Chapter 1440： Dual energy CT

Pulmonary embolism, also known as pulmonary stem.

It refers to a clinical condition in which an endogenous or exogenous embolus blocks the pulmonary artery or its branches causing pulmonary circulatory disorders.

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

For example, amniotic fluid embolism is a serious complication after caesarean section. Still not thrombolytic therapy, a decade ago, almost no solution.

In orthopedic surgery, one of the most feared complications is fat embolism.

After the patient has pulmonary embolism, there will be severe pain in the chest and back and difficulty breathing.

But early patients generally feel that they have to endure and endure the best treatment time.

But even in 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.

From the perspective of the film, there is nothing to be suspected, that is, the thrombus originating from the pulmonary valve, blocking the trunk of the pulmonary artery.

There is no way to take the bolt, grinding... The blood vessel wall is too thin, and the coronary artery is completely different. In addition to the pulmonary valve, the embolus on the valve cannot be treated.

Grinding surgery is impossible.

Zheng Ren’s first impression, like many directors of the 912, believes that patients can only be treated with thrombolysis.

However, when the gaze was just about to move away from the image, Zheng Rensheng stopped his eyes.

For a moment, the vestibular nerve trembled fiercely, so uncomfortable.

It’s like a roller coaster ride.

I was aware that Zheng Ren was wrong. Director Wei asked: "Zheng boss, is it a day to be tossed, a little tired?"

"No, there is a problem with the film." Zheng Ren looked at the film with a straight eye.

"Hmm?" Director Wei is puzzled.

The image is typical, the whole hospital consults, no one has any objection to the diagnosis. A little disagreement, but there are some differences in treatment.

"Wait a minute, let me think about it." Zheng Rendao, immediately began to use the ability to rebuild.

Images at this location, 3D reconstruction, nuclear magnetic enhancement, and vascular cta are of little use.

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

The dual-energy ct system can image an object using x-rays of two different energies, and can accurately obtain the composition ratio of the object.

Its principles have been proposed in the 1970s.

Photon beams of two different energies are imaged through the stage, and the composition of the object can be accurately estimated by using the difference in energy absorption curves of different substances.

Of course, it is very close to the truth, and doctors who need to read the film have an in-depth understanding of the image.

Zheng Ren is this person.

Rebuilding ability is very difficult. But doing dual-energy ct, Zheng Ren feels a little hard.

The brain is fully open, like a machine, and the roar is constant. Cpu quickly processed all kinds of data, Zheng Ren slightly overwhelmed.

But the dual-energy ct image is still built.

Some blurry, and the image made by the standard machine is still different. Even so, Zheng Ren feels that it is enough.

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

In the large area of ​​the filling defect near the pulmonary valve, it is not a thrombus embolus!

It is not a blood clot, but an echo of an abnormal body tissue.

Zheng Ren looked at the dual-energy ct image that was re-added in his mind. After an instant excitement, he suddenly became silent.

Although not an embolus, the previous diagnosis was overturned.

However, 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 tumors, which are quite rare.

"Su Yun, called Fuguier up." Zheng Ren Shen said.

Director Wei and Ringer both stunned. What does Zheng boss mean?

After a short, embarrassing silence, Zheng Ren immediately realized that he was in the doctor's office of Icu, and Su Yun did not stay with him.

"Sorry, Director Lin, Director Wei." Zheng Renxiao smiled.

“Zheng Boss? What did you find?” Director Wei asked whispered.

This kind of pulmonary valve has a thrombosis leading to pulmonary embolism, Zheng boss also used surgical treatment?

Because some of the thrombus is not fixed in the original position, embolization at other locations may occur during the surgical procedure.

So this is a contraindication to surgery!

Zheng boss is preparing to launch an impact on the restricted area? impossible.

No, he wants to call Professor Rudolf Wagner. Is he going to use interventional surgery?

No, the director Mao said nothing.

"Director Wei, I also began to feel pulmonary embolism." Zheng Rendao: "But after reading the film, I feel that there is a problem."

"What problem?" Director Wei asked.

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

"..." Director Wei was dumb.

This passage is slightly oyster for ordinary people. But for doctors, the appearance of body tissue in the pulmonary valve area means that there are benign or malignant tumors there!

I am going to... a tumor in the pulmonary valve area?

Zheng boss really dared to think.

However, Director Wei did not refute. He chatted with Feng Jianguo some time ago and said that Zheng Bo may not be good at laparoscopic surgery.

Then he was hit by a standard endoscopic emergency hemostasis and foreign body surgery.

Immediately, Zheng boss diagnosed the pulmonary valve tumor. Director Wei really wants to squirt Zheng boss two sentences, but he has resisted his life.

Forget it, listen to it honestly, don't make the same joke as laparoscopic surgery.

"Go, go and take a look at the patient." Zheng Rendao.

Ringer felt that the boss of Zheng at this time was completely uncontrolled, like a little beast.

His mind is full of surgery, all patients.

Give Zheng boss more opportunities for surgery? I can't seem to do it myself. Besides, Director Kong has already contacted the boss of Zheng to contact the community hospital.

Everyone else who did the work did it, and it was a bit late.

How do you do that?

Zheng Ren took out his mobile phone while walking out of the icu doctor's office.

"Su Yun, icu, called Fuguier."

"Busy, that line, the tumor of the pulmonary valve, I am looking for Zhao Yunlong, you are busy."

After that, Zheng Ren did not wait for Su Yun to say anything on the phone and hang up directly.

But he did not continue to call.

"Zheng boss, are you looking for someone who is in the heart?" Ringer immediately asked.

"No, Su Yun will arrive soon."

"Dr. Su is not busy?" Ringer has some doubts, whether he is wrong.

"Pulmonary valve tumor patients, there are only 37 cases reported in the world, of which 35 cases were known after death and 2 cases were surgery, but the operation failed." Zheng Rendao: "In this case, he has Everything has to be let go."