小動物心臟病基礎培訓課程回放的光檢查

1、Radiographyin cardiac disease 心臟病的X光檢查 - stillan optioninthe daysof echocardiography?- 也是超聲波心動描記術時的一個選擇Johann Lang DECVDIDivision of RadiologyDepartment of Clinical Veterinary MedicineVetsuisse Faculty Bernwhy taking radiographs?為什么要拍攝X光片severity of cardiomegaly- effects on other structures 心臟擴張癥的嚴重

2、性-影響其他結構differentiate compensated non compensated cardiac disease 鑒別代償性與非代償性心臟病assess therapy 確定療法course of disease progression 疾病過程-進行性shorten list of DDx 減少鑒別診斷目錄Yorkshire, f, 11y 約克夏，母犬，11歲coughing after removing tartar therapy: prednisolone 清除牙垢后咳嗽：氫化潑尼松RR 右側DV背腹位How do we assess heart size?我們?nèi)绾?/p>

3、評價心臟大??？a 10-152,5 - 3,5Th4cat: 7,8dog: 2/3Yorkshire, f, 11yDachshound , f, 12yand in cats?貓？Assessemnt of cardiac silhouette 心臟輪廓評估species, breed 種類，品種right vs. left 右側 vs.左側size + shape 大小形狀young vs. old 年輕 vs.老年radiographic anatomy-heart解剖學-心臟12 1 2 9 36young vs. old 年輕 vs.老年size vs. shape 大小 vs.形

4、狀right vs. left 右側 vs.左側vessels/circulation! 血管/循環(huán)aorta/caudal vena cava 大動脈/后腔靜脈lung/lung vessels 肺/肺血管abdomen/pleura 腹部/胸膜12 1 2 9 36pulmonnic stenosis 肺狹窄r-l PDA r-l嵴下型動脈導管未閉Eisenmenger 艾森曼格綜合征right heart failure 右側心衰pulmonic stenosis 肺狹窄r-l PDA r-l嵴下型動脈導管未閉Eisenmenger 艾森曼格綜合征right heart failure

5、右心衰PDA 嵴下型動脈導管未閉VSD先天性心臟病室間隔缺損MI 二尖瓣關閉不全DCMP 擴張型心肌病 Cardiomegaly 心臟擴大癥vs. heart failure 心衰how can we differentiate between compensated and non compensated heart disease 如何鑒別代償性和非代償性心臟病Phase I/IVSuter & Gomez, 1981+ enlarged left atrium and auricle 左心房和心耳擴大normal ventricle 心室正常example: mitral insuffi

6、ciency例：二尖瓣關閉不全phase I 第I階段Phase II/IVphase II 第II階段+ enlarged left atrium/auricle and left ventricle 左心房/心耳和左心室擴大+normal lung vessels and lung 肺血管和肺正常Phase III/IVphase III 第III階段moderate enlargement of left 左側中度擴大atrium/auricle and left ventricle; right ventricle also prominent 心房/心耳和左心室；右心室突出dilat

7、ed pulmonary veins, hazy lung, blurred lung vessels - active interstitial pattern 肺靜脈擴張、Phase IV/IVdistended pulmonary veins; 肺靜脈擴張alveolar pattern centrally: cardiac pulmonary edema 中央呈現(xiàn)小泡狀圖案；心肺水腫signs of right heart failure 表現(xiàn)右心衰癥狀phase IV 第IV階段Dalmatian 12j, m. 大麥町，12歲，公犬 Dalmatian 12j, m. course

8、 of disease 疾病過程 Cardiomegaly vs. heart failure心臟擴大癥vs.心衰how can we differentiate between compensated and non compensated heart disease?我們?nèi)绾舞b別代償性和非代償性心臟?。縯he vessels are the key 血管是關鍵also important: abdomen, pleura 同樣重要：腹部、胸膜Dalmatian 12j, m. course of disease 疾病過程 why is this Dachshoundcoughing? 這只

9、臘腸犬為什么咳嗽？severity of cardiomegaly- effects on other structures 心臟擴大癥的嚴重性-影響其他結構differentiate compensated non compensated cardiac disease 鑒別代償性-非代償性心臟病assess therapy 確定療法course of disease progression 疾病過程-進行性shorten list of DDx 減少DDx目錄does a radiographically normal heart exclude cardiac disease? X光表現(xiàn)

10、正常的心臟可排除心臟病嗎？ further diagnostic work-up進一步診斷cat, 6y, f: acute paraplegia, cold and painful hindlimbs; heart murmur 母貓，6歲，急性下身麻痹、后肢冰冷且疼痛；心雜音Dx: HCMPwe still take radiographs because we can assess:我們還是拍攝了X光片，這樣我們就可以了解：severity of cardiomegaly- and its effects on other structures 心臟擴大癥的嚴重程度-及其對其他結構的影響。differentiate compensated non compensated cardiac disease 鑒別代償性-非代償性心臟病success of therapy 治療有效性course of disease pro