修翻译张七制呼吸影像 课件.ppt

呼吸系统影像诊断学 Imaging diagnostics of the Respiratory system 郑州大学第一附属医院MRI室 the first affiliated hospital radiology department of the Zhengzhou University 张焱 Zhang Yan L200812@163.com ;三、胸部基本病变的影像 Basic imaging findings in disease of respiratory system;气管支气管病变disease of the tracheobronchus： （一）支气管阻塞及其后果 bronchi obstruction and the results： 病因 ： etiopathogenisis ①管内 : intralumen 异物、分泌物和血块等 foreign body, excretion and blood clot ②管壁 ： tubal wall肿瘤、痉挛、先天性和炎症等 tumor, spasm,congenital and inflammation ③管外：extralumen有肿瘤、增大淋巴结压迫等 tumor and enlargement of the lymph nodes;病理 pathologically： ①部分阻塞引起肺气肿 obstructive emphysema (incomplete obstruction) ②完全阻塞引起肺不张 atelectasis (complete obstruction);1.阻塞性肺气肿 obstruction emphysema： ①部分阻塞致肺内气体不能完全排出，肺泡过度膨胀形成肺气肿 incomplete obstruction cause to emphysema ②终未细支气管以远的含气腔隙过度充气、异常扩大，可伴有不可逆性肺泡壁的破坏 enlargement of alveoli ,accompanied by destruction of alveolar walls ③若多个肺泡膨胀破裂，融合则成肺大泡 bulla is formed due to rupture of alveolar wall and communicated with each other, pneumatocele;（1）弥漫性肺气肿diffuse obstruction emphysema ： ①两肺纹理变细、少、分散及肺透过度增大 lung markings appear thinner than normal, increase lucency of both lungs ②膈肌低、动度弱 depression and flattening of the diaphragm ③肋间隙增宽；心影狭长 intercostal space widen, heart shadow appears long and narrow ;（2）局限性肺气肿localized emphysema ： ①局部透过度高 increase lucency of the affected ②肺纹理细、少、分散 lung markings appear as thinner of the involved area ③肺门、叶间胸膜、纵隔及膈肌移位 displacement of hilum, pleura, mediastinum and diaphragm to the unaffected side ④有时可见纵隔摆动 pendular movement of the mediastinum;CT findings： ⑴小叶中央型肺气肿 病变累及肺小叶中央部分，上叶多见 ⑵全小叶型肺气肿 病变累及全部肺小叶，下叶多见 ⑶间隔旁型肺气肿 病变累及肺小叶边缘，多见于胸膜下或小叶间隔周围; 弥 漫 性 肺 气 肿diffuse obstruction emphysema ; 右上慢性纤维空洞肺结核伴左侧代偿性肺气肿 局 限 性 肺 气 肿; 小叶中心性肺气肿 正常肺HRCT; 小叶中心性肺气肿 正常肺HRCT; ; 小叶中心型 全小叶型; 间隔旁型 肺大泡; 2.阻塞性肺不张（obstructive atelectasis）： ①支气管完全阻塞 complete obstruction