七年制呼吸影像-胸部基本病变的影像表.ppt

（2）液气胸 hydropneumothorax ： ①外伤、手术后及胸腔穿刺后均可产生液气胸hydropneumothorax after trauma, operation and chest puncture ②气胸下部可见均匀致密的液平面 homogeneous dense air-fluid level in lower hydropneumothorax ③如脏、壁层胸膜粘连，也可形成局限性或多房性液气胸 pleural adhesions, can be formed local or multilocular hydropneumothorax ④其余征象同气胸 with the remaining signs of pneumothorax 左侧气胸 右侧液气胸 3、胸膜增厚、粘连、钙化 （Pleural thickening, adhesion and calcification） （1）病理 Pathology： 胸膜炎治愈出现纤维素沉着、增厚、粘连和钙化 pleural deposition of cellulose, thickening, adhesion and calcification after pleurisy （2）X线表现 X-ray findings： A.轻度 Mild： 肋膈角变钝、膈肌平直、膈肌活动受限 blunting of the costophrenic angle, depression and flattening of the diaphragm, limitation of activity of the diaphragm B.重度 severe： ①沿胸壁有带状致密影 a high dense band-like shadow along the chest wall ②肺野密度增高或有钙化影 dense or calcification in lung fields ③患侧膈肌升高、不规则、拉直 elevation of diaphragm and irregular, straightened on the affected side ④肋间隙变狭窄和纵隔移向患侧 narrowing of the intercostals spaces on the affected side, displacement of mediastinum to the affected side 4、胸膜结节、肿块（pleural nodule 、mass） ①胸膜结节、肿块见于胸膜原发或转移性肿瘤 found in pleural primary or metastatic tumors ②原发多为胸膜间皮瘤 more for pleural endotheliomas ③少数为来自结缔组织的纤维瘤、平滑肌瘤、神经纤维瘤等 minority from the fibroma of connective tissue, liomyoma and neurofibroma ④也可见于机化性脓胸及石棉肺形成的胸膜斑块等 Can also be found in pleural plaque caused by organizing empyema and asbestosis ⑤胸膜肿瘤可为局限性或弥漫性 pleural tumors can be local or diffuse ⑥弥漫性均为恶性 diffuse are malignant ⑦可伴或不伴有胸腔积液 with or without pleural effusion ⑧肿块合并胸水多为恶性 mass with pleural effusion always malignant ⑨弥漫性间皮瘤可伴有胸腔积液 Diffuse mesothelioma may be associated with pleural effusion ⑩转移瘤可伴有肋骨破坏 Metastases may be associated with rib damage X线 X-ray： ①表现为半球形、扁丘状或不规则形肿块 hemispherical, hummocky or irregular-shaped mass ②密度均匀 homogeneous density ③边缘清楚 well-defined ④与胸壁呈钝角相交 obtuse-Angle intersection with the chest wall ⑤胸膜外脂肪层完整 extrapleural fatty integrity CT： ①除X线检查所见外，有时可见肿块周边与胸膜相延续而形成胸膜尾征 In addition