_normal and abnormal 胸腔正常和异常影像学表现课件.ppt

CHESTnormal and abnormal HUA-DAN XUE 2008 09 X ray Normal chest plain radiograph Soft tissue breast and nipple Companion shadows Bone Ribs: Calcification of the cartilage Congenital rib abnormality：cervical rib, fused rib, bifid rib Clavicle Scapula Sterni：manubrium柄、corpus体 Thoracic vertebral bodies The ribs Including pulmonary artery, vein, lymphatics, mainly artery; Distribution: Radiating from the hilum, branches； lower part is rougher than upper part. Hilum (肺门) Normal chest plain film field (area) 肺野与带 Medial middle lateral area, from the hilum to the rib. Upper, middle, lower field, lower rim of the 2nd/4th anterior rib as the boundary Lobes 肺叶 Right lobe: upper, middle and lower lobe Fissures 叶间裂 : horizontal fissure, oblique fissure Left lobe: upper and lower lobe only (lingula) Fissure: oblique fissure Lobes Lobes Air way Diaphragm Cardiophrenic angle Costophrenic angle Right higher than left Posterior lowere than anterior Be aware of … Vessles and hilum Bronchi Mediastinum (thymus, esophagus, lymph node) We can see more details in HRCT Secondary pulmonary lobule 次级肺小叶 Air way abnormality Stricture / Stenosis Bronchiectasis emphysema Which lobe? Transverse “S” sign Spectrum of chest manifestations Consolidation & effusion Calcification Nodules and mass-differential diagnosis Intrapulmonary air containing space and cavity Interstitial abnormalities Consolidation Patchy opacity – effusion/exudation Calcification Mass Lobulation Spiculation Air way sign Convergence of vascular structure Intrapulmonary air containing space Sundry Cavities Differential diagnosis Pleural abnormality Pleural effusion Pneumothorax, hydropneumothorax Thickening, adhesion and calcification Mass Thickening, adhesion and calcification Nodule and mass Mediastinum Differential diagnosis Intrapulmonary mass vs. Mediastinum mass CAMM Center; Angle; Margin; Movement Reference reading Primer of Diagnositic Imaging Ralph Weissleder, Jack Wittenberg, Mukesh G. Harisinghani M