医学影像学_中英文名词解释

医学影像学名词解释 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 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, 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 contrast. 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 decrease 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 abscess, 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 often 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: a horizontal line passing through the right diaphragmatic apex between inner edges of the thorax. maximum in adults: 0.5 Degeneration 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, 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 osteolytic 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 limited to the mucosa and submucosa regardless of the presence or absence of lymph node involvement. Epiphyseal fracture: occurs in children’s 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 metaphysis 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. 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 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 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 bone 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 superior lobe, elevated horizontal fissure, hilar mass, central bronchogenic carcinoma in the right superior lobe Kerley 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: 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 entire 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 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 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 decrease 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 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 increase 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 tumor, inflammation, and trauma. Pancoast’s tumor: peripheral bronchogenic carcinoma in the apex. can infiltrate into neighboring vertebrae and ribs, involves cervical sympathetic nerve and cause Horner’s syndrome. Periosteal reaction: when the periosteum is irritated pathologically, osteoblasts in the 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, dense shadow between the mass and pleura, contraction of scar tissue in tumor, adenocarcinoma, bronchioalveolar carcinoma Primary complex: a combination of primary pulmonary tuberculous focus, hilar tuberculous lymphangitis and lymphadenitis. fomrs a typical dumbbell-like X-ray image. Primary complex 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. Schmorl’s nodule: Prolapse of the nucleus pulposus through the vertebral body endplate into the spongiosa 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 of both. It is suggestive of tuberculosis of intestine. Subpleural line: thickened adjacent interlobular septa connects together, dermatasclerosis, asbestosis The third pathologic arch: It may form a separate arch between the pulmonary segment and the left ventricle ,due to enlargement of the atrial appendage. It is called the third pathologic arch. Tree-budded sign: bronchiolus, diffuse panbronchiolitis, bronchogenic dissemination 流空效应:由于信号的采集需要一定的时间，快速流动的血液不产生或只产生极 低的信号，与周围组织、结构间形成良好的对比，这种现象叫流空效应。 驰豫时间:静态磁场中，质子从高能态恢复到低能态所需要的时间。 像素pixel:扫描所得的数据经计算而获得每个体素的X线衰减系数或称吸收系 数，再排列成矩阵，其中每个数字经数字、模拟转换器转换为黑到白的不同灰度 的小方块，称~ CT图像处理时将选定的层面分成若干个体积相等的小方块，称~ 体素voxel: 数字减影血管造影DSA:digitial substraction angiography 利用计算机处理数字影像信息，将两幅图重叠，消除血管周围组织影，使血管显 像清晰的成像技术。 DSA is a procedure,,using computer techonolgy to process imforamtion.It substracts two pictures to allow for visualization of blood vessels without interference from surrounding structure. 自然对比:根据人体组织密度即比重的高低，人体组织可概括分为骨骼、软组织 (包括液体)脂肪及存在于人体内的气体四类。这种人体组织自然存在的密度差 别称为~ 造影检查:对缺乏自然对比的结构或器官，可将密度高于或低于该结构或器官的 物质引入器官内或周围间隙，使之产生对比显影，即为造影检查造影检查的应用 扩大了X线检查的范围。 介入放射学:以影象学为基础，并在影象设备的介导下，利用经皮穿刺和导管技 术等，对一些疾病进行非手术治疗或者用以取得组织学、细菌学、生理和生化材 料，已明确病变性质。 骨龄:骺软骨按不同发育时期逐渐骨化，骨化的程度与年龄有相对的稳定关系， 将这种骺软骨骨化与年龄的关系称为骨龄。通过发育的骨龄与真实年龄比较，可 以对骨骼生长代谢情况进行评价。 骨折:是骨骼发生断裂，骨的连续性中断。骨骺分离也属骨折。在X线上呈不 规则的透明线，称~根据骨折的程度可分为完全性和不完全性。 关节脱位:失足成关节骨骼的脱离、错位，有完全性脱位和半脱位两种。 骨质疏松osteoporosis;一定单位体积内正常钙化的骨组织减少，有机物和无机 物均减少，但二者比例正常。其X线表现为骨密度减低，骨松质内骨小梁变细、 减少、间隙增狂，骨皮质出现分层和变薄。在脊柱，椎体内结构呈纵行条纹，甚 至消失，周围皮质变薄。椎体变扁，锥间间隙增宽，椎体可呈琐形。常见于老年、 营养不良、代谢和内分泌障碍、骨折、感染等。 骨质软化osteomalacia:一定单位体积内骨组织有机成分正常，无机成分减少。其X线表现为骨密度减低，骨小梁和骨皮质边缘模糊，承重骨常发生变形。常见于佝偻病、骨软化症。 骨质破坏destruction of bone:局部骨质为病理组织所代替形成的骨质缺损，其中全无骨质结构。X线表现为骨质局限性密度减低，骨小梁消失或形成骨质缺损。骨皮质虫蚀状筛孔状缺损，骨松质斑片状缺损。常见于炎症、肉芽肿、肿瘤或瘤样病变。 骨质增生硬化:一定单位体积内骨量的增多。X线表现为骨质密度增高，伴或不伴有骨骼增大，骨小梁增多增粗密集，骨皮质增厚、致密，二者分界不清。多见于慢性骨髓炎、外伤和某些原发性骨肿瘤。 骨膜增生(骨膜反应)periosteal proliferation reaction 骨膜受到刺激，骨膜内层成骨细胞活动增加形成骨膜新生骨。X线早期表现为长短不定与骨皮质表面平行的细线状致密影，晚期表现为与骨皮质平行的线状、层状、花边状影。 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 density and occurs in various of forms. 骨膜三角Codman三角 恶性骨肿瘤累及骨膜及骨外软组织，刺激骨膜成骨，肿瘤继而破坏新生骨骨质，其边缘残余骨质形成三角形高密度灶，是恶性肿瘤的重要特征。 骨质坏死:骨组织局部代谢的停止，坏死的骨组织称为死骨。X线表现为骨质局限性密度增高。多见于化脓性骨髓炎。 骺离骨折:骨折发生于儿童长骨，由于骨骺尚未与干骺端结合，外力可经过骺板达干骺端而引起骨骺分离。其骨折线不能显示，X线上显示骺线增宽或骺于干骺端对位异常。 青枝骨折greenstick fracture:在儿童，骨骺柔韧性比较大，外力不易使骨质完全断裂，仅表现为局部骨皮质和骨小梁的扭曲，而不见骨折线，或只引起骨皮质发生皱折、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:称伸展型桡骨远端骨折，为桡骨远端2—3cm以内的横行或粉碎性骨折，骨折远端向背侧移位，断断向掌侧成角畸形，可伴尺骨茎突骨折。 肺间质:肺泡、肺壁间的纤维结缔组织支架。 肺实质:具气体交换功能的肺泡、肺壁。 肺纹理:在充满气体的肺野，可见肺门向外呈放射分布的树枝状影。 空洞cavity:肺内病变组织坏死、液化，经支气管排出后留下的，X线显示大小不等边界清楚的密度减低区，多见于结核、肺癌。 The cavity is formed as result of the expulsion of necrotic material into the bronchus. 空腔intrapulmonary air contain lug space:肺内生理性腔隙的病理性扩大，如肺大泡bulla、含气囊肿cist及肺气囊。 结核球/结核瘤:纤维组织包裹的干酪性结核病灶，胸片上为边界清楚、密度较高的致密影，其直径一般在2厘米以上，其内可有钙化斑。 支气管充气症Air Bronchogram Sign:肺实变时，实变的肺组织内含气支气管呈树枝状低密度的现象，多见于炎症。 原发综合症primary complex:指原发肺结核的三个X线症—原发浸润(见于中 上肺叶)，淋巴管炎，肺门，纵膈淋巴结肿大。 The combination of the primary pulmonary tuberculous focus,lymphangitis and intrathoraclo lymphadenitis is known as primary complex. 反S症:胸部正位片右肺上叶肺不张时，由于不张肺叶体积缩小上叶向上移位，不张上叶下缘与肺门肿块上缘的连线呈横置S形。 毛刺症:周围型肺癌浸润性生长，发生渗出和增殖，X线显示肿块边缘长短不一细毛刺结构。 肺门舞蹈:肺动脉高压时，肺门血管搏动明显增强的现象，常见于左向右分流的先心痛。 心胸比率cardio-thoracic ratio(CTR):心影最大横径与胸廓最大横径之比。0..51~0.55为轻度增大，0.56~0.60为中度，大于0.60为重度。 The ratio between the maximal transverse diameter of the heart and the maximal width or the thorax. Kerley 线:间质肺水肿时出现各种间隔线，B线表现为肋膈角区横行线状密度增高影，见于肺动脉高压。A线见于上叶的斜形线状影，急性左心衰多见。C线为下肺叶网格状影，可见于重度肺静脉高压。 胸膜凹陷症:肺内病灶邻近脏层胸膜脐样，横断面常呈三角形凹陷，尖端指向病变，与病变间借索条影相连的现象。多见于恶性肿瘤，偶尔于良性肿瘤、慢性炎症或炎性肉芽肿。 相反搏动点opposite pulsation:后前位片上，左心缘左室段与肺动脉的搏动相反，两者交点称为~ The motion of the left ventricle is impart on systole,opposite to the outward pulsation of the pulmonary segment and the aortic knuckle.This is the point of opposite pulsation which serve a landmark of the left ventricle. 漏斗征:指主动脉弓与肺动脉段之间的小隆起，是未闭的动脉导管漏斗部在正位像上的投影。 Pancoast’s瘤:发生于肺间边缘部位的肺癌称~常破坏邻近椎体、肋骨，累及臂丛神经引起同侧臂痛，累及颈交感神经节引起Horner’s综合征(同侧眼睑下垂、瞳孔缩小和眼球内陷)。 双房影:后前为片上左心房向右增大明显时可达右房边缘或超过后者形成双重影。见于二尖瓣狭窄等左心房增大时。 假肿瘤症:闭袢型梗阻，即闭袢内充满大量液体的表现。其密度较高，在仰卧正位片上呈肿块影，侧卧水平照片上在该块影的上部显示出短小液面。见于绞窄性肠梗阻。 充盈缺损filling defect:由于消化管内占位性病变，造影时其位置造影剂无法填充，出现造影剂缺损的情况，此时，钡剂勾画的轮廓是肿块突向腔内的边缘。常见于肿瘤等。 Filling defect is caused by a space occupying mass producing defect on the barium. 龛影niche:溃疡形成的管壁凹陷被钡剂充盈，在切线位时形成局限性向轮廓外突出的阴影，称~多见于溃疡。 指压迹:造影像上，龛影口部癌结节呈向龛影的弧形压迹，谓之~，提示溃疡为恶性。 裂隙症:溃疡周边癌结节向溃疡口凸出，使龛影呈不规则树根状，谓之~或“角症 状”，提示恶性溃疡的特征影像。 穿透性溃疡:龛影深而大，深度、大小均超过1cm，龛影周围常有范围较大的水肿带。 穿孔性溃疡:龛影很大，如囊带状，其中常出现液面和分层现象，即气液钡三层或气钡两层现象。 狭颈症和项圈症:溃疡四周的炎症水肿向龛影内突出，切线位时龛影口部局限性狭窄，称狭颈症;若水肿明显，适当加压，龛影口部可见0.5~1cm宽，形态规律的密度减低影，称项圈症。二者均提示良性溃疡。 环提:位于溃疡龛影周围的宽窄不等的透明带，轮廓不规律则而锐利，其中常见结节状和压指切迹充盈缺损。 半月综合症:切线位横跨角切迹或胃小弯垂直部的半月形、龛底向内周围有宽窄不等的透明带(环提);轮廓不规律而锐利，其中常见结节状和压指切迹状充盈缺损(指压症)的龛影，提示胃癌。 跳跃症stirlin sign:病变的肠管由于炎症刺激状态，长时间痉挛收缩。钡剂在该处不能正常停留，而迅速推向下段肠管，出现病变肠管不显影，两侧肠管显影正常，称~。好发与回肠末端，常见于溃疡型肠结核。 结肠袋:由于结肠外纵肌长度比消化管短，加上肌环收据，结肠呈现为大小不等 ”。 的半月形囊袋状结构，即“结肠袋 肾自截:全肾广泛破坏、干酪样坏死钙化，X线显示全肾密度致密增高，肾功能完全丧失，称~，常见于晚期肾结核。 中央型肺癌的X线表现: 早期局限于粘膜内，可见异常表象。病变逐渐发展，支气管官腔逐渐狭窄至完全阻塞，相继出现局限性肺气肿，阻塞性肺炎和肺不张，如肿瘤同时向腔外生长和伴有非门淋巴结转移可在肺门部形成肿块，发生在右肺上叶支气管的肺癌，其肺门肿块与右肺上叶不张共同构成反“S”征。 周围型肺癌与结核球的鉴别: 周围型肺癌分叶状肿块，边缘小切迹，细小毛刺，支气管狭窄、阻塞、中断、缺损，可有空泡征，胸膜凹陷征;结核球好发于尖后段、下叶背段，多小于3cm，圆形或椭圆形，无切迹分叶，常有钙化及周围病灶。 露骨骨折的类型及X线表现: 线性骨折、凹陷性骨折、粉碎性骨折和穿入性骨折 颅骨骨折线与颅骨血管压迹不同，表现为:走向僵直，密度低，多不跨过颅缝。 1线性骨折:X线表现颅骨出现线样低密度负影，骨皮质不连续，骨小梁中断; 2凹陷性骨折:颅骨向内凹陷，断裂，小孩则不一定出现骨折线，紧表现为局部凹陷; 3粉碎性骨折:多块碎骨片形成，碎骨片可分离、凹入或重叠移位; 4传入性骨折是由于颅骨穿透伤所致。 早期胃癌的定义和X线表现: 早期胃癌是指肿瘤局限于粘膜或粘膜下层，肌层及浆膜层未受累，而不论其大小或是否有转移。分隆起型、浅表型及凹陷型三类。X线表现: 1隆起型:肿瘤呈类圆形突向胃腔。高度超过5mm，基地宽，表面粗糙;双重法及加压法显示为不规律的充盈缺损; 2浅表型:肿瘤表浅、平坦，形态不规律，隆起与凹陷不超过5mm，在良好的气钡双重造影及加压像上得以显示胃小区、胃小沟不规则，呈颗粒状，有轻微的 凹陷与僵直。、; 3凹陷型:肿瘤形成凹陷，深度超过5mm，形态不规则，双重法及加压法表现为小的龛影，周边粘膜出现杵状增粗或融合。 良恶性溃疡的鉴别: 1良性溃疡龛影形态为圆形或椭圆形，突出于胃腔轮廓之外;临近胃壁柔软，有蠕动波;粘膜向病变部位集中达到溃疡口部，无中断、破坏;口部有粘膜线、项圈征及狭颈征; 2恶性溃疡位于为轮廓之内，形态不规则有多个尖角;可见局部胃壁僵直、蠕动波消失;临近胃粘膜皱襞向病变部位纠集、中断、破坏、可见半月征、环堤征。 1.良恶性骨肿瘤的鉴别生长情况:良缓慢，不侵及邻近软组织，但可引起压迫移位;恶迅速，易累及邻近的组织器官。局部骨变化:良膨胀性骨质破坏，与正常骨界线清晰，边缘锐利，骨皮质变薄，保持其连续性;恶浸润性骨质破坏，与正常骨分界不清，累及骨皮质，造成不规则破坏与缺损，可有肿瘤骨。骨膜增生:良一般无，病理骨折后可有少量骨膜增生，骨膜新生骨不被破坏;恶多出现不同形式的骨膜增生，并可被肿瘤侵犯破坏。周围软组织:良多无肿胀或肿块影，边缘清楚;恶侵入的软组织形成肿块，与周围组织分界不清。2.第2孔型房间隔缺损的血液动力学改变及影像学表现由继发房间隔生长不足所导致的房间隔缺损称为第2孔型房间隔缺损，缺损位于房间隔的中部，此型占房间隔缺损的80%左右。血液动力学:正常情况下左房压力高于右房，房间隔缺损时，左房的血液可分流进入右房，分流的血液经右心系统、肺循环、左房，最后又回到右房，从而加重右心系统的负荷，导致右房的扩张和右室的扩张、肥厚。长期的肺血流量的增加使肺血管发生改变，并最终出现肺动脉高压。随着肺动脉压力增高，右房压力增高，分流量减少，甚至发生分流方向的逆转，呈右到左分流。影像学表现:心影增大呈二尖瓣心型，肺血增多，肺动脉段突出，肺门动脉扩张，外围分支增多增粗，搏动增强。主动脉结偏小或正常。右房右室增大，尤其右房增大为房间隔缺损的重要征象。3.周围型肺癌与结合瘤在影像学上如何进行鉴别,结核球好发于尖后段、下叶背段，多小于3cm，圆形或椭圆形，无切迹分叶，常有钙化及周围卫星灶。周围型肺癌分叶状肿块，边缘小切迹，细小毛刺，支气管狭窄、阻塞、中断、缺损，可有空泡征，胸膜凹陷征 4.良恶性溃疡的鉴别要点龛影形状:良圆形或椭圆形，边缘光滑整齐;恶不规则、扁平，有多个尖角。龛影位置:良突出于胃轮廓外;恶位于胃轮廓之内。龛影周围和口部:良黏膜线，项圈征，狭颈征等，黏膜线外皱襞向龛影集中直达龛口;恶指压迹样充盈缺损，环堤，皱襞中段破坏。附近胃壁:良柔软、有蠕动波;恶僵硬、蠕动消失。 5.左心房增大的X线表现和常见疾病后前位:右心缘呈双弧影，心影中可见增大的左房影。右前斜:食管左房段压迹明显，向后移位。左前斜:增大左房使左主支气管上移、变窄。左侧位:可见增大的左房。病因:二尖瓣病变、左室衰竭及 某些先心病，如动脉导管未闭。6.胃癌的X线表现1)充盈缺损2)胃腔狭窄胃壁僵硬3)龛影，形状不规则，多呈半月形，外缘平直，内缘不整齐而有多个尖角;龛影周围绕以宽窄不等的透明带，即环堤，轮廓不规则而锐利，其中常见到结节状和指压迹状充盈缺损4)黏膜皱襞破坏、中断或消失5)癌瘤区蠕动消失7.中央型肺癌的X线表现早期局限于黏膜内，可见异常表现:病变逐渐发展，支气管管腔逐渐狭窄至完全阻塞，相继出现局限性肺气肿，阻塞性肺炎和肺不张;如肿瘤同时向腔外生长和伴有肺门淋巴结转移可在肺门部形成肿块;发生在右肺 ”。8脊上叶支气管的肺癌，其肺门肿块与不张右上叶共同构成的下缘呈“反S征柱压缩性骨折、脊柱结核和脊柱骨转移瘤的X线诊断要点脊柱骨折一般单个椎体压缩成楔形，不见骨折线，反见一致密影，邻近椎间隙正常。结核多累及邻近两个或以上椎体，附件较少受累，椎体松质骨骨质破坏，椎体塌陷变扁或成楔形，邻近椎间隙变窄甚至消失，病变在破坏骨质时可产生大量干酪样物质流入脊柱周围软组织中形成冷脓肿。脊柱骨转移瘤多为多个跳跃性椎体广泛性骨质破坏，因承重压缩变扁，椎间隙保持完整，椎弓根多受侵蚀，破坏 9肺部基本病变有哪些，其病理基础和X线表现如何,1)肺实变:急性炎症反应，肺泡内液体渗出所致肺实变。X线表现为大小、数目不一致的斑片状模糊影2)增殖病变:为慢性肉芽肿性炎症。X线上呈密度增高的斑点状阴影3)纤维病变:为炎症修复期表现。X线上呈索条状阴影，排列不规则4)钙化病变:在组织坏死变性基础上有钙盐沉积。X线上呈边缘锐利的致密影，大小形状不一5)肿块病变:由肿瘤增殖或炎性肉芽肿所致。X线良性肿块的边缘光滑，恶性肿瘤边缘不规则，有分叶、毛刺征6)空洞与空腔:肺部病变坏死液化后，经支气管引流排出，使形成空洞;肺内腔隙病理性扩张，称为空腔。空洞和空腔X线大小和形状不一的透亮区7)支气管阻塞:由腔内阻塞或外在性的压迫所致，阻塞的原因可以是炎症、肿瘤等。支气管阻塞可以引起阻塞性肺不张、肺炎和肺气肿10.鉴别化脓性关节炎与关节结核化脓性关节炎急性起病，早期即可出现关节间隙变窄，骨端破坏先见关节的承重面，破坏区比较广泛，晚期表现为关节骨性强直。关节结核慢性发展，骨质破坏见于关节面边缘，然后才累及承重部分。关节间隙变窄出现晚，程度轻。关节囊肿胀、密度增高，邻近骨骼肌肉多有明显疏松和萎缩。11.食管静脉曲张X线:食管黏膜皱襞增粗、迂曲，连续性不中断，可见串珠状或蚯蚓状充盈缺损，管壁呈锯齿状改变，但仍柔软、舒缩自如。病理:是门静脉高压的重要并发症，常见于肝硬化。门静脉血液受阻时，来自消化器官及脾等的静脉血不能进入肝内，大量血液通过胃冠状动脉和胃短静脉进入食管黏膜下静脉和食管周围静脉丛，再经奇静脉进入上腔静脉，形成食管和胃底静脉曲张。与癌鉴别:癌病变局限，充盈缺损不规则，黏膜皱襞不规则破坏，管壁僵硬，蠕动消失 12.骨质疏松与骨质软化的区别定义:疏一定单位体积内正常钙化的骨组织减少即有机成分与钙盐成比例减少;软一定单位体积内骨组织有机成分正常而矿物质含量减少。组织学变化:疏骨皮质变薄，哈氏管扩大和骨小梁减少;软骨组织钙化不足，常见中央钙化周边不钙化。X线表现:疏骨密度降低，骨小梁变细减少，间隙增宽皮质出现分层变薄现象;软密度减低，骨皮质、骨小梁模糊，骨骼变形， 假骨折线。临床:疏见于废用性;软见于佝偻病13.骨肉瘤的好发年龄、好发部位及X线平片表现多见于青少年，好发于干骺端，可分为成骨型、溶骨型和混合型。X线表现:1)骨质破坏，与正常骨分界欠清2)肿瘤骨形成，表现可分为云絮状、放射状和象牙质样，溶骨型肿瘤骨形成相对较少3)骨膜反应，骨膜三角4)软组织肿块14.肺良性肿块和恶性肿块的鉴别要点形状:良多为球形，恶不规则。包膜:良有包膜，恶无包膜。边缘:良锐利、光滑;恶不锐利，有短细毛刺、分叶或脐样切迹。肿瘤坏死:良无、恶有，部分可形成空洞。生长:良慢，无周围浸润;恶快，呈浸润性生长15.第1孔型房间隔缺损病理:由心内膜垫发育障碍造成，缺损一般较大，下缘缺乏心房间隔组织，而由房室瓣和心室间隔的上缘组成。血流动力学:左心房血液通过缺损分流入右房，右房同时接受来自体循环和左房分流来的血液，血容量明显增大，大量的血液在右房、右室、肺血管、左房，最后又回到右房。肺循环的血量增加，右房和右室因负荷量过大而肥厚、扩张。左房血液同时经缺损和二尖瓣孔排血，负担无明显增加。肺动脉压力增大，出现右心衰，右房压力接近或超过左房压力，分流量减少，甚至出现逆分流。 X线表现:由于第一孔型房缺损伤常较大，整个心脏、大血管和肺部血管的改变较严重，心影明显增大，呈二尖瓣型，右房右室大，心尖园钝，位置较高，肺动脉段突隆肺充血，肺门血管增粗，搏动增强，即肺门舞蹈征 16.肺结核进展期可能变化1)病灶范围增大，或出现新的病灶2)空洞较前增大增多3)临床症状加剧，出现咳血、发热等4)痰菌培养转阳17.气管、支气管异物的X线检查方法及X线表现气管异物检查方法:颈部后前位显示纵形条状异物影，颈部侧位显示异物宽面。直接征象:气管内不透X线异物影。间接:阻塞性肺气肿，两肺透亮度增高，吸呼气时肺透亮度改变不明显。无纵隔摆动。支气管检查方法:后前位胸片。直接:不透X线异物影。间接:肺不张、纵隔摆动、阻塞性肺气肿18.心脏X线平片应从哪6个方面进行分析1)心脏大小2)心脏形态3)主动脉形状及密度的改变4)心脏、大血管搏动的改变5)肺循环的改变6)心血管造影的异常所见19.法乐氏四联症的血流动力学及X线平片表现血流动力学:膜部室间隔缺损，肺动脉狭窄，主动脉骑跨，右心室肥大。由于狭窄主要在右室流出道，心脏收缩期，右心室射血阻力增高，使右心室肥厚，内压增大，大于左心室压，未氧合的静脉血经室间隔缺损部进入左心室流出道和体循环，临床表现为紫绀，因大部分血液经左心室流出道射入主动脉，使主动脉管径明显增宽，左心室因回流血减少而缩小。X线表现:心脏大小正常或略缩小，心尖上翘呈羊鼻头状，心腰凹陷，右心室肥大，肺血减少，纵隔增宽20.周围型肺癌与肺结核球鉴别诊断部位:癌任何部位，结核球上叶尖后段，下叶背段。形态:癌不规则，结核圆或椭圆。边缘:癌分叶、毛糙，结核多光滑。密度:癌多均匀，偶有坏死和钙化，结核常有钙化。周围:癌无卫星灶，结核有卫星灶。远隔:癌肺门纵隔淋巴结肿大，结核肺门纵隔淋巴结钙化。动态:癌逐渐增大，结核一般不增大 21.肺脓肿性空洞、结核空洞、癌性空洞的鉴别急性肺脓肿在致密的实变区中出现含有液平的空洞，壁内缘可光滑或略不规整，慢性肺脓肿周围炎性浸润大部吸收，纤维结缔组织增生，表现为厚壁空洞，有或无液平;结核性空洞多发生在上肺野，较小，壁薄，壁内缘光滑，周围常有多发小斑片状或索条状卫星病灶，可有对侧的散播病灶;癌性空洞多见于老年，临床无急性病史，空洞壁内缘高低不等，可有癌结节，洞壁厚，可有分叶及毛刺征22.儿童长骨与成人长骨的区别儿童长骨为软骨化骨，出生时两端仍为骺软骨，由骨干、干骺端、骺、骺板组成;成人长骨分骨干和骨端23.原发性与继发性肺结核鉴别原发性:肺内原发病灶，淋巴管炎，淋巴结炎。继发性:多发于上叶尖后段，下叶背段，病灶多样性，慢性病程24.早期胃癌的定义与分型早期胃癌是指肿瘤局限于黏膜下层，肌层及浆膜层未受累，而不论其大小或是否有转移。分隆起型、浅表型和凹陷型25.怎样判断长骨骨折的移位及成角情况以骨折近端为固定点判断远端移位情况，两骨折断端纵轴相交角的角尖所指方向为成角方向