응급실에서 접하는 의학적 영상 Chest Radiograph (Plain) Brain CT 건국대학교 충주병원 영상의학과

Presentation on theme: "응급실에서 접하는 의학적 영상 Chest Radiograph (Plain) Brain CT 건국대학교 충주병원 영상의학과"— Presentation transcript:

1 응급실에서 접하는 의학적 영상 Chest Radiograph (Plain) Brain CT 건국대학교 충주병원 영상의학과
응급실에서 접하는 의학적 영상 Chest Radiograph (Plain) Brain CT 건국대학교 충주병원 영상의학과 최 영 칠

2 응급실에서 접하는 의학적 영상 I - Chest Radiograph

3 조직의 X선 감약도 . (이 순서대로 크다 – 사진상 희다) 1. Bone density; 골 2. Water density;
근육, 혈액, 삼출액, 흉수등 3. Fat density; 지방 4. Air density; 공기 .

4 흉부X선사진에서 볼 것 1. 기관지와 폐혈관을 포함하는 폐실질 종격동과 심장 및 대혈관 횡경막과 흉벽 및 흉곽의 골격

5 폐실질; 폐엽의 구분

6 정상 Chest PA and Lateral

7

8 Alveolar Dz. Airway Dz. Interstitial Dz. Vascular Dz. Neoplastic Dz
* Alveolar Dz * Airway Dz * Interstitial Dz * Vascular Dz * Neoplastic Dz * Mediastinal Dz * Pleural, Diaph. and Th. Wall Dz * Congenital Dz

9 Alveolar vs Interstitial lesion

10 Silhouette sign

11 Hematogeneous vs Lymphangitic Metastasis

12 Diffuse nodular lesion

13 Atelectasis

14 Pneumonia

15 Tuberculosis

16 Bronchiectasis

17 Lung cancer

18 Emphysema

19 Trauma

20 Diaphragmatic Hernia

21 Effusion

22 .

23 응급실에서 접하는 의학적 영상 II - Brain CT

24 정상 brain CT

25 정상 brain CT

26 * Stroke * Trauma * Tumor * Infection * Congenital Anomaly

27 I. Stroke; loss of a neurologic function secondary to parenchymal
A new, often acute, loss of a neurologic function secondary to parenchymal ischemia or hemorrhage.

28 A. Cerebral infarction Large vessel occlusions
Small vessel infarctions Cardiac emboli Blood disorders Vasculitis...

29 Vascular Territories

30 Hyperacute infarction (<12 hours, or within first few hours)
Normal (50% to 60%) Hyperdense artery sign Obscuration of lentiform nucleus

31 Acute Infarction (12 - 24 hours) Low density in basal ganglia
Loss of gray-white matter differentiation   (loss of insular ribbon, obscuration of cortex-white matter border) sulcal effacement

32 Acute Infarction (1 - 3 days) (4 - 7 days) Increasing mass effect
  Wedge-shaped low density involves both gray and white matter   Hemorrhagic transformation may occur (4 - 7 days)   Gyral enhancement   Mass effect, edema persists

33 B. Primary intracranial hemorrhage
Very common    Hypertension    Aneurysm    Vascular malformation    Prematurity

34 Location of Hypertensive Hemorrhage
  Putamen/external capsule      60% to 65%   Thalamus                      15% to 25%   Pons                               5% to 10%   Cerebellum                        2% to 5%   Subcortical white matter           1% to 2%

35 Imaging of ICH Acute Subacute Chronic

36 C. Nontraumatic SAH Aneurysm Vascular malformation

37 II. Trauma Traumatic Craniocerebral Lesions Skull & Scalp lesions
Extracerebral hemorrhage EDH SDH SAH Intraaxial lesions Diffuse axonal injury (shearing injury) Cortical contusion Deep cerebral gray matter and brainstem injury Intraventricular/choroid plexus hemorrhage

38 Skull fracture, Scalp hematoma/laceration

39 Cortical contusion

40 Epidural hematoma

41 Subdural hematoma Acute Subacute Chronic

42 Subarachnoid hemorrhage

43 Diffuse axonal injury (shearing injury)