肺脓肿影像诊疗.pptVIP

肺脓肿影像诊疗;主要内容;(A) An X-ray shows an abnormal shadow in the right upper lobe. (B) Chest CT with contrast enhancement shows a ring-enhancing solid mass measuring 53×43 mm in size in the right upper lobe with significant mediastinal lymphadenopathy. (C) A PET/CT scan reveals a high uptake in the mass, with a maximum SUV of 8.7, and the mediastional lymph node, with a maximum SUV of 3.7 … Am J Case Rep. 2014; 15: 243–245. ;A follow-up CT scan shows an increase in the size of the mass 59×49 mm( 53×43 mm) The final results of the pathologic examination showed a pleomorphic carcinoma ;Figure 1. Chest radiograph shows a large cavity with air fluid level in left lung. Figure 2. CECT Thorax at the level of carina showing a large cavity with air fluid level in left lung. Wall of the cavity is irregular. The Clinical Respiratory Journal. 2009 : 116–117 ;Figure 1: Chest X-ray at presentation showing complete opacification of the right hemithorax. Figure 2: CT scan chest showing complete replacement of the right lung with multiple abscesses. ; male， 24 years old, cough, fever; 文献;*; 肺脓肿概述;临床分型; 【病理】三期;脓肿的特征为坏死的肺组织形成空洞。 空洞充满脓液（坏死物质碎片/液体）或脓液加气体（空气）。 脓肿可大可小，可单个或多发。 脓肿可出现在肺的任何部位，根据不同的分类，有相应的好发部位。;;肺脓肿、脓气胸;吸入性肺脓肿;吸入性肺脓肿;继发性肺脓肿;继发性肺脓肿;血源性肺脓肿;血源性肺脓肿;  【临床表现】 ;X线、CT表现;X线、CT表现;X线、CT表现;治疗后有所吸收; 肺脓肿;影像学表现;;鉴别诊断;一、干酪样肺炎;*;;二、慢性纤维空洞型肺结核 以纤维厚壁空洞、广泛的纤维性变及支气管播散病灶组成病变主体 肺内有一个或多个厚壁空洞 余肺组织见支气管播散引起的多发病灶 后期肺广泛纤维化、变形、肺膜增厚并与胸壁粘连 ;鉴别诊断：空洞性肺结核继发感染;结核性空洞;三、肺癌空洞 支气管肺癌致肺脓肿 常无或仅有低度毒性症状，病程较长，易反复 支气管鳞癌形成空洞，常偏心、壁较厚、内壁凹凸不平，周围少炎症浸润 肺门部淋巴结可肿大 支气管镜肺组织活检、痰脱落细胞检查可确诊 ; 鉴别诊断：支气管肺癌;四、肺囊肿继发感染 炎症反应相对轻，常无明显中毒症状和脓痰 呈圆形、壁薄光洁而整齐面的囊腔 ;鉴别诊断：肺囊肿继发感染;小结;