呼吸系統(tǒng)X線診斷-英文PPT演示幻燈片

1、1,Radiodiagnosis in the Respiratory System,呼吸系統(tǒng)X線診斷,貴州省人民醫(yī)院放射科 唐雷,2,Section 1 The lungs,The thoracic cage 胸廓 The thoracic cage is in symmetry（對稱） or not. The ribs and the other bones seen, appear to be normal, or in destruction（骨質(zhì)破壞）, or malformation（畸形）, and deformation（變形）. The intercostal spaces

2、（肋間隙）are symmetrical or not, broadened, or narrowed. Soft tissues seem normal or abnormal.,3,2. The lungs Location : If lesions are limited by boundaries of a lobe（肺葉） or a segment（肺段）, the location of the lesion is defined and described directly with the specific lobe or segment. If the lesion has

3、a massive range and vague margin, it can be described according to the upper, middle or lower regions from top to bottom, and inner, middle or outer zones from inside to outside of the lung fields.,4,Lung fields（肺野） and pulmonary zones（肺帶）,5,Lung lobes（肺葉） and segments（肺段),6,Lung lobes（肺葉） and segme

4、nts（肺段),7,Sizes of opacities can be described according to the number of intercostal spaces, lobes and segmengts and/ or direct measurements. If a lesion is round, the diameter can indicate its size.,(2) Sizes of opacities:,8,(3)Shapes of shadows:,miliary shape 粟粒狀 Spots or patches 斑點狀或斑片狀 Single sm

5、all nodule 單發(fā)小結(jié)節(jié)狀 Multiple nodules 多發(fā)結(jié)節(jié)狀 Mass 團(tuán)塊狀 Fog-like shadow 云霧狀陰影 Consolidation 實變 Calcification 鈣化 Flocculent opacities 絮狀陰影 Stripe-like opacities 索條狀影 Cavity shadows 空洞影 Honeycomb shadows 蜂窩狀影 Reticular shadows 網(wǎng)狀陰影,9,The margins of lesions can be manifested as fuzzy（模糊）, clear（清晰）, sharp（銳利

6、）, smooth（光整）, irregular, radiating（放射狀）, spiculation（毛刺狀）, and etc. (5)Relationship between lessions and the surrounding tissues: Pulmonary atelectasis（肺不張） pulls adjacent mediastinum to the affected side. Lung cancer can infiltrate（侵犯） thoracic vertebrae（胸椎） and adjacent ribs.,(4)Margins :,10,3. T

7、he pulmonary hilum （肺門）： Hilar enlargement, decrease, nodules, mass, calcification, reationship with mediastinum, alteration of density, and displacement. 4. The mediastinum（縱隔）: Observation should include location of the trachea（氣管）, width of the mediastinum; location, size, shape, displacement of

8、the heart and great vessels. 5. The diaphragm（膈肌）: Assessment should involve shape of surface, and sharpness of the costophrenic angles（肋膈角）.,11,Cases in the lungs,12,Case 1. 正常胸片,The thoracic cage remains symmetrical. All the seen bones are nothing remarkable. The trachea locates centrally without

9、deviation. The lungs are clear, while the lung markings are natural and regular. Both pulmonary hila show neither enlargement nor decrease. The heart and great vessels appear normal in their position, size and shape. The diaphragm has a smooth surface with sharp costophrenic angles. Diagnosis: Norma

10、l in the lungs, heart, and diaphragm.,13,Case 2. 患兒2y，咳嗽1周,The thoracic cage remains symmetrical. All the seen bones are nothing remarkable. The trachea locates centrally without deviation. The lungs markings become thickened in the inner and middle zones of bilateral middle and lower lung fields. S

11、ome scattered patch-like infiltrations mix with the thickened lung markings. Their margins appear vague. Both pulmonary hila show blurred, but not in evident enlargemen. There is nothing remarkable in the heart and great vessels. The diaphragm has a smooth surface with sharp costophrenic angles. Dia

12、gnosis: Bronchopneumonia.（支氣管肺炎）,14,Case 3. 男，18y，咳嗽1周、發(fā)熱2天,The thoracic cage remains symmetrical. All the seen bones are nothing remarkable. The trachea locates centrally without deviation. There is a large patchy homogeneous opacity in the right middle lobe with a slightly fuzzy margin. It covers

13、the right pulmonary hilum. The rest of the lungs remain clear. The left pulmonary hilum has no enlargement. No suspected signs are found in the heart and great vessels. The diaphragm has a smooth surface with sharp costophrenic angles. Diagnosis: Pneumonia（肺炎） in the right middle lobe. Re-examinatio

14、n is suggested after treatment.,15,Case 4. 高熱、咳嗽、膿痰10天,There is a large round-like opacity in the posterior segment of the left lower lung with a fuzzy margin, in the size of 2.0cm3.0cm. A cavity can be found with an air-fluid level （氣液平面）in the shadow, which involves the left pulmonary hilum and ad

15、jacent lung. Nothing is special in the heart, diaphragm and right lung. Diagnosis: A pulmonary abscess in the posterior segment of the left lower lung .,16,Case 5. 腮腺腺樣囊性癌術(shù)后3年，復(fù)發(fā)2月,The thoracic cage remains symmetrical. All the seen bones are nothing remarkable. Multiple nodules with clear margins are dis-played diffusely in both lungs in different sizes. Both pulmonary hila show neither enlargement nor decrease. The heart and great vessel