肺CT基础-教学讲解课件

胸部CT基础胸部CT基础1纵隔窗右头臂静脉左头臂静脉左颈总动脉食管气管左锁骨下动脉头臂干纵隔窗右头臂静脉左头臂静脉左颈总动脉食管气管左锁骨下动脉头臂2纵隔窗右头臂静脉左头臂静脉左颈总动脉食管气管左锁骨下动脉头臂干气管前间隙纵隔窗右头臂静脉左头臂静脉左颈总动脉食管气管左锁骨下动脉头臂3纵隔窗主动脉弓食管气管4R淋巴结正常小于10mm上腔静脉纵隔窗主动脉弓食管气管4R淋巴结上腔静脉4纵隔窗升主动脉食管气管qi奇静脉弓上腔静脉降主动脉主肺动脉窗心包上隐窝纵隔窗升主动脉食管气管qi奇静脉弓上腔静脉降主动脉主肺动脉窗5纵隔窗升主动脉食管7组隆突下淋巴结不超过15mm奇静脉上腔静脉降主动脉右主支左主支右肺动脉左肺动脉纵隔窗升主动脉食管7组隆突下淋巴结奇静脉上腔静脉降主动脉右6纵隔窗升主动脉食管奇静脉上腔静脉降主动脉右主支左主支主肺动脉右肺动脉左肺动脉纵隔窗升主动脉食管奇静脉上腔静脉降主动脉右主支左主支主肺动脉7纵隔窗升主动脉食管奇静脉上腔静脉降主动脉右下肺动脉左下叶支气管主肺动脉左心耳左下肺动脉左上肺静脉左心房右心耳中间支气管奇静脉食管隐窝右上肺静脉纵隔窗升主动脉食管奇静脉上腔静脉降主动脉右下肺动脉左下叶支气8纵隔窗冠脉左前降支走行部位纵隔窗冠脉左前降支走行部位9纵隔窗纵隔窗10纵隔窗右心室左心室左下肺静脉主动脉根部右心房左心房纵隔窗右心室左心室左下肺静脉主动脉根部右心房左心房11纵隔窗右心室右心房左心室左心房右下肺静脉纵隔窗右心室右心房左心室左心房右下肺静脉12纵隔窗右心室室间隔左心室二尖瓣左心房房间隔右心房三尖瓣纵隔窗右心室室间隔左心室二尖瓣左心房房间隔右心房三尖瓣13纵隔窗下腔静脉左心室右心室纵隔窗下腔静脉左心室右心室14肺窗尖后段V尖段V后段V肺窗尖后段V尖段V后段V15肺窗右肺上叶动脉前段动脉左肺上叶动脉尖后段动脉尖后段静脉肺窗右肺上叶动脉前段动脉左肺上叶动脉尖后段动脉尖后段静脉16肺窗前段静脉后段静脉前段静脉尖后段静脉上叶支气管上支肺窗前段静脉后段静脉前段静脉尖后段静脉上叶支气管上支17肺窗左肺上叶静脉左肺动脉右肺上叶静脉水平裂左上叶支气管舌支肺窗左肺上叶静脉左肺动脉右肺上叶静脉水平裂左上叶支气管舌支18肺窗上舌段支气管下舌段支气管上段支气管右肺上叶静脉舌动脉干右肺上叶前段右肺中叶叶间动脉肺窗上舌段支气管下舌段支气管上段支气管右肺上叶静脉舌动脉干右19肺窗上叶前段上段静脉内前底段动脉外后底段动脉上叶前段上段支气管右下肺动脉肺窗上叶前段上段静脉内前底段动脉外后底段动脉上叶前段上段支气20肺窗内前底段支气管外后底段支气管肺窗内前底段支气管外后底段支气管21肺窗内前外后肺窗内前外后22肺窗肺韧带胸膜反折肺窗肺韧带胸膜反折23病变常见征象1.ground-glassopacity（GGO）病变常见征象1.ground-glassopacity（2423-year-oldwomanafterbonemarrowtransplantationforacutelymphocyticleukemiawithacutealveolarhemorrhage.TargetedhighresolutionCTscanofrightupperloberevealslobulardistributionofground-glassopacity.23-year-oldwomanafterbonem2545-year-oldHIV-positivewomanwithpneumocystispneumonia.High-resolutionCTscanshowsrandomdistributionofground-glassopacity.45-year-oldHIV-positivewoman26HP-mosaicpatternHP-mosaicpattern27NSIPNSIP28Crazypavingalveolarproteinosisbutisalsoseeninmanyotherdiseasessuchaspneumocystiscariniipneumonia,bronchoalveolarcarcinoma,sarcoidosis,nonspecificinterstitialpneumonia(NSIP),organizingpneumonia(COP),adultrespiratorydistresssyndromeandpulmonaryhemorrhage.Crazypavingalveolarproteinos292.ConsolidationandatelectasisConsolidationandAirbronchogramsign2.Consolidationandatelectasi30COPCOP313.Emphysemaandcysticdensity3.Emphysemaandcysticdensity32emphysemaemphysema33UIP-honeycombingUIP-honeycombing34LAMLAM35PLCHPLCH364.Nodulesandmass4.Nodulesandmass37结节影结节影38ToDiagnoseOneofThreePatternsofMultipleNodulesfirstdeterminethepresenceorabsenceofnodulesinrelationtothepleuralsurfacesandparticularlyalongthefissures.Ifpleuralnodulesareabsent,thedistributioniscentrilobular,iftheyarepresent,thenthedistributionoflungnodulesdeterminesthepatternpresent.Noduleswithapatchydistributionandoccurringinrelationtothespecificstructuresindicateaperilymphaticdistributionadiffuseanduniformdistributionindicatesarandompattern.Thismethodcanbeusedtocorrectlycategorizemorethan95%ofthecasesyouwillsee.ToDiagnoseOneofThreePatte39sarcoidosissarcoidosis40PulmonarymetastasesPulmonarymetastases41hypersensitivitypneumonitishypersensitivitypneumonitis42Tree-in-budsignTree-in-budsign43良性钙化类型良性钙化类型44adenocarcinoma离心性钙化离心性钙化和点状钙化不能区分良恶性adenocarcinoma离心性钙化离心性钙化和点状钙化不455.其他征象5.其他征象46InterlobularseptalthickeningInterlobularseptalthickening47侵袭性曲霉菌病Halosign坏死侵袭性曲霉菌病Halosign48侵袭性曲霉菌病Air-crescentsignaspergillosis侵袭性曲霉菌病Air-crescentsign49癌性空洞癌性空洞50Feedingvesselsign

Apatientwithbronchialcarcinoma.

Pulmonaryarteryleadingdirectlytothemassisseen.Feedingvesselsign

Apatient51GlovedfingersignGlovedfingersign526.纵隔及血管病变6.纵隔及血管病变53肺动脉高压肺动脉高压54sarcoidosissarcoidosis55支气管肺癌支气管肺癌56气管肿瘤气管肿瘤57心包囊肿心包囊肿58心房转移瘤心房转移瘤59房间隔脂肪瘤房间隔脂肪瘤60支气管囊肿支气管囊肿61纵隔炎纵隔炎62神经纤维瘤病神经纤维瘤病63胸骨后甲状腺肿胸骨后甲状腺肿64