swi-2d-gre\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/jurmed.ro\/medici\/"},{"@type":"ListItem","position":2,"name":"Evaluarea depunerilor de fier hepatice prin secven\u021ba de rezonan\u021b\u0103 magnetic\u0103 SWI 2D GRE"}]},{"@type":"WebSite","@id":"https:\/\/jurmed.ro\/medici\/#website","url":"https:\/\/jurmed.ro\/medici\/","name":"Jurmed - Medici","description":"JURMED \u2013 Jurnal de Sanatate este o publicatie lunara de informare si preventie medicala. Revista si site-ul au un continut bogat de articole si informatii cu adresabilitate catre publicul larg.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/jurmed.ro\/medici\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"ro-RO"},{"@type":"Person","@id":"https:\/\/jurmed.ro\/medici\/#\/schema\/person\/d32bd0fe3243bb12082045e5e5635d2d","name":"costelv","image":{"@type":"ImageObject","inLanguage":"ro-RO","@id":"https:\/\/jurmed.ro\/medici\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/562bbd538aef9094eff6466c34ed9504fe82c1cb144e421d853e80c3b3d5a9f8?s=96&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/562bbd538aef9094eff6466c34ed9504fe82c1cb144e421d853e80c3b3d5a9f8?s=96&r=g","caption":"costelv"},"url":"https:\/\/jurmed.ro\/medici\/author\/costelvoicu\/"}]}},"_links":{"self":[{"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/posts\/5137","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/comments?post=5137"}],"version-history":[{"count":4,"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/posts\/5137\/revisions"}],"predecessor-version":[{"id":5244,"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/posts\/5137\/revisions\/5244"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/media\/5243"}],"wp:attachment":[{"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/media?parent=5137"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/categories?post=5137"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jurmed.ro\/medici\/wp-json\/wp\/v2\/tags?post=5137"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}