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BG HC trung that cua thay NQK
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October 31, 2014 1
CHAN OAN HNH ANH
HOI CHNG TRUNG THAT
BS.NGUYEN QUY KHOANG
BS.NGUYEN QUANG TRONG
KHOA CHAN OAN HNH ANH
BENH VIEN AN BNH -TP.HCM
2October 31, 2014
DAN BAI
I.nh ngha.
II.Nhac lai giai phau trung that.
III.Trieu chng hoc X quang.
IV.Chan oan cac khoi u da vao v tr.
V.Mot so benh ly trung that.
VI.Ket luan.
3October 31, 2014
DAN BAI
I.nh ngha.
II.Nhac lai giai phau trung that.
III.Trieu chng hoc X quang.
IV.Chan oan cac khoi u da vao v tr.
V.Mot so benh ly trung that.
VI.Ket luan.
4October 31, 2014
NH NGHA
Hoi chng trung that bao gom cac dau hieu X
quang dien ta s hien dien cua cac te bao bat
thng trong trung that (Kh,dch,ong voi,
bu).
Can lu y rang ng knh cua hach c qui
c o theo be ngang ch khong phai la be
dai cua hach va neu kch thc nay 1cm la hach bnh thng (khong phai la hach benh
ly).
5October 31, 2014
DAN BAI
I.nh ngha.
II.Nhac lai giai phau trung that.
III.Trieu chng hoc X quang.
IV.Chan oan cac khoi u da vao v tr.
V.Mot so benh ly trung that.
VI.Ket luan.
6October 31, 2014
NHAC LAI GIAI PHAU TRUNG THAT
NG VIEN TRUNG THAT
B PHAI TRUNG THAT
1.Than TM canh tay-au (P).
2.TMC tren.
3.Nh (P).
4.TMC di.
5.Ron phoi (P).
6.Vien m trc tim (Franges graisseuses).
B TRAI TRUNG THAT
7.M di on (T).
8.Quai MC.
9.Cung MP.
10.That (T).
11.Ron phoi (T).
12.Vien m trc tim (Franges graisseuses).
7October 31, 2014
NHAC LAI GIAI PHAU TRUNG THAT
CACH PHAN CHIA TRUNG THAT
THEO BENJAMIN FELSON THEO LUCY SQUIRE
8October 31, 2014
DAN BAI
I.nh ngha.
II.Nhac lai giai phau trung that.
III.Trieu chng hoc X quang.
IV.Chan oan cac khoi u da vao v tr.
V.Mot so benh ly trung that.
VI.Ket luan.
9October 31, 2014
TRIEU CHNG HOC X QUANG
A.Cac ac iem chung: Khoi u mat o dch,thng ong nhat.
1.Co b ngoai ro,lien tuc.
2.Loi ve pha phoi.
3.Tao mot goc tu vi trung that.
4.B trong khong ro.
B.Cac ac iem rieng: Moi khoi u khac nhau
1.V tr.
2.ng vien.
3.Hnh dang.
4.Mat o.
5.Kch thc.
C.Lam sao khu tru c khoi u trung that?
1.Dau hieu bong b (Silhouette sign).
2.Dau hieu co-ngc (Cervico-thoracic sign).
3.Dau hieu tang bang (Iceberg sign).
4.Dau hieu che lap & Dau hieu hoi tu ve ron phoi
(Hilum overlay sign & Hilum convergence sign).
5.Dau hieu canh buom (Sail sign).
6.Dau hieu co keo thc quan.
10October 31, 2014
DAU HIEU BONG B
SILHOUETTE SIGN
SILHOUETTE SIGN (+) SILHOUETTE SIGN (-)
D.Anthoine et al.LImagerie Thoracique.1996-1998.
11October 31, 2014
DAU HIEU BONG B
SILHOUETTE SIGN
SILHOUETTE SIGN (+)
D.Anthoine et al.LImagerie Thoracique.1996-1998.
12October 31, 2014
DAU HIEU CO NGC
CERVICO-THORACIC SIGN
B:CERVICO-THORACIC SIGN (+) A:CERVICO-THORACIC SIGN (-)
D.Anthoine et al.LImagerie Thoracique.1996-1998.
13October 31, 2014
DAU HIEU CO NGC
CERVICO-THORACIC SIGN
CERVICO-THORACIC SIGN (+):
BU GIAP THONG
14October 31, 2014
DAU HIEU CO NGC
CERVICO-THORACIC SIGN
CERVICO-THORACIC SIGN (-): NEUROBLASTOMA
15October 31, 2014
DAU HIEU NGC-BUNG
THORACO-ABDOMINAL SIGN (ICEBERG SIGN)
ICEBERG SIGN (+) ICEBERG SIGN (-)
16October 31, 2014
DAU HIEU NGC-BUNG
THORACO-ABDOMINAL SIGN (ICEBERG SIGN)
ICEBERG SIGN (+) :NEUROBLASTOMA
17October 31, 2014
DAU HIEU CHE LAP RON PHOI & DAU HIEU HOI TU RON PHOI
HILUM OVERLAY SIGN & HILUM CONVERGENCE SIGN
D.Anthoine et al.LImagerie Thoracique.1996-1998.
18October 31, 2014
DAU HIEU CHE LAP RON PHOI & DAU HIEU HOI TU RON PHOI
HILUM OVERLAY SIGN & HILUM CONVERGENCE SIGN
HILUM OVERLAY SIGN:
TERATOMA
A.J.Chandrasekhar,M.D.Chest X-ray Atlas.
19October 31, 2014
DAU HIEU CHE LAP RON PHOI & DAU HIEU HOI TU RON PHOI
HILUM OVERLAY SIGN & HILUM CONVERGENCE SIGN
HILUM OVERLAY SIGN:
TERATOMA
20October 31, 2014
DAU HIEU CHE LAP RON PHOI & DAU HIEU HOI TU RON PHOI
HILUM OVERLAY SIGN & HILUM CONVERGENCE SIGN
HILUM CONVERGENCE SIGN:
PHNH ONG MACH PHOI (T)
D.Anthoine et al.LImagerie Thoracique.1996-1998.
21October 31, 2014
DAU HIEU CANH BUOM
SAIL SIGN
Bong tuyen c bnh
thng (normal
thymus) tre di
3 tuoi oi khi b
chan oan lam la
khoi u trung that.
Hnh anh thay
c tren X quang
rat a dang,trong
o dau hieu canh
buom la ien hnh.
22October 31, 2014
DAU HIEU CANH BUOM
SAIL SIGN
THYMIC SAIL SIGN
23October 31, 2014
24October 31, 2014
THYMIC SAIL SIGN
Cau truc hoi am luon luon ac,
ong dang
25October 31, 2014
Bong m trung that trc vi dau hieu
che lap ron phoi (T),khong chen ep kh
phe quan-Khong co hnh anh xep phoi (T).
Tre 11 thang tuoi,
khong trieu chng ho hap.
Bong m trung that trc co am
o ong nhat
Tuyen c bnh thng.
26October 31, 2014
Tre 9 thang tuoi: Tuyen c bnh
thng (cac mui ten trang).am o
tuyen c ong nhat va bang vi
am o c thanh ngc.Mui ten en
ch ong sonde trong thc quan.
Tre 14 tuoi: Tuyen c bnh
thng (cac mui ten
trang).am o tuyen c
ong nhat va bang vi am
o c thanh ngc.
27October 31, 2014
DAN BAI
I.nh ngha.
II.Nhac lai giai phau trung that.
III.Trieu chng hoc X quang.
IV.Chan oan cac khoi u da vao v tr.
V.Mot so benh ly trung that.
VI.Ket luan.
28October 31, 2014
CHAN OAN X QUANG CAC KHOI U TRUNG THAT
DA VAO V TR (THEO LUCY SQUIRE)
1.Bu giap thong.
2.Bu tuyen hung.
3.Bu d hnh.
4.U hach.
5.Thoat v qua lo Morgagni.
6.Nang phe tam mac.
7.Nang phe quan.
8.Thoat v qua khe thc quan.
9.Khoi u thc quan.
10.Tui phnh ong mach chu.
11.Thoat v qua lo Bochdallek.
12.Bu than kinh.
29October 31, 2014
CHAN OAN X QUANG CAC KHOI U TRUNG THAT
DA VAO V TR
30October 31, 2014
CHAN OAN X QUANG CAC KHOI U TRUNG THAT
DA VAO V TR
31October 31, 2014
DAN BAI
I.nh ngha.
II.Nhac lai giai phau trung that.
III.Trieu chng hoc X quang.
IV.Chan oan cac khoi u da vao v tr.
V.Mot so benh ly trung that.
VI.Ket luan.
32October 31, 2014
MOT SO BENH LY TRUNG THAT
TRAN KH TRUNG THAT
33October 31, 2014
MOT SO BENH LY TRUNG THAT
RING AROUND THE ARTERY SIGN
Dau hieu nay thay c chu yeu tren phim ngc nghieng giup chan oan
Tran kh trung that.
34October 31, 2014
MOT SO BENH LY TRUNG THAT
KHOI U TRUNG THAT SAU + CALCIFICATION
= NEUROBLASTOMA
35October 31, 2014
MOT SO BENH LY TRUNG THAT
HODGKINS DISEASE
36October 31, 2014
MOT SO BENH LY TRUNG THAT
Bong m a cung canh (P) kh quan
Luon luon phai ngh LAO HACH
37October 31, 2014
MOT SO BENH LY TRUNG THAT
HODGKIN MYCOPLASME TUBERCULOSE
38October 31, 2014
MOT SO BENH LY TRUNG THAT
KHOI U TRUNG THAT TRC + CALCIFICATION
+ M + DCH = TERATOMA
39October 31, 2014
MOT SO BENH LY TRUNG THAT
Tre 8 tuoi:Bong m trung that
nam canh (P) kh quan.BRONCHOGENIC CYST
40October 31, 2014
MOT SO BENH LY TRUNG THAT
BRONCHOGENIC CYST
41October 31, 2014
MOT SO BENH LY TRUNG THAT
NANG PHE TAM MAC
42October 31, 2014
MOT SO BENH LY TRUNG THAT
NANG MANG TIM / ASBESTOSIS
43October 31, 2014
DAN BAI
I.nh ngha.
II.Nhac lai giai phau trung that.
III.Trieu chng hoc X quang.
IV.Chan oan cac khoi u da vao v tr.
V.Mot so benh ly trung that.
VI.Ket luan.
44October 31, 2014
KET LUAN
ng bao gi chan oan U tuyen c
tre < 3 tuoi.Neu co g nghi van,co the
dung Sieu am e xac nh chan oan
(tuyen c bnh thng co cau truc
ac,ong dang).
Dau Bernou ch co gia tr tng oi,v co
nhng bong m tng la trong nhu
mo phoi,nhng thc te lai la bong m
trung that.
45October 31, 2014
CAM N S CHU Y THEO DOI CUA QUY BAC S