HD(Hemodialysis ) 案例之 Abdomen 做法
-
Upload
finn-burris -
Category
Documents
-
view
47 -
download
3
description
Transcript of HD(Hemodialysis ) 案例之 Abdomen 做法
![Page 1: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/1.jpg)
HD(Hemodialysis )案例之 Abdomen做法
CAPD之病患 ,懷疑有 Leakage時 ,由腎臟科醫師執行打入 60ml Contrast Agent (Ominipaque 350mgI/ml)加 1500ml Dialysate(滲透液 )
經過 30分鐘再掃描 Abdomen Survey
![Page 2: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/2.jpg)
Hip DDH
• Topogram: Laser Line對準 Iliac CrestSupine Position,通常不需加造影劑
• Note:• 1.運用 Thin Slice 2/1.4作MPR O-coronal2/2和 O-sagitt
al2/2及 Axial 2/2 與 SSD• 2.DDH(Developmental Dysplasia of Hip)髖骨發育不良開刀的幼兒 ,
• 切記 !只需要 Scan Hip Only.(dose!!)
![Page 3: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/3.jpg)
Protocol Range Slice CollSli Increment Kernel Indication
DDH Topogram 1 T80s
PelvisRoutine 1 0.75 1 B31f
1 0.7 B31f
![Page 4: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/4.jpg)
![Page 5: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/5.jpg)
![Page 6: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/6.jpg)
Cholangiography
• 20G Jelco Elbow
• 喝水 Distension
• Buscopan IV 1Amp
• Dicubitus Right Side 5-10min
![Page 7: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/7.jpg)
Post Angiogram
• 梁主任 case
• Catheter直達 Liver
• Scan Liver Only
• 0.5ml/s 打 15sec 共 7.5ml
• Scan Start Delay:10sec
![Page 8: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/8.jpg)
CTV
• 130ml Contrast Agent
• 2.5ml/s
• Scan Start Delay:3min
• Range: DiaphragmPubic Symphysis
(視臨床要看那一個部位 ,主要是 Abdomen)
Indication:1.Vetebral Plasy2.IVC Lesion 3.Low Limb DVT(Deep Vein Thrombosis)
![Page 9: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/9.jpg)
Subclavian Artery Occlusion
• 利用 Aorta Chest做法• 由 Neck切至 Diaphragm• 20 jelco要 on腳上• Trigger ROI at Aorta Lumen• Threshold:100HU• 雙手擺身體兩旁• 使用 0.75mm Collimator• 組 5/5,1/0.7各一組影像 .
![Page 10: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/10.jpg)
T-M joint Routine
Pre-CM: AXL 2/2(Bilateral)
Post-CM:AXL 2/2(Bilateral)Close&Open
Month,兩邊分開作MPR,SSD
![Page 11: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/11.jpg)
Shoulder下之 Soft Tissue mass(R/O hemangioma)之做法 :
• 1.ShoulderSpiral Protocol2.ROI at Descending Aorta3.分為 3Phase:
• a.Artery Phase b.Capillary Phase c.Venous Phase* .Capillary Phase 是為了避免 A-Phase太早 ,產生 CM未達mass內之 Images
![Page 12: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/12.jpg)
CTA,Low Limb
• 20’Jelco,On Elbow
• 100-120ml Contrast Agent,Rate:3-3.5ml/s
• ROI at L5 Level Aorta
• Threshold:100-120H.U
![Page 13: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/13.jpg)
![Page 14: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/14.jpg)
ROI at L5 Aorta
![Page 15: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/15.jpg)
![Page 16: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/16.jpg)
右側的動脈比左側的動脈相對明顯
![Page 17: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/17.jpg)
![Page 18: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/18.jpg)
Coronal View
![Page 19: HD(Hemodialysis ) 案例之 Abdomen 做法](https://reader033.fdocument.pub/reader033/viewer/2022061607/568131de550346895d9844a5/html5/thumbnails/19.jpg)
3D Display
比較清楚發現左側小腿有明顯 Occlusion