胸膜病变的影像诊断课件.ppt

1、胸膜脏层胸膜壁层胸膜肋胸膜膈胸膜纵膈胸膜胸膜顶脏、壁胸膜在肺根处相互移行，两者之间形成的潜在间隙肋胸膜与膈胸膜转折形成；是胸膜腔的最低部位。胸膜炎化脓性胸膜炎病理：邻近脏器感染灶的直接蔓延或经血循环到达胸膜，引起胸腔积脓和胸膜肥厚粘连等症状：急性期：高热、气急、胸痛和全身中毒症状；慢性期：慢性消耗性疾病的症状胸膜炎的影像学表现急性期：胸腔积液（主要）慢性期：胸膜肥厚、粘连游离性胸腔积液少量中等量大量132大量胸腔积液1324123位于叶间裂内两层脏层胸膜间的积液。叶间积液边缘清晰，密度均匀的梭形阴影，两端呈细长尖形，长轴与叶间裂方向一致。叶间裂积液包裹性胸腔积液脏、壁层胸膜发生粘连使积液局限于

2、胸膜腔的某一部位，多见于胸下部侧后胸壁（胸膜炎时）。自胸壁向肺野突出的半圆形或扁丘状阴影，其上下缘与胸壁的夹角呈钝角，密度均匀，边缘清楚。肺下积液聚集在肺底和膈肌之间的液体称为肺下积液。因液体将肺下缘向上推移，其上缘呈圆顶状，易误诊为膈肌升高（X线）。pneumothorax and hydropneumothoraxpneumothorax and hydropneumothoraxpneumothorax and hydropneumothoraxpneumothorax and hydropneumothorax132pneumothorax and hydropneumothorax1

3、5432pneumothorax and hydropneumothoraxpneumothorax and hydropneumothoraxpneumothorax and hydropneumothoraxpneumothorax and hydropneumothoraxpneumothorax and hydropneumothorax132pneumothorax and hydropneumothoraxpneumothorax and hydropneumothoraxpneumothorax and hydropneumothoraxpleural thickening ,a

4、dhesion and calcification pleural thickening ,adhesion and calcification pleural thickening ,adhesion and calcification pleural thickening ,adhesion and calcification pleural thickening ,adhesion and calcification Pleural tumormesothelioma of pleuramesothelioma of pleuramesothelioma of pleura局限性胸膜间皮

5、瘤12胸膜间皮瘤气腹胸膜间皮瘤气腹胸膜间皮瘤气腹弥漫性胸膜间皮瘤（恶性）mesothelioma of pleuramesothelioma of pleura胸膜间皮瘤mesothelioma of pleuramesothelioma of pleura胸膜间皮瘤胸膜间皮瘤Pleural tumormetastatic tumor of pleurametastatic tumor of pleurametastatic tumor of pleurametastatic tumor of pleurametastatic tumor of pleura胸膜转移患者，女，56岁，呼吸困难，咳嗽，咳痰带血丝，于哈医大四院抽水2次，未作化验，抗炎治疗2周，未穿刺，CT示左肺上叶占位，胸腔积液。诊断：胸膜多发转移瘤