Chapter 1439 Dual Energy CT

Pulmonary embolism, also known as pulmonary infarction.

It refers to a clinical condition in which endogenous or exogenous emboli block the pulmonary artery or its branches and cause pulmonary circulation disorders.

The main source is mainly thrombosis, and others include amniotic fluid embolism, fat embolism, air embolism, foreign body embolism and so on.

For example, amniotic fluid embolism is a very serious complication after caesarean section. Thrombolytic therapy is not yet available. Ten years ago, it was almost a disease with no solution.

One of the most feared complications of orthopedic surgery is fat embolism.

Patients with pulmonary embolism may experience severe pain in the chest and back and difficulty breathing.

However, in the early stage, patients generally feel that they will pass by forbearance, delaying the best treatment time.

But even at the hospital, when the earliest symptoms are not typical, the embolization site is not as typical as this patient, and it is easy to be missed.

Judging from the film, there is no doubt that the thrombus originating from the pulmonary valve has blocked the main pulmonary artery.

No thrombectomy, grinding... The wall of the blood vessel is too thin, and it is completely different from the coronary artery. In addition to originating from the pulmonary valve, the emboli on the valve cannot be treated.

Abrasive surgery is impossible.

Zheng Ren's first impression, like many directors of 912, believed that the patient could only be treated with thrombolysis.

But just as he was about to look away from the image, Zheng Rensheng stopped his eyes again.

For a moment, the vestibular nerve trembled violently, which was very uncomfortable.

It's like riding a roller coaster in an instant.

Sensing that something was wrong with Zheng Ren, Director Wei asked, "Boss Zheng, are you tired after tossing for a day?"

"No, there is something wrong with the film." Zheng Ren said while looking at the film.

"Huh?" Director Wei was puzzled.

The imaging was typical, and the whole hospital was consulted, and no one objected to the diagnosis. Slight differences, but some differences in treatment.

"Wait a minute, I'll think about it." Zheng Ren said, and immediately began to use the reconstruction ability.

Imaging at this location, 3D reconstruction, MRI enhancement, and vascular CTA are all useless.

Based on the most basic imaging data, Zheng Ren began to re-observe the lesions originating from the pulmonary valve using dual-energy CT reconstruction mode.

The dual-energy CT system can use two different energies of X-rays to image the object, and can accurately obtain the composition ratio of the object.

Its principle has been proposed in the 1970s.

Through the imaging of two photon beams of different energies penetrating the stage, the composition of the object can be accurately calculated by using the difference of the energy absorption curves of different substances.

Of course, to get very close to the truth, the doctor who reads the film needs to have a very deep understanding of the image.

And Zheng Ren is this person.

The ability to rebuild is very handy. But doing dual-energy CT, Zheng Ren felt a little difficult.

The brain is full of horsepower, like a machine, and the roar is constant. The CPU quickly processed various data, and Zheng Ren was slightly overwhelmed.

But dual-energy CT images are still established.

It's a little blurry, and it's still different from the images made by standard machines. Even so, Zheng Ren felt that enough was enough.

Another situation was shown on the image, which was completely different from the previous judgment.

In the large filling defect near the pulmonary valve, there is no thromboembolism!

Not a blood clot, but an echo of abnormal body tissue.

Zheng Ren looked at the dual-energy CT image that had been re-added in his mind. After a moment of excitement, he fell silent.

Although not an embolus, the previous diagnosis was overturned.

But abnormal body tissue...means that there is a tumor tissue in the patient's pulmonary valve area!

Whether benign or malignant, it is a tumor tissue!

Pulmonary valve tumor, which is quite rare.

"Su Yun, ask Fugui'er to come up." Zheng Ren said solemnly.

Director Wei and Linge were both stunned, what does Boss Zheng mean?

After a brief, awkward silence, Zheng Ren immediately realized that he was in the doctor's office in the ICU and Su Yun was not with him.

"I'm sorry, Director Lin, Director Wei." Zheng Ren sneered.

"Boss Zheng? What did you find?" Director Wei asked in a low voice.

In such a case of pulmonary embolism caused by thrombosis in the pulmonary valve, Boss Zheng also has to use surgery to treat it?

Because part of the thrombus is not fixed in its original position, embolism in other positions is very likely to occur during the surgical operation.

So, this is a contraindication to surgery!

Boss Zheng is ready to attack the penalty area? impossible.

No, he wants to be called Professor Rudolf Wagner, is he going to be treated with interventional surgery?

No, Director Mao Chi didn't say anything.

"Director Wei, I also thought it was a pulmonary embolism at first." Zheng Ren said, "But after watching the film, I felt something was wrong."

"What's the problem?" Director Wei asked.

"How do you say it? From a subtle feeling, I preliminarily judged that the filling defect in the pulmonary valve area is the body tissue."

"..." Director Wei was dumbfounded.

For ordinary people, this sentence is a bit jerky. But for doctors, the presence of body tissue in the area of ​​the pulmonary valve means that there is a benign or malignant tumor there!

I go to... a tumor in the area of ​​the pulmonary valve?

Boss Zheng really dares to think about it.

But Director Wei did not refute, and chatted with Feng Jianguo some time ago, saying that Boss Zheng may not be good at endoscopic surgery.

Then he was slapped in the face by a standard endoscopic emergency hemostasis and foreign body removal operation.

Immediately, Boss Zheng diagnosed a pulmonary valve tumor. Director Wei really wanted to criticize Boss Zheng, but he held back.

Forget it, just listen honestly, don't make jokes like laparoscopic surgery.

"Go, take a look at the patient." Zheng Ren said.

Linger felt that Boss Zheng at this time was out of control at all, like a little beast.

His mind was full of surgeries, all patients.

Provide Boss Zheng with more surgical opportunities? I can't seem to do it myself. Besides, Director Kong has contacted the community hospital to Boss Zheng.

Everyone else has done what should be done, and I am a little late.

How to do it?

Zheng Ren walked out of the doctor's office in the ICU while taking out his mobile phone.

"Su Yun, ICU, called Fu Gui'er to come."

"I'm busy, okay, pulmonary valve tumor, I'm looking for Zhao Yunlong, you're busy."

After speaking, Zheng Ren hung up without waiting for what Su Yun said on the phone.

But he didn't keep calling.

"Boss Zheng, are you looking for someone who is willing to come up?" Linger immediately leaned over and asked.

"No, Su Yun will be here soon."

"Isn't Dr. Su busy?" Ringer was a little puzzled, did he hear it wrong.

"For patients with pulmonary valve tumors, there are only 37 cases reported in the world, of which 35 cases were known by autopsy after death, and 2 cases were operated, but the operation failed." Zheng Ren said: "When encountering such a case, he has Big things have to be let go."