高分辨率肺部CT诊断（下）.pptVIP

Case 61 in a 73-year-old woman with cough 支扩 大边界不清的结节 树芽征 What is the most likely diagnosis in this patient最可能的诊断? (a) Bacterial bronchopneumonia细菌性支气管肺炎 (b) Tuberculosis肺结核 (c) Infection with atypical mycobacteria非典型分支杆菌感染 Infection with atypical mycobacteriaCorrect. In an elderly woman, the combination of bronchiectasis, nodules, and tree-in-bud is highly suggestive of MAC infection 支扩、结节、树芽征高度暗示分支杆菌感染。 Case 62 in a 35-year-old man with leukemia 白血病 On the lung window scan, a lung nodule is surrounded by a halo of ground-glass opacity磨玻璃晕征. This is termed the “halo sign晕征”. On the soft tissue window scan, low-attenuation necrosis is visible in the central portion of the nodule结节中心可见坏死. 晕征 坏死 Diagnosis: Invasive 入侵的aspergillosis曲霉病 with the “halo sign晕征 Case 63 in a 28-year-old man with leukemia 白血病and treated aspergillosis曲霉病治疗 不规则的空洞 结节影像 Diagnosis: Invasive aspergillosis 曲霉病with infarction坏死 and air-crescent sign 新月征 Case 64 in a 31-year-old woman with an abnormal chest radiograph异常胸部表现. Diagnosis: Wegener‘s granulomatosis with multiple nodules韦格纳肉芽肿 DISCUSSION：Large lung nodules can be associated with a variety of lung diseases, and in most instances, their appearance is nonspecific无特殊性 . The differential diagnosis鉴别诊断 includes metatstatic tumor转移瘤, infectious 感染or inflammatory lesions炎性损害, infarctions肉芽肿病, nodules of Wegener‘s granulomatosis, sarcoidosis结节病, and fibrotic masses 纤维块as are common in sarcoidosis or silicosis在结节病、硅肺病. INCREASED OPACITY 肺不透明性增加 Case 65 in a 35-year-old woman who has a history of asthma哮喘史, progressive shortness of breath进行性喘憋 Does the principal abnormality visible on CT represent consolidation or ground-glass opacity首要异常是实变还是磨玻璃改变? (a) Consolidation实变 (b) Ground-glass opacity磨玻璃密度 ConsolidationCorrect. HRCT shows patchy areas of consolidation in the lung periphery肺外围不均的实变. Note that vessels are not visible within the areas of increased opacity密度增高影内肺血管影像未见. Some areas of ground glass opacity are also visible一些磨玻璃区是可见的.