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Lectures on diagnostic_ultrasound

Lectures on diagnostic_ultrasound



Lectures on diagnostic_ultrasound

Lectures on diagnostic_ultrasound



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    Lectures on diagnostic_ultrasound Lectures on diagnostic_ultrasound Presentation Transcript

    • Lectures on diagnostic ultrasound Uzm.Dr. BAHRİ YILDIZ Uzm.Dr.M.EROL YAYLA
      • Saggital sonogram of the gall bladder shows multiple, echogenic, non-mobile foci without posterior shadowing, located in the wall
    • Marked wall thickening of the extrahepatic bile duct is noted.
    • Transverse section through the liver at the level of the hepatic veins, showing 2 curvilinear, parallel, echogenic lines coursing through the vein, identified as the TIPS stent .
    • Sagittal view of the liver demonstrates a large multi-cystic mass occupying most of the right lobe. The liver is enlarged
    • Transverse view of the right lobe, revealing a multi-cystic mass.
    • Transverse view of the right lobe of liver, demonstrating the anterior branch of the right portal vein entering the mass. The echogenic tissue appears to be the compressed liver parenchyma.
    • Transverse scan demonstrating a thickened gallbladder wall, with cholelithiasis. The gallbladder wall shows alternate hypo and hyperechoic layers. The patient was very tender while scanning .
    • Sagittal scan demonstrating a distended gallbladder with multiple, mobile calculi that shadow. The gallbladder wall is significantly thickened. No pericholecystic fluid is seen.
    • Transverse view showing the laminated appearance of the gallbladder wall.
    • There is very minimal intrahepatic biliary tree dilatation
    • The gallbladder is distended and shows layering of multiple, brightly echogenic calculi which show dense shadowing. The gallbladder wall is greatly thickened [9 mm]. Patient had focal tenderness over the gallbladder while scanning .
    • The transverse view shows the thickened gallbladder wall and the lumen filled with multiple gallstones .
    • An elongated, well defined, heterogeneously hypoechoic lesion is seen in the hepatic parenchyma.
    • The well defined hypoechoic lesion is seen again anterior to portal vein bifurcation. There was no flow noted in this lesion on color Doppler [image not shown here ].
    • The liver shows a coarse echotexture with a nodular surface and poor through transmission of sound. These findings are consistent with changes of cirrhosis. Also noted is ascitic fluid surrounding the liver .
    • The gallbladder shows a large calculus with posterior shadowing . The walls of the gallbladder appear thickened and indistinct, and exhibit scattered punctate high-amplitude echoes, suggesting emphysematous cholecystitis .
    • The gallbladder with calculus is again demonstrated. No portion of the gallbladder lumen can be reliably identified. There was tenderness over the area with transducer pressure while scanning
    • Two gallbladders are noted, having nearly mirror image shapes.
    • Transverse images right upper quadrant In these images the two gallbladders appear to arise from a common cystic duct .
    • Follow up scan of the patient after a fatty mealThis image shows the normal physiological contraction of both the gallbladders after a fatty meal. [compare with image 1 and
    • There is evidence of intrahepatic biliary dilatation. The visualized liver parenchyma appears normal.
    • Non shadowing mobile calculi are seen in the gallbladder