胸部正常影像演示文稿

胸部正常影像演示文稿当前1页，总共79页。（优选）胸部正常影像当前2页，总共79页。当前3页，总共79页。读片顺序胸壁/胸廓软组织：胸缩乳头肌及锁骨上皮肤皱褶、胸大肌、女性乳房及乳头骨骼：肋骨、肩胛骨、锁骨、胸骨、胸椎膈肌右高于左1-2cm，第9、10后肋/第6前肋间隙局限性膈膨升、波浪膈胸膜胸腔积液、气胸及液气胸、胸膜肥厚、粘连及钙化肺纵隔当前4页，总共79页。1.Trachea2.Rmainbronchus3.Lmainbronchus4.Lpulmartery5.RULpulmvein6.R(desc)pulmartery7.RLLandRMLveins8.Aorticarch9.S.venacava10.Azygousvein当前5页，总共79页。Normalleftlateralview.当前6页，总共79页。当前7页，总共79页。1.Trachea2.Rmainbronchus3.LULbronchus4.RULbronchus5.Lpulmonaryartery6.Rpulmonaryartery7.Pulmonaryvein8.Aorticarch9.BrachiocephalicvesselsNote:Vasculardetailsarevariablefromfilmtofilm当前8页，总共79页。右正侧位当前9页，总共79页。左正侧位当前10页，总共79页。右上叶当前11页，总共79页。右中叶当前12页，总共79页。右下叶当前13页，总共79页。左上叶当前14页，总共79页。左下叶当前15页，总共79页。当前16页，总共79页。当前17页，总共79页。正常HRCT当前18页，总共79页。中央肺动脉。当前19页，总共79页。支气管与相邻肺动脉直径大致相等。当前20页，总共79页。肺动脉常分为两个直径相当的分支。

当前21页，总共79页。肺静脉常分成许多细小的分支,这些分支与主支构成直角。

当前22页，总共79页。叶间裂（厚度小于1mm，边缘光滑，均一厚度）当前23页，总共79页。常见伪影双侧下肺近心脏处，肺血管脉动伪影。低密度区，可以错当作扩大的支气管。当前24页，总共79页。常见伪影主叶裂伪影。当前25页，总共79页。常见伪影血管双重伪影。当前26页，总共79页。TheSecondaryPulmonaryLobule肺小叶（直径1-2.5CM）当前27页，总共79页。小叶支气管、终末细支气管当前28页，总共79页。肺动脉pulmonaryartery

当前29页，总共79页。小叶间隔interlobularsepta

当前30页，总共79页。肺静脉pulmonaryvein

当前31页，总共79页。腺泡pulmonaryacini

当前32页，总共79页。正常小叶间隔normalsepta

当前33页，总共79页。正常小叶中心动脉当前34页，总共79页。centrilobularartery2当前35页，总共79页。肺静脉Pulmonaryveins

当前36页，总共79页。

胸部CT两个窗：纵隔窗和肺窗三个系统：管道系统；肺系统；淋巴系统断面：头臂干层面；主动脉弓层面；主肺动脉层面；左肺动脉层面；右肺动脉层面；左心房层面（基底干上方层面）；四腔心层面（两下肺静脉层面）当前37页，总共79页。MediastinumAnterior:thymus,lymphnodes,mammaryvesselsMiddle:pericardium,heart,greatvessels,trachea,mainbronchi,fat,nerves,lymphnodesPosterior:esophagus,descendingaorta,nerves,azygosandhemiazygosveins,lymphnodes当前38页，总共79页。BrachiocephalicArteryLevel

(Sterno-clavicularJointLevel)BA:brachiocephalicarterySCJ:Sterno-clavicularJointLCC:leftcommoncarotidLSA:leftsubclavianarteryRBV:rightbrachiocephalicveinLBV:leftbrachiocephalicveinLSALCCBALBVRBVSCJ当前39页，总共79页。AorticArchLevelSVC:superiorvenacavaIMV:internalmammaryvessels＊:pretracheal-retrocavalspacethymusarchtracheaesophagusSVC＊IMV当前40页，总共79页。AortopulmonaryWindowLevelSVC:superiorvenacavaAA:ascendingaortaDA:descendingaortaAZ:azygosAADAAZarchcarinaSVC当前41页，总共79页。LeftPulmonaryArteryLevelSVC:superiorvenacavaLPA:LeftPulmonaryArteryLPASVCpericardium当前42页，总共79页。RightPulmonaryArteryLevelRPA:RightPulmonaryArteryA-ER:azygoesophagealrecessRPAA-ER当前43页，总共79页。AorticRootLevelA:aorticrootLA:leftatriumPA:pulmonaryarteryPV:pulmonaryveinPALAAPV当前44页，总共79页。CardiacLevelLV:leftventricleRV:rightventricleLA:leftatriumRA:rightatriumIS:interventricularseptumRVLVRALAIS当前45页，总共79页。Lobes当前46页，总共79页。当前47页，总共79页。SegmentsandBronchiEachlobeiscomprisedofseveralsmallerunitsreferredtoaspulmonarysegments.Itisimportanttorememberthatsegmentalanatomyispredicatedonbronchialanatomy.Similartobronchialnomenclature,eachsegmentcanbenamednumerically,usinga"S",andthesamenumberofthecorrespondingbronchusthatsuppliesit.

当前48页，总共79页。Segment

Bronchus

UpperLobe

ApicalS1B1PosteriorS2B2AnteriorS3B3MiddleLobe

LateralS4B4MedialS5B5LowerLobe

SuperiorS6B6MedialBasalS7B7AnteriorBasalS8B8LateralBasalS9B9PosteriorBasalS10B10UpperLobe

ApicalPosteriorS1+2

B1+2

AnteriorS3B3SuperiorLingularS4B4InferiorLingularS5B5LowerLobe

SuperiorS6B6AnteriorMedialBasalS8B8LateralBasalS9B9PosteriorBasalS10B10SegmentBronchusRightLungLeftLung当前49页，总共79页。RightLungSegmentsTheapicalsegment(orS1segment)isshapedlikeatruncatedconewithitsbroadestbaselocatedsuperiorlyfillingthecupulaofthelung.Thissegmentthusextendsoverthepulmonaryapexbutdoesnotextendinferiorlytotheinterlobar(minorfissure)surface.当前50页，总共79页。当前51页，总共79页。当前52页，总共79页。Theposteriorsegment(S2)extendsfromtherighthilum,posteriorlyandinferiorlyandformstheposteriorhalfoftheinterlobarsurfacerelatingtotherightmajorfissure.Theanteriorsegment(S3)oftherightupperlobe,whichlikeS2extendsfromtherighthilararea,isorientedanteriorlyandsomewhatsuperiorly.TheanteriorsurfaceofS3extendstothechestwall,whilethebroadestinferiorsurfaceborderstheminorfissurewhichseparatingS3fromtherightmiddlelobe.当前53页，总共79页。当前54页，总共79页。当前55页，总共79页。Therightlowerlobeiscomprisedoffivepulmonarysegments:thesuperiorsegment(S6)issituatedimmediatelyinferiortotheposteriorsegmentoftherightupperlobe(S2)fromwhichitisseparatedbytherightmajorfissure.S6isborderedbythemajorfissureanteriorlyandcomprisesasizeableportionoftheposteriormarginoftherightlowerlobesuperiorly.Itisthissegmentthatsurprisinglyoccupiesasizeableareabehindtheanteriorsegment(S3)oftheRUL.当前56页，总共79页。当前57页，总共79页。当前58页，总共79页。Therightmiddlelobehastwopulmonarysegmentswhicharesituatedsidebyside;themorelateralsegment(S4),approximatesthesizeofitsadjacentneighbor,S5(medialsegment).S5neartherightheartbordermedially,whileS4extendstoandcomprisesaportionofthelateralborderoftherightlung.Superiorly,bothsegmentsbordertherightminorfissure,andlikewise,bothabutthemajorfissurealongtheirinferiormargins.BothS4andS5touchthediaphragmaticsurfaceattheiranteroinferioredges.Anteriorly,bothsegmentsareadjacenttotheanteriorribsendsofthe5th,6th,and7thribs.当前59页，总共79页。当前60页，总共79页。ImmediatelyanteriortoS10isthemedialbasalsegment(S7)whichtypicallyisthesmallestpulmonarysegmentofthelowerlobe.Alongitssuperiormargin,S7formsaportionofthemajorfissuremedially,anditslocationcanbebestthoughtofasbeingimmediatelyinferiortotherighthilum,abuttingthemajorfissureventrally.当前61页，总共79页。InferiortoS7istheanteriorbasalsegmentS8,whichtendstoberatherlargeinsize.ThissegmentalongwithS6comprisealargeportionofthemajorfissuresurface,laterally.S8residesinapredominantlylaterallocationhavingalargeperipheralsurface.当前62页，总共79页。Thelateralbasalsegment(S9),locatedbetweenS8andS10isshapedlikeatrianglewithitsbasedirectedlaterallyandassuchformsaportionofthelateralsurfaceoftherightlowerlobe.

ThepulmonarysegmentswhichborderortouchtherighthemidiaphragmareS4,S5,S7,S8,S9,andS10.S8andS10havethelargestsurfaceareasabuttingthediaphragm.

当前63页，总共79页。Theposteriorbasalsegment(S10)asitsnameimpliesoccupiestheposteriormostandinferiormostportionoftherightlowerlobe.Assuch,itcanbebestrememberedasthepulmonarysegmentwhichoccupiesmostoftheposteriorcostophrenicgutter.S10alsocomprisesalargeportionoftheposteromedialborderoftherightlowerlobeandisthesegmentwhichislocatedimmediatelyinferiortoS6.S10characteristicallytendstobethelargestsegmentoftherightlowerlobe.当前64页，总共79页。LeftLungSegments(S1+2)representsacombinationofthetwoseparate(apicalandposterior)segmentsseenontherightupperlobe.Itisreferredtoastheapicalposteriorsegment.Combined,S1+2anatomicallyissimilarinshapetothetwosegmentsontheright.当前65页，总共79页。TheS3oranteriorsegmentalsoissimilartotherightS3segment,havingalargeareadirectedanteriorly.当前66页，总共79页。Thesuperiorlingularsegment(S4)ispositionedimmediatelyinferiortoS3andisdirectlyabovetheinferiorlingularsegment(S5).Bothlingularsegmentshavetheirgreatestareadirectedanteriorlyandinferiorly.Additionally,S4tendstohavemoreareadirectedlaterallywhileS5hasmoreareadirectedmedially,abuttingthemediastinum.Bothsegmentsextendanteroinferiorlytoreachtheventralsurfaceofthelefthemidiaphragm,andhenceborderalargeportionoftheanteroinferiorsurfaceofthemajorfissure.当前67页，总共79页。Formingtheremainderoftheinterlobarsurfaceisthesuperiorsegment(S6).S6isidenticaltoitscounterpartontheright.当前68页，总共79页。Theleftlowerlobesegmentalarchitectureissimilartothatoftherightlowerlobe,howeverbecausetheanteriorandmedialbasalsegmentsshareacommonbronchialsupply,thesetwosegmentsarecharacteristicallycombined,formingananteriormedialbasalsegment(S8).Therefore,theanteriorsegmentiscombinedwiththemedialsegmentbutmaybedenotedbySX7.Theanteriormedialbasalsegmentisborderedanteriorlybytheinterlobar(majorfissure),andabutsthevisceralpleuralsurfacesofthetwolingularsegmentslocatedanterosuperiorly.当前69页，总共79页。Thelateralbasalsegment,S9andtheposteriorbasalsegment,S10alsocloselyapproximatethesamesegmentsintherightlowerlobe.S9(lateralbasalsegment)hasitsbroadestsurfaceareaexposedposterolaterally,andmaybeslightlylargerthanS9ontheright.S9,notincontinuitywiththemajorfissure,occupiesmuchoftheposteriorcostophrenicsulcusposterolaterally.当前70页，总共79页。Likeitscontralateralcounterpart,S10(posteriorbasalsegment)isquitelargeandoccupiestheposteriorandinferiormostportionoftherightlowerlobeoccupyingtheposteromedialcostophrenicgutter.当前71页，总共79页。ThecourseofB1+2hasverticallyandhorizontallyorientedcomponentsasbronchialramidividetosupplytheapicalposteriorsegment.TheB3bronchuswillhaveamorehorizontalcourse,similartothatseenontherightside.B3suppliestheanteriorsegmentoftheleftupperlobe.当前72页，总共79页。Therightmainstembronchusisconsideredtoextendnofartherinferiorlythantheoriginoftherightupperlobebronchus.Theairwaydistaltotheupperlobebronchusisreferredtoasthebronchusintermedius(BI).BIgenerallyaverages2cminlengthandterminatesatthepointattheoriginoftherightmiddlelobebronchus.

当前73页，总共79页。ThelingularsegmentalbronchiaresomeofthemostdifficultsegmentalbronchitovisualizeonCT.Theirinconspicuousnessisaresultoftheir