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介入放射学示教 Zhongshan Hospital Fudan University.

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Presentation on theme: "介入放射学示教 Zhongshan Hospital Fudan University."— Presentation transcript:

1 介入放射学示教 Zhongshan Hospital Fudan University

2 第一部分 介入放射学简介 Zhongshan Hospital Fudan University

3 介入放射学 以影像诊断学为基础,并在影像设备的导向下,利用经皮穿刺和导管技术等,对一些疾病进行非外科手术治疗或者以取得组织学、细菌学、生理和生化材料,以明确病变性质。 它又可称为微创手术治疗学。 分为血管介入和非血管介入。 Zhongshan Hospital Fudan University

4 介入所需的导向设备 最常用的是X线电视透视(DSA) 其次是B超、CT或MRI 各种导向设备均有各自的优越性,应合理应用。
Zhongshan Hospital Fudan University

5 DSA Zhongshan Hospital Fudan University

6 DSA Zhongshan Hospital Fudan University

7 DSA操作台 Zhongshan Hospital Fudan University

8 B超 Zhongshan Hospital Fudan University

9 B超 Zhongshan Hospital Fudan University

10 CT Zhongshan Hospital Fudan University

11 CT操作台 Zhongshan Hospital Fudan University

12 介入常用的器械 穿刺针 Zhongshan Hospital Fudan University

13 介入常用的器械 导管鞘 Zhongshan Hospital Fudan University

14 介入常用的器械 导丝 Zhongshan Hospital Fudan University

15 介入常用的器械 导管 Zhongshan Hospital Fudan University

16 介入常用的栓塞物质 明胶海绵(固体、短、中期栓塞剂) Zhongshan Hospital Fudan University

17 介入常用的栓塞物质 碘油(液体、长期栓塞剂) Zhongshan Hospital Fudan University

18 介入常用的栓塞物质 无水酒精(液体、长期栓塞剂) Zhongshan Hospital Fudan University

19 介入常用的栓塞物质 不锈钢圈(固体、长期栓塞剂) Zhongshan Hospital Fudan University

20 介入常用的栓塞物质 聚乙烯醇(PVA)(固体、长期栓塞剂) Zhongshan Hospital Fudan University

21 经皮血管穿刺技术 主要步骤:穿刺血管,引入导丝,沿导丝引入导管 技术改进:空芯前壁穿刺 其他改进:导管鞘,微穿刺套装,超声引导技术
Zhongshan Hospital Fudan University

22 Zhongshan Hospital Fudan University
Dr Sven-Ivar Seldinger ( ), a Swedish radiologist from Mora, Dalarna County Zhongshan Hospital Fudan University

23 Seldinger法示意图 Zhongshan Hospital Fudan University

24 Seldinger法示意图 Zhongshan Hospital Fudan University

25 Seldinger法示意图 Zhongshan Hospital Fudan University

26 Seldinger法示意图 Zhongshan Hospital Fudan University

27 Seldinger法示意图 Zhongshan Hospital Fudan University

28 Seldinger法示意图 Zhongshan Hospital Fudan University

29 Seldinger法示意图 Zhongshan Hospital Fudan University

30 Seldinger法示意图 Zhongshan Hospital Fudan University

31 Zhongshan Hospital Fudan University

32 Zhongshan Hospital Fudan University

33 Zhongshan Hospital Fudan University

34 Zhongshan Hospital Fudan University

35 Zhongshan Hospital Fudan University

36 Zhongshan Hospital Fudan University

37 血管穿刺途径包括: 股动脉:全身各动脉入路,应用最广泛 股静脉:下腔静脉、肺动脉、肾静脉、精索静脉和肝静脉入路
锁骨下静脉:是上腔静脉和肺动脉的入路,用于肺动脉溶栓,静脉高营养留置导管 颈静脉:TIPS、DIPS入路;布加氏综合症破膜处理;静脉高营养留置导管 锁骨下动脉:肝动脉泵置入;主动脉夹层造影;腹主动脉腔内支架置入术牵引 Zhongshan Hospital Fudan University

38 血管造影 脑血管造影 Zhongshan Hospital Fudan University

39 血管造影 主动脉弓造影 Zhongshan Hospital Fudan University

40 血管造影 腹主动脉造影 Zhongshan Hospital Fudan University

41 血管造影 支气管动脉 支气管动脉造影 Zhongshan Hospital Fudan University

42 血管造影 肝动脉造影(正常) Zhongshan Hospital Fudan University

43 血管造影 肠系膜血管造影 Zhongshan Hospital Fudan University

44 血管造影 肾动脉造影 Zhongshan Hospital Fudan University

45 血管造影 髂动脉造影 Zhongshan Hospital Fudan University

46 血管造影 下肢血管造影 Zhongshan Hospital Fudan University

47 血管造影 下肢血管造影 Zhongshan Hospital Fudan University

48 血管造影 下肢血管造影 Zhongshan Hospital Fudan University

49 血管造影 下腔静脉造影 Zhongshan Hospital Fudan University

50 胃肠道出血的栓塞 胃冠状静脉栓塞 Zhongshan Hospital Fudan University

51 血管性疾病的栓塞 肾动脉瘤 Zhongshan Hospital Fudan University

52 血管性疾病的栓塞 肾动脉瘤 Zhongshan Hospital Fudan University

53 血管性疾病的栓塞 颈部动-静脉畸形 Zhongshan Hospital Fudan University

54 血管性疾病的栓塞 颈部动-静脉畸形 Zhongshan Hospital Fudan University

55 肿瘤的栓塞治疗 原发性肝癌 介入前 DSA Zhongshan Hospital Fudan University

56 肿瘤的栓塞治疗 原发性肝癌 DSA 碘油平片 Zhongshan Hospital Fudan University

57 肿瘤的栓塞治疗 原发性肝癌 介入后3月 介入后9月 Zhongshan Hospital Fudan University

58 肿瘤的栓塞治疗 原发性肝癌 介入前 介入后2月 介入后8月 Zhongshan Hospital Fudan University

59 肿瘤的栓塞治疗 原发性肝癌 介入前 介入后2月 介入后2年 Zhongshan Hospital Fudan University

60 肿瘤的栓塞治疗 原发性肝癌 Zhongshan Hospital Fudan University

61 肿瘤的栓塞治疗 原发性肝癌 Zhongshan Hospital Fudan University

62 肿瘤的栓塞治疗 继发性肝癌 Zhongshan Hospital Fudan University

63 肿瘤的栓塞治疗 肝血管瘤 Zhongshan Hospital Fudan University

64 肿瘤的栓塞治疗 肝血管瘤 Zhongshan Hospital Fudan University

65 肿瘤的栓塞治疗 子宫肌瘤 介入前 介入后 Zhongshan Hospital Fudan University

66 消除病变器官功能 脾功能亢进、部分脾动脉栓塞 Zhongshan Hospital Fudan University

67 PTA(经皮血管成形术) 肾动脉PTA PTA前 PTA PTA后 Zhongshan Hospital Fudan University
(球囊扩张) PTA后 Zhongshan Hospital Fudan University

68 PTA 下肢血管PTA PTA前 PTA PTA后 Zhongshan Hospital Fudan University

69 血管内支架 Zhongshan Hospital Fudan University

70 血管内支架 颈动脉支架 Zhongshan Hospital Fudan University

71 血管内支架 主动脉支架 Zhongshan Hospital Fudan University

72 血管内支架 肾动脉支架 Zhongshan Hospital Fudan University

73 血管内支架 下肢血管支架 支架前 支架后 支架后 Zhongshan Hospital Fudan University

74 血管内支架 下腔静脉支架 支架前 支架后 Zhongshan Hospital Fudan University

75 血管内支架 门静脉支架 PVTT Zhongshan Hospital Fudan University

76 内支架 Tipss分流道支架 Zhongshan Hospital Fudan University

77 非血管性的介入治疗 食管狭窄的球囊扩张 Zhongshan Hospital Fudan University

78 非血管性的介入治疗 胃窦部狭窄的支架治疗 Zhongshan Hospital Fudan University

79 非血管性的介入治疗 胆道梗阻的经皮穿刺引流(内、外引流) Zhongshan Hospital Fudan University

80 非血管性的介入治疗 胆道梗阻的经皮穿刺引流(内、外引流) Zhongshan Hospital Fudan University

81 非血管性的介入治疗 胆道内支架 Zhongshan Hospital Fudan University

82 第二部分 血管造影的基本表现和病例示教 Zhongshan Hospital Fudan University

83 肿瘤病变的血管造影基本表现 供血动脉增粗和血管移位 肿瘤染色 tumor staining 和血管湖 肿瘤血管 tumor vessel
动门脉瘘或动静脉瘘 arterioportal shunt 肿瘤血管“包埋征” 癌栓“条纹征” Zhongshan Hospital Fudan University

84 血管性病变的血管造影基本表现 Zhongshan Hospital Fudan University 动脉夹层
dissecting aneurysm 动静脉畸形 arteriovenous malformation 动静脉瘘 arteriovenous shunt 出血 bleeding 血管栓塞及血栓形成 embolism and thrombosis 血管狭窄或闭塞 stenosis and occlusion 侧支循环 Collateral branch 动脉瘤或静脉瘤 aneurysm 假性动脉瘤 pseudoaneurysm Zhongshan Hospital Fudan University

85 血管移位 Zhongshan Hospital Fudan University

86 血管狭窄 Zhongshan Hospital Fudan University

87 肝动脉造影(原发性肝癌)(肿瘤染色) Zhongshan Hospital Fudan University

88 肿瘤染色+动静脉漏 肝动脉造影(原发性肝癌) Zhongshan Hospital Fudan University

89 肿瘤染色 肝动脉造影(继发性肝癌) Zhongshan Hospital Fudan University

90 肿瘤染色和肿瘤血管(子宫肌瘤) Zhongshan Hospital Fudan University

91 血管湖 Zhongshan Hospital Fudan University

92 肝动门静脉瘘 Zhongshan Hospital Fudan University

93 癌栓“条纹征” Zhongshan Hospital Fudan University

94 动静脉畸形 Zhongshan Hospital Fudan University

95 肺动-静脉畸形 Zhongshan Hospital Fudan University

96 颈动脉海绵窦瘘 carotid cavernous fistula
Zhongshan Hospital Fudan University

97 侧支循环 Zhongshan Hospital Fudan University

98 假性动脉瘤 Zhongshan Hospital Fudan University

99 动脉夹层 Zhongshan Hospital Fudan University

100 动脉瘤 Zhongshan Hospital Fudan University

101 血管栓塞 Zhongshan Hospital Fudan University

102 谢 谢! Zhongshan Hospital Fudan University


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