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Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
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8  The Digestive System Organ Scanning

263

 

 

1.31\ Portal Vein Blood Flow

Spectrum from Right

Subcostal Margin

Fig. 8.31  Portal vein blood flow spectrum from right subcostal margin

1.31.1\ Scanning Method

Patient should be on fast for 8–12 h. Subcostal scanning should be performed with patient in a left lateral decubitus or supine position. Showing oblique scan of the right liver through the porta hepatis. The Doppler sample volume is put in the middle of the cavity of the portal vein. Measuring angle is less than 60°.

1.31.2\ Section Structure

The blood flow moveform of the portal vein is gentle and consecutive, appears small pulse with breathing rhythm.

1.31.3\ Measuring Method and the Normal

Showing pulsed Doppler blood flow spectrum and measuring blood flow velocity of the portal vein; normal is 15–20 cm/s or 23.8 ± 4.9 cm/s (zhangmei 1993).

1.31.4\ Clinical Application Value

(1) In patients with portal hypertension, portal vein blood flow slows down and pulse will disappear. (2) To diagnose portal venous obstructive diseases such as portal vein thrombosis or tumor emboli.

264

2\ The Gallbladder and Biliary

System Scanning

2.1\ Longitudinal Scanning of the

Gallbladder from the Right

Subcostal Margin

Fig. 8.32  Longitudinal view of the gallbladder from right subcostal margin

RL

RPV

CHA

IVC

M. Zhang

Gb

P

SMV

8  The Digestive System Organ Scanning

265

 

 

2.1.1\ Scanning Method

The patient should be on fast for 8–12 hours with a left lateral decubitus or supine position. Subcostal scanning should be performed. The transducer should be parallel to the longitudinal axis of the gallbladder. The patient keeps a deep inspiration so that the liver moves down as an acoustic window and a more clear image can be shown.

2.1.2\ Section Structure

Major areas: the gallbladder. Ancillary areas— the portal vein, right hepatic artery, pancreas, superior mesenteric vein, and oblique section of the right liver lobe.

2.1.3\ Measuring Method and Normal

Measuring the gallbladder size/transverse diameter ≤ 3.5 cm and long axis diameter <9 cm. The thickness of the gallbladder wall is ≤0.3 cm. Measuring distance should be made from the

outer edge to the inner edge or from the inner edge to the outer edge or from the middle wall to the middle wall.

2.1.4\ Clinical Application Value

This is a standard section of the gallbladder, is used to measure the size and wall thickness of the gallbladder, and is used to observe cholecystitis, gall stones, space-occupying lesions, and other abnormal echogenicities in the gallbladder cavity.

2.1.5\ Notice

The gallbladder anatomic position may be in variation. General variants are as follows: (1) intrahepatic (2), located in the posterior-inferior of the right lobe (3), located in the posterior-infe- rior of the left liver lobe (4), horizontal position. In this situation, scans should be obtained with the patient in a variety of positions.

266

2.2\ Short axis Scanning of the Gallbladder by

the Right Subcostal Margin

Fig. 8.33  Longitudinal scan of the gallbladder by the right subcostal margin

RL

Au

SpV

IVC

RK

M. Zhang

QL

LTH

Gb

P

SMA

Ao