Edema of the parenchyma of the kidney
This syndrome includes diffuse cystic kidney damage, edema kidney and clitoral changes in the kidney (nephrosclerosis).
Diffuse cystic kidney damage manifests itself in four variants.
Polycystic kidney "adults". The kidneys are deformed, as a rule, increased insizes. Well-distinguished individual cystic formations are large, different-sized, separated by interlayers of the functioning parenchyma. There may be rounded small cysts of various sizes, which diffuse the entire parenchyma of the kidney.
Juvenile polycystosis. The kidneys are evenly and significantly enlarged,their embryonic lobulation persists. Cysts of small or "miliary" size, diffusely affect the entire parenchyma of the kidney. The parenchyma looks highly echoic.
Multicystosis of the kidneys. One-sided defeat (bilateralis incompatible with life). The kidney is totally replaced by different small cysts, both parenchyma and sinus elements are affected. The kidney is usually of small size, irregular shape, with uneven contour, in the form of a conglomerate of hyperechoic heterogeneous tissue.
Spongy kidney. There is the formation of small cysts in the terminaldepartments of the tubules, because of which the pyramids acquire a spongy structure, the cortical substance is intact. Subsequently, cystic tubulopathy leads to the development of calcification of the substance of the pyramids, that is, to the formation of nephrolithiasis. At US of a kidney usual or a little the reduced size. The kidney parenchyma seems thinned due to the fact that the pyramids have an increased echogenicity and almost merge with the hyperechoic sinus.
Edema of the renal parenchyma of the kidney is manifestedan increase in the kidney in size with preservation of the contour. The parenchyma is thickened, which is manifested by a relative decrease in the area of the sinus. As a result of disturbances in microcirculation and edema, the echogenicity of the cortex increases and the echogenicity of the pyramids decreases (a symptom of the "emerging" pyramids).
When deepening the inflammatory process,the progression of exudation, the development of purulent-destructive processes (apostematous pyelonephritis, acute obstructive pyelonephritis, initial phases of kidney carbuncle development), cortico-medullary differentiation is lost, the echogenicity of the parenchyma increases, the sinus becomes virtually indistinguishable from the thickened heterogeneous echo parenchyma due to fiber infiltration. The mobility of the kidney is limited by the development of inflammatory infiltration in the paranephric fiber. Edemary kidney is typical of most acute kidney diseases, both with damage to cortex (glomerulonephritis, HFRS, etc.), and tubulo-interstitial structures (acute pyelonephritis).
Sclerotic changes in the parenchyma arethe manifestation of the outcome of a variety of acute and chronic kidney diseases. With ultrasound of the kidneys of reduced size, the contour is uneven, the parenchyma is unevenly thinned, the sine is also deformed. The echogenicity of the cortical and cerebral substance is increased, cortico-medullar differentiation is often erased. In the parenchyma, individual hyperechoic foci are identified, corresponding to the zones of development of connective tissue, often with calcification sites.
The syndrome of isolated liquid kidney formation</ i> .
Characteristic for a simple (monolocular) cyst,parasitic cyst, abscess and tuberculous cavern. When ultrasound is rounded, with a clear contour anechogenic formations with the effect of dorsal pseudo-amplification of different diameters. Depending on the localization, anechoic formations may be intraparenchymal, sinusal, parapelvic. In kidney abscess, the ultrasound picture is characterized by the presence of a clearly outlined, almost anehogenous formation with heterogeneous amorphous masses in the lumen of formation (pus, detritus), with the effect of dorsal reinforcement and signs of edema of the parenchyma. Tuberculosis caverns. differ from banal abscesses by irregular shape, with an unevenly thick capsule, a large number of highly echo masses in the lumen of formation (detritus). Often along the periphery of education - zones and areas of calcification.
All topics in this section:
1.1. The principle of X-ray diagnosis consists in visualizing the internal organs with the help of an X-ray radiation directed toward the object, which has a high penetration
Description (interpretation) of radiographs
Interpretation of radiographs should be carried out in a certain sequence. This reduces the risk of missing X-ray symptoms and allows obtaining false information. Allocate the following
Basic methods of SPL.
Methods of ultrasound investigation by the method of generation, signal processing and ultrasound imaging can be divided into 4 groups: one-dimensional echography (A-mode or method
Fundamentals of ultrasonic semiotics.
The image of the object obtained by ultrasound examination has a number of specific characteristics recorded in the study protocol. These include: - morphometric characteristics
X-ray computed tomography (CT).
4.1 The principle of CT is to obtain a series of transverse sections of the organ under investigation by means of a collimated X-ray radiation moving around the slices along the circumference, with n
Imaging technology for CT.
After laying the patient on the desk of the device, a survey image of the organ or part of the body - the topogram - is made. On the monitor screen, the physician is on the topogram, depending on the size of the organ and target and
Advantages of CT.
The CT image, first of all, gives an isolated image of the transverse layer of tissues according to the principle of the piego slice, that is, the CT image is devoid of superposition of structures typical for traditionally
Types of CT.
CT is divided into turn-based computed tomography (CT), referred to above, for spiral computed tomography (CT), multis
Imaging technology for MRI.
The nuclei of the atoms of elements in which there is an odd number of nucleons (1Н1, 13С6, 19Fe9, etc.) are dipoles, that is, the magnet
Advantages and disadvantages of MRI.
First of all, it is non-invasiveness and no radiation exposure. Further - a high tissue contrast, based not on the density of the substance being studied, but on parameters that depend on the physico-chemical
The mechanism of the biological effect of ionizing radiation.
All types of ionizing radiation (both corpuscular and quantum) have a biological effect, i.e. cause functional or morphological changes in living cells, organs and organism
Molecular stage of BDII.
At the first, molecular stage, the physical, physico-chemical and chemical phases are isolated. In the first, physical phase, which is extremely short (about 10-12 sec), there is a process
Cell stage of BDII.
The processes mentioned above begin to affect the viability of cells-the cellular stage of the biological action of ionizing radiation is coming, the longest and most variable in terms of
Somatic stage of BDII.
Radiosensitivity (radioopazhaemost) of the whole organism, due to the complexity of the physiological processes taking place in it, can not be the cumulative result of cellular damage. This is difficult
Radiation reactions of the body.
Radiation reactions of the body are divided into general, which consist of the defeat of the hematopoietic system, the organs of the digestive tract and the central nervous system, and
Ensuring the radiation safety of personnel.
4. Test questions. 5. Literature. 1. Dosimetry of ionizing radiation. 1.1. Doses for registration
Ensuring radiation safety of patients.
Radiation safety of patients should be provided in all types of radiological radiation exposure - diagnostic, preventive, preventive, research. Pat
Ensuring the radiation safety of personnel.
Ensuring the radiation safety of personnel is provided by - limiting the admission to work with sources of ionizing radiation, - knowledge and observance of the rules for working with the source
Radiation methods of KSS research.
1.1. X-ray methods of research. Radiography is the main method of radiation research KCC. It begins with her radiation examination of the patient after
X-ray anatomy of bones and joints.
Bones. According to the anatomical classification, the bones are divided into 4 groups: a) tubular (short, or monoepiphysic and long, or biepiphysis), b) spongy (short, long, sesamoid
X-ray semiotics of traumatic injuries of bones and joints.
Allocate fracture, fracture and fracture of bone. In case of fracture, the breach of the integrity of the bone occupies the entire diameter or length of the bone, at a fracture - more than half the diameter and any part of the long, at n
X-ray semiotics of diseases of bones and joints.
The following syndromes are distinguished for KSS diseases: a) soft tissue damage syndrome, b) bone volume change syndrome, c) syndrome of altered bone contour, d)
Algorithms of radiation examination in pathology of KSS.
Suspicion of developmental abnormality or tumor process. Stanadraft X-ray for the detection of the lesion site. Ultrasound of soft tissues for the purpose of differentiation
1. X-ray of the hand with epiphysiolysis. Determine the type of injury, the nature of the displacement of fragments. 2. X-ray of the hip with a fracture. Determine the type of injury, the limitation of the fracture.
Methods of ultrasound
Ultrasound with diseases of the chest is used in the search for small amounts of fluid in the pleural cavity and in the mediastinal tissue, when identifying the volume and fluid formations in the cortex
X-ray anatomy of the lungs.
X-ray of the lungs is studied from survey photographs (Figures 19 and 20), but first assesses the condition of the bones that form the skeleton of the chest, and those soft-tissue structures,
Algorithms of radiation examination in the pathology of the respiratory and mediastinal organs.
Acute pain in the chest of non-cardiac localization. Chest X-ray of the chest Delayed picture after 3-4 days (with suspected PE)
1. Chest X-ray in the right lateral projection. Determine the projection of the study. 2. Chest X-ray in the forward anterior projection. Identify the project
An overview radiograph of the chest is used to determine the state of pulmonary hemodynamics, assess the position, shape and size of the heart, identify calcifications of the aorta and coronary sores
Multispiral computed tomography (MSCT).
MSCT is performed both in native conditions and with artificial contrast - CT angiocardiography, CT coronary (CAG). The native MSCT is shown for evaluation
Ultrasonic methods in the diagnosis of heart disease are now the leading role among other radiation research methods. In addition to the possibility of rapid and accurate determination of the anthomical and
Perfusion scintigraphy of the heart, performed with SPECT and PET, is used to assess the viability of the myocardium, and these methods are more sensitive than perf
X-ray of the heart in a direct projection.
The heart in a direct projection has a shadow of an obliquely located oval (Figure 30). Isolate the usual, oblique position of the axis of the heart, when the axis of the heart (it is carried from the top of the heart - the intersection of the left
X-ray signs of enlargement of the chambers of the heart.
An increase in the left ventricle. When the left ventricle is enlarged in a direct projection, the expansion of the heart shadow to the left at the level of the fourth arc is revealed - it goes to the middle-clavicular line. If
The syndrome of the presence of free fluid in the pericardium.
The fluid in the pericardial cavity is visualized as an anechoic layer between several millimeters and several centimeters in thickness. It is clearly visualized as an internal contour cardio
Algorithms of radiation examination in the pathology of the heart.
Acute pain in the region of the heart (it is necessary to exclude AMI) UZD (sonography) Chest X-ray (to exclude pathology of the lungs
1. Coronarygram. Determine the method of radiation research, name the possible contrast, assess the state of the vessels. 2. Abdominal aortogram. Determine the method of radiation
Survey radiography of the abdominal cavity. An overview radiograph of the abdominal cavity is necessary, first of all, in the syndrome of an acute abdomen, since it is on it that it is possible
Gammascintigraphy of the stomach. The method is designed to study the evacuation function of the stomach. The essence of the method consists in giving the patient various test breakfasts labeled with radioactive substances
A review of the liver and pancreas. It is used in the search for mineral stones of the gallbladder and pancreas. If for a gallbladder he almost lost his
Native CT is currently one of the leading methods of radiation visualization of the liver and pancreas together with ultrasound. CT, above all, are informative for bulk
Methods of ultrasound.
Transabdominal ultrasound of the liver and biliary tract. The leading method of radiation diagnosis in diseases of the liver and biliary tract, from which usually begins radiation examination
Hepatoscintigrafia.Method is indicated for diffuse lesions of the liver, to study the barrier function of the liver and its structure. Phytate complexes labeled with technetium-99
UZ syndromes in diseases of the digestive system.
Data obtained by ultrasound are composed of two groups of signs: a) detectable (measurable, estimated) standard parameters of organs - location, shape, size, structure and acoustics
Algorithms of radiation examination for diseases of the digestive system.
Acute pain in the abdominal cavity. Ultrasound, a survey of the abdominal cavity (with the capture of pleural sinuses) Contrast study of the gastrointestinal tract with urograph
1. Radiograph with esophageal diverticulum. Determine the nature of the filling of the organ and the type of diverticulum. 2. Radiograph with a stomach ulcer. Determine the nature of filling op
Survey urography. A review of the kidneys and urinary tract is mainly used to detect stones. If the patient is scheduled, to improve visualization of the kidneys,
Methods of ultrasound.
Currently, ultrasound is the main method of radiation diagnosis of kidney and bladder diseases. Transabdominal examination of the kidneys, bladder and prostate
X-ray of the kidneys, ureters and bladder.
The kidneys are located at the level of Th12-L4 in children and Th12-L3 in adults, with 60-70% of the left kidney above the right kidney. The displacement of the kidneys (inhalation-exhalation or ortho- trochozposition) does not exceed 1.5 vertebrae. The form
The syndrome of kidney dislocation.
The main causes that cause this syndrome are kidney dystopia, nephroptosis and retroperitoneal neoplasms. Dystopias have an innate genesis, the kidneys are mainly displaced in the distal direction
Syndrome of anomalies of the kidneys and upper urinary tract (VMP).
To it carry neizualiziruemuyu kidney and an atypical sintopy of a kidney. The nonvisualizable kidney is always a one-sided process and manifests itself in the impossibility of visualizing the kidney against the background of cellulose and
The syndrome of volumetric education of the kidney.
It is characterized by the presence of voluminous solid formations of various echogenicity. Volumetric education with signs of good quality. Relatively small, clearly delineated
Fig. 45. Scheme of periapical radiography of lower teeth.
Extraoral methods are divided into two groups: survey radiography and targeted and targeted radiography. An overview radiography of the facial skull is shown
Special methods of radiation research.
Linear tomography is used to isolate various parts of the jaws, to visualize the NVNS, to detail the inflammatory and tumor processes. Currently active
X-ray anatomy of teeth and jaws.
Each tooth consists of a crown, where the enamel and dentin, the root (or roots), consisting of dentine and cement, and the cervix are extracted. On the roentgenogram, dentin and cement do not differentiate, so the tooth's neck
In the formation of the dentoalveolar system, several stages are distinguished.
The first stage, which distinguish the periods of newborn and temporary bite. Newborn period (0 - 6, 7 months). By the time of birth, there are 18 follicles in each jaw (1
X-ray diagnostics of traumatic injuries of teeth and jaws.
Fractures of the upper jaw. In an isolated form, almost do not occur, but are combined with damage to other bones of the facial skull. Three types of fractures are distinguished by Lefort.
X-ray diagnosis of diseases of teeth and jaws.
Caries. Depending on the depth of destruction of hard tooth tissues, the initial caries are distinguished (stain stage, radiographically not revealed), surface (decay to the limit
X-ray diagnosis of neoplasm of jaws.
Neoplasms of the jaws Odontogenic Neodontogenic Benign Malignancies
Algorithms of radiation research in the pathology of FHC.
Injuries of the bones of the facial skull Radiography in two projections Periapical radiography (in the presence of a fracture line in the zone of the socket) Linear volume
1. Radiographs with a fracture of the upper jaw To determine the type of fracture according to Lefort 2. Radiographs with a fracture of the lower jaw To determine the type and duration of the fracture, the nature