如何初步判讀腹部X光 - SlideShare

在這個PPT裡面，簡單介紹了判讀腹部X光的幾個面向以及常見X光變化，希望對大家有所幫助。

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Readmore TsungAnChen Follow 受傷的醫者 TsungAnChen 全民身體活動指引整理 TsungAnChen 奴工島 TsungAnChen 在宅醫療，從cure到care TsungAnChen 初步了解腫瘤指標 TsungAnChen 原子習慣 TsungAnChen WhattoUploadtoSlideShare SlideShare BeAGreatProductLeader(Amplify,Oct2019) AdamNash TrillionDollarCoachBook(BillCampbell) EricSchmidt APIdaysParis2019-Innovation@scale,APIsasDigitalFactories'NewMachi... apidays RelatedBooks Freewitha30daytrialfromScribd Seeall Hunt,Gather,Parent:WhatAncientCulturesCanTeachUsAbouttheLostArtofRaisingHappy,HelpfulLittleHumans MichaeleenDoucleff (4/5) Free TheWell-GardenedMind:TheRestorativePowerofNature SueStuart-Smith (3.5/5) Free AnAnatomyofPain:HowtheBodyandtheMindExperienceandEndurePhysicalSuffering Abdul-GhaaliqLalkhen (2.5/5) Free Let'sTalkAboutHardThings AnnaSale (4/5) Free HowtoSleep:TheNewScience-BasedSolutionsforSleepingThroughtheNight RafaelPelayo (2/5) Free HappinessBecomesYou:AGuidetoChangingYourLifeforGood TinaTurner (4/5) Free WeNeedtoHangOut:AMemoirofMakingFriends BillyBaker (0/5) Free TheSecrettoSuperhumanStrength AlisonBechdel (4/5) Free ToRaiseaBoy:Classrooms,LockerRooms,Bedrooms,andtheHiddenStrugglesofAmericanBoyhood EmmaBrown (3/5) Free The4SeasonSolution:AGroundbreakingPlantoFightBurnoutandTapintoOptimalHealth DallasHartwig (4/5) Free TheVaginaBible:TheVulvaandtheVagina:SeparatingtheMythfromtheMedicine Dr.JenGunter (4.5/5) Free SuperHuman:TheBulletproofPlantoAgeBackwardandMaybeEvenLiveForever DaveAsprey (4.5/5) Free TheLittleBookofGameChangers:50HealthyHabitsforManagingStress&Anxiety JessicaCording (4/5) Free TheRabbitEffect:LiveLonger,Happier,andHealthierwiththeGroundbreakingScienceofKindness KelliHarding (5/5) Free WhyDidIComeintoThisRoom?:ACandidConversationaboutAging JoanLunden (2.5/5) Free WhyWeSleep:UnlockingthePowerofSleepandDreams MatthewWalker (4.5/5) Free RelatedAudiobooks Freewitha30daytrialfromScribd Seeall LiveYourLife:MyStoryofLovingandLosingNickCordero AmandaKloots (4.5/5) Free WorldWarC:LessonsfromtheCovid-19PandemicandHowtoPreparefortheNextOne SanjayGupta (4.5/5) Free TheNightLake:AYoungPriestMapstheTopographyofGrief LizTichenor (5/5) Free TheWorkingParent'sSurvivalGuide:HowtoParentSmarterNotHarder AnitaCleare (0/5) Free 10RulesforResilience:MentalToughnessforFamilies JoeDeSena (5/5) Free ThePainGap:HowSexismandRacisminHealthcareKillWomen AnushayHossain (4.5/5) Free ABodytoLove:CultivateCommunity,BodyPositivity,andSelf-LoveintheAgeofSocialMedia AngelinaCaruso (5/5) Free Yoke:MyYogaofSelf-Acceptance JessamynStanley (4.5/5) Free NobodyKnowstheTroubleI’veSeen:TheEmotionalLivesofBlackWomen IngerBurnett-Zeigler (4.5/5) Free Self-HelpfortheHelpless:ABeginner'sGuidetoPersonalDevelopment,UnderstandingSelf-care,andBecomingYourAuthenticSelf ShelleyWilson (5/5) Free PermissiontoDream ChrisGardner (4.5/5) Free LifeIsa4-LetterWord:LaughingandLearningThrough40LifeLessons DavidA.Levy (4/5) Free TheAweFactor:HowaLittleBitofWonderCanMakeaBigDifferenceinYourLife AllenKlein (4/5) Free TheEnergyParadox:WhattoDoWhenYourGet-Up-and-GoHasGotUpandGone StevenR.Gundry,MD (4.5/5) Free Heartwood:TheArtofLivingwiththeEndinMind BarbaraBecker (4.5/5) Free SingleOnPurpose:RedefineEverything.FindYourselfFirst. JohnKim (4.5/5) Free 2Likes Statistics Notes JouyuLin 1monthago Lecturesync 3monthsago Views Totalviews 334 OnSlideShare 0 FromEmbeds 0 NumberofEmbeds 191 Actions Shares 0 Downloads 4 Comments 0 Likes 2 Nonotesforslide 如何初步判讀腹部X光 1. 如何初步判讀 腹部X光 2. 常見腹部X光種類 Abdominalplainfilm 站著的PAview，上緣包含橫膈膜 KUB 躺著的APview，照到kidney、ureter、bladder Leftdecubitus 左側躺，肝臟在上 3. 腹部X光觀察重點 AAir BBone CCalcification DSofttissueDensity 4. Air–正常腹部可看到的air 胃 左上腹，有時會看 到air-fluidlevel 5. Air–正常腹部可看到的air 小腸 可以看到plicae circulares 6. Air–正常腹部可看到的air 大腸 可以看到Haustra， 裡面可能有stool 7. Air–異常的bowelgas Perforation小腸阻塞 大腸阻塞Volvulus 腸壁發炎 8. Air–異常的bowelgas Perforation 在CXR看到橫膈膜 下有freeair 9. Air–異常的bowelgas Perforation 在Leftdecubitus下 看到肝臟上方有air 10. Air–異常的bowelgas 小腸阻塞 小腸>3cm，有stackof coinsign。

可能是 obstructionorileus 11. Air–異常的bowelgas 小腸阻塞 若附近局部發炎造成 ileus，也可能看到 sentinelloop 12. Air–異常的bowelgas 大腸阻塞 大腸>6cm或直腸>9cm 阻塞近端脹，但遠端無腸氣 可能是obstruction或 pseudo-obstruction 13. Air–異常的bowelgas Volvulus 乙狀結腸volvulus 會有coffeebeansign 14. Air–異常的bowelgas Volvulus 直腸volvulus 15. Air–異常的bowelgas 腸壁發炎 腸壁變厚，形成 thumbprintingsign 16. Air–異常的bowelgas 腸壁發炎 Leadpipecolon 長期ulcerativecolitis 造成haustrum消失 17. Air–異常的bowelgas 腸壁發炎 Toxicmegacolon 可以看到很多腸壁發炎腫脹 形成pseudo-polyps 18. Bone–腹部可看到的bone Rib Lspine 沒有rib相接 sacrum Iliacbone Femurhead 19. Bone–腹部可看到的異常 骨折髖關節腔狹窄 脊椎退化蝕骨性變化 成骨性變化 20. Bone–腹部可看到的異常 退化性骨刺 髖關節腔狹窄 骨折 21. Bone–腹部可看到的異常 蝕骨性變化 有些骨轉移會有蝕骨性變化， 如本片的左側femurhead 22. Bone–腹部可看到的異常 成骨性變化 有些骨轉移會有成骨性變化， 本片為攝護腺髖骨轉移 23. Calcification–腹部的異常鈣化點 腎結石膽結石 淋巴結鈣化糞石 腎上腺鈣化 血管鈣化慢性胰臟炎 24. Calcification–腹部的異常鈣化點 腎結石 90%腎結石在腹部X光中可 見。

尿酸結石則看不到。

25. Calcification–腹部的異常鈣化點 腎結石 較小的結石會 卡在輸尿管中 26. Calcification–腹部的異常鈣化點 膽結石 在右上腹，只有10-15% 膽結石可以被看見 淋巴結鈣化 位置有時候需要與腎 結石做鑑別 27. Calcification–腹部的異常鈣化點 糞石 在Rightiliacfossa中，與 闌尾炎有高度相關性 28. Calcification–腹部的異常鈣化點 血管鈣化 在腹部X光中看到血管鈣化， 代表嚴重的動脈硬化 29. Calcification–腹部的異常鈣化點 慢性胰臟炎 在腹部X光中看到胰臟的鈣 化，暗示有慢性胰臟炎 30. Calcification–腹部的異常鈣化點 腎上腺鈣化 在腎臟上方，呈現三角形的鈣化 多與之前出血或TB感染有關 31. Density–腹部正常軟組織 Liver spleen Kidney bladder Psoasmuscle 32. Density–腹部異常軟組織 肝臟腫大脾臟腫大 腎臟擴大腹水 骨盆腔腫塊 33. Density–腹部異常軟組織 肝臟腫大 可以看到腸子被 推開 34. Density–腹部異常軟組織 脾臟腫大 可以看到腸子被 推開 35. Density–腹部異常軟組織 腎臟腫大 腎臟在後腹腔，不 會影響腸子空間 36. Density–腹部異常軟組織 腹水 KUB，腸氣飄在中央，後 面是不透光的腹水 37. Density–腹部異常軟組織 骨盆腔腫塊 可以看到腸子 被向上推開 38. Summary Air Perforation、小腸阻塞、大腸阻塞、volvulus、腸壁發炎 Bone 骨折、髖關節腔狹窄、脊椎退化、蝕骨性變化、成骨性變化 Calcification 腎結石、膽結石、淋巴結鈣化、糞石、血管鈣化 慢性胰臟炎、腎上腺鈣化 SofttissueDensity 肝臟腫大、脾臟腫大、腎臟擴大、腹水、骨盆腔腫塊 39. 參考資料 RadiologyMasterclass https://www.radiologymasterclass.co.uk/ Radiopaedia https://radiopaedia.org/?lang=us 受傷的醫者 TsungAnChen 全民身體活動指引整理 TsungAnChen 奴工島 TsungAnChen 在宅醫療，從cure到care TsungAnChen 初步了解腫瘤指標 TsungAnChen 原子習慣 TsungAnChen WhattoUploadtoSlideShare SlideShare BeAGreatProductLeader(Amplify,Oct2019) AdamNash TrillionDollarCoachBook(BillCampbell) EricSchmidt APIdaysParis2019-Innovation@scale,APIsasDigitalFactories'NewMachi... apidays 在這個PPT裡面，簡單介紹了判讀腹部X光的幾個面向以及常見X光變化，希望對大家有所幫助。

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