醫(yī)學(xué)影像學(xué)課件：Respiratory infections and interstitial disease

RespiratoryinfectionsandinterstitialdiseaseDistributionLobarpneumoniaBronchopneumoniaExtensivebilateralpneumoniaBilaterallowerlobepneumoniaPeripheralpneumoniaClassificationsBacterialpneumoniaLobarlobularViralpneumoniaBronchi+peribronchialtissuesDirtychestInterstitialpneumoniaLobarpneumoniaConsolidationAirwaysignLackofvolumelossComplicationsAbscess：膿腫-見后…Cavitarynecrosis：空洞樣壞死Pneumothorax：氣胸Pyopneumothorax：膿氣胸Bronchopleuralfistula：支氣管胸膜瘺化膿性肺炎（金葡菌感染）：右肺多發(fā)膿腔及氣囊Smallfluffyill-definedacinarnodulesLobar+segmentaldensitieswithvolumelossfromairwayobstructionsecondarytobronchialnarrowing+mucusplugging肺紋理增厚、模糊散在、密度不均勻、1～2cm的斑片狀實(shí)變影，可融合成大片（可見支氣管通氣征）兩肺中下野中內(nèi)帶金葡菌感染可出現(xiàn)空洞、肺氣囊LobularpneumoniaInterstitialpneumoniaNonbacterialpneumoniaAcuteinterstitialpneumoniaChronicinterstitialpneumoniaInterstitialpneumoniaDiffuseinterstitialprocesswithperibronchialthickening，支氣管周增厚Segmental/lobardensities(mucusplugging)Kerleylines，斑片影Thickeningofinterlobularfissures，小葉間膈增厚Blurringofpulmonaryvascularmarkings，肺血管影模糊Blurringofhilarshadows，肺門影模糊ChronicinterstitialdiseaseReticulations:fineorcoarseNodularity:interstitialnodularLinearityHoneycombingAbscess早期：blurringconsolidationshadow壞死物咳出后：cavityformation，air-fluidlevel常見氣液平；Thickenedwall厚壁空洞、外緣模糊、內(nèi)壁多光滑Pleuralthickening鄰近胸膜明顯增厚或少量胸腔積液Chronicpulmonaryabscess慢性肺膿腫：內(nèi)外壁均清晰，厚壁，周圍可見纖維索條。支氣管擴(kuò)張bronchiectasisX線：肺紋理增粗，“軌道征”tram-tracksign；囊狀陰影蜂窩狀signet-ringsign。合并感染時(shí)可見液平。CT：支氣管壁增厚；多發(fā)囊狀影像，囊壁光滑，囊內(nèi)見液平。鄰近的支氣管扭曲并攏。柱狀cylindricalortubular；曲張型varicose；囊狀cystic合并感染時(shí)可見肺實(shí)變；支氣管周圍纖維化致肺段性肺不張肺結(jié)核pulmonarytuberculosis原發(fā)型肺結(jié)核primaryPTB：原發(fā)綜合癥及支氣管淋巴結(jié)結(jié)核血行播散型肺結(jié)核hemo-disseminatedPTB急性與亞急性（兩上肺）繼發(fā)性肺結(jié)核secondaryPTB（浸潤(rùn)性、纖維空洞性）結(jié)核性胸膜炎tuberculouspleuritis：積液、胸膜增厚、鈣化其他肺外結(jié)核原發(fā)肺結(jié)核原發(fā)綜合征原發(fā)型肺結(jié)核斑片狀或大片實(shí)變，滲出為主結(jié)核性淋巴管炎結(jié)核性淋巴結(jié)炎肺結(jié)核pulmonarytuberculosis原發(fā)型肺結(jié)核primaryPTB：原發(fā)綜合癥及支氣管淋巴結(jié)結(jié)核血行播散型肺結(jié)核hemo-disseminatedPTB急性與亞急性（兩上肺）繼發(fā)性肺結(jié)核secondaryPTB（浸潤(rùn)性、纖維空洞性）結(jié)核性胸膜炎tuberculouspleuritis：積液、胸膜增厚、鈣化其他肺外結(jié)核血行播散型肺結(jié)核亞急性粟粒性肺結(jié)核肺結(jié)核pulmonarytuberculosis原發(fā)型肺結(jié)核primaryPTB：原發(fā)綜合癥及支氣管淋巴結(jié)結(jié)核血行播散型肺結(jié)核hemo-disseminatedPTB急性與亞急性（兩上肺）繼發(fā)性肺結(jié)核secondaryPTB（浸潤(rùn)性、纖維空洞性）結(jié)核性胸膜炎tuberculouspleuritis：積液、胸膜增厚、鈣化其他肺外結(jié)核繼發(fā)性肺結(jié)核secondaryPTB（浸潤(rùn)性、纖維空洞性）

浸潤(rùn)性活動(dòng)：斑片性滲出、干酪性肺炎；結(jié)核性空洞；支氣管播散（衛(wèi)星灶）穩(wěn)定：間質(zhì)結(jié)節(jié)（增殖）；結(jié)核球；鈣化、纖維索條慢性纖維空洞性：纖維、空洞、肺葉萎縮；胸膜粘連斑片性滲出、干酪性肺炎；肺浸潤(rùn)及增殖infiltrationandproliferation浸潤(rùn)肺結(jié)核結(jié)核性空洞結(jié)核性空洞支氣管播散（衛(wèi)星灶）繼發(fā)性肺結(jié)核secondaryPTB（浸潤(rùn)性、纖維空洞性）

浸潤(rùn)性活動(dòng)：斑片性滲出、干酪性肺炎；結(jié)核性空洞；支氣管播散（衛(wèi)星灶）穩(wěn)定：間質(zhì)結(jié)節(jié)（增殖）；結(jié)核球；鈣化、纖維索條慢性纖維空洞性：纖維、空洞、肺葉萎縮鈣化，纖維索條，間質(zhì)結(jié)節(jié)（增殖）結(jié)核球結(jié)核球tuberculoma浸潤(rùn)肺結(jié)核繼發(fā)性肺結(jié)核secondaryPTB（浸潤(rùn)性、纖維空洞性）

浸潤(rùn)性活動(dòng)：斑片性滲出、干酪性肺炎；結(jié)核性空洞；支氣管播散（衛(wèi)星灶）穩(wěn)定：間質(zhì)結(jié)節(jié)（增殖）；結(jié)核球；鈣化、纖維索條慢性纖維空洞性：纖維、空洞、肺葉萎縮慢性纖維空洞結(jié)核性胸膜炎彌漫小結(jié)節(jié)鑒別粟粒性肺結(jié)核結(jié)節(jié)病癌性淋巴管炎血行轉(zhuǎn)移瘤分布均勻不均勻（氣管血管束周圍）不均勻（氣管血管束周圍）不均勻（外野多見）大小一致不一致不一致不一致間質(zhì)病變無