醫(yī)學(xué)影像學(xué)中英文名詞解釋

1、醫(yī)學(xué)影像學(xué)名詞解釋accessory lobe: additional pleura extending into the pulmonary segments, forming additional pulmonary lobe. the most commonly seen are azygos lobe in the inner zone superior to the right hilum, and inferior accessory lobe in the inner zone of inferior lobe.air bronchogram sign : because the

2、 air in the alveoli is replaced by exudates, while the air in the bronchus is not displaced and remain patent. this produces contrast between the air in the bronchial tree and the surrounding airless parenchyma. ankylosis of joint: bony or fibrous tissues connect the articular surface. in plain film

3、, it is characterized by a narrowed articular space. whether the trabeculae pass through the articular space distinguishes bony or fibrous ankylosis.artificial contrast:those organs or spaces lack of natural contrast，can be renderde to be visible by means of contrast agents to create an artificial c

4、ontrast.bone destruction: localized absence of normal bone tissue and replaced by pathological tissues. both the cortical and spongy bone are destructed because of either the absorption of bone tissues or the activation of osteoclasts by the pathological tissue. in plain film, it appears to be a dec

5、rease in bone density locally, absence of normal bone tissue, and probably worm-eaten or sievelike cortical bone.cavity: formed as a result of the expulsion of necrotic tissues through bronchus. it can be devided into worm-eaten, thin-walled, and thick-walled cavities. often seen in tb, pulmonary ab

6、scess, and lung cancer.codman triangle: codman triangle is due to direct erosion of the already formed periosteal new bone by fast growing tumor.colles fracture : the fracture line is within 2-3cm from the articular end of the radius, the distal fragment is displaced dorsally and radially and is oft

7、en associated with fracture of the styloid process of the ulna and separation of the radioulnar joint.ctr: the ratio between maximal transverse diameter of the heart: summation of maximal diameter from left and right margin of the heart respectively to the mid line, and maximal width of the thorax:

8、a horizontal line passing through the right diaphragmatic apex between inner edges of the thorax. maximum in adults: 0.5degeneration of joint: degenerated and necrotic articular cartilage, replaced by fibrous tissues gradually. when the bony surface is involved, it can cause hyperostosis of the bone

9、, which leads to rough articular surface, formation of osteophyte, and ossification of ligament. it is often seen in weight-bearing or frequently used joints.destruction of bone: bone tissue elimination caused by sclerotin partly substituted with pathologic organism. roentgenologically,it shows oste

10、olytic bone areas of decreased density and loss of bone structures. double contour: on pa film, the right border of an enlarged left atrium may produce an extra shadow superimposed on the right cardiac border, giving a double contour.early gastric cancer : early gastric cancer is define as carcinoma

11、 limited to the mucosa and submucosa regardless of the presence or absence of lymph node involvement.epiphyseal fracture: occurs in childrens long bone, for the epiphysis has not linked with metaphysic, so they may separate when there is an external force acting. in plain film, the epiphysis and met

12、aphysis are not in the normal place, or the epiphyseal plate is broader than normal. the fracture line does not exist. filling defect: filling defect is caused by a space occuping mass producing defect on the barium . fracture: a complete/ incomplete break in the continuity of a bone or a cartilage.

13、 incomplete fractures include crack and greenstick . complete fractures include transverse, oblique, vertical, spiral, fragmented, impacted, compression , and avulsion .greenstick fracture:greenstick fracture occur almost exclusively during infancy and childhood. it is not easy for external force to

14、 cause the bone cortex complete break because of its pliant, so this kind of fracture showed buckling of the cortex without fracture lines or a transver fracture occur in the cortex, extending into the midport of the bone and then orienting along the longitudinal axis of the bone without disrupting

15、the opposite cortex. hilar dance: under fluorescence, there will be an obviously enhanced pulsation of the hilar arteries in pulmonary hypertension, seen in congenital heart diseases with left-to-right shunt.hyperostosis osteoscleroses: osteosclerosis is abnormal hardening or increased density of bo

16、ne on radiographs intrapulmonary air containing space: pathological distension of physiological space in the lung. it appears to be a round translucency with a smooth wall about 1mm in x-rays. such as bullae and air containing bronchial cysts. inverted s curve sign: pa film, atelectasis of the right

17、 superior lobe, elevated horizontal fissure, hilar mass, central bronchogenic carcinoma in the right superior lobekerley line: pulmonary interstitial edema, formed due to thickening interalveolar septa in different area. a: stretching form the outer zone to the hilum obliquely, seen in acute lhf; b:

18、 in the costophrenic angle, 2-3cm long, stretches horizontally, seen in ms and chronic lhf; c: in the inferior field, netlike, seen in severe pulmonary venous hypertension.kidney autonephretomy :the caseous lesion of renal tuberculosis can produce calcification, and even result in calcification of e

19、ntire kidney called autonephritomy lung markings: consisting of pulmonary a.,v., bronchi, and lymph tissues. in plain film, it appears to be branch like shadow radiating outward from the hilum and disappear with a gradual reduction in size.niche: on profile, this unchanging collection of barium will

20、 project outside the confines of the stomach. osteomalacia: osteomalacia is a group of disorders resulting from inadequate or delayed mineralization of osteoid in mature cortical and spongy byne. the radiographic changes are characterized by general marked decrease of bone density, thick cortex, the

21、 normal outline of the bone is blurred. osteonecrosis: osteonecrosis occurs when metabolism of bone cells cease forever from local ischemia bone. the chief characteristic that is responsible for the radiographic definition of dead bone is its apparent increase in density.osteoporosis: refers to a de

22、crease in normal bone tissue per unit volume, in which mineral and organic matters decrease in proportion, leaving a qualitatively normal but quantitatively deficient bone tissue. the deficient bone becomes more fragile and more vulnerable to fractures. in plain film, it appears to be a decrease in

23、bone density generally, thin and sparse trabeculae, wide intertrabecular space, and a thinner and stratiform cortical bone. it often occurs in the elderly, menopause in women, and other circumstances such as tumor, infection, endocrine disorders, etc.osteosclerosis and hyperostosis: refers to an inc

24、rease in normal bone tissue per unit volume. in plain film, it appears to be an increase in bone density generally, with thickened cortex and trabeculae. the medullary space is narrowed or even vanished, and sometimes the cortical bone and spongy bone cannot be distinguished. it is usually seen in t

25、umor, inflammation, and trauma. pancoasts tumor: peripheral bronchogenic carcinoma in the apex. can infiltrate into neighboring vertebrae and ribs, involves cervical sympathetic nerve and cause horners syndrome.periosteal reaction: when the periosteum is irritated pathologically, osteoblasts in the

26、inner layer will be activated and produce sub-periosteal new bone. in plain film, it appears to be a high density shadow parallel to the cortex, with various patterns as linear, luminar, or lacelike. it usually indicates a destruction or injury of the bone.pleural indentation: v-shaped or cordlike,

27、dense shadow between the mass and pleura, contraction of scar tissue in tumor, adenocarcinoma, bronchioalveolar carcinomaprimary complex: a combination of primary pulmonary tuberculous focus, hilar tuberculous lymphangitis and lymphadenitis. fomrs a typical dumbbell-like x-ray image.primary complex

28、tuberculosis; the combination of the primary pulmonary tuberculous focus, lymphangitis and intrathoracic lymphadenitis is known as the primary complex tuberculosis. it occurs chiefly in children. schmorls nodule: prolapse of the nucleus pulposus through the vertebral body endplate into the spongiosa

29、 of the vertebra, accompanied by responsive hyperostosis.stirlin sign: there is a lack of barium retention in a diseased segment of ileum and caecum but with a column of barium remains on either side of the affected area. this phemonenon may result from spasm, organic constracture of a combination o

30、f both. it is suggestive of tuberculosis of intestine. subpleural line: thickened adjacent interlobular septa connects together, dermatasclerosis, asbestosisthe third pathologic arch: it may form a separate arch between the pulmonary segment and the left ventricle ,due to enlargement of the atrial a

31、ppendage. it is called the third pathologic arch. tree-budded sign: bronchiolus, diffuse panbronchiolitis, bronchogenic dissemination流空效應(yīng)：由于信號(hào)的采集需要一定的時(shí)間，快速流動(dòng)的血液不產(chǎn)生或只產(chǎn)生極低的信號(hào)，與周圍組織、結(jié)構(gòu)間形成良好的對(duì)比，這種現(xiàn)象叫流空效應(yīng)。馳豫時(shí)間：靜態(tài)磁場(chǎng)中，質(zhì)子從高能態(tài)恢復(fù)到低能態(tài)所需要的時(shí)間。像素pixel：掃描所得的數(shù)據(jù)經(jīng)計(jì)算而獲得每個(gè)體素的x線衰減系數(shù)或稱吸收系數(shù)，再排列成矩陣，其中每個(gè)數(shù)字經(jīng)數(shù)字、模擬轉(zhuǎn)換器轉(zhuǎn)換為黑到白的不同

32、灰度的小方塊，稱體素voxel：ct圖像處理時(shí)將選定的層面分成若干個(gè)體積相等的小方塊，稱數(shù)字減影血管造影dsa：digitial substraction angiography利用計(jì)算機(jī)處理數(shù)字影像信息，將兩幅圖重疊，消除血管周圍組織影，使血管顯像清晰的成像技術(shù)。dsa is a procedure,using computer techonolgy to process imforamtion.it substracts two pictures to allow for visualization of blood vessels without interference from su

33、rrounding structure.自然對(duì)比：根據(jù)人體組織密度即比重的高低，人體組織可概括分為骨骼、軟組織（包括液體）脂肪及存在于人體內(nèi)的氣體四類。這種人體組織自然存在的密度差別稱為造影檢查：對(duì)缺乏自然對(duì)比的結(jié)構(gòu)或器官，可將密度高于或低于該結(jié)構(gòu)或器官的物質(zhì)引入器官內(nèi)或周圍間隙，使之產(chǎn)生對(duì)比顯影，即為造影檢查造影檢查的應(yīng)用擴(kuò)大了x線檢查的范圍。介入放射學(xué)：以影象學(xué)為基礎(chǔ)，并在影象設(shè)備的介導(dǎo)下，利用經(jīng)皮穿刺和導(dǎo)管技術(shù)等，對(duì)一些疾病進(jìn)行非手術(shù)治療或者用以取得組織學(xué)、細(xì)菌學(xué)、生理和生化材料，已明確病變性質(zhì)。骨齡：骺軟骨按不同發(fā)育時(shí)期逐漸骨化，骨化的程度與年齡有相對(duì)的穩(wěn)定關(guān)系，將這種骺軟骨骨化與年齡

34、的關(guān)系稱為骨齡。通過(guò)發(fā)育的骨齡與真實(shí)年齡比較，可以對(duì)骨骼生長(zhǎng)代謝情況進(jìn)行評(píng)價(jià)。骨折：是骨骼發(fā)生斷裂，骨的連續(xù)性中斷。骨骺分離也屬骨折。在x線上呈不規(guī)則的透明線，稱根據(jù)骨折的程度可分為完全性和不完全性。關(guān)節(jié)脫位：失足成關(guān)節(jié)骨骼的脫離、錯(cuò)位，有完全性脫位和半脫位兩種。骨質(zhì)疏松osteoporosis;一定單位體積內(nèi)正常鈣化的骨組織減少，有機(jī)物和無(wú)機(jī)物均減少，但二者比例正常。其x線表現(xiàn)為骨密度減低，骨松質(zhì)內(nèi)骨小梁變細(xì)、減少、間隙增狂，骨皮質(zhì)出現(xiàn)分層和變薄。在脊柱，椎體內(nèi)結(jié)構(gòu)呈縱行條紋，甚至消失，周圍皮質(zhì)變薄。椎體變扁，錐間間隙增寬，椎體可呈瑣形。常見(jiàn)于老年、營(yíng)養(yǎng)不良、代謝和內(nèi)分泌障礙、骨折、感染等。

35、骨質(zhì)軟化osteomalacia：一定單位體積內(nèi)骨組織有機(jī)成分正常，無(wú)機(jī)成分減少。其x線表現(xiàn)為骨密度減低，骨小梁和骨皮質(zhì)邊緣模糊，承重骨常發(fā)生變形。常見(jiàn)于佝僂病、骨軟化癥。骨質(zhì)破壞destruction of bone：局部骨質(zhì)為病理組織所代替形成的骨質(zhì)缺損，其中全無(wú)骨質(zhì)結(jié)構(gòu)。x線表現(xiàn)為骨質(zhì)局限性密度減低，骨小梁消失或形成骨質(zhì)缺損。骨皮質(zhì)蟲(chóng)蝕狀篩孔狀缺損，骨松質(zhì)斑片狀缺損。常見(jiàn)于炎癥、肉芽腫、腫瘤或瘤樣病變。骨質(zhì)增生硬化：一定單位體積內(nèi)骨量的增多。x線表現(xiàn)為骨質(zhì)密度增高，伴或不伴有骨骼增大，骨小梁增多增粗密集，骨皮質(zhì)增厚、致密，二者分界不清。多見(jiàn)于慢性骨髓炎、外傷和某些原發(fā)性骨腫瘤。骨膜增生（

36、骨膜反應(yīng)）periosteal proliferation reaction 骨膜受到刺激，骨膜內(nèi)層成骨細(xì)胞活動(dòng)增加形成骨膜新生骨。x線早期表現(xiàn)為長(zhǎng)短不定與骨皮質(zhì)表面平行的細(xì)線狀致密影，晚期表現(xiàn)為與骨皮質(zhì)平行的線狀、層狀、花邊狀影。in the forepart of the disease it appears to be a linear opacity curving slightly away from the cortex of the bone and separated from it.periosteal reaction casts shadow of increase of

37、 density and occurs in various of forms.骨膜三角codman三角惡性骨腫瘤累及骨膜及骨外軟組織，刺激骨膜成骨，腫瘤繼而破壞新生骨骨質(zhì)，其邊緣殘余骨質(zhì)形成三角形高密度灶，是惡性腫瘤的重要特征。骨質(zhì)壞死：骨組織局部代謝的停止，壞死的骨組織稱為死骨。x線表現(xiàn)為骨質(zhì)局限性密度增高。多見(jiàn)于化膿性骨髓炎。骺離骨折：骨折發(fā)生于兒童長(zhǎng)骨，由于骨骺尚未與干骺端結(jié)合，外力可經(jīng)過(guò)骺板達(dá)干骺端而引起骨骺分離。其骨折線不能顯示，x線上顯示骺線增寬或骺于干骺端對(duì)位異常。青枝骨折greenstick fracture：在兒童，骨骺柔韌性比較大，外力不易使骨質(zhì)完全斷裂，僅表現(xiàn)為局部骨皮

38、質(zhì)和骨小梁的扭曲，而不見(jiàn)骨折線，或只引起骨皮質(zhì)發(fā)生皺折、凹陷或隆突。it may be incomplete in which only on part of cortex is buckled,or broken ,called greenstick fracture and usually occurs in children.clles 骨折：稱伸展型橈骨遠(yuǎn)端骨折，為橈骨遠(yuǎn)端23cm以內(nèi)的橫行或粉碎性骨折，骨折遠(yuǎn)端向背側(cè)移位，斷斷向掌側(cè)成角畸形，可伴尺骨莖突骨折。肺間質(zhì)：肺泡、肺壁間的纖維結(jié)締組織支架。肺實(shí)質(zhì)：具氣體交換功能的肺泡、肺壁。肺紋理：在充滿氣體的肺野，可見(jiàn)肺門向外呈放射分布的

39、樹(shù)枝狀影。空洞cavity：肺內(nèi)病變組織壞死、液化，經(jīng)支氣管排出后留下的，x線顯示大小不等邊界清楚的密度減低區(qū)，多見(jiàn)于結(jié)核、肺癌。the cavity is formed as result of the expulsion of necrotic material into the bronchus.空腔intrapulmonary air contain lug space：肺內(nèi)生理性腔隙的病理性擴(kuò)大，如肺大泡bulla、含氣囊腫cist及肺氣囊。結(jié)核球/結(jié)核瘤：纖維組織包裹的干酪性結(jié)核病灶，胸片上為邊界清楚、密度較高的致密影，其直徑一般在2厘米以上，其內(nèi)可有鈣化斑。支氣管充氣癥air b

40、ronchogram sign：肺實(shí)變時(shí)，實(shí)變的肺組織內(nèi)含氣支氣管呈樹(shù)枝狀低密度的現(xiàn)象，多見(jiàn)于炎癥。原發(fā)綜合癥primary complex：指原發(fā)肺結(jié)核的三個(gè)x線癥原發(fā)浸潤(rùn)（見(jiàn)于中上肺葉），淋巴管炎，肺門，縱膈淋巴結(jié)腫大。the combination of the primary pulmonary tuberculous focus,lymphangitis and intrathoraclo lymphadenitis is known as primary complex.反s癥：胸部正位片右肺上葉肺不張時(shí)，由于不張肺葉體積縮小上葉向上移位，不張上葉下緣與肺門腫塊上緣的連線呈橫置s形

41、。毛刺癥：周圍型肺癌浸潤(rùn)性生長(zhǎng)，發(fā)生滲出和增殖，x線顯示腫塊邊緣長(zhǎng)短不一細(xì)毛刺結(jié)構(gòu)。肺門舞蹈：肺動(dòng)脈高壓時(shí)，肺門血管搏動(dòng)明顯增強(qiáng)的現(xiàn)象，常見(jiàn)于左向右分流的先心痛。心胸比率cardio-thoracic ratio（ctr）：心影最大橫徑與胸廓最大橫徑之比。0.510.55為輕度增大，0.560.60為中度，大于0.60為重度。the ratio between the maximal transverse diameter of the heart and the maximal width or the thorax.kerley 線：間質(zhì)肺水腫時(shí)出現(xiàn)各種間隔線，b線表現(xiàn)為肋膈角區(qū)橫行線狀密

42、度增高影，見(jiàn)于肺動(dòng)脈高壓。a線見(jiàn)于上葉的斜形線狀影，急性左心衰多見(jiàn)。c線為下肺葉網(wǎng)格狀影，可見(jiàn)于重度肺靜脈高壓。胸膜凹陷癥：肺內(nèi)病灶鄰近臟層胸膜臍樣，橫斷面常呈三角形凹陷，尖端指向病變，與病變間借索條影相連的現(xiàn)象。多見(jiàn)于惡性腫瘤，偶爾于良性腫瘤、慢性炎癥或炎性肉芽腫。相反搏動(dòng)點(diǎn)opposite pulsation：后前位片上，左心緣左室段與肺動(dòng)脈的搏動(dòng)相反，兩者交點(diǎn)稱為the motion of the left ventricle is impart on systole,opposite to the outward pulsation of the pulmonary segment a

43、nd the aortic knuckle.this is the point of opposite pulsation which serve a landmark of the left ventricle.漏斗征：指主動(dòng)脈弓與肺動(dòng)脈段之間的小隆起，是未閉的動(dòng)脈導(dǎo)管漏斗部在正位像上的投影。pancoasts瘤：發(fā)生于肺間邊緣部位的肺癌稱常破壞鄰近椎體、肋骨，累及臂叢神經(jīng)引起同側(cè)臂痛，累及頸交感神經(jīng)節(jié)引起horners綜合征（同側(cè)眼瞼下垂、瞳孔縮小和眼球內(nèi)陷）。雙房影：后前為片上左心房向右增大明顯時(shí)可達(dá)右房邊緣或超過(guò)后者形成雙重影。見(jiàn)于二尖瓣狹窄等左心房增大時(shí)。假腫瘤癥：閉袢型梗阻，即閉袢

44、內(nèi)充滿大量液體的表現(xiàn)。其密度較高，在仰臥正位片上呈腫塊影，側(cè)臥水平照片上在該塊影的上部顯示出短小液面。見(jiàn)于絞窄性腸梗阻。充盈缺損filling defect：由于消化管內(nèi)占位性病變，造影時(shí)其位置造影劑無(wú)法填充，出現(xiàn)造影劑缺損的情況，此時(shí)，鋇劑勾畫(huà)的輪廓是腫塊突向腔內(nèi)的邊緣。常見(jiàn)于腫瘤等。filling defect is caused by a space occupying mass producing defect on the barium.龕影niche：潰瘍形成的管壁凹陷被鋇劑充盈，在切線位時(shí)形成局限性向輪廓外突出的陰影，稱多見(jiàn)于潰瘍。指壓跡：造影像上，龕影口部癌結(jié)節(jié)呈向龕影的弧形壓

45、跡，謂之，提示潰瘍?yōu)閻盒?。裂隙癥：潰瘍周邊癌結(jié)節(jié)向潰瘍口凸出，使龕影呈不規(guī)則樹(shù)根狀，謂之或“角癥狀”，提示惡性潰瘍的特征影像。穿透性潰瘍：龕影深而大，深度、大小均超過(guò)1cm，龕影周圍常有范圍較大的水腫帶。穿孔性潰瘍：龕影很大，如囊?guī)睿渲谐３霈F(xiàn)液面和分層現(xiàn)象，即氣液鋇三層或氣鋇兩層現(xiàn)象。狹頸癥和項(xiàng)圈癥：潰瘍四周的炎癥水腫向龕影內(nèi)突出，切線位時(shí)龕影口部局限性狹窄，稱狹頸癥；若水腫明顯，適當(dāng)加壓，龕影口部可見(jiàn)0.51cm寬，形態(tài)規(guī)律的密度減低影，稱項(xiàng)圈癥。二者均提示良性潰瘍。環(huán)提：位于潰瘍龕影周圍的寬窄不等的透明帶，輪廓不規(guī)律則而銳利，其中常見(jiàn)結(jié)節(jié)狀和壓指切跡充盈缺損。半月綜合癥：切線位橫跨角切

46、跡或胃小彎垂直部的半月形、龕底向內(nèi)周圍有寬窄不等的透明帶（環(huán)提）；輪廓不規(guī)律而銳利，其中常見(jiàn)結(jié)節(jié)狀和壓指切跡狀充盈缺損（指壓癥）的龕影，提示胃癌。跳躍癥stirlin sign：病變的腸管由于炎癥刺激狀態(tài)，長(zhǎng)時(shí)間痙攣收縮。鋇劑在該處不能正常停留，而迅速推向下段腸管，出現(xiàn)病變腸管不顯影，兩側(cè)腸管顯影正常，稱。好發(fā)與回腸末端，常見(jiàn)于潰瘍型腸結(jié)核。結(jié)腸袋：由于結(jié)腸外縱肌長(zhǎng)度比消化管短，加上肌環(huán)收據(jù)，結(jié)腸呈現(xiàn)為大小不等的半月形囊袋狀結(jié)構(gòu)，即“結(jié)腸袋”。腎自截：全腎廣泛破壞、干酪樣壞死鈣化，x線顯示全腎密度致密增高，腎功能完全喪失，稱，常見(jiàn)于晚期腎結(jié)核。中央型肺癌的x線表現(xiàn)：早期局限于粘膜內(nèi)，可見(jiàn)異常表

47、象。病變逐漸發(fā)展，支氣管官腔逐漸狹窄至完全阻塞，相繼出現(xiàn)局限性肺氣腫，阻塞性肺炎和肺不張，如腫瘤同時(shí)向腔外生長(zhǎng)和伴有非門淋巴結(jié)轉(zhuǎn)移可在肺門部形成腫塊，發(fā)生在右肺上葉支氣管的肺癌，其肺門腫塊與右肺上葉不張共同構(gòu)成反“s”征。周圍型肺癌與結(jié)核球的鑒別：周圍型肺癌分葉狀腫塊，邊緣小切跡，細(xì)小毛刺，支氣管狹窄、阻塞、中斷、缺損，可有空泡征，胸膜凹陷征；結(jié)核球好發(fā)于尖后段、下葉背段，多小于3cm，圓形或橢圓形，無(wú)切跡分葉，常有鈣化及周圍病灶。露骨骨折的類型及x線表現(xiàn)：線性骨折、凹陷性骨折、粉碎性骨折和穿入性骨折顱骨骨折線與顱骨血管壓跡不同，表現(xiàn)為：走向僵直，密度低，多不跨過(guò)顱縫。1線性骨折：x線表現(xiàn)顱骨

48、出現(xiàn)線樣低密度負(fù)影，骨皮質(zhì)不連續(xù)，骨小梁中斷；2凹陷性骨折：顱骨向內(nèi)凹陷，斷裂，小孩則不一定出現(xiàn)骨折線，緊表現(xiàn)為局部凹陷；3粉碎性骨折：多塊碎骨片形成，碎骨片可分離、凹入或重疊移位；4傳入性骨折是由于顱骨穿透?jìng)隆Ｔ缙谖赴┑亩x和x線表現(xiàn)：早期胃癌是指腫瘤局限于粘膜或粘膜下層，肌層及漿膜層未受累，而不論其大小或是否有轉(zhuǎn)移。分隆起型、淺表型及凹陷型三類。x線表現(xiàn)：1隆起型：腫瘤呈類圓形突向胃腔。高度超過(guò)5mm，基地寬，表面粗糙；雙重法及加壓法顯示為不規(guī)律的充盈缺損；2淺表型：腫瘤表淺、平坦，形態(tài)不規(guī)律，隆起與凹陷不超過(guò)5mm，在良好的氣鋇雙重造影及加壓像上得以顯示胃小區(qū)、胃小溝不規(guī)則，呈顆粒狀

49、，有輕微的凹陷與僵直。、；3凹陷型：腫瘤形成凹陷，深度超過(guò)5mm，形態(tài)不規(guī)則，雙重法及加壓法表現(xiàn)為小的龕影，周邊粘膜出現(xiàn)杵狀增粗或融合。良惡性潰瘍的鑒別：1良性潰瘍龕影形態(tài)為圓形或橢圓形，突出于胃腔輪廓之外；臨近胃壁柔軟，有蠕動(dòng)波；粘膜向病變部位集中達(dá)到潰瘍口部，無(wú)中斷、破壞；口部有粘膜線、項(xiàng)圈征及狹頸征；2惡性潰瘍位于為輪廓之內(nèi)，形態(tài)不規(guī)則有多個(gè)尖角；可見(jiàn)局部胃壁僵直、蠕動(dòng)波消失；臨近胃粘膜皺襞向病變部位糾集、中斷、破壞、可見(jiàn)半月征、環(huán)堤征。1.良惡性骨腫瘤的鑒別生長(zhǎng)情況：良緩慢，不侵及鄰近軟組織，但可引起壓迫移位；惡迅速，易累及鄰近的組織器官。局部骨變化：良膨脹性骨質(zhì)破壞，與正常骨界線清晰

50、，邊緣銳利，骨皮質(zhì)變薄，保持其連續(xù)性；惡浸潤(rùn)性骨質(zhì)破壞，與正常骨分界不清，累及骨皮質(zhì)，造成不規(guī)則破壞與缺損，可有腫瘤骨。骨膜增生：良一般無(wú)，病理骨折后可有少量骨膜增生，骨膜新生骨不被破壞；惡多出現(xiàn)不同形式的骨膜增生，并可被腫瘤侵犯破壞。周圍軟組織：良多無(wú)腫脹或腫塊影，邊緣清楚；惡侵入的軟組織形成腫塊，與周圍組織分界不清。2.第2孔型房間隔缺損的血液動(dòng)力學(xué)改變及影像學(xué)表現(xiàn)由繼發(fā)房間隔生長(zhǎng)不足所導(dǎo)致的房間隔缺損稱為第2孔型房間隔缺損，缺損位于房間隔的中部，此型占房間隔缺損的80%左右。血液動(dòng)力學(xué)：正常情況下左房壓力高于右房，房間隔缺損時(shí)，左房的血液可分流進(jìn)入右房，分流的血液經(jīng)右心系統(tǒng)、肺循環(huán)、左房

51、，最后又回到右房，從而加重右心系統(tǒng)的負(fù)荷，導(dǎo)致右房的擴(kuò)張和右室的擴(kuò)張、肥厚。長(zhǎng)期的肺血流量的增加使肺血管發(fā)生改變，并最終出現(xiàn)肺動(dòng)脈高壓。隨著肺動(dòng)脈壓力增高，右房壓力增高，分流量減少，甚至發(fā)生分流方向的逆轉(zhuǎn)，呈右到左分流。影像學(xué)表現(xiàn)：心影增大呈二尖瓣心型，肺血增多，肺動(dòng)脈段突出，肺門動(dòng)脈擴(kuò)張，外圍分支增多增粗，搏動(dòng)增強(qiáng)。主動(dòng)脈結(jié)偏小或正常。右房右室增大，尤其右房增大為房間隔缺損的重要征象。3.周圍型肺癌與結(jié)合瘤在影像學(xué)上如何進(jìn)行鑒別？結(jié)核球好發(fā)于尖后段、下葉背段，多小于3cm，圓形或橢圓形，無(wú)切跡分葉，常有鈣化及周圍衛(wèi)星灶。周圍型肺癌分葉狀腫塊，邊緣小切跡，細(xì)小毛刺，支氣管狹窄、阻塞、中斷、缺損

52、，可有空泡征，胸膜凹陷征4.良惡性潰瘍的鑒別要點(diǎn)龕影形狀：良圓形或橢圓形，邊緣光滑整齊；惡不規(guī)則、扁平，有多個(gè)尖角。龕影位置：良突出于胃輪廓外；惡位于胃輪廓之內(nèi)。龕影周圍和口部：良黏膜線，項(xiàng)圈征，狹頸征等，黏膜線外皺襞向龕影集中直達(dá)龕口；惡指壓跡樣充盈缺損，環(huán)堤，皺襞中段破壞。附近胃壁：良柔軟、有蠕動(dòng)波；惡僵硬、蠕動(dòng)消失。5.左心房增大的x線表現(xiàn)和常見(jiàn)疾病后前位：右心緣呈雙弧影，心影中可見(jiàn)增大的左房影。右前斜：食管左房段壓跡明顯，向后移位。左前斜：增大左房使左主支氣管上移、變窄。左側(cè)位：可見(jiàn)增大的左房。病因：二尖瓣病變、左室衰竭及某些先心病，如動(dòng)脈導(dǎo)管未閉。6.胃癌的x線表現(xiàn)1）充盈缺損2）胃

53、腔狹窄胃壁僵硬3）龕影，形狀不規(guī)則，多呈半月形，外緣平直，內(nèi)緣不整齊而有多個(gè)尖角；龕影周圍繞以寬窄不等的透明帶，即環(huán)堤，輪廓不規(guī)則而銳利，其中常見(jiàn)到結(jié)節(jié)狀和指壓跡狀充盈缺損4）黏膜皺襞破壞、中斷或消失5）癌瘤區(qū)蠕動(dòng)消失7.中央型肺癌的x線表現(xiàn)早期局限于黏膜內(nèi)，可見(jiàn)異常表現(xiàn)：病變逐漸發(fā)展，支氣管管腔逐漸狹窄至完全阻塞，相繼出現(xiàn)局限性肺氣腫，阻塞性肺炎和肺不張；如腫瘤同時(shí)向腔外生長(zhǎng)和伴有肺門淋巴結(jié)轉(zhuǎn)移可在肺門部形成腫塊；發(fā)生在右肺上葉支氣管的肺癌，其肺門腫塊與不張右上葉共同構(gòu)成的下緣呈“反s征”。8脊柱壓縮性骨折、脊柱結(jié)核和脊柱骨轉(zhuǎn)移瘤的x線診斷要點(diǎn)脊柱骨折一般單個(gè)椎體壓縮成楔形，不見(jiàn)骨折線，反見(jiàn)

54、一致密影，鄰近椎間隙正常。結(jié)核多累及鄰近兩個(gè)或以上椎體，附件較少受累，椎體松質(zhì)骨骨質(zhì)破壞，椎體塌陷變扁或成楔形，鄰近椎間隙變窄甚至消失，病變?cè)谄茐墓琴|(zhì)時(shí)可產(chǎn)生大量干酪樣物質(zhì)流入脊柱周圍軟組織中形成冷膿腫。脊柱骨轉(zhuǎn)移瘤多為多個(gè)跳躍性椎體廣泛性骨質(zhì)破壞，因承重壓縮變扁，椎間隙保持完整，椎弓根多受侵蝕，破壞9肺部基本病變有哪些，其病理基礎(chǔ)和x線表現(xiàn)如何？1）肺實(shí)變：急性炎癥反應(yīng)，肺泡內(nèi)液體滲出所致肺實(shí)變。x線表現(xiàn)為大小、數(shù)目不一致的斑片狀模糊影2）增殖病變：為慢性肉芽腫性炎癥。x線上呈密度增高的斑點(diǎn)狀陰影3）纖維病變：為炎癥修復(fù)期表現(xiàn)。x線上呈索條狀陰影，排列不規(guī)則4）鈣化病變：在組織壞死變性基礎(chǔ)上

55、有鈣鹽沉積。x線上呈邊緣銳利的致密影，大小形狀不一5）腫塊病變：由腫瘤增殖或炎性肉芽腫所致。x線良性腫塊的邊緣光滑，惡性腫瘤邊緣不規(guī)則，有分葉、毛刺征6）空洞與空腔：肺部病變壞死液化后，經(jīng)支氣管引流排出，使形成空洞；肺內(nèi)腔隙病理性擴(kuò)張，稱為空腔?？斩春涂涨粁線大小和形狀不一的透亮區(qū)7）支氣管阻塞：由腔內(nèi)阻塞或外在性的壓迫所致，阻塞的原因可以是炎癥、腫瘤等。支氣管阻塞可以引起阻塞性肺不張、肺炎和肺氣腫10.鑒別化膿性關(guān)節(jié)炎與關(guān)節(jié)結(jié)核化膿性關(guān)節(jié)炎急性起病，早期即可出現(xiàn)關(guān)節(jié)間隙變窄，骨端破壞先見(jiàn)關(guān)節(jié)的承重面，破壞區(qū)比較廣泛，晚期表現(xiàn)為關(guān)節(jié)骨性強(qiáng)直。關(guān)節(jié)結(jié)核慢性發(fā)展，骨質(zhì)破壞見(jiàn)于關(guān)節(jié)面邊緣，然后才累及承重部分。關(guān)節(jié)間隙變窄出現(xiàn)晚，程度輕。關(guān)節(jié)囊腫脹、密度增高，鄰近骨骼肌肉多有明顯疏松和萎縮。11.食管靜脈曲張x線：食管黏膜皺襞增粗、迂曲，連續(xù)性不中斷，可見(jiàn)串珠狀或蚯蚓狀充盈缺損，管壁呈鋸齒狀改變，但仍柔軟、舒縮自如。病理：是門靜脈高壓的重要并發(fā)癥，常見(jiàn)于肝硬化。門靜脈血液受阻時(shí)，來(lái)自消化器官及脾等的靜脈血不能進(jìn)入肝內(nèi)，大量血液通過(guò)胃冠狀動(dòng)脈和胃短靜脈進(jìn)入食管黏膜下靜脈和食管周圍靜脈叢，再經(jīng)奇靜脈進(jìn)入上腔靜脈，形成食管和胃底靜脈曲張。與癌鑒別：癌病變局限，充盈缺損不規(guī)則，黏膜皺襞不規(guī)則破壞，管壁僵硬，蠕動(dòng)消失12.骨質(zhì)疏松與骨質(zhì)軟化的區(qū)別定義：疏一定單位體