同济《医学影像学》2-呼吸系统英文版.ppt

Imaging diagnosis of lung and mediastinum Wu Hanping examination technique Chest fluoroscopy Chest radiography Tomography Bronchography CT MR DSA Chest radiography Routine examination for patients Exclude serious chest disease Provide evidence of the preoperative condition of lung and heart before surgery Find out the postoperative complications: basal collapse, lung infections, pulmonary embolus. Chest radiography PA (Posteroanterior) view: Standard Erect position Anterior chest wall against the film Scapulae rotate forward End-inspiration Short exposure time High voltage radiography The bones and abnormal calcification are poorly demonstrated, but the pulmonary and mediastinal detail is improved. Lateral view: Other views Anteroposterior views Supine film Apical and lordotic(前弓) views Decubitus views Oblique views Chest fluoroscopy Simple, assisted means Multiposition and dynamic view diaphragm movement—paralysis Mediastinum movement—obstructive emphysema Locate abnormality Disadvantage Hard to detect small lesion No record Hight dose Bronchography Radiographic examination of the bronchial tree by instillation of contrast medium directly into the trachea or bronchi. Evaluation of bronchiectasis Replaced by CT, and especially high resolution CT Computed Tomography Advantage Excellent anatomic detail (chest wall, pleura, lungs, mediastinum) Contrast enhancement — great vessels Indication Staging lung cancer and other malignant tumors Diffuse lung disease — high-resolution CT Pleural disease Mediastinal disease Magnetic Resonance Imaging, MRI More sensitive than CT in detecting hilar and mediastinal lymphadenopathy. Less value in lung diseases. Angiography Pulmonary arteriography Pulmonary embolism Vascular abnormalities Bronchial arteriography The source of hemoptysis咯血 Normal Radiological Anatomy Thoracic cage Mediastinum Diaphragm Pleura Trachea bronchi Lung Thoracic cage – soft tissues Thoracic cage - bone Lung Lung fields Lung markings hilum of lung F