mediastinal syndrome

October 31, 2014 1

CHAN OAN HNH ANH

HOI CHNG TRUNG THAT

BS.NGUYEN QUY KHOANG

BS.NGUYEN QUANG TRONG

KHOA CHAN OAN HNH ANH

BENH VIEN AN BNH -TP.HCM

2October 31, 2014

DAN BAI

I.nh ngha.

II.Nhac lai giai phau trung that.

III.Trieu chng hoc X quang.

IV.Chan oan cac khoi u da vao v tr.

V.Mot so benh ly trung that.

VI.Ket luan.

3October 31, 2014

DAN BAI

I.nh ngha.





VI.Ket luan.

4October 31, 2014

NH NGHA

Hoi chng trung that bao gom cac dau hieu X

quang dien ta s hien dien cua cac te bao bat

thng trong trung that (Kh,dch,ong voi,

bu).

Can lu y rang ng knh cua hach c qui

c o theo be ngang ch khong phai la be

dai cua hach va neu kch thc nay 1cm la hach bnh thng (khong phai la hach benh

ly).

5October 31, 2014

DAN BAI

I.nh ngha.





VI.Ket luan.

6October 31, 2014

NHAC LAI GIAI PHAU TRUNG THAT

NG VIEN TRUNG THAT

B PHAI TRUNG THAT

1.Than TM canh tay-au (P).

2.TMC tren.

3.Nh (P).

4.TMC di.

5.Ron phoi (P).

6.Vien m trc tim (Franges graisseuses).

B TRAI TRUNG THAT

7.M di on (T).

8.Quai MC.

9.Cung MP.

10.That (T).

11.Ron phoi (T).

12.Vien m trc tim (Franges graisseuses).

7October 31, 2014

NHAC LAI GIAI PHAU TRUNG THAT

CACH PHAN CHIA TRUNG THAT

THEO BENJAMIN FELSON THEO LUCY SQUIRE

8October 31, 2014

DAN BAI

I.nh ngha.





VI.Ket luan.

9October 31, 2014

TRIEU CHNG HOC X QUANG

A.Cac ac iem chung: Khoi u mat o dch,thng ong nhat.

1.Co b ngoai ro,lien tuc.

2.Loi ve pha phoi.

3.Tao mot goc tu vi trung that.

4.B trong khong ro.

B.Cac ac iem rieng: Moi khoi u khac nhau

1.V tr.

2.ng vien.

3.Hnh dang.

4.Mat o.

5.Kch thc.

C.Lam sao khu tru c khoi u trung that?

1.Dau hieu bong b (Silhouette sign).

2.Dau hieu co-ngc (Cervico-thoracic sign).

3.Dau hieu tang bang (Iceberg sign).

4.Dau hieu che lap & Dau hieu hoi tu ve ron phoi

(Hilum overlay sign & Hilum convergence sign).

5.Dau hieu canh buom (Sail sign).

6.Dau hieu co keo thc quan.

10October 31, 2014

DAU HIEU BONG B

SILHOUETTE SIGN

SILHOUETTE SIGN (+) SILHOUETTE SIGN (-)

D.Anthoine et al.LImagerie Thoracique.1996-1998.

11October 31, 2014

DAU HIEU BONG B

SILHOUETTE SIGN

SILHOUETTE SIGN (+)


12October 31, 2014

DAU HIEU CO NGC

CERVICO-THORACIC SIGN

B:CERVICO-THORACIC SIGN (+) A:CERVICO-THORACIC SIGN (-)


13October 31, 2014

DAU HIEU CO NGC


CERVICO-THORACIC SIGN (+):

BU GIAP THONG

14October 31, 2014

DAU HIEU CO NGC


CERVICO-THORACIC SIGN (-): NEUROBLASTOMA

15October 31, 2014

DAU HIEU NGC-BUNG

THORACO-ABDOMINAL SIGN (ICEBERG SIGN)

ICEBERG SIGN (+) ICEBERG SIGN (-)

16October 31, 2014

DAU HIEU NGC-BUNG

THORACO-ABDOMINAL SIGN (ICEBERG SIGN)

ICEBERG SIGN (+) :NEUROBLASTOMA

17October 31, 2014

DAU HIEU CHE LAP RON PHOI & DAU HIEU HOI TU RON PHOI

HILUM OVERLAY SIGN & HILUM CONVERGENCE SIGN


18October 31, 2014



HILUM OVERLAY SIGN:

TERATOMA

A.J.Chandrasekhar,M.D.Chest X-ray Atlas.

19October 31, 2014



HILUM OVERLAY SIGN:

TERATOMA

20October 31, 2014



HILUM CONVERGENCE SIGN:

PHNH ONG MACH PHOI (T)


21October 31, 2014

DAU HIEU CANH BUOM

SAIL SIGN

Bong tuyen c bnh

thng (normal

thymus) tre di

3 tuoi oi khi b

chan oan lam la

khoi u trung that.

Hnh anh thay

c tren X quang

rat a dang,trong

o dau hieu canh

buom la ien hnh.

22October 31, 2014

DAU HIEU CANH BUOM

SAIL SIGN

THYMIC SAIL SIGN

23October 31, 2014

24October 31, 2014

THYMIC SAIL SIGN

Cau truc hoi am luon luon ac,

ong dang

25October 31, 2014

Bong m trung that trc vi dau hieu

che lap ron phoi (T),khong chen ep kh

phe quan-Khong co hnh anh xep phoi (T).

Tre 11 thang tuoi,

khong trieu chng ho hap.

Bong m trung that trc co am

o ong nhat

Tuyen c bnh thng.

26October 31, 2014

Tre 9 thang tuoi: Tuyen c bnh

thng (cac mui ten trang).am o

tuyen c ong nhat va bang vi

am o c thanh ngc.Mui ten en

ch ong sonde trong thc quan.

Tre 14 tuoi: Tuyen c bnh

thng (cac mui ten

trang).am o tuyen c

ong nhat va bang vi am

o c thanh ngc.

27October 31, 2014

DAN BAI

I.nh ngha.





VI.Ket luan.

28October 31, 2014

CHAN OAN X QUANG CAC KHOI U TRUNG THAT

DA VAO V TR (THEO LUCY SQUIRE)

1.Bu giap thong.

2.Bu tuyen hung.

3.Bu d hnh.

4.U hach.

5.Thoat v qua lo Morgagni.

6.Nang phe tam mac.

7.Nang phe quan.

8.Thoat v qua khe thc quan.

9.Khoi u thc quan.

10.Tui phnh ong mach chu.

11.Thoat v qua lo Bochdallek.

12.Bu than kinh.

29October 31, 2014


DA VAO V TR

30October 31, 2014


DA VAO V TR

31October 31, 2014

DAN BAI

I.nh ngha.





VI.Ket luan.

32October 31, 2014

MOT SO BENH LY TRUNG THAT

TRAN KH TRUNG THAT

33October 31, 2014


RING AROUND THE ARTERY SIGN

Dau hieu nay thay c chu yeu tren phim ngc nghieng giup chan oan

Tran kh trung that.

34October 31, 2014


KHOI U TRUNG THAT SAU + CALCIFICATION

= NEUROBLASTOMA

35October 31, 2014


HODGKINS DISEASE

36October 31, 2014


Bong m a cung canh (P) kh quan

Luon luon phai ngh LAO HACH

37October 31, 2014


HODGKIN MYCOPLASME TUBERCULOSE

38October 31, 2014


KHOI U TRUNG THAT TRC + CALCIFICATION

+ M + DCH = TERATOMA

39October 31, 2014


Tre 8 tuoi:Bong m trung that

nam canh (P) kh quan.BRONCHOGENIC CYST

40October 31, 2014


BRONCHOGENIC CYST

41October 31, 2014


NANG PHE TAM MAC

42October 31, 2014


NANG MANG TIM / ASBESTOSIS

43October 31, 2014

DAN BAI

I.nh ngha.





VI.Ket luan.

44October 31, 2014

KET LUAN

ng bao gi chan oan U tuyen c

tre < 3 tuoi.Neu co g nghi van,co the

dung Sieu am e xac nh chan oan

(tuyen c bnh thng co cau truc

ac,ong dang).

Dau Bernou ch co gia tr tng oi,v co

nhng bong m tng la trong nhu

mo phoi,nhng thc te lai la bong m

trung that.

45October 31, 2014

CAM N S CHU Y THEO DOI CUA QUY BAC S

mediastinal syndrome

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