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1、DiagnosisforDiseasesofLiverandSpleenwithUltrasonography肝脾疾病超聲診斷1PreparationsbeforeExamination1.fasting（禁食)formorethaneighthours.2.performingbeforebariummeal（鋇餐)andgastroscopy（胃鏡).2Ⅰ.AnatomyandNormalUltrasonogramofThe Liver肝臟解剖及正常聲像圖3AnatomyTheliveristhelargestorganinthehumanbodyandissituatedinth
2、erightupperabdomen.4Therearethreefissures（裂隙）thatformaH-shapedditchonthevisceralsurface(臟面,inferiorsurface)oftheliveranddividetheliverintofourlobes（葉）:theright,left,quadrate（方葉）andcaudate（尾狀葉）lobe.5Thethreefissuresarethefossae(凹陷）pressedbyinferiorvenacava(IVC)andgallbladder,ligamentumteres(round
3、ligament圓韌帶）andligamentumvenosum（靜脈韌帶），andportahepatis(肝門).6ligamentumvenosumLigamentumteresinferiorvenacava(IVC)gallbladderPortahepatisPosteriorview7Normalsonograms1.ShapeandContourShape:Theshapeoftheliveronsonogramvariesaccordingtothesectionwescan.Itcanpresentawedge(楔形）oratriangle（三角形）.8Contou
4、r:Thereisahyperechoiclinearoundtheliverthatissmoothandregular.It’stheechoofliver’scapsule.92.SizeThemaximalobliquediameter(最大斜徑)oftherightlobeislessthan14cm.10Thelongitudinaldimensionandthethicknessoftheleftlobearewithin9cmand6cm,respectively.113.Parenchymaltexture（實(shí)質(zhì)）Onthesonogram,thenormallive
5、rparenchymahasahomogeneousecho-texture.12parenchyma134.IntrahepaticvesselsandductsOnsonogram,withinthehomogeneousliverparenchymaliethethin-walledhepaticveins(HV,肝靜脈),thebrightlyreflectiveportalveins(PV，門靜脈),thehepaticarteries（肝動(dòng)脈)andbileduct(BD，膽管).14parenchymahepaticveinportalvein15mainportalve
6、incommonbileduct(CBD)16Thenormalinternaldiametersofthosevesselsandductsareasfollows:PV:1-1.2cmHV:0.5-0.9cmcommonbileduct,CBD(膽總管):0.4-0.6cm171819Ⅱ.UltrasonicDiagnosisofLiverDiseases20CategoriesofLiverdiseasehepatictumorfocallesionsdiffuselesionsHepatictraumaHepatictransplant211.SimpleCystshapean
7、dwall:Theshapeofthecystisroundanditswallsarethin.internalecho:Noechoescanbeseenincyst(anechoic,無回聲).22posteriorenhancement（后方回聲增強(qiáng)):Theechoesoftheareabehindthecystarebrighterthanthatofareaasidetoit.2324252.PrimaryHepaticCance
