5.空洞(cavity)定义及病理(definitionandpathology)常见疾病(maindisease)空洞CT 表现(CTrepresentationofcavity)部位、数目和大小(position,numberands ize)洞壁厚度(thewallthicknessofcavity)虫蚀样空洞(moth-eatencavity) 薄壁空洞(thin-walledcavity)厚壁空洞(thick-walledcavity)洞壁外缘(outered geofcavity,asExudationandconsolidation, mass)洞壁内缘(inneredgeofcavity,noduleofthewall)洞内气液平(air-f luidlevel)邻近结构改变(changesaroundthemass)随访复查(followup) moth-eatencavitythin-walledcavitythick-walledcavityair- fluidlevelIrregularwallandnoduleofit曲菌球空气半月征空腔(intrap ulmonaryaircontainingspace)定义及病理(definitionandpatholog y)CT的鉴别要点(mainpointofdifferentiation)囊腔壁(thicknessandedg eofthewall)<1mm洞内气液平(air-fluidlevel)邻近结构改变(adjacentchan ge)肺囊肿并感染早期肺气肿示意图1、小叶中心型2、全小叶型3、间隔旁或胸膜下 4、瘢痕旁型肺气肿小叶中心型2-10mm呼吸系统基本病变的CT表现THEBASICPATHOLOGICAL CHANGESOFTHERESPIRATORYSYSTEMONCT刘源(liuyuan) Departmentofradiology1staffiliatedhospitalShantouuniversit ymedicalcollege一、概述(SUMMARIZE)1.基本病变与基本征象的关系Therelations hip(connection)betweenbasicpathologicalchangesandbasicsig n2.基本征象在影像分析、诊断中的重要性Thesignificanceofbasicsignforimagi nganalysisanddiagnosis3.与影像基本病变密切相关的组织学SecondarylobuleTer minalbronchioleRespiratorybronchioleAlveolarductAlveolarsa cPulmonaryalveoli肺实质(lungparenchyma)肺间质(interstitialtissu e):肺的框架结构--各级支气管和血管周围、小叶间隔、胸膜下和肺泡粘膜下的结缔组织二、肺的基本病变Thebasicp athologicalchangesoflung渗出与实变(Exudationandconsolidation) 肺泡充实性病变分肺实变(密度高于血管)和磨沙玻璃样影(密度低于血管)定义及病理(definitionand pathology)常见疾病炎症、肺水肿、肺泡蛋白沉着症CT表现(CTrepresentation)形 态(shape)小片、大片、肺段性、大叶性、弥漫性。密度(density)致密增高支气管气相 层—层、肺窗—纵膈窗间的变化(changesbetweenslicesandwindows)支 气管气像(airbronchogram)小叶性肺炎实变,部分融合云雾、云絮、斑片、大片、团片2.增殖性病变(prolif erativelesion)定义及病理(definitionandpathology)常见疾病肉芽肿、炎性假瘤、慢性炎 症CT表现(CTrepresentation)形态结节、肿块、大片状。小结节多为肉芽肿,较大结节及肿块可为 炎性假瘤,肿块性及肺段或肺叶实变影像可为慢性肺炎边缘清楚密度(density)随访复查(followup) 动态变化慢浸润型肺结核中的渗出、增殖和干酪坏死病灶机化性肺炎的增殖和纤维化结节病3.纤维性病变(fibrot iclesion)定义及病理(definitionandpathology)常见疾病(maindisease)CT 表现(CTrepresentation)大小、形态、分布(size,shape,distribution) 边缘(edgeormargin)密度(density)浸润型肺结核中有明显的纤维性病灶机化性肺 炎的增殖和纤维化弥漫性纤维化,RA侵犯肺4.钙化病变(calcification)定义及病理(definitionand pathology)常见疾病局限性:斑片块状:结核爆花生米:错构瘤弥漫性:细点状:肺泡微石症小结节状:尘肺CT 表现(CTrepresentation)大小及形态(sizeandshape)边缘(edg eormargin)密度(density)一般CT值>100HU肺结核球中的钙化错构瘤钙化周围型肺癌的 点状钙化5.肿块和结节(pulmonarymassandnodule)定义及病理(definitionandpat hology)常见疾病(maindisease)CT表现(CTrepresentation)肿块的 确定(confirmationofthemass)A.形态相对规则、轮廓较清,各径线接近B.密 度相对较均匀C.层—层、肺窗—纵膈窗间变化小(相对于斑片状实变病灶)肿块的确定 具体表现(particularrepresentation)部位(position)数目和大小(numberandsi ze)轮廓、形态(outlineorshape)边缘(edgeormargin)密度、内部结构(density,insidestructure)肿块强化(enhancementofthemass)邻近结构改变(changesaroundthemass)随访复查(followup)良性肿块短毛刺、棘状突起、胸膜凹陷征肺门肿块肿块强化 |
|