肺病征象尋找并列出光片表現(xiàn)

pulmonary肺病的X片征DominiqueRadiographicRadiographicinterpretationprotocoleX光片的解-knowthenormalappearanceofthethorax知道胸腔的正常表-lookforandlisttheradiographicsigns尋找并列出X光片表-summupthesignsintoaradiographicpicture?總結(jié)征象到X光??-interpret 解讀*comparethepicturetowhatisknownofcommonaspectofthoracicdiseases*listthepossiblelesions/fromthemosttotheleastLookingLookingforradiographicsigns尋找XVolume oro LOCALISATIONLOCALISATIONofthelesion?-Thoraciccage胸腔邊-Thoraxitself

-Pleural-Mediastinal縱-PulmonaryPulmonarylesion TheabnormalradiographicsignsX 常析 解Lungvolume Lungopacity肺大小改變 Lungopacity肺不透射

1DecreasedopacityNormal2Increasedopacity或1Decreasedopacity或局

多ThinandregularThinandregularwallBenignlookingOrThickandirregularwallAgressivelooking看起來侵襲1Decreasedopacity 局

多ThinandregularwallBenignlooking看起來良Bulla atocele肺膨出

Or

ThickandirregularwallAgressivelooking看起來侵襲AbcessNecrotictumor腫死ThickandirregularwallAgressivelooking看起來侵襲Commonaspectforprimarylungcancerin 性肺癌的常見表 Generalized全肺Decreasedopacity+increasedlung不透射性降低+=airasthmaairwayobstructionGeneralized全肺Decreasedvolumeofblood=shockdecreased erfusionpulmonarystenosispulmonaryinfart肺梗 shuntRihtto2-increasedopacity不透明性增Single=單個=局

?Others其他多2-increasedopacity2-不透明性增強Focal局 Multifocal多

Infiltrate?浸潤FocalNoduleFocalClearborder清晰的邊界Spherical球形CANCER/CANCER/MultifocalMultifocal多 CANCER/Nodulesingle單個CANCER/ CancersinglemetastaseHematoma血腫Granuloma肉芽腫Filledcyst….充滿局2-increasedopacity2-不透明性局

Infiltrate浸潤SofttissueheterogeneousVariousshapetriangular…形態(tài)不一，三角形Inflammation/Thrombosis/ Thrombosis/ Cancer/primary癌 MultifocalMultifocalIncreased

Infiltrate=localizedalveolarSingle單

Multiple多個Single單個Multiple多個NonfocalBronchial型

Vascular血管的Alveolar肺泡的Interstitial間質(zhì)的2-increasedopacitynon-Vascular血管-Alveolar-Interstitial間質(zhì)

Normal正 Bronchialpattern支氣管

railroadtracks軌Dog/mediumtoCat/

Cat/Interpretation:ChronicbronchitisCatnormal

BUT但是BronchialpatternmayalsobeinconjonctionwithmanyotherCat/Pulmonaryedema貓/肺水 Exemple例Bronchialinterstitialpattern間質(zhì)alveolarfocicardiomegalyclinicalsigns臨床表

水-Vascular血管-Alveolar肺泡-Interstitial間質(zhì)Normal正 -Veins:passive靜脈 -Arteries:pulmonary動脈：肺動脈高-Veins+arteries*Activecongestion自動?Cardiovascularmalformation:lefttorightArteryArtery動VeinIncreasedveinsize assivecon Increasedarterysize:pulmonary-Dirofilariosis-Thrombosis-Pulmonarylesioncreating肺的病灶導(dǎo)致高-Vascular血管-Alveolar肺泡-Interstitial間質(zhì),Illdefined,邊緣不清MoreorlesscoalescentFocal,illdefinedLobarinfltrates…肺葉浸潤… Orseverallobes…或幾個肺葉Alveolarpattern/the-Exsudate:-Broncho - --Blood:Hemorrhage, -Tumorcells:-Emptyalveoli: ia, Alveolarpattern/the-Exsudate:-Broncho- -

-Blood:Hemorrhage, -Tumorcells:-Emptyalveoli: ia,Broncho oniaAlveolar肺泡 Ventral腹Asymetrical不對Broncho oniaAlveolar肺泡 Ventral腹

Oftenassociatedbronchial通常與支氣管型伴Asymetrical不對 MultifocalinfiltratesPeripheral(dorsal)外周（背外周（背側(cè)

1–

貓

1– 2–細3-Eosinophilic嗜酸性細胞浸Alveolarpattern/the肺泡型/病-Exsudate:-Broncho - -Blood:Hemorrhage, -Tumorcells:-Emptyalveoli: ia,cardiogenicedema/dog心源性水腫/cardiomegalyDorsal背側(cè)Dorsal背側(cè)Central中間Symétrical對Dorsal背Central中MaybemoresevereontheAlveolarcardiogenicedema/dog心源性水腫/Maybemostlyoronly+/_largepulmonrycardiogenicedema/dog心源性水腫/Maybemostlyoronlycardiogenicedema/cat心源性水腫/Dorsal背Doughnoutawayfromthehilus+/-Symétrical對稱的Alveolar肺泡型

+/_MayhaveanonspecificClinicalsignevery位置可能無特異性臨床癥狀很重Noncardiogenicedema非心源性水Alveolarpattern/the肺泡型/病-Exsudate:-Broncho- -

-Blood:Hemorrhage, -Tumorcells:-Emptyalveoli: ia,Veryvariable變化很Siteandintensityfunctionofthecauseofthe Siteandintensityfunctionofthecauseofthe Hemorrhage,necrosis,Ie:Ie:Alveolarpattern/the肺泡型/病-Exsudate:-Broncho- -

-Blood:Hemorrhage, -Tumorcells:-Emptyalveoli: ia,PrimaryLobar肺葉Mass腫塊效Primary Lobarwithnosizeincrease無肺葉增extensiontootherlobes)擴張Primary MultifocalalveolarPrimary Dorsal背OftenDorsal背TracheoRightRightand/orPrimarytumor:Verylargespectrumofpossibleprimarytumor VerylargespectrumofpossibleAlveolarNodularprimarytumor Oneorseveralperipheral一個或多個外周浸Maybeprimarytumor Oneorseveralperipheral一個或多個外周浸MaybeAlveolarpattern/the肺泡型/病-Exsudate:-Broncho- -

-Blood:Hemorrhage, -Tumorcells:-Emptyalveoli: ia,CollapsusPeripheral Bronchogramin ectatic

?normalbronchogram Bronchial needstobe Left

=支氣管阻塞腫左

左 Complicationofchronicbronchitis/asthmaintheMiddlelobe 中間肺葉不 Complicationofchronicbronchitis/asthmaintheMiddlelobe Differentialdiagnosis-clinical-鏡

-CT CT-Vascular-Alveolar-Interstitial間質(zhì)-Vascular-Alveolar-Interstitial間質(zhì)NodularDiffuseTechnicalerrors技-Expiration呼氣- 不Inspiration吸氣Increasedopacity不透射性增

Single單Multiple多個Single單個浸 Multiple多 1–1腫NonfocalBronchial型

Alveolar肺泡的Interstitialnodular 間質(zhì)

Miliarymetastases粟粒狀轉(zhuǎn) Primary Histiocytosis組織細Lymphoma淋巴

Tumor腫 Miliarymetastase粟粒轉(zhuǎn)移Primary

NodularorHistiocytosis組織細胞增多-Lymphoma淋巴-Fungal onia真菌-Chronic,granulomatous onia Pulmonarymetaplasia肺轉(zhuǎn)移

Interstitial間質(zhì)-Diffuse-Generalized-Fibrosis纖維-Interstitial onia(viral)間質(zhì)）-Eosinophilic InterstitialInterstitial間質(zhì)Diffuse-butnongeneralizedInterstitialedema間質(zhì)性水Interstitialandvascularn-,間質(zhì)-Pulmonarycontusion肺挫傷InterstitialInterstitial間質(zhì)Diffuse-nongeneralizedClinicalinformationessentialtolistdifferential要建立鑒別診斷，臨床信息是必須CONCLUSION- ysisofthoracic=sumofradiographic

-Preciselocalisationof

-Knowthemainaspectofcommonpulmonary-Historyandclinical ? ligent?diagnosic聰?假設(shè)診 支氣

Single單Single

Tipoflobe(s),NonNonfocalBronchial型型AlveolarLobarAlveolarVentralVentral腹InterstitialInterstitial onia均質(zhì)

Single單Single

oflobe(s),dorsal,NonfocalBronchial型

Alveolar肺泡Multifocal,dorsal,Multifocal,dorsal, Viral 性

Single單SingleNonfocalBronchial型

Vascular血管Alveolar肺泡Interstitial間質(zhì)

Generalized全肺

Single單SingleNonfocalBronchial型

Alveolar肺泡LobarorflakyLobarorflaky分葉或絮片狀A(yù)nylocation Anyappearance任意 Thrombosis血

Single單Single

Tipoflobe(s),dorsal,NonNonfocalBronchialAlveolar型Multifocal,Alveolar型InterstitialInterstitial Lungtorsion肺葉扭

Single單SingleBronchial

Oneloberightmiddle,rightcranial型

Alveolar肺泡Interstitial間質(zhì)

IncreasedvolumeDisplacedPleural 慢性支氣管

Single單SingleAlveo