医学影像学：消化系统七年制1
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Why gas? To help distend the esophagus
and produce double contrast effect (for better definition of small mucosal abnormalities)
16
食管esophagus
observations
8
X线钡餐造影检查方法
禁忌证 contraindications Forbidding from the following diseases
完全性肠梗阻 the completely intestines obstruction 胃肠道穿孔 the perforation of gastrointestinal tract 急性胃肠道出血 the acute bleeding of gastrointestinal tract
1) 立位腹部平片 2) 仰卧前后位 3) 倒立侧位
➢ 透视(fluoroscopy, given up)
4
Barium contrast examination
• method 单用硫酸钡溶液: single contrast 气钡双重造影 : air-barium double contrast 辅助用药：解痉药、增强胃肠动力药物
9
钡剂检查注意： The attentions about barium studies
透视与摄片结合 fluoroscopy combined with the films 形态与功能并重 the conformation is important as well as the function 触诊与透视并重
2
消化道检查方法 The examination methods
• X- ray 普通检查 • 钡剂造影(barium study) • 血管造影(angiography） • CT computed tomography • MRI magnetic resonance imaging • 超声Ultrasonography
barium concentration is about 200%
• The passage of barium is “screened” with x-ray (patient standing, 正位、右前斜位、左前斜位、左侧位)
• Spot X-ray films are taken
15
Barium swallow 食管吞钡检查
• 核医学 nuclear medicine (SPET PET)
3
消化道检查方法 X- ray The examination methods
➢ 腹 部 平 片 (plain film radiograph often serve as scout films prior to contrast studies)
7
Barium/Contrast studies How to do?
• All utilize X-rays to image the bowel • “Screening” (fluoroscopy) is used to view the
passage of barium/contrast through the bowel. This is in “real-time” and is like a video. It is done intermittently throughout the examination. Images are shown on a monitor. • “Spot films” are x-ray films (radiographs) taken at specific times and of a specific area of the bowel
the palpation and the fluoroscopy are all important
10
DSA 肠系膜上动脉造影
血管造影检查 DSA 适用征：血管性病变、出血、富血供肿瘤
11
CT检查
扫描技术与参数 检查前准备 CT扫描参数 平扫与增强
CT仿真内窥镜 扫描参数 重建
12
MRI检查 超声检查：超声内镜 核医学
消化系统 digestive system
1
digestive system
一、digestive tract (空腔脏器，organs with cavity or lumen) esophagus, stomach, small and large bowel
二、digestive gland liver, gall, pancreas and the spleen
• 检查范围 食管 上消化道：到十二指肠 小肠：回盲部 大肠
5
Barium contrast examination 钡剂造影
wk.baidu.com
Ba swallow
Barium enema
Ba meal
Ba follow through
Small bowel enema
6
钡剂造影检查前准备及注意事项
检查前3天停服含重金属药物 禁食水6小时以上 钡灌肠检查前进行肠道清洁准备 检查前询问病史，了解梗阻程度，决定使用药物浓度 疑诊为胃肠道穿孔、气管瘘等，用可吸收造影剂 多方位和多角度观察与摄片
13
The normal manifestations 正常影像
14
Barium swallow
食管吞钡检查
How it is done?
• Swallow baking soda crystals (to make gas) with little water
• Drink the barium liquid
• 充盈相 barium filling phase • 粘膜相 mucosal phase • 双对比相 double contrast phase • 蠕动波 the first, the second
and the third squirm wave • 食管胃连接部 esophagogastric junction
and produce double contrast effect (for better definition of small mucosal abnormalities)
16
食管esophagus
observations
8
X线钡餐造影检查方法
禁忌证 contraindications Forbidding from the following diseases
完全性肠梗阻 the completely intestines obstruction 胃肠道穿孔 the perforation of gastrointestinal tract 急性胃肠道出血 the acute bleeding of gastrointestinal tract
1) 立位腹部平片 2) 仰卧前后位 3) 倒立侧位
➢ 透视(fluoroscopy, given up)
4
Barium contrast examination
• method 单用硫酸钡溶液: single contrast 气钡双重造影 : air-barium double contrast 辅助用药：解痉药、增强胃肠动力药物
9
钡剂检查注意： The attentions about barium studies
透视与摄片结合 fluoroscopy combined with the films 形态与功能并重 the conformation is important as well as the function 触诊与透视并重
2
消化道检查方法 The examination methods
• X- ray 普通检查 • 钡剂造影(barium study) • 血管造影(angiography） • CT computed tomography • MRI magnetic resonance imaging • 超声Ultrasonography
barium concentration is about 200%
• The passage of barium is “screened” with x-ray (patient standing, 正位、右前斜位、左前斜位、左侧位)
• Spot X-ray films are taken
15
Barium swallow 食管吞钡检查
• 核医学 nuclear medicine (SPET PET)
3
消化道检查方法 X- ray The examination methods
➢ 腹 部 平 片 (plain film radiograph often serve as scout films prior to contrast studies)
7
Barium/Contrast studies How to do?
• All utilize X-rays to image the bowel • “Screening” (fluoroscopy) is used to view the
passage of barium/contrast through the bowel. This is in “real-time” and is like a video. It is done intermittently throughout the examination. Images are shown on a monitor. • “Spot films” are x-ray films (radiographs) taken at specific times and of a specific area of the bowel
the palpation and the fluoroscopy are all important
10
DSA 肠系膜上动脉造影
血管造影检查 DSA 适用征：血管性病变、出血、富血供肿瘤
11
CT检查
扫描技术与参数 检查前准备 CT扫描参数 平扫与增强
CT仿真内窥镜 扫描参数 重建
12
MRI检查 超声检查：超声内镜 核医学
消化系统 digestive system
1
digestive system
一、digestive tract (空腔脏器，organs with cavity or lumen) esophagus, stomach, small and large bowel
二、digestive gland liver, gall, pancreas and the spleen
• 检查范围 食管 上消化道：到十二指肠 小肠：回盲部 大肠
5
Barium contrast examination 钡剂造影
wk.baidu.com
Ba swallow
Barium enema
Ba meal
Ba follow through
Small bowel enema
6
钡剂造影检查前准备及注意事项
检查前3天停服含重金属药物 禁食水6小时以上 钡灌肠检查前进行肠道清洁准备 检查前询问病史，了解梗阻程度，决定使用药物浓度 疑诊为胃肠道穿孔、气管瘘等，用可吸收造影剂 多方位和多角度观察与摄片
13
The normal manifestations 正常影像
14
Barium swallow
食管吞钡检查
How it is done?
• Swallow baking soda crystals (to make gas) with little water
• Drink the barium liquid
• 充盈相 barium filling phase • 粘膜相 mucosal phase • 双对比相 double contrast phase • 蠕动波 the first, the second
and the third squirm wave • 食管胃连接部 esophagogastric junction