Sleepless Doctor

"Ground glass shadow? Take a look at the film." Director Lu was also helpless.

The CT films of the lung window and the mediastinum window were inserted into the reader. Director Lu took out the glasses and began to look at it carefully.

Although I was complaining, after seeing the film, all the complaints were thrown away. She watched intently, her eyes almost touching the film.

There is a large area of ​​ground-glass shadow in the upper lobe of the patient's left lung, with many lesions and a large area. Some of the lesions are consolidated, and the ground-glass shadow coexists with the consolidation shadow or the striped shadow.

Judging from the image alone, it is a very typical "paving stone sign."

Paving stone sign, also known as "gravel road sign".

The hrct feature of this image is that the thickening of the interlobular spacing and the line shadow of the interlobular spacing are superimposed on the ground glass opaque background, which is named after the paving stone of similar irregular shape.

The paving stone sign was originally described in alveolar proteinosis. It usually manifests as the coexistence of bilateral ground-glass densitometry and smooth septal thickening, which is patchy and map-like, mainly located in the perihilar area and lower lobe area.

However, the patient has a problem with the upper left lung, which is still different from the general situation.

"Director Tang, do you think it is invasive mucinous adenocarcinoma? How do I feel like cancer." Director Lu asked.

Generally speaking, images of paving stone signs mainly appear in patients with pulmonary edema, c, exogenous lipid pneumonia, sarcoidosis, diffuse alveolar hemorrhage, viral and opportunistic infections, and aggressive mucinous adenocarcinoma.

If there is no outbreak of pneumonia in Tianhe City, Director Lu will then see the patient, ask about the medical history, and make a differential diagnosis for invasive mucinous adenocarcinoma.

She has seen many patients with paving stone sign, most of which are invasive mucinous adenocarcinoma, which is part of a wealth of clinical experience.

"Consideration is not the same." Director Tang Yingtang said, "The patient had a physical examination before returning from Hainan and there was no problem."

"Uh..." Director Lu stared at the film blankly.

Virus?

Director Lu vaguely heard about the situation in Tianhe City, but like ordinary people, she was not clear about the specific situation. If it's a virus...

She glanced at Tang Ying secretly, and carefully moved to the opposite side of Tang Ying.

"Oss, you want to bring so many films together, is it necessary?!" A noisy voice came from outside.

"Teacher Wu, please come here." Han Guangyun's voice also came in.

Teacher Wu is here? Tang Ying didn't notice Director Deer's small movements and hurried out.

Before going out, Wu Mian walked in carrying a large stack of films.

"Mr. Wu." Director Tang greeted respectfully.

But Wu Mian's face was sinking and he didn't speak. He glanced at the reader and asked, "Is it the patient's film?"

He was wearing a mask and talking a little dull.

"Yes."

"Put on all the masks." Wu Mian didn't even look at Tang Ying, and went directly to the reader after speaking.

Director Lu was taken aback when seeing Wu Mian wearing an n95, and suddenly had a bad feeling in his heart.

Wu Mian stared at the lung window, especially the few ground-glass-like images, watching very carefully.

"Oss, although I am not an expert in respiratory medicine, this patient can rule out the possibility of invasive mucinous adenocarcinoma, which is pneumonia caused by a viral cold." Professor Barack said.

"cold?"

"It must be, I have seen countless images of this."

Wu Mian selected a bag from the film bag he was carrying, with the logo of Jianxie Hospital on it, and drew a weird logo on it with a pen.

"Card~~"

The lung window is inserted into the reader.

Director Lu and Director Tang, as well as Han Guangyun and Xue Chunhe behind them were all dumbfounded at the almost identical images.

To say they are exactly the same, but only from the perspective of imaging, it is clear that they are images of two different people.

"Oss, I am more and more suspicious that you have the power of an unexplored prophet. You are like a red witch with super powers. I praise you!" Professor Belak said.

"Guess, whose film is this?" Wu Mian's right index finger was bent, and his knuckles hit the film on the reader twice.

"This question is too inhumane, oss, you asked it from the perspective of God." Professor Barack said everyone's doubts.

"This is the image data of e-cigarette pneumonia in the late summer and early autumn last year." Wu Mian said softly, "I did the reconstruction and left the image."

"..." Professor Barak was taken aback, his attitude straightened up.

E-cigarette pneumonia, there was a column in "New England" at the time. Although Professor Barack did not conduct similar research, he knew that there was such a thing.

Does oss laboriously reconstruct the image and print it out? !

Based on Professor Belak's knowledge of his own oss, he had planned all this.

When you look closely, the two films are compared with each other. They are both typical paving stone signs, and even the exuded flocs are basically similar.

Professor Barack’s mouth gradually grew.

"Oss, I know why you didn't let me go back to Massachusetts!"

"Xue Yuan, where is the Dean of the Second House?"

"..." Xue Chunhe didn't speak ~www.wuxiaspot.com~ just glanced at Han Guangyun.

"Mr. Wu, there is something wrong with Dean He's house, and it hasn't arrived yet." Han Guangyun said, "However, Dean He has already contacted. The machine for sequencing the virus gene of respiratory specimens or blood specimens is still communicating with each other."

"Xue Yuan, communicated with the provincial government, highly suspected that the patient has been infected with the same virus as Tianhe City." Wu Mian said affirmatively, "contact the infectious disease hospital and prepare to be admitted."

"..."

Everyone concluded.

"Oss, don't you think it's too arbitrary?" Professor Barack asked.

"Arbitrary?" Wu Mian said, taking pictures, and then took out another film and inserted it into the reader.

"This is an image of a patient with mild pneumonia from the'e-cigarette'. The source is from New England." Wu Mian said, "There are two small shadows in the lower left lung, a faint, focal, ground-glass density shadow, is it a bit?" "Looking at flowers in the mist?"

"Look at the lesions in a magnified manner. The density of the lesions on the inside near the thoracic aorta is uneven, some pale and some snow white. What is the reason? Barack, you answer this question."

"Oss, I am not an expert in respiratory medicine." Professor Barak directly refused.

"The pneumonia caused by the virus has relatively little exudate in the alveoli, and there are few proteins, white blood cells, and epithelial cells in the liquid, which presents a relatively transparent liquid film.

Therefore, the image has low density and unclear borders.

However, as the disease progresses, and bacterial infections are combined, and the contents of the exudate become more and more, the density will gradually increase, and the density difference with the blood vessels will become smaller and smaller, showing a large-scale consolidation. "

"I have always been concerned about'electronic cigarette' pneumonia." Wu Mian said, "Looking at it now, the two... are similar."

Wu Mian forcibly endured it, only to describe it in a similar way.