修翻译张七制呼吸影像课件

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1、呼吸系统影像诊断学ImagingdiagnosticsoftheRespiratorysystem郑州大学第一附属医院MRI室thefirstaffiliatedhospitalradiologydepartmentoftheZhengzhouUniversity张焱ZhangYanL200812@163.com三、胸部基本病变的影像Basicimagingfindingsindiseaseofrespiratorysystem气管支气管病变diseaseofthetracheobronchus：（一）支气管阻塞及其后果bro

2、nchiobstructionandtheresults：病因：etiopathogenisis①管内:intralumen异物、分泌物和血块等foreignbody,excretionandbloodclot②管壁：tubalwall肿瘤、痉挛、先天性和炎症等tumor,spasm,congenitalandinflammation③管外：extralumen有肿瘤、增大淋巴结压迫等tumorandenlargementofthelymphnodes病理pathologically：①部分阻塞引起肺气肿obstructive

3、emphysema(incompleteobstruction)②完全阻塞引起肺不张atelectasis(completeobstruction)1.阻塞性肺气肿obstructionemphysema：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incompleteobstructioncausetoemphysema②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enlargementofalveoli,accompaniedbydestructionofalveolarwalls③

4、若多个肺泡膨胀破裂，融合则成肺大泡bullaisformedduetoruptureofalveolarwallandcommunicatedwitheachother,pneumatocele（1）弥漫性肺气肿diffuseobstructionemphysema：①两肺纹理变细、少、分散及肺透过度增大lungmarkingsappearthinnerthannormal,increaselucencyofbothlungs②膈肌低、动度弱depressionandflatteningofthediaphragm③肋间隙增宽

5、；心影狭长intercostalspacewiden,heartshadowappearslongandnarrow（2）局限性肺气肿localizedemphysema：①局部透过度高increaselucencyoftheaffected②肺纹理细、少、分散lungmarkingsappearasthinneroftheinvolvedarea③肺门、叶间胸膜、纵隔及膈肌移位displacementofhilum,pleura,mediastinumanddiaphragmtotheunaffectedside④有时可见纵

6、隔摆动pendularmovementofthemediastinumCTfindings：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diffuseobstructionemphysema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（obstructiveat

7、electasis）：①支气管完全阻塞completeobstructionofthebronchus②有时并发肺炎或支气管扩张concomitantconditionssuchaspneumoniaorbronchiectasis（1）一侧性肺不张atelectasisofanentirelung：①患侧肺密度高increasedensityoftheaffected②肋间隙狭窄narrowingoftheintercostalsspacesontheaffectedside③膈肌升高theaffectedsideprese

8、ntselevationofdiaphragm④纵隔移向患侧displacementofmediastinumtotheaffectedside⑤健侧代偿性肺气肿compensatoryemphysemaontheoppositesidelung（2）肺叶不张lobarate