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肝、胆、胰、脾 Liver, bile duct, pancreas and spleen 陈少琼( Chen,Shaoqiong)
 
Technique and methods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],PTC   --------Percutancous transhepatic cholangiography ERCP  ------Endoscopic retrograde cholangiopancreatography
Technique and methods T -tube Cholangiography
Technique and methods PTC 造影
ERCP 显示胆总管、肝总管及肝内胆管及胰管情况
CT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Imaging of the hepatic vessels Artery Portal vein Hepatic vein
Hepatic vessels ,[object Object],[object Object],[object Object],[object Object]
Normal anatomy
Proper  hepatic A Gastro-duodenal A. 脾动脉 splenic artery SMA   superior mesenteric artery
 
门脉主干及其分支清晰显示。
门静脉 CE MRA 3ml/s 20mlGd-DTPA
门静脉 hepatic portal vein
Portal vein and hepatic vein
Hepatic vein right   intermediate  left
 
肝右 V
Celiac trunk Splenic artery Common hepatic a .
Hepatic artery
Left branch of hepatic portal vein
Right branch of hepatic portal vein
Hepatic vein
Liver lobes ,[object Object]
Liver lobes Quadrate lobe Left lobe Caudate lobe Quadrate lobe 上段 下段 Left lobe Right lobe 右后叶 上段 下段 1 上段 下段 左外叶 尾状叶 方叶 左内叶 Right lobe 右后叶 上段 下段
( 二 )  Couinaud  肝段划分法  ( 8  段划分法 ) 肝门静脉 肝圆韧带 肝左静脉 下腔静脉 肝中静脉 肝右静脉
CT
4 8 7 2
2 4 8 7
2 4 8 7 1
2/3 4 8 7 1
1 3 4 8/5 7/6
3 4 5 6 1
3 4 5 6
5 6
5 6
MR
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
3 4 5 6 T2WI
3 4 5 6 T1WI
ERCP 正常胆道 Bile duct system
Intrahepatic bile duct
MRCP
P ancreas
CT body of pancreas   head of pancreas splenic vein Portal vein
tail of pancreas   body of pancreas   head of pancreas MR  T1WI
head of pancreas
T2  FAT SAT 胰腺 pancreatic duct
胰头 head of pancreas Portal vein gallbladder
23 4 7  8 6  5 冠状位 GB
7 8 6  5 6   5
7  8 6  5 肾上腺 M
 
76 SP
Disease of the liver
Hepatic cyst ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CT Appearance  Hepatic  C yst -C  venous  phase arterial phase
CT Appearance  Hepatic  C yst Polycystic disease
MR appearance  Hepatic cyst
Hepatic Abscess P yogenic   abscess - bacterium   or  Amoeba
Plain Radiography
CT Appearance of hepatic abscess ,[object Object],[object Object],[object Object],[object Object]
肝脓肿 肝右叶圆形低密度区,脓肿壁密度高于脓腔、低于正常肝。增强扫描:脓肿壁环形强化,轮廓光滑,厚度均匀,外围可见低密度水肿带
肝脓肿 肝右叶椭圆形低密度区,增强扫描脓肿壁环形强化,轮廓光滑,厚度均匀,外围可见低密度水肿带
MR Appearance of abscess ,[object Object],[object Object]
平扫 T 1 WI 平扫 T 2 WI 静脉期 septum 肝脓肿 肝右叶两个不规则形异常信号区, T 1 WI 脓肿壁信号高于脓腔、低于正常肝, T 2 WI 反之。增强扫描:脓肿壁环形强化,轮廓不光滑,边缘不整
Common hepatic tumors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
H emangiomas of liver ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Plain scan P ortal phase   D elayed phase A rterial phase
 
 
 
Plain Scan E nhancement D elayed scan
[object Object],[object Object],[object Object],[object Object]
 
 
C avernous hemangioma
Hepatocellular carcinoma ,[object Object],[object Object],[object Object]
CT ,[object Object],[object Object],[object Object],[object Object],[object Object]
Key points ,[object Object]
Important features that guide treatment include: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CT appearance of HCC ,[object Object],[object Object]
CT appearance of HCC ,[object Object],[object Object],[object Object]
低密度 高密度 稍低密度 混杂密度
CT appearance of HCC
CT enhancement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CT appearance of HCC
巨块型肝癌、肝内子灶、 IVC 癌栓 CT appearance of HCC Massive type
肝硬化合并原发性结节型肝癌   nodular type CT appearance of HCC
CT appearance of HCC 原发型肝细胞癌合并 门静脉、下腔静脉癌栓 Diffuse type IVC
MR appearance of HCC ,[object Object],[object Object]
MR appearance of HCC
 
 
time CT Value HCC Hemangioma
CT-H epatic metastasis ,[object Object],[object Object],[object Object]
CT-H epatic metastasis
CT-H epatic metastasis
 
[object Object],[object Object],C holelithiasis
[object Object],[object Object],[object Object],[object Object],[object Object],C holelithiasis-radiologic findings
C holelithiasis 平  片
C holelithiasis
C holelithiasis Cholecystography----radioparent calculus
C holelithiasis T -tube Cholangiography
C holelithiasis PTC 造影
[object Object],[object Object],C holelithiasis
C holelithiasis cholecystography CT 检查
C holelithiasis
C holelithiasis MRCP
[object Object],[object Object],[object Object],[object Object],[object Object],C holecystitis
cholecystitis
Chronic  cholecystitis   : shrink of the gallbladder and thickening wall
Calcification
P ancreatitis ,[object Object],[object Object],[object Object],[object Object]
Acute pancreatitis Excessive swelling of the pancreas
Acute pancreatitis
Acute pancreatitis
Chronic P ancreatitis ,[object Object],[object Object],[object Object],[object Object]
[object Object],Chronic P ancreatitis
[object Object],[object Object],[object Object],[object Object],Chronic P ancreatitis
Chronic P ancreatitis ,[object Object]
[object Object],[object Object],[object Object],[object Object],肝胆胰脾 --- 胆管癌
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],肝胆胰脾 --- 胆管癌
肝胆胰脾 --- 胆管癌
肝胆胰脾 --- 胆管癌

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