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RadiologyGastrointestinal Tract

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Techniques

Fluoroscopy ， plain radiograph

（ can find abnormal gas or calcification)Barium examination (BE) （ Mainly use

d ）CT( computed tomography)

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Barium---BaSO4 (Barium sulfate)

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• Oral administration

• barium enema

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good quality

• Stable

• No absorption

• Cheap

• Few side effect

• No hypersensitiveness

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side effect

• Nausea ， constipation ， diarrhea

• perforation of intestine ， peritonitis ， etc

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Taboo

• Acute gastric-intestinal perforation

• Esophago-tracheal fistula

• Obstruction of colon

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Type Ⅰ• BaCl2 + Na2SO4 → BaSO4↓ + 2NaCl• BaCO3 + H2SO4 → BaSO4↓ + H2O + CO2↑ • BaCl2 + H2SO4 → BaSO4↓ +2HCl

PS: BaCl2 :barium chloride BaCO3 :barium carbonate H2SO4 :sulphuric acid HCl ： hydrochloric acid NaCl ： sodium chloride

Na2SO4 ： Sodium Sulfate H2O ： water CO2 ： carbon dioxide

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TypeⅡ

• Barite size reduction BaSO4

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Barium examination

LAO; left anterior obliqueRAO; right anterior oblique

right anterior oblique positionOther positions.

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Esophagus LAO

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Esophagus RAO

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Gastrointestinal Tract Position

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What’s this?

• Diagnosis

• Differential diagnosis

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Imagings

• Mucosa imaging

• Turgor (full) imaging

• Compression imaging

• Double contrast imaging (barium & gas )

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Mucosa imaging

Not too much

barium

Which part is

mucous

membrane?

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Turgor (full) imaging

much barium

Appearance

Outline

peristaltic

movement

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Compression

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Compression

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BE (Compression) VS Endoscopy

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Double contrast

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pharynx

cardiac orifice

Esophagus

Liver

stomach

duodenum

colon

jejunumcecum

appendix

ileum rectum

Mouth

common bile duct

pyloric orifice

Anatomy

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Throat

larynx

sinus piriformis

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食管解剖

impression of aortic arch

Impression of left principal bronchus

Impression of left atrium

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gastric fundus

gastric body

cardiac orifice

cardiac orifice zone

lesser curvature

pyloric orifice

pyloric orifice zone

sinus ventriculi

greater curvature

angular notch

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Appearance of stomach

Crochetage

Fish hook

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horn of a cattle

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Cascade stomach

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asthenic type

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Mucosa of stomach

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peristaltic movement

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Duodenum

• ‘C’

• Four parts:

duodenal bulb;

descending part ;

horizontal part ;

ascending part

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???

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jejunum &ileum

jejunum :Feather (Mucous membrane )

• Ileum: few &superficial mucous membrane

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colon

haustra of colon

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rectum

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Basic changes

Outline

size

Mucosa

function

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Outline

Filling defect

niche sign

diverticulum

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Filling defect

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Filling defect

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• leiomyoma

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gastric cancer

• face lying

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Filling defect –where?

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• Leiomyoma of fundus

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• Gastrolith (Gastric stone)• Eat persimmon, hawthorn,date when the stomach is empty or after

drinking alcohol

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persimmon

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hawthorn

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date

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niche sign

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niche sign

“Out the lumen ”

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Where?

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“in the lumen ”

niche sign

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niche sign ---barium fleck/patch

Where?

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diverticulum

• Like a sac

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diverticulum

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size

stricture

Ectasia/expansion

•inflammation•tumor•compression •congenital disease •adherence •spasm

obstruction

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stricture &expansion

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expansion

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Mucosa

destruction

widen 、 thickening 、 crooked

packed

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destruction

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widen

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packed

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packed &

destruction