3esvas b超-腹部淋巴结lymph nodes ultrasound

SonographyofAbdominalLymphNodes

腹部淋巴结的超声检查PatrickKircherDipECVDI

欧洲兽医诊断影像学学会认证医师DivisionofRadiology

临床放射学部UniversityofBern

伯尔尼大学Anatomy解剖Drainageofabdominalorgans

腹部器官的淋巴液排出系统Hepatic肝淋巴结Splenic脾淋巴结Jejunal空肠淋巴结Colics结肠淋巴结Gastric胃淋巴结Panc-reatic胰腺淋巴结Aortic主动脉淋巴结Iliac髂淋巴结Hypo-gastric腹下部淋巴结Liver肝脏Spleen脾脏Esophagus食管Stomach胃Duodenum十二指肠Pancreas胰腺Jejunum空肠Ileum回肠Cecum盲肠Colon结肠Kidneys肾脏Adrenals肾上腺Bladder膀胱Uterus输尿管Prostate前列腺Gonad性腺Nyland,Mattoon,SmallAnimalDiagnosticUltrasound小动物超声诊断Spleen脾脏Cranialmesentericartery颅侧肠系膜动脉Jejunallymphnodes空肠淋巴结Leftkidney左肾Mesentericlymphnodes肠系膜淋巴结Mesenteric(jejunal)lymphnodes

肠系膜（空肠）淋巴结Nyland,Mattoon,SmallAnimalDiagnosticUltrasound小动物超声诊断AO腹主动脉CVC后腔静脉PV门静脉Splenicartery脾动脉Spleniclymphnode脾淋巴结AO腹主动脉CVC后腔静脉PV门静脉Hepaticln肝淋巴结Fundus胃底Gastricln胃淋巴结Nyland,Mattoon,SmallAnimalDiagnosticUltrasound腹腔动脉AOAorticlymphnode主动脉淋巴结CVC后腔静脉PV门静脉Sublumbarlymphnodes

腰下淋巴结Medialiliaclymphnodes髂内淋巴结Normalmesentericlymphnodes4monthsoldMastiff正常的肠系膜淋巴结4月龄的马士提夫犬Normalorabnormal?

正常还是异常？Normalorabnormal?

正常还是异常？Weimaraner,4monthsold:suppurativelymphadenitis德国魏玛猎犬，4月龄：化脓性淋巴结炎Reactiveorneoplastic?

炎性反应还是肿瘤？

4yoldAkitawithchronicenteritis患有慢性肠炎的秋田犬，4岁Reactivelymphnode反应性淋巴结Reactiveorneoplastic?

炎性反应还是肿瘤？Felinejejunallymphnode:lymphoma猫的空肠淋巴结：淋巴瘤Benignormalignant?

良性的还是恶性的？Regionallymphadenopathy

局部的淋巴结病LN淋巴结Mix,„Lara“,fs,9yPV门静脉Reactiveorneoplastic?炎性反应还是肿瘤？Intestinaladenocarcinoma肠腺癌Reactiveorneoplastic?炎性反应还是肿瘤？Caninemulticentriclymphoma:

犬的多中心淋巴瘤Liver:large,hypoechoic,normalorhyperechoic...肝脏：大，低回声，正常回声或高回声Usuallylargeabdominallymphnodes通常有变大的腹部淋巴结Hepaticlnn肝淋巴结Spleniclnn脾淋巴结Gastriclnn胃淋巴结Medialiliaclnn髂内淋巴结Spleen脾脏DomesticShorthairCat,„Fantasy“

12yearsold,femalespayed

家养短毛猫，„Fantasy“，12岁，绝育母猫Vomiting,weightlossforseveralweeks

呕吐，数周以来体重减轻Milddehydration,smallmasspalpatedinthemiddleabdomen(notsureiffecalmaterial)

轻度脱水，在腹中部触诊到小的团块（不确定是否是粪便）CBC/chemistry:normal

血常规/血液生化：正常SensitivityandSpecificityofDifferentMethodsforDetectionofMetastasis:

不同方法检查转移情况的敏感性和特异性：Modality方法Sensitivity敏感性Specificity特异性CT计算机X射线断层造影40-83%78-100%MRI核磁共振成像55-80%82-92%US超声检查58%75%FNA细针抽吸42-73%100%VandenBrekeletal.EurJofRadiology2000Ultrasonographicmethodstodetectneoplasticlymphnodes

使用超声检查来检测形成肿瘤的淋巴结Grayscaleultrasound:size,shape,internalarchitecture,necrosis,calcification灰级超声：大小，形状，内部构造，坏死，钙化Colordoppler:detectionofneovascularization

彩色多普勒：检测新血管形成情况Powerdoppler:distributionofvessels

能量多普勒：脉管的分布情况Spectraldoppler:intravascularresistance

频谱多普勒：血管内阻力Ultrasonographicmethods

超声检查的方法Grayscaleimage灰度图象ColorDoppler彩色多普勒PowerDoppler能量多普勒Normalvasculature

正常的脉管系统Central,hilarvesselwithuniformbranches

中央的门脉具有一致的分支Tumorvascularization:

肿瘤的血管化作用：Musclelayerisabsentintumorvessels

在肿瘤的脉管中缺少肌层Arteriovenousfistulas动静脉瘘

lowerresistance血管内阻力较低Inflammation:vasodilation: 炎症：血管舒张

lowerresistance血管内阻力较低Compressionbytumortissue受到肿瘤组织的压迫

higherresistance血管内阻力较高Abnormal:Displacement

异常：置换81%Images:RTO‘Brien,UniversityofMadison-WisconsinAreasofnecrosis坏死的区域SubcapsularV

被膜下血管36.3%Images:RTO‘Brien,UniversityofMadison-WisconsinDestructionofhilarvessels:peripheralvascularsupply门脉系统