正常的肺韧带和膈神经在胸片上能看到吗?

探讨正常人胸透上膈顶尖角状突起影的解剖学基础。材料与方法,胸透正常人２０４３例,对膈顶有尖角状影者其中１３例行胸部正侧位摄片和ＨＲＣＴ扫描对照。复习１１７例正常胸部常规ＣＴ扫描肺窗片。用间距５ｍｍ的ＨＲＣＴ扫描２０例正常人胸部。结果胸透膈顶尖角状影检为率：男３．５％,女７．０％。结论胸透（片）膈顶尖角状突起影ＣＴ上显示为肺韧带或膈神经。     

胸膜间皮瘤的胸部X线平片诊断2例

胸膜间皮瘤是发生于胸膜的肿瘤,比较少见。临床上往往经X线检查发现,并通过胸膜穿刺或剖胸活检等病理检查手段最后确诊。现就本院2例经胸部X线平片发现的病例分析报道如下。1病例简介1·1例1,女,60岁,平时咳嗽、咳痰、气促,偶有胸痛。临床治疗效果不佳。胸部X线平片示右侧中上胸腔内有一个巨大肿块,大小约11.0 cm×8.0 cm,边界清楚,密度均匀。肿块的左下边界与右肺门相邻且有胸膜粘连。右膈肌胸膜有幕状粘连,右膈面稍抬高。双侧肋膈角稍欠清晰。右侧位示肿块的基底紧贴前胸壁,胸腔无明显积液现象(图1,2)。1·2例2,男,72岁。咳嗽、胸闷、咳…     

借助超声液体支气管图鉴别胸膜疾病和肺实变

一例44岁男性患者,以双侧肺炎入院。平片示双下肺实变,左膈面模糊,CT片示肺门下3～4匣米层面大片致阴密影,左下叶大支气管内见液平面,更下层面见左半胸有均一的软组织密度的区域,与脾脏、胸膜和横膈均不能区分,未能作出诊断。而超声波检查则清楚地显示左膈上的中等回声区域,其间有多发的、分支状的、无搏动     

包裹性胸腔积液的X线诊断

包裹性胸腔积液是发生在胸膜粘连基础上的局限性胸膜积液，可以是大量胸膜积液局限后形成，也可以是局部胸膜粘连同时有渗液形成。无论是哪一种原因引起的，总是要在有胸膜粘连的基础上形成包裹性胸膜积液。包裹性胸膜积液可发生在胸膜的任何部位分有胸壁包裹，时间包裹，叶间合并其它部位的包裹性积液；还发生在横膈、纵膈胸膜的包裹性积液等几种类型。下面介绍几种比较常见的包裹性积液：     

胸膜凹陷征在孤立性肺结节MSCT诊断中的价值

目的:评价胸膜凹陷征在孤立性肺结节定性诊断中的价值。方法:回顾性分析经手术、病理或临床随访证实的60例周围型肺癌和40例良性结节的MSCT资料,并行MPR、VR、SSD等显示结节与胸膜之间关系的影像表现。结果:胸膜凹陷发生于肺肋胸膜面46例,纵隔面11例,膈面22例,叶间胸膜面13例,壁胸膜与叶间胸膜同时发生8例。图像后处理技术对胸膜凹陷征的检出率均显著高于轴位图像(P0.05)。周围型肺癌典型胸膜凹陷征和伴相关结节切迹的出现例数显著高于良性结节组(P0.05);良性结节粗线影和伴胸膜粘连增厚的检出例数高于周围型肺癌(P0.05)。结论:MSCT图像后处理显示胸膜凹陷征对孤立性肺结节的定性诊断具有指导意义。     

膈肌巨大脂肪瘤一例

患者　男 ,2 6岁。右胸心前区疼痛 ,胸闷不适半年入院。Ｘ线检查 :胸部正位片示右心膈角区类半卵圆形巨大软组织块影 ,密度均匀稍淡 ,边缘光滑 (图 1)。右侧位片示肿块影占据前肋膈窦 ,与右膈面移行 ,呈“山丘”状突入肺内 ,约9ｃｍ× 12ｃｍ大小 ,膈面光滑 (图 2 )。透视见块影有宽基底与膈肌相连 ,深呼吸时能随膈肌运动。Ｘ线诊断 :右膈肌良性肿瘤可能性较大。手术所见 :右侧剖胸探查 ,术中见肿块位于右膈肌上 ,大小约 8ｃｍ× 10ｃｍ× 12ｃｍ ,质较软 ,有完整包膜 ,基底位于膈肌顶部 ,肿物与肺组织及心包部分粘连。将肺侧及心包粘连处钝…     

肺膈韧带的X线影像

在正位胸片上近左、右心缘处膈上常有幕状阴影,其可见频度约10-20%,侧位像有时亦可见到,1978年Hanke提出为肺膈韧带(lig pulmodiaphragmale)形成,其后对肺韧带的变异有了较明确的概念。作者收集40余例肺膈韧带的病人,按其形态分为下列三种。 1.正常范围的肺膈韧带影像:正位胸片,右膈近心膈角区境界模糊,左膈心尖部下方有幕状线条影,内侧膈面模糊。侧位像,左、右膈肌中部均可见幕状线条影像,为肺膈韧带典型的X线征。 2.肺膈韧带肥厚的影像:在正位上,左肺门下方与心脏阴影重叠区有较粗的索条状阴影,非呈幕状线条表现。于右前斜位,左膈中部在心脏阴影的后下方,可见一段模糊区,为肺膈韧带增厚、粘连     

胸膜瘤—癌—类似肺不张性假肿瘤

作者在斯德哥尔摩医院观察到一种类似癌的肺不张性假肿瘤称之为胸膜瘤,这些病例针刺活检均找不到癌细胞,故应属于良性病变。胸膜瘤常位于下叶后基底段、尖段或尖下段,肺外侧带,邻近横膈面或叶间裂等部位,一般以下叶基底即后肋膈角上方多见。胸膜瘤直径一般为2-8厘米左右。病灶通常以胸膜面为基底,不按肺段排列,部份边缘表现清晰光滑,密度通常均匀,25例中有6例出现空洞或裂隙征。胸膜瘤的典型X线表现: 大部病例呈胸膜增厚且同胸膜面呈锐角交接,因半液体胸膜渗出物收缩成硬性纤维肿块,病灶中     

膈疝的X线诊断(附21例报告)

腹部脏器穿过横膈突入胸腔者称为膈疝。好发于膈肌的薄弱部分,如食管裂孔,胸骨后裂孔,胸膜裂孔,外伤性裂孔及横膈先天性缺损部分。此病X线表现复杂,容易误诊,现将我院经手术或X线检查证实的21例报告如下:     

胸腔积液:US显示胸膜转移灶的“声窗”

作者对胸部 X 线片仅显示胸腔积液,而 US 尚显示胸膜转移灶的32例患者进行了研究。US 探头频率3.5～5.0MHz。为了充分显示脏层、壁层胸膜、膈面、下胸部及上腹部情况,仔细作多切面纵     

Humanity and radiation: the good, the bad, and the unusual.

Radiation has permeated the universe since time began. People disagree widely about the merits and dangers of nuclear technology. Radiation is often associated in the minds of people with bombs, fallout, destruction, and death rather than with the many benefits of nuclear technology that are present in our daily lives. Rarely do individuals focus on the medical applications of radiation and the fact that nuclear technology saves lives. Over the years, accidents have happened in the nuclear industry; some have produced fatalities, but most proved to be a major source of concern only to the local populace. Since the discovery of naturally occurring radium and uranium and the advent of synthetic radionuclides, a number of consumer products have used radiation, some of which were beneficial and some which were of no benefit at all.     

Sonography of the wrist and the hand

Sonographic examination of the hand requires high-frequency linear transducers. As the relevant structures are located very close to the surface, water stand-off pads are mandatory. Owing to the high sensitivity of sonography in the detection of fluid, exudative synovitis, tenosynovitis and ganglia can be easily diagnosed. Sonographic information on muscle atrophy and alterations of the shape and echogenicity of the median nerve in patients with carpal tunnel syndrome may be useful in evaluating the extent of disease. Further indications for the sonographic examination of the hand include suspected tumors, foreign bodies and synovial proliferation. Osseous destruction can be visualized in patients with rheumatoid disease, but the precise extent is hard to determine.