1 Radiology Gastrointestinal Tract. 2 Techniques Fluoroscopy , plain radiograph ( can find...
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Transcript of 1 Radiology Gastrointestinal Tract. 2 Techniques Fluoroscopy , plain radiograph ( can find...
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RadiologyGastrointestinal Tract
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Techniques
Fluoroscopy , plain radiograph
( can find abnormal gas or calcification)Barium examination (BE) ( Mainly use
d )CT( computed tomography)
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Barium---BaSO4 (Barium sulfate)
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• Oral administration
• barium enema
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good quality
• Stable
• No absorption
• Cheap
• Few side effect
• No hypersensitiveness
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side effect
• Nausea , constipation , diarrhea
• perforation of intestine , peritonitis , etc
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Taboo
• Acute gastric-intestinal perforation
• Esophago-tracheal fistula
• Obstruction of colon
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Type Ⅰ• BaCl2 + Na2SO4 → BaSO4↓ + 2NaCl• BaCO3 + H2SO4 → BaSO4↓ + H2O + CO2↑ • BaCl2 + H2SO4 → BaSO4↓ +2HCl
PS: BaCl2 :barium chloride BaCO3 :barium carbonate H2SO4 :sulphuric acid HCl : hydrochloric acid NaCl : sodium chloride
Na2SO4 : Sodium Sulfate H2O : water CO2 : carbon dioxide
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TypeⅡ
• Barite size reduction BaSO4
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Barium examination
LAO; left anterior obliqueRAO; right anterior oblique
right anterior oblique positionOther positions.
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Esophagus LAO
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Esophagus RAO
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Gastrointestinal Tract Position
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What’s this?
• Diagnosis
• Differential diagnosis
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Imagings
• Mucosa imaging
• Turgor (full) imaging
• Compression imaging
• Double contrast imaging (barium & gas )
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Mucosa imaging
Not too much
barium
Which part is
mucous
membrane?
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Turgor (full) imaging
much barium
Appearance
Outline
peristaltic
movement
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Compression
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Compression
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BE (Compression) VS Endoscopy
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Double contrast
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pharynx
cardiac orifice
Esophagus
Liver
stomach
duodenum
colon
jejunumcecum
appendix
ileum rectum
Mouth
common bile duct
pyloric orifice
Anatomy
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Throat
larynx
sinus piriformis
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食管解剖
impression of aortic arch
Impression of left principal bronchus
Impression of left atrium
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gastric fundus
gastric body
cardiac orifice
cardiac orifice zone
lesser curvature
pyloric orifice
pyloric orifice zone
sinus ventriculi
greater curvature
angular notch
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Appearance of stomach
Crochetage
Fish hook
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horn of a cattle
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Cascade stomach
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asthenic type
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Mucosa of stomach
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peristaltic movement
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Duodenum
• ‘C’
• Four parts:
duodenal bulb;
descending part ;
horizontal part ;
ascending part
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???
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jejunum &ileum
jejunum :Feather (Mucous membrane )
• Ileum: few &superficial mucous membrane
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colon
haustra of colon
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rectum
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Basic changes
Outline
size
Mucosa
function
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Outline
Filling defect
niche sign
diverticulum
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Filling defect
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Filling defect
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• leiomyoma
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gastric cancer
• face lying
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Filling defect –where?
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• Leiomyoma of fundus
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• Gastrolith (Gastric stone)• Eat persimmon, hawthorn,date when the stomach is empty or after
drinking alcohol
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persimmon
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hawthorn
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date
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niche sign
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niche sign
“Out the lumen ”
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Where?
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“in the lumen ”
niche sign
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niche sign ---barium fleck/patch
Where?
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diverticulum
• Like a sac
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diverticulum
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size
stricture
Ectasia/expansion
•inflammation•tumor•compression •congenital disease •adherence •spasm
obstruction
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stricture &expansion
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expansion
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Mucosa
destruction
widen 、 thickening 、 crooked
packed
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destruction
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widen
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packed
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packed &
destruction