肝脏疾病超声诊断 diagnosis of liver disease with ultrasound sonography
TRANSCRIPT
肝脏疾病超声诊断肝脏疾病超声诊断 Diagnosis of Liver Disease Diagnosis of Liver Disease with Ultrasound Sonography with Ultrasound Sonography
肝脏疾病超声诊断肝脏疾病超声诊断
肝脏弥漫性疾病肝脏弥漫性疾病 Diffuse Liver DiseaseDiffuse Liver Disease
肝脏占位性疾病肝脏占位性疾病FocalFocal AbnormaliesAbnormalies
正常肝脏声像图正常肝脏声像图 大小、形态、包膜、边界大小、形态、包膜、边界 size shapesize shape capsule boundary capsule boundary
肝实质回声 肝实质回声 liver parenchymaliver parenchymaecho patternecho pattern : : isoechoic homogeneousisoechoic homogeneous
肝內管道系统肝內管道系统hepatic artery portal vein hepatic veinshepatic artery portal vein hepatic veins
intrahepatic biliary intrahepatic biliary 肝质地肝质地
left lobeleft lobe sagittal sagittal sectionsection
right lobe right lobe sagittal oblique sagittal oblique view view
right loberight lobe sagittal oblique sagittal oblique viewview
Port vein (color Doppler Port vein (color Doppler mode)mode)
Port vein (color Port vein (color Doppler+spectrum)Doppler+spectrum)
Hepatic arteryHepatic artery
Hepatic arteryHepatic artery (color (color Doppler+spectrum)Doppler+spectrum)
Hepatic vein Hepatic vein
Hepatic vein Hepatic vein
Hepatic veinHepatic vein (color (color Doppler+spectrum)Doppler+spectrum)
Cystic lesionCystic lesion
simple hepatic cysts (congenital hepatic cysts) simple hepatic cysts (congenital hepatic cysts) Traumatic cysts Traumatic cysts parasitic cysts parasitic cysts inflammatory cystsinflammatory cysts polycystic diseasepolycystic disease pseudo-cystspseudo-cysts
Simple Hepatic CystsSimple Hepatic Cysts
Ultrasound findingsUltrasound findings The cyst walls are thin with well-defined The cyst walls are thin with well-defined
bordersborders anechoic in the cystanechoic in the cyst distal posterior enhancementdistal posterior enhancement Sometimes cysts contain fine linear Sometimes cysts contain fine linear
internal septal.internal septal.
Hepatic AbscessHepatic Abscess
Ultrasound findingsUltrasound findings
Round or ovoid shape with thick wallRound or ovoid shape with thick wall Hypoechoic , complex , may be have a fluid level Hypoechoic , complex , may be have a fluid level (with some debris along the posterior margin) (with some debris along the posterior margin) hyperechoic with dirty shasowing (if gas is present) hyperechoic with dirty shasowing (if gas is present) posterior enhancementposterior enhancement
Cavernous HemangiomaCavernous Hemangioma
ultrasound findings ultrasound findings
round , oval, or lobulated shape with well- round , oval, or lobulated shape with well-
defined bordersdefined borders hyperechoic, anechoic, mixed pattern hyperechoic, anechoic, mixed pattern
posterior enhancement posterior enhancement
Hepatocellular CarcinomaHepatocellular Carcinoma
ultrasoud findingsultrasoud findings round, irregular shape round, irregular shape
hypoechoic, hyperechoic, isoechoic hypoechoic, hyperechoic, isoechoic
a halo surround the lesion a halo surround the lesion
color Doppler signal was presented in the tumor or surround color Doppler signal was presented in the tumor or surround the tumor the tumor
Metastatic DiseaseMetastatic Disease
ultrasoun findingsultrasoun findings
shape round or oval shape round or oval
number two or more thannumber two or more than
echoic pattern various echoic pattern various
color Doppler no flow insidecolor Doppler no flow inside
CirrhosisCirrhosis
Ultrasound findingsUltrasound findings
the liver size: smallerthe liver size: smaller
nodularity of the liver edge nodularity of the liver edge
parenchyma: coarsening, increased attenuationparenchyma: coarsening, increased attenuation
portal hypertention portal hypertention
the diameter of hepatic vein tiny and twist the diameter of hepatic vein tiny and twist
severe : invisiblesevere : invisible
hardnesshardness
regeneratinregeneratingg
HCC secondary HCC secondary cirrhosiscirrhosis
portal vein spectrum portal vein spectrum pattern pattern
flattenflatten
Portal hypertentionPortal hypertention
portosystemic venous portosystemic venous collateralscollaterals
paraumbilical vein; coronary vein; paraumbilical vein; coronary vein;
gastroesophageal vein; gastroesophageal vein;
splenorenal-gastrorenal veinsplenorenal-gastrorenal vein
splenomegalysplenomegaly
ascitesascites
ascitesascites
FFatty Liver (fatty atty Liver (fatty infiltration)infiltration)
Ultrasound findingsUltrasound findings
increased echogenicity with increased echogenicity with increased increased
atenuation ( far field )atenuation ( far field )
hepatic vessel unclare hepatic vessel unclare
focal sparing focal sparing
masslike hypoechoicmasslike hypoechoic
FFatty Liver (fatty atty Liver (fatty infiltration)infiltration)
Ultrasound findingsUltrasound findings
increased echogenicity with increased echogenicity with increased increased
atenuation ( far field )atenuation ( far field )
hepatic vessel unclare hepatic vessel unclare
focal sparing focal sparing
masslike hypoechoicmasslike hypoechoic