读完此文，教你学会看胸片！

admin · 发表于 2020-10-20 12:15:59

<section data-id="134" data-color="#009896" data-custom="#009896" style="padding-left: 1em;padding-right: 1em;"><section><section><section data-brushtype="text">胸部正位片与胸部侧位片</section></section></section><section> </section></section>1.胸部正位片<img data-ratio="0.773109243697479" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OFcY9pga0OficQJoJ8qV0hw9f6W75lguVlJIKqQPM7NCBVPn6HUC0OoA/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="595" />临床拍标准的胸部正位片其实是后前位片，如上图。 <img data-ratio="0.8146551724137931" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0O3jiaC0GW6NjYChTXjBR75282ubNwXteOKvenLIp7m7FrcIiaded4I9ww/640?wx_fmt=jpeg" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" title="正常胸部X线.jpg" width="auto" data-w="464" />上图为正常胸部后前位片 2.胸部侧位片<img data-ratio="0.719327731092437" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OMaaFMQca2GXSZicP4fOEdzia9TGOlXObia5zqVCA5bqGKZYDLWce6YHhg/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="595" />胸部侧位片的拍摄，一般采取右侧位拍片，如果看心脏影可以采取左侧位片。 <img data-ratio="0.9850498338870431" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0O3TK8DQ2ibiaYtyvPe8mur8I1iatV7G5ibrHNubXowXgMbrC1IgNGgLhtVw/640?wx_fmt=jpeg" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" title="胸部侧位.jpg" width="auto" data-w="602" /> 下面为大家依次介绍胸部正常X线解剖 <section data-id="134" data-color="#009896" data-custom="#009896" style="padding-left: 1em;padding-right: 1em;"><section><section><section data-brushtype="text">1.肺叶段X线解剖 </section></section></section><section> </section></section><img data-ratio="0.7114624505928854" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OUuScPicEPKTRjYNZuSRsvlCsK3qkObtbOWGqY96KcTqoCjjOQs2p18A/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="506" />肺叶右肺：由水平裂和斜裂分为上、中、下三叶左肺：由斜裂分为上、下两叶 斜裂：起自第5胸椎水平，倾斜向前下，大致与第6肋骨平行，止于前胸膜沟（前肋膈窦）后方数厘米的膈肌处。 水平裂：大致呈水平走形，与第4前肋大致同水平，前部常低于后部，外侧部常低于内侧部。 <img data-ratio="0.7171875" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0O9cvWfQFibtiapzcia0iaIIx49ibrQSW4egU06uhtoZzcDjSLvIex1lR6zJw/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="640" />上图为：右肺上叶在正位与侧位的投影区域 <img data-ratio="0.7109375" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OwHjCbnuP1A1uBtEOKGdWUmfNeaFxrWMkd4QMzQZnr3qh8YAHUN1fhg/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="640" />上图为：右肺中叶在正位与侧位的投影区域  <img data-ratio="0.7125" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OCtzgx981fkSHXNnLN4ia5m9Rj6ue18bjmW7HVL7GzDHfLqmkVFnDygA/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="640" />上图为：左肺下叶在正位与侧位的投影区域由于正位片通常会有一定的的重叠，因此侧位片可以对重叠部位的区域的定位起到很好的补充！ <section data-id="134" data-color="#009896" data-custom="#009896" style="padding-left: 1em;padding-right: 1em;"><section><section><section data-brushtype="text">2.肺纹理</section></section></section><section> </section></section>肺纹理为自肺门向肺野呈放射状分布的树枝状阴影，它主要是肺动脉的投影，肺静脉、支气管和淋巴管也参与形成。肺纹理由肺门向外围延伸，逐渐变细，至肺野外带渐细小而稀少，距侧胸壁内缘约1cm范围内的肺野基本无肺纹理可见（图下图）。 <img data-ratio="0.46875" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0Ol88f2j5oNKUyibIVrrHhbjib4Lg0tZT2ueLckia7e5jibpym58mMmkI4iag/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="640" /> <section data-id="134" data-color="#009896" data-custom="#009896" style="padding-left: 1em;padding-right: 1em;"><section><section><section data-brushtype="text">3.肺野、肺带的划分 </section></section></section><section> </section></section><img data-ratio="0.5466237942122186" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0Okh12Y88nlErpsHicCZctgVdH8BKnicx966dvK5MX1ibgQ6AfEXjkUvlTQ/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="622" /> 纵隔两旁含气的肺在胸片上所显示的透明区域称肺野，其透明度随呼吸而改变，深吸气时肺内含气量增多，透明度增高，呼气时则相反。  <img data-ratio="0.7963302752293578" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OicQMlGiceJMHErrISnE1h1llak0wCrWgsqKEUT03UlrlZ25dOkCxtTkQ/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="545" /> 为便于指明病变的部位，通常人为地将一侧肺野纵向分为三等分，即内、中、外带。又分别在两侧第2、4肋骨前端下缘划一水平线，将肺野横向分为上、中、下三个肺野。(如上图)。 <section data-id="134" data-color="#009896" data-custom="#009896" style="padding-left: 1em;padding-right: 1em;"><section><section><section data-brushtype="text"> 4.肺门的大小和位置</section></section></section><section> </section></section>x线肺门指肺动脉、肺叶动脉、肺段动脉、伴行支气管以及肺静脉构成。 <img data-ratio="0.6171875" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OxiagVS4HFzPdafPjNIZ3es2ZY1pIiaAibctia5FaYFibSrKtCmib7VDB9N4w/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="640" /><img data-ratio="0.5739837398373984" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OWXiacccOtgssMIYr1zXvPibva9NdE0oAVb3ElHHzZLoU9BtiagOGPmJng/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="615" />右肺门可分为上、下两部。上部约占1/3，由上肺静脉、上肺动脉及下肺动脉后回归支构成。上肺静脉下后干构成右上肺门的外缘；右肺门下部 约占2/3，由右下肺动脉干构成，其正常宽度不超过15mm，沿中间段支气管外缘平行向外下走行。右肺门上、下部相交形成一钝的夹角，称肺门角，正常该角顶清晰。如下图 <img data-ratio="0.784375" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OX1aWaZ6MQia4icTgounFGloqtic3BecZJibQcQKyLfq10jJiczh2gupxDHw/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="640" /> <img data-ratio="0.5171875" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OFAHVMlOb8rb8j3ibqQFGzL8PofibDg086DCF917V3WgZibk1rZebV1U2g/640?wx_fmt=png" style="z-index: -1;cursor: pointer;font-size: 16.3636px;line-height: 23.2727px;box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="640" />左肺门亦分为上、下两部。上部由左肺动脉及其分支、左上叶支气管和左上肺静脉及其分支构成；下部由左下肺动脉及其分支构成，常被心影所遮盖。 <img data-ratio="0.721875" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OA7zIf7LKJNic677GYbfnRx4s0Xp4vQkaEPlPkX8WseHGuUMCXBY5iaKA/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="640" /> <section data-id="134" data-color="#009896" data-custom="#009896" style="padding-left: 1em;padding-right: 1em;"><section><section><section data-brushtype="text">5.心影位置及大小</section></section></section><section> </section></section><img data-ratio="1.055393586005831" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OgelJYM7ib6yJpUjzwXibhYuPrnlFYEogXwevtZKo4pMV5CDMyl44R9Rg/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="343" />T1:心脏最右缘至前正中线距离T2: 心脏最左缘至前正中线距离L:通过膈肌顶部至两侧胸廓内沿并平行于膈肌的线 心胸比=(T1+T2)/L1.正常<=0.502. 轻度增大 0.51-0.553. 中度增大0.56-0.604. 重度增大>=0.60 <section data-id="134" data-color="#009896" data-custom="#009896" style="padding-left: 1em;padding-right: 1em;"><section><section><section data-brushtype="text">6. 纵隔的分区</section></section></section><section> </section></section>纵隔位于胸骨之后，胸椎之前，介于两肺中间，从上至下、自前至后把胸腔分为左右两半。其上界是胸腔入口，下界为膈。两侧为纵隔胸膜和肺门。其中有心脏、大血管、气管、主支气管、食管、淋巴组织、胸腺、神经及脂肪等器官和组织。  <img data-ratio="0.484375" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0O5n02SR0ibly0D4GeNP2gLKTgedALMhhTPPWcdU0GRtmrwoXicOiay8IOw/640?wx_fmt=png" style="box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="640" /> 纵隔的分区对确定纵隔病变的部位和分析病变性贡有重要意义。一般采用九分区法，即在侧位胸片上将纵隔划分为前、中、后及上、中、下共九个区。 <section data-id="134" data-color="#009896" data-custom="#009896" style="padding-left: 1em;padding-right: 1em;"><section><section><section data-brushtype="text">7.胸廓</section></section></section><section> </section></section>正常胸廓由软组织与骨骼组成，两侧对称。 <img data-ratio="0.5875" data-type="png" src="http://mmbiz.qpic.cn/mmbiz/GY2dXcc1W2vYPvG4RndChC0rh34dJic0OoTaEpruukYW45nAqptHrZfrhQuVIYZLH1BfmibeAbiaiaVGeFnljrUkBQ/640?wx_fmt=png" style="line-height: inherit;box-sizing: border-box !important;overflow-wrap: break-word !important;visibility: visible !important;width: auto !important;" width="auto" data-w="640" /> ①骨性结构： 肋骨、锁骨、肩胛骨、胸椎 ②软组织结构：胸锁乳头肌、锁骨上皮肤皱褶、胸大肌、女性乳房                               来源：医学资源中心免责声明：本文版权归原作者所有，内容代表作者个人观点，转载分享，如有问题，请联系删除。 <p style="white-space: normal;max-width: 100%;min-height: 1em;font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", &quot

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