1 Radiology Gastrointestinal Tract

2 Techniques  Fluoroscopy ， plain radiograph （ can find abnormal gas or calcification)  Barium examination (BE) （ Mainly used ）  CT( computed tomography)

3 Barium---BaSO 4 (Barium sulfate)

4 Oral administration barium enema

5 good quality Stable No absorption Cheap Few side effect No hypersensitiveness

6 side effect Nausea ， constipation ， diarrhea perforation of intestine ， peritonitis ， etc

7 Taboo Acute gastric-intestinal perforation Esophago-tracheal fistula Obstruction of colon

8 Type Ⅰ BaCl 2 + Na 2 SO 4 → BaSO 4 ↓ + 2NaCl BaCO 3 + H 2 SO 4 → BaSO 4 ↓ + H 2 O + CO 2 ↑ BaCl 2 + H 2 SO 4 → BaSO 4 ↓ +2HCl PS: BaCl 2 :barium chloride BaCO 3 :barium carbonate H 2 SO 4 :sulphuric acid HCl ： hydrochloric acid NaCl ： sodium chloride Na 2 SO 4 ： Sodium Sulfate H 2 O ： water CO 2 ： carbon dioxide

9 Type Ⅱ Barite  size reduction  BaSO 4

10 Barium examination LAO; left anterior oblique RAO; right anterior oblique right anterior oblique position Other positions.

11 Esophagus LAO

12 Esophagus RAO

13 Gastrointestinal Tract Position

14 What’s this? Diagnosis Differential diagnosis

15 Imagings Mucosa imaging Turgor (full) imaging Compression imaging Double contrast imaging (barium & gas )

16 Mucosa imaging  Not too much barium  Which part is mucous membrane?

17 Turgor (full) imaging  much barium  Appearance  Outline  peristaltic movement

18

19 Compression

20 Compression

21 BE (Compression) VS Endoscopy

22 Double contrast

23 pharynx cardiac orifice Esophagus Liver stomach duodenum colon jejunum cecum appendix ileum rectum Mouth common bile duct pyloric orifice Anatomy

24 Throat larynx sinus piriformis

25 食管解剖 impression of aortic arch Impression of left principal bronchus Impression of left atrium

26 gastric fundus gastric body cardiac orifice cardiac orifice zone lesser curvature pyloric orifice pyloric orifice zone sinus ventriculi greater curvature angular notch

27 Appearance of stomach Crochetage Fish hook

28 horn of a cattle

29 Cascade stomach

30 asthenic type

31 Mucosa of stomach

32 peristaltic movement

33 Duodenum ‘C’ Four parts: duodenal bulb; descending part ; horizontal part ; ascending part

34 ???

35 jejunum &ileum Yjejunum :Feather (Mucous membrane ) Ileum: few &superficial mucous membrane

36 colon haustra of colon

37

38 rectum

39 Basic changes Outline size Mucosa function

40 Outline  Filling defect  niche sign  diverticulum

41 Filling defect

42 Filling defect

43 leiomyoma

44 gastric cancer face lying

45 Filling defect –where?

46 Leiomyoma of fundus

47 Cecum cancer

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

49 persimmon

50 hawthorn

51 date

52 niche sign

53 niche sign “Out the lumen ”

54 Where?

55 “in the lumen ” niche sign

56 niche sign ---barium fleck/patch Where?

57 diverticulum Like a sac

58 diverticulum

59 size  stricture  Ectasia /expansion inflammation tumor compression congenital disease adherence spasm obstruction

60 stricture &expansion

61

62 expansion

63 Mucosa  destruction  widen 、 thickening 、 crooked  packed

64  destruction

65 widen

66  packe d

67 packed & destruction