NEURORADIOLOŠKA DIJAGNOSTIKA HOSPITALIZIRANIH BOLESNIKA PSIHIJATRIJSKE BOLNICE VRAPČE

Krešimir Hrabrić, Vlado Jukić, Petar Bilić, Ivan Ćelić, Miroslav Herceg

Sažetak. U radu je istražena učestalost indiciranja i potom rezultati CT-a i MR-a mozga u hospitaliziranih bolesnika Psihijatrijske bolnice Vrapče. Željeli smo pridonijeti rješavanju dileme treba li neuroradiološke pretrage provoditi kao dio rutinske dijagnostičke obrade svih psihijatrijskih pacijenata. Retrospektivno, na temelju povijesti bolesti analizirani su bolesnici u prvome devetomjesečnom razdoblju 2006. U tom je razdoblju snimljeno 90 CT-a mozga i 2 MRI-a, relativno najčešće kod bolesnika koji su obrađivani pod dijagnozama endogenih psihoza, psihoorganskog sindroma (demencija), afektivnih poremećaja i epilepsije. Većina CT-a mozga (59%) i oba MR-a mozga bila je uredna. Najčešći promijenjeni nalazi opisivali su moždanu atrofiju u različitim oblicima, nađen je samo jedan tumor mozga. Elektroencefalografski nalazi su bitno češće signifikantno odstupali od normale kod pacijenata s izmijenjenim CT-om mozga nego kada je on bio uredan. Zaključak je da vrlo malen broj pozitivnih nalaza osim atrofije mozga ne opravdava rutinsko snimanje CT-a i MR-a mozga svim hospitaliziranim psihijatrijskim bolesnicima. Indikacija se mora donijeti selektivno na temelju kliničke prosudbe psihijatra u konzultaciji s neurologom. EEG uz ograničenja pri tome može pomoći.

Summary. The authors discuss the frequency of indication for and the results of CT and MRI brain scans in patients hospitalized in Vrapče Psychiatric Hospital. They wanted to contribute to the solving of the dilemma whether neuroradiologic tests should be a part of a routine diagnostic procedure in all psychiatric patients. Retrospectively, on the basis of case histories, the patients were analyzed in the first nine months of 2006. In this period 90 CT brain scans and two MRI brain scans were done, most often in the patients who were treated under the diagnoses of endogeneous psychoses, psychoorganic syndrome (dementia), affective disorders and epilepsy. Most CT findings (59%) and both MRI findings were normal. Abnormal findings were most often described as various forms of brain atrophy. Only one brain tumor was found. Electroencephalographic findings quite more often differed significantly from normal in the patients with abnormal CT findings compared with the patients with normal CT findings. The conclusion is that very small number of positive findings, except the brain atrophy, does not give good reason for routine CT and MRI brain scan in all hospitalized psychiatric patients. Indication must be made selectively on the basis of clinical psychiatric-neurologic evaluation. EEG, with limitations, can be of help in this matter.