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Gao Xuemei
Imageological Diagnosis of the Esophageal Diseases
Imageological Diagnosis of the Esophageal Diseases
Esophagitis
motor disorders of the
esophagus
Esophageal tumor
Other diseases
esophageal varices
Esophageal varices
Pathogeny and pathology :
a complication of portal hypertension
cirrhosis of liver → portal
hypertension(PV↑)→blood obstructed in portal
vein →flow into latteralcirculation→varices of
submucosal and periesophageal v. →azygos
vein→SVC
clinical symptoms : hematemesis and melaena
Esophageal varices
Differential diagnosis :
●Peptic esophagitis
● Achalasia
● benign stricture
● varices
● Extraluminal compression of eso.
● Carcinosarcoma
胃部疾病的影像学诊断
Imageological diagnosis of the gastric diseases
gastric ulcer
Gastric ulcer
Pathogeny : hydrochloric acid in gastric juice,
smoke, alcohol,coffee,medicine and spirit
Pathology : mucosa ,submucosa and muscle
coat are corrupted –round or oval breach-crater
most at the lesser curve, single, 2cm in size
Clinical symptom : chronic and epigastric pain
with regularity and rhythm
Dianosis : imaging + endoscopy
X-ray findings of gastric ulcer
Round ulcer
Linear ulcer
Multiple ulcer
Ulcer at special position
Healing or recurrence of
ulcer
The main X-ray findings of round ulcer
Crater
projecting beyond the lumen of the
stomach. <2cm
in profile : nipple-like or triangular
protrusion
en face: a round collection of barium
粘膜线 (Hampton’s line)
lucent line at the edge of niche, 1-
2mm width
The main X-ray findings of round ulcer
collarsign ( 项圈征 ):
a lucent zone at the edge of ulcer, 0.5-1.0cm in
width
Narrow neck sign( 狭颈征 ) :
the edge of ulcer is very narrow like a long neck
Pathogeny :
external cause: environment,diet
internal cause: many kinds
Pathology :
early stage (Ⅰ 、Ⅱ、Ⅲ )
advanceed stage (BorrmannⅠ-Ⅳ)
Diagnosis :imaging endoscopy
Gastric Carcinoma
Gao Xuemei
Imageological Diagnosis of Duodenal diseases
Duodenal diseases
Ulcer, diverticula
Maligant tumor : carcinoma,
sarcoma,carcinoid 类癌
Benign tumor : adenoma, leiomyoma
TB
extraluminal compression :
SMA 、 pancreas
Disease of jejunum and ileum
tuberculosis
Crohn disease
Benign tumor : adenoma, leiomyoma
Malignant tumor :
adenocarcinoma,lymphoma,carcinoid 类癌
other : diverticula
Duodenal ulcer
Direct signs :
Nitch or crater :
en face : the ulcer shows round opaque with lucent
zone around the its periphery and radiating mucosal folds
toward the edge of nitch
in profile : nipple-like or lapper protrusion
Deformed bulb : (due to scar)
unilateral or lateral
Duodenal ulcer
Indirect signs :
accelerating evacuation
Pyloric spasm
Hypersecretion of stomach
Fixed tenderness on bulb
Imageological Diagnosis of the Small Intestine
Intestinal tuberculosis
Hyperplastic type :
•multiple small polyp-like filling defect due to
hyperplasia
•cecum and ascending colon becomes short,
narrowing and irregular
•evacuation time of small intestine is delayed
Mixed type :
showing above both X-ray features
大肠疾病的影像学诊断
Imageological Diagnosis of the Large Intestine
Common diseases of large intestine
ulcerative colitis
Crohn’s disease of the colon
tuberculosis of the colon
colorectal carcinoma
colonic diverticulosis
Colonic polyps and polyposis syndrome
colonic polyps
polyposis syndrome ( 家族性结
familial
肠息肉综合征 )
Gardner 综合征 (Gardner syndrome)
Peutz-Jepher 综合征 (P-J syndrome)
Colonic polyps and polyposis syndrome
Hyperplastic(polypoid)type :
Irregular filling defect projecting into the
lumen of the bowel
eccentric stricture
Rigidity of the wall of intestine,destruction of
mucosa and loss of peristalsis
Main X-ray findings of advanced large intestine
Ulcerative type :
Large and irregular ulcer seen in the lumen of
intestine
A lucent zone with different width around the ulcer
Rigidityof the wall of intestine , destruction of
mucosa, loss of peristalsis
Main X-ray findings of advanced large intestine
Infiltrative type :
Irregular and annular stricture ,
obstruction
Destruction of mucosa, rigidity of the
wall of intestine, loss of haustration
Other X-ray findings of advanced large intestine
Intussusception( 肠套叠)