腹部影象学概述

1、Radiography of the Abdomen腹部影像学概述- general aspects,Johann Lang Clinical radiology DCVM Vetsuisse Faculty Bern,Radiography of the Abdomen 腹部影像学,Anatomy 解剖学 technical remarks 技术注意事项 Interpretation 判读 abdominal detail 腹部细节 Pathologies 病理学 Limitations 局限性 Alternatives 其他,Anatomical remarks解剖注意事项,Boundar

2、y structures 边界结构 body wall, diaphragm, spine, musculature, plevis 体壁,横隔,脊椎,肌肉,骨盘 -intra-, retroperitoneal space 腹膜后腔内腔 Fat脂肪: falciform ligament 镰状韧带, mesentery肠系膜, omentum大网膜: contrast 对比! Organs/structures 器官/结构,Two types of organs and structures 两种器官和结构 Organs/structures we normally see 正常见到的器官/

3、结构 Organs/structures we normally dont see 不正常见到的器官/结构,Anatomical remarks解剖注意事项,Anatomical remarks解剖注意事项,Anatomical remarks解剖注意事项,Anatomical remarks解剖注意事项,Anatomical remarks解剖注意事项,Radiographs - InformationX光图 讯息,depends on 依赖 preparation of animal 动物的准备 radiographic technique X光技术 species, breed, age

4、 动物, 品种, 年龄 body condition 身体状况 structure/organ of interest 结构/器官特性,Radiographic technique X光技术,increase contrast增加对比 by lowering 降低kVp Expiration 效期 dont stretch legs 不要把腿伸展 prepare animal (withdraw food, empty colon) 准备动物(禁食,空的大肠),Radiographic qualityX光质量,Radiographic quality X光质量,Reading a radiog

5、raph: 读片 要系统化Be systematic,Check for 检查 Positioning位置 Exposure 曝光度 opacity and detail of abdominal cavity 腹腔影象和细节 boundary structures 边界结构 structures/organs 结构/器官,Radiography of the Abdomen腹部影像学,Anatomy 解剖学 technical remarks技术注意事项 Interpretation判读 abdominal detail腹部细节 pathologies病理学 limitations局限性 a

6、lternatives其他,Abdominal detail腹部细节,Reasons for bad abdominal detail 腹部细节不清楚原因,no fat没有脂肪,Abdominal detail腹部细节,Reasons for bad abdominal detail,任何一种液体 fluid of any kind,Abdominal detail腹部细节,胃肠道肿块full GI-tract masses,Abdominal detail腹部细节,Reasons for bad abdominal detail 腹部细节不清楚原因,young age 年幼,Radiogra

7、phy of the Abdomen腹部影像学,Anatomy 解剖学 technical remarks技术注意事项 Interpretation判读 abdominal detail腹部细节 pathologies病理学 limitations局限性 alternatives其他,How sensitive is Radiography? 影像学敏感度如何?,is there lymph node enlargement? 是否有淋巴节肿大?,How sensitive is Radiography?影像学敏感度如何?,cat with right heart failure 右心衰竭的猫

8、 and palpable abdominal mass 可触到的腹部肿块,Intra- retroperitoneal structures腹膜后腔内结构,How sensitive is Radiography? 影像学敏感度如何?,Nine-year old female dog with pollakisuria 9岁母犬频尿,How can we improve sensitivity of Radiography?如何提高影像学敏感度,Radiography positional, compression 位置,压迫 contrast studies 对比研究 negative,

9、positive and double contrast studies of GI- and urinary tract 胃肠道和尿道阴性,阳性,双对比研究 sonography超声波检查 Endoscopy 内窥镜 endoscopic ultrasonography 超声波内窥镜 CT/MRI,Can we diagnose ileus?如何诊断肠梗塞?,Yes, very often we can without any other help 很多时候没有其他帮助 depends on type, location, and time依赖于种类,位置,时间,Can we diagnos

10、e ileus?如何诊断肠梗塞?,depends on cause of obstruction: opacity of foreign body 依赖于阻塞的原因: 异物的不透明度,dilation of small bowel, 小肠扩张 peristaltic activity of bowel 肠道蠕动,Can we diagnose ileus?如何诊断肠梗塞?,dilation of small bowel, 小肠扩张 peristaltic activity of bowel肠道蠕动 focal 局部- generalised 全身,Can we diagnose ileus?如

11、何诊断肠梗塞?,cat with ?猫患有?,dog with linear foreign body犬有线状异物,but sometimes we need help 有时候我们需要帮忙,Radiography of the Abdomen腹部影像学,Anatomy 解剖学 technical remarks技术注意事项 Interpretation判读 abdominal detail腹部细节 pathologies病理学 limitations局限性 alternatives其他,How can we improve sensitivity of Radiography?如何提高影像学敏

12、感度,Radiography positional, compression 位置,压迫 contrast studies 对比研究 negative, positive and double contrast gastrography 阴性,阳性,双对比胃动描记术研究 sonography超声波检查 Endoscopy 内窥镜 endoscopic ultrasonography 超声波内窥镜 CT/MRI,Diseases and methods of choice 疾病和选择方法,Radiography影像学 -special views 特别投影位置 -contrast studies

13、对比研究 Sonography 超声波检查,GIT胃肠道 urinary tract尿道 parenchymas: liver, spleen,肝,脾实质 endocrine organs内分泌器官 abdominal cavity 腹腔 genital tract生殖道,Good indications for x-ray and contrast procedures 好的X光和显影对比步骤,Urinary tract diseases including trauma 尿道疾病包括外伤,Good indications for x-ray and contrast procedures好

14、的X光和显影对比步骤,Urinary tract diseases including trauma 尿道疾病包括外伤,How sensitive is Radiography? 影像学敏感度如何?,Samira, mix, 10 y - vomiting for several weeks, lost weight 10岁杂交Samira, 呕吐好几周, 体重下降,How sensitive is Radiography?影像学敏感度如何?,Samira, mix, 10 y - vomiting for several weeks, lost weight 10岁杂交Samira, 呕吐好

15、几周,体重下降,Nico, Golden Retriever, 10 m.月龄金毛 vomiting - acute onset, painful abdomen 呕吐, 急性发作, 腹部疼痛,Ileus肠阻塞? Plan计划?,repeat radiograph later重复拍X光 contrast study显影对比 Ultrasound超声波 Laparotomy剖腹手术,ultrasound diagnosis 超声波诊断,Intussusception 肠套叠,gall bladder mucocele 膀胱粘液囊肿 acute nephritis急性肾炎 Leptospirosis 钩端螺旋体,Imaging protocols in abdominal diseases in the dog and cat犬猫腹部疾病的影像学诊断方案,survey radiographs X光检查 ultrasound 超声波 x-ray/contrast X光造影 FNA/biopsy 活检 CT endoscopy 内窥镜检查 diagnostic (biopsy) /therapeutic lapa