呼吸系统影像学Imaging of respiratory system.docx

呼吸系统影像学Imaging of respiratory system.docx

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呼吸系统影像学Imagingofrespiratorysystem

呼吸系统影像学（Imagingofrespiratorysystem）

呼吸系统影像学（Imagingofrespiratorysystem）2.1respiratorysystem1.Obstructiveatelectasis（endobronchialtumor,mucoussuppository,bronchialstenosisorexternalcompression,thelungtissueatrophiedwhentherewasnogasinthealveoliorasmallamountofgaswasincluded）.CTmanifestations:

thelungtissuedensityincreases,thevolumeshrinks,thetriangleistriangular,theedgeisclearandsharp,thetippointstothelungdoor,thebaseisattachedtotheseptumorthechestwall,enhancedafterenhancement.Theadjacentstructureiscompensatedfor.2.EmphysemaandlunghyperinflationPrinciple:

thebronchiolesarenotcompletelyobstructed,andthelivingflapisventilated.Thetwolungsarewidelydistributedwiththeirreversibledamageofthealveolarwall.Thelatterisnotassociatedwiththedestructionofthealveolarwallandisoftenoverinflatedwithonesideoronelobe.ThepathologicalanatomycanbedividedintosmallleafcentralemphysemaandpulmonaryemphysemaattheintervalofpulmonaryemphysemaThree,theconsolidationofthelung（referstotheterminalbronchiolesgasbeyondlacunainairwerereplacedbyaliquid,cellortissuepathological.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）andnon-neoplasticlesions（nodules,inflammatorypseudotumor）.Characteristicsofbenignlungtumors:

circularorelliptic,marginsmoothsharpseeexplosionincornfigureadiposetissuecalcificationormildenhancementCTvalueincreaseslessthan20hu,below3cmindiameter,masssurroundedbysatellitekitchenadjacentpleuralthickeningandadhesionMalignantlungtumorcharacteristics:

1.Marginallobesormarks2.Thereareradiated,shortandthinburrsaround3.Theadjacentpleuralmembraneisconcavetothemass4.Theinnerbloodvesselsofthemasses5.Thebronchialtubeofthetumoristruncatedornarrow,andthewallthickens6.Enlargementofthemediastinallymphnode,shorterthan1-1.5cm7.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.Atthesametimewhendiseaseandpulmonaryinterstitial,canbeproducedwithinthepulmonaryinterstitialgappathologicalliquid,inflammatoryinfiltration,granulationtissue,fibroustissueandtumortissue.Differentinfringementofpulmonaryinterstitialdiseaseareacanbefoundin:

chronicidiopathicinterstitialpneumonia,interstitialfibrosis,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,whichis1-2cminlengthandis0.5-2cmapart,andisalsoknownastheintervalline,whichisinthecentralareaofthelunginapolygonandarch.Oftenaccompaniedbylobulestructuredeformation,irregular,smallleafinternallinelikeshadow.3.Thickeningofperibronchovascularinterstitium:

acommonsignofinvasivelungdisease.Themostcommonlesionsareinterstitialpulmonaryedema,primaryandprogressivelymphaticlesionssuchaslymphangiopathy,sarcoidosisandpulmonaryfibrosisNodules（2-5mmnodules）4.Smallleafinternalline:

thethickeningofinterstitialthickeningofthesmallleafiscausedbythinmeshandscreenshape,whichiscommoninpulmonaryfibrosisSmallvesiclesandhoneycombs:

smallvesiclesarecircular,andhaveaclearboundarywall,commonlyseeninidiopathicpulmonaryfibrosis,fibroticalveoli,asbestos,andchronicallergicpneumonia.Cysticlumenisseenintheendoffibrosis,oftenaccompaniedbystructuraldeformationandtraction.6,nodularshadows:

1~10mmsmallnodularshadows,oftenhasawellasinterstitiallesions,boundaryisnotclearorthegroundglassdensitymainlyaffectedgasgap,buttoidentifythestromaorsubstantialinvolvementisoftendifficult7.Groundglassdensity:

themistdensityincreases,andthebronchovascularstructurecanbedistinguished.Canbecausedbyairgaplesions,interstitialthickeningorboth.Iftherearenootherfibrosissigns,itisoftensuggestedtobearecoverablelesion.Inchronicinvasivelunglesionsfoundinidiopathicpulmonaryfibrosis,withhairincollagenvasculardiseasefibrosisalveolarinflammation,desquamationofinterstitialpneumonia,hypersensitivitypneumonitis,sarcoidosis,alveolarproteinADcool-headeddisease.）Vii.PleurallesionsPleuraleffusionandfluidpneumothoraxThepleuralcavityisapotentialnegativepressurecavity,andthereisasmallamountofliquidinnormal,whichcanbeusedtolubricatethechestPleuraltumors:

pleuraltumorscanbefoundinthepleuraprimaryormetastatictumors,suchaspleuralmesothelioma（benignandmalignant）,malignantthymomaextendsalongthepleuraandlungcancermetastasis,etc.,alsovisibleinthetumorlesionsuchasmachinesexpyothoraxandpleuralplaquesareasbestosisPneumothorax:

CTimage（lungwindow）isseeninthevolumeofthegas,whichcanbeseenindifferentareasofthelung,withnolungtexture,andtheinnermarginofthecompressedlungedgeBasicshadowdiagnosisofmajorcommondiseasesinthechestChronicbronchitisPneumonia（largeleaf）LungabscessTuberculosis（TB）bronchiectasisLungcancerMediastinaltumorCommoncardiovasculardisease1.ChronicbronchitisChroniccoughandphlegm-twoconsecutiveyears,threemonthsinayear--------------------------------------------Causes:

smoking,infection,airpollutionClinicaldiagnosisisthemain,imagingdiagnosisisauxiliaryThemainmanifestationsofCTare:

pulmonarytexturedisorder,distortion-webweaves,thickeningofbronchialwall-tracksign,secondaryemphysemaCTisusedtoidentifyotherdiseasesthatcausecoughandcough,suchasbronchiectasis,lungcancer,andpulmonaryinfection2,pneumonia

（1）largeleafpneumonia（mainlycausedbypneumococcus,alsoknownasklebsiella,legionellainfection;typicallobulepneumoniainyoungpeople）CTmanifestations:

hyperemiaperiod:

itcanbefoundthatthelesionareaisintheshadowofthegroundglass,andtheedgesareblurred.Bloodvesselsinthediseasedareaarestillvisible.Theperiodofrealchange:

alarge,flakyshadowthatcanbeseeninthedistributionoflungsegmentsorlungleaves,visiblebronchialmeteorology.Dissipationperiod:

withtheabsorptionofthelesion,thedensityoftherealvariableshadowdecreases,andthespecularshadowisscatteredindifferentsizesThefinalabsorptioniscomplete

（2）lobule（bronchial）pneumoniaBronchialenlargementofbloodvesselbundleintheconventionalCTscanbothlungspart,visiblenodularshadowsandflakeofdifferentsize,about1~2cmsize,edgeblur,multiplesmallshapeshadowbetweendopedwithgaslungtissue.（3）interstitialpneumoniaEarlyormildcasesofinterstitialpneumonia,canbeperformedonbothsidesofthebronchialenlargementofbloodvesselbundle,accompaniedbyshadowgrindingofglasssamples,onbehalfofthebronchialaroundwithinterstitialinflammatoryinfiltratesandalveoliinflammatoryinfiltratesandasmallamountofeffusion.Thecontrastcanbeaccompaniedbyasmallleaf,whichcanbeseenasaspecularshadow.Thepulmonaryandmediastinallymphnodesmayincrease.Iii.Pulmonaryabscess（progressofpulmonaryinfection）Pulmonaryabscessisthelocalnecrosisandsuppurativeinflammationcausedbythesuppurativebacteria.Clin