tailieunhanh - CLINICAL SKILLS - PART 7

Sinh thiết lõi cốt lõi mô nhỏ (30 ¥ 1 mm) thu được thông qua kim đâm thủng của cơ quan cho mô học điều tra: - gan - xơ gan, bệnh gan do rượu, viêm gan mạn tính hoạt động | Radiology 185 Colposcopy Examination of cervix usually to take a cervical investigate premalignant changes or cancer Needle biopsy Core biopsy A small core of tissue 30 I mm is obtained through needle puncture of organs for histological investigate liver cirrhosis alcoholic liver disease chronic active hepatitis kidney glomerulonephritis interstitial nephritis lung fibrosis tumours tuberculosis Fine-needle aspiration A technique to obtain cells for diagnosis of tumours or for microbiological needle position is guided by ultrasound computed tomographic CT scan or magnetic resonance imaging MRI scan. For investigation of many unexplained lumps . pancreas or breast lumps to diagnose carcinoma. Radiology Conventional X-rays visualize only four basic radiographic densities air metal fat and water. Air densities are black metal densities the most common of which are calcium and barium are white with well-defined edges fat and water densities are dark and mid grey. There can be difficulty in visualizing a three-dimensional structure from a two-dimensional film. One helpful rule in deciding where a lesion is situated is to note which if any adjacent normal landmarks are obliterated. For example a water density lesion which obliterates the right border of the heart must lie in the right middle lobe and not the lower different view . lateral chest radiograph is needed to be certain of the position of densities. Chest radiograph Use a systematic approach. 186 Chapter 11 Imaging Techniques and Clinical Investigations o Posteroanterior PA or anteroposterior AP which are only done when the patient is in a bed Fig. .The correct name for the usual chest study is a PA chest radiograph . This means that the anteriorly situated heart is as close to the film as possible and its image will be minimally enlarged. o Follow a logical progression from centre of film to periphery interfaces are only seen in silhouette when adjacent .