概论纵隔窗的CT解剖肺窗的CT解剖2肺、纵隔内部组织结构之间、正 常结构与病变之间的密度差异CT满意显示胸部正常结构和病灶 的夫体解剖旷定位、定量准确，为定 性分析提供形态学基础有关胸部CT检查技术的几个问题1、CT值与窗宽、窗位肺窗和纵膈窗，双2、层厚和层距吸气末扫描，薄层/重叠扫 描；减小部分容积效应、肺血坠积现象3、平扫和增强扫描LN,病灶，血管二4、高分辨CT High ResoIut ion ,HRCT层厚1 - - 2 mm,显示次级收磔回修吉构y 显示间质性病变、支扩6 o u1.507DFOV 320mmSTDSTD ，。1 .j|ODD r T T D s 3CI50/43 JUN 训））加训0Fni - J J 5-JI p.jDFOV 320mrSTD01491011290mmFOV 290mmPF-1.50D D T T s s主要观察内容1、纵膈有无纵膈肿块、多余结构LN有无肿大或/及增多“三管”结构形态（气道结合肺窗）2、较大范围的肺、胸膜（腔）病变的内部结构3；阅片顺序辨认每一层纵膈内的“三管”结自上而下、由近段向远段 .尧敢如破苴一姑痂王要层面和结构 主动脉弓及其以上层面辨认头臂血管 主肺动脉窗层面窗空虚/潜在，气管分叉，奇V弓 右上叶支气管层面左PA弓、右上PV前干,右上PA,上腔V 左上叶支气管层面右中间段支气管，右 PA,右下PA,左上PV,左PA降支其他肺门层面两侧大小基本对称（肺窗显示更佳），相伴随的支气管和PA分支,由近向远渐小1617Phrenic NSu，ACan you find the right and left subclavian arteries clic25The right subclavian artery as it dumps into the brachiocephalic artery,click to highlightT -.A --tITHU/hat are the yellow tiMilled black structures These are tlH ighlighted here click to highlightRight lung afeTrachea ancH Esophagus,This is contrast white tinto the left subclavian vBrachiocephalic Left Common CIncidental lipoma fat tumor density as fat in the chest wall27*Can you find the left brachiocephalic vein as it dumps intc pl click for answerWe are at the level of the top of the aortic arch click to hig山Can you find the right pectorahs major and minor click forWhat is the structure in blue click to highlight37、一Can you find the azygous arch where the azygousNotice the bifurcation ofthe trachea coriftia at this level click to46What is the structure in red click to highlightOHWrB-i3，left pulmonary artery.tn you find the pulmonary trunk and right pulmonary arteryTK3一 rWhere are the ascending A and descending D limb噩幽时thorgoeaorta click to highlight十We are at the level of the top of the left atrium.Notice The pulmoclumping into it as they return from the lungs,click to highlightm you find the left main coronary artery coming off the aorta47.rrYou canThe left co.Circumflex arteryLAD artery 咽Here is a good image of the aortic semi-l you find them click for answerunar valve leaflets50Here is a good image of the left atrium clumpingInto the left ventricle.Can you find it click to highlight52