胸腹部影像学精要--影像解剖、影像表现、诊断与鉴别诊断

**部分 胸部 ........................................ 1 **章 纵隔 ............................................................. 2 **节 解剖 ......................................................... 2 一、位置和分区 ................................................. 2 二、影像学标志 ................................................. 2 三、检查方式选择 ............................................. 3 第二节 常规胸片对纵隔的评估 ......................... 4 一、边缘掩盖征 ................................................. 4 二、侧向效应 ..................................................... 4 第三节 弥漫性纵隔疾病 ..................................... 7 一、急性纵隔炎 ................................................. 7 二、慢性纵隔炎和多灶性纤维硬化 ................. 8 第四节 纵隔肿块 ................................................. 8 一、前纵隔 ......................................................... 9 胸内甲状腺肿 ............................................. 9 胸腺增生 ................................................... 10 胸腺瘤和胸腺癌 ....................................... 11 胸腺囊肿 ................................................... 12 胸腺神经内分泌肿瘤；胸腺和 纵隔类癌 ............................................... 12 性腺外生殖细胞肿瘤 ............................... 13 脂肪肉瘤 ................................................... 15 肉瘤 ........................................................... 15 囊性肿块 ................................................... 16 淋巴管瘤和囊状水瘤 ............................... 18 二、中纵隔 ....................................................... 18 结节病 ....................................................... 19 淋巴瘤 ....................................................... 19 Castleman病(血管滤泡性淋巴组织 增生) ...................................................... 21 三、后纵隔 ....................................................... 22 神经源性肿瘤 ........................................... 23 髓外造血 ................................................... 25 Bochdalek疝、Morgagni疝和 Larrey疝 ................................................ 25 第五节 创伤合并纵隔损伤：纵隔气肿 ................ 27 第二章 心脏和心包.................................................... 29 **节 心脏 ........................................................... 29 一、解剖 ............................................................... 29 心脏的边界 ....................................................... 29 心腔 ................................................................... 29 二、疾病 ............................................................... 31 心衰 ................................................................... 31 冠心病与心肌梗死 ........................................... 35 心肌疾病 ........................................................... 41 心脏肿瘤 ........................................................... 49 获得性瓣膜病 ................................................... 57 第二节 心包................................................................ 63 一、解剖 ................................................................... 63 二、疾病 ................................................................... 65 心包炎 ................................................................... 65 缩窄性心包炎 ....................................................... 65 心包肿块 ............................................................... 66 心包间皮瘤 ........................................................... 66 第三章 大血管............................................................ 70 **节 主动脉 ....................................................... 70 一、解剖 ............................................................... 70 二、发育 ............................................................... 71 三、先天性异常 ................................................... 71 主动脉上血管起源的变异 ............................... 71 迷走右锁骨下动脉和Kommerell憩室 ............ 72 动脉导管未闭 ................................................... 73 主动脉狭窄 ....................................................... 74 双主动脉弓 ....................................................... 75 右主动脉弓 ....................................................... 76 先天性腹主动脉狭窄 ....................................... 76 四、主动脉疾病 ....................................................... 77 主动脉瘤 ........................................................... 77 急性主动脉综合征 ........................................... 83 主动脉夹层 ....................................................... 83 壁内血肿 ........................................................... 85 主动脉穿通性溃疡 ........................................... 86 主动脉破裂 ....................................................... 87 Leriche综合征 .................................................. 89 珊瑚礁主动脉 ................................................... 89 主动脉炎 ........................................................... 92 血管炎 ............................................................... 93 恶性血管肿瘤 ................................................... 94 主动脉瘘 ........................................................... 96 锁骨下盗血综合征 ........................................... 97 胸廓出口和胸廓入口综合征 ........................... 98 第二节 腔静脉与大静脉 ..................................... 100 一、解剖 ............................................................. 100 二、发育 ............................................................. 100 三、先天性畸形 ................................................. 101 永存左上腔静脉 ............................................. 101 左侧下腔静脉和重复下腔静脉 ..................... 101 奇静脉或半奇静脉延续 ................................. 102 四、疾病 ............................................................. 103 胡桃夹综合征 ................................................. 103 May—Thurner综合征 ...................................... 103 上腔静脉综合征 ............................................. 103 腔静脉血栓形成 ............................................. 105 腔静脉内瘤栓形成 ......................................... 105 第三节 肺血管系统 ............................................. 108 一、解剖 ............................................................. 108 二、发育 ............................................................. 108 三、先天性异常 ................................................. 108 肺动脉不发育 ................................................. 108 肺动脉吊带 ..................................................... 109 异常肺静脉回流 ............................................. 109 四、常见疾病 ..................................................... 109 肺动脉瘤 ......................................................... 109 肺动脉栓塞 ......................................................111 肺动脉高压 ..................................................... 113 肺动静脉畸形 ................................................. 114 第四章 肺和胸膜...................................................... 118 **节 解剖 ......................................................... 118 一、胸膜和叶间裂 ............................................. 118 二、气管和肺段 ................................................. 118 三、血管 ............................................................. 119 四、肺静脉 ......................................................... 121 五、肺实质 ......................................................... 121 第二节 气管和支气管系统 ................................. 124 一、正常变异：气管性支气管 .......................... 124 二、气管狭窄和骨化性气管支气管病 ............. 124 三、支气管扩张 ................................................. 125 四、细支气管炎 ................................................. 125 五、闭塞性细支气管炎 ..................................... 127 六、 肺气肿、α1抗胰蛋白酶缺乏症和慢性 阻塞性肺疾病 ............................................. 127 七、肺不张 ......................................................... 128 第三节 肺 ............................................................. 131 一、先天性肺畸形 ............................................. 131 肺实质畸形 ..................................................... 131 二、感染 ............................................................. 135 肺炎 ................................................................. 135 化脓性栓塞 ..................................................... 136 结核 ................................................................. 137 曲霉病 ............................................................. 138 Swyer—James—MacLeod综合征(单侧 透明肺) ........................................................ 142 三、肿瘤 ............................................................. 142 肺结节 ............................................................. 142 肺癌 ................................................................. 144 错构瘤 ............................................................. 147 四、弥漫性肺疾病 ............................................. 148 间质性肺病：特发性间质性肺炎 .................. 148 结节病 ............................................................. 153 朗格汉斯细胞组织细胞增生症 ..................... 154 肺淋巴管平滑肌瘤病和结节性硬化累及肺部 ...... 155 囊性肺纤维化 ................................................. 155 五、尘肺 ............................................................. 156 矽肺 ................................................................. 157 石棉肺 ............................................................. 158 其他尘肺病 ..................................................... 159 六、外源性过敏性肺泡炎 ................................. 160 七、肺损伤 ......................................................... 161 吸入烟雾、火焰或有毒气体所致损伤 ........... 161 吸入其他物质所致损伤 ................................. 161 八、血管炎 ......................................................... 161 韦格纳肉芽肿 ................................................. 161 Churg—Strauss综合征 ..................................... 162 九、结缔组织疾病 ............................................. 163 ......