胸部正常CT断层解剖图片.ppt

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1、胸部正常CT解剖.目录概论纵隔窗的CT解剖肺窗的CT解剖.前言肺、纵隔内部组织结构之间、正常结构与病变之间的密度差异CT满意显示胸部正常结构和病灶的大体解剖，定位、定量准确，为定性分析提供形态学基础.有关胸部CT检查技术的几个问题1、CT值与窗宽、窗位：肺窗和纵膈窗，双窗技术2、层厚和层距：吸气末扫描，薄层/重叠扫描；减小部分容积效应、肺血坠积现象3、平扫和增强扫描：LN，病灶，血管4、高分辨CT（HighResolution,HRCT）层厚1～2mm，显示次级肺小叶结构；显示间质性病变、支扩、孤立

2、小病灶.........胸部正常CT解剖纵隔窗.一、主要观察内容1、纵膈：有无纵膈肿块、多余结构LN有无肿大或/及增多“三管”结构形态（气道结合肺窗）2、较大范围的肺、胸膜（腔）病变的内部结构3、阅片顺序：辨认每一层纵膈内的“三管”结构自上而下、由近段向远段完整观察某一结构.主要层面和结构主动脉弓及其以上层面：辨认头臂血管主-肺动脉窗层面：窗空虚/潜在，气管分叉，奇V弓右上叶支气管层面：左PA弓、右上PV前干，右上PA，上腔V左上叶支气管层面：右中间段支气管，右PA，右下PA，左上PV，左PA降支其

3、他肺门层面：两侧大小基本对称（肺窗显示更佳），相伴随的支气管和PA分支，由近向远渐小.....Canyoufindtherightandleftsubclavianarteries?(clickforanswer).Therightsubclavianarteryasitdumpsintothebrachiocephalicartery.(clicktohighlight).Whatarethe3yellowair-filled(black)structureshighlightedhere?(cl

4、icktohighlight)ThesearetheRightlungapexTracheaandEsophagus..Thisiscontrast(white)beinginjectedintotheleftsubclavianvein..Canyoufindthefirst3branchesofftheaorticarch?(clickforanswer)BrachiocephalicarteryLeftCommonCarotidarteryLeftSubclavianartery.Incide

5、ntallipoma(‘fattumor’)(noticeitisthesamedensityasfatinthechestwall)...CanyoufindtheleftbrachiocephalicveinasitdumpsintotheSVC?(clickforanswer).Weareatthelevelofthetopoftheaorticarch(clicktohighlight).Canyoufindtherightpectoralismajorandminor?(clickfor

6、answer).Whatisthestructureinblue?(clicktohighlight)ThisistheSuperiorVenacava...Canyoufindtheazygousarch?(wheretheazygousveincomesacrosstodumpintotheSVC)(clickforanswer)..Noticethebifurcationofthetrachea(corina)atthislevel(clicktohighlight)..Whatisthest

7、ructureinred?(clicktohighlight)Thisistheleftpulmonaryartery.....Canyoufindthepulmonarytrunkandrightpulmonaryartery?(clickforanswer).Wherearetheascending(A)anddescending(D)limbsofthethoracicaorta?(clicktohighlight)AD..Weareatthelevelofthetopoftheleftatr

8、ium.NoticeThepulmonaryveinsdumpingintoitastheyreturnfromthelungs.(clicktohighlight).Canyoufindtheleftmaincoronaryarterycomingofftheaorta?(clickforanswer).YoucanfurtherseeTheleftcoronarybranchintotheCircumflexarteryandtheLADartery(clickt