最新Chest X-ray Interpretation胸部X射线解释幻灯片.ppt

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1、ChestX-rayInterpretation胸部X射线解释IntroductionRoutinelyobtainedPulmonaryspecialistconsultationInherentphysicalexamlimitationsChestx-raylimitationsPhysicalexamandchestx-rayprovidecomplimentEssentialsBeforeGettingStartedExposureOverexposureUnderexposureSexofPatientMale

2、FemaleSystematicApproachBonyFragmentsRibsSternumSpineShouldergirdleClaviclesSystematicApproachSoftTissuesBreastshadowsSupraclavicularareasAxillaeTissuesalongsideofbreastsSystematicApproachLungFieldsandHilaHilumPulmonaryarteriesPulmonaryveinsLungsLinearandfinenodul

3、arshadowsofpulmonaryvesselsBloodvessels40%obscuredbyothertissueSystematicApproachDiaphragmandPleuralSurfacesDiaphragmDome-shapedCostophrenicanglesNormalpleuralisnotvisibleInterlobarfissuresSystematicApproachMediastinumandHeartHeartsizeonPARightsideInferiorvenacava

4、RightatriumAscendingaortaSuperiorvenacavaSystematicApproachMediastinumandHeartLeftsideLeftventricleLeftatriumPulmonaryarteryAorticarchSubclavianarteryandveinSystematicApproachAbdomenandNeckAbdomenGastricbubbleAirunderdiaphragmNeckSofttissuemassAirbronchogramSummar

5、yofDensityAirWaterBoneTissueTissuePitfallstoChestX-rayInterpretationPoorinspirationOverorunderpenetrationRotationForgettingthepathofthex-raybeamLungAnatomyTracheaCarinaRightandLeftPulmonaryBronchiSecondaryBronchiTertiaryBronchiBronchiolesAlveolarDuctAlveoliLungAna

6、tomyRightLungSuperiorlobeMiddlelobeInferiorlobeLeftLungSuperiorlobeInferiorlobeLungAnatomyonChestX-rayPAView:ExtensiveoverlapLowerlobesextendhighLateralView:ExtentoflowerlobesLungAnatomyonChestX-rayTherightupperlobe(RUL)occupiestheupper1/3oftherightlung.Posteriorl

7、y,theRULisadjacenttothefirstthreetofiveribs.Anteriorly,theRULextendsinferiorlyasfarasthe4thrightanteriorribLungAnatomyonChestX-rayTherightmiddlelobeistypicallythesmallestofthethree,andappearstriangularinshape,beingnarrowestnearthehilumLungAnatomyonChestX-rayTherig

8、htlowerlobeisthelargestofallthreelobes,separatedfromtheothersbythemajorfissure.Posteriorly,theRLLextendasfarsuperiorlyasthe6ththoracicvertebralbody,ande