department of ultrasound li feng-hua
DESCRIPTION
彩色多普勒超声的临床应用 Ultrasonic diagnosis. Department of Ultrasound Li Feng-hua. Ultrasonic Examination. Definition 超声检查( ultrasonic examination )利用超声波的物理特性和人体器官组织声学特性相互作用后产生的信息,并将其接收、放大和信息处理后形成图形、曲线或其他数据,借此进行疾病诊断的检查方法。. 主要内容 Main contents. 超声诊断基础 Basis of ultrasonic diagnosis 肝脏和脾脏 - PowerPoint PPT PresentationTRANSCRIPT
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Department of Ultrasound Department of Ultrasound
Li Feng-huaLi Feng-hua
彩色多普勒超声的临床应用 Ultrasonic diagnosis
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• DefinitionDefinition
超声检查(超声检查( ultrasonic examinationultrasonic examination )利用)利用超声波的物理特性和人体器官组织声学特超声波的物理特性和人体器官组织声学特性相互作用后产生的信息,并将其接收、性相互作用后产生的信息,并将其接收、放大和信息处理后形成图形、曲线或其他放大和信息处理后形成图形、曲线或其他数据,借此进行疾病诊断的检查方法。数据,借此进行疾病诊断的检查方法。
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主要内容主要内容 Main contentsMain contents
• 超声诊断基础超声诊断基础
Basis of ultrasonic diagnosis Basis of ultrasonic diagnosis
• 肝脏和脾脏 肝脏和脾脏
Liver and SpleenLiver and Spleen
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超声诊断基础超声诊断基础
Basis of ultrasonic Basis of ultrasonic diagnosisdiagnosis
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超声基础超声基础
• 超声波(超声波( ultrasoundultrasound )是指振动频率大于)是指振动频率大于 20000H20000Hzz (赫兹),即超过人耳的听觉阈值上限的声波。(赫兹),即超过人耳的听觉阈值上限的声波。
• 超声波在弹性介质中以规则的纵波形式传播,有超声波在弹性介质中以规则的纵波形式传播,有波长(波长( λλ )、频率()、频率( ff )和声速()和声速( cc )三个基本)三个基本物理量。物理量。
它们的关系:它们的关系: cc == f f ×λ×λ。。 一般人体软组织的平均声速为一般人体软组织的平均声速为 1540m/s1540m/s
超声波的物理特性
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• 声阻抗(声阻抗( acoustic impedanceacoustic impedance ,, ZZ )) 等于介质的密度(等于介质的密度( ρρ )与超声波在该介质 中)与超声波在该介质 中
传播速度(传播速度( cc )的乘积,即)的乘积,即 ZZ == ρ×cρ×c 。。 • 反射(反射( reflectionreflection )、折射()、折射( refractiorefractio
nn )和散射()和散射( scatterscatter )) • 吸收(吸收( absorptionabsorption )与衰减()与衰减( attenuatioattenuatio
nn ))•多普勒(多普勒( DopplerDoppler)效应)效应
超声基础超声基础 超声波的物理特性
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• 逆电压效应——逆电压效应—— 电能转变为声能,发射超声电能转变为声能,发射超声
• 正压电效应正压电效应 ———— 声能转变为电能,接收超声声能转变为电能,接收超声
超声基础超声基础 超声波的产生
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• AA 型诊断法型诊断法 • BB 型诊断法型诊断法 • MM 型诊断法型诊断法 • DD 型(型( doppler typedoppler type )诊断法)诊断法
超声基础超声基础 超声诊断仪类型
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• 无反射型(无回声型)—胆汁、腹水等无反射型(无回声型)—胆汁、腹水等 • 少反射型(低回声型)—肝脏、心肌等少反射型(低回声型)—肝脏、心肌等• 多反射型(高回声型)—肾包膜 、乳腺等 多反射型(高回声型)—肾包膜 、乳腺等 • 全反射型(强回声型)—含气组织 、钙 全反射型(强回声型)—含气组织 、钙 化、结石等。化、结石等。
超声基础超声基础 超声诊断基础
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超声检查临床应用超声检查临床应用 1. 1. 检测实质性脏器大小、形态、结构、病变检测实质性脏器大小、形态、结构、病变 22 .囊性器官、软组织形态、病变.囊性器官、软组织形态、病变 33 .心、血管结构、功能、血流参数.心、血管结构、功能、血流参数 44 .鉴别占位性病变物理性质.鉴别占位性病变物理性质 55 .检测积液.检测积液 66 .介入性超声应用.介入性超声应用 77 .随访.随访
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肝脏和脾脏肝脏和脾脏
Liver and Liver and SpleenSpleen
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位置 右季肋部位置 右季肋部 形态 立体楔形形态 立体楔形 肝的上面与膈肌相附—膈面肝的上面与膈肌相附—膈面 肝膈面附有镰状韧带,将肝分成左、右两叶。肝膈面附有镰状韧带,将肝分成左、右两叶。 肝下面为脏面,有两条纵沟和一条横沟。肝下面为脏面,有两条纵沟和一条横沟。
右纵沟:胆囊窝、下腔静脉右纵沟:胆囊窝、下腔静脉 左纵沟:脐静脉窝和静脉韧带左纵沟:脐静脉窝和静脉韧带 横 沟:门静脉、胆总管、肝动脉横 沟:门静脉、胆总管、肝动脉
解剖概要
Anatomy
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解剖概要
Anatomy
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正常肝脏声像图USG of normal liver
剑突下纵切
右肋间斜切
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正常肝脏声像图USG of normal liver
右肋缘下斜切
二维显示
彩色多普勒
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正常肝脏声像图USG of normal liver
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肝硬化Liver cirrhosis
•形态增大或缩小 形态增大或缩小 size increase or decrease
•肝表面不平整,边缘变圆钝 肝表面不平整,边缘变圆钝 surface uneven
•肝实质回声弥漫增强、增粗、不均 肝实质回声弥漫增强、增粗、不均 coarse echo
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肝硬化Liver cirrhosis
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肝硬化Liver cirrhosis
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• 门静脉增宽 门静脉增宽 wide PV
• 脾大 脾大 splenomegalia
• 腹水 腹水 ascites
肝硬化Liver cirrhosis
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肝囊肿Liver cyst
• 边清壁薄液性暗区伴后方回声增强
•anechoic lumen•clear wall•acoustic enhancement deep to the lesion
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肝囊肿Liver cyst
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肝囊肿Liver cyst
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肝脓肿Liver abscess
• hypoechoic or anechoic lumen• rough wall
• 低回声或无回声肿块• 脓肿壁厚薄不等
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肝血管瘤liver hemangioma
•高回声结节 hyperechoic
•边界清 clear margin
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肝血管瘤liver hemangioma
右肋间斜切
右肋缘下斜切
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肝血管瘤liver hemangioma
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原发性肝癌primary liver carcinoma
实性团块 solid mass
边界清 clear margin
低回声晕 halo
Color Doppler flow
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原发性肝癌primary liver carcinoma
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原发性肝癌primary liver carcinoma
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转移性肝癌secondary tumors of the liver
多发实性团块 multiple mass
牛眼征 bull's-eye configuration
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转移性肝癌secondary tumors of the liver
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解剖概要Anatomy
•位于左季肋部后方,胃左侧,膈肌下方
•脾外形似蚕豆,分膈脏两面, 近中央处为脾门,有血管神经出入。
•正常脾脏长 10- 12cm ,宽 6- 8cm ,厚 3- 4cm 。
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正常脾脏声像图USG of normal spleen
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• 二维表现:二维表现: 圆形高回声,边界清楚,高回声区内显示圆形高回声,边界清楚,高回声区内显示
无回声和强回声间隔光带,呈网格状。无回声和强回声间隔光带,呈网格状。
• 彩色多普勒:彩色多普勒: 血管瘤周围或其内部可有脾动脉或脾静脉 血管瘤周围或其内部可有脾动脉或脾静脉
分支绕行或穿行。血管瘤内无明显血流信分支绕行或穿行。血管瘤内无明显血流信号。号。
脾血管瘤Splenic hemangioma
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splenic lymphoma
脾恶性淋巴瘤
SPSP
圆形低回声结节Hypoechoic tubercle
边界清楚Clear margin
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• 二维图像:二维图像: 单个或多个楔形或不规则低回声区。单个或多个楔形或不规则低回声区。 内可呈蜂窝状回声或不均匀分布的斑片状内可呈蜂窝状回声或不均匀分布的斑片状
强回声。强回声。 梗死灶坏死液化时,呈无回声或形成假性梗死灶坏死液化时,呈无回声或形成假性
囊肿。囊肿。 陈旧性梗死灶纤维化、钙化时,病灶回声陈旧性梗死灶纤维化、钙化时,病灶回声明显增强,后方伴有声影。明显增强,后方伴有声影。
splenic infarction
脾梗死
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Questions Questions 11
Clinical history
Found in
the medical
examination
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Questions Questions 22
Clinical history
Male , 56y ,hepatitis B for 10 yeas
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Questions Questions 33
Clinical history
Female , 60y ,high fever and pain in right upper quadrant
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Questions Questions 44
Clinical history
Found in
the medical
examination
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Questions Questions 55 Clinical history
Vague pain in right upper quadrant and weight loss
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