常见疾病的呼吸诊断.ppt

* Giant cell interstitial pneumonia 52m patchy areas of GGO and fine reticulation in both lower lung zones * Giant cell interstitial pneumonia Bilateral areas of small cysts, GGO, fine reticular hyperattenuation, and traction bronchiectasis, sugest fibrosis * Giant cell interstitial pneumonia 45y Saw manufacturing plant patchy areas of ground-glass attenuation and fine linear hyperattenuating areas predominantly involving the lower lung zones The diagnosis of hard metal pneumoconiosis was proved with occupational history and surgical biopsy * Pleural plaques M50, with asbestos exposure from working in a brake lining production plant Diffuse thickening of the left pleura and curvilinear band opacities in the left lower lung zone * Pleural plaques Pleural plaques on the right side and rounded atelectasis with adjacent diffuse pleural thickening on the left side * Chronic pulmonary embolism M62 Dyspnea Pulmonary arterial wall calcification A secondary sign of chronic pulmonary embolism * Pulmonary arterial hypertension secondary to chronic pulmonary embolism Ancillary findings pulmonary artery diameter ﹥33mm pericardial fluid Pulmonary artery measures 41mm in diameter indicates hypertension * Chronic pulmonary embolism Pericardial fluid associated with pulmonary arterial hypertension Secondary to chronic pulmonary embolism * 尘 肺 Pneumocomosis 肺通过气道与外界相通，吸入在空气中悬浮的无机与有机尘粒，这些尘粒中部分可致病 正常情况下肺有很强的能力来清除这些尘粒。然而，过多的生产性粉尘则可引起气道和肺泡的损伤，导致肺部弥漫性纤维化，称为尘肺 * 国家现行规定的12种尘肺 矽肺 silicosis 煤工尘肺 coalworker pneumoconiosis 石墨尘肺 graphite pneumoconiosis 炭黑尘肺 anthracosis 石棉肺 abestosis 滑石尘肺 talc pneumoconiosis 水泥尘肺 cement pneumoconiosis 云母尘肺 mica pneumoconiosis 陶工尘肺 kaolin pneumoconiosis 铝尘肺 aluminum pneumoconiosis 电焊工尘肺 electric and welder pneumoconiosis 铸工尘肺 foundry worker pneumoconiosis * 尘肺的诊断原则 ①根据目前我国现行政策的规定：尘肺的诊断必须是由国家卫生行政部门指定的尘肺诊断小组来进行，任何个人作出的诊断都是无效的 ②由于许多疾病可以形成类似尘肺的肺部弥漫性改变，因此作为影像专业的医师，应对引起尘肺的病因学、生产现场的流行病学调查及其临床病理资料有所了解 ③尘肺诊断的前提是病人必须有明确的生产性粉尘接触史，并且有同行业人发病年龄作为参考资料 * 基本影像学表现 类圆形小阴