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24/12/241呼吸系统影像诊断河南大学淮河临床学院医学影像教研室李长波24/12/242呼吸系统一、检查方法二、正常胸部影像表现三、基本病变表现四、常见病的影像诊断24/12/243一、检查方法（一）常规X线检查透视胸片体层摄影（肺门、病灶）高千伏摄影支气管造影（二）CT检查（平扫、增强）（三）MR检查（平扫、增强）24/12/244透视透视方法简单多体位、动态观察不易发现细小病变没有永久记录24/12/245RADIOGRAPHYRADIOGRAPHY摄影摄影正位（P-A位A-P位）侧位（左右侧）前弓位卧位点片24/12/246Frontalview暗盒CASSETTE正位胸片优点：射线较透视少；有永久记录，便于复查。24/12/247Lateralview暗盒CASSETTEX-ray侧位胸片缺点：不能动态观察24/12/248高千伏摄影≥120kv、5-7mAs减少胸壁、软组织及肋骨对肺部病变的干扰。24/12/249支气管造影24/12/241024/12/241124/12/2412二、正常胸片表现及变异24/12/2413WebZIP7.0.2.1028on02/13/09下午02:52:54.Address:http://202.113.53.133/national/yxx/doc/4-1.files/slide0695.htmTitle:幻灯片1•Size:8291•LastModified:Thu,15Jun200603:23:18GMT一、正常X线表现（1）㈠胸廓（正位）1.骨骼⑴肋骨：肋软骨钙化呈条带状或斑点状常见变异：颈肋、叉状肋、肋骨联合⑵锁骨：内端下缘半圆形凹陷为菱形窝⑶肩胛骨：肩胛骨下角可出现二次骨化中心，勿误为骨折⑷胸骨：大部与纵隔影重叠⑸胸椎：1～4胸椎清楚可见，其余隐约可见24/12/241424/12/2415WebZIP7.0.2.1028on02/13/09下午02:52:54.Address:http://202.113.53.133/national/yxx/doc/4-1.files/slide0659.htmTitle:幻灯片1•Size:4177•LastModified:Thu,15Jun200603:23:08GMT胸廓骨骼（线图）胸廓骨骼（线图）胸廓骨骼（线图）胸廓骨骼（线图）24/12/2416WebZIP7.0.2.1028on02/13/09on02/13/09下午下午02:52:54.02:52:54.Address:Address:http://202.113.53.133/national/yxx/doc/4-1.files/slide0660.htmTitle:Title:幻灯片幻灯片1•1•Size:Size:4403•4403•LastModified:LastModified:Thu,15Jun200603:23:10GMTThu,15Jun200603:23:10GMT颈肋（图）颈肋（图）24/12/2417肋骨联合24/12/2418WebZIP7.0.2.1028on02/13/09on02/13/09下午下午02:52:54.02:52:54.Address:Address:http://202.113.53.133/national/yxx/doc/4-1.files/slide0384.htmTitle:Title:幻灯片幻灯片1•1•Size:Size:6942•6942•LastModified:LastModified:Thu,15Jun200603:22:38GMTThu,15Jun200603:22:38GMT一、正常X线表现（2）㈠胸廓（正位）2.软组织：⑴胸锁乳突肌和锁骨上皮肤皱褶⑵胸大肌⑶女性乳房和乳头⑷伴随阴影24/12/2419WebZIP7.0.2.1028on02/13/09下午02:52:54.Address:http://202.113.53.133/national/yxx/doc/4-1.files/slide0662.htmTitle:幻灯片1•Size:3640•LastModified:Thu,15Jun200603:23:10GMT软组织（线图）软组织（线图）24/12/2420乳腺影乳头影24/12/2421WebZIP7.0.2.1028on02/13/09on02/13/09下午下午02:52:54.02:52:54.Address:Address:http://202.113.53.133/national/yxx/doc/4-1.files/slide0663.htmTitle:Title:幻灯片幻灯片1•1•Size:Size:3661•3661•LastModified:LastModified:Thu,15Jun200603:23:12GMTThu,15Jun200603:23:12GMT软组织（图）软组织（图）24/12/2422WebZIP7.0.2.1028on02/13/09on02/13/09下午下午02:52:54.02:52:54.Address:Address:http://202.113.53.133/national/yxx/doc/4-1.files/slide0386.htmTitle:Title:幻灯片幻灯片1•1•Size:Size:8587•8587•LastModified:LastModified:Thu,15Jun200603:22:38GMTThu,15Jun200603:22:38GMT一、正常X线表现（3）㈡气管、支气管（正位）1.气管：起于环状软骨下缘，5/6胸椎水平分左右主支气管，分叉角度65～850（<900）2.支气管及其分支：右主支气管与体轴成200～300，左主支气管成400～55024/12/242324/12/2424WebZIP7.0.2.1028on02/13/09下午02:52:54.Address:http://202.113.53.133/national/yxx/doc/4-1.files/slide0652.htmTitle:幻灯片1•Size:7751•LastModified:Thu,15Jun200603:23:06GMT一、...