呼吸系统放射影像学.ppt
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1、Radiology of Respiratory System,Aims,BasicsBest exam resultsAppreciate the role radiology plays?Instill an interest in radiology,Before Class:,TextbookReference bookLiteratureInternetAppsTeacher&classmate,Histology and EmbryologyAnatomyPathologyInternal MedicineSurgeryGynecologyPediatricsNeurology。E
2、verything。U need to know,methods,X-rayCTMRDSAUSNuclear Medicine PET/CT Radionuclide ventilation perfusion imaging,X-ray Techniques,PA(posteroanterior)&LateralMore informationTwo viewsStandardizedDistancePt needs to be stable,PortableQuickAnywhereOne shotNo standardization,PA,Portable,Techniques-Proj
3、ection,P-A(relation of x-ray beam to patient),Techniques-Projection(continued),A-P Supine/Erect,Techniques-Projection(continued),Lateral,Techniques-Projection(continued),Lateral Decubitus,Oblique,Technical Details,TypeOrientationRotation Inspiration/expirationPenetration,Rotation,Rotation(continued)
4、,Penetration,Inspiration/Expiration,Things to see,ABCDEAirwaysTrachea,endotracheal tube,etcBonesClavicles,ribs,etcCardiacDiaphragm(Right hemidiaphragm slightly higher(1.5 cm)Everything else(tubes),effusions,Densities,The big two densities are:(1)WHITE-Bone(2)BLACK-AirThe others are:(3)DARK GREY-Fat(
5、4)GREY-Soft tissue/water And if anything Man-made is on the film,it is:(5)BRIGHT WHITE-Man-made,Anatomy,Anatomy,Bronchopulmonary Anatomy,Cross-sectional Anatomy of Lung Segments(CT),Lobes,Right upper lobe:,Lobes(continued),Right middle lobe:,Lobes(continued),Right lower lobe:,Lobes(continued),Left l
6、ower lobe:,Lobes(continued),Left upper lobe with Lingula:,Lobes(continued),Lingula:,Lobes(continued),Left upper lobe-upper division:,Heart,Right border:Edge of(r)Atrium3.Left border:(l)Ventricle+Atrium4.Posterior border:Reft Ventricle5.Anterior border:Right Ventricle,Heart(continued。),Heart,ITS NOT
7、MINE.,Hilum,Made of:1.Pulmonary Art.+Veins2.The Bronchi Left Hilum higher(max 1-2,5 cm)Identical:size,shape,density,Hilum,Ribs,Review areas:,Apices Behind the heart Costophrenic angle(CPA)Below the diaphragm Soft tissues(breast,surgical emphysema)Ribs&clavicle Vertebrae,Abnormals,Lung findings,Darke
8、r areasradiolucentPneumothoraxCysts/bullaAir bronchograms,Lighter areasOpacitiesAtelectasis“infiltrates”BloodPusWaterNodules or mass,Opacities,Lobar or not.PneumoniaPulmonary Edema“fluffy,”diffuse,“bat wing”distributionHemorrhageCant tell by x-ray,need bronch,RML pneumonia,Opacities,RLL pneumonia,Op
9、acities,RUL pneumonia,LLL pneumonia,Consolidation on CT,The Enlarged Hila,Causes:1.Adenopathies(neoplasia,infection)2.Primary Tumor3.Vascular4.Sarcoidosis,Mass,Hilar Lymphadenopathy-BL,Multiple Masses,Metas,Pleural Effusion,Pulmonary Fibrosis,Heart failure,Kerley A/B line(Interstitial lung hyperplas
10、ia edema),Heart failure,Pneumothorax,Emphysema,Cavitating lesion,Thin-walled Cavitating lesion,Thick-walled Cavitating lesion,3mm,Bronchiectasis,Miliary shadowing,Calcification,Benign Patterns of Calcification Within a Solitary Pulmonary Nodule,Chest Tube,NG Tube,Pulm.artery cath,CT Indications,Key,
11、Clinical FactorsGrowth PatternSizeMargin(Border)CharacteristicsDensityContrast-Enhanced CTOther findings,Pulmonary Infection,airspace opacification,air bronchograms,dense multifocal segmental,pneumonia,lung abscess,cavitation,Lobar/segmental consolidation,Pneumonia finding,Tuberculosis,infiltrates,M
12、iliary shadowing,Tuberculoma,Chronic fibro-cavitary TB,CAUSES OF SOLITARY PULMONARY NODULES(SPN),Neoplastic:MalignantBronchogenic carcinomaSolitary metastasisLymphomaCarcinoid tumorNeoplastic:BenignHamartomaBenign connective tissue and neural tumors(e.g.,lipoma,fibroma,neurofibroma)InflammatoryGranu
13、lomaLung abscessRheumatoid noduleInflammatory pseudotumor(plasma cell granuloma)CongenitalArteriovenous malformationLung cystBronchial atresia with mucoid impactionMiscellaneousPulmonary infarctIntrapulmonary lymph nodeMucoid impactionHematomaAmyloidosisNormal confluence of pulmonary veinsMimics of
14、SPNNipple shadowCutaneous lesion(e.g.,wart,mole)Rib fracture or other bone lesion loculated pleural effusion,Neoplastic:Benign,Hamartoma,Neoplastic:Malignant,Bronchogenic carcinoma,Neoplastic:Malignant,Bronchogenic carcinoma,Inflammatory,Granuloma,chest radiograph shows a small,well-circumscribed,ro
15、und opacity at the right lung base(arrows).,Lateral view shows that the opacity is within the lung on two views(posterior segment of the right lower lobe)and thus represents a pulmonary nodule(arrow).,Contrast CT in Malignant Solitary Pulmonary Nodule.Thin-collimation(3-mm)CT scans through left uppe
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