医学影像学课件：solid organ disorders

SolidorgandisordersSolidorgandisordersLiverDiffuseliverdiseaseCirrhosisFattyinfiltrationhemochromatosisLocalizedliverlesionAbscessesHepaticcystsCavernoushemangiomaHepatocellularcarcinomaMetastaticdiseaseSolidorgandisordersBiliarytree&gallbladderCongenitaldisorders胆囊炎胆系结石胆系肿瘤PancreasAcute/chronicpancreatitisPancreaticcancerSpleenFattyinfiltrationLackofmasseffectLackofdisplacementofhepaticbloodvesselsDiffuselowdensitySometimesfattyinfiltrationcanalsobelocalizedImagingtoolsBariumswallow:esophagusvaricesCT：shapeMRI：nodularregenerationdifferentialdiagnosisDSA：therapyRadiographicfeatures:HepatomegalyHepaticatrophyCoarseningofhepaticparenchymaltextureNodularityofliversurfaceHypertrophyofcaudatelobewithatrophyofrightlobenodularregenerationCirrhosisHepaticabscessThickwall(enhanced)masswithlow-attenuationcenterPyogenic;fungal;amebicRing–likeenhancementSinglering：wall脓肿壁Dualring：wall+edema脓肿壁＋水肿带Triplering：necrosis+fibroticogranuloma+edema

炎性坏死＋纤维肉芽＋水肿HepaticcystHepatichemengingomaClassificationsolitarymassive>5cmmulticentricsmallnodular<5cmdiffusemicroscopic<1cmEnhancementduringarterialphase(inhomogeneouscontrastaccumulation),WashoutduringportalphaseMetastaticdisease影像学征象CT平扫：多发大小不等圆形结节，边缘光整或不光整，多呈低密度；增强扫描：环状或结节状增强，血供丰富的显著强化，少数增强后变为等密度；MRI：“靶征”、“晕圈征”；DSA：多血管、等血管、少血管型。肝转移癌CongenitaldeformityofbileductCongenitalcholedochocystCholecystolithiasis(胆囊结石)Chololithiasis(胆管结石)Chololithiasis(胆管结石)Cholecystitis(胆囊炎)胆囊增大囊壁增厚囊周水肿胆囊增大或缩小囊壁均匀增厚囊壁可见钙化AcuteChronic胆囊癌Cholecystocarcinoma隆起型厚壁型实块型混合型肝门部胆管细胞癌伴肝内胆管扩张急性胰腺炎acutpancreatitis急性水肿型胰腺炎：

平扫胰腺体积弥漫性或局限性增大，密度减低，边缘模糊，肾前及肾周筋膜增厚，增强扫描胰腺轻度强化，胰周水肿更明显；急性出血坏死型胰腺炎：

胰腺明显增大，胰腺内由于出血出现不均匀密度增高，增强扫描坏死的胰腺组织不强化，还可出现胰周积液和腹水；胆源性急性水肿型胰腺炎Chronicpancreatitis胰腺大小正常或缩小；胰管串珠状扩张；胰管结石；假性囊肿形成。胰腺疾病胰腺癌(pancreaticcarcinoma)90%起源于胰腺导管上皮，约10%为腺泡细胞癌；80%位于胰头，其余在体尾部，少数呈弥漫性生长；肿瘤以浸润性生长方式向周围扩展。PancreaticcancerPancreaticcancerSplenictraumaSplenict