呼吸系統(tǒng)影像學(xué)(Imaging of respiratory system)

最新資料推薦呼吸系統(tǒng)影像學(xué)（Imagingofrespiratorysystem）呼吸系統(tǒng)影像學(xué)（Imagingofrespiratorysystem） 2.1respiratorysystem1.Obstructiveatelectasis(endobronchialtumor,mucoussuppository,bronchialstenosisorexternalcompression,thelungtissueatrophiedwhentherewasnogasinthealveoliorasmallamountofgaswasincluded).CTmanifestations:thelungtissuedensityincreases,thevolumeshrinks,thetriangleistriangular,theedgeisclearandthetippointstothelungdoor,thebaseisattachedtotheseptumorthechestwall,enhancedafterenhancement.Theadjacentstructureiscompensatedfor.2.EmphysemaandlunghyperinflationPrinciple:thebronchiolesarenotcompletelyobstructed,andthelivingflapisventilated.Thetwolungsarewidelydistributedwiththeirreversibledamageofthealveolarwall.Thelatterisnotassociatedwiththedestructionofthealveolarwallandisoftenoverinflatedwithonesideoronelobe.ThepathologicalanatomycanbedividedintosmallleafcentralemphysemaandpulmonaryemphysemaattheintervalofpulmonaryemphysemaThree,theconsolidationofthelung(referstotheterminalbronchiolesgasbeyondlacunainairwerereplacedbyaliquid,cellortissue1/13pathological.Involvingtherangecanbeacini,lobular,pulmonarylobectomyorparagraph.) CTmanifestations:glandularnodulesandflakymarginblurredimages.Theshapeofthelungsectionorthedistributionofthepulmonarylobe,whichcanbeseenintheinteriorofthebloodvessels,canbeseenasalarge,high-densitysolidshadow,whichcanbeseenasbronchimeteorology.Bronchimeteorology:thesolidlungtissueissetoffbythebronchialbronchialfacies.Intherealchangearea,thetransparenttrachealshapeofthebranchisknownasbronchialmeteorology.Alsoknownasairbronchialsigns,includingbronchialsigns(commonin:pneumonia(largeleaf),pulmonaryedema,pulmonarytuberculosis,pulmonarycontusion,pulmonaryhemorrhage,pulmonaryinfarction)4.Pulmonarymasses(2cmindiameter,withclear,rounded,roundedshapes.Seeninneoplasticlesions(benign,malignant)and non-neoplastic lesions (nodules, inflammatorypseudotumor). Characteristicsofbenignlungtumors:circularorelliptic,marginsmoothsharpseeexplosionincornfigureadiposetissuecalcificationormildenhancementCTvalueincreaseslessthan20hu,below3cmindiameter,surroundedbysatellitekitchenadjacentpleuralthickeningandadhesion Malignantlungtumorcharacteristics: 1.最新資料推薦Marginallobesormarks2.Thereareradiated,shortandthinburrsaround3.Theadjacentpleuralmembraneisconcavetothemass4.Theinnerbloodvesselsofthemasses5.Thebronchialtubeofthetumoristruncatedornarrow,andthewallthickens 6.Enlargementofthemediastinallymphnode,shorterthan1-1.5cm 7.Theemptyinnerwallformedisirregularandhaswallnodules8.Thereare1-2mmvacuolesandairbronchogenicsignsinthemassThechestwall,thepleuraanddistantmetastasesVoidandcavityCavitation:necroticliquefactionofdiseasedtissueinthelungisformedbytheremovalofbronchialtubes.Common:pulmonaryabscess,tuberculosis,lungcancer,staphylococcalpneumonia,fungaldisease.Above3~10mmisthickwallhole,3mmbelowisthinwallhole.Cavity:thepulmonarycavitywasenlargedwiththepathologicandthelocalgasswellingandlocalpneumothoraxcausedthecollectionofalveolarwalls.Common:pulmonaryalveolar,branched,pneumatocyst,pulmonarycyst,etc.Cavitywallthicknessaboutlmm. Six,pulmonaryinterstitiallesions(mainlyreferstoinfringementofinterstitiallungdisease,infactisoftenaccompaniedbythechangeofthelungparenchyma.Atthesametimewhendiseaseandpulmonary3/13interstitial, can be produced within the pulmonaryinterstitial gap pathological liquid, inflammatoryinfiltration,granulationtissue,fibroustissueandtumortissue.Differentinfringementofpulmonaryinterstitialdiseaseareacanbefoundin:chronicidiopathicpneumonia, interstitial fibrosis, sarcoidosis, andlymphangiticspreadofcarcinoma,connectivetissuedisease,pneumoconiosis,etc.) CTmanifestations: Interfacialfeatures:theinterfacebetweenthickeningandaeropulmonarytissuecontrast. Thebronchus,thebloodvesselsarethickening. ThickeningoftheinterlobularseptumandcentrilobularstructureExtensionoftractionandtractionThechangesofthegrindingglass:pathologicalcanbeasmallamountofseepageinthealveoli,theswellingofthealveolarwallortheinflammationofthealveolarseptum.(1)interfacesign:forearlyperformance.Inflatablelungandbronchus,bloodvessels,dirtyappearedirregular,notsmoothinterfacebetweenpleura,foundinmostofthepulmonaryinterstitiallesions(89%)andidiopathicpulmonaryfibrosis(98%).Nonspecific.2.Thickeningoflobularseptum:oneofthecharacteristicsofpulmonaryinterstitiallesions.Itisshownastheverticallineshadowofthepleuralsurface,which最新資料推薦1-2cminlengthandis0.5-2cmapart,andisalsoknownastheintervalline,whichisinthecentralareaofthelunginapolygonandarch.Oftenaccompaniedbylobulestructuredeformation,irregular,smallleafinternallinelikeshadow.Thickeningofperibronchovascularinterstitium:acommonsignofinvasivelungdisease.Themostcommonlesionsareinterstitialpulmonaryedema,primaryandprogressivelymphaticlesionssuchaslymphangiopathy,sarcoidosisandpulmonaryfibrosisNodules(2-5mmnodules)4.Smallleafinternalline:thethickeningofinterstitialthickeningofthesmallleafiscausedbythinmeshandscreenshape,whichiscommoninpulmonaryfibrosisSmallvesiclesandhoneycombs:smallvesiclesarecircular,andhaveaclearboundarycommonlyseeninidiopathicpulmonaryfibrosis,fibroticalveoli,asbestos,andchronicallergicpneumonia.Cysticlumenisseenintheendoffibrosis,oftenaccompaniedbystructuraldeformationandtraction.6,nodularshadows:1~10mmsmallnodularshadows,oftenhasawellasinterstitiallesions,boundaryisnotclearorthegroundglassdensitymainlyaffectedgasgap,buttoidentifythestromaorsubstantialinvolvementisoftendifficult7.Groundglass5/13density:themistdensityincreases,andthebronchovascularstructurecanbedistinguished.Canbecausedbyairgaplesions,interstitialthickeningorboth.Iftherearenootherfibrosissigns,itisoftensuggestedtobearecoverablelesion.Inchronicinvasivelunglesionsfoundinidiopathicpulmonaryfibrosis,withhairincollagenvasculardiseasefibrosisalveolarinflammation,desquamationofinterstitialpneumonia,hypersensitivitypneumonitis,sarcoidosis,alveolarproteinADcool-headeddisease.) Vii.Pleurallesions Pleuraleffusionandfluidpneumothorax Thepleuralcavityisapotentialnegativepressurecavity,andthereisasmallamountofliquidinnormal,whichcanbeusedtolubricatethePleuraltumors:pleuraltumorscanbefoundinthepleuraprimaryormetastatictumors,suchaspleuralmesothelioma(benignandmalignant),malignantthymomaextendsalongthepleuraandlungcancermetastasis,etc.,alsovisibleinthetumorlesionsuchasmachinesexpyothoraxandpleuralplaquesareasbestosisPneumothorax:CTimage(lungwindow)isseeninthevolumeofthegas,whichcanbeseenindifferentareasofthelung,withnolungtexture,andtheinnermarginofthecompressedlungedgeBasicshadowdiagnosisofmajorcommondiseasesinthechestChronicbronchitisPneumonia(large最新資料推薦leaf)LungabscessTuberculosis(TB)bronchiectasisLungcancerMediastinaltumorCommoncardiovasculardisease ChronicbronchitisChroniccoughandphlegm-twoconsecutiveyears,threemonthsinayear--------------------------------------------Causes:smoking,infection,airpollutionClinicaldiagnosisisthemain,imagingdiagnosisisauxiliaryThemainmanifestationsofCTare:pulmonarytexturedisorder,distortion-webweaves,thickeningofbronchialwall-tracksign,secondaryemphysemaCTisusedtoidentifyotherdiseasesthatcausecoughandsuchasbronchiectasis,lungcancer,andpulmonaryinfection2,pneumonia (1)largeleafpneumonia(mainlycausedbypneumococcus,alsoknownasklebsiella,legionellainfection;typicallobulepneumoniainyoungpeople)CTmanifestations:hyperemiaperiod:itcanbefoundthatthelesionareaisintheshadowofthegroundglass,andtheedgesareblurred.Bloodvesselsinthediseasedareaarestillvisible.Theperiodofrealchange:alarge,flakyshadowthatcanbeseeninthedistributionoflungsegmentsorlungleaves,visiblebronchialmeteorology.Dissipationperiod:withtheabsorptionofthelesion,thedensityoftherealvariableshadowdecreases,and7/13thespecularshadowisscatteredindifferentsizesThefinalabsorptioniscomplete (2)lobule(bronchial)pneumoniaBronchialenlargementofbloodvesselbundleintheconventionalCTscanbothlungspart,visiblenodularshadowsandflakeofdifferentsize,about1~2cmsize,edgeblur,multiplesmallshapeshadowbetweendopedwithgaslungtissue.(3)interstitialpneumonia Earlyormildcasesofinterstitialpneumonia,canbeperformedonbothsidesofbronchialenlargementofbloodvesselbundle,accompaniedbyshadowgrindingofglasssamples,onbehalfofthebronchialaroundwithinterstitialinflammatoryinfiltratesandalveoliinflammatoryinfiltratesandasmallamountofeffusion.Thecontrastcanbeaccompaniedbyasmallleaf,whichcanbeseenasaspecularshadow.Thepulmonaryandmediastinallymphnodesmayincrease.Iii.Pulmonaryabscess(progressofpulmonaryinfection) Pulmonaryabscessisthelocalnecrosisandsuppurativeinflammationcausedbythesuppurativebacteria.Clinicalmanifestationiscoldwar,highfever,coughpurulentphlegm Pathogenicbacteria:staphylococcus,pneumococcal,anaerobe,clostridium,etc.Infectionpathway:pathologicalstage:--absorption;-theacutephaseBloodsourcesex;--subacutephase --directinvasion--slowtime Iv.最新資料推薦TuberculosisPrimarytuberculosisofthelungistypical:primarysyndromesinclude(1)primarylesion:uniformshadow,borderlinefuzzy,mostlyinthemiddle,lowerorupperlobe(2)lymphangitis:asilhouetteofashadow,theboundaryblurred. (3)lymphnodeenlargement:lungportalandmediastinallymphnodePulmonarysecondarytuberculosis(TB)ischaracterizedbymultiplelesions,suchasshading,hardjunction, inane, fibrosis, calcification, and othercharacteristicsoftheposteriorsegmentoftheupperlobeandthelowerlobe.5.BronchiectasisTheelastictissueandmuscletissueofthebronchialwallaredestroyedandthebronchialirreversibilityexpands. Thesymptomis:coughphlegm,haemoptysis,infectionFewarecongenital,mostcausedbylaternature.Congenitalbronchodilatationofbronchialwalliscausedbythecongenitaldefectofthebronchialwall.ThebronchiexpansionismainlycausedbybronchialinfectionandobstructionHRCTisthebestmethodfortheexpansion Commonbronchiectasis: Columnarbronchiectasis:thickenedbronchialwallandwidenedtubecavity Visibledouble-tracksign:theexpansionofthebronchialwallinparallelwiththescanningplaneisa9/13dual-trackrailwaySignetring:dilatedbronchiwallwithringsealastheexpansionofthebronchiisperpendicularthescanningplaneThecysticbronchiectasis:thedistalendofthebronchusiscysticdilated.Whentheinfectionwasinfected,theintrasyclesandthewallofthecapsulethickened.Varicularbronchiectasis:manifestedasthethicknessofthebronchialdiameterofthecysticcolumnarchanges. Lungcancer Histologyisdividedintosquamouscarcinoma,adenocarcinoma,undifferentiatedcarcinoma(includinglarge,smallcellcarcinoma)andbronchialalveolarcarcinomaItisdividedintocentertype,peripheraltypeanddiffusetypeCentraltypeoflungcancer:malignanttumoroccurringinbronchial,pulmonarybronchusandbronchus PeripheralpulmonaryCa:amalignanttumorthatoccursinthelungsectionbelowthebronchialtubeBronchialalveolarCa;Amalignanttumorthatoccursinabronchialoralveolarepitheliumtumor,lungmetastatictumor(1)mainCTmanifestationsofcentrallungCa:Bronchialwallthickening:whenthetumorisinfiltrating,thewallismoreirregularandthickened.Bronchialstenosis:endoscopictechniquecanbeusedtodisplaylumenofbronchiallumenandlumenlumen.Lungportalalumpyorirregularmass,oftenaccompaniedbyobstructive最新資料推薦pneumoniaoratelectasis.Obstructivepneumoniaismanifestedasthedistallungtissueinthedistalbronchialbronchi.(4)infringementofmediastinumstructure:oftenwearoutthebronchialwalldirectinvasionmediastinalstructures,suchasbetweenthetumorsandthemediastinumstructuredisappearfatinterface,areconnectedtothestructureofmediastinaltumorshad directly, infiltrating mediastinal structure.Mediastinallymphnodemetastasis:CTtodeterminethenodemetastasisismainlybasedonthesizeofthelymphnode.Thetransversediameterofthemediastinallymphnodeisgreaterthan15mmorthepulmonaryportallymphnodeisgreaterthan10mm,whichisusuallyindicatedasmetastasis,buttherearesomefalsepositiveandfalsenegative. 2.MainCTmanifestationsofperipherallungCa:Earlylungcancerunder3cmindiameter,canappearwithinthenodulesormassescavitation character and contain air bronchogram,characterizedbysmallroundandtubularlowdensityshadow,manyedgepoints,radialburr,andpleuralindentationLarge3~6cmlump,theedgecanhavedividedleaf,withorwithoutburr,thedensityiseven,thedensityisincreasedevenlyinthescanningtime,theCTvaluecanincreasebymore11than20hu.Largemassescanbenecrotic,Theinnermarginofthewallisthehollowofthethickwall,theoutermarginischaracterizedbymalignanttumor,morecommonlyseeninsquamouscellcarcinoma.CommonCTsignsaredividedintoleaf,burr,cavitation,pleuralsag,andbronchialsignsBronchialpulmonarycarcinoma:Thenodulesinthelungsweremore3cm,andthenodulesormassesofthenodulesormassesweremorefreeofthesigns,thebronchialsigns,themarginburrs,andthepleuraldepressionsTwolungdiffusenodules,morethan1cm,edgefuzzy,oftenaccompaniedbypulmonaryportal,mediastinallymphnodemetastasis Pneumonia(3)alargesampleconsolidationshadows,