腹部电脑断层做法简介课件.ppt

1、嘉庚吳萬福w 前言w 解剖學上之分類w 簡述各項疾病不同之做法w 病例討論w 結論前言w 隨著 MDCT 不斷地進步,掃描時間縮短,後處理能力增強,更能提供任意角度切面影像,也因此CT之掃描方式,將因不同疾病有著不同的掃描方式,而非傳統之“包 山包海“,只要全部包括進去即可.解剖學上之分類w 胃及十二指腸球疾病w 胰臟及十二指腸壺腹疾病w 肝膽疾病w 泌尿系統疾病w 大腸系統疾病w 女性生殖系統疾病胃及十二指腸球疾病w 胃之構造可分成四層(由內向外):1.黏膜層 2.黏膜下層 3.肌肉層 4.漿膜層常見疾病w Gastritisw Gastric ulcerw Gastric cancer掃描

2、方式w 喝水3至 5杯w C-:whole gastric 5mm/15mmw C+:(1)whole gastric 2.5mm (2)whole abdomen 5mm (3)delay urinary systemw C+之第(1)組需reformat Axial 5mm 傳上 PACS胰臟及十二指腸壺腹疾病w Acute pancreatitisw Chronic pancreatitisw Pseudocyst(tail)w Pancreatic carcinoma(head-jaundice)掃描方式w 喝水3至 5杯w C-:whole pancreats 5mmw C+:(1)

3、whole pancreats 1.25mm (2)liver 5mm (3)whole abdomen 5mm (4)delay urinary systemw C+之第(1)組需reformat Axial 2.5mm 及做P-duct CPR image傳上 PACS肝膽疾病w Chololithiasisw Cholecystitisw Common bile duct stonew Cancer of gallbladderw Cholangio-carcinomaw Liver abcessw Hepatitis掃描方式w Routine abdomen scan modew C-

4、:whole liver 5mm/15mmw C+:(1)whole liver 5mm (2)whole abdomen 5mm (3)delay urinary system肝臟疾病w Hepatocellular carcinomaw Hemeningioma掃描方式w C-:liver 7.5mmw C+:Triphase scan (1)Artery phase 2.5 mm (2)Portal phase 5 mm (3)Hepatic vein phase 5mmw 須注意 Recon 2 位置,若kidney hydronephrosis 需加作delay phase泌尿系統疾

5、病w Stone w Hematuria w Renal cell carcinomaw Hydronephrosisw Renal cyst掃描方式w C-:whole urinary system 7.5mm/15mmw C+:(1)whole liver 5mm (2)whole abdomen 5mm (3)delay urinary system(連切)w 需看到Renal pelvis,ureter,bladder 有藥泌尿系統疾病w Bladder tumorw Tumor of urinary collecting system (Renal pelvis urethra Tr

6、ansitional epithelium cell carcinoma)掃描方式w C-:whole urinary system 7.5mm/15mmw C+:(1)Bladder 2.5mm (2)whole liver 5mm (3)whole abdomen 5mm (4)delay urinary system(連切)w 需看到Renal pelvis,ureter,bladder 有藥w(1)組需reformat 5mm axial,sagital,coronal腎臟血管性疾病w Hypertensionw R/O renal artery stenosis掃描方式w CTA w

7、 C-:whole kidney 5mm/11.25mmw C+:(1)adrenal+kidney 2.5mm (2)whole abdomen 5mm (3)delay urinary system(連切)w 需看到Renal pelvis,ureter,bladder 有藥w MIP,VR image大腸系統疾病w Colon carcinoma post opw Appendicitis掃描方式w Routine abdomen scan modew C-:Lesion 5mm/15mmw C+:(1)whole liver 5mm (2)whole abdomen 5mm (3)de

8、lay urinary system大腸系統疾病w Colon carcinoma pre operation掃描方式w 需 enemaw C-:Lesion 5mm/15mmw C+:(1)Lesion 1.25mm (2)whole liver 5mm (3)whole abdomen 5mm (4)delay urinary system w 需看到Renal pelvis,ureter,bladder 有藥w(1)組需reformat 3.8mm axial,sagital,coronal (指平行及垂直tumor)女性生殖系統疾病w Ovary tumorw Cervical can

9、cerw Endometrial carcinoma掃描方式w 需 enemaw C-:Lesion 5mm/15mmw C+:(1)Lesion 2.5mm (2)whole liver 5mm (3)whole abdomen 5mm (4)delay urinary system w 需看到Renal pelvis,ureter,bladder 有藥w(1)組需reformat 5mm axial,sagital,coronal 病例討論-腦力激盪(1)Rectal ca,liver meta,post operation(2)P-duct dilatation(3)RCC&TCC different(4)Bladder tumor,jaudice(5)Sigmoid ca,liver tumor favor HCC