- CT chest and whole abdomen- Plain chest and whole abdomen,arterial phase of the upper abdomen, PVP of the whole chest and abdomen and delayed phase of the upper abdomen were performed- History A 72 year old man suspected liver mass from previous us study- Results the study shows- Minimal bilateral pleural effusions with compressive atelectasis of both lower lobes- Multiple subsegmental atelectasis in medial segment of RML lingular segment of LuL,anteromedial basal segment of LLL and all basal segments of Rll atelectasis- The remaining lung parenchyma is unremarkable- Mild cardiomegaly without pericardial effusion cardiomegaly- No significant mediastinal lymphadenopathy- Multiple ill-defined hypodense lesions scattering in both hepatic lobes.the larguest one inhepatic segment 4 a is measured about 2.7 cm. the hepatic and portal veins are patent- an ill-defined enhancing mass located in the ampullary area, measuring about1.6x1.1cm. in axial plane. This lesion causes moderately dilated CBD and intrahepatic bile ducts of both hepatic lobes and moderately dilated pancreatic duct and gallbladder distension. The CBD is2.2cm. in diameter and the main pancreatic duct is0.8cm. in diameter- Diffuse pancreatic atrophy- Normal appearance of the spleen and both adrenal glands- Severe bilateral hydronephrosis and hydroureter with abrupt luminal narrowing of both ureters at about L3vertebral body level. A 0.8 – cm cyst at upper pole of right kidney.- Mild rather smooth circumferential wall thickening of the rectum,measuring about 1.4 cm in maximal thickness.- The remaining opacified bowel loops are unremarkable.- Diffuse thickening wall of the urinary bladder,measuring about 0.8 cm in maximal thickness.- Few small calcifications at superoanterior aspect of urinary bladder,measuring up to 1.0 cm in sixe,could be the calcified urachal remnant- Enlarged prostate gland, 4.1 x 4.7 x6.1 cmต่อมลูกหมากโตขนาด4.1 x 4.7 x6.1ซม- Multiple lymphadenopathy in aortocaval,retrocaval and paraaortic regions. The largest one in paraaortic region is measure about 1.6x1.7 cm- Minimal ascites in perihepatic,perisplenic regions,bilateral paracolic gutters and pelvic cavitymultiple osteolytic blastic lesions scattering throughout the spine,bilateral ribs,both proximal humerus and femur,pelvic bones,likely bone metastasis imp-periampullary carcinomaincluding CA ampulla of vater or CCA in distal CBD is first considered causing moderate biliary obstruction- Multiple liver and bone metastasis- Diffuse pancreatic atrophy- Mild rather smooth circumferential wall thickening of the rectum, could be proctitis. However the rectal tumor cannot be entirely excluded. Please correlate clinically- Diffuse thickening wall of the urinary bladder,could be due to chronic bladder outlet obstruction or cystitis. Please correlate clinically- Calcified urachal remnant- Enlarged prostate gland- Minimal ascites- Minimal bilateral pleural effusions- Multiple subsegmental atelectasis
สวัสดีค่ะ จากการตรวจผลเอ๊กซเรย์คอมพิวเตอร์นี้ แพทย์ที่ไม่ใช่แพทย์ผู้ดูแล จะไม่สามารถระบุโรคใดๆได้ชัดเจนนะคะจุดหลักๆที่พบความผิดปกติ มีก้อนที่บริเวณตับหรือบริเวณถุงน้ำดี และมีท่อไตและไตบวมทั้ง2ข้างค่ะซึ่งข้อมูลโดยละเอียด โรคหรือภาวะที่คนไข้เป็น และแนวทางการรักษา แนะนำให้ ไปพบแพทย์ที่ดูแลเพื่อขอข้อมูลเหล่านี้นะคะ