2012ARDS柏林定义中的12张标准胸片.doc

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1、CXR#1–CONSISTENTWITHARDSThisisanexampleofapatientwithbilateralinfiltratesconsistentwithpulmonaryedema.Thelefthemidiaphragmisvisible,arguingagainstleftlowerlobeatelectasis.TypicalorclassicradiographicfindingsofARDShavebeencharacterizedasbilateralconfluentopacitiesasdemonstratedinthisr

2、adiograph.However,theAECCdefinitionexpandedthescopeofradiographicopacitiesthatareconsistentwithARDStoincludebilateralopacitiesthataresimplyconsistentwithpulmonaryedema,evenifpatchyandinhomogeneous.这是与肺水肿一致双侧浸润的患者的一个例子。左侧膈肌可见，在反对左下叶肺不张。急性呼吸窘迫综合征的典型或经典的X线表现已被定性为如本胸片双侧融合阴影。然而，AECC定义扩大放射

3、线阴影是急性呼吸窘迫综合征一致，以包括，双边阴影是简单地与肺水肿一致，即使片状和不均匀的范围。符合ARDS，两肺浸润影符合肺水肿。CXR#2–INCONSISTENTWITHARDSTheopacitiesintherightlowerlobearelikelyduetoapleuraleffusion,whilethereisevidenceofeitheratelectasisintheleftlowerlobeoraleftpleuraleffusion.Thereisnoconvincingevidenceofopacitiesinthemid-orup

4、per-lungzonesconsistentwithpulmonaryedema.在右下叶的阴影可能是由于胸腔积液，同时有肺不张或者在左下肺叶或左侧胸腔积液的证据。有在中间或上肺区有肺水肿一致阴影没有令人信服的证据。不符合ARDS，右下叶为胸腔积液，左下肺为肺不张或者胸腔积液。CXR#3–INCONSISTENTWITHARDSAlthoughthischestx-rayisunderpenetrated,theopacificationsofbothlowerlobesarelikelyduetopleuraleffusionsand/oratelectas

5、is.Theredoesnotappeartobeconvincingevidenceofbilateralopacitiesconsistentwithpulmonaryedema.虽然这个胸部X射线underpenetrated，无论下叶的opacifications可能是由于胸腔积液和/或肺不张。似乎没有要与肺水肿一致的双边阴影有说服力的证据。不符合ARDS，两下肺显示胸腔积液或肺不张。CXR#4–EQUIVOCALFORARDSThischestx-raydemonstratessomeequivocalfindingsforbilateralinfil

6、tratesconsistentwithpulmonaryedema.Theremaybeopacificationsinleftmid-lungfieldconsistentwithedema.Lossofthelefthemidiaphragmmaybeduetoleftlowerlobeatelectasisorpleuraleffusion.Theopacitiesandabnormalitiesintherighthemithoraxmaybeprimarilyduetoapleuraleffusion.Giventheequivocalnatureo

7、fthischestx-ray,thecontext(e.g.,medicalhistory,presenceofriskfactors)andevolutionofthepatient’sclinicalconditionandchestx-rayovertime(e.g.,8-12hours)maybehelpfultoascertainwhetherthereareopacitiesconsistentwithpulmonaryedema.Dependingonthemechanismofactionandrisksofaconsideredinterve

8、ntion,clinic