Doctor Xu slapped the student on the head and said: Do you give up?
In fact, it is not necessarily more difficult to detect. The free thrombus may be very small or attached to the wall, making it difficult to distinguish. If you go to the source, you may find a larger one. A damaged heart will definitely show certain changes in its anatomical structure.
With this idea as a guide, doctors in the CT room must scan the key areas of the patient more carefully.
The speed of CT scanning is not slow, but it takes time for the doctor to read the film. Not long after, Xiao Shugang was pushed out of the examination room. Xie Wanying came out and greeted her cousin and his wife, asking them to go to the inpatient department first, while she stayed in the office to read the film with Teacher Xu.
Because the scans are detailed and hundreds of images are displayed on the computer, it is not easy for doctors to read them one by one and find faults.
Xie Wanying and Dr. Zhao sat next to Teacher Xu and the three of them read together. To be honest, if you are not used to this job, you will really doubt your eyesight when you first look at these hundreds of seemingly similar images.
"This is the terminal ridge, not a blood clot nor a tumor." Dr. Xu said, pointing to a small gray area in the white area on the film that looked like an abnormal protrusion.
The terminal ridge is the fusion line between the primitive atrial appendage and the vena cava sinus, located between the right atrial appendage and the vena cava sinus, extending from the superior vena cava to the inferior vena cava. The doctor in the CT room of the Provincial People's Hospital used this to play a trick in the report, which was where Dr. Xu saw at a glance that the report was partially fabricated.
After an enhanced CT scan, it seems difficult to find the thrombus in the right atrium. Then look for the ventricle mentioned in the previous discussion.
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If there is a suspected thrombus in the right atrium, the right ventricle will be the next focus. Anatomically, the right ventricle can be divided into three parts: the inflow part, the tricuspid valve inlet and its accessory structures. The second is the outflow part, a tubular structure such as the arterial cone that supports the pulmonary artery lobe. The third is the trabeculae between the above two.
When the heart is impacted by external force, the first manifestation may be damage to the ventricular wall.
The wall of the right ventricle is very thin, only 3 mm. Doctors need to be more patient in finding it.
If the general outline of the heart structure is normal, it is best to do an ultrasound examination to see if there is a problem with the activity function. Echocardiography can check the valve activity and blood flow in the heart. From CT, only the static structure of the tricuspid valve and pulmonary valve can be identified.
Three pairs of eyes searched through hundreds of images like looking for a needle in a haystack.
Experienced doctors read more films, and their brains change quickly when they look at images. Young doctors may not be able to keep up with this pace.
Doctor Zhao rubbed his eyes from time to time. As a student of imaging, not only his eyes were dazzled, but his brain was also confused. For this reason, he glanced at Xie, a student beside him.
Xie Wanying followed the teacher closely with her eyes fixed on him, her expression appearing very calm and composed, and she was meticulous.
Teacher Xu is fast. In a top-level tertiary hospital like theirs, the CT room has a huge workload every day. When encountering difficult cases, doctors may spend more time and energy to study, but if they really can't find the answer, no matter how much time they spend studying, it will not be effective. It is impossible to do research in a year or two. It's not that the doctor can't wait, but the patient's condition can't wait. However, today's patients are more difficult to find, and Doctor Xu has no time to teach students. While staring at the images, his brows are slightly anxious.
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