Chapter 1487: 1440 Dual-Energy C

Pulmonary artery embolism, also called pulmonary infarction.

It refers to a clinical condition where endogenous or embolic material blocks the pulmonary artery or its branches, causing obstruction of pulmonary circulation.

Its source is mainly thrombus, besides amniotic fluid embolism, fat embolism, air embolism, foreign body embolism, etc.

For example, amniotic fluid embolism is a severe complication after cesarean section; it cannot be treated with thrombolysis, and ten years ago it was almost untreatable.

In orthopedic surgery, one of the most feared complications is fat embolism.

After a patient develops pulmonary artery embolism, they experience severe anterior chest and back pain and dyspnea.

But early patients usually think they can endure it and it will pass, delaying the optimal treatment time.

But even when they reach the hospital, if early symptoms are atypical, the embolism site may not be as typical in this patient, making it easy to miss diagnosis.

From the images, there is nothing doubtful: it is a thrombus originating from the pulmonary valve that blocks the main trunk of the pulmonary artery.

Thrombectomy cannot be performed; atherectomy… the vessel wall is too thin, completely unlike coronary arteries. Moreover, since it originates from the pulmonary valve, the thrombus on the valve cannot be dealt with.

Atherectomy is impossible.

Zheng Ren's first impression, like many directors in 912, was that the patient could only be treated with thrombolysis.

But just as his gaze was about to move away from the image, Zheng Ren forced his gaze to stop.

In an instant, the vestibular nerve trembled violently, feeling awful.

Like riding a roller coaster for a moment.

Noticing that Zheng Ren was off, Director Wei asked, "Boss Zheng, are you tired from working all day?"

"No, there's a problem with the image," Zheng Ren said, staring fixedly at the image.

"Huh?" Director Wei did not understand.

The image is quite typical; the whole hospital consulted, and no one objected to the diagnosis. There was only slight disagreement, merely a difference in treatment approach.

"Wait, let me think again," Zheng Ren said, and immediately began using his reconstruction ability.

For this location's image, 3D reconstruction, contrast-enhanced NMR, and vascular CTA are of little use.

Zheng Ren, based on the most basic image data, adopted dual-energy CT reconstruction mode to start re-examining the lesion originating from the pulmonary valve.

The dual-energy CT system can image an object using two different X-ray energies, allowing precise determination of the object's composition ratio.

Its principle was already proposed in the 1970s.

By letting photon beams of two different energies penetrate the target for imaging, and using the difference in energy absorption curves of different substances, the object's composition can be accurately calculated.

Of course, to be very close to the factual truth, the doctor reading the films must have an extremely deep understanding of the images.

And Zheng Ren is that person.

Reconstruction ability is very handy, but doing dual-energy CT, Zheng Ren feels somewhat strained.

His brain is at full throttle, like a machine, with a constant rumbling. The CPU rapidly processes various data, and Zheng Ren feels somewhat overwhelmed.

Nevertheless, the dual-energy CT image is still constructed.

It is somewhat blurry, still different from the image produced by a standard machine. Even so, Zheng Ren feels it is sufficient.

The image shows another situation, completely different from the previous judgment.

In the large area of filling defect near the pulmonary valve, it is not a thrombus embolus!

It is not a thrombus, but an echo of abnormal bodily tissue.

Zheng Ren looked at the dual-energy CT image reconstructed in his mind, instantly excited, then fell silent.

Although it is not an embolus, it overturns the previous diagnosis.

But abnormal bodily tissue…… means that there is a —— tumor tissue in the patient's pulmonary valve area!

Whether benign or malignant, it is a tumor tissue!

Pulmonary valve tumor, this is quite rare.

"Su Yun, call Fugui'er up," Zheng Ren said in a low voice.

Director Wei and Lin Ge were stunned; what does Boss Zheng mean?

After a brief, awkward silence, Zheng Ren immediately realized he was in the ICU doctor's office, and Su Yun was not by his side.

"Sorry, Director Lin, Director Wei," Zheng Ren gave an embarrassed smile.

"Boss Zheng, what did you find?" Director Wei asked softly.

For cases of pulmonary artery valve thrombosis leading to pulmonary embolism, Boss Zheng also wants to treat with surgery?

Because part of the thrombus is not fixed in its original position, during surgery there is a high chance of embolism occurring elsewhere.

Therefore, this is a contraindication for surgery!

Is Boss Zheng preparing to assault the forbidden zone? Impossible.

No, he wants to call Professor Rudolf Wagner; does he mean to treat with interventional surgery?

Impossible; Director Mao Chi hasn't said anything about it.

"Director Wei, I initially also thought it was pulmonary embolism," Zheng Ren said, "but after looking at the images, I felt something was wrong."

"What problem?" Director Wei pressed.

"How to put it? Based on a subtle feeling, I preliminarily judge that the filling defect in the pulmonary valve area is bodily tissue."

"……" Director Wei was speechless.

This sentence is somewhat obscure for laypeople, but for doctors, the presence of bodily tissue in the pulmonary valve area means that a benign or malignant tumor has grown there!

Good grief…… a tumor in the pulmonary valve area?

Boss Zheng really dares to think that.

But Director Wei did not refute; earlier he had chatted with Feng Jianguo, saying Boss Zheng might not be skilled at laparoscopic surgery.

Soon after, he was slapped in the face by a standard laparoscopic emergency hemostasis and foreign body removal surgery.

Zheng Lao Ban immediately diagnosed a pulmonary Artery valve tumor. Director Wei really wanted to say a couple of things to Zheng Lao Ban, but he managed to hold back.

Forget it, just listen honestly, don't make a joke like laparoscopic Shou Bing.

"Let's go, go take a look at the patient." Zheng Ren said.

Lin Ge felt that Zheng Lao Ban at this moment was completely uncontrollable, like a little wild beast.

His mind is full of Shou Bing, full of patients.

Give Zheng Lao Ban more Shou Bing Opportunities? I probably can't do that. Besides, Director Kong has already contacted the Community Hospital for Zheng Lao Ban.

What should be done, others have already done it; I'm a bit late.

Then what should we do?

Zheng Ren took out his phone while walking out of the ICU doctors' office.

"Su Yun, ICU, call Fugui'er over."

"Busy, okay, the tumor of the pulmonary artery valve, I've found Zhao Yunlong, you go ahead and be busy."

After saying that, Zheng Ren didn't wait for Su Yun to say anything on the phone, and hung up directly.

But he also didn't continue calling.

"Zheng Lao Ban, do you want to call a thoracic specialist up?" Lin Ge immediately went over and asked.

"No need, Su Yun will be here right away."

"Isn't Doctor Su busy?" Lin Ge was a bit doubtful, wondering if he had misheard.

"Patients with pulmonary artery valve tumors, there are only 37 case reports worldwide, of which 35 were known from autopsy after death, 2 cases were Shou Bing, but the Shou Bing failed." Zheng Ren said: "When encountering such a case, he must drop even the most important matters."