小動(dòng)物內(nèi)科學(xué)腹部x光解剖學(xué)

1、執(zhí)業(yè)獸醫(yī)師，歐洲獸醫(yī)影像學(xué)認(rèn)證獸醫(yī)Radiographic anatomy of the abdomen腹部的X光解剖學(xué)Edoardo Auriemma, DVM, DipECVDIRadiographic anatomy ofthe abdomen 腹部X光解剖學(xué)Technique 技術(shù)Evaluation/anatomy abdominal radiographs:腹部X光的評(píng)估/解剖學(xué):-Extra-abdominal structures 腹腔外結(jié)構(gòu)Abdominal contrast 腹腔內(nèi)結(jié)構(gòu)的對(duì)比度Peritoneal VS retroperitoneal organs腹膜內(nèi)器官

2、與腹膜后腔器官的比較-Not visible abdominal structures/contraststudies 不可見(jiàn)的腹腔結(jié)構(gòu)/對(duì)比造影檢查TechniqueExposure: Low Kvp High mAs technique（技術(shù)：低千伏高毫安秒技術(shù) Espiration 在呼氣時(shí)拍攝Radiographic anatomy of the abdomen腹部X光解剖學(xué)Technique 技術(shù) Always two views 總是拍攝兩個(gè)面的X光片 VD, LR/RL Lateral, DV views腹背位，左右側(cè)位/右左側(cè)位，背腹位投射 Entire abdomen整個(gè)腹腔

3、（膈-骨盆，背部，腹部和側(cè)壁軟組織邊緣）Radiographic anatomy of the abdomen腹部X光解剖學(xué)Technique 技術(shù)Radiographic anatomy ofthe abdomen 腹部X光解剖學(xué)Standard views: VD and Lateral標(biāo)準(zhǔn)投射面：腹背位和側(cè)位Always two orthogonal projections!總是要拍攝兩個(gè)相互垂直的投射片！Two views!兩個(gè)拍攝面！Radiographic anatomy ofthe abdomen 腹部的X光解剖學(xué)Extra-abdominal structures 腹外結(jié)構(gòu)-R

4、adiographic anatomy: X光解剖學(xué):Peritoneal 腹膜Retroperitoneal space 腹膜后腔Radiographic anatomy of the abdomen腹部X光解剖學(xué)Radiographic anatomy of the abdomen腹部X光解剖學(xué)Radiographic anatomy ofthe abdomen 腹部的X光解剖學(xué) Extra-abdominal bony structures:腹外的骨質(zhì)結(jié)構(gòu)Lumbar vertebrae, pelvis, hind limbs腰椎，骨盆，后肢Abdominal walls (gas, m

5、ineralization, masses)腹壁（氣體，礦化，腫塊Perinal, inguinal regions 腹膜，腹股溝區(qū)域Abdominal contrast腹部對(duì)比造影Radiographic anatomy of the abdomen腹部X光解剖學(xué)Abdominal contrast 腹部對(duì)比造影Technique 技術(shù)Fat (amount of fat, “puppy fat”)脂肪（脂肪的數(shù)量，“幼犬脂肪”）Fluid 液體Peritonitis 腹膜炎Abdominal masses 腹部包塊Survey radiographs 常規(guī)X光片Abdominal cont

6、rast 腹部對(duì)比造影Peritoneal space腹膜腔Cranial abdomen 顱側(cè)腹部Diaphragm 膈Not entirely visible 不能完整看到R/L crura, intercrural cleft, cupula右/左膈腳，膈腳間隙，膈頂Variation in shape and position 形狀和位置可變Sometimes rough ventral border L3-L4 (attachment pars lumbalis)有時(shí)大致位于第3第4腰椎的腹側(cè)邊緣（附著腰部）Cranial abdomen 顱側(cè)腹部Liver 肝臟Uniform so

7、ft tissue opacity 均一的軟組織不透明性Dogs symmetrically distributed 犬的為對(duì)稱性的分布Cat mostly right hemiabdomen 貓大多位于右腹部Liver lobes, gallbladder not visible 肝葉，膽囊不可見(jiàn)Cranial abdomen 顱側(cè)腹部Dog 犬Cat 貓Cranial abdomen 顱側(cè)腹部Liver 肝臟Liver size usually best assessed on Lat view最好通過(guò)側(cè)位片來(lái)進(jìn)行評(píng)定肝臟大小Normal liver 正常肝臟Contained withi

8、n costal arch 位于肋弓內(nèi)Sharp and pointed caudo-ventral margin具有在輪廓清晰且突出的后腹緣LiverHow about the liver size?肝臟肝臟的大?。縈icrohepatia 小肝Cranial abdomen 顱側(cè)腹部Stomach 胃Dog: “U” shaped 犬：“U”型Cat: “J” shaped 貓：“J”型Fundus and corpus left hemiabdomen胃底和胃體占據(jù)腹部左半部Pyloric region right hemiabdomen dog犬腹部右半部份為幽門區(qū)域Pyloric r

9、egion across midline abdomen cat貓的胃幽門區(qū)域橫跨腹正中線Cranial abdomen 顱側(cè)腹部Stomach 胃Size, shape and opacity extremely variable大小，形狀和不非常多變Gas and fluid patterns depending from positioning氣體和液體的模式取決于具體的情況Gastric folds visible in obese cats肥胖的貓可以看到胃皺褶Cranial abdomen 顱側(cè)腹部Stomach 胃DV 背腹側(cè)VD 腹背側(cè)Cranial abdomen 顱側(cè)腹部S

10、tomach 胃RLat 右側(cè)面LLat左側(cè)面Cranial abdomenStomach 胃Gastric folds胃皺褶Mid-abdomen腹中部Mid-abdomen 腹中部Spleen 脾Relatively smaller in the cat as compared to the dog 與犬的相比，貓的脾相對(duì)較小Not entirely visible 不能完全看到Homogenous soft tissue opacity均質(zhì)的軟組織不透明性Mid-abdomen 腹中部Spleen 脾Lat view: 側(cè)面觀：Usually not visible in the cat

11、通常貓的脾是不可見(jiàn)的Head and tail visible in the dog犬的能看到脾頭和脾尾VD view: 腹背位觀：Head of the spleen visible both in thed the cat犬和貓均可見(jiàn)脾頭Mid-abdomen 腹中部Spleen 脾Mid-abdomen 腹中部Small Intestine 小腸Smoothly marginated tubular or circular (if seen end- on) structures邊緣光滑的管狀或環(huán)狀（如果能看到橫切面）結(jié)構(gòu)Opacity depends from intestinal c

12、ontent不取決于腸道內(nèi)容物Normal size ? 正常大小？Mid-abdomen 腹中部Small Intestine 小腸Not exceeding twice rib widthNot exceeding height body L2Dog犬SI/L51.6小腸/第五腰寬度超過(guò)肋超過(guò)第二腰椎椎體的高度椎1.6骨寬度的兩倍Not exceeding 12 mmNot exceedingCat貓twice the heightL4寬度12mm超過(guò)超過(guò)第四腰椎椎體高度的2倍Mid-abdomenMid-abdomenSmall Intestine 小腸Normal size ?正常的大

13、??？Mid-abdomenSmall Intestine 小腸Ileus!腸梗阻！Mid-abdomen 腹中部Large Intestine 大腸Cecum: “C” shaped in the dog (L2-L3)盲腸：犬的盲腸呈C型（第二腰椎-第三腰椎）Cecum: usually not visible in the cat盲腸：貓的通常不能看到Colon: question mark shape結(jié)腸：?jiǎn)柼?hào)狀的形狀Mid-abdomen 腹中部Caudal abdomen尾側(cè)腹部Homogeneous soft tissue opacity均質(zhì)的軟組織不 Oval shape, in

14、tra-abdominal or pelvic position in the dog犬的膀胱位于腹腔內(nèi)或骨盆處，呈卵圓形 Ellipsoid and intra-abdominal position in the cat貓的膀胱在腹腔內(nèi)，呈橢圓形Caudal abdomen 尾側(cè)腹部Urinary bladder 膀胱Caudal abdomen 尾側(cè)腹部Caudal abdomen 尾側(cè)腹部Caudal abdomen 尾側(cè)腹部ProstateSmall oval soft tissue opacity caudal to the urinary bladder in the dog犬的位

15、于膀胱后部，為小的卵圓形，表現(xiàn)為軟組織不In normal castrated dog not visible在正常去勢(shì)的犬上看不到Not visible in the cat 在貓上不可見(jiàn)Caudal abdomen 尾側(cè)腹部ProstateSurvey radiographs常規(guī)X光片?Two soft tissue opacity: which one is the urinary bladder?兩個(gè)軟組織不透明陰影：哪一個(gè)是膀胱？Caudal abdomen 尾側(cè)腹部Retroperitoneal space腹膜后間隙成對(duì)，具有均質(zhì)的軟組織不 Located at the level

16、 of L1-L3位于第一腰椎到第三腰椎的位置 Right kidney not completely visible右腎不能完全被看到（其邊緣被肝尾葉遮住） Left kidney slightly caudal to right kidney左腎稍比右腎更靠近尾側(cè)Retroperitoneal organs 腹膜外器官Kidneys 腎臟 Pair organs of homogenous soft tissue opacityRetroperitoneal organs 腹膜外器官Kidneys 腎臟-Size? 大??？Rule of thumb: 經(jīng)驗(yàn)性標(biāo)準(zhǔn)：Dog: 2.5-3.5

17、times length of L2 (VD view)犬：第二腰椎長(zhǎng)度的2.5-3.5倍（腹背側(cè)觀）-Cat: 2.4-3 times length of L2 (VD view)貓：第二腰椎長(zhǎng)度的2.4-3倍（腹背側(cè)觀）Retroperitoneal organs 腹膜外器官Kidneys 腎臟Retroperitoneal organs 腹膜外器官?Retroperitoneal organs 腹膜外器官Survey radiographs 常規(guī)X光片Not visible structures 不可見(jiàn)的結(jié)構(gòu)Pancreas 胰腺Abdominal lymph nodes and ves

18、sels腹部淋巴結(jié)和Uterus (non pregnant) and ovariesUrethra（未妊娠）和Ureters, adrenal glands, sublumbar lymph nodes輸尿管，腎上腺，腰下淋巴結(jié)Retroperitoneal organs 腹膜外器官? ?Contrast studies對(duì)比造影檢查Urinary tract 泌Contrast studies I對(duì)比造影檢查IIntravenous pyelography (IVP), antegrade pyelography靜脈腎盂造影（IVP），順行腎盂造影Retrograde cystography 逆行膀胱造影Retrograde