咯血的多层螺旋CT血管成像-陈占勋20120723.ppt

与咯血有关的血管的影像表现 咯血相关的支气管动脉及其他非支气管动脉 咯血相关的肺动脉 咯血相关的支气管动脉及其他非支气管动脉的影像表现 无支气管动脉供血：支气管动脉起源正常，未见明显增粗，病灶内未见支气管动脉供血 支气管动脉单支供血：供血支气管动脉主干增粗、扭曲，可伴有分支的增多、增粗，或伴动脉瘤 支气管动脉多支供血：表现为向病灶供血的支气管动脉有2~3支，相互交通吻合，形成血管网 支气管动脉与非支气管动脉共同供血：支气管动脉与肺外体循环动脉同时向病变供血，包括肋间动脉、内乳动脉、膈下动脉等 直接异常体循环动脉供血： Martine Remy-Jardin，et al. Radiology 2004; 233:741–749 Martine Remy-Jardin，et al. Radiology 2004; 233:741–749 Figure 6. Images in a 19-year-old man with chronic recur-rent minor hemoptysis originating from the right lowerlobe. (a) Inferior-superior MIP obtained from multi–detec-tor row CT of the lower lung zones and (b) anterior volume-rendered CT image of the thoracolumbar region depict theabnormal systemic artery (arrows) supplying the postero-basal segment of the right lower lobe and its origin from theanterior wall of the descending aorta. (c) Selective arterio-gram demonstrates the abnormal systemic artery (arrows)prior to coil deposition, enabling its complete occlusion. Antoine Khalil ,et al. AJR September 2010 vol. 195 no. 3 772-778 74-year-old man with active tuberculosis who was admitted for hemoptysis. Axial (A) and sagittal (B) multiplanar reconstruction images on mediastinal window setting and sagittal multiplanar reconstruction image (C) on lung window setting show pulmonary artery false aneurysm in wall of cavity corresponding to Rasmussen aneurysm (arrow). Selective pulmonary artery angiogram was performed with MDCT angiography guidance. Type A PAP in 49-year-old man with pulmonary tuberculosis. (a) Pulmonary CT angiogram shows a PAP (假性肺动脉瘤，arrow) in the posterior segment of the right upper lobe. (b) Main pulmonary angiogram shows a PAP (arrow). Suyoung Shin，et al. August 2010 Radiology, 256, 656-664. 1A —45-year-old man with hemoptysis. Axial (A), sagittal (B), and coronal (C) MDCT reconstructions with 1-mm-thick slice viewed at lung window settings show ground-glass opacities on anterior segment of left upper lobe. Multiplanar MDCT reconstructions (not shown) did not add information