放射科心脏大血管正常及基本病变影像学表现.ppt 74页

A 肺淤血 B 治疗后复查 C 重度肺淤血 A：上肺静脉扩张，肺门影增大，边缘略模糊，肺野透明度降低。 B：同一病人，抗心衰治疗后，肺淤血情况好转。 C：上肺静脉扩张、肺门影增大及模糊、肺野透明度降低均明显。 肺淤血 间质性肺水肿 A 间质性肺水肿 B 间质性肺水肿 C 间质性肺水肿 克氏A线、B线 叶间胸膜少量积液 克氏B线和网格状结构 肺泡性肺水肿 肺动脉高压 ASD + PH (房间隔缺损肺动脉高压) VSD + PH (室间隔缺损肺动脉高压) VSD + ASD + PH RDPA usually > 15 mm Main Pulmonary Artery projects beyond tangent line 异常CT影像 缩窄性心包炎 心包钙化 右心房、左心室血栓心包积液 RA RA LV LV LAD闭塞 ，RCA-CB-LAD中段，RCA-RV-LAD中段侧支循环 RCA发自LAD 左主干缺如 冠状动脉变异 异常MRI影像 动物实验 磁共振心肌成像 右房、右室增大，右室壁不规则膨出，右室壁变薄 心包积液 * There are several modalities for cardiac imaging, The most common one is chest film. Others include Echocardiography, Radionuclide imaging, Magnetic resonance imaging, Computed tomography, and Angiography. Although modern technologies, such as CT and MR, provide three-dimensional images and functional analysis of heart. Chest film is simple and convenient and remains basic and wide use (in diagnosis of heart disease). It is important for medical student to learn the basic findings of heart on chest film. * There are four positions for viewing the heart. That is posteroanterior, lateral, right and left anterior oblique. PA is most commonly used. From the axial image, we find that RV forms the anterior border, RA forms the right border, LA forms the posterior border, and LV forms the left border * Portable AP films （床旁胸片） Obesity （肥胖） Pregnant（怀孕的） Ascites （腹水） Pectus excavatum （漏斗胸） * Normally the left atrium sits in the middle of the heart posteriorly and does not form a normal border on the frontal film. When the LA enlarges, it may produce the third arch on the left side of the heart. The first is aortic knob, second is main PA. on the right side of the heart, it may produce double contour. Two shadows overlap each other, the yellow arrow pointing to the RA and the red arrow to the LA The related diseases are MS, PDA 后前位 1 左心耳突出 2 心底部双重密度 见于：二尖瓣狭窄、左心功能不全、动脉导管未闭等 * The typical sign of Right Atrial