医学影像诊断学02心脏大血管课件

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1、HeartandGreatVessels心脏大血管王翠艳山东大学医学院山东省医学影像学研究所目的要求UnderstandthecardiovasculardetectionsofX-rayandUSGMasterthenormalX-rayappearanceoftheheartandgreatvesselsMastertheX-rayappearanceofenlargmentofeverychamberMastertheradiologicalcharacters(X-ray,USG)ofseveralcardiovasculardiseases课时分配1Unit1Examin

2、ationTechniquesX-ray5minCT5minMRI5minUSG5minUnit2ObservationandAnalysisofImagingTopographyofthenormalheartandthegreatvesselsintheX-rayexaminations40minX-raysignsofcommonpathologicalchanges40min课时分配2Unit3ImagingdiagnosisofdiseasesRHD20minASD20minF420minPericardiaceffusionandconstrictivepericard

3、itis20minAorticdissection20min第三节疾病诊断Unit3Imagingdiagnosisofdiseases风湿性心脏病RheumaticHeartDisease----------RheumaticHeartDiseaseClinicalfeaturesandpathologyPathology:valvularstenosis/insufficiencyHemodynamics:MS:LA↑→PV↑→PA↑(Pul.Hypertension)→RV↑AS:LV↑→LA,PV↑,post-stenosisdilatationofaortaValvula

4、rinsufficiency:dilatationofchambersMI:EarlystageLatestage:LA↑→PA↑(Pul.Hypertension)Clinicalfeatures:20-40Y,female;MS,AS,TS;rarePSSignsandsymptomsSignsofimagingX-raysigns:calcificationofvalveMS:Mitralconfiguration(heartshape)Bulgingofpul.arterysegment,atrophyofknobandLVLA,RV↑(enlargement)“doubl

5、econtour”,retrosternalspace↓Pul.congestion→interstitialpul.edema“hemosiderosis”（含铁血黄素沉着）----------RheumaticHeartDiseaseSignsofimagingMI:LA,LV↑,RV↑,normalsizeoratrophyofaorticknob(severeMI)pul.circulatoryhypertensionvenous→venousandarterial----------RheumaticHeartDiseaseMitralStenosisMitralSten

6、osisMitralInsufficiencyMitralInsufficiencyTS/TI：USGsignsAS/AI:“Aorticshape”oftheheartsilhouette----------RheumaticHeartDiseaseAorticStenosisAorticInsufficiencyAS.+AI.CTsignsCalcificationofvalveSizeofchambersThrombusinLA----------RheumaticHeartDiseaseMRIsignsthickeningofvalveSizeofchambersThrom

7、businLAMRImovie----------RheumaticHeartDiseaseDiagnosisanddifferentialdiagnosisClinicalsigns&symptoms+x-ray→USGTherapy:percutaneousballoonmitralvalvuloplasty(PBMV,1984)----------RheumaticHeartDisease房间隔缺损Atrialseptaldefect(ASD)--------A