[临床医学]呼吸系统放射学诊断-刘辉-2.ppt

Respiratory Radiology  刘辉 Department of Radiology, the second Xiangya hospital 薄壁空洞Thin-walled cavity 洞壁厚3mm以下内壁光滑境界清楚的园形透亮区，见于肺结核 结核性空洞常无或仅少量液体多为薄壁TB cavity with a little or not fluid level  大量积液pleural effusion 纵隔？肋骨？横膈？ 胸腔心包积液CT表现 支气管疾病—支气管扩张bronchiectasis 支气管疾病—支气管扩张bronchiectasis continuous cough and purulent sputum A history of recurrent haemoptysis bronchiectasis bronchiectasis X-线表现 bronchiectasis ---CT： 肺炎pneumonia According to anatomic distributing,pneumonia can be as follows: Lobar pneumonia Bronchopneumonia interstitial pneumonia Lobar pneumonia—临床 caused by pneumococcus rapid development of high pyrexia a characteristic rusty color sputum The basic pathologic lesion is acute inflammatory exudation of the pulmonary parenchyma 大叶性肺炎 pathologic changings 充血期The congestive stage (it is about 24 hours after onset) 红色肝变期The red consolidation stage 灰色肝变期The gray consolidation stage 消散期Resolution stage Lobar pneumonia充血期 It may be no X-ray changes or with an increase of lung markings or with a faint shadow in the inflammatory area many of the alveoli are still aerated Lobar pneumonia----肝变期 The X-ray feature is a large homogenous radiopaque shadow there is no volume loss air bronchogram is common Borders of the shadow appear as a sharply defined margin Lobar pneumonia Resolution stage the alveolar exudates are absorbed there are filled with air in the alveoli the shadow of consolidation becomes scatter resorption may be delayed up to one or two months Lobular pneumonia (bronchopneumonia) caused lobular pneumonia are streptococcus, staphylococcus, pneumococcus The common symptoms are fever, cough, purulent sputum and pleuritic pain etc Lobular pneumonia X-ray features There is intensification of lung markings Small patchy opaque shadows are seen in the middle and lower lung fields especially by the heart border Emphysema of the both lungs is usually visible. Confluence of