1 / 86

Gastrointestinal Radiology

Gastrointestinal Radiology. Contrast media. Type of contrast media Barium sulfate Water soluble. สารทึบรังสีที่ใช้ตรวจมี 2 ชนิด คือ 1. Barium sulfate 2. Water-soluble contrast agent. BARIUM SULFATE. WATER SOLUBLE CONTRAST AGENT. Questions.

clayland
Download Presentation

Gastrointestinal Radiology

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Gastrointestinal Radiology

  2. Contrast media Type of contrast media • Barium sulfate • Water soluble

  3. สารทึบรังสีที่ใช้ตรวจมี 2 ชนิด คือ 1. Barium sulfate 2. Water-soluble contrast agent

  4. BARIUM SULFATE

  5. WATER SOLUBLE CONTRAST AGENT

  6. Questions • 1. The case in aspiration is suspected, which contrast medium is preferred? • 2.The case in perforation is suspected, which contrast media is preferred?

  7. TECHNIQUE • การตรวจหาความผิดปกติของระบบทางเดินอาหารด้วย barium มี 2 วิธี คือ • 1. SINGLE CONTRAST STUDY • 2. DOUBLE CONTRAST STUDY

  8. SINGLE CONTRAST STUDY

  9. SINGLE CONTRAST TECHNIQUE

  10. DOUBLE CONTRAST STUDY

  11. DOUBLE CONTRAST TECHNIQUE

  12. PRINCIPLE ความผิดปกติที่พบในภาพถ่ายรังสีของทางเดินอาหาร แบ่งได้เป็น 2 ประเภทดังนี้ 1. ความผิดปกติที่เกิดจากพยาธิสภาพนอกทางเดินอาหาร (Extrinsic lesion) 2. ความผิดปกติของระบบทางเดินอาหาร (Intrinsic lesion) 2.1 Protruded lesion ได้แก่ mucosal fold, polyp, tumor และ varices เป็นต้น 2.2 Depressed lesion ได้แก่ ulcer, diverticulum และ perforation เป็นต้น

  13. A B C submucosal or intramural mass extrinsic mass mucosal mass Diagram

  14. MASS Extrinsic lesionความผิดปกติที่เกิดจากพยาธิสภาพนอกทางเดินอาหาร

  15. ความผิดปกติที่เกิดจากพยาธิสภาพนอกทางเดินอาหาร

  16. A B ความผิดปกติที่เกิดจากพยาธิสภาพของทางเดินอาหาร: Protruded lesion mucosal mass

  17. A B Polyp

  18. submucosal or intramural mass Diagram

  19. A Double contrast B upright C Single contrast En-face Profile ความผิดปกติที่เกิดจากพยาธิสภาพของทางเดินอาหาร: Depressed lesion

  20. CARCINOMA

  21. CARCINOMA (2)

  22. CARCINOMA (3)

  23. CARCINOMA (4)

  24. CARCINOMA (5)

  25. ESOPHGUS

  26. Achalasia

  27. ACHALASIA CARDIA

  28. THORACIC DIVERTICULUM • - Arises in the middle third of the thoracic esophagus- Traction diverticulum (arrow) that develops in response to the pull of fibrous adhesion after mediastinal lymph node infection or inflammation (star)

  29. EPIPHRENIC DIVERTICULUM • Arises in the distal of the esophagus, just above diaphragm • Pulsion diverticulum (arrow) that probably related to incoordination of esophageal peristalsis and relaxation of the loweresophageal sphincter

  30. ESOPHAGEAL VARICES : The characteristic radiographic appearance 1. Serpiginous filling defects which appear as round or oval filling defects resembling the beads of a rosary( dilated venous structures) ( arrowhead). 2. Changes size and appearance with variations in intrathoracic pressure and collapse with esophageal peristalsis and distension. 3. Varices related to portal hypertension are most commonly demonstrated in the lower third of the esophagus. 4. In portal hypertension ; common accompanying gastric varices(arrow).

  31. Answer : CANDIDA ESOPHAGITIS • INFECTIOUS ESOPHAGITIS : Increasingly common because of the use of steroid and cytotoxic drugs, disseminated malignancy, and increasing incidence of acquired immunodeficiency syndrome • CANDIDA ESOPHAGITIS: : Most common infectious disease of the esophagus : Radiographic findings include 1. Abnormql esophageal motility ( dilated, atonic esophagus ) is often an early stage 2. Irregular, nodular, plaque-like mucosal pattern ( arrow), irregular folds(arrowhead) with marginal serrations ( shaggy appearance ) 3. Multiple ulcerations of various sizes 4. Frequently involve the entire thoracic esophagus Esophagogram

  32. Answer : CORROSIVE ESOPHAGITIS • Most severe corrosive injuries are caused by alkalis • Barium study is unnecessary during acute phase. • Radiographic findings; 1. Diffuse superficial or deep ulceration involving long portion of the distal esophagus 2. Abnormal motility 3. Fibrotic healing results in a long esophageal stricture ( arrow) that extends down to the cardioesophageal junction. Note : barium was aspirated into left main bronchus(green arrow)

  33. Major radiographic findings: EARLY STAGE - Flat plaque-like lesion or small polypoid lesion)on one wall of the esophagus

  34. A B : Major radiographic appearances (2) : ADVANCED STAGE • A. Large Polypoid ( often fungating ) filling defect (arrow) with overhanging edge (yellow arrow) • B. Large ulcer niche (yellow arrow) within a bulging mass (ulcerated mass) (arrow)

  35. A B Major radiographic appearances (3) • Advanced stage • A. Encircling mass with irregular luminal narrowing (green arrow) and shelf like margins (black arrow) • B. Nodular thickened folds (varicoid type)(black arrow); Extension of the tumor (green arrow)

  36. PSEUDO-ACHALASIA caused by direct spread to the distal esophagus from gastric carcinoma Radiographic findings : 1. Irregularly, narrowed and nodular( arrowhead), sometimes ulcerated (arrow), lesion at distal esophagus 2. Rapid transition between normal and abnormal part. 3. Dilatation of proximal esophagus.

  37. STOMACH

  38. WHAT IS YOUR DIAGNOSIS ?

More Related