RadiodiagnosisintheRespiratorySystem呼吸系統(tǒng)X線診斷貴州省人民醫(yī)院放射科唐雷Section1ThelungsThethoraciccage胸廓Thethoraciccageisinsymmetry（對(duì)稱(chēng)）ornot.Theribsandtheotherbonesseen,appeartobenormal,orindestruction（骨質(zhì)破壞）,ormalformation（畸形）,anddeformation（變形）.Theintercostalspaces（肋間隙）aresymmetricalornot,broadened,ornarrowed.Softtissuesseemnormalorabnormal.2.ThelungsLocation:Iflesionsarelimitedbyboundariesofalobe（肺葉）orasegment（肺段）,thelocationofthelesionisdefinedanddescribeddirectlywiththespecificlobeorsegment.Ifthelesionhasamassiverangeandvaguemargin,itcanbedescribedaccordingtotheupper,middleorlowerregionsfromtoptobottom,andinner,middleorouterzonesfrominsidetooutsideofthelungfields.Lungfields（肺野）andpulmonaryzones（肺帶）upperlungfieldmiddlelungfieldlowerlungfieldInnerpulmonaryzonemiddlepulmonaryzoneouterpulmonaryzoneLunglobes（肺葉）andsegments（肺段)superiorlobeofleftlung（左肺上葉）

inferiorlobeofleftlung（左肺下葉

）superiorlobeofrightlung（右肺上葉）

middlelobeofrightlung（右肺中葉）

inferiorlobeofrightlung（右肺下葉）

Lunglobes（肺葉）andsegments（肺段)posterior背anteromedialbasal前內(nèi)lateralbasal外側(cè)基底posteriorbasal后基底segmentofsuperior

lobeofleftlungsegmentofinferior

lobeofleftlungapicoposterior尖后anterior前superiorlingular上舌inferiorlingular下舌posterior背anteriorbasal前基底medialbasal內(nèi)側(cè)基底lateralbasal外側(cè)基底posteriorbasal后基底segmentofsuperior

lobeofrightlungsegmentofmiddle

lobeofrightlungsegmentofinferior

lobeofrightlungapical尖posterior后anterior前l(fā)ateral外側(cè)medial內(nèi)側(cè)Sizesofopacitiescanbedescribedaccordingtothenumberofintercostalspaces,lobesandsegmengtsand/ordirectmeasurements.Ifalesionisround,thediametercanindicateitssize.(2)Sizesofopacities:(3)Shapesofshadows:miliaryshape粟粒狀Spotsorpatches斑點(diǎn)狀或斑片狀Singlesmallnodule單發(fā)小結(jié)節(jié)狀Multiplenodules多發(fā)結(jié)節(jié)狀Mass團(tuán)塊狀Fog-likeshadow云霧狀陰影Consolidation實(shí)變Calcification鈣化Flocculentopacities絮狀陰影Stripe-likeopacities索條狀影Cavityshadows空洞影Honeycombshadows蜂窩狀影Reticularshadows網(wǎng)狀陰影Themarginsoflesionscanbemanifestedasfuzzy（模糊）,clear（清晰）,sharp（銳利）,smooth（光整）,irregular,radiating（放射狀）,spiculation（毛刺狀）,andetc.(5)Relationshipbetweenlessionsandthesurroundingtissues:Pulmonaryatelectasis（肺不張）pullsadjacentmediastinumtotheaffectedside.Lungcancercaninfiltrate（侵犯）

thoracicvertebrae（胸椎）andadjacentribs.

(4)Margins:3.Thepulmonaryhilum（肺門(mén)）：Hilarenlargement,decrease,nodules,mass,calcification,reationshipwithmediastinum,alterationofdensity,anddisplacement.4.Themediastinum（縱隔）:Observationshouldincludelocationofthetrachea（氣管）,widthofthemediastinum;location,size,shape,displacementoftheheartandgreatvessels.5.Thediaphragm（膈?。?Assessmentshouldinvolveshapeofsurface,andsharpnessofthecostophrenicangles（肋膈角）.CasesinthelungsCase1.正常胸片Thethoraciccageremainssymmetrical.Alltheseenbonesarenothingremarkable.Thetrachealocatescentrallywithoutdeviation.Thelungsareclear,whilethelungmarkingsarenaturalandregular.Bothpulmonaryhilashowneitherenlargementnordecrease.Theheartandgreatvesselsappearnormalintheirposition,sizeandshape.Thediaphragmhasasmoothsurfacewithsharpcostophrenicangles.Diagnosis:Normalinthelungs,heart,anddiaphragm.Case2.患兒2y，咳嗽1周Thethoraciccageremainssymmetrical.Alltheseenbonesarenothingremarkable.Thetrachealocatescentrallywithoutdeviation.Thelungsmarkingsbecomethickenedintheinnerandmiddlezonesofbilateralmiddleandlowerlungfields.Somescatteredpatch-likeinfiltrationsmixwiththethickenedlungmarkings.Theirmarginsappearvague.Bothpulmonaryhilashowblurred,butnotinevidentenlargemen.Thereisnothingremarkableintheheartandgreatvessels.Thediaphragmhasasmoothsurfacewithsharpcostophrenicangles.Diagnosis:Bronchopneumonia.（支氣管肺炎）Case3.男，18y，咳嗽1周、發(fā)熱2天Thethoraciccageremainssymmetrical.Alltheseenbonesarenothingremarkable.Thetrachealocatescentrallywithoutdeviation.

Thereisalargepatchyhomogeneousopacityintherightmiddlelobewithaslightlyfuzzymargin.Itcoverstherightpulmonaryhilum.Therestofthelungsremainclear.Theleftpulmonaryhilumhasnoenlargement.Nosuspectedsignsarefoundintheheartandgreatvessels.Thediaphragmhasasmoothsurfacewithsharpcostophrenicangles.Diagnosis:Pneumonia（肺炎）intherightmiddlelobe.Re-examinationissuggestedaftertreatment.Case4.高熱、咳嗽、膿痰10天Thereisalargeround-likeopacityintheposteriorsegmentoftheleftlowerlungwithafuzzymargin,inthesizeof2.0cm×3.0cm.Acavitycanbefoundwithanair-fluidlevel（氣液平面）intheshadow,

whichinvolvestheleftpulmonaryhilumandadjacentlung.Nothingisspecialintheheart,diaphragmandrightlung.Diagnosis:Apulmonaryabscessintheposteriorsegmentoftheleftlowerlung.Case5.腮腺腺樣囊性癌術(shù)后3年，復(fù)發(fā)2月Thethoraciccageremainssymmetrical.Alltheseenbonesarenothingremarkable.Multiplenoduleswithclearmarginsaredis-playeddiffuselyinbothlungsindifferentsizes.Bothpulmonaryhilashowneithere