彩色多普勒超声的临床应用2课件

澳大利亚热带雨林

HISTORY

OFULTRASOUND2D3D4D澳大利亚热带雨林 HISTDepartmentofUltrasoundLiFeng-hua彩色多普勒超声的临床应用

UltrasonicdiagnosisDepartmentofUltrasound彩色多普勒UltrasonicexaminationUltrasonicexaminationhasmanyadvantages:⒈无创non-invasivediagnosistechnique⒉易操作operatedeasily⒊无害notdangeousandnotharmfultothepatients⒋短期内可重复检查repeatedmanytimesintheshortperiod超声检查优势UltrasonicexaminationUltras主要内容Maincontents

胆囊、胰腺和肾脏

Gallbladder,pancreasandKidney子宫与胎儿显像Uterusandfetus主要内容Maincontents胆囊、胰腺和肾脏胆囊和胰腺超声检查GallbladderandPancreas胆囊和胰腺超声检查GallbladderandPanc

Ultrasonography(USG）of

thenormalgallbladder胆囊(gallbladder)Shape:pear-shaped（梨形）Size:3x9cmWallthickness:<3mmLumen:anechoic(胆囊腔内呈无回声）正常声像图

Ultrasonography(USG）of

the胆囊结石(gallstone)

典型声像特征Classicsonographicsigns⑴强回声strongecho⑵清晰声影clearacousticshadow⑶随体位改变移动mobile(shiftwithpositionchanges)胆囊结石(gallstone)典型声像特征⑴强回

“胆囊－结石－声影”三合征

Wall-echo-shadowcomplex(WES)原因：胆囊腔内充满结石causes:astone-filledgallbladder表现为两条弧形高回声线后方伴声影

appearance:arc-shapedlinesfollowedbyaacousticshadowWall-echo-shadow“胆囊－结石－声影”三合征

Wall-echo-shado

“胆囊－结石－声影”三合征

Wall-echo-shadowcomplex(WES)“胆囊－结石－声影”三合征

Wall-echo-shado结石：声影并移动Stone:Shadowingandmobile胆泥：无声影但可移动sludge:Nonshadowingandmobile息肉：无声影和移动polyp:Nonshadowingandnonmobile

胆囊结石、息肉及胆泥间的鉴别诊断DifferentialdiagnosisamongStone,sludgeandpolyp

结石：声影并移动胆囊结石、息肉及胆泥间的鉴别诊断胆囊息肉polyp

正常胆囊

胆囊结石、息肉及胆泥间的鉴别诊断DifferentialdiagnosisamongStone,sludgeandpolyp

Normalgallbladder胆囊息肉polyp正常胆囊胆囊结石、息肉及胆泥胆泥声像图

胆囊结石、息肉及胆泥间的鉴别诊断DifferentialdiagnosisamongStone,sludgeandpolyp

胆泥声像图胆囊结石、息肉及胆泥间的鉴别诊断

胆囊结石、息肉及胆泥间的鉴别诊断DifferentialdiagnosisamongStone,sludgeandpolyp

正常胆囊胆囊结石、息肉及胆泥间的鉴别诊断正常胆囊胆囊增大

Gallbladderenlargement

胆壁增厚Gallbladderwallthickening>3mm胆腔内见胆泥Sludgeinthegallbladderlumen

急性胆囊炎的声像特征

Ultrasonographyofacutecholecystitis胆囊增大急性胆囊炎的声像特征正常胆囊胆汁淤积sludge

急性胆囊炎的声像特征

Ultrasonographyofacutecholecystitis正常胆囊胆汁淤积sludge急性

正常声像图

胰腺(pancreas)大小Size:head<3cm,body<2cm,tail1~3cm胰管Pancreaticduct:<2mm回生强度Echogenicity:>liver实质回声echotexturre:homogeneousUSGofthenormalpancreas正常声像图

胰腺(pancreas)大胰腺(pancreas)下腔静脉theinferiorvenacava(IVC)腹主动脉aorta(AO)肠系膜上动脉superiormesentericartery(SMA)脾静脉splenicvein(SV)

胰腺周围血管Pancreasandvasculature胰腺(pancreas)下腔静脉theinferior急性胰腺炎(acutepancreatitis)胰腺增大Pancreasenlargement胰腺回声减低Decreasedpancreaticechogenicity胰周积液Peripancreaticfluid

collections

声像特征

Ultrasonography急性胰腺炎(acutepancreatitis)胰腺增大P胰周积液

Perikidneyfluidcollections急性胰腺炎(acutepancreatitis)

声像特征

Ultrasonography胰周积液Perikidneyfluidcollecti急性胰腺炎(acutepancreatitis)

声像特征

Ultrasonography急性胰腺炎(acutepancreatitis)低回声肿块hypoechoicmass胰管及胆道梗阻

obstructionofthepancreaticandbiliaryduct:⑴胰管及胆总管扩张dilated

pancreaticductandcommonbileduct⑵胆囊增大enlargedgallbladder胰腺癌(pancreaticcancer)

声像特征

Ultrasonography低回声肿块hypoechoicmass胰腺癌(pancre

胆道梗阻部位的诊断◆高位梗阻upperobstruction

肝总管以上梗阻

obstructionofthecommon

hepaticductandsuperiorpartofit◆低位梗阻lowerobstruction

胆总管及壶腹部病变引起的梗阻

obstructioncausedbydiseasesofCBDand

Duodenalampulla胆道梗阻部位的诊断◆高位梗阻upperobstr胰腺癌(pancreaticcancer)胰腺癌(pancreaticcancer)Kidney肾脏Kidney肾脏肾脏(kidney)肾长径

lenth:average11cm(range9~13cm)肾实质呈低回声Parenchyma:hypoechic肾窦呈高回声Renalsinus:hyperechic肾表面呈线状高回声Surface:hyperechicline

正常声像图

USGofnormalkidney

肾脏(kidney)肾长径正常声肾窦内结石呈强回声伴声影strongechointherenalsinusacousticshadow肾结石(kidneystone)

声像特征(USG）肾窦内结石呈强回声伴声影肾结石(kidneystone)肾盂积水(Hydronephrosis)肾窦扩张呈液性暗区dilatedrenalsinus≥1cm(collectingsystem):anechoicspacemildhydronephrosismoderatehydronephrosismarkedhydronephrosis

声像特征(USG）肾盂积水(Hydronephrosis)肾窦扩张呈液性暗区肾盂积水(Hydronephrosis)肾盂积水(Hydronephrosis)肾盂积水(Hydronephrosis)

声像特征（USG

）肾盂积水(Hydronephrosis)声像特征肾囊肿(kidneycyst)边清壁薄液性暗区伴后方回声增强anechoiclumenclearwallacousticenhancementdeeptothelesion典型声像特征Classicsonographicsigns

声像特征

（

USG

）肾囊肿(kidneycyst)边清壁薄液性暗区伴后方回声增彩色多普勒超声的临床应用2课件彩色多普勒超声的临床应用2课件

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