I Can See Health

   Chapter 522 White Calcified Plaques

Beside him, Fatty Cheng quickly explained to Lu Chen, "This is a patient with chest pains for a day. He has a history of high blood pressure and diabetes. The county hospital does not have imaging conditions. It happened that the CTA machine was broken, so the patient was transferred."

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

   The patient is a 60-year-old male with coronary heart disease, chronic hypertension and diabetes, and a BMI of around 30.

The reason why the    county hospital encouraged the patient to come forward was mainly because they considered the cause of this chest pain to be unusual.

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

  To diagnose aortic dissection, you need a CTA machine, but the hospital machine just happened to be broken!

   Step back 10,000 steps, even if aortic dissection is diagnosed, county hospitals generally have cardiac surgery, and there is no condition to treat patients with "aortic dissection".

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

   "Why don't you just do an aortic CTA in the outpatient clinic?" Lu Chen wondered.

   "It's not too expensive!" Fatty Cheng said helplessly, "The outpatient clinic is not reimbursed, and this examination will cost thousands of dollars!"

   This is hard to do!

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

  The most important thing is that the health value on the patient's head is 35(——)!

   This level of HP has reached the edge 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 expenses on the first day will cost three or four thousand yuan!"

   The family member of the patient is a man in a black trench coat. Judging from his clothes, he doesn't look like someone who can't afford the thousands of dollars.

   "Hey, what can I do!" The patient's family sighed, "My uncle has no children and no daughters. He is usually alone at home and has no relatives. Even if he is hospitalized, no one will take care of him."

  It turned out not to be an immediate family member...

   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 get hospitalized quickly, it might be dangerous in the next second!

  Lu Chen 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 said to the patient's family: "Did you have a chest CT when you were in the county hospital?"

   The patient's family members saw a young doctor appearing beside them. Although they were a little puzzled, they nodded slightly, "Yes, but it's just plain CT scan. Didn't you say enhanced CT?"

   Aortic dissection, which is a disease of the blood vessels.

  In clinical practice, 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 is difficult to see clearly the lesions of blood vessels.

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

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

   The doctor from the county hospital said that there was nothing wrong with ordinary CT scans, so he did not take ordinary plain CT scans to heart at all.

   "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 before he is diagnosed and admitted to the CCU.

   "A friend of mine is in the car, let him 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 they are still contacting other family members.

   "Lu Chen, what are you doing with a plain CT scan? It's useless!" Fatty Cheng whispered aside.

   "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 scurrying around like a headless fly.

   Even if he could see the patient's health, there was nothing he could do.

   Less than ten minutes.

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

   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.

   Fatty Cheng and Gu Xinyue immediately put their heads together.

  The chest CT scan is actually very simple. It is equivalent to taking 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 scans and 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 an 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 vascular imaging?

   As we all know, the imaging of blood vessels needs to be injected into the contrast agent before it can be displayed.

   Ordinary CT, at most, depends on the diameter of the blood vessel and whether there is vascular calcification. As for the changes in the lumen, it is basically invisible!

   "Yeah." Lu Chen nodded slightly, completely ignoring the shock of the two beside him.

   At this point, Lu Chen has devoted himself to the identification of CT images.

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

   But usually there is no chance to display it.

   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, and the rest is fine!"

   On normal CT, the vascular shadows are generally black.

   If there is a white plaque on the blood vessel wall, it means that the blood vessel is calcified.

   Calcified plaques are 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 this."

  Gu Xinyue glanced at Fatty Cheng, and continued: "This is only so much you can see on an ordinary CT, right?"

   At this time, Lu Chen's eyes were like torches, but he didn't speak.

   He stared closely at the chest CT, carefully checked every slice, and kept comparing the front and back.

  Gu Xinyue is right. What can be seen on this plain CT scan is calcified plaques, except for the larger diameter of the blood vessels.

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

  Suddenly, Lu Chen was stunned. He looked at the calcified spots on the blood vessels of the chest CT, showing a sudden realization.

   (end of this chapter)