CASCAP
โครงการพัฒนาระบบสาธารณสุขเพื่อการตรวจคัดกรอง ตรวจวินิจฉัย และบริหารจัดการผู้ป่วยมะเร็งท่อน้ำดี ในภาคตะวันออกเฉียงเหนือ (Cholangiocarcinoma Screening and Care Program: CASCAP)
- Fatty liver
- Liver cirrhosis
- Periductal fibrosis
Normal parenchymal echo
Liver echo > renal cortex
Liver echo < renal capsule (ตับดำกว่า เนื้อนอกของไต)
Visible tubular structures are hepatic vein ( intersegmental ) and portal vein ( intrasegmental )
Hepatic vein runs toward IVC with thin wall
Portal vein runs in middle part of the liver with echoic wall and accompanying bile duct ( content in periportal space HA,BD,LYMPH… )
Bile duct runs paralell with portal vein
Fatty liver
Mild = midly increased liver echogenicity (compared to the renal cortex)
Moderate = blurring of veins margins
Severe = significant posterior shadowing
Cirrhosis
causes
Regeneration
Inflammation and Necrosis
Fibrosis
Vascular change
Steatosis
Iron
Neoplasm
Sign U/S
Surface nodularity
Abnormal increase echo texture
coarsen
Small right lobe and medial segment left lobe
Hypertrophy lateral segment of left lobe ,caudate lobe
Ultrasound of Portal hypertension
Dilatation of
portal vein > 13mm ,
splenic vein > 11mm,
SMV >12mm,
coronary vein > 7 mm
Diminished respiratory variation in splenic and SMV
Increased overall blood flow of the splenic and SMV
Recanalized paraumbilical vein
Varices
Dilatation of splenic and hepatic artery demonstrating increase flow
Splenomegaly
Ascites
Periductal fibrosis ( PDF )
= Screening Cholangiocarcinoma
= Screening Cholangiocarcinoma
Increase periportal echo ( IPE )
Periportal fibrosis ( PPF )
Periductal fibrosis ( PDF )
