肺真菌病的影像诊断--2PPT.pptVIP

* 肺真菌病的影像诊断Imaging Diagnosis of Pulmonary Mycoses 彭文鸿 解放军第306医院呼吸内科 小叶中心性结节Centrilobular nodule 小叶中心性结节分布广泛，酷似随机分布的表现，但不累及胸膜面和小叶间隔。 Centrilobular nodules are usually of similar size and spaced at regular distances from each other. If the nodules are each at the center of a lobule, the internodular distance will be approximately 1-2.5 cm. At the periphery they occur 5-10 mm from the pleural surface (1/2 the diameter of a lobule). They usually represent linear peribronchiolar or bronchiolar densities cut in cross-section. 淋巴管周围性结节（Perilymphatic nodules） 淋巴管周围结节主要在肺门旁的支气管血管周围区、小叶中心区和与小叶间隔和胸膜面有关。 Ground glass ,consolidation 马赛克衰减（Mosaic attenuation） The term ‘mosaic attenuation’ is used to describe density differences between affected and non-affected lung areas.There are patchy areas of black and white lung. 马赛克灌注，肺灌注的区域性差异，导致吸气时HRCT上可见肺衰减的差异。反映了血管阻塞或通气异常，多见于气道疾病透亮区的血管特征性地表现为较致密肺内的血管细小。呼气HRCT 在由气道疾病中导致的马赛克灌注诊断上的价值。 马赛克衰减（Mosaic attenuation） Airway invasive aspergillosis Mosaic attenuation PCP in AIDS 实变影 Consolidation 肺衰减增加并掩盖了该区域内的肺血管，可见支气管空气征。 complete opacification of this area. When the bronchi remain aerated, they are seen as branching lucencies called air-bronchograms, which are present in this image. This image represents infectious pneumonia, which is limited by the major fissure, resulting in a sharp border. The advancing anteromedial margin shows ground-glass opacity (see later). 实变影 Consolidation 支气管肺活检证实为曲霉性支气管炎和肺炎 树芽征（Tree in Bud） 树芽征（Tree in Bud） 扩大的小叶中心细支气管，管腔内为黏液、液体或脓液所嵌塞，常伴细支气管炎症。 Hypodense sign(在实变及结节出现中心性低密度区) Halo---Hypodense----Air crescent 纵隔窗示中心密度低，有组织梗死 Halo Hypodense Reversed Halo Reversed Halo 空洞Cavitation  指肺组织坏死、液化，坏死物质经支气管排除后形成的病变。 Cavitating aspergillus nodule * * *