I can see health

Chapter 522 White Calcified Plaque

At the side, Fatty Cheng quickly explained to Lu Chen: "This is a patient with chest pain for a day. He has a history of hypertension and diabetes. The county hospital does not have imaging facilities. It just so happened that the CTA machine was broken, so the patient was transferred."

Lu Chen nodded slightly, and took over the patient's medical records at the county hospital from Fatty Cheng.

The patient is a 60-year-old male with coronary heart disease, long-term hypertension, diabetes, and BMI30 or so.

The reason why the county hospital encouraged the patient to refer was mainly because they considered that the cause of the chest pain was unusual.

Lu Chen looked at the case book, there were a few large characters written on it - possible aortic dissection!

If you want to diagnose aortic dissection, you need a CTA machine, but the machine in the hospital happened to be broken!

Taking a step back, even if aortic dissection is diagnosed, county hospitals generally have cardiac surgery, and there is no way to treat patients with "aortic dissection".

"Lu Chen, the patient's family is struggling right now. If it's a dissection, they just know there's no way to cure it, so they drag it home. If it's not a dissection, they want to go to the general ward." Fatty Cheng explained in a low voice, "CCU ward The fee for the first day is 8000 yuan, and the patient's family may not be able to bear it..."

"Why not just do a CTA of the aorta in the outpatient clinic?" Lu Chen wondered.

"It's not too expensive!" Fatty Cheng said helplessly, "If the outpatient clinic is not reimbursed, this check will cost thousands of dollars!"

This matter can be difficult to handle!

Lu Chen looked at the patient on the hospital bed. He was in a very sluggish state. He lay limp on the bed, his eyes half-opened, and a few painful groans came out of his mouth from time to time.

Most importantly, the health value on the patient's head is 35(——)!

This level of health is on the verge of sudden death at any time.

At this time, Zhou Bin on the side continued to persuade: "The patient's situation is too dangerous. Even in an ordinary ward, all your first day's expenses will cost 4000 to [-] yuan!"

The patient's family member was a man in a black windbreaker. Judging by his attire, he didn't seem like someone who couldn't afford these thousands of dollars.

"Hey, what can I do!" The patient's family member sighed, "My uncle has no children, and he usually lives alone at home without any relatives. Even if he is hospitalized, no one will take care of him."

It turns out that they are not immediate family members...

This problem is getting more and more complicated.

But Lu Chen is even more anxious now, because he can clearly see the life value on the patient's head. If he doesn't rush to the hospital for treatment, it might be dangerous in the next second!

Lu Chenfan looked at the patient's only medical records, and suddenly saw a sentence, the patient had undergone a chest CT scan at the county hospital, and the results showed localized emphysema and widened aorta.

Lu Chen hurriedly asked the patient's family: "When you were in the county hospital, did you have a chest CT?"

The family members of the patient saw a young doctor appearing from the side. Although they were a little puzzled, they still nodded slightly, "Yes, but it's just a plain CT scan. Didn't you say to enhance the CT scan?"

Aortic dissection, which is a type of blood vessel disease.

Clinically, as long as it is a disease involving blood vessels, it is necessary to use enhanced CT or angiography to see vascular lesions.

Ordinary plain CT scan, it is difficult to see vascular lesions clearly.

"Where is the film?" Lu Chen asked. He looked at the things that the patient's family had brought with him, but he didn't see the film.

"It's in my car. My car is in the hospital." The patient's family member said, "If you want to see it, I can go and get it."

The doctor at the county hospital said that there was nothing wrong with ordinary CT, so he didn't take ordinary plain CT to heart.

"You can't go!" Lu Chen shook his head.

The patient's condition is so serious that he must not be separated from his family members until he is diagnosed and admitted to the CCU.

"A friend of mine is in the car, I'll ask him to bring it up." The patient's family said.

Lu Chen nodded slightly, "Okay!"

……

Currently, the patient is stuck at the door of the CCU.

The family members have been unable to make a decision for a long time and are still in contact with other family members.

"Lu Chen, what do you think the plain CT scan is for? It's useless!" Fatty Cheng whispered beside him.

"There is no other good way now." Lu Chen frowned deeply, "The only way is to take out the existing inspection results and study it."

Lu Chen is also running around like a headless fly.

Even if he could see the patient's health, he couldn't do anything about it.

Less than 10 minutes.

A young man rushed to the gate of the CCU with a video bag.

Zhou Bin was still communicating with the patient's family about the condition, so Lu Chen took the imaging bag and took out the CT film from it.

Fatty Cheng and Gu Xinyue immediately moved their heads closer.

Chest plain CT scan is actually very simple. It is equivalent to treating a person as a cross-section and cutting it into many parts, and you can see the image of each cross-section.

"Lu Chen, what are you looking at?" Fatty Cheng glanced at the CT scan, but found nothing unusual.

"Look at the blood vessels." Lu Chen frowned. He was staring at the patient's ascending aorta, thoracic aorta, and abdominal aorta, looking at each level in turn.

"You use ordinary chest CT to see blood vessels?" Gu Xinyue was also stunned, and looked at Lu Chen in surprise.

How does ordinary CT look at angiography?

As we all know, the imaging of blood vessels can only be displayed after injection of contrast agent.

Ordinary CT, at most, can look at the diameter of blood vessels and whether there is vascular calcification. As for the changes in the lumen, they are basically invisible!
"Yeah." Lu Chen nodded slightly, completely ignoring the shock of the two people around him.

At this time, Lu Chen had already devoted himself to the identification of CT images.

Since he exchanged the "CT Interpretation" skill book, his ability to judge images has also been greatly improved.

But usually there is no chance to display it at all.

At this time, Gu Xinyue frowned and said, "Lu Chen, I saw some calcified plaques in the patient's thoracic aorta, and the diameter was a little larger than normal. There is nothing wrong with the rest!"

On normal ordinary CT, vascular shadows are generally black.

If there are white plaque shadows on the blood vessel wall, it means that the blood vessel has calcification.

Calcified plaque is related to basic diseases such as hyperlipidemia and hypertension.

"Yes, I also saw these calcified plaques." Fatty Cheng also nodded, "The patient has always had high blood pressure, which should be related to it."

Gu Xinyue glanced at Fatty Cheng, and continued: "This is the only thing that can be seen on an ordinary CT, right?"

At this moment, Lu Chen's gaze was like a torch, and he didn't speak.

He stared closely at the chest CT, carefully inspected each section, and kept comparing before and after.

What Gu Xinyue said is right, this plain CT scan, what can be seen, except for the larger diameter of blood vessels, is only calcified plaque.

However, do calcified plaques really only represent high blood pressure or high blood lipids?

Suddenly, Lu Chen was taken aback. He looked at the calcification spots on the chest CT blood vessels, showing a look of sudden realization.

(End of this chapter)