医学影像学英文课件：Clinical diagnosis of Ultrasound

anecho
increased Enhancement
isoecho
homogeneous hyperecho
hypoecho heterogeneous
decreased shadowing
The through of transmission of the sound is either increased, unchanged or decreased
Longitude section below the xiphoid
Transverse section at the sencond porta Transverse section at the first porta
To a beginner, sonographic appearance is easy to grasp. The correct orientation of an ultrasound image is difficult.
Posterior echo enhancement
No CDFI signal
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Pathological Diagnosis
Distinct or indistinct borders Internal echoes Decreased transmission Posterior echo attenuate CDFI signal
Benign or malignant. maybe more specific.
Ultrasonography of the system of digestion
● liver ● Gallbladder ● pancreas
From Normal to Abnormal
Liver
Anatomy of the liver
Hepatocellular carcer HCC
The pathogenesis of hepatocellular carcinoma is related to cirrhosis, 80% of patients with preexisting cirrhosis develop of hepatocellular carcinoma. This tumor comprises 90% of all primary liver malignancies. Ultrasound findings: Hypoechoic isoechoic Heterogeneous mosaic sign periphery halo
Echo Inside and behind the structure
Intensity of Echo Posterior echo texture
How to analyze images of Ultrasound and make diagnosis
Position
size
Cyst
shape
Clinical diagnosis of Ultrasound
Objective:
Recognizing normal and abnormal sonography findings of abdomen, breast, thyroid, uterus and obstetrics.
Descriptive Terminologies
Hepatic cyst
• Hepatic cysts may be congenical or acquired, solitary or multiple. • Ultrasound findings:
thin cyst wall well-defined borders anecho with distal posterior enhancement
Liver diseases
● Focal lesions：cystic lesions， hemangioma，hepatocellular carcinoma ● Diffuse lesions ：fatty liver， cirrhosis
Focal liver lesions Ultrasonography
texture echo
Physical diagnosis
Complex
border CDFI Solid
Smooth, well-defined borders
Anechoic Distinct boder Increased transmission
Has characteristic of both solid and cyst
The liver is the largest organ in the body and is quite accessible to sonographic evaluation.
Normal Ultrasonography of the liver
Transverse
Longitude
Size of the liver （right lobe）：14cm homogeneous texture Capsule：smooth, hyperechoic The presence of portal vein, hepatic vein, bile duct system and hepatic artery
Hemangiomas
A hemangioma is begin, congetinal tumor consisting of large, bloodfilled cystic spaces. The tumor is found more frequently in females. The ultrasound appearance is typical: Most are hyperechoic with acoustic enhancement They are round , oval, or lobulated with well-defined borders
Portal vein and Hepatic vein system
Portal vein system
Hepatic vein system
The best way to distinguish the hepatic from the portal vessels is to trace their points of entry to the liver. Real time sector scanning allows the sonographer to make this assessment within a few seconds.