Kodi kupangika kwa hypoechoic n'koopsa?

Kupanga kwa hypoechoic m'thupi linalake, mosiyana ndi hyperechoic, kumachitika chifukwa cha kuchepa kwa minofu - poyerekeza ndi magawo a kupindika kwa ziwalo za thupi. Ndiye kuti, gawo ili limafooketsa chizindikiro cha akupanga cholowera pamenepo (m'magawo pafupipafupi a 2-5, 5-10 kapena 10-15 MHz). Ndipo uwu ndi umboni kuti kapangidwe kameneka - kuchokera pomwe lingaliro lakapangidwe ake - imakhala ndi madzi kapena ali ndi mawonekedwe.

Mapangidwe a Hypoechoic pazenera amawoneka mwanjira ya imvi, imvi yakuda komanso pafupifupi madera akuda (okhala ndi malo okhala ndi zopepuka, nthawi zambiri amakhala oyera). Kutsitsa chithunzi cha ultrasound, pali magawo asanu ndi limodzi amtundu wa imvi Gray Scale Imaging, pomwe pixel iliyonse ya chithunzi yomwe imapezeka pazowunikira ma hypoechoic - kutengera mphamvu ya chizindikiro cha ultrasound kubwerera ku masensa - imayimira mthunzi wina wa imvi.

Olimbikitsidwa ndi ma diagnostologists a ultrasound (sonographs), zotsatira za mayeso a ultrasound amaphunziridwa ndi madokotala a mbiri yapadera (endocrinologist, gastroenterologist, urologist, nephrologist, oncologist, etc.), poyerekeza ndi magawo a mayeso operekedwa ndi odwala komanso zotsatira za maphunziro ena.

Nthawi zambiri, kuwunika kusiyanasiyana kumafunikira, komwe, kuphatikiza ndi ultrasound, njira zina zamagetsi zoganizira zam'maganizo (angiography, color Doppler, CT, MRI, etc.) zimagwiritsidwanso ntchito, ndipo kuwunika kwa zitsanzo za biopsy kumachitidwanso.

Matenda a kapamba ndi ultrasound (nkhani pa Diagnostic) - Diagnostic

Dinani pazithunzi kuti mukulitse.

Cysts imodzi yaying'ono yosavuta imapezeka ngati yapezeka mwachangu mu kapamba wabwino. Mu chifuwa chachikulu, ma cysts ang'onoang'ono ndizofala kwambiri. Ngati mukukayikira cyst, yang'anani kukuzika kwa contour ya khoma lakutali ndi momwe kukwezedwa kwa chizindikirocho kumankhwala kumbuyoku. Ma cysts osavuta amasiyanitsidwa kuchokera parenchyma yokhala ndi khoma losalala. Mkati simuyenera kukhala magawano kapena zosakhazikika kukhoma, zomwe zili mu cyst ndizowonekera. Ma cysts osavuta nthawi zonse amakhala ovomerezeka. Koma, ngati ma cyst siwodziwikiratu "osavuta," kufufuza kwina kumafunikira.

Chithunzi Losavuta pancreatic cysts pa ultrasound. A, B - Cysts imodzi yosavuta m'dera la thupi (A) ndi khosi (B) la kapamba ndi khoma losalala losalala komanso zolembedwa za anechogenic. B - Zizindikiro zakale za kapamba: the pancreatic duct is dilated to the background of parenchyma atrophy, the contour of the gland is unree and serrations, calcication in the parenchyma and cysts yaying'ono.

Ndikofunikira. Nthawi zambiri pamakhala ma pancreatic cysts osavuta, koma musaiwale za zotupa za cystic. Khansa ndi matenda oopsa kwambiri a kapamba.

Pali mitundu iwiri ya zotupa za cystic za kapamba: benign microcystic adenoma ndi zilonda zazikulu za adenoma. Microcystic adenoma imakhala ndi cysts zambiri zazing'ono ndipo pa ultrasound imawoneka ngati mapangidwe opindika. Macrocystic adenoma, monga lamulo, imaphatikizapo ma cysts ochepera asanu mm 20. Nthawi zina mu ma cysts, mawonekedwe a polypoid amatha kuwoneka.

Chithunzi A, B - Benign microcystic pancreatic adenoma: misa yayikulu ya cystic pamutu wa kapamba. B - Adenoma wa kapamba wokhala ndi mbali yayikulu kwambiri ndi yaying'ono.

Ndi kapamba, katulutsidwe wa kapamba limayamwa minofu yoyandikana ndi ma pseudocysts. Ma pseudocysts ochokera pamimba amatha kudutsa pachifuwa ndi Mediastinum. Ma pseudocysts nthawi zambiri amapezeka mwa odwala pambuyo pancreatitis ya pachimake (onani pansipa).

Chifukwa cha kufalikira kodziwika kwa kapamba wa pancreatic dal komwe kumatsekeredwa, pseudocysts posunga amatha kupanga.

Pachimake kapamba pa ultrasound

Acute pancreatitis ndi vuto lalikulu la matenda a gallstone kapena zotsatira za poizoni, monga mowa.

Manc pancreatitis sikuwoneka pa ultrasound (CT ndi njira yovutikira kwambiri). Pancreatitis yayikulu imapezeka mosavuta ndi ultrasound. Ngati kapamba womveka bwino komanso wosiyanitsa pakati pa minyewa yoyandikira, munthu amatha kuganiza kutupira kwa m'mimba ndi minyewa yoyandikana nayo. Ngati tinthu tating'onoting'ono tambiri tomwe timayang'ana kuzungulira kapamba, m'mimba, m'mzipata za chiwindi ndi ndulu, kapamba angadziwe kuti ali ndi vuto.

Chithunzi Pachimake pancreatitis pa ultrasound: A - Kutupa kwa pancreatic parenchyma (p), kutsutsana kwa mapiko ndi kumveka bwino, kupendekera pang'ono kwa madzimadzi m'malire (mivi). B, C - Kudzikundikira kwa madzi m'mbali mwa thupi la kapamba, mkombero wowonda kwambiri m'mphepete mwa mitsempha ya splenic (mivi), parenchyma ndi yotopetsa, minofu yoyandikana nayo ndi hyperechoic - edema ndi kutupa, chotupa chofala cha bile duct (C) chikukulitsidwa. Pankhaniyi, matenda a gallstone sayenera kupatula.

Pafupifupi zotupa zonse za pancreatic ndi hypoechoic poyerekeza ndi kapamba wamba. Ultrasound yokha siyingasiyanitse okhazikika pancreatitis ndi chotupa cha pancreatic. Tumor ndi kapamba zimatha kuphatikizidwa.

Chithunzi Acute pancreatitis pa ultrasound: Zikondamoyozi zimasiyanitsidwa mosiyanasiyana motsutsana ndi maziko azinthu zozungulira za hyperechoic, mzere woonda wamafuta m'mphepete mwa contour (A), chidwi cha hypoechoic mchira (B), ndi madzimadzi pachipata cha ndulu (C). Mchira wa Hypoechoic ukhoza kulakwitsa chifukwa chotupa.

Milandu yayikulu ya kapamba, chifinyezi cha m'mimba chimayala minofu yoyandikana nayo, ndikupanga pseudocysts. Cysts zotere zimatha kukhala chimodzi kapena zingapo. Amatha kukula komanso kuphulika.

Pa ultrasound, ma pseudocysts amatanthauzidwa ngati mawonekedwe ozungulira kapena ozungulira a hypoechoic omwe amapangidwa momveka bwino. M'migawo yoyambirira ya mapangidwe a cyst, ndimapangidwe apakati amadzi ndipo ali ndi mawonekedwe ovuta okhala ndi mawonekedwe amkati ndi mawonekedwe opyapyala. Pambuyo pake, chifukwa cha njira zakudziyimira pawokha komanso kufotokozera kwa zinthu zomwe zayimitsidwa kuchokera m'magazi ndi mafinya, Zizindikiro zomveka zamadzimadzi zimatuluka ndi kapisozi wabodza wokhala ndi mafupa. Nthawi zambiri pamakhala kachilombo ka pseudocyst, ndiye kuti kafotokozedwe kamkati kapena kagawo kakang'ono kokhazikika kamatha kutsimikizika. Ngati ma cyst apezeka, ndikofunikira kufufuza kulumikizana kwa cyst ndi duct, chifukwa izi ndizofunikira kudziwa njira zamankhwala. Pamene pseudocyst ndi yokulirapo kuposa 10 cm, zovuta zimayamba kudziwa komwe zimachokera.

Chithunzi A - Pseudocyst wamkulu pakati pamutu wa kapamba ndi chiwindi atadwala kapamba. B, C - Gawo lalikulu la lecotic pancreatitis longitudinal (B) ndi magawo (C): kuchuluka kwa necrosis, kusungunuka kwamafuta ozungulira m'chigawo cha mchira, kudzikundikira kwa madzimadzi mozungulira gland.

Matenda a kapamba pa ultrasound

Matenda apansi a pancreatitis amatha kuwonetseredwa, kuchokera ku chinyezi chachilendo mpaka kukafika patali kwambiri komanso kupweteka kwa parenchyma. Zikondazo zimayamba kucheperachepera, chimbudzi cha pancreatic nthawi zina chimawoneka kuti chikukulira, kutsutsana kwa gland nthawi zambiri kumakhala kosagwirizana ndi notches. Ma cysts osavuta ndiofala, ndipo amatha kukhala akulu kwambiri. Nthawi zambiri, miyala imakhala mu pancreatic duct.

Kuwerengera kwapancreatic mu scan ya ultrasound

Ndikofunikira. Ngati pali kuchepa kwa pancreatic duct, muyenera kuyang'ana miyala mu pancreatic duct ndi wamba duct.

Zowunikira mkati mwa kapamba zimatha kutulutsa mthunzi wamtundu, koma ngati ndizochepa kukula, zimawoneka ngati mawonekedwe owala owoneka popanda mthunzi. Mu chifuwa chachikulu, mawerengeredwe amagawidwa mosiyanasiyana mu kapamba. Miyala mu duct ili pafupi ndi duct. Ma gallst mu distal choledoch amatha kulakwitsa pakuwunika mu kapamba. Zowunikira zikuwoneka bwino pa CT, komanso kwa miyala yosadziwika, makamaka MRI kapena ultrasound.

Chithunzi A - Mu duct yokulitsidwa, mwala wawung'ono. B - Mu dengu lokwakulitsidwa pancreatic, mzere wa miyala ingapo yokhala ndi shading kumbuyo. B - Wodwala wokhala ndi pancreatitis yayitali ali ndi miyala yayikulu mu duct yokulitsidwa. Onani kugwedeza kwakukulu kumbuyo.

Chithunzi A, B - Kuwerengeredwa kwa kapamba ka pancreatic odwala omwe ali ndi chifuwa chachikulu. Zolemba zina zimakhala ndi mthunzi. B - Mnyamata wazaka 5 zokhala ndi chibadwa chaphokoso: ma calcication (mivi yaying'ono) ndikufinya kwa pancreatic duct (muvi waukulu). C - kuphatikizidwa kwa mitsempha yapamwamba ya mesenteric ndi splenic.

Anakulitsa pancreatic duct ndi ultrasound

Kukula kwamkati mwa pancreatic duct kochepa kuposa 3 mm. Kupendekera kumawonekera bwino ndikuwunika ndikusuntha pakati penipeni pa kapamba. Kuti muwonetsetse kuti mwazindikira densi, muyenera kuwona minyewa ya mbali zonse ziwiri. Msempha wa splenic kumbuyo kapena khomalo lam'mimba kumbuyo lingatanthauzidwe zabodza kuti pancreatic duct.

Makoma a pancreatic duct ayenera kukhala osalala komanso lumen bwino. Densi likapukutidwa, makhoma amakhala osagwirizana, samangoyang'ana mutu wa kapamba, komanso thirakiti lonse la biliary.

Zomwe zimayambira kukulira kwa kapamba wa kapamba: chotupa m'mutu wa kapamba kapena ampulla wam'mimba wa Vater (kuphatikiza jaundice ndi dilatation ya thirakiti la biliary), miyala yodziwika bwino ya bile duct kapena pancreatic duct, pancreatitis aakulu.

Chithunzi Mwamuna yemwe amadwala matenda a shuga amayamba kudandaula kuti amachepetsa thupi komanso kupweteka kwam'mimba kwa miyezi ingapo. Pa ultrasound, kufalikira kofalikira kwa kapamba wokhala ndi khoma losagwirizana. Mukapendanso, ma calcifying amawoneka bwino mumsuziwo ali ndi mthunzi kumbuyo (B).

Chithunzi Wodwala ndi pancreatitis pachimake: pamlingo wa mchira, pseudocyst yayikulu idapangidwa (onani pamwambapa), duct yowonjezera pancreatic imatsegukira mu pseudocyst.

Pancreatic chotupa pa ultrasound

Mwambiri (50-80%), chotupa chimakhudza mutu wa kapamba. Mankhwala omata akumeta amafinya wamba bile duct. Mu khansa, contour ya kapamba ndiwofinya, wodziwika ndi kukulira kapena kutulutsa kwa tiziwalo, nthawi zina kamatulutsa ulusi wozungulira ngati malilime kapena pseudopodia.

Nthawi zambiri, chotupa cha pancreatic ndi hypoechoic misa, pafupifupi yopanda tanthauzo lamkati. Komabe, pali zotupa zokhala ndi ma sign ofala obalalika ndipo ndimayikidwe apamwamba kwambiri pakatikati pomwe palibe. Ngakhale kuti malire pakati pa chotupa ndi mafunde ena onse a chimbudzi ndiwofatsa, akhoza kumakokedwa pafupifupi chifukwa chosiyana minyewa yachilengedwe komanso chotupa.

Ngakhale hypoechoic kapangidwe ka chotupa, makamaka pakalibe malo ochepa owonjezera kachulukidwe mkati mwake, amafanana ndi a cysts, kusowa kwa mphamvu ya distal kupititsa kumapangitsa madzi kumapangidwe. Kwa ma cysts, kuphatikiza, malire omveka bwino komanso omveka ali ndi chikhalidwe.

Chithunzi Pancreatic head carcinoma (muvi): wamba bile duct (A) ndi pancreatic duct (B) amamuchepetsa, hypoechoic chotupa chozungulira chotupa chachikulu cha mesenteric (B).

Ndi zotupa za mutu wa kapamba, bile duct yodziwika bwino komanso kapamba wa pancreatic nthawi zambiri imachepetsedwa, mosiyana ndi chifuwa chachikulu, makoma ake amakhala osagwirizana.

Ndikofunikira. Kuwona kwakukulu kwa pancreatic duct mkati mwa hypoechoic zone ndi umboni wa edema yakwanuko komanso motsutsana chotupacho.

Nthawi zina khansa ya pancreatic imawulula nthawi yayitali zizindikiro za chifuwa cham'mimba, komanso ma pseudocysts omwe amakhala mbali ya zotupa. Izi ndi zotsatira za zolepheretsa. Ma metraases a intrahepatic, celiac opitilira patsogolo, zotumphukira ndi zotumphukira za m'mimba zimachitira umboni mokomera khansa.

Chithunzi Pancreatic carcinoma ya mutu: contour ya mutu ndi yosasinthika chifukwa volumetric hypoechoic mapangidwe, thupi parenchyma limachepa kwambiri (atrophy), kapamba (A) ndi ma ducts wamba a bile amakulitsidwa, ndipo khosi lalikulu la lymph node (C) pachipata cha chiwindi.

Chithunzi Muvi waukulu wamitsempha pafupi ndi kapamba ukhoza kulakwitsa chifukwa chotupa chamutu. Zolemba zazikulu za mesenteric lymph za mawonekedwe ozungulika, a hypoechoic komanso opanda chilonda chapakati, chomwe chikuwonetsa kuti ali ndi vuto.

Chithunzi Chotupa chachikulu cha neuroendocrine (mivi) ya kapamba wokhala ndi mawonekedwe ndi mawonekedwe a metastases mu chiwindi (B).

Dzisamireni, Diagnostic Yanu!

Zosiyanasiyana zama hyperechoic inclusions mu kapamba ndi kufunikira kwake

29.06.2017

Nthawi zambiri, pakufotokozera koyeserera kwa maphunzirowa a chifuwa cham'mimba, odwala ambiri amatha kuwerengetsa kuti pali ma hyperechoic inclusions mu kapamba. Kukhalapo kwa chizindikiro chotere kungasonyeze kukula kwa vuto lalikulu la pathological mu chiwalo chomwe chikufufuzidwa. Pawunikaku, tikambirana mwatsatanetsatane: kodi ma hyperechoic inclusions ndi mitundu yanji yomwe ilipo.

Kupanga kwa hypoechoic

Mapangidwe a Hypoechoic ndi kupangika kwina kulikonse m'chiwalo chilichonse ndipo kumakhala ndi echogenicity pansi pazoyenera. Webusayiti yoteroyo imafooketsa ma ray omwe akupanga. Wowunikira ndi wakuda kuposa madera ena.

Mapangidwe ndi hypoechoicity mumakhala madzi kapena patsekeke. Pa polojekiti, malowa amawoneka amvi kapena akuda. Ndi hyperechoicity, magawo ndi opepuka kapena ngakhale oyera kwathunthu.

Kujambula chithunzicho, sikelo yapadera yokhala ndi magulu 6 amimvi amagwiritsidwa ntchito. Kuzindikira kumapangidwa ndi madokotala omwe ali ndi chidwi kwambiri. Nthawi zambiri ma hypoechoic amapanga ma cysts. Pankhaniyi, wodwalayo amawonjezeranso kupweteka kwa biopsy.

Mutha kubisa chithunzicho pogwiritsa ntchito mawonekedwe apadera

Zomwe zimayambitsa hypoechogenicity

Mapangidwe ake akhoza kukhala ndi kutulutsa kulikonse. Mafomuwo amakhalanso osiyanasiyana omwe amayambitsa chitukuko ndi zizindikiro.

Zomwe zimayambitsa hypoechogenicity kutengera momwe mapangidwewo adalembedwera m'ndandanda.

Pazifukwa zonsezi, kuyezetsa magazi pa intaneti kudzawonetsa kuperewera kwapafupipafupi ndi kuchepa kwa mphamvu ya kuchuluka kwa zinthu. Sikuti nthawi zonse kuphwanya komwe kumafunikira chithandizo chamankhwala chapadera.

Mitundu yofananira imatha kupezeka mu ziwalo zosiyanasiyana.

Malo osintha

Chithunzi cha chipatala ndi kuzindikira kwakukuru kwatengera kutengera maphunziro ndi chisonyezo chotsika.Kusintha kwathanzi kungakhudze:

• chithokomiro
• chiberekero
• zofunikira mammary
• ndulu
• thumba losunga mazira
• impso
• kapamba
• chiwindi.

Hypoechogenicity sikuti ndikuzindikira, koma zotsatira zakuwunika. Ndiye chifukwa chake ndi tsamba lokhala ndi kachulukidwe kakang'ono, simuyenera kudandaula pasadakhale.

Ngati njira ya pathological yakhudza chithokomiro cha chithokomiro, ndiye kuti kupezeka kwa ma cysts ndi ma fupa amatha kukayikiridwa. Khansa imapezeka mwa odwala 5 okha mwa 100. Kapangidwe kamene kamasinthidwa ka chiberekero kumawonetsa kutupa, kuwonongeka kwa khungu, kapena kulakwika. Nthawi zambiri chizindikiro chimawonetsa kupendekera kwachilendo kapena kovulaza.

Hypoechoogenicity mu tiziwalo tosiyanasiyana tingaonetse ma pathologies osiyanasiyana

Nthawi zambiri, hypoechoicity imawonedwa ndendende m'matumbo a mammary. Zizindikiro zikuwonetsa:

• khansa
• adenosis
• kukhalapo kwa mawonekedwe a cystic.

Mu impso, malo ochepa amakhala ngati khansa kapena mawonekedwe a cystic. Ndi chotupa choyipa, malire a hypoechoicity amachotsedwa, ndipo kapangidwe kake sikofanana. Kuphatikiza apo, biopsy ikhoza kulimbikitsidwa kwa wodwala.

Zosintha kapamba mwina chifukwa cha:

Hypoechoicity imatha kudziwonetsera kwathunthu mkati mwa munthu aliyense wamkati. Zina mwazomwe zimayambitsa zimafunikira chithandizo chamankhwala kapena opaleshoni yofulumira. Kunyalanyaza kusankha kwa dokotala kuli koletsedwa. Choyambirira, ndikofunikira kupatula kuti mwina khansa ilipo.

Mitundu imodzimodziyo imatha kuwonetsa khansa ndipo imawonedwa m'malo osiyanasiyana.

Nthawi zina, hypoechoicity siyipangitsa vuto lililonse ndipo sizipangitsa kuti pakhale zizindikiro zosalimbikitsa. Kuchepa kocheperako kumapezeka mwangozi.

Chithunzi cha kuchipatala

Chithunzi cha chipatala ndi chosiyana kutengera zomwe zimayambitsa ndikusinthidwa kwachotengera. Zizindikiro zazikulu zowopsa zikuphatikiza:

• kuyesa kumeza ndi kudya chakudya,
• kupuma movutikira,
• kupindika pakhosi
• kumva kopweteka ndi kusapeza bwino pa malo a hypoechoicity,
• kugwedezeka ndi kuwunda kwa mawu
• kuchepa kopanda mphamvu kapena kuchuluka kwa thupi,
• Kugwiritsa ntchito bwino dongosolo la chimbudzi,
• kugona kwanthawi zonse komanso kumva kuti watopa,
• kusintha kwadzidzidzi,
• kusintha kwa kutentha kwa thupi
• tsitsi likutha,
• fragility ya msomali mbale.

Odwala nthawi zambiri amadandaula za kugona komanso kutopa.

Zizindikiro zonse ndizofala. Wodwala amatha kukhala ndi zizindikiro zingapo, kapena zonse nthawi imodzi. Zonse zimatengera chomwe chinapangitsa kuchepa kwa kupsinjika.

Pamaso pa matenda akuluakulu, thanzi la wodwalayo limayamba kuchepa. Tsiku lililonse munthu amakhala ndi mphamvu zochepa komanso zochepa. Zochita mtsogolo zimakhala mayeso enieni. Khungu limakhala louma.

Pali zizindikiro za kuledzera kwathunthu kwa thupi. Mkangano ungachitike popanda chifukwa chodziwika bwino. Kuopsa kwambiri.

Njira zopezera matenda

Njira yokhayo yodziwira dera la hypoechoic ndikugwiritsa ntchito ma diagnostics a ultrasound. Pankhaniyi, kuyesedwa kumachitika ndi zida zapadera zomwe zimatulutsa mafunde omwe akupanga.

Ultrasound - njirayi yopweteka komanso yotetezeka kwathunthu

Pokhudzana ndi ziwalo zamkati, mafunde akupanga amawonetsedwa ndikubwerera. Chifukwa cha izi, zonse zomwe zimachitika zimawonetsedwa pa polojekiti. M'tsogolomu, adokotala amatsutsa zotsatira zake.

Ultrasound imakhala yopanda vuto kaya ndi zaka zingati wodwala. Njirayi itha kugwiritsidwa ntchito pa nthawi yoyembekezera komanso yoyamwitsa. Njira sifunikira kukonzekera mwapadera. Chosiyana ndi chamimba cham'mimba. Pankhaniyi, nthawi zina muyenera kudzaza chikhodzodzo kapena kutsatira zakudya.

Pamaso pa ultrasound, gel yamu lamaso imayikidwa kumalo oyeserera. Chidacho chimathandizira kutsetsereka bwino. Sizimasokoneza ma visualization ndipo sizimayambitsa mavuto.

Pambuyo pakuzindikira, muyenera kuchotsa ma gel otsala. Izi zitha kuchitika ndi zopukuta zowuma. Dotolo amawerengera zomwe zikuwonetsa ndikutsimikizira kapena kukana mwayi wokhala ndi ma hypoechoic zimakhala.

Kuchokera kanemayu mutha kudziwa zambiri zam'mimba zotupa zomwe zimayambitsa matenda a m'mimba:

Njira zochizira

Chithandizo chimasankhidwa ndi dokotala. Nthawi zina sipafunikanso chithandizo. Kutengera ndi matendawo, wodwalayo angalangizidwe:

• vitamini mankhwala
• physiotherapy
• wowerengeka azitsamba
• mankhwalawa
• opaleshoni kuchitapo kanthu
• kumwa mankhwala.

Palibe chithandizo chimodzi chamankhwala. Njira yodzipatsira yokha imatsutsana, chifukwa hypoechoicity imatha kupangitsa zinthu zingapo zoyambitsa.

Zowopsa

Choyambitsa chachikulu kwambiri cha hypoechogenicity ndi neoplasm yoyipa. Zotupa zina sizingatheke. Mkhalidwe wa wodwalayo ukuipiraipira mosalekeza. Kulemera kwa thupi kumachepa kwambiri, ndipo chilakolako cha thupi chimatha.

Khansa ndi matenda oopsa, popanda chithandizo nthawi zonse imabweretsa imfa.

Ndi khansa, kugwira ntchito kwa thupi lonse kumasokonezeka. Ngati sanachiritsidwe, wodwalayo amatha kufa mwadzidzidzi. Tsiku lililonse lidzayamba ndi kuzunza kosalephera.

Pofuna kupewa zovuta zazikulu, kufufuza kwa prophylactic kumathandizidwa. Ultrasound iyenera kuchitidwa chaka chilichonse.

Ndichite chiyani ngati ndili ndi funso lofananalo koma losiyana?

Ngati simunapeze zofunikira zomwe mukufuna mu mayankho a funso ili, kapena ngati vuto lanu ndi losiyana pang'ono ndi lomwe laperekedwa, yesani kufunsa dokotala funso lina patsamba lomwelo ngati ali pa mutu wa funso lalikulu. Mutha kufunsanso funso latsopano, ndipo patapita kanthawi madotolo athu ayankha. Ndi ufulu. Mutha kusanthula zidziwitso zofananira pankhaniyi patsamba lino kapena patsamba losaka. Tidzakhala othokoza kwambiri mutatipangira kwa anzanu pamasamba ochezera.

Medportal 03online.com imapereka zokambirana zachipatala mu kulumikizana ndi madokotala pamalowa. Apa mukupeza mayankho kuchokera kwa akatswiri enieni m'munda wanu. Pakadali pano malowa akupereka malangizo mmalo 48: a allergist, anesthetist-resuscitator, venereologist, gastroenterologist, hematologist, geneticist, gynecologist, homeopath, dermatologist, Dokotala wazachipatala, dokotala wazachipatala, dokotala wothandiza , katswiri wa matenda opatsirana, katswiri wamtima, katswiri wazodzikongoletsa, katswiri wazamalankhulidwe, katswiri wa zamankhwala, wazamalamulo wamankhwala, wamisala, wamisala, wamisala, wazachipatala, wazachipatala a, dotolo, opaleshoni ya pulasitiki, proctologist, psychologist, pulmonologist, rheumatologist, radiologist, sexologist andrologist, mano, urologist, pharmacist, herbalist, phlebologist, opaleshoni, endocrinologist.

Timayankha mafunso 96.27%..

Lingaliro la hyperecho

Kwa zaka zambiri, osagwirizana pancreatitis?

Katswiri wamkulu wa gastroenterologist wa ku Russia Federation: "Mudzadabwa momwe zimavutira kuthana ndi kapamba.

Kutanthauzira koteroko monga kuchuluka kwa ziwalo zamkati kumagwiritsidwa ntchito pokhapokha pa maphunziro a ultrasound ndipo zimawonetsa kuchuluka kwa komwe ziwalo zomwe zikufufuzidwa zimatha kuwonetsera mawonekedwe omwe akupangidwira kudzera mwa sensor yapadera ya zida za ultrasound.

Chiwalo chilichonse chimakhala ndi chizolowezi chake pachizindikiro ichi, kutengera ndi msinkhu wake. Mu ziwalo zokhala ndi kachulukidwe kakang'ono, kuchuluka kwa echogenicity kumakhala kokwezeka kuposa ziwalo zomwe zili ndi mawonekedwe omasuka.

Kuwonjezeka kwa kuchuluka kwa kuphatikizika kwa kapamba kumawonetsa kuchuluka kwa minyewa ya fibrous komanso kukula kwa hyperechoicity.

Panthawi yopanga hyperechoogenicity mu kapamba, mitundu iyi ya hyperechoic inclusions imatha kuwonedwa:

1. Mfundo zazikuluzikulu za hyperechoic inclusions, zomwe ndi zowerengera. Monga mukudziwa, mphamvu ya kapamba ndikupanga ma enzymes apadera, gawo laling'ono lomwe limatha kuchepetsedwa pazitseko zazing'onoting'ono. Popita nthawi, pazikhala izi, mchere wa calcium umayamba kuyikiridwa, zomwe zimapangitsa kuti pakhale calculi, kapena kuwerengera. Mwa anthu nthawi zambiri amatchedwa timiyala ting'onoting'ono, tomwe mkati mwawo simomwe timakhala pachiwopsezo chachikulu. Ngati kutha kwa kuyesa kwa ultrasound kukuwonetsa kuti parenchyma ili ndi gawo lokwanira la echogenicity, ndiye kuti tikulankhula za kukhazikika kwa njira yotupa yotupa, yotchedwa pancreatitis aakulu.
2. Hyperachogenic liniya inclusions, omwe sakhala chizindikiro chatsatanetsatane wa njira yodutsira, yomwe ndi kukhalapo kwa minofu yowonda, nthawi zambiri, mapangidwe a foci m'malo mwa minofu yathanzi.

Kukhalapo kwa hyperechoic inclusions kungadziwike ndi chitukuko cha zotsatirazi matenda a pathological:

• pancreatic lipomatous lesion, yomwe ndi gawo lochotsa minofu ya glandular ndi mafuta, momwe mulibe kuchuluka kwa chiwalochi kukula kwake,
• chitukuko cha pachimake kapamba, limodzi ndi kupezeka kwa edema, kuwonetsedwa ndi kupweteka m'mimba, kusanza ndi kukula kwa m'mimba.
• kupezeka kwa zotupa ngati ma neoplasms, limodzi ndi kutsekeka kwa khungu, kuchepa kwambiri kwa thupi, kusowetsa chimbudzi komanso kuchepa kwa chakudya,
• Kukula kwa kapamba ka necosis, komwe amadziwika ndi kufa kwa minyewa ya ma cell a parenchymal pa cellular level, kuwonetseredwa ndi kuwoneka kwa kupweteka kosaletseka pamimba, komwe kumatha kudzutsa kupweteketsa mtima, komanso njira yosasinthika yotulutsira masanzi ndi m'mimba.
• pancreatic fibrosis, yodziwika ndi kuchuluka kwa minofu yolumikizana.

Kupezeka kwa hyperechoogenicity mu chiwalo chophunziridwachi kungakhale kwakanthawi kochepa, kuwonekera pazochitika zotsatirazi:

• motsutsana ndi chitukuko cha matenda opatsirana am'mimba opumira, monga chimfine, chibayo, kapena amodzi mwa matenda ambiri opatsirana.
• nditasintha zakudya,
• Kusintha kowopsa m'moyo,
• Mukamayendetsa ndi ultrasound mukatha kudya chakudya cham'mawa chotsimikizika, kapena nkhomaliro.

Zikatero, kuchuluka kwa kufalikira kumawonjezeka mpaka kukula, pomwe hyperechoogenicity yokhala ndi vuto la pathological imakhala ndi zotsatira zapamwamba.

Zosiyanasiyana zama hyperechoic inclusions

Hyperachogenic inclusions mu gulu la parenchymal pansi pa kafukufuku atha kukhala:

• pseudocyst, womwe ndi mapangidwe amadzimadzi omwe amapezeka pambuyo poti mawonekedwe a pancreatic lesion a gland atachotsedwa, amadziwika ndi kupangidwe kwa contour yosasinthika komanso serated,
• monga tafotokozera pamwambapa, awa atha kukhala mawonekedwe, kapena miyala yaying'ono,
• zotupa metastatic
• magawo a adipose kapena minyewa yolumikizana,
• cystic fibrous malo a tiziwalo timene timatulutsa.

Njira zochizira

Pofuna kupewa komanso kuchiza matenda a kapamba, owerenga athu amalimbikitsa tiyi wa Monastic. Ichi ndi chida chapadera chomwe chimaphatikizapo zitsamba 9 zogwiritsa ntchito mwamafuta othandizira kapamba, omwe samangothandiza, komanso kuwonjezera zochita za wina ndi mnzake. Tiyi ya monastic sidzangochotsa zisonyezo zonse za kutukusira kwa England, komanso ndikuchotseratu zomwe zimayambitsa.

Njira zochizira kuti ziwonjezere kuchulukirapo kwa kapamba ziyenera kuyikidwa kokha ndi katswiri woyenera mu mbiri ya gastroenterological.

Kuti ayambe kupanga njira yodalirika yothandizira, katswiri ayenera kuyambitsa zenizeni zomwe zimapangitsa kuti pakhale kuperewera kwa hyperechoicity.

Pochitika kuti kupangika kwa chisonyezo ichi kumayambitsidwa ndi kapangidwe kake ka kapamba, ndiye kuti chithandizo chamankhwala chiyenera kukhala ndi kumwa mankhwala apadera, zomwe zimapangitsa kuti achepetse hydrochloric acid m'matumbo am'mimba ndikuletsa ntchito ya enzymatic mu chifuwa cha pancreatic.

Ndi kuwonjezeka kwa chiwonetsero ichi cha kuyesa kwa ultrasound komwe kumachitika chifukwa cha zilonda zam'mimba, akatswiri amalimbikitsa kutsatira zakudya zapadera zomwe sizimapatula zakudya zonse zomwe zimakhala ndi mafuta a nyama.

Ngati kupangika kwa ma calcication kapena kukula kwa chotupa cha fibrotic cha chiwalocho chikuyang'aniridwa kumachitika ngati chinthu chogwirizana, ndiye kuti akatswiri amapanga mankhwala kuti azitsatira mosamalitsa pazakudya, ndipo pakakhala kuti pali mphamvu zabwino, madokotala amakayikira chithandizo cha matenda opangira matenda.

Kapangidwe kokhazikika kwa pancreatic lesion kumafuna kuchiritsa kwazomwe zimayambitsa matenda mogwirizana ndi zakudya zapadera.

Ndikofunikira kukumbukira kuti kuchuluka kwa echogenicity ndi chizindikiro chabe cha kuyesa kwa ultrasound kwa ziwalo za parenchymal. Kuti mupeze mankhwala othandizira, akatswiri alibe data yokwanira kuchokera pazotsatira za ultrasound. Kuti mupeze njira zothandiza kwambiri zothetsera matenda am'mimba, ndikofunikira kuti mupite mayeso ena ochulukirapo, kutengera zotsatira zomwe njira zamachitidwe othandizira zidzamangidwira.

Zoyenera kuchita ngati muli ndi kapamba?

Kunyalanyaza kapena kulandira chithandizo choyipa cha kapamba kumabweretsa zotsatira zoyipa:

• matenda ashuga
• chiwindi ndi matenda a impso,
• oncology, yomwe imawopseza kuchotsedwa kwina kapena kwathunthu kwa kapamba.

Osanenapo, kudya mosamalitsa, kuchuluka kwa michere ndi kutalika kwa nthawi, pomwe kulibe mphamvu yokhala ndi moyo. "Koma kuiwala za kapamba ndizotheka," akutero mkulu wa gastroenterologist wa Russian Federation.

Zomwe muyenera kudziwa zokhudza maphunziro apamwamba?

Mwa mapangidwe a hypoechoic amatanthauza kuti mu chiwalocho mumakhala malo owuma kwambiri kuposa timinofu tomwe tili pafupi ndi izi. Maphunzirowa amathanso kukhala matenda enieni, komanso abwinobwino. Ichi ndichifukwa chake ambiri amafuna kudziwa kuti kupangidwa kwa hypoechoic ndi, komanso momwe kungapezeke.

Ultrasound ya ziwalo zamkati imakhazikitsidwa ndi chuma chowonetsa mafunde amtunduwu pafupipafupi kuchokera kuzinthu zimakhala ndi kachulukidwe kwambiri

Ultrasound ya ziwalo zamkati imakhazikitsidwa ndi katundu wowonetsa mafunde amtundu wa pafupipafupi kuchokera zimakhala zimakhala ndi kachulukidwe kakakulu. Komabe, zimakhala zokhala ndi madzimadzi mkati mwake zimakhala ndi malowa pang'ono. Chipangizocho chimatumiza kugwedeza kwamphamvu ku chiwalo china, chomwe chimabweranso chikuwonekera kuchokera ku minofu. Chipangizocho chimatembenuza zomwe zalandilidwa kukhala chithunzi chomwe chikuwonetsedwa. Pambuyo pake, sonologist amawunikira zomwe adalandira ndikuwona. Koma ziyenera kukumbukiridwa kuti kuyeserera kumakhala kochitika nthawi zonse, chifukwa zimatengera kuchuluka kwa ma ultrasound omwe amagwiritsidwa ntchito, mtundu wa zida, mawonekedwe a wodwala komanso ziyeneretso za katswiri.

Ngati pasadakhale pali zidziwitso za wodwalayo komanso zomwe zimayambitsa kudwala, zomwe zimatha kukhala chifukwa chofufuzira ziwalo, zomwe zimayang'aniridwa kukhalapo kwa mapangidwe a hypoechoic mwa iwo.

Hypoechoic node nthawi zambiri amapanga mawonekedwe a cystic. Zimatsata kuti mu chiwalo, mwina, mapangidwe amkati omwe ali ndi makhoma owonda ndipo odzazidwa ndi madzi amachitika.Koma kuti zitsimikizire kuti mumapezeka matendawa, kuwonjezeranso biopsy kumachitika.

Zinthu zofunika kwambiri ndi mawonekedwe ndi kukula kwa msonkhano. Ngati dera la hypoechoic lazungulira ma contour, zikutanthauza kuti mitundu ina ya zotupa zitha kupezeka m'gulu loyesedwa. Malo omwe ali ndi mthunzi phunziroli nthawi zambiri amakhala pabwino ndipo amawapanga mawonekedwe osakhazikika, mwachitsanzo, pachifuwa pakubala. Mapangidwe a Hypoechoic amatha kupezeka m'magulu osiyanasiyana: kapamba, chiwindi, impso, chiberekero, mazira, gland ya mamm, etc.

Hypoechoic kapangidwe ka kapamba, impso ndi chiwindi

Panthawi ya ultrasound ya kapamba, zimakhala zokhala ndi kachulukidwe pang'ono zimatha kupezeka. Izi zimapangitsa kuti azindikire ma pathologies osiyanasiyana.

Ngati mawonekedwe amdima amdima ndi malire a mapangidwe apangidwe amawunikira polojekiti, ndiye kuti izi zikuwonetsa kuti pali ma metastases a khansa mu chiwalo. Ngati chiwonetserochi chikuwoneka kuti sichikuyenda bwino, chimakhala chozungulira komanso chazungulira, izi zikuwonetsa kukhalapo kwa chotupa.

Ndi chotupa cha khansa, njira zowonda zimatha kuwoneka zomwe zimayenda m'mphepete mwa mapangidwe. Zikondamoyo zomwe zili pachithunzichi zimakulitsidwa kukula pomwe zombo zazikulu zimasiyidwa ndikusokonekera. Kudzera mu kafukufuku wa Doppler, kuzindikira izi kumatha kutsimikiziridwa ngati magazi abwinobwino sangathe kupezeka m'malo awa.

Zinthu zofunika kwambiri ndi mawonekedwe ndi kukula kwa msonkhano.

Ngati malo a hypoechoic amapezeka m'matumbo a impso, ndiye kuti akuwonetsa chotupa kapena chotupa. Pakakhala chotupa, nthawi zambiri kutupa kwa mitsempha ya m'mimba kumachitika m'mitsempha ndi m'mimba. Mukamachita kafukufuku wa Doppler mu mawonekedwe a hypoechoic, kusowa kwa magazi mkati mwake kumatha kupezeka.

Ngati mapangidwe a cyst adachitika, ndiye kuti izi zitha kutsimikizika ndi mtundu wopanda malire ndi malire omveka, pomwe chotupa pa polojekiti chikuwonetsedwa ndi mafunde obowoka. Ultrasound yokhayo sikokwanira kuchiza kwa impso ndikuzindikira matenda oyenera. Kuti mupeze izi, kuyezetsa kachipatala kokwanira kumachitika, komwe kumaphatikizapo kuyezetsa magazi, biopsy, computer tomography ndi angiography.

Hypoechoic node yomwe imapezeka m'chiwindi imawonetsa kupezeka kwa chotupa, chotupa, ndi ma pathologies ena. Kuti kuyezetsa kwa chiwindi kukhala kolondola momwe kungathekere, wodwalayo ayenera kukonzekera phunzirolo m'njira inayake. Hypoechoic node nthawi zambiri imawonetsa kukhalapo kwa zotsatirazi zotsatirazi:

• ndi kunenepa kwambiri, minofu yathanzi imatsalira
• matenda a chiwindi
• kutupa
• thrombus wopangidwa mu portal vein vein,
• carcinoma metastases,
• zotupa, adenomas, cysts.

Chiberekero ndi thumba losunga mazira

Kuzindikira mu chiberekero nthawi ya ultrasound ya hypoechoic formations nthawi zambiri kumawonetsa kukula kwa chotupa. Koma itha kukhala yoyipa komanso yachilengedwe. Chifukwa chake, kuti mupeze kuyanjana kwake ndizotheka pokhapokha mutazindikira matenda osiyanasiyana. Mwachitsanzo, kupezeka kwa ma fibroids (mapangidwe oyipa) kumawonetsedwa ndi dera lakuda lomwe limatha kuwoneka pakhoma la chiberekero. Mapangidwe a Hypoechoic ngati zotupa za chiberekero zimakhala ndi ecostosition.

Ngati malo a hypoechoic ali ndi mawonekedwe otumphukira, ndiye kuti akuwonetsa carcinoma. Mwa izi, kufalikira kwamchiberekero ndi kupezeka kwa mthunzi wotsatira. Ngati mapangidwe ake adapezeka pafupi ndi dzira la fetal ndipo ali ndi kachulukidwe kakang'ono, ndiye kuti uku ndikutheka kwa vuto lomwe layamba.

Izi zikuwonetsa kuti pali kuchuluka kwa magazi pansi pa mwana wosabadwayo, ndipo mwanjira iyi, kuchitapo kanthu kwachipatala ndikofunikira.

Ngati malo opangira hypoechoic amapezeka m'mimba, izi ndizotsatira za kukhalapo kwa thupi luteal, kupanga kwa mtima kapena cyst. Nthawi zambiri, m'mazira, mawonekedwe ocheperako amayamba khansa. Ndi ultrasound yamchiberekero, mphamvu yakubereka ya mkazi komanso msinkhu wake imachita mbali yofunika. Kwa azimayi onse omwe amatha kubereka ndi kubereka mwana, mawonekedwe ake ndiomwe amakhala. Komanso, kapangidwe kake kamayenderana ndi kusamba.

Malo okhala Hypoechoic mu gland ya mamm

Kuzindikira dera la hypoechoic m'chifuwa molondola kwambiri, sonologist ikamachita ultrasound iyenera kuganizira zotsatirazi:

• mtundu wofanana,
• malo omwe ali pafupi ndi mapangidwe a hypoechoic,
• mawonekedwe ndi contour
• kukhalapo kwa mithunzi yammbali,
• mapangidwe amitsempha yamagazi m'matumbo am'mbali.

Ngati minyewa ya tinthu tambiri timene timakhala ndi madera ochepa mphamvu, izi zitha kuonetsa kukhalapo kwa chifuwa chowopsa pachifuwa. Chifukwa, mwachitsanzo, ngati malo amdima okhala ndi masamba osagawika awoneka, ndiye kuti akhoza kukhala carcinoma. Mawonekedwe owopsa ali ndi mthunzi wamtambo, ndipo ndiwopangidwe modabwitsa. Komabe, muyenera kukumbukira kuti zizindikiritso zotere zimachitika nthawi zambiri. Ma cyst wamba, monga lamulo, amadziwika ndi mawonekedwe ake ozungulira, komanso ma contour omveka bwino. Kukayikiridwa kwa kukhalapo kwa chotupa cha khansa nthawi zambiri kumayamba chifukwa chakuti mawonekedwe omwe ali ndi makoma olimba ndikuwonjezereka mkati mwazoyesedwa zamkati amadziwika.

Ndi ma diagnostics a ultrasound a mawere mwa akazi, kuchuluka kwa msambo kuyenera kukumbukiridwa, makamaka makamaka patsiku lomwe ultrasound imachitidwa. Nthawi yomweyo, palibe chifukwa chokonzekera kuyeserera, chifukwa chimachitika nthawi yomweyo munthu akangolumikizana ndi kuchipatala. Mukazindikira madera omwe ali ndi hypoechoicity, ndikofunikira kuti mupangitsenso ultrasound m'mwezi umodzi.

1️⃣ Ndimayesa kutsatsa malonda ndi manja anga 2️⃣ Ndimayenda mofufuzira 3️⃣ Ndikudziwa Sochi 4️⃣ Kupewa kutopa

Zomverera zoyipa zoyambirira zidawonekera kumapeto kwa June. Kulemera m'mimba, kupweteka pang'ono. Zonsezi motsutsana ndi maziko azakudya zambiri ndi abwenzi ku Sochi komanso zomwe zidaphatikizidwa kale ku Turkey.

Masiku adapita, koma kusasangalala sikudatha. Osati zowawa, chifukwa chake, kulemera m'dera lamapulogalamu olimbitsa dzuwa ndipo patsiku la 7 ndidafika kwa gastroenterologist ngati khola. Zinali 11.08.

- adotolo, ndikuti, sizabwino kwa ine pano.
- adamwa?
- anamwa
- adadya chilichonse?
- adadya

Ndipo kotero ndinazindikira kuti kapamba ndi chiyani ndi kapamba ndi chiani.

Tsiku lotsatira adaperekanso magazi ndipo adabwera kwa dokotala yemweyo kuti azimufufuza.

M'magazi, zizindikiritso zokhudzana ndi pancreatic ntchito ndi shuga zidachulukitsidwa, koma ma ultrasound adawonetsa "kupangika kwa hypoechoic m'mutu wa pancreatic" ndipo adotolo adalemba kamvekedwe ka MRI.

Kwa sabata limodzi ndidapita kukakhala ndi ana ku Urals, ndipo nditabwerako, ndidapita ku uzist ina, ndikuganiza kuti zidawoneka mwadzidzidzi.

Uzist wachiwiri adaganiziranso
07/30 ndidachita MRI, yomwe idalemba kukayikira kuti ili ndi chotupa muzakuda ndi zoyera.

Mitima yosiyanasiyana idandikhudza usikuwo, koma zinali zokwanira kuyimbira foni dokotala yemwe adalemba zonsezi pomaliza kwa MRI ndikufunsa kuti "ndichitenji nayo", adotolo adaganizira izi ndikuyesa kunditumiza kwa dokotala yemwe amandichitira.

Koma ndinalibe dokotala wochizira chotupacho, kenako adapumira mpaka m'mawa, ndipo m'mawa adapereka foni ya dotolo wa oncologist kuchokera ku Vishnevsky Surgery Research Institute, yemwe pafoni adati, muchite nawo MSCT ya m'mimba yonse ndikubwera.

Adapanga ndipo adafika. Dotolo adatenga zithunzizo ndikunyamuka kwa ola limodzi, ndipo pakubwera adati pali chotupa, ndi chaching'ono, chitha kuchotsedwa ndipo opaleshoniyo imatchedwa pancreatoduodenal resection, yomwe imayesedwa mbali ya zikondamoyo, gawo la duodenum, ndulu ya ndulu ndi m'mimba pang'ono.

Poganizira kuti opaleshoni iyi imachitidwa ndi 20% ya omwe zotupa zawo zimadziwika ndi zizindikiro zamankhwala, pomwe atakula kale komanso kumera, kuchuluka kwa kupulumuka kwa zaka zopitilira 5 zitatha 5-10%.

M'malo mwanga, kunalibe chipatala, ndinathamangira ku Sochi kukatsegula kampu yolimbitsa thupi, kumeneko ndinadutsa mayeso opaleshoni, mu PM pali zotupa zolemba ca 19-9 ndi ca 242, zomwe sizitsimikiziro, koma zonse ndizabwinobwino.

Nthawi yomweyo, ndidapempha kutanthauzira kwa zithunzizi, zomwe zidatsimikiziranso mapangidwe ake, ndipo Lolemba, Ogasiti 13, ndidachita kafukufuku wina, yemwe adati, inde, pali chotupa.

Sizikudziwika pakalipano kuti ndi chotupa chotani, koma sindinachite biopsy, chifukwa chilichonse chomwe chinali, ndimayenera kuwuma.

Pa maphunziro onse, idagwiritsidwa ntchito 50-60 tr

Malinga ndi ziwerengero, 90% ya zotupa mu kapamba ndizoyipa, koma kupatula mbali yoyamba pali mwayi woti uchira.

Ndipo inde, pancreatitis yoopsa siyinatsimikizidwe kwa ine. M'malo mwake, likukhalira kuti thupi adayitanitsa kuti ayang'ane zodutsazo. Chiyembekezo pa nthawi.

Opaleshoniyo idakonzedwa Lachitatu, Ogasiti 15, kudzera mu njira yopita kuchipatala kwa akatswiri azachipatala. Izi ndi ziwongola dzanja zomwe chipatala chimalandila ku unduna wa zaumoyo ngati thandizo likufunika.

Dzulo, 08/16/18 ndinachita opaleshoni yochotsa chinthuchi. Chidacho chidatumizidwa kuti chidzakhale mbiriyakale, zotsatira zake ndizomwe zidzatsatire zotsatirazi.

Ndipo ndiyenera kupeza mankhwala obwezeretsa, kulimbitsa thupi, ndipo ndikuganiza kuti kuyambira Lolemba ndiyamba kugwira ntchito pang'ono.

Pali zambiri zomwe tiyenera kuchita.

Ndime yotsatira ikukufotokozerani za opaleshoni, kukonzekera komanso za chipatala. Ndizoyenera apa.

Padzakhala nkhani yina yokhudza kutsatsa mankhwala, kutengera anthu osadziwa zoyenera kuchita ndi zotere. Ndi zakufunika kwa kuthekera kosanthula zidziwitso.

Zimayambitsa mapangidwe a hypoechoic

Monga chizindikiro cha ultrasonography, mapangidwe a hypoechoic amatha kukhala ndi kutanthauzira kulikonse. Zomwe zimayambitsa mapangidwe a hypoechoic ndizosiyana komanso zimadalira kwathunthu ku etiology ndi pathogenesis am'matenda omwe amapezeka mwa odwala.

Mwachitsanzo, mapangidwe a hypoechoic mu kapamba amadziwika kuti ndi njira yodziwira matenda monga cysts, hemorrhagic pancreatitis, mucinous cystoadenoma (womwe umakonda kupweteka), pancreatic mutu adenocarcinoma, metastases mu zilonda zotupa za ziwalo zina.

Kupanga kwa Hypoechoic mu chiwindi ndi chikhodzodzo

Thanzi lathanzi lathanzi limakhala moderoteic hyperechoic, ndipo kupangika kwa hypoechoic m'chiwindi kumatha kuchitika ndi matenda amitsempha yamagazi, kuyang'ana kwa steatosis, cysts (kuphatikizapo Echinococcus multilocularis), biliary abscess, hepatocellular adenoma, kagawo kakang'ono ka intrenchymal hyperplasia, ndi hepatic pulmonary hyperplasia yaying'ono.

Mapangidwe a Hypoechoic amawonekeranso ngati pali vuto la khansa yapakhungu, thumba losunga mazira, tiziwalo ta mammary, testicle, ndi m'mimba thirakiti lomwe limafalikira ku chiwindi.

Pakuwunikidwa kwa ma ultrasound a gallbladder pathologies, kapangidwe ka makoma ake ndikofunikira kwambiri, popeza pakalibe kuwonongeka kwa ziwalo, amawoneka ngati mawonekedwe atatu: zigawo zakunja ndi zamkati za hyperechoic ndi sekondale hypoechoic.

Mwa zina mwazomwe zimayambitsa kupangika kwa hypoechoic mu ndulu, ma polyps, adenocarcinoma (wokhala ndi chikhazikitso chakunja cha chikhodzodzo), lymphoma (chotupa cha mwanabele), angiosarcoma ayenera kutchulidwa.

Hypoechoic mapangidwe a ndulu

Nthawi zambiri, kufalikira kwa ndulu kumakhala yunifolomu, ngakhale kuli kokulirapo kuposa chiwindi. Koma chifukwa cha kukwezedwa kwa mtima kwakukulu, ma ultrasound a ndulu amachitika ndi chothandizira chosakanikirana chomwe chimasonkhana parenchyma ndikupangitsa kuti zithe (kumapeto kwa gawo la parenchymal) kuti muwone ngati zotupa ndi mapangidwe a ndulu ya hypoechoic.

Izi ndi monga:

• pachimake intraparenchymal hematoma ndi kupasuka kwa ndulu (chifukwa cha kuvulala kwamimba),
• hemangiomas (benign vascular formings) ndi splenomegaly,
• matenda am'mitsempha (kulowetsedwa kapena hematologic),
• ndulu yamitsempha,
• metastases ya magwero osiyanasiyana (nthawi zambiri sarcomas ofewa minofu, osteosarcoma, khansa ya impso, bere kapena ovary).

Monga momwe akatswiri amanenera, echinococcal, kupangira payekha komanso dermoid cystic kapangidwe kake kumatha kukhala ndi mapangidwe osakanikirana.

Kupanga kwa Hypoechoic mu impso, ma adrenal gland komanso chikhodzodzo

Mapangidwe a Hypoechoic mu impso amatha kuwoneka ngati mawonekedwe a cystic (kuphatikizapo osauka) akuphatikizidwa parenchyma, hematomas (m'magawo oyamba), pyrogenic perinephral abscesses (mu gawo la necrosis) kapena cavernous chifuwa chachikulu cha impso.

Malinga ndi akatswiri a endocrinologists, sichinthu chovuta kudziwa kupangika kwa chithokomiro cha adrenal, ndipo mwatsoka, sizipilira nthawi zonse. Mwachitsanzo, kutsimikizika kwa kupezeka kwa adenoma mu aldosteronism yoyamba, komanso kuchuluka kwa kuchuluka kwa maselo a adrenal cortex mu hypercorticism (matenda a Itsenko-Cushing) kumayambira pazizindikiro. Ultrasound imazindikira bwino pheochromocytoma, komanso lymphoma, carcinoma ndi metastases. Chifukwa chake, ndizoyenera kwambiri kupenda ma adrenal glands pogwiritsa ntchito CT ndi MRI.

Ndi kukula kwa benign leiomyoma, kusintha kwa cell carcinoma wa chikhodzodzo kapena pheochromocytoma (paraganglioma) wa chikhodzodzo, komwe kumayendera limodzi ndi matenda oopsa ndi hematuria, mawonekedwe a ultrasound amawona mapangidwe a hypoechogenic mu chikhodzodzo.

Kupanga kwa Hypoechoic pamimba pamimba ndi m'chiuno chaching'ono

Pathologies omwe atulutsidwa m'matumbo am'mimba, makamaka, m'matumbo am'mimba, amawunika momasuka ndi ultrasound: matumbo opanda kanthu adakulitsa makoma a hypoechoic, mosiyana ndi minofu yoyandikira ya adipose.

Pafupifupi mndandanda wathunthu wazomwe zimayambitsa kuwona kwa hypoechoic pamimba pamimba ndi ultrasound, olemba awa ndi awa:

• hernia ikulowerera mu ngalande ya inguinal,
• intra-m'mimba hematomas (zoopsa kapena zolumikizana ndi coagulopathies),
• serous ndi purulent phlegmon wa peritoneum kapena malo a retroperitoneal,
• abscess of terminal ileum ndi transmural ileitis (matenda a Crohn),
• kutupa kwa mesenteric lymph node (mesenteric lymph node),
• B-cell non-Hodgkin lymphoma kapena Burmitt's lymphoma,
• metastasis kumitsempha yamagazi ya m'mimba,
• carcinoma wa cecum, etc.

Ultrasound ya pelvic ndi ziwalo za chiberekero zimawulula kachulukidwe kachulukidwe kachulukidwe ka akazi - pamaso pa fibroids, adenomas, cysts kapena endometriosis ya chiberekero, magwiridwe antchito kapena matumba a mafinya. Kupanga kwa hypoechoic mu ovary kumachitika ndi hemorrhagic cyst, komanso tubo-ovarian abscess (purulent kutupa mu fallopian machubu ndi thumba losunga mazira), follicular lymphoma ndi carcinoma.

Mwa amuna, ma pathologies omwe ali ndi chizindikiritso chotere ndi khansa ya testicular, lymphocele, ndi varicocele, ndipo panthawi yopanga ma prostate odwala odwala benign adenoma kapena khansa ya gland, mapangidwe a hypoechoic a prostate gland.

Mapangidwe a Hypoechoic m'chigawo cha subclavia

Mapangidwe a Hypoechoic omwe apezeka pa ultrasound m'chigawo cha subclavia akhoza kukhala chizindikiro:

• benign neoplasms ndi zilonda zam'mimba za anterior Mediastinum,
• matenda a lymphocytic leukemia,
• zotupa za zotumphukira zamitsempha ndi ma metastases a khansa ya chithokomiro, larynx, esophagus, bere jelly, mapapu,
• osteosarcoma wa kutulutsa kwatsatanetsatane,
• cysts ndi pulmonary echinococcosis,
• thymomas kapena carcinomas a thymus (thymus gland).

Kapangidwe ka Hypoechoic m'derali amadziwika ndi akatswiri azachipatala odwala hyperplasia kapena parathyroid cysts, hyperparathyroidism kapena nodular adenomatosis.

Mitundu ya mitundu yopanga hypoechoic

Kuphatikiza pa mawonekedwe a anatomical ndi topographic a mapangidwewo, ma ultrasonography amawulula mawonekedwe ake (ozungulira, ozungulira, osakhazikika), m'lifupi (cranio-caudal) kukula ndi kuzama kofanana ndi khoma lakunja kwa chiwalo kapena patsekeke.

Malinga ndi gawo ili, mitundu yayikulu ya mapangidwe a hypoechoic ndi:

• mapangidwe ozungulira a hypoechoic kapena ma hypoechoic oval mapangidwe (awa ndi ma cysts osiyanasiyana, varicocele, adenomas, adrenal chotupa cha metastatic etiology),
• mapangidwe a hypoechoic nodular (a hemangiomas, nodular biliary hypertrophy, uterine fibroids, nodular adenomatosis, etc.),
• hypoechoic focal mapangidwe (mawonekedwe a cirrhosis komanso oyang'ana wamafuta chiwindi kulowetsedwa, hematomas ndi ndulu infarction, etc.).

Mukumaliza kwa ultrasound, mawonekedwe azithunzi amawonekera:

• mapangidwe a hypoechoic okhala ndi mawonekedwe osalala (ma cysts, nodular chiwopsezo cha chiwindi, zotupa zam'mawere),
• mapangidwe a hypoechoic okhala ndi magetsi osasintha (zotupa zambiri, metastase yambiri),
• kupangika kwa hypoechoic ndi chithunzi chomveka bwino (cysts, adenomas, abscesses ndi ulalo wozizira wazithunzi pazithunzi za ultrasound),
• kupangika kwa hypoechoic ma contours ozizira (cavernous hemangions a chiwindi, khansa ya chithokomiro, metastases mu minofu ya ziwalo zamtundu uliwonse).

Kenako, homogeneity / heterogeneity ya mapangidwe imayesedwa, ndiko kuti, mkati mwake:

• kupangika kwapadera (carcinomas),
• Hypoechoic heterogeneous mapangidwe (ma adenomas akulu, khansa ya chiwindi, kuphatikiza mitundu ya carcinomas, etc.),
• kupangika kwa hypoechoic ndi hyperechoic inclusions (khansa ya impso, a adanoma a ovary, khansa ya Prostate.

Malongosoledwe amtundu wazomwe zimakhala pafupi, mawonekedwe a distal acoustic (kuphatikiza, mayendedwe achestic, mthunzi wamtundu) ndi mawonekedwe a mithunzi yamtundu (symmetry, asymmetry, palibe) ndizovomerezeka.

Kuphatikiza apo, pali kukhalapo / kusowa kwa mitsempha ya mitsempha (i.e. mitsempha yamagazi) m'magulu ophatikizika ndi tanthauzo la mitundu monga: mapangidwe a hypoechoic popanda magazi (otaya mtima) ndi mapangidwe a hypoechoic ndi magazi.

Mapangidwe omwe ali ndi mitsempha yamagazi amagawidwa m'magulu:

• kupangika kwa hypoechoic ndi magazi othamanga a magazi (subtype ndi perinodular, i.e. vascularization ozungulira node),
• mapangidwe a hypoechoic ndi magazi ophatikizika (mitsempha ili pafupi ndi mapangidwe ndi mkati mwake),
• kupangika kwa hypoechoic ndi magazi oyenda ndi intranodular (kukhalapo kwa vascularization kulembedwa kokha mkati mwa mapangidwe).

Monga momwe machitidwe azachipatala akuwonetsera, kupangika kwa hypoechoic kochita ndi magazi m'mitsempha yake kungasonyeze kuti ali ndi vuto.

Ndipo pamapeto pake, kupezeka kwa mankhwala a calcium pamapangidwe amakumbukiridwa. Ndipo kupangika kwa ma hypoechoic ndi ma calcified (calcification) kumakhala kofanana ndi kuwonongeka kwa chiwindi chokwanira pakakhala amoebiasis, khansa ya chiwindi, neoplasms mu chithokomiro ndi chithokomiro cha Prostate, zotupa zamabele.

Pancreas anatomy

Kukula kwa kapamba kumayambira masentimita 12 mpaka 14 kutalika kwake, kutalika kwake pafupifupi masentimita 2-3, ndi m'lifupi mwake mpaka masentimita 9. Kulemera kwabwinobwino ndi 70-80 g.Gawo la endocrine limakhala pafupifupi 1-2% ya kulemera konseko kwa England.

Chiwalo chamkati chimakhala mkati mwa peritoneum kumbuyo kwa m'mimba, yomwe ili pafupi ndi mphete ya umbilical pamalo a hypochondrium yamanzere. Kumbuyo kwake kuli mitsempha ya portal, diaphragm, mitsempha yama mesenteric yolowa m'matumbo ang'ono ili pansi.

M'mphepete mwenimweni mwa kapamba ndimitsempha yamagazi ndi mitsempha yamagazi ya ndulu. Kuzungulira mutu ndi duodenum.

• Mutu umafanana ndi mbedza yaying'ono, yomwe imakhazikitsidwa pamlingo wa woyamba kapena wachitatu wa lumbar vertebra. Amakumana ndi chifuwa chaching'ono, kumbuyo kwa mitsempha ya portal, kutsogolo kuli kolowera kolowera.
• Thupi la chiwalo limadziwika ndi mawonekedwe achitatu. Mwanjira ina, ngati muwona ndi mawonekedwe pa ultrasound scan, imawoneka ngati pembetatu yokhala ndi mawonekedwe atatu. Kutsogolo kuli chopumphunza, kumbuyo kwa dera la aorta ndi mesenteric.
• Mchira wa kapamba uli ndi mawonekedwe otambalala, omwe ali pamlingo wa 11-12 wa thoracic vertebra. Imakwera chamba, kumbuyo kwa chithaphwi cha adrenal, pomwe.

Chiwalo chonse chimakutidwa ndi minofu yolumikizana, yopangidwa ndi lobules. M'malo otayirira pali zisumbu za Langerhans. Ntchito yawo ndikupanga mahomoni - insulin ndi glucagon, omwe amayang'anira kuchuluka kwa shuga m'magazi.

Ma ducts odzipereka amapanga pancreatic duct, yomwe imayamba pakati mchira, imayenda kulowa m'dera la duodenum.

Matenda a kapamba

Kupanga kwa Hypoechoic mu kapamba ndimawu owunikira a matenda ena - ma cysts, hemorrhagic mawonekedwe a kapamba, cystadenoma - nthendayo imakonda kupweteka, metastases mu zotupa za zilonda zaminyezi zina.

Ngati mchira wa kapamba umapweteka, izi zitha kuwonetsa kukula kwa kapamba kapamba kapenanso kakhansa. Malinga ndi ICD 10 kukonzanso code, matendawa amapatsidwa manambala K86.0 ndi K86.1, motsatana.

Zomwe zimayambitsa pancreatitis yovuta ya pachimake ndi chifukwa chachulukidwe katulutsidwe ka michere ndi England komanso kutsekeka kwa kuchuluka kwa papilla ya duodenal. Madzi a pancreatic amapangidwa, koma pali kusokonezeka kwake kutuluka kwake kupita ku duodenum.

Kuunika kwa Ultrasound kumawonetsa kuwonjezeka kwa parenchyma yamkati yamkati, yomwe imayika kukakamiza kwa kapisozi. Popeza chiwalo chimaperekedwa bwino ndi magazi, kutupa kumayamba msanga.

Odwala amadandaula za kupweteka kwambiri. Afunika chithandizo chamankhwala. Kunyalanyaza zizindikirazo kumawonjezera mwayi wamavuto - necrosis ndi peritonitis.

Ngati palibe chithandizo chokwanira cha kapamba mu gawo la pachimake, ndiye kuti kutupa kosatha kumachitika. Zimabwera m'mitundu iyi:

1. Mtundu woyamba. Matenda odziyimira pawokha, kutupa kumachitika chifukwa cha mowa, kuperewera kwa zakudya m'thupi, matenda a metabolic.
2. Mawonedwe achiwiri amakhala chifukwa cha matenda am'mimba ena - cholelithiasis, kutupa kwa ndulu (cholecystitis).
3. Mtundu wotsatira wa zowawa ndi zotsatira za kuyesa kwa endoscopic kapena kuvulala kosiyanasiyana.

Fomu yokhazikika imayendera limodzi ndi kuperewera kwa England, chifukwa chomwe sichingatulutse michere moyenera. Ultrasound yamthupi imawonetsa kusokonezeka kwapangidwe, kapangidwe ka khungu, kapangidwe ka miyala.

Zotsatira za kupsa mtima kwa njira yotupa ndi ma cysts ndi zotupa. Tumor neoplasms ndiyomwe imakhala yogwira timadzi komanso timadzi timadzi.

Amakhala ovuta kudziwa, omwe amapezeka ndi matenda a shuga. Ma tumor amangochitidwa opaleshoni.

Chithandizo cha kumutu ndi mchira

Kupereka kapamba ndi mtundu wa matenda. Dzinalo limachitika chifukwa cha kuwonjezeka kwa mutu wamkati wam'mimba wogaya dongosolo. Zizindikiro zazikulu zimaphatikizapo kupweteka kwambiri. Mavuto nthawi zambiri amakula mwa odwala - chifukwa champhamvu mosalekeza.

Kuzindikira kumapangidwa pamaziko a zotsatira zomwe zimapezeka ndi CT, MRI ndi ultrasound. Amawonetsa kapangidwe ka ziwalo, kukula kwa mutu kupitirira masentimita anayi. Nthawi zina cysts amapanga kunja kwa parenchyma.

Pancreatic chithandizo chamutu chimafuna opaleshoni. Mankhwala sangathandize kuchiritsa wodwala. Njira yochitira opaleshoni ndi Median laparotomy, yomwe imatanthawuza kusakhazikika kwa mutu malinga ndi Kocher. Zoyipa zamankhwala opaleshoni ya pancreatic zimaphatikizapo kuvulala kwambiri, kuvuta kwa magwiridwe antchito.

Iron motsutsana ndi maziko a kutupa njira ukuwonjezeka. Kutupa kofala kwambiri kwa mchira ndikuti kumakhala kofinya komanso yokulirapo, komwe kumayambitsa kutsekeka kwamitsempha ya splenic ndi mawonekedwe a portal a impso.

Kuchulukitsa kwamisala kuli ndi zifukwa:

• Mwala womwe umatsekera mzere.
• Mawonekedwe a cystic a adenoma.
• Kusintha kwa mutu.
• Pseudocists.
• Tumor wa papilla yaying'ono yamatumbo.
• Pancreatic cyst.
• Khansa yapakansa.

Nthawi zambiri, kuwonjezeka mchira chifukwa cha chotupa neoplasms. Kumayambiriro, nkovuta kukayikira njira yothandizira matenda. Nthawi zambiri, chotupa chimapezeka chikakhala chachikulu. Chithandizo chokha ndikuchita opareshoni. Koma ilinso ndi zovuta zake, chifukwa kuti mufike mchira wa chiwalo muyenera kudutsa ndulu kapena impso kumanzere.

Pakupanga opaleshoni, mchira wokhudzidwa umachotsedwa, mitsempha yamagazi imayima. Ngati kuwonongeka kwa ziwalo zapafupi kumawonedwa, ndiye kuti kumachoka kwathunthu kapena pang'ono. Magawo omwe adachotsedwa pa nthawi ya opareshoni amatumizidwa kukayesedwa kwa mbiriyakale. Kuphatikiza mankhwala kwamankhwala kumadalira zotsatira zake.

Pazambiri za kapangidwe kake kapangidwe kake kafotokozerani katswiri mu kanemayu.