影像学-总论、基本病变.pptVIP

Right lower lobe collapse atelectasis Left upper lobe collapse atelectasis atelectasis Left lower lobe collapse atelectasis atelectasis 左肺上叶不张。CT增强扫描，不张的肺组织可见强化 左肺中央型肺癌并左肺上叶不张 肺不张 肿块 右肺中叶不张 右肺上叶肺不张 右肺中叶不张 左肺上叶舌段肺不张 再见！ 胸廓入口平面 正常纵隔 胸骨柄平面 正常纵隔 主动脉弓平面 正常纵隔 主-肺动脉窗平面 正常纵隔 肺动脉分叉平面 正常纵隔 左下肺静脉干平面 正常纵隔 正常胸部MRI表现 正常MR表现 A．为冠状位MRA图像 B．为轴位像（白血技术） C．轴位像，显示心腔结构 胸部冠状位（主支气管平面） A、B．轴位T1WI，C．冠状位T2WI 基本病变的影像表现 （一）气管、支气管改变 （二）肺部病变 （三）肺门的改变 （四）胸膜病变 （五）纵隔的改变 （六）横膈的改变 主要是支气管阻塞引起的改变 支气管阻塞最常见病因有支气管腔内肿瘤、异物、结核及先天狭窄等。淋巴结肿大是支气管外压性狭窄最常见的原因。 （一）气管、支气管改变 阻塞性肺气肿----因支气管活瓣性狭窄，空气易进难出，肺内含气增多。 阻塞性肺不张----因支气管完全阻塞所致。气体吸收，肺体积缩小。 阻塞性肺炎----为阻塞后并发症。 Pulmonary emphysema Types associated conditions Panlobular emphysema 全小叶型肺气肿 Centrilobular emphysema 小叶中央型肺气肿 Paracicatricial emphysema 瘢痕旁肺气肿 Obstructive emphysema 阻塞性肺气肿/obstructive hyperinflation阻塞性肺过度充气 Compensatory emphysema 代偿性肺气肿 Bulla 肺大疱(1cm) Panlobular emphysema Reduction of peripheral pulmonary vascularity Fewer lung markings Pulmonary hyperinflation Barrel-shaped chest Flattened diaphragm Translucent lung fields Alteration of the central pulmonary arteries and heart Pulmonary artery enlarge Heart elongated emphysema Radiological appearance CT Panlobular emphysema Centrilobular emphysema bulla 慢性支气管炎并肺气肿 弥漫性肺气肿 弥漫性肺气肿 Pulmonary collapse/ obstructive atelectasis Complete bronchial obstruction, gradual resorption of air Include: Complete collapse of a long Lobar collapse rounded atelectasis Lobular atelectasis Radiological signs of collapse Direct signs Displacement of fissures Loss of aeration: increased radiodensity Vascular and bronchial signs-crowded Indirect signs Elevation of the diaphragm Mediastinal displacement Compensatory hyperinflation atelectasis Opacification of the hemithorax intercostal space decreased Mediastinum shift to the affected side Diaphragm rises The contralateral lung is hyperinflated and may herniate across the midline. Complete collapse of a long atelectasis Lobar collapse Fissure distort叶间裂移位 Volume decreas