呼吸系统影像学(Imagingofrespiratorysystem)

1、最新资料推荐呼吸系统影像学 (Imaging of respiratory system)呼吸系统影像学( Imaging of respiratory system ) 2.1 respiratory system 1. Obstructive atelectasis (endobronchial tumor, mucous suppository, bronchial stenosis or external compression, the lung tissue atrophied when there was no gas in the alveoli or a small amou

2、nt of gas was included). CT manifestations: thelung tissue density increases, the volumeshrinks, the triangle is triangular, the edge is clear and sharp, the tip points to the lung door, the base is attached to the septum or the chest wall, enhanced after enhancement. The adjacent structure is compe

3、nsated for. 2. Emphysemaa nd lung hyperinflation Principle: the bronchioles are not completely obstructed, and the living flap is ventilated. The two lungs are widely distributed with the irreversible damage of the alveolar wall. The latter is not associated with the destruction of the alveolar wall

4、 and is often overinflated with one side or one lobe. The pathological anatomy can be divided into small leaf central emphysema and pulmonary emphysema at the interval of pulmonary emphysema Three, the consolidation of the lung (refers to the terminal bronchioles gas beyond lacuna in air were replac

5、ed by a liquid, cell or tissue1 / 13pathological. Involving the range can be acini, lobular, pulmonary lobectomy or paragraph.) CT manifestations: glandular nodules and flaky margin blurred images. The shape of the lung section or the distribution of the pulmonary lobe, which can be seen in the inte

6、rior of the blood vessels, can be seen as a large, high-density solid shadow, which can be seen as bronchi meteorology. Bronchi meteorology: the solid lung tissue is set off by the bronchial bronchial facies. In the real change area, the transparent tracheal shape of the branch is known as bronchial

7、 meteorology. Also known as air bronchial signs, including bronchial signs (common in: pneumonia (large leaf), pulmonary edema, pulmonary tuberculosis, pulmonary contusion, pulmonary hemorrhage, pulmonary infarction) 4.Pulmonary masses (2 cm in diameter, with clear, rounded, rounded shapes. Seen in

8、neoplastic lesions (benign, malignant) and non-neoplastic lesions(nodules, inflammatorypseudotumor). Characteristicsof benign lung tumors:1.circular or elliptic, margin smooth sharp see explosion in corn figure adipose tissue calcification or mild enhancement CT value increases less than 20 hu, belo

9、w 3 cm in diameter, mass surrounded by satellite kitchen adjacent pleural thickening and adhesion Malignant lung tumor characteristics:最新资料推荐Marginal lobes or marks 2. There are radiated, short and thin burrs around 3. The adjacent pleural membrane is concave to the mass 4. The inner blood vessels o

10、f the masses 5. The bronchial tube of the tumor is truncated or narrow, and the wall thickens 6. Enlargement of the mediastinal lymph node, shorter than 1-1.5 cm 7. The empty inner wall formed is irregular and has wall nodules 8. There are 1-2mmv acuoles and air bronchogenic signs in the mass The ch

11、est wall, the pleura and distant metastases Void and cavity Cavitation: necrotic liquefaction of diseased tissue in the lung is formed by the removal of bronchial tubes. Common: pulmonary abscess, tuberculosis, lung cancer, staphylococcal pneumonia, fungal disease. Above 3 10mm is thick wall hole, 3

12、mm below is thin wall hole. Cavity: the pulmonary cavity was enlarged with the pathologic and the local gas swelling and local pneumothorax caused the collection of alveolar walls. Common: pulmonary alveolar, branched, pneumatocyst, pulmonary cyst, etc. Cavity wall thickness about l mm. Six, pulmona

13、ry interstitial lesions (mainly refers to infringement of interstitial lung disease, in fact is often accompanied by the change of the lung parenchyma. At the same time when disease and pulmonary3 / 13 interstitial, can be produced within the pulmonary interstitial gap pathological liquid, inflammat

14、ory infiltration, granulation tissue, fibrous tissue and tumor tissue. Different infringement of pulmonary interstitial disease area can be found in: chronic idiopathic interstitial pneumonia, interstitial fibrosis, sarcoidosis, and lymphangitic spread of carcinoma, connective tissue disease, pneumo

15、coniosis, etc.) CT manifestations: Interfacial features: the interface between thickening and aeropulmonary tissue contrast. The bronchus, the blood vessels are thickening. Thickening of the interlobular septum and centrilobular structure Extension of traction and traction The changes of the grindin

16、g glass: pathological can be a small amount of seepage in the alveoli, the swelling of the alveolar wall or the inflammation of the alveolar septum. (1) interface sign: for early performance. Inflatable lung and bronchus, blood vessels, dirty appeared irregular, not smooth interface between pleura,

17、found in most of the pulmonary interstitial lesions (89%) and idiopathic pulmonary fibrosis (98%). Nonspecific. 2. Thickening of lobular septum: one of the characteristics of pulmonary interstitial lesions. It is shown as the vertical line shadow of the pleural surface, which is最新资料推荐1-2cm in length

18、 and is 0.5-2cm apart, and is also known as the interval line, which is in the central area of the lung in a polygon and arch. Often accompanied by lobule structure deformation, irregular, small leaf internal line like shadow. 3. Thickening of peribronchovascular interstitium: a common sign of invas

19、ive lung disease. The most common lesions are interstitial pulmonary edema, primary and progressive lymphatic lesions such as lymphangiopathy, sarcoidosis and pulmonary fibrosis Nodules (2-5mm nodules) 4. Small leaf internal line: the thickening of interstitial thickening of the small leaf is caused

20、 by thin mesh and screen shape, which is common in pulmonary fibrosis Small vesicles and honeycombs: small vesicles are circular, and have a clear boundary wall, commonly seen in idiopathic pulmonary fibrosis, fibrotic alveoli, asbestos, and chronic allergic pneumonia. Cystic lumen is seen in the en

21、d of fibrosis, often accompanied by structural deformation and traction. 6, nodular shadows: 1 10 mm small nodular shadows, often has a well as interstitial lesions, boundary is not clear or the ground glass density mainly affected gas gap, but to identify the stroma or substantial involvement is of

22、ten difficult 7. Ground glass5 / 13 density: the mist density increases, and the bronchovascular structure can be distinguished. Can be caused by air gap lesions, interstitial thickening or both. If there are no other fibrosis signs, it is often suggested to be a recoverable lesion. In chronic invas

23、ive lung lesions found in idiopathic pulmonary fibrosis, with hair in collagen vascular disease fibrosis alveolar inflammation, desquamation of interstitial pneumonia, hypersensitivity pneumonitis, sarcoidosis, alveolar protein AD cool-headed disease. ) Vii. Pleural lesions Pleural effusion and flui

24、d pneumothorax The pleural cavity is a potential negative pressure cavity, and there is a small amount of liquid in normal, which can be used to lubricate the chest Pleural tumors: pleural tumors can be found in the pleura primary or metastatic tumors, such as pleural mesothelioma (benign and malign

25、ant), malignant thymoma extends along the pleura and lung cancer metastasis, etc., also visible in the tumor lesion such as machine sex pyothorax and pleural plaques are asbestosis Pneumothorax: CT image (lung window) is seen in the volume of the gas, which can be seen in different areas of the lung

26、, with no lung texture, and the inner margin of the compressed lung edge Basic shadow diagnosis of major common diseases in the chest Chronic bronchitis Pneumonia (large最新资料推荐leaf) Lung abscess Tuberculosis (TB) bronchiectasis Lung cancer Mediastinal tumor Common cardiovascular disease 1. Chronic br

27、onchitis Chroniccough and phlegm - two consecutiveyears, three months in a year Causes: smoking, infection, air pollution Clinical diagnosis is the main, imaging diagnosis is auxiliary The main manifestations of CT are: pulmonary texture disorder, distortion - web weaves, thickening of bronchial wal

28、l - track sign, secondary emphysema CT is used to identify other diseases that cause cough and cough, such as bronchiectasis, lung cancer, and pulmonary infection2, pneumonia (1) large leaf pneumonia (mainly caused by pneumococcus, also known as klebsiella, legionella infection; typical lobule pneum

29、onia in young people) CT manifestations: hyperemia period: it can be found that the lesion area is in the shadow of the ground glass, and the edges are blurred. Blood vessels in the diseased area are still visible. The period of real change: a large, flaky shadow that can be seen in the distribution

30、 of lung segments or lung leaves, visible bronchial meteorology. Dissipation period: with the absorption of the lesion, the density of the real variable shadow decreases, and7 / 13the specular shadow is scattered in different sizes The finalabsorption is complete (2) lobule (bronchial) pneumonia Bro

31、nchial enlargement of blood vessel bundle in the conventional CT scan both lungs part, visible nodular shadows and flake of different size, about 1 2 cm size, edge blur, multiple small shape shadow between doped with gas lung tissue. (3) interstitial pneumonia Early or mild cases of interstitial pne

32、umonia, can be performed on both sides of the bronchial enlargement of blood vessel bundle, accompanied by shadow grinding of glass samples, on behalf of the bronchialaround with interstitialinflammatory infiltrates and alveoliinflammatory infiltratesand a small amount of effusion. Thecontrast can b

33、e accompanied by a small leaf, which can be seen as a specular shadow. The pulmonary and mediastinal lymph nodes may increase. Iii. Pulmonary abscess (progress of pulmonary infection) Pulmonary abscess is the local necrosis and suppurative inflammation caused by the suppurative bacteria.Clinical man

34、ifestation is cold war, high fever, cough purulentphlegm Pathogenic bacteria: staphylococcus, pneumococcal, anaerobe, clostridium, etc. Infection pathway: pathological stage: - absorption; - the acute phase Blood source sex; -subacute phasedirect invasionslow timeIv.最新资料推荐Tuberculosis Primary tuberc

35、ulosis of the lung is typical: primary syndromes include (1) primary lesion: uniform flaky shadow, borderline fuzzy, mostly in the middle, lower or upper lobe (2) lymphangitis: a silhouette of a shadow, the boundary blurred. (3) lymph node enlargement: lung portal and mediastinal lymph node Pulmonar

36、y secondary tuberculosis (TB) is characterized by multiple lesions, such as shading, hard junction, inane, fibrosis, calcification, and other characteristics of the posterior segment of the upper lobe and the lower lobe. 5. Bronchiectasis The elastic tissue and muscle tissue of the bronchial wall ar

37、e destroyed and the bronchial irreversibility expands. The symptom is: cough phlegm, haemoptysis, infection Few are congenital, most are caused by later nature. Congenital bronchodilatation of the bronchial wall is caused by the congenital defect of the bronchial wall. The bronchi expansion is mainl

38、y caused by bronchial infection and obstruction HRCT is the best method for the expansion Common bronchiectasis: Columnar bronchiectasis: thickened bronchial wall and widened tube cavity Visible double-track sign : the expansion of the bronchial wall in parallel with the scanning plane is a9 / 13 du

39、al-track railway Signet ring : dilated bronchi wall with a ring seal as the expansion of the bronchi is perpendicular to the scanning plane The cystic bronchiectasis: the distal end of the bronchus is cystic dilated. When the infection was infected, the intrasycles and the wall of the capsule thicke

40、ned. Varicular bronchiectasis: manifested as the thickness of the bronchial diameter of the cystic columnar changes. Lung cancer Histology is divided into squamous carcinoma, adenocarcinoma, undifferentiated carcinoma (including large, small cell carcinoma) and bronchial alveolar carcinoma It is div

41、ided into center type, peripheral type and diffuse type Central type of lung cancer: malignant tumor occurring in the bronchial, pulmonary bronchus and bronchus Peripheral pulmonary Ca: a malignant tumor that occurs in the lung section below the bronchial tube Bronchial alveolar Ca; A malignant tumo

42、r that occurs in a bronchial or alveolar epithelium Lung tumor, lung metastatic tumor (1) main CT manifestations of central lung Ca: Bronchial wall thickening: when the tumor is infiltrating, the wall is more irregular and thickened. Bronchial stenosis: endoscopic technique can be used to display lu

43、men of bronchial lumen and lumen lumen. Lung portal mass: a lumpy or irregular mass, often accompanied by obstructive最新资料推荐pneumonia or atelectasis. Obstructive pneumonia is manifested as the distal lung tissue in the distal bronchial bronchi. (4) infringement of mediastinum structure: often wear ou

44、t the bronchial wall direct invasion mediastinal structures, such as between the tumors and the mediastinum structure disappear fat interface, are connected to the structure of mediastinal tumors had directly, infiltrating mediastinal structure. Mediastinal lymph node metastasis: CT to determine the

45、 lymph node metastasis is mainly based on the size of the lymph node. The transverse diameter of the mediastinal lymph node is greater than 15mmo r the pulmonary portal lymph node is greater than 10mm, which is usually indicated as metastasis, but there are some false positive and false negative. 2.

46、 Main CT manifestations of peripheral lung Ca: Early lung cancer under 3 cm in diameter, can appear within the nodules or masses cavitation character and contain air bronchogram, characterized by small round and tubular low density shadow, many edge points, radial burr, and pleural indentation sign.

47、 Large 3 6cm lump, the edge can have divided leaf, with or without burr, the density is even, the density is increased evenly in the scanning time, the CT value can increase by more11 / 13 than 20 hu. Large masses can be necrotic, The inner margin of the wall is the hollow of the thick wall, the out

48、er margin is characterized by malignant tumor, more commonly seen in squamousc ell carcinoma. Common CT signs are divided into leaf, burr, cavitation, pleural sag, and bronchial signs Bronchial pulmonary carcinoma: The nodules in the lungs were more than 3cm, and the nodules or masses of the nodules

49、 or masses were more free of the signs, the bronchial signs, the margin burrs, and the pleural depressions Two lung diffuse nodules, more than 1cm, edge fuzzy, often accompanied by pulmonary portal, mediastinal lymph node metastasis Pneumonia (3) a large sample consolidation shadows, can press lobectomy or lung segment dist