3-october-49hb gi 3.pps
TRANSCRIPT
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การตรวจสะแกนทางเดิ�นน��าดิ�และทางเดิ�นอาหาร
ส�าหร�บน�กศึ�กษาแพทย์� ชั้��นปี ท�!3อ.นพ. เฉล�มชั้�ย์ อภิ�ญญาน&ร�กษ�
หน'วย์เวชั้ศึาสตร�น�วเคล�ย์ร� ภิาคว�ชั้าร�งส�ว�ทย์า คณะแพทย์ศึาสตร� มหาว�ทย์าล�ย์ขอนแก'น
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Gamma Camera
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ว�ตถุ&ปีระสงค�•คำ��จำ��กั�ดคำว�ม•ข้�อบ่�งชี้��ในกั�รส่�งตรวจำ• เภส่�ชี้ร�งส่�และกัลไกักั�รส่ะส่ม
(mechanism of localization)•ล�กัษณะภ�พส่ะแกันปกัต"•ล�กัษณะภ�พส่ะแกันที่�$ผิ"ดปกัต"
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การตรวจสะแกนทางเดิ�นน��าดิ� Hepatobiliary scintigraphy
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Hepatobiliary scintigraphy: คำ��จำ��กั�ดคำว�ม
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Hepatobiliary scintigraphy: ข-อบ'งชั้��ในการส'งตรวจ
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Hepatobiliary scintigraphy:การเตร�ย์มผู้0-ปี1วย์
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ล�กัษณะภ�พส่ะแกันปกัต"• Present in liver in 5 min.• Progression clearance – become less
apparent• Excreted into the biliary tree
– > hepatic and common duct– > cystic duct, gallbladder– > small bowel
• Gallbladder is filled through cystic duct
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• Visualization of these structures is complete by 1 hour
• Bile reflux into the stomach– Normal variant: a small amount
or occasionally– Abnormal: a large amount or
persistent
ล�กัษณะภ�พส่ะแกันปกัต"
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ล�กัษณะภ�พส่ะแกันที่�$ผิ"ดปกัต"1. Acute Cholecystitis
•Proved and greatest value in the diagnosis
•> 95% of patients have cystic duct obstruction (from inflammation)–Radiopharmaceuticals cannot enter GB
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2.CBD obstruction
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3. Neonatal hepatitis
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4. Biliary atresia
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- 1. Gastro esophageal reflux - 2. Gastro intestinal bleeding 3. Gastric emptying time 4. ’Meckel s diverticulum
การตรวจสะแกนทางเดิ�นอาหาร
GI scintigraphy
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- 1. Gastro esophageal reflux:ค�าจ�าก�ดิความ
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- Gastro esophageal reflu x : ข-อบ'งชั้��
เภิส�ชั้ร�งส�ท�!ใชั้-: Tc-99m sulfur colloid ผู้สมในอาหาร
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- Gastro esophageal reflux :การเตร�ย์มผู้0-ปี1วย์
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ล�กัษณะภ�พส่ะแกันที่�$ผิ"ดปกัต"
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-2. Gastro intestinnn nnnnnnnn
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-2. Gastro intestinnn nnnnnnnn
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Rectosigmoid bleeding
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Small bowel bleeding
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3. Gastric emptying time
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Gastric emptying time: Indication
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Tc-99m sulfur colloid ผิส่มในอ�ห�ร
Gastric emptying time: เภส่�ชี้ร�งส่�ที่�$ใชี้�
การเตร�ย์มผู้0-ปี1วย์
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Gastric emptying time images
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nnnnnnn nnnnnnnn nnnn: curve
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4. ’Meckel s diverticulum
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เภิส�ชั้ร�งส�ท�!ใชั้- : Tc-99m pertechnetate I.V.
4. Meckel’s diverticul um: ข-อบ'งชั้��
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4. ’Meckel s diverticulum
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Suggested reading• Guideline for Radionuclide Imaging
Technique CD-ROM – Mr.Tanawat Sontrapornpol– Dr.Sasitorn Sirisalipoch
(Nuclear Medicine Society of Thailand and Chulalongkorn University)
• ร�งส�ว�ทย์าคล�น�ก เล'ม 2. การถุ'าย์ภิาพทางเวชั้ศึาสตร�น�วเคล�ย์ร�และการใชั้-สารก�มม�นตร�งส�ไอโอดิ�น131ในการร�กษาโรคของต'อมธั�ย์รอย์ดิ�. ภิาคว�ชั้าร�งส�ว�ทย์า คณะแพทย์ศึาสตร� มหาว�ทย์าล�ย์ขอนแก'น, 2548.
• เทคโนโลย์�ทางเวชั้ศึาสตร�น�วเคล�ย์ร� ฉบ�บแก-ไขปีร�บปีร&ง, 2545.
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Suggested reading• Nuclear medicine in clinical diagnosis and
treatment. 2nd ed., 1998.• Nuclear medicine technology and
technique. 4th ed., 1997.• An atlas of nuclear medicine,1994.• Nuclear medicine diagnosis and therapy,
1996.• Diagnostic nuclear medicine.2nded., 1996.• Nuclear medicine the requisite,1995.