彩色多普勒超声的临床应用.ppt

HISTORYOFULTRASOUND2D3D4DDepartmentofUltrasoundLiFeng-hua彩色多普勒超声的临床应用UltrasonicdiagnosisUltrasonicexaminationhasmanyadvantages:⒈无创non-invasivediagnosistechnique⒉易操作operatedeasily⒊无害notdangeousandnotharmfultothepatients⒋短期内可重复检查repeatedmanytimesintheshortperiod超声检查优势主要内容Maincontents胆囊、胰腺和肾脏Gallbladder,pancreasandKidney子宫与胎儿显像Uterusandfetus胆囊和胰腺超声检查01GallbladderandPancreas02胆囊(gallbladder)Ultrasonography(USG）of

thenormalgallbladder正常声像图Shape:pear-shaped（梨形）Size:3x9cmWallthickness:3mmLumen:anechoic(胆囊腔内呈无回声）胆囊结石(gallstone)⑴强回声strongecho⑵清晰声影clearacousticshadow⑶随体位改变移动mobile(shiftwithpositionchanges)典型声像特征Classicsonographicsigns“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-shadowcomplex(WES)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,sludgeandpolypNormalgallbladder胆泥声像图胆囊结石、息肉及胆泥间的鉴别诊断DifferentialdiagnosisamongStone,sludgeandpolyp胆囊结石、息肉及胆泥间的鉴别诊断DifferentialdiagnosisamongStone,sludgeandpolyp正常胆囊胆囊增大Gallbladderenlargement胆壁增厚Gallbladderwallthickening3mm胆腔内见胆泥Sludgeinthegallbladderlumen急性胆囊炎的声像特征Ultrasonographyofacutecholecystitis正常胆囊胆汁淤积sludge急性胆囊炎的声像特征Ultrasonographyofacutecholecystitis胰腺(pancreas)正常声像图1大小Size:head3cm,body2cm,tail1~3cm胰管Pancreaticduct:2mm回生强度Echogenicity:liver实质回声echotexturre:homogeneous2USGofthenormalpancreas3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spl