"Grinding glass? Take a look at the film." director Lu is also very helpless. He has come. Take a look at the film first.
The CT films of lung window and mediastinal window were inserted into the film reader. Director Lu took out his reading glasses and began to look at them carefully bit by bit.
Although full of complaints, after seeing the film, all the complaints were thrown out of the sky. She watched intently, her eyes almost sticking to the film.
There was a large area of ground glass shadow in the upper lobe of the left lung. There were many lesions with a large range. Some lesions were consolidation. The ground glass shadow coexisted with consolidation shadow or strip shadow.
From the image alone, it is a very typical "paving stone sign".
Paving stone sign, also known as "gravel pavement sign".
The HRCT feature of this image is that interlobular septal thickening and intralobular septal linear shadow are superimposed on the opaque ground glass background, which is similar to the irregular shape of paving stone.
The paving stone sign was initially described in alveolar proteinosis. It is usually characterized by the coexistence of bilateral ground glass density shadow and smooth septal thickening, patchy and map like distribution, mainly located in the perihilar area and lower lobe area.
But the patient is a problem with the left upper lung, which is still different from the general situation.
"Director Tang, do you think it''s invasive mucinous adenocarcinoma? How do I feel like cancer?" director Lu asked.
Generally speaking, the images of paving stone sign mainly appear in patients with pulmonary edema, PCP, exogenous lipoid pneumonia, sarcoidosis, diffuse alveolar hemorrhage, virus and opportunistic infection and invasive mucinous adenocarcinoma.
If there is no outbreak of pneumonia in Tianhe City, director Lu next needs to see the patient, ask the medical history, and make a differential diagnosis for invasive mucinous adenocarcinoma.
She has seen many patients with paving stone sign, most of whom are invasive mucinous adenocarcinoma, which is part of her rich clinical experience.
"I don''t think so." director Tang Yingtang said, "the patient had a physical examination before returning from Hainan, and there was no problem."
"Er..." director Lu stared at the film.
virus
Director Lu vaguely heard about the situation in Tianhe City, but like ordinary people, she didn''t know the specific situation. If it''s a virus
She glanced at Tang Ying secretly and carefully moved to the opposite side of Tang Ying.
"Boss, you should bring so many films together. Is it necessary?" a noisy voice came from the outside.
"Miss Wu, please come here." Han Guangyun''s voice also came in.
Miss Wu is here? Tang Ying didn''t notice director Lu''s little action and ran out quickly.
Before going out, Wu Mian came in with a large stack of films.
"Miss Wu," said Director Tang respectfully.
But Wu Mian''s face was as heavy as water. He didn''t speak. He glanced at the film reader and asked, "is it the patient''s film?"
He wears a mask and speaks a little stuffy.
"Yes."
"Put on all the masks." Wu Mian didn''t look at Tang Ying. After that, he came directly to the film reader.
Director Lu was stunned when he saw Wu Mian wearing N95. He suddenly had a bad feeling in his heart.
Wu Mian stared at the lung window, especially several ground glass images.
"Boss, although I''m not an expert in respiratory department, this patient can rule out the possibility of invasive mucinous adenocarcinoma, which is pneumonia caused by viral cold," Professor beilac said.
"Cold?"
"It must be. I''ve seen countless images."
Wu Mian chose a bag from the film bag he was carrying. It had the logo of jianxie hospital on it, and drew a strange logo on it with a pen.
"Card ~ ~"
Insert the lung window into the reader.
Almost as like as two peas, Han Guangyun and Xue Chun and director of the Tang Dynasty were all foolish.
As like as two peas, just judging from the perspective of imaging, it is clearly the image of two different people.
"Boss, I increasingly doubt that you have the ability to predict. You are like a red witch. You have super powers. I praise you!" Professor bellac said.
"Guess whose film is this?" Wu Mian bent his right index finger and beat the film on the film reader twice.
"This question is simply inhuman, boss. You asked it from the perspective of God." Professor beilac said everyone''s doubts.
"This is the image data of e-cigarette pneumonia in late summer and early autumn last year," Wu Mian said gently. "I reconstructed it and left the image."
"..." Professor bellac was surprised and his attitude straightened up.
E-cigarette pneumonia was featured in New England at that time. Although professor beilac did not conduct similar research, he knew it.
Boss even painstakingly reconstructed the image and printed it?!
Based on Professor beilac''s understanding of his boss, he planned all this.
Close up, the two films are compared with each other, which are very typical paving stone signs, and even the flocs exuded are basically similar.
Professor bellac''s mouth grew.
"Boss, I know why you don''t let me go back to Massachusetts!"
"Xue Yuan, what''s the dean of the second hospital?"
"..." Xue Chunhe didn''t speak, just glanced at Han Guangyun.
"Mr. Wu, president he has something at home and hasn''t arrived yet." Han Guangyun said, "but President he has contacted the machine for virus gene sequencing of respiratory tract samples or blood samples. The details are still being communicated."
"Xue hospital, in communication with the provincial department, highly suspected that the patient was infected with a virus homologous to Tianhe City." Wu Mian affirmed, "contact the infectious hospital and prepare for admission."
“……”
Everyone concluded.
"Boss, don''t you think it''s too arbitrary?" Professor bellac asked.
"Arbitrary?" Wu Mian said, taking photos, then took out another film and inserted it into the film reader.
"This is an image of a patient with mild pneumonia caused by ''electronic cigarette'', and the source is New England." Wu Mian said, "there are two small shadows in the left lower lung. Light, focal and ground glass density shadows. Is it a bit like" looking at flowers in the fog? "
"Zoom in on the lesion. The density of the lesion near the thoracic aorta is uneven, some light white and some snow-white. What''s the reason? Bellac, you answer this question."
"Boss, I''m not a respiratory expert." Professor beilac refused directly.
"Pneumonia caused by virus has relatively less alveolar exudate, less protein, leukocytes and epithelial cells in the fluid, and presents a relatively transparent liquid membrane.
Therefore, the image has low density and unclear boundary.
However, with the progress of the disease and bacterial infection, there are more and more contents in the exudate, the density will gradually increase, and the density difference between the exudate and the blood vessels will become smaller and smaller, which is manifested as a large solid shadow. "
"I''ve always been concerned about ''e-cigarette'' pneumonia," Wu Mian said. "Now, the two... Are similar."
Wu Mian forced himself to endure, but used a similar description.