呼吸系统正常和异常(影像).pptVIP

第一节 检查技术 Examination Technique （一）胸部透视（Chest fluoroscopy ） （二）胸部摄片（ Chest radiography ） 高千伏摄影（High voltage radiography） （三）造影检查（pulmonary angiography） （四）CT （肺窗、纵隔窗、增强扫描） （五） MRI （六）超声检查（Ultrasonograph） Chest radiography（胸片） Routine examination for patients Exclude serious chest disease Provide evidence of the preoperative condition of lung and heart before surgery Find out the postoperative complications: basal collapse, lung infections, pulmonary embolus. Chest radiography PA (Posteroanterior后前) view: Standard Erect position Anterior chest wall against the film Scapulae rotate forward End-inspiration Short exposure time 能显示＞5mm的病灶 High voltage radiography（高千伏摄影） The bones and abnormal calcification are poorly demonstrated, but the pulmonary and mediastinal detail is improved. Other views Anteroposterior views Supine film（背靠胶片） Apical and lordotic(前弓) views Decubitus views (卧位） Oblique views Bronchography（支气管造影） Radiographic examination of the bronchial tree by instillation of contrast medium directly into the trachea or bronchi. Evaluation of bronchiectasis Replaced by CT, and especially high resolution CT Computed Tomography（CT） Advantage Excellent anatomic detail (chest wall, pleura, lungs, mediastinum) Contrast enhancement — great vessels Indication Staging lung cancer and other malignant tumors Diffuse lung disease — high-resolution CT Pleural disease Mediastinal disease 呼吸系统螺旋CT临床应用进展 1、肿瘤普查 2、显示病灶细微结构 3、CT仿真支气管镜 4、CTA 5、肺功能检测 6、肺癌的诊断和分期 7、智能化引导穿刺活检 8、计算机辅助诊断 Magnetic Resonance Imaging, MRI More sensitive than CT in detecting hilar and mediastinal lymphadenopathy. Less value in lung diseases. 肺部MR检查应用指证： 1、肺部球形病灶。病灶上肺野、＞3mm； 2、中央型肺癌。了解肿瘤对纵隔脏器的累及； 3、特殊部位的肺癌。如肺上沟瘤； 4、纵隔型肺癌。位于纵隔旁的肺癌。 5、新检查方法： （1）超极化气体弥散成像； （2）肺灌注成像； （3）肺血管成像。 第二节 呼吸系统正常X线表现  Normal X