彩色多普勒超的临床应用2.ppt

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－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 * * 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 has many advantages: ⒈ 无创 non-invasive diagnosis technique ⒉ 易操作 operated easily ⒊ 无害 not dangeous and not harmful to the patients ⒋ 短期内可重复检查 repeated many times in the short period 超声检查优势 胆囊和胰腺超声检查 Gallbladder and Pancreas Ultrasonography(USG）of the normal 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 典型声像特征 Classic sonographic signs ⑴ 强回声 strong echo ⑵ 清晰声影 clear acoustic shadow ⑶ 随体位改变移动 mobile(shift with position changes) 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 大小 Size: head3cm, body2cm, tail 1~3cm 胰管 Pancreatic duct:2mm 回生强度 Echogenicity:liver 实质回声 echotexturre:homogeneous USG of the normal 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splen