I Can See Health

Remember [new] in one second! On the side, Fatty Cheng quickly explained to Lu Chen: "This is a patient who has had chest pain for a day. He has a history of high blood pressure and diabetes. The county hospital does not have imaging conditions. The CTA machine happened to be broken, so the patient was transferred."

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

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

The reason why the county hospital encouraged the patients to transfer was mainly because they considered the cause of the chest pain to be unusual.

Lu Chen looked at the case book. There were several big words written on it - Possible aortic dissection!

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

To put it bluntly, even if aortic dissection is diagnosed, county hospitals usually have cardiac surgery departments and are simply not equipped to treat patients with "aortic dissection".

"Lu Chen, now the patient's family is in a dilemma. If it's a mezzanine, they only know that there's no way to cure it, so they just drag it home. If it's not a mezzanine, they want to go to the general ward." Fatty Cheng explained in a low voice, "CCU ward The first day’s cost is seven to eight thousand yuan, which may not be affordable for the patient’s family.”

"Why not just do an aortic CTA in the outpatient clinic?" Lu Chen asked doubtfully.

"It's not too expensive!" Fatty Cheng said helplessly, "The outpatient clinic is not reimbursed, so this examination costs thousands of yuan!"

This matter is really difficult to handle!

Lu Chen looked at the patient in the hospital bed. He was in a very sluggish state, lying slumped on the bed with his eyes half-opened and a few painful moans coming out of his mouth from time to time.

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

With this level of health, he was 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 the expenses for your first day will cost three to four thousand yuan!"

The patient's family member was a man wearing a black windbreaker. Looking at his dress, he didn't look like someone who couldn't afford the thousands of dollars.

"Hey, what can we do?" The patient's family members sighed, "My uncle has no children. He is usually alone at home and has few relatives. Even if he is hospitalized, there is no one to take care of him."

It turns out they are not direct relatives...

The problem is getting more and more complex.

But Lu Chen was even more anxious now, because he could clearly see the life value on the patient's head. If he was not hospitalized quickly, he might be in danger in the next second!

Lu Chen looked through 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 a widened aorta.

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

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

Aortic dissection is a type of vascular disease.

Clinically, as long as there are diseases involving blood vessels, enhanced CT or angiography is required to see the vascular lesions.

It is difficult to see clearly the lesions of blood vessels with ordinary plain CT scan.

"Where is the film?" Lu Chen asked. He looked at the things the patient's family members brought with them, but did not see the film.

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

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

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

The patient's condition is so serious that he must not be separated from his family 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 member said.

Lu Chen nodded slightly, "Okay!"

…

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

The family has been unable to make a decision and is still contacting other family members.

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

"There is no other good way now." Lu Chen frowned deeply, "We can only take out the existing test results and study them."

Lu Chen was now 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 carried a video bag and ran to the CCU gate 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 scan.

Fatty Cheng and Gu Xinyue immediately put their heads over.

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

"Lu Chen, what are you looking at?" Fatty Cheng took a look at the CT film and found nothing abnormal.

"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 used a regular chest CT scan to see the blood vessels?" Gu Xinyue was also stunned and looked at Lu Chen in surprise.

How to view vascular imaging with ordinary CT?

As we all know, imaging of blood vessels requires the injection of contrast agent before they can be displayed.

Ordinary CT scans can only check 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 beside him.

At this time, Lu Chen has devoted himself to the recognition of CT images.

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

But he usually has no chance to use it.

At this time, Gu Xinyue frowned and said, "Lu Chen, I just saw that the patient's thoracic aorta has some calcified plaques, and the diameter is a little larger than normal, and there is no problem with the rest!"

On normal ordinary CT scans, the blood vessel shadows are generally black.

If white plaques appear on the blood vessel wall, it means that the blood vessel is calcified.

Calcified plaques are related to basic diseases such as high blood lipids and high blood pressure.

"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 all that can be seen on this ordinary CT scan, right?"

At this time, Lu Chen's eyes were like torches, and he didn't say anything.

He stared at the chest CT scan closely, carefully checking every section, and constantly comparing it.

Gu Xinyue was right. This plain scan CT scan can only show calcified plaques, except that the blood vessels are a little larger in diameter.

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

Suddenly, Lu Chen was stunned. He looked at the calcified points on the blood vessels on the chest CT scan and showed a look of sudden enlightenment.