胸部正常影像演示文稿

胸部正常影像演示文稿现在是1页\一共有79页\编辑于星期二（优选）胸部正常影像现在是2页\一共有79页\编辑于星期二现在是3页\一共有79页\编辑于星期二读片顺序胸壁/胸廓软组织：胸缩乳头肌及锁骨上皮肤皱褶、胸大肌、女性乳房及乳头骨骼：肋骨、肩胛骨、锁骨、胸骨、胸椎膈肌右高于左1-2cm，第9、10后肋/第6前肋间隙局限性膈膨升、波浪膈胸膜胸腔积液、气胸及液气胸、胸膜肥厚、粘连及钙化肺纵隔现在是4页\一共有79页\编辑于星期二1.Trachea2.Rmainbronchus3.Lmainbronchus4.Lpulmartery5.RULpulmvein6.R(desc)pulmartery7.RLLandRMLveins8.Aorticarch9.S.venacava10.Azygousvein现在是5页\一共有79页\编辑于星期二Normalleftlateralview.现在是6页\一共有79页\编辑于星期二现在是7页\一共有79页\编辑于星期二1.Trachea2.Rmainbronchus3.LULbronchus4.RULbronchus5.Lpulmonaryartery6.Rpulmonaryartery7.Pulmonaryvein8.Aorticarch9.BrachiocephalicvesselsNote:Vasculardetailsarevariablefromfilmtofilm现在是8页\一共有79页\编辑于星期二右正侧位现在是9页\一共有79页\编辑于星期二左正侧位现在是10页\一共有79页\编辑于星期二右上叶现在是11页\一共有79页\编辑于星期二右中叶现在是12页\一共有79页\编辑于星期二右下叶现在是13页\一共有79页\编辑于星期二左上叶现在是14页\一共有79页\编辑于星期二左下叶现在是15页\一共有79页\编辑于星期二现在是16页\一共有79页\编辑于星期二现在是17页\一共有79页\编辑于星期二正常HRCT现在是18页\一共有79页\编辑于星期二中央肺动脉。现在是19页\一共有79页\编辑于星期二支气管与相邻肺动脉直径大致相等。现在是20页\一共有79页\编辑于星期二肺动脉常分为两个直径相当的分支。

现在是21页\一共有79页\编辑于星期二肺静脉常分成许多细小的分支,这些分支与主支构成直角。

现在是22页\一共有79页\编辑于星期二叶间裂（厚度小于1mm，边缘光滑，均一厚度）现在是23页\一共有79页\编辑于星期二常见伪影双侧下肺近心脏处，肺血管脉动伪影。低密度区，可以错当作扩大的支气管。现在是24页\一共有79页\编辑于星期二常见伪影主叶裂伪影。现在是25页\一共有79页\编辑于星期二常见伪影血管双重伪影。现在是26页\一共有79页\编辑于星期二TheSecondaryPulmonaryLobule肺小叶（直径1-2.5CM）现在是27页\一共有79页\编辑于星期二小叶支气管、终末细支气管现在是28页\一共有79页\编辑于星期二肺动脉pulmonaryartery

现在是29页\一共有79页\编辑于星期二小叶间隔interlobularsepta

现在是30页\一共有79页\编辑于星期二肺静脉pulmonaryvein

现在是31页\一共有79页\编辑于星期二腺泡pulmonaryacini

现在是32页\一共有79页\编辑于星期二正常小叶间隔normalsepta

现在是33页\一共有79页\编辑于星期二正常小叶中心动脉现在是34页\一共有79页\编辑于星期二centrilobularartery2现在是35页\一共有79页\编辑于星期二肺静脉Pulmonaryveins

现在是36页\一共有79页\编辑于星期二

胸部CT两个窗：纵隔窗和肺窗三个系统：管道系统；肺系统；淋巴系统断面：头臂干层面；主动脉弓层面；主肺动脉层面；左肺动脉层面；右肺动脉层面；左心房层面（基底干上方层面）；四腔心层面（两下肺静脉层面）现在是37页\一共有79页\编辑于星期二MediastinumAnterior:thymus,lymphnodes,mammaryvesselsMiddle:pericardium,heart,greatvessels,trachea,mainbronchi,fat,nerves,lymphnodesPosterior:esophagus,descendingaorta,nerves,azygosandhemiazygosveins,lymphnodes现在是38页\一共有79页\编辑于星期二BrachiocephalicArteryLevel

(Sterno-clavicularJointLevel)BA:brachiocephalicarterySCJ:Sterno-clavicularJointLCC:leftcommoncarotidLSA:leftsubclavianarteryRBV:rightbrachiocephalicveinLBV:leftbrachiocephalicveinLSALCCBALBVRBVSCJ现在是39页\一共有79页\编辑于星期二AorticArchLevelSVC:superiorvenacavaIMV:internalmammaryvessels＊:pretracheal-retrocavalspacethymusarchtracheaesophagusSVC＊IMV现在是40页\一共有79页\编辑于星期二AortopulmonaryWindowLevelSVC:superiorvenacavaAA:ascendingaortaDA:descendingaortaAZ:azygosAADAAZarchcarinaSVC现在是41页\一共有79页\编辑于星期二LeftPulmonaryArteryLevelSVC:superiorvenacavaLPA:LeftPulmonaryArteryLPASVCpericardium现在是42页\一共有79页\编辑于星期二RightPulmonaryArteryLevelRPA:RightPulmonaryArteryA-ER:azygoesophagealrecessRPAA-ER现在是43页\一共有79页\编辑于星期二AorticRootLevelA:aorticrootLA:leftatriumPA:pulmonaryarteryPV:pulmonaryveinPALAAPV现在是44页\一共有79页\编辑于星期二CardiacLevelLV:leftventricleRV:rightventricleLA:leftatriumRA:rightatriumIS:interventricularseptumRVLVRALAIS现在是45页\一共有79页\编辑于星期二Lobes现在是46页\一共有79页\编辑于星期二现在是47页\一共有79页\编辑于星期二SegmentsandBronchiEachlobeiscomprisedofseveralsmallerunitsreferredtoaspulmonarysegments.Itisimportanttorememberthatsegmentalanatomyispredicatedonbronchialanatomy.Similartobronchialnomenclature,eachsegmentcanbenamednumerically,usinga"S",andthesamenumberofthecorrespondingbronchusthatsuppliesit.

现在是48页\一共有79页\编辑于星期二Segment

Bronchus

UpperLobe

ApicalS1B1PosteriorS2B2AnteriorS3B3MiddleLobe

LateralS4B4MedialS5B5LowerLobe

SuperiorS6B6MedialBasalS7B7AnteriorBasalS8B8LateralBasalS9B9PosteriorBasalS10B10UpperLobe

ApicalPosteriorS1+2

B1+2

AnteriorS3B3SuperiorLingularS4B4InferiorLingularS5B5LowerLobe

SuperiorS6B6AnteriorMedialBasalS8B8LateralBasalS9B9PosteriorBasalS10B10SegmentBronchusRightLungLeftLung现在是49页\一共有79页\编辑于星期二RightLungSegmentsTheapicalsegment(orS1segment)isshapedlikeatruncatedconewithitsbroadestbaselocatedsuperiorlyfillingthecupulaofthelung.Thissegmentthusextendsoverthepulmonaryapexbutdoesnotextendinferiorlytotheinterlobar(minorfissure)surface.现在是50页\一共有79页\编辑于星期二现在是51页\一共有79页\编辑于星期二现在是52页\一共有79页\编辑于星期二Theposteriorsegment(S2)extendsfromtherighthilum,posteriorlyandinferiorlyandformstheposteriorhalfoftheinterlobarsurfacerelatingtotherightmajorfissure.Theanteriorsegment(S3)oftherightupperlobe,whichlikeS2extendsfromtherighthilararea,isorientedanteriorlyandsomewhatsuperiorly.TheanteriorsurfaceofS3extendstothechestwall,whilethebroadestinferiorsurfaceborderstheminorfissurewhichseparatingS3fromtherightmiddlelobe.现在是53页\一共有79页\编辑于星期二现在是54页\一共有79页\编辑于星期二现在是55页\一共有79页\编辑于星期二Therightlowerlobeiscomprisedoffivepulmonarysegments:thesuperiorsegment(S6)issituatedimmediatelyinferiortotheposteriorsegmentoftherightupperlobe(S2)fromwhichitisseparatedbytherightmajorfissure.S6isborderedbythemajorfissureanteriorlyandcomprisesasizeableportionoftheposteriormarginoftherightlowerlobesuperiorly.Itisthissegmentthatsurprisinglyoccupiesasizeableareabehindtheanteriorsegment(S3)oftheRUL.现在是56页\一共有79页\编辑于星期二现在是57页\一共有79页\编辑于星期二现在是58页\一共有79页\编辑于星期二Therightmiddlelobehastwopulmonarysegmentswhicharesituatedsidebyside;themorelateralsegment(S4),approximatesthesizeofitsadjacentneighbor,S5(medialsegment).S5neartherightheartbordermedially,whileS4extendstoandcomprisesaportionofthelateralborderoftherightlung.Superiorly,bothsegmentsbordertherightminorfissure,andlikewise,bothabutthemajorfissurealongtheirinferiormargins.BothS4andS5touchthediaphragmaticsurfaceattheiranteroinferioredges.Anteriorly,bothsegmentsareadjacenttotheanteriorribsendsofthe5th,6th,and7thribs.现在是59页\一共有79页\编辑于星期二现在是60页\一共有79页\编辑于星期二ImmediatelyanteriortoS10isthemedialbasalsegment(S7)whichtypicallyisthesmallestpulmonarysegmentofthelowerlobe.Alongitssuperiormargin,S7formsaportionofthemajorfissuremedially,anditslocationcanbebestthoughtofasbeingimmediatelyinferiortotherighthilum,abuttingthemajorfissureventrally.现在是61页\一共有79页\编辑于星期二InferiortoS7istheanteriorbasalsegmentS8,whichtendstoberatherlargeinsize.ThissegmentalongwithS6comprisealargeportionofthemajorfissuresurface,laterally.S8residesinapredominantlylaterallocationhavingalargeperipheralsurface.现在是62页\一共有79页\编辑于星期二Thelateralbasalsegment(S9),locatedbetweenS8andS10isshapedlikeatrianglewithitsbasedirectedlaterallyandassuchformsaportionofthelateralsurfaceoftherightlowerlobe.

ThepulmonarysegmentswhichborderortouchtherighthemidiaphragmareS4,S5,S7,S8,S9,andS10.S8andS10havethelargestsurfaceareasabuttingthediaphragm.

现在是63页\一共有79页\编辑于星期二Theposteriorbasalsegment(S10)asitsnameimpliesoccupiestheposteriormostandinferiormostportionoftherightlowerlobe.Assuch,itcanbebestrememberedasthepulmonarysegmentwhichoccupiesmostoftheposteriorcostophrenicgutter.S10alsocomprisesalargeportionoftheposteromedialborderoftherightlowerlobeandisthesegmentwhichislocatedimmediatelyinferiortoS6.S10characteristicallytendstobethelargestsegmentoftherightlowerlobe.现在是64页\一共有79页\编辑于星期二LeftLungSegments(S1+2)representsacombinationofthetwoseparate(apicalandposterior)segmentsseenontherightupperlobe.Itisreferredtoastheapicalposteriorsegment.Combined,S1+2anatomicallyissimilarinshapetothetwosegmentsontheright.现在是65页\一共有79页\编辑于星期二TheS3oranteriorsegmentalsoissimilartotherightS3segment,havingalargeareadirectedanteriorly.现在是66页\一共有79页\编辑于星期二Thesuperiorlingularsegment(S4)ispositionedimmediatelyinferiortoS3andisdirectlyabovetheinferiorlingularsegment(S5).Bothlingularsegmentshavetheirgreatestareadirectedanteriorlyandinferiorly.Additionally,S4tendstohavemoreareadirectedlaterallywhileS5hasmoreareadirectedmedially,abuttingthemediastinum.Bothsegmentsextendanteroinferiorlytoreachtheventralsurfaceofthelefthemidiaphragm,andhenceborderalargeportionoftheanteroinferiorsurfaceofthemajorfissure.现在是67页\一共有79页\编辑于星期二Formingtheremainderoftheinterlobarsurfaceisthesuperiorsegment(S6).S6isidenticaltoitscounterpartontheright.现在是68页\一共有79页\编辑于星期二Theleftlowerlobesegmentalarchitectureissimilartothatoftherightlowerlobe,howeverbecausetheanteriorandmedialbasalsegmentsshareacommonbronchialsupply,thesetwosegmentsarecharacteristicallycombined,formingananteriormedialbasalsegment(S8).Therefore,theanteriorsegmentiscombinedwiththemedialsegmentbutmaybedenotedbySX7.Theanteriormedialbasalsegmentisborderedanteriorlybytheinterlobar(majorfissure),andabutsthevisceralpleuralsurfacesofthetwolingularsegmentslocatedanterosuperiorly.现在是69页\一共有79页\编辑于星期二Thelateralbasalsegment,S9andtheposteriorbasalsegment,S10alsocloselyapproximatethesamesegmentsintherightlowerlobe.S9(lateralbasalsegment)hasitsbroadestsurfaceareaexposedposterolaterally,andmaybeslightlylargerthanS9ontheright.S9,notincontinuitywiththemajorfissure,occupiesmuchoftheposteriorcostophrenicsulcusposterolaterally.现在是70页\一共有79页\编辑于星期二Likeitscontralateralcounterpart,S10(posteriorbasalsegment)isquitelargeandoccupiestheposteriorandinferiormostportionoftherightlowerlobeoccupyingtheposteromedialcostophrenicgutter.现在是71页\一共有79页\编辑于星期二ThecourseofB1+2hasverticallyandhorizontallyorientedcomponentsasbronchialramidividetosupplytheapicalposteriorsegment.TheB3bronchuswillhaveamorehorizontalcourse,similartothatseenontherightside.B3suppliestheanteriorsegmentoftheleftupperlobe.现在是72页\一共有79页\编辑于星期二Therightmainstembronchusisconsideredtoextendnofartherinferiorlythantheoriginoftherightupperlobebronchus.Theairwaydistaltotheupperlobebronchusisreferredtoasthebronchusintermedius(BI).BIgenerallyaverages2cminlengthandterminatesatthepointattheoriginoftherightmiddlelobebronchus.

现在是73页\一共有79页\编辑于星期二ThelingularsegmentalbronchiaresomeofthemostdifficultsegmentalbronchitovisualizeonCT.Theirinconspicuousnessisa