腹部超聲課件

1、腹部超聲腹部超聲 Also known as -Abdominal ultrasound (US) scanning -Abdominal US imaging -Abdominal ultrasonography -Abdominal ultrasound About the course What is Abdominal Sonography? What is an Abdominal Sonogram? What are some common uses of the procedure? How would patients prepare? How does the procedu

2、re work? What does the equipment look like? Who interprets the results? What are the benefits vs. risks? What are the limitations of Abdominal USG? Ultrasonography Info What is Abdominal Sonography? Abdominal sonography is a method of obtaining images of internal organs by sending high-frequency sou

3、nd waves into the body. The reflected sound waves are returned as echoes. The echoes are then recorded and displayed as a real-time visual image. Since ultrasound images are captured in real-time they have the ability to show movement of internal tissues, liver function, and blood flow. Ultrasonogra

4、phy is a noninvasive medical test that helps physicians diagnose and treat medical conditions. An abdominal ultrasonography produces a picture of the organs and other structures in the upper abdomen. What is Abdominal Sonography? A Doppler ultrasound study may be part of an abdominal ultrasound exam

5、ination. Doppler ultrasound is a special ultrasound technique that evaluates blood as it flows through a blood vessel, including the bodys major arteries and veins in the abdomen, arms, legs and neck. What is Abdominal Sonography? What is an Abdominal Sonogram? An abdominal sonogram can help to diag

6、nose a variety of conditions and to assess damage caused by illness. Liver, gallbladder, spleen, pancreas, and kidneys will be evaluated during an abdominal sonogram. Various reasons are: abdominal pain, abnormal lab results, and enlarged abdominal organs. What is an Abdominal Sonogram? An abdominal

7、 sonographer will be required to image small body parts as well. These parts include: thyroid gland, testicles, breast, and various soft tissue of body parts. Doctors can also use abdominal sonography to guide them as they perform needle biopsies on abdominal organs. What are some common uses of the

8、 procedure? -Kidneys -Liver -Gallbladder -Pancreas -Spleen -Abdominal aorta and other blood vessels Abdominal ultrasound imaging is performed to evaluate the: What are some common uses of the procedure? Abdominal pains Abnormal liver function Enlarged abdominal organ Abnormalities in the abdomen :ga

9、llstones, liver cirrhosis, cyst, tumor, etc. An aneurysm in the aorta What are some common uses of the procedure? Doppler ultrasound images can help the physician to see and evaluate: Blockages to blood flow (blood clots/atherosclerotic plaque) Narrowing of vessels (which may be caused by plaque) Tu

10、mors and congenital malformation 血凝塊血凝塊/動脈粥樣硬化斑塊動脈粥樣硬化斑塊 What are some common uses of the procedure? Guide invasive procedures such as needle biopsy and withdrawal of fluid How would patients prepare? （）wear comfortable, loose-fitting clothing （）barium enema or upper GI (gastrointestinal) tests 鋇餐灌腸

11、鋇餐灌腸 上消化道檢上消化道檢 查查 For a study of the liver, gallbladder, spleen, and pancreas, patient may be asked to eat a fat-free meal on the evening before the test and then to avoid eating for 8 to 12 hours before the test. For ultrasound of the kidneys, may be asked to drink 4 to 6 glasses of water about an

12、 hour before the test to fill your bladder. may be asked to avoid eating for eight to 12 hours before the test to avoid gas buildup in the intestines. For ultrasound of the aorta, you may need to avoid eating for eight to 12 hours before the test. How would patients prepare? In case of an emergency,

13、 exams can be done without special preparations. Tell the sonographer, sonologist, or physician conducting the examination about pain, bleeding, or any other symptoms. Telling the examiner about past ultrasounds and surgeries is helpful, and sometimes provides crucial information. （重要信息）（重要信息） How w

14、ould patients prepare? How does the procedure work? You will be positioned on an examination table and made to lie down on your back and lay your hands above your head. It may become necessary to change positions during the exam, and lie down on your side or sit up. A lubricating gel（甘油凝膠（甘油凝膠/耦合劑）耦

15、合劑） is applied to the patients abdominal area. How does the procedure work? An apparatus known as a transducer is placed on the abdominal area and moved around to get real time images. Sometimes you will have to breathe in and hold your breath according to the technologist, sonologist, or physicians

16、 instructions. Examinations usually take 10-30 minutes. Instrumentation Who interprets the results? A radiologist, or sonogist What are the benefits vs. risks? Benefits noninvasive (no needles or injections) and is usually painless. widely available, easy-to-use and less expensive than other imaging

17、 methods. uses no ionizing radiation. gives a clear picture of soft tissues that do not show up well on x-ray images. causes no health problems and may be repeated as often as is necessary. provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as injections

18、, needle biopsies and needle aspiration of fluid What are the benefits vs. risks? Risks For standard diagnostic ultrasound there are no known harmful effects on humans. Pregnant women and fetuses can be safely examined. What are the limitations of Abdominal USG? Ultrasound waves are disrupted by air

19、 or gas; therefore ultrasound is not an ideal imaging technique for the bowel or organs obscured by the bowel. In most cases, barium exams, CT scanning, and MRI are the methods of choice in this setting. What are the limitations of Abdominal USG? Ultrasound waves do not pass through air; therefore a

20、n evaluation of the stomach, small intestine and large intestine may be limited. Intestinal gas may also prevent visualization of deeper structures such as the pancreas and aorta. Large patients are more difficult to image because tissue attenuates (weakens) the sound waves as they pass deeper into

21、the body Gallstones and cholecystitis 膽結石，膽管炎膽結石，膽管炎 Hepatitis/liver cirrhosis 肝炎肝炎/肝硬化肝硬化 Kidney/Bladder stones 腎腎/膽囊結石膽囊結石 Hydronephrosis 腎積水腎積水 Tumors 腫瘤腫瘤 Cancers of the liver, kidneys, pancreas, gallbladder, biliary tree 癌癌 Lymphoma 淋巴瘤淋巴瘤 Metastasis 轉移灶轉移灶 Cysts 囊腫囊腫 Infections 感染感染 Common con

22、ditions revealed by Abdominal sonography Abscesses 膿腫膿腫 Appendicitis 闌尾炎闌尾炎 Enlarged liver, spleen, kidneys, lymph nodes 增大增大 Pancreatitis 胰腺炎胰腺炎 Congenital malformation 先天畸形先天畸形 Injury - hematoma, tear, rupture 創(chuàng)傷（血腫、撕創(chuàng)傷（血腫、撕 裂、破裂）裂、破裂） Hemorrhage of the adrenal gland 腎上腺出血腎上腺出血 Abdominal aortic an

23、eurysm 腹主動脈瘤腹主動脈瘤 Ascites腹水腹水 Peritonitis腹膜炎腹膜炎 Bowel obstruction 腸梗阻腸梗阻 Hernia 疝氣疝氣 The size The echo and attenuation of the organ Parenchyma實質(zhì)實質(zhì) The texture質(zhì)地質(zhì)地 The presence of vascular structures, ligaments, and fissures裂隙裂隙 Abnormality異常異常 and mass占位占位 The normal or abnormal images of abdominal

24、organs The Liver Ultrasound is often the first line of investigation for suspected liver pathology and the decision to proceed to secondary investigative procedures, such as further radiology or histology. Ultrasound is used in the diagnosis, staging and monitoring of liver disorders and also contri

25、butes to their treatment with ultrasound-guided invasive procedures. Developing technology and techniques now result in improved diagnostic accuracy and are increasingly obviating the need for further radiology. Intraoperative and laparoscopic ultrasound, using high-frequency, direct-contact techniq

26、ues, set the standard for liver imaging in many cases. The simple cyst has three acoustic properties anechoic has a well-defined smooth capsule exhibits posterior enhancement (increased through transmission of sound) 肝血管瘤肝血管瘤 Hepatic hemangioma Small solitary or multiple nodular lesion Rounded well-

27、defined Hyperechoic mass Usually not visualize colour flow 術語Terms This term describes the effect of a focal mass, whether benign or malignant, on surrounding structures and is a useful diagnostic tool. It implies the lesions displacing or invasive nature, i.e. the displacement of vessels and/or inv

28、asion or distortion of adjacent structures and tissues as a result of the increasing bulk of a lesion. This effect differentiates a true mass from an infiltrative process 占位效應Mass effect massive type nodular type diffusely infiltrating type Primary Carcinoma hyperechoic hypoechoic hypoechoic isoecho

29、ic Primary Carcinoma HemangiomaN/ASolitary or multiple Round or oval Well-defined border Hyperechoic（most parts） Color flow Solitary or multiple Infiltrative,diffuse Hypoechoic, isoechoic, hyperechoic Portal veins/hepatic veins invaded thrombus Solitary or multiple Well-,ill-defined Hypoechoic or hy

30、perechoic Diffuse distortion of bulls eye pattern hemangioma Simple hepatic cyst hyperechoic hypoechoic hypoechoic isoechoic Hepatic carcinoma Metastatic tumor USG-Guided Liver Biopsy Liver biopsy is a diagnostic procedure used to obtain a small amount of liver tissue, which can be examined under a

31、microscope to help identify the cause or stage of liver disease. The gallbladder Ultrasound is an essential first-line investigation in suspected gallbladder and biliary duct disease It is highly sensitive, accurate and comparatively cheap Gallbladder pathology is common and is asymptomatic in over 13% of the popu