腹部实质性脏器的正常及异常影像学表现
Abdominal CT 腹部实质性脏器的正常及异常影像学表现,Which animal is your favorite,1,2,3,4,CT增强的各期如何分辨,Please arrange the images A-D in the order of nonenhanced, arterial, portal and delay phase,A,B,C,D,A,B,C,D B,C,A,D D,B,C,A C,B,D,A,图像是上下连续的。,Hepatic lobes and segments,left lateral superior/inferior medial caudal left right caudal right anterior superior/inferior posterior superior/inferior,*肝裂：fissures 左叶间裂 肝主裂,Bile duct system,Bile duct： intrahepatic duct 肝内胆管 Hepatic duct 左右肝管 Common bile duct胆总管 Gall bladder胆囊及胆囊管,How many different imaging tools for cholangiography?,MRCP(Magnetic Resonance Cholangio-Pancreatography),CTCP(Computed Tomography Cholangio-Pancreatography),ERCP(Endoscopic Retrograde Cholangio-Pancreatography),PTC(Percutaneous Transhepatic Cholangiography),左侧肝内胆管,肝总管,胆总管十二指肠后段,胆总管胰内段,胆管系统的变异,Pancreas,Fat infiltration Pancreatic duct,Pancreas,胰头、胰颈、胰体、胰尾、胰腺钩突,MSCT Cholangiopancreaticography,Spleen,脾高; 肋单位; 分叶; 副脾accessory spleen； 脾脏的强化: arterial phase,脾动脉,肠系膜上动脉,肠系膜下动脉,胃十二指肠动脉,胃左动脉,肝总动脉,脾静脉,肠系膜上静脉,门静脉,肠系膜下静脉,Abnormalities,Liver,肝脏的异常影像学表现,肝叶大小改变 增大：代偿 缩小：损伤 肝脏轮廓 外凸：mass 内凹：牵拉,Size and Ratio,Noted： 肝裂的变化,Contour,肝脏的异常影像学表现,肝脏密度 弥漫与局灶 低密度 高密度 等密度,肝脏强化 高强化 低强化 延迟强化 特殊强化,Density,Noted： 异常密度的边界,平扫：低密度；增强：高强化,平扫：低密度；增强：无强化,容积效应,特殊强化特征,靶征，病理结构基础？,填充式强化，快进慢出,True False,B,请判断：图A、B中的病灶最外缘具有相同的强化特点？,A,差别在哪里？,Bile duct system,胆道系统的异常影像学表现,胆道梗阻与扩张 充盈缺损与腔内异常密度 胆道系统管壁异常,Obstruction,Different levels Intrahepatic duct Hepatic duct Common hepatic duct Common bile duct Vaters ampulla,无梗阻的胆道扩张,充盈缺损 Filling defect,胆道腔内异常密度,胆道壁异常密度、异常强化?,5 months later,Pancreas,Size Shape and border Density Enhancement Pancreatic duct,Size, shape and the border,Density,Enhancement,囊性病变：无强化 实性病变：低/高强化；不均匀强化,Pancreatic duct,The density of the pancrea is abnormal,True False,The pancreatic duct is dilated,True False,脾脏,大小及数目异常 size and number 密度异常 density 强化异常 enhancement：血管及淋巴系统,大小及数目异常,密度异常,强化异常,Which spleen is abnormal?,A,B,A B A+B,Take home message,消化系统实质性脏器的读片规范 位置localization 大小size 形态shape 密度density 强化enhancement,
