ARDS柏林定义中的12张标准胸片#严选优质

1、CXR #1 CONSISTENT WITH ARDSThis is an example of a patient with bilateral infiltrates consistent with pulmonary edema. The left hemidiaphragm is visible, arguing against left lower lobe atelectasis. Typical or classic radiographic findings of ARDS have been characterized as bilateral confluent opaci

2、ties as demonstrated in this radiograph. However, the AECC definition expanded the scope of radiographic opacities that are consistent with ARDS to include bilateral opacities that are simply consistent with pulmonary edema, even if patchy and inhomogeneous.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

3、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 INCONSISTENT WITH ARDSThe opacities in the right lower lobe are likely due to a pleural effusion, while there is evidence of either atelectasis in the left lower lobe or a left pleura

4、l effusion. There is no convincing evidence of opacities in the mid- or upper-lung zones consistent with pulmonary edema.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 INCONSISTENT WITH ARDS Although this chest x-ray is underpenetrated, the o

5、pacifications of both lower lobes are likely due to pleural effusions and/or atelectasis. There does not appear to be convincing evidence of bilateral opacities consistent with pulmonary edema.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。C

6、XR #4 EQUIVOCAL FOR ARDSThis chest x-ray demonstrates some equivocal findings for bilateral infiltrates consistent with pulmonary edema. There may be opacifications in left mid-lung field consistent with edema. Loss of the left hemidiaphragm may be due to left lower lobe atelectasis or pleural effus

7、ion. The opacities and abnormalities in the right hemithorax may be primarily due to a pleural effusion. Given the equivocal nature of this chest x-ray, the context (e.g., medical history, presence of risk factors) and evolution of the patients clinical condition and chest x-ray over time (e.g., 8-1

8、2 hours) may be helpful to ascertain whether there are opacities consistent with pulmonary edema. Depending on the mechanism of action and risks of a considered intervention, clinicians and researchers may want to include (e.g., low tidal volume ventilation) or exclude (e.g., higher risk biologic ag

9、ent) such patients.这胸部X线显示出一些模棱两可的结果与肺水肿一致的双侧浸润。可能有阴影在左中肺野水肿是一致的。左侧膈肌的损失可能是由于左肺下叶肺不张或胸腔积液。在右胸部的阴影和异常可能是主要是由于胸腔积液。鉴于这种胸部X光，背景的模棱两可的性质（如病史，存在的风险因素）的病人的临床情况及胸部X光，并随时间演变（如8-12小时），可能会有所帮助确定是否有肺水肿一致的阴影。根据所考虑的干预行动和风险的机制，临床医生和研究人员可能要包括（例如，小潮气量通气）或排除（例如，高风险生物制剂），这类病人。不确定，左中肺浸润影示肺水肿，左下肺为不张或者积液。右中肺浸润影示积液，病史、病情

10、进展及8-12小时再摄片观察是否符合肺水肿。可取决于医师。CXR #5 CONSISTENT WITH ARDSThis is an example of a patient with bilateral infiltrates consistent with pulmonary edema.Although there is poor inspiration, which tends to accentuate all markings (both normal and abnormal), there is clear evidence of opacification in both l

11、ungs, consistent with pulmonary edema.这是与肺水肿一致双侧浸润的患者的一个例子。 虽然有灵感差，这往往会加重所有标记（正常和异常），有阴影的两肺明确的证据，与肺水肿一致。符合ARDS，两肺浸润影符合肺水肿。CXR #6 CONSISTENT WITH ARDSThis is an example of a patient with bilateral infiltrates consistent with pulmonary edema. There is clear evidence of confluent airspace opacities whi

12、ch are not fully explained by effusions, nodules, masses, or lobar/lung collapse.这是与肺水肿一致双侧浸润的患者的一个例子。有一种融合的空域阴影而不是完全由积液，结节，肿块，或肺叶/肺塌陷解释清楚的证据。符合ARDS，两肺浸润影符合肺水肿。CXR #7 INCONSISTENT WITH ARDSThe opacifications in both upper lung fields may be due to prominent first rib costochondral junctions. Althoug

13、h there appear to be prominent vascular markings of both lungs, there is no evidence of bilateral opacities that are clearly consistent with pulmonary edema. Radiographs of patients with extrathoracic opacities like cooling blankets or backboards may be difficult to interpret for opacities consisten

14、t with pulmonary edema and ARDS.在两个上肺野的阴影可能是由于突出的第一肋肋软骨。虽然似乎有两肺血管突出标志，没有证据双边阴影是显然与肺水肿一致的。患者胸腔外阴影状冷却毯子或篮板X光片可以是难以解释为与肺水肿和ARDS一致阴影。不符合ARDS，两肺野血管影明显，浸润影不符合肺水肿。CXR #8 EQUIVOCAL FOR ARDSThere is evidence of bilateral interstitial opacities, without any significant airspace opacities, which appear chronic

15、 in nature and are not clearly consistent with pulmonary edema. Given the equivocal nature of this chest x-ray, the context (e.g., medical history, presence of risk factors) and evolution of the patients clinical condition and chest x-ray over time (e.g., 8-12 hours) may be helpful to ascertain whet

16、her there are opacities consistent with pulmonary edema. Depending on the mechanism of action and risks of a considered intervention, clinicians and researchers may want to include (e.g., low tidal volume ventilation) or exclude (e.g., higher risk biologic agent) such patients.有双边间质性阴影的证据，而没有任何显著空域阴

17、影，从而出现慢性性质，而且不与肺水肿明显一致的。鉴于这种胸部X光，背景的模棱两可的性质（如病史，存在的风险因素）的病人的临床情况及胸部X光，并随时间演变（如8-12小时），可能会有所帮助确定是否有肺水肿一致的阴影。根据所考虑的干预行动和风险的机制，临床医生和研究人员可能要包括（例如，小潮气量通气）或排除（例如，高风险生物制剂），这类病人。不确定。两肺间质浸润影，肺泡浸润不明显。病史、病情进展及8-12小时再摄片观察是否符合肺水肿。可取决于医师。CXR #9 CONSISTENT WITH ARDSThere is evidence of bilateral airspace opacities

18、 which are consistent with pulmonary edema, including dense right upper lobe opacification, with additional opacifications and air bronchograms in right lower, as well as the left mid-lung zone. Lobar opacities are considered to be consistent with pulmonary edema.有双边空域阴影这与肺水肿，包括致密右上叶阴影一致，用另外阴影和空气支气管

19、在右下，以及左中肺区的证据。大叶性肺炎阴影被认为是与肺水肿一致。符合ARDS。两肺浸润影符合肺水肿，包括右上肺密实影，左中肺右下肺浸润影及支气管充气征。CXR #10 INCONSISTENT WITH ARDSDespite the limited exposure of this chest x-ray, both hemidiaphragms are visible and there is no clear evidence of bilateral opacities consistent with pulmonary edema. Radiographs in severely o

20、bese patients are difficult to interpret for opacities consistent with pulmonary edema and ARDS.尽管胸部X光的风险敞口有限，既hemidiaphragms是可见的，并有肺水肿一致的双边阴影没有明确的证据。在严重肥胖的患者X线片难以解释的肺水肿和急性呼吸窘迫综合征一致阴影。不符合ARDS。整体曝光不足。两肺浸润影不符合肺水肿。特别肥胖者难以判断。CXR #11 EQUIVOCAL FOR ARDSThe opacities in both lower lung fields could be from

21、 atelectasis and/or pleural effusion. There is no evidence of opacities in the mid- to upper-lung fields consistent with pulmonary edema. Given the equivocal nature of this chest x-ray, the context (e.g., medical history, presence of risk factors) and evolution of the patients clinical condition and

22、 chest x-ray over time (e.g., 8-12 hours) may be helpful to ascertain whether there are opacities consistent with pulmonary edema. Depending on the mechanism of action and risks of a considered intervention, clinicians and researchers may want to include (e.g., low tidal volume ventilation) or exclu

23、de (e.g., higher risk biologic agent) such patients.在这两个下肺野的阴影可能是从肺不张或胸腔积液。没有证据表明在中期与肺水肿一致的上层肺野阴影。鉴于这种胸部X光，背景的模棱两可的性质（如病史，存在的风险因素）的病人的临床情况及胸部X光，并随时间演变（如8-12小时），可能会有所帮助确定是否有肺水肿一致的阴影。根据所考虑的干预行动和风险的机制，临床医生和研究人员可能排除如下几类病人，包括（小潮气量通气）或（高风险生物制剂）。不确定。两下肺浸润影可能是积液或肺不张。两上中肺无肺水肿浸润影。病史、病情进展及8-12小时再摄片观察是否符合肺水肿。可取

24、决于医师。CXR #12 EQUIVOCAL FOR ARDSThere is evidence of some opacities in the left lower lobe, which could be due to atelectasis, and is not clearly consistent with pulmonary edema. The focal opacities in right upper lung field may be due to a confluence of the first rib and prominent blood vessels, but could be consistent with pulmonary edema. Given the equivocal n