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1、Abdominal CT 腹部实质性脏器的正常及异常影像学表现,Which animal is your favorite,1,2,3,4,CT增强的各期如何分辨,Please arrange the images A-D in the order of nonenhanced, arterial, portal and delay phase,A,B,C,D,A,B,C,D B,C,A,D D,B,C,A C,B,D,A,图像是上下连续的。,Hepatic lobes and segments,left lateral superior/inferior medial caudal left
2、 right caudal right anterior superior/inferior posterior superior/inferior,*肝裂：fissures 左叶间裂 肝主裂,Bile duct system,Bile duct： intrahepatic duct 肝内胆管 Hepatic duct 左右肝管 Common bile duct胆总管 Gall bladder胆囊及胆囊管,How many different imaging tools for cholangiography?,MRCP(Magnetic Resonance Cholangio-Pancrea
3、tography),CTCP(Computed Tomography Cholangio-Pancreatography),ERCP(Endoscopic Retrograde Cholangio-Pancreatography),PTC(Percutaneous Transhepatic Cholangiography),左侧肝内胆管,肝总管,胆总管十二指肠后段,胆总管胰内段,胆管系统的变异,Pancreas,Fat infiltration Pancreatic duct,Pancreas,胰头、胰颈、胰体、胰尾、胰腺钩突,MSCT Cholangiopancreaticography,S
4、pleen,脾高; 肋单位; 分叶; 副脾accessory spleen； 脾脏的强化: arterial phase,脾动脉,肠系膜上动脉,肠系膜下动脉,胃十二指肠动脉,胃左动脉,肝总动脉,脾静脉,肠系膜上静脉,门静脉,肠系膜下静脉,Abnormalities,Liver,肝脏的异常影像学表现,肝叶大小改变 增大：代偿 缩小：损伤 肝脏轮廓 外凸：mass 内凹：牵拉,Size and Ratio,Noted： 肝裂的变化,Contour,肝脏的异常影像学表现,肝脏密度 弥漫与局灶 低密度 高密度 等密度,肝脏强化 高强化 低强化 延迟强化 特殊强化,Density,Noted： 异常密度
5、的边界,平扫：低密度；增强：高强化,平扫：低密度；增强：无强化,容积效应,特殊强化特征,靶征，病理结构基础？,填充式强化，快进慢出,True False,B,请判断：图A、B中的病灶最外缘具有相同的强化特点？,A,差别在哪里？,Bile duct system,胆道系统的异常影像学表现,胆道梗阻与扩张 充盈缺损与腔内异常密度 胆道系统管壁异常,Obstruction,Different levels Intrahepatic duct Hepatic duct Common hepatic duct Common bile duct Vaters ampulla,无梗阻的胆道扩张,充盈缺损 F
6、illing defect,胆道腔内异常密度,胆道壁异常密度、异常强化?,5 months later,Pancreas,Size Shape and border Density Enhancement Pancreatic duct,Size, shape and the border,Density,Enhancement,囊性病变：无强化 实性病变：低/高强化；不均匀强化,Pancreatic duct,The density of the pancrea is abnormal,True False,The pancreatic duct is dilated,True False,脾脏,大小及数目异常 size and number 密度异常 density 强化异常 enhancement：血管及淋巴系统,大小及数目异常,密度异常,强化异常,Which spleen is abnormal?,A,B,A B A+B,Take home message,消化系统实质性脏器的读片规范 位置localization 大小size 形态shape 密度density 强化enhancement,
