循环系统X线诊断-英文

RadiodiagnosisintheCirculatorySystem循环系统X线诊断贵州省人民医院放射科唐雷Section1TheHeart1.TypesofHeartinthePlainFilmsInthenormalcondition,aheartoftenappearsinthehorizontal（横型）,oblique（斜型）,andpendulous（悬垂型）typerespectivelyonaposteroanteriorradiographoftheheart.Theangleofthecardiacaxis（心轴角）:itisanacuteangleformedbyalinefromtheconjunctionofthegreatvessulesoftherightcardiacborderandtherightatrium（心房）

tothecardiacapex（心尖）

andahorizontallinewhichpassesthroughthecardiacapex.心轴角：右心缘大血管与右房交界点至心尖的连线，与水平线的夹角。Thehorizontaltype（横型）<45°(32°~35°)Theobliquetype（斜型）=45°(43°~45°)Thependuloustype（悬垂型）>45°(52°~55°)ThreetypesoftheheartintheplainfilmInthepathologicalstates,theheartcanbedeformedinthemitral（二尖瓣型）,aortic（主动脉型）,andgeneralenlarged（普大型）typeseparately.Atypeoftheheartcanderivefromseveralheartdiseases.Forexample,Themitraltypeoftheheartmayoriginatefrompulmonaryheartdiseases,rheumaticheartdiseases,congenitalheartdiseasesofshuntfromlefttoright.Theaortictypeoftheheartmaycomefromhypertensiveheartdiseases,rheumaticheartdiseases(involingaorticvalves),congenitalheartdiseases,cardiomyopathy.Thegeneralenlargedtypeoftheheartmaycomefromcardiomyopathy,pericardialeffusion.2.DifferentroutineprojectionsofthecardiacatriaandventriclesPA:posteroanteriorradiograph（后前位）LL:leftlateralradiograph（左侧位）RAO:rightanteriorobliqueradiograph（右前斜位）LAO:leftanteriorobliqueradiograph（左前斜位）PA:posteroanteriorradiograph（后前位）LL:leftlateralradiograph（左侧位）RAO:rightanteriorobliqueradiograph（右前斜位）cardiacatriaaredistinguishedfromcardiacventricles.Twocardiacatrialocateintheposteriorsuperiorpartoftheheartandtwocardiacventriclesoverlapandsettledownintheanteriorinferiorpartoftheheart.LAO:leftanteriorobliqueradiograph（左前斜位）theshadowoftheheartisdividedintotwohalvesoftherightheartandleftone.Therightonestaysinthefrontandtheleftonerestsontheback.3.Thecardiothoracicratio(心胸比率)Calculationofthecardiothoracicratiohasbeenthesimplestandmostfrequentlyusedmethodformeasurementoftheheart.Thecardiothoracicratio=(A+B)/CTheratioisdefinedasthevalueofthetransversedimensionoftheheartdividedbytheinnnerdimensionofthethoraciccavityatthelevelofcrossingthedomeoftherighthemidiaphragm.Relationbetweensizeoftheheartandthecardiothracicratio:Normalheartlessthan0.52Slightenlargement0.52~0.55Moderateenlargement0.56~0.60Severeenlargementmorethan0.604.ChangesofpulmonarybloodPulmonaryarterialpleonaemia(肺充血)：meansthatpulmonaryarterieshavebeenbroadenedinallitstrunksandbranches.

Pulmonaryvenouspleonaemia(肺淤血)：referstothesituationthatexcessivebloodstagnatesinthepulmonaryveins.So,thelungfieldshaveanattenuatedradiolucencyandseemlikegroundglass.5.Pulmonaryedema(肺水肿)Ininterstitialedema(间质性肺水肿)，bothpulmonaryhilaexhibitenlargementandhazyshadows.Thelungmarkingsappearabundantwithfuzzymargins.Theseblurtheborderoftheheartassociatedwithdilationofbilateralupperpulmonaryveins.Inalveolaredema(肺泡性肺水肿)，therearelargepatchyopacitiessurroundingthepulmonaryhilaintheshapeofabutterfly.Theshadowsofthearchesfadeoutintheheart.CasesintheHeartCase1.正常心脏三位片Thethoraciccageremainssymmetrical.Alltheseenbonesarenothingremarkable.Thetrachealocatescentrallywithoutdeviation.Thelungsareclear,whilethelungmarkingsarenaturalandregular.Bothpulmonaryhilashowneitherenlargementnordecrease.Theheartandgreatvesselsappearnormalintheirposition,sizeandshape.Thecardiothoracicratiois0.48,andalltheshadowsofthearchesshownaturallyinthemarginsoftheheart.Thediaphragmhasasmoothsurfacewithsharpcostophrenicangles.OntheLLradiograph,thespacesexistintheprecardiacandretrocardiacclearances.Thereisnosignificantchangeintheshadowsofthearchesoftheheart.OntheRAOradiograph,alltheshadowsofthearchesappearclearandnatureintheheart.Thereisnocompressivedisplacementintheesophagus.Nothingisremarkableintheprecardiacandretrocardiacapaces.Diagnosis:Normalinthelungs,heart,anddiaphragm.Case1.正常心脏三位片Case2.风湿性心脏病Thelungfieldshaveanattenuatedradiolucency.Thelungmarkingsexhibitthickeningsanddistortionswithblurrededgesandseemlikegroundglass.Bothpulmonaryhilaareenlarged,andthediameteroftherightinferiorartery（右下肺动脉）totals1.8cmwiththesignofresidualroot（残根征）.Theheartappearsinthemitraltype（二尖瓣型）.Theshadowoftheheartextendsonbothsidesinthecardiothroacicratioof0.65.Thereare4archesintheleftmargin（四弧征）,whiledualbows（双房影）intherightmarginoftheheart.Theangleisalmost90°betweenthetwomainbronchi.OntheLLradiograph,theclearancesareclosedinbothprecardiacandretrocardiacspacesduetoenlargementoftheheart.Theenlargedleftatriumcompressestheesophagustoformanindentation.OntheRAOview,theprecardiacandretrocardiacspacesareenclosed.Theenlargedheartpushestheesophagusbackward,forminganarchindentationintheesophagusandoverlapswiththespinalcolumn.Meanwhile,thesegmentofthepulmonaryarterybulgessignificantly.

Diagnosis:Rheumaticheartdisease.FurtherexaminationisneededbyheartDopplerul