彩色多普勒超声的临床应用2

澳大利亚热带雨林,HISTORY OF ULTRASOUND,2D,3D,4D,Department of Ultrasound Li Feng-hua,彩色多普勒超声的临床应用Ultrasonic diagnosis,Ultrasonic examination,Ultrasonic examination has many advantages: 无创 non-invasive diagnosis technique 易操作 operated easily 无害 not dangeous and not harmful to thepatients 短期内可重复检查 repeated many times in theshort period,超声检查优势,主要内容Main contents,胆囊、胰腺和肾脏Gallbladder,pancreas and Kidney 子宫与胎儿显像Uterus and fetus,胆囊和胰腺超声检查,Gallbladder and Pancreas,Ultrasonography(USG）of the normal gallbladder,胆囊(gallbladder),Shape: pear-shaped（梨形） Size: 3 x 9 cm Wall thickness: 3 mm Lumen: anechoic(胆囊腔内呈无回声）,正常声像图,胆囊结石(gallstone),典型声像特征 Classic sonographic signs, 强回声 strong echo 清晰声影 clear acoustic shadow 随体位改变移动 mobile(shift with position changes),“胆囊结石声影”三合征 Wall-echo-shadow complex(WES),原因：胆囊腔内充满结石causes: a stone-filled gallbladder 表现为两条弧形高回声线后方伴声影appearance: arc-shaped lines followed by a acoustic shadow,Wall-echo-shadow,“胆囊结石声影”三合征 Wall-echo-shadow complex(WES),结石：声影并移动 Stone :Shadowing and mobile 胆泥：无声影但可移动 sludge :Nonshadowing and mobile 息肉：无声影和移动 polyp : Nonshadowing and nonmobile,胆囊结石、息肉及胆泥间的鉴别诊断 Differential diagnosis among Stone,sludge and polyp,胆囊息肉 polyp,正常胆囊,胆囊结石、息肉及胆泥间的鉴别诊断 Differential diagnosis among Stone,sludge and polyp,Normal gallbladder,胆泥声像图,胆囊结石、息肉及胆泥间的鉴别诊断 Differential diagnosis among Stone,sludge and polyp,胆囊结石、息肉及胆泥间的鉴别诊断 Differential diagnosis among Stone,sludge and polyp,正常胆囊,胆囊增大 Gallbladder enlargement 胆壁增厚 Gallbladder wall thickening3 mm 胆腔内见胆泥 Sludge in the gallbladder lumen,急性胆囊炎的声像特征Ultrasonography of acute cholecystitis,正常胆囊,胆汁淤积sludge,急性胆囊炎的声像特征Ultrasonography of acute cholecystitis,正常声像图,胰腺(pancreas),大小 Size: headliver 实质回声 echotexturre:homogeneous,USG of the normal pancreas,胰腺(pancreas),下腔静脉 the inferior vena cava (IVC) 腹主动脉 aorta (AO) 肠系膜上动脉 superior mesenteric artery(SMA) 脾静脉splenic vein (SV),胰腺周围血管 Pancreas and vasculature,急性胰腺炎(acute pancreatitis),胰腺增大Pancreas enlargement 胰腺回声减低Decreased pancreatic echogenicity 胰周积液 Peripancreatic fluid collections,声像特征Ultrasonography,胰周积液 Perikidney fluid collections,急性胰腺炎(acute pancreatitis),声像特征Ultrasonography,急性胰腺炎(acute pancreatitis),声像特征Ultrasonography,低回声肿块hypoechoic mass 胰管及胆道梗阻obstruction of the pancreatic and biliary duct:胰管及胆总管扩张dilatedpancreatic duct and common bile duct 胆囊增大enlarged gallbladder,胰腺癌(pancreatic cancer),声像特征Ultrasonography,胆道梗阻部位的诊断,高位梗阻 upper obstruction肝总管以上梗阻 obstruction of the commonhepatic duct and superior part of it低位梗阻 lower obstruction胆总管及壶腹部病变引起的梗阻obstruction caused by diseases of CBD andDuodenal ampulla,胰腺癌(pancreatic cancer),Kidney,肾 脏,肾脏(kidney),肾长径 lenth:average 11cm(range 913cm) 肾实质呈低回声 Parenchyma: hypoechic 肾窦呈高回声 Renal sinus: hyperechic 肾表面呈线状高回声 Surface: hyperechic line,正常声像图USG of normal kidney,肾窦内结石呈强回声伴声影 strong echo in the renal sinus acoustic shadow,肾结石(kidney stone),声像特征(USG）,肾盂积水(Hydronephrosis),肾窦扩张呈液性暗区 dilated renal sinus 1cm(collecting system):anechoic space mild hydronephrosis moderate hydronephrosis marked hydronephrosis,声像特征(USG）,肾盂积水(Hydronephrosis),肾盂积水(Hydronephrosis),声像特征（ USG ）,肾囊肿(kidney cyst),