2消化系统基本病变x线表现.ppt

第三节 消化道基本病变表现Abnormal radiographic appearances 1、轮廓改变 Changes of the contour of alimentary tract 1.1 龛影（Crater or niche） 溃疡的直接X线征象，溃疡被钡剂充填，切线位表现为向腔外凸出的阴影，正位呈圆点状或不规则状的致密斑。 Crater represents the existence of the ulcer of alimentary tract.When seen in profile , the crater appears as the barium-filled projec-tion extending from the lumen. When seen en face, it appears as a dense ovoid barium shadow. On double contrast films, anterior wall ulcer craters Occasionally may be seen as complete or incomplete ring shadow 龛影正位观 1.2 憩室（Diverticulum) 消化道黏膜经过管壁的薄弱区向外膨出，或管外邻近病变的粘连牵拉使管壁各层向腔外凸出，呈袋状，其内及附近的黏膜皱襞形态正常，称为憩室。 憩室（内有黏膜） 1.3 充盈缺损(Filling defect) 占位性病变的直接X线征象。消化道腔内肿瘤或其他占位性病变，在造影检查时造影剂充填缺损，密度减低。 Filling defect appears as an ovoid ,crescent or irregular radiolucent shadow 充盈缺损 2、黏膜皱襞改变 Changes of the mucosal folds 黏膜皱襞的异常表现对早期病变和疾病的鉴别诊断有重要意义。 If there are inflamma-tory infiltration ,edema hyperplasia in mucosa or varices in submucosa radiolucent strips of the mucosal folds become wider and more twisted. 2.1黏膜迂曲增宽(circumflex and extension ) （1）病理：黏膜和黏膜下层炎性细胞浸润、充血、肿胀和结缔组织增生。 （2）X线：透明条纹影增宽、迂曲紊乱、双重对比见胃小区不规则，直径大于3mm。 2.2黏膜皱襞萎缩平坦 atrophy and flatness （1）病理：黏膜层变薄，皱襞变细或 黏膜层、黏膜下层被肿瘤组织侵蚀或炎性水肿引起。 The reasons that cause the flattening of mucosal folds are as followed : One is that mucosa and submucosa are infiltrated by cells of inflammation or tumor.The other is that mucosa and submucosa have inflammatory edema. （2）X线：黏膜纤细甚至消失。肿瘤引起的与正常区界限明显，炎症引起的为逐渐移行。 粘膜皱襞平坦 ２.3　黏膜皱襞纠集　 Collections of mucosa　 （1）病理：黏膜或黏膜下层纤维结缔组织增生，瘢痕收缩形成。（When there is a chronic ulcer with scarring forma-tion ,the mucosa surround-ing the ulcer crater are ra-diating into the edge of the crater and the deformation of the lumen is produced） 　 ２.3　黏膜皱襞纠集　 Collections of mucosa 　 　（2）X线：黏膜皱襞从四周向一处集中，呈车辐状肿瘤浸润也可产生类似改变，但僵硬而不规则，有黏膜中断。