胸部正常影像hr课件

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1、胸部正常影像北京协和医院呼吸科黄蓉胸部x-ray读片顺序胸壁/胸廓软组织：胸缩乳头肌及锁骨上皮肤皱褶、胸大肌、女性乳房及乳头骨骼：肋骨、肩胛骨、锁骨、胸骨、胸椎膈肌右高于左1-2cm，第9、10后肋/第6前肋间隙局限性膈膨升、波浪膈胸膜胸腔积液、气胸及液气胸、胸膜肥厚、粘连及钙化肺纵隔1.Trachea2.Rmainbronchus3.Lmainbronchus4.Lpulmartery5.RULpulmvein6.R(desc)pulmartery7.RLLandRMLveins8.Aorticarch9.S.venacava10.Azygousv

2、einNormalleftlateralview.1.Trachea2.Rmainbronchus3.LULbronchus4.RULbronchus5.Lpulmonaryartery6.Rpulmonaryartery7.Pulmonaryvein8.Aorticarch9.BrachiocephalicvesselsNote:Vasculardetailsarevariablefromfilmtofilm右正侧位左正侧位右上叶右中叶右下叶左上叶左下叶正常HRCT中央肺动脉。支气管与相邻肺动脉直径大致相等。肺动脉常分为两个直径相当的分支。肺静脉常

3、分成许多细小的分支,这些分支与主支构成直角。叶间裂（厚度小于1mm，边缘光滑，均一厚度）常见伪影双侧下肺近心脏处，肺血管脉动伪影。低密度区，可以错当作扩大的支气管。常见伪影主叶裂伪影。常见伪影血管双重伪影。TheSecondaryPulmonaryLobule肺小叶（直径1-2.5CM）小叶支气管、终末细支气管肺动脉pulmonaryartery小叶间隔interlobularsepta肺静脉pulmonaryvein腺泡pulmonaryacini正常小叶间隔normalsepta正常小叶中心动脉centrilobularartery2肺静脉Pul

4、monaryveins胸部CT两个窗：纵隔窗和肺窗三个系统：管道系统；肺系统；淋巴系统断面：头臂干层面；主动脉弓层面；主肺动脉层面；左肺动脉层面；右肺动脉层面；左心房层面（基底干上方层面）；四腔心层面（两下肺静脉层面）MediastinumAnterior:thymus,lymphnodes,mammaryvesselsMiddle:pericardium,heart,greatvessels,trachea,mainbronchi,fat,nerves,lymphnodesPosterior:esophagus,descendingaorta,ne

5、rves,azygosandhemiazygosveins,lymphnodesBrachiocephalicArteryLevel(Sterno-clavicularJointLevel)BA:brachiocephalicarterySCJ:Sterno-clavicularJointLCC:leftcommoncarotidLSA:leftsubclavianarteryRBV:rightbrachiocephalicveinLBV:leftbrachiocephalicveinLSALCCBALBVRBVSCJAorticArchLevel

6、SVC:superiorvenacavaIMV:internalmammaryvessels＊:pretracheal-retrocavalspacethymusarchtracheaesophagusSVC＊IMVAortopulmonaryWindowLevelSVC:superiorvenacavaAA:ascendingaortaDA:descendingaortaAZ:azygosAADAAZarchcarinaSVCLeftPulmonaryArteryLevelSVC:superiorvenacavaLPA:LeftPulmonaryA

7、rteryLPASVCpericardiumRightPulmonaryArteryLevelRPA:RightPulmonaryArteryA-ER:azygoesophagealrecessRPAA-ERAorticRootLevelA:aorticrootLA:leftatriumPA:pulmonaryarteryPV:pulmonaryveinPALAAPVCardiacLevelLV:leftventricleRV:rightventricleLA:leftatriumRA:rightatriumIS:interventricularse

8、ptumRVLVRALAISLobesSegmentsandBronchiEachlobeiscompris