Abdominal Ultrasound

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abdominal ultrasound

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  • ABDOMINALULTRASOUND

  • This edition of Abdominal Ultrasound-How, Why and When, Third edition by Jane Bates Mphil DMU DCR is published by arrangement with Elsevier Limited.

    Copyright 1999, 2004, 2011 by ELSEVIER Limited. All rights reserved.ISBN 13: 978-0-443-06919-2

    Authorized translation from English language edition published by the Proprietor.Copyright 2012 by Elsevier Taiwan LLC. All rights reserved.ISBN:

    No part of this publication may be reproduced or transmitted in any form or by any means, electronic or me-chanical, including photocopying, recording, or any information storage and retrieval system, without permis-sion in writing from the publisher. Details on how to seek permission, further information about the Publishers permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions .This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).

    http://www.elsevier.com/permis-sions

    Elsevier Taiwan LLCRm. N-412, 4F, Chia Hsin Building II, No. 96, Zhong Shan N. Road, Sec. 2, Taipei10449 TaiwanTel: 886-2-2522-5900Fax: 886-2-2522-1885

    First Published Jan. 2012Printed in Taiwan

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    2 ................................................................. 21

    3 .............................................................. 51

    4 ............................................... 99

    5 ................................................................................. 155

    6 .................................................... 175

    7 ...................................................................... 191

    8 ................................................. 243

    9 ............................................................... 267

    10 ............................................................... 297

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    ...................................................................... 333

  • 7

    Grant Baxter FRCRWestern Infirmary, Glasgow, UK

    Terry M Humphrey MHSC DMU DCR St. Jamess University Hospital, Leeds, UK

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    Leeds

    Jane Bates

    2010

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    APCDK (autosomal dominant polycystic

    disease of the kidney)

    AFP (alpha-fetoprotein)

    AI (acceleration index)

    AIDS (acquired immune deficiency syndrome)

    AIUM (American Institute for Ultrasound in

    Medicine)

    ALARA (as low as reasonably achieved)

    ALT (alanine amino-transferase)

    AML (angiomyoli-pomas)

    APKD ( ) (autosomal dominant (adult) polycystic kidney)

    ARPCDK (autosomal recessive polycystic

    disease of the kidney)

    AST (aspartate aminotransferase)

    AT (acceleration time)

    AV (arteriovenous)

    BCS BuddChiari (BuddChiari syndrome)

    CAPD (continuous ambulatory peritoneal

    dialysis)

    CBD (common bile duct)

    CD (common duct)

    CF (cystic fibrosis)

    CT (computed tomog-raphy)

    DIC (disseminated intravascular coagulation)

    DMSA (dimercaptosuc-cinic acid)

    DTPA (diethylene triaminepenta-acetic acid)

    EDF (end-diastolic flow)

    ERCP (endoscopic retrograde cholangiopancreatog-

    raphy)

    ESWL (extracorporeal shock wave lithotripsy)

    EUS (endoscopic

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    12

    ultrasound)

    FAST (focused assessment with sonography for

    trauma)

    FDA (Food and Drug Administration)

    FDG-PET [18F]([18F]2-fluoro-2-deoxy-d-glucose

    positron emission tomography)

    FPS (frames per second)

    HA (hepatic artery)

    HCC (hepatocellular carcinoma)

    HELLP (haemolytic anaemia, elevated liver enzymes and low

    platelet)

    HIDA (hepatic iminodiace-tic acid)

    HOP (head of pancreas)

    HPS (hypertrophic pyloric stenosis)

    HV (hepatic vein)

    INR (international normalized ratio)

    IOUS (intraoperative ultrasound)

    IVC (inferior vein cava)

    IVU (intravenous urogram)

    LFT (liver function test)

    LPV (left portal vein)

    LRV (left renal vein)

    LS (longitudinal section)

    LUQ (left upper quadrant)

    MCKD (multicystic dysplastic kidney)

    MHA (middle hepatic artery)

    MHV (middle hepatic vein)

    MI (mechanical index)

    MPV (main portal vein)

    MRA (magnetic resonance angiography)

    MRCP (magnetic resonance cholangiopancreatogra-

    phy)

    MRI (magnetic resonance imaging)

    MRV (main renal vein)

    ODS (output display standard)

    PAC (photographic archiving and communications)

    PACS (photographic archiving and communications

    systems)

    PBC (primary biliary cirrhosis)

    PCKD (polycystic kidney disease)

    PCS (pelvicalyceal system)

    PD (pancreatic duct)

    PI (pulsatility index)

    PID (pelvic inflammatory

  • 13

    disease)

    PRF (pulse repetition frequency)

    PSC (primary sclerosing cholangitis)

    PTLD (post-transplant lymphoproliferative

    disorder)

    PV (portal vein)

    RAS (renal artery stenosis)

    RCC (renal cell carcinoma)

    RF (radiofrequency)

    RHV (right hepatic vein)

    RI (resistance index)

    RIF (right iliac fossa)

    RK (right kidney)

    RPV (right portal vein)

    RRA (right renal vein)

    RUQ (right upper quadrant)

    RVT (renal vein thrombosis)

    SA (splenic artery)

    SLE (systemic lupus erythematosus)

    SMA (superior mesenteric artery)

    SV (splenic vein)

    TB (tuberculosis)

    TGC (time gain compen-sation)

    THI (tissue harmonic

    imaging)

    TI (thermal index)

    TIB (bone-at-focus index)

    TIC (cranial index)

    TIPSS (transjugular intrahepatic portosys-

    temic shunt)

    TIS (soft-tissue thermal index)

    TOP (tail of pancreas)

    TORCH (toxoplasmosis, rubella, cytomegalovirus and HIV)

    TS (transverse section)

    UTI (urinary tract infection)

    VHL (von HippelLindau disease)

    VUJ (vesicouretic junction)

    WRMSD (work-related musculoskeletal disorders)

    XGP (xantho-granulomatous pyelonephritis)

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    12 13 13 13 14 14

    14 15 15 15 16

    ( ) 16 16 17 17 17 18 18 18

    19

    1

  • 1

    2

    1. 2.

    ( )3.

    4.

    ( )

    ( ) ( )

    ( 1.1)

  • 3

    ( 1.1) ( 1.2)

    ( 1.3)

    ( 1.4)

    ( 1.5) 1

    ( 1.6)

    ( )( 1.7) (power Doppler)

    ( 1.8)

    1.1

    1.

    2.

    3.

    4. 5.

    6.

  • 1

    4

    A B

    DC

    1.1(A) 2.7 (MHz)(B) 5.1 MHz

    (C) 5.0 MHz(D) 7.5 MHz

    (C)

    ( B)

    A B

    1.2(A) 76 (FPS)(B)36 FPS

  • 5

    C D

    1.2 ( )(C)(D)

    A B

    DC

    1.3(A)(B)(C)

    ( )(D) ( )

  • 1

    6

    BA

    1.4(A)(B)

    1.5

  • 7

    B

    A

    1.6(A)(B) ( )

  • 1

    8

    B

    A

    1.7

  • 9

    (IVC) (pulsed Doppler)

    ( 1.9)

    ( 1.10)

    1.8

    BA

    1.9(A)(B)

    (

    )

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    10

    ( 1.2) 0 ( ) (PRF)

    PRF ( 1.10)

    AiiAi

    B

    1.10(Ai) 90(Aii)(B)PRF

    PRF (RPV)

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    ( ) ( )1,2

    CiiCi

    1.10 ( )(Ci) PRF(Cii) PRF

    1.2

    1. < 60

    2. ( )

    3. 4. PRF PRF

    ( )

    5. ( )

    6.

    7.

    8.

    9.

  • 1

    12

    3

    4

    ( ) 5

    6

    ( )

    ( ) ( )

    ( 1.11)

  • 13

    3.5 6 MHz 7 10 MHz

    ( )

    (TGC)

    ( ) (WRMSDs)7

    1.11 ( )5 7.5 MHz ( )

  • 1

    14

    ( )

    8

    9 (

    PACS)

  • 15

    10

    (European Federation for Ultrasound in Medicine and Biology; EFSUMB) 11 (European Commit-tee for Ultrasound Radiation Safety; ECURS)

    (World Federa-tion for Ultrasound in Medicine and Biology;

    WFUMB) B 12

    13,14 ( )

    B (American Institute for Ultrasound in Medicine; AIUM) 100 Wcm-2 15 (ISPTA)

    B FDA( ) 16

  • 1

    16

    5 B

    PRF

    ( )

    1998(ODS) (MI)

    (TI)

    (TIS) (TIB)(TIC) 17

    TIMI TI

    10

  • 17

    WRMSDs 7WRMSDs

    X ALARA ALARA(1.3)

    ( 1.4)13

    19

    1.3

    1.

    2. ( )

    3. 4. 5.

    6.

    7.

  • 1

    18

    ( ) ( ) 20 Bolam (Bolam test)

    3 ( )

    ( )

    ( ) ( )

    1.4 (Meire18)

    1.

    2.

    3. 4. 5. 6. 7.

    8.

  • 19

    ( 1.12)

    (Slice)

    ( )

    1. Desser TS, Jedrzejewicz MS, Bradley C. Native

    tissue harmonic imaging: basic principles and clinical applications. Ultrasound Q 2000; 16: 4048

    2. Choudhry S, Gorman B, Charboneau JW et al. Com-parison of tissue harmonic imaging with conventional US in abdominal disease. Radiographics 2000; 20: 11271135

    3. Kim SH, Lee JM, Kim KG et al. Comparison of fundamental sonography, tissue-harmonic sonogra-phy, fundamental compound sonography, and tissue-harmonic compound sonography for focal hepatic lesions. Eur Radiol 2006; 16: 24442453

    4. Elliott S. A user guide to compound imaging.

    A B

    1.12(A)(B)

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    Ultrasound 2005; 13: 1121175. Elliott ST. Volume ultrasound: the next big thing? Br

    J Radiol 2008; 81: 896