呼吸系統(tǒng)放射影像學(xué)

RadiologyofRespiratorySystemAimsBasicsBestexamresultsAppreciatetheroleradiologyplays?InstillaninterestinradiologyBeforeClass:TextbookReferencebookLiteratureInternetAppsTeacher&classmateHistologyandEmbryologyAnatomyPathologyInternalMedicineSurgeryGynecologyPediatricsNeurology。。。Everything。。。UneedtoknowmethodsX-rayCTMRDSAUSNuclearMedicinePET/CTRadionuclideventilationperfusionimagingX-rayTechniquesPA（posteroanterior)&LateralMoreinformationTwoviewsStandardizedDistancePtneedstobestablePortableQuickAnywhereOneshotNostandardizationPAPortableTechniques-ProjectionP-A(relationofx-raybeamtopatient)Techniques-Projection(continued)A-PSupine/ErectTechniques-Projection(continued)LateralTechniques-Projection(continued)LateralDecubitusObliqueTechnicalDetailsTypeOrientationRotationInspiration/expirationPenetrationRotationRotation(continued)PenetrationInspiration/ExpirationThingstoseeABCDE…AirwaysTrachea,endotrachealtube,etcBonesClavicles,ribs,etc…CardiacDiaphragm(Righthemidiaphragmslightlyhigher(~1.5cm)Everythingelse(tubes),effusionsDensitiesThebigtwodensitiesare:(1)WHITE-Bone(2)BLACK-AirTheothersare:(3)DARKGREY-Fat(4)GREY-Softtissue/water

AndifanythingMan-madeisonthefilm,itis:(5)BRIGHTWHITE-Man-madeAnatomyAnatomyBronchopulmonaryAnatomyCross-sectionalAnatomyofLungSegments（CT）LobesRightupperlobe:Lobes(continued)Rightmiddlelobe:Lobes(continued)Rightlowerlobe:Lobes(continued)Leftlowerlobe:Lobes(continued)LeftupperlobewithLingula:Lobes(continued)Lingula:Lobes(continued)Leftupperlobe-upperdivision:HeartRightborder:Edgeof(r)Atrium3.Leftborder:(l)Ventricle+Atrium4.Posteriorborder:ReftVentricle5.Anteriorborder:RightVentricleHeart(continued。。。。)Heart

IT’SNOTMINE….HilumMadeof:1.PulmonaryArt.+Veins2.TheBronchi

LeftHilumhigher(max1-2,5cm)Identical:size,shape,densityHilumRibsReviewareas:ApicesBehindtheheart

Costophrenicangle(CPA)BelowthediaphragmSofttissues(breast,surgicalemphysema)Ribs&clavicleVertebrae

AbnormalsLungfindingsDarkerareasradiolucentPneumothoraxCysts/bullaAirbronchogramsLighterareasOpacitiesAtelectasis“infiltrates”BloodPusWaterNodulesormassOpacitiesLobarornot….PneumoniaPulmonaryEdema“fluffy,”diffuse,“batwing”distributionHemorrhageCan’ttellbyx-ray,needbronchRMLpneumoniaOpacitiesRLLpneumoniaOpacitiesRULpneumoniaLLLpneumoniaConsolidationonCTTheEnlargedHilaCauses:

1.Adenopathies(neoplasia,infection)

2.PrimaryTumor

3.Vascular

4.SarcoidosisMass

HilarLymphadenopathy-BL

MultipleMassesMetasPleuralEffusionPulmonaryFibrosisHeartfailure，KerleyA/Bline（Interstitiallunghyperplasiaedema）HeartfailurePneumothoraxEmphysemaCavitatinglesionThin-walledCavitatinglesionThick-walledCavitatinglesion

3mmBronchiectasisMiliaryshadowingCalcificationBenignPatternsofCalcificationWithinaSolitaryPulmonaryNoduleChestTube,NGTube,Pulm.arterycathCTIndicationsKeyClinicalFactorsGrowthPatternSizeMargin(Border)CharacteristicsDensityContrast-EnhancedCTOtherfindingsPulmonaryInfection

airspaceopacificationairbronchogramsdensemultifocalsegmentalpneumonialungabscesscavitationLobar/segmentalconsolidationPneumoniafindingTuberculosisinfiltratesMiliaryshadowingTuberculomaChronicfibro-cavitaryTBCAUSESOFSOLITARYPULMONARYNODULES（SPN）Neoplastic:Malignant

Bronchogeniccarcinoma

Solitarymetastasis

Lymphoma

Carcinoidtumor

Neoplastic:Benign

Hamartoma

Benignconnectivetissueandneuraltumors(e.g.,lipoma,fibroma,neurofibroma)

Inflammatory

Granuloma

Lungabscess

Rheumatoidnodule

Inflammatorypseudotumor(plasmacellgranuloma)

Congenital

Arteriovenousmalformation

Lungcyst

Bronchialatresiawithmucoidimpaction

Miscellaneous

Pulmonaryinfarct

Intrapulmonarylymphnode

Mucoidimpaction

Hematoma

Amyloidosis

Normalconfluenceofpul