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MindMap Gallery Medicine-Respiratory System Mind Map
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Medicine-Respiratory System Mind Map
This is a mind map about medicine-respiratory system, which mainly covers trachea and bronchi lesions, lung lesions, pleura and chest wall lesions, pleura and chest wall lesions, chest trauma, etc.
Edited at 2023-11-29 00:06:32
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Medicine-Respiratory System Mind Map
- bacteria
This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
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- Outline
respiratory system
normal imaging performance
X-ray
thorax
skeleton
Common congenital variations of ribs: cervical ribs, forked ribs, and rib symphysis
During the development process of the scapula, a secondary ossification center may appear in the lower corner, which can easily be mistaken for a fracture.
Soft tissue
sternocleidomastoid muscle
pectoralis major
Female breasts and nipples
trachea
The trachea originates from the lower edge of the cricoid cartilage in the larynx, which is equivalent to the level of the 6th to 7th cervical vertebrae, and is divided into the left and right main bronchi at the level of the 5th to 6th thoracic vertebrae.
The width of the trachea is generally 1.5~2 cm
lung
Lung field
The lungs appear as transparent areas on both sides of the chest X-ray
The lower edges of the front ends of the 2nd and 4th ribs are divided horizontally into upper, middle, and lower areas, and longitudinally into inner, middle, and outer areas.
Lobe
Second from left, third from right
lung segment
hilum
The hilar shadow is the combined projection of the pulmonary artery, pulmonary vein, bronchi, and lymphoid tissue
The left side is 1~2cm higher than the right side
In normal adults, the width of the right lower pulmonary artery trunk is less than or equal to 15 mm. If it is greater than this value, it is pulmonary hypertension.
Lung texture
Arbor-like shadows radiating outward from the hilum of the lungs
Mainly composed of pulmonary arteries, pulmonary veins, bronchi, lymphatic vessels and a small amount of interstitial tissue
Mediastinum
The three-partition method is often used: on the lateral radiograph, the mediastinum is divided into three parts: anterior, middle and posterior.
Anterior mediastinum: The narrow triangular area located behind the sternum and in front of the heart, ascending aorta, and trachea.
Middle mediastinum: area occupied by the heart, aortic arch, trachea, and hilum
Posterior mediastinum: esophagus, thoracic paravertebral area
pleura
Divide into visceral pleura and parietal pleura
oblique split, horizontal split
diaphragm
Usually the right diaphragm is 1~2cm higher than the left diaphragm
Cardiophrenic angle - the angle between the inner side of the diaphragm and the heart; costophrenic angle - the sharp angle between the inner side of the diaphragm and the chest wall
Localized diaphragmatic bulging: In some patients with a weak diaphragm, a semicircular bulge may appear on the upper edge of the diaphragmatic vault, which is more common on the right side and is obvious during deep inhalation.
Wave diaphragm: During deep inhalation, the diaphragm becomes wavy.
CT
chest wall
The soft tissue and bones of the chest wall need to be displayed in the mediastinal window, and bone lesions can be observed using the bone window
trachea and bronchi
Low-density duct images can be seen on the lung window, and the direction of the bronchi is consistent with the lung texture.
Lobes and segments
Method to determine the location: Judgment based on the distribution of the corresponding bronchi and accompanying blood vessels and the general anatomical position
The pulmonary bronchi and their accompanying segmental arteries are located in the center of the pulmonary lobes and segments
Interlobar fissures and segmental veins form the lobes, the edges of lung segments
HRCT can observe pulmonary lobules (lobular core, lobular parenchyma, interlobular septa), Irregular polygon or frustum shape, with the base toward the pleura and the apex toward the hilum.
hilum
Mediastinum
Observed primarily through the soft tissue window (mediastinal window)
Lymph nodes are generally less than or equal to 1cm in ordinary people
5 gaps shown by CT
retrosternal space
prevascular space
pretracheal space
subcarinal space
diaphragm crural space
pleura
Under normal circumstances, the pleura cannot be seen. After seeing the pleura, the pleura is thickened.
Interlobar fissures are extensions of the pleura
diaphragm
MRI
Basic imaging manifestations of lesions
X-ray
Trachea, main bronchial lesions
obstructive emphysema
localized obstructive emphysema
Caused by larger bronchial stenosis
Increased translucency in one lobe or side of the lung and sparse lung texture
diffuse obstructive emphysema
Barrel-shaped chest, ribs deformed and flattened, intercostal space widened
The transparency of both lungs increases, and bullous shadows can be seen The lung texture becomes sparse and thinned, and the lung texture in the middle and outer lung lobes disappears.
The shadow of the heart is narrow and long, showing a vertical heart
obstructive atelectasis
The lung field on the affected side has a uniform and consistent density increase, the chest collapses, and the intercostal space narrows. The mediastinum shifts to the affected side, and the unaffected lung shows compensatory emphysema.
lung disease
alveolar consolidation
The gas in the alveolar space is replaced by pathological tissues such as inflammation, edema, and hemorrhage, which can produce patchy shadows.
X-ray signs
Consolidation density is high and uniform - ground glass density shadow
Air bronchogram—large alveolar consolidation lesions with air-containing bronchial shadows
tuberculosis, pneumonia
proliferative disease
Chronic inflammation of the lungs forms granulation tissue in the lung tissue (such as inflammatory pseudotumor, tuberculosis, silicosis)
X-ray signs
Nodular, flaky, mass-like increased density shadows
The lesions are highly dense and have clear borders
Dynamic changes are slow
fibrous disease
During the healing process of chronic inflammatory/proliferative lesions of the lungs, the fibrous component forms scars
X-ray signs
localized fibrosis
Stiff, cord-like high-density shadow with clear edges
When the range is large, it often causes the trachea and mediastinum to shift toward the affected side.
Chronic pneumonia, tuberculosis
diffuse fibrosis
Diffuse reticular, linear, and honeycomb-like shadows extending from the hilar area to the outer lung area
Against the background of reticular fibrosis, there are diffuse granular nodular shadows - reticular nodular lesions
Rheumatoid, chronic bronchitis, pneumoconiosis, scleroderma
Nodules and masses
Less than or equal to 3cm is a nodule, and greater than 3cm is a mass
Cavities and cavities
Cavities are pathological structures that are formed after the diseased tissue in the lungs is necrotic and is expelled through the drainage bronchi and inhaled gas.
Liquefaction of necrotic tissue in the cavity can form an air-liquid level, which is more common in lung abscesses.
Three x-ray manifestations of hollows
Moth-eaten cavity/wallless cavity
Thin wall cavity: below 3mm
Thick-walled voids: more than 3mm, mostly with gas-liquid level
A cavity is a pathological enlargement of a physiological cavity
Calcification
The density of the lesions is very high, the edges are clear and sharp, and they can be spots, lumps, or spherical shadows.
Hamartoma - popcorn calcification
Lymph nodes - eggshell calcification
Tuberculosis - annular calcification
Osteosarcoma - scattered nodular calcifications in both lungs
Alveolar microlithiasis – miliary/nodular calcification
Hilar changes
size change
Enlargement (unilateral/bilateral)
Zoom out (one side/both sides)
Density change
location change
Pleural lesions
pleural effusion
free effusion
tuberculous pleurisy
small amount of effusion
Moderate effusion
Massive effusion
localized effusion
encapsulated effusion
It is most common, such as in pleurisy, when adhesions occur in the visceral wall of the pleura, causing the effusion to be localized in a certain part of the pleural cavity.
interleaf effusion
Confined to horizontal or oblique fissures
Fluid under the lungs
A collection of fluid in the pleural space between the base of the lungs and the diaphragm
pneumothorax
Air enters the pleural cavity
X-ray signs
No lung markings, the width depends on the amount of air
When there is a large amount of pneumothorax, the pneumothorax area can occupy the middle and outer zones of the lung field, and the inner zone is the compressed lung.
hydropneumothorax
The coexistence of fluid and gas in the pleural cavity is a hydropneumothorax
Pleural thickening, adhesions, and calcification
Caused by inflammatory fibrin exudation, granulation tissue hyperplasia, and traumatic bleeding organization
X-ray signs
Mild, the costophrenic angle becomes flattened and shallowed, and diaphragmatic movement is slightly restricted.
Extensive adhesions: collapse of the thorax on the affected side, narrowing of the intercostal space, increased density of the lung field, elevated diaphragm, flattening of the diaphragm roof, and mediastinal shift to the affected side
pleural tumors
It appears as a hemispherical, flat, mound-shaped or irregular mass with uniform density and clear edges.
Fibrous tumors, mesothelioma, metastases
Diffuse mesothelioma, which may be associated with pleural effusion
Metastasis may be accompanied by rib destruction
mediastinal changes
Mediastinal widening is the most common
Diaphragmatic changes
CT
trachea, main bronchi
obstructive atelectasis
obstructive emphysema
lung disease
alveolar consolidation
proliferative disease
fibrotic lesions
HRCT manifestations of diffuse interstitial pulmonary fibrosis
Leaflet core enlargement
Intralobular interstitial thickening
Interlobular septal thickening
Abnormalities of the bronchovascular bundle
subpleural arc shadow
honeycomb shadow
traction bronchiectasis
Nodules and masses
vacuole sign
Gas density shadows with a diameter of 1 to 3 mm can sometimes be seen in the lesions, which are more common in lung cancer.
Lobation sign
Burrs can be seen on the edges of peripheral lung cancer nodules or masses, and the outline may have multiple arc-shaped bulges.
pleural invagination
Formation of pleural traction caused by adjacent pleural nodules, seen in peripheral lung cancer
Ground glass nodule (GGN)
Refers to the nodules in the lungs that are slightly high-density and do not cover up the pulmonary blood vessels.
Small nodules in the lungs
Refers to nodular lesions below 1cm, and miliary nodules below 3mm.
HRCT manifestations of small intrapulmonary nodules
Hematogenous nodules
perilymphatic nodules
centrilobular nodules
small airway nodules
branch sign
There are small nodules and short-line shadows in the center of the lobules, which are connected to the branches of the bronchial and vascular bundles, like branches.
Cavities and cavities
Air half-moon sign: There are spherical objects in the cavity, most commonly seen in aspergillus balls, and a half-moon-shaped air shadow is formed between the aspergillus balls and the cave wall.
Calcification
Hilar changes
Pleural lesions
pleural effusion
small amount of effusion
High on the outside and low on the inside
Moderate effusion
The inner edge of the posterior chest wall has a crescent shape with neat edges.
Massive effusion
The entire chest cavity is occupied by a fluid-like density shadow
encapsulated effusion
A convex fluid shadow protruding from the chest wall to the lung field, with a wide base, mostly at an obtuse angle with the chest wall, and a smooth edge, forming the pleural tail sign
Does not change with changes in body position
Pneumothorax and hydropneumothorax
Pneumothorax appears on the lung window as a highly radiolucent area with no lung markings on the lateral side of the lung.
The medial pneumothorax can be seen as an arc, and the visceral pleura shows a thin line-like soft tissue density shadow.
Lung tissue is compressed and atrophied to varying degrees
Pleural thickening, adhesions, and calcification
pleural tumors
mediastinal changes
MRI
Application value and limitations
X-ray
Two-dimensional imaging, overlapping images, prone to misdiagnosis
Low density resolution, small GGN, easy to miss diagnosis
Cannot directly display lesions in the mediastinum
CT is significantly better than X-ray
MRI is insensitive to display calcifications and is rarely used in chest trauma
Comprehensive economy, simplicity and practicality, safety principles
chest trauma
Tracheal and bronchial lacerations
It is more common near the carina, often 1~2cm below the carina, more on the left side than on the right side.
Pulmonary contusion and laceration
Laceration: terminal trachea, blood vessel rupture
Videography
X-ray
Pneumothorax, pneumomediastinum, subcutaneous emphysema and other indirect signs
CT
It is difficult for conventional CT to show mild to moderate symptoms, but the three-dimensional reconstructed tracheal tree can be seen on multi-slice spiral CT.
Clinical pathology: interstitial and intraparenchymal fluid exudation, more common in the periphery of the lungs
Rib fractures
It can be single or multiple. A single rib can have double fractures or multiple fractures. It is more common in ribs 3 to 10.
Clinical pathology: The main symptoms are chest pain, which is aggravated during breathing and activities, lasts for a long time, has multiple rib fractures, and causes abnormal movement of the chest wall during breathing.
Videography
CT: can sensitively detect rib fractures and show costal cartilage fractures
X-ray
Complete fracture: The continuity of the rib cortex is interrupted, and the broken ends are well aligned/displaced
Incomplete fracture: the long axis of the bone is twisted and the bone cortex on one side is separated
Secondary signs: pneumothorax, hydropneumothorax and pneumomediastinum
Diaphragm disease
Three holes: aortic hole, esophageal hole, vena cava hole There are four septal openings: two anterior: the anterior and inferior rib-sternal spaces, and two posterior: thoracoabdominal hiatus, which are common sites for diaphragmatic hernia.
Diaphragmatic hernia
hiatal hernia
Most common, common in infants and young children
parasternal hernia
Gastrointestinal tissue seen next to sternum on CT
thoracoabdominal hiatal hernia
The most common congenital diaphragmatic hernia in babies is mostly on the left side
Videography
X-ray
CT
MRI
Traumatic diaphragmatic hernia
diaphragm distension
Congenital dysplasia/acquired atrophy, the muscle layer becomes weak and lifts up into the chest cavity
clinical pathology
A middle-aged and elderly man, asymptomatic, had dyspnea, chest pain, and upper abdominal discomfort when the interval rose to 3 anterior ribs. Localized, more common on the right side; diffuse, more common on the left side
X-ray
It is obvious when inhaling, the density is uniform, and the edges are smooth
Differential diagnosis
Diaphragm paralysis, the elevation is not as obvious as diaphragm expansion, but the range of contradictory movements is large
Diaphragmatic hernia, with normal septal height and overall mobility, usually with localized elevation.
Diaphragmatic paralysis
The phrenic nerve is injured, the diaphragm is relaxed and lifted up, and there is no activity during breathing and abnormal movement.
X-ray
The septal elevation is not obvious and the range of contradictory movements is large.
Diaphragm tumor
mediastinal lesions
Mediastinal tumors and tumor-like lesions
intrathoracic goiter
Moves when swallowing, mostly benign
clinical pathology
Retrosternal goiter, common
Vagal goiter, rare
Videography
X-ray
CT
Higher density, common cystic degeneration, hemorrhage, calcification, compression and displacement of adjacent structures
MRI
T1 is low, T2 is high
thymoma
clinical pathology
More common in adults, 30% to 50% have myasthenia gravis
Videography
CT
It is round, can be divided into lobes, mostly located in the middle of the anterior mediastinum, and a few are located in the neck, pleura, and lungs.
Enhancement: The solid part is uniformly enhanced
teratoma
Composed of somatic cells of two or three germ layers, common mediastinal tumors, retrosternal, prevascular
clinical pathology
Mature: Dermoid cyst
Immature: may contain embryonic or fetal-type tissue, or consist of three germ layers
Videography
X-ray: The junction between the heart and the great blood vessels, more on the left than on the right, often round, with lighter and uneven density. There may be scattered irregular calcifications in the tumor, and there may be teeth and bones.
CT: Thick-walled unilocular or multilocular cystic mass with mixed density including fat, calcification or bone, watery density and soft tissue
Other non-neoplastic lesions of the mediastinum
Mediastinitis
pneumomediastinum
mediastinal hematoma
Lymphoma (malignant)
clinical pathology
Hodgkin's disease is the most common and occurs in young people; non-Hodgkin's lymphoma is more common in adolescents
X-ray
The mediastinum is widened, mainly the upper mediastinum, with clear edges and may be lobulated.
neurogenic tumors
90% are located in the posterior mediastinal paravertebral space
Videography
X-ray
Most of them are located next to the posterior mediastinal spine, with an inner round or dumbbell shape. It can be seen that the intervertebral foramen is enlarged and the adjacent bone is destroyed.
CT
Benign ones have smooth and sharp edges; malignant ones have unclear infiltrative growth boundaries and uneven internal density.
MRI
Other rare tumors and cysts in the mediastinum
Lipomas and liposarcoma
bronchial cyst
Videography
X-ray
It is a round, uniform and dense shadow, which can also be lobed. The border on one side close to the trachea or bronchi is usually straight, and the corresponding wall is slightly compressed.
CT
Adjacent to the air inlet, the outer edge is smooth and sharp
Serous cyst 0~20Hu
Mucinous cyst 30~4 is Hu
Cyst combined with infection or intracystic bleeding for more than 30Hu
The contents contain calcification or oxalic acid crystals 100 Hu
There is uneven density of blood clots
pericardial cyst
Clinical pathology: clear liquid inside
Videography
X-ray
Most of them are located at the right cardiophrenic angle. They are mostly round or oval in shape, with smooth and clear outlines. On the lateral view, they are teardrop-shaped, with an upper tip and a rounded lower part.
CT
There is no liquid in the cyst, it is not smooth, and there is mostly no calcification.
MRI
Cystic t1 is high, mucinous (high protein content) t1 is high and t2 is high
Pleural and chest wall lesions
pleurisy
Videography
X-ray
Acute stage: free pleural effusion, enclosed effusion, blunting of costophrenic angle, air-fluid level
Pneumothorax and hydropneumothorax
Rupture of the visceral pleura or pleural wall
Pleural thickening, adhesions and calcification
Videography
X-ray
Commonly seen in the costophrenic angle, which becomes blunt, flattened, or disappears
Extensive, intercostal space narrowing, diaphragm elevation, mediastinal shift to the affected side
pleural tumors
primary pleural tumor
Mesothelial cells and fibroblasts originating from the pleura
pleural metastases
chest wall lesions
lung disease
congenital lung disease
pulmonary sequestration
pulmonary arteriovenous fistula
lung inflammation
Lobar pneumonia
Pathogenic bacteria: Streptococcus pneumoniae
clinical pathology
A young adult with sudden high fever, chest pain, and coughing up rust-colored phlegm.
Hyperemia period: 12~24h
Red hepatoid degeneration stage: 2 to 3 days, a large amount of fibrin and red blood cell exudates
Gray liver-like degeneration stage: 4 to 5 days, large amounts of fibrin and white blood cells
Dissipation period: one week after onset of illness
Location: lung lobes, lung segments
image
X-ray (exudation and consolidation)
Congestive period: not obvious
Consolidation stage: large areas of uniform dense shadow, air bronchogram
Dissipation stage: scattered, patchy shadows of different sizes and irregular distribution, with cord shadows and thickened lung texture appearing after absorption.
CT
air bronchogram
Bronchopneumonia/lobular pneumonia
Pathogenic bacteria: Staphylococcus, Streptococcus, Pneumococcus
clinical pathology
The elderly, the weak, the sick and the young; high fever, cough, foamy sticky sputum/purulent sputum, accompanied by difficulty breathing, cyanosis and chest pain, emphysema and atelectasis may occur
image
X-ray
The middle and lower fields of both lungs, the inner middle zone
Spots/patches with increased density, the edges are light and blurred, and the lesions can merge into flakes/large flakes
Lobular exudation and consolidation, increased and disordered lung markings, and localized emphysema
CT
Diffuse patchy shadows, typically in the form of alveoli with blurred edges, distributed along the bronchi
Mycoplasma pneumonia
Pathogenic bacteria: Mycoplasma is spread through the air (oral and nasal secretions)
Laboratory: Mycoplasma antibody positive, 2 to 3 weeks after onset, cold agglutination test ratio increased, up to 1:64
interstitial pneumonia
Infection: mainly mycoplasma, more common in children
Clinical pathology: shortness of breath, cyanosis, cough, nasal flaring Serous fluid exudation and inflammatory cell infiltration in the bronchiolar and alveolar walls, and there may be mild exudation in the alveolar cavity.
image
X-ray
It often occurs near the two lung hilums. The grid-like density in the lower lung field increases, the hilar shadow increases, the density increases, and the structure is unclear.
CT
Diffuse reticular shadows can be seen in the lung fields on both sides, and the lower lung fields are obvious.
HRCT shows interlobular septal and interlobular pleural thickening
severe respiratory distress syndrome
Caused by SARS coronavirus, ground glass density shadow
lung abscess
clinical pathology
Acute: high fever, chills, cough, chest pain, coughing up a large amount of purulent sputum with a fishy smell, divided into three layers after being placed, poisoning with blood in the sputum, obvious symptoms, increased wbc
Chronic: cough, purulent sputum/purulent blood sputum, chest pain, weight loss, decreased WBC
Large exudation, consolidation, central necrosis, liquefaction, cavitary abscess, and surrounding fibrous hyperplasia
image
X-ray: cavity, gas-liquid plane
Acute stage (<3 months): large dense shadow with blurred edges, central cavity, and liquid level visible in the cavity
Chronic stage (>3 months): uneven density, clear edges, cavities inside, multiple rooms connected, multiple branches connected, multiple leaves may be affected
CT
air bronchogram, air-fluid level, fluid-fluid level
tuberculosis
Pathogenic bacteria
Mycobacterium tuberculosis
clinical pathology
Symptoms: Cough, hemoptysis, chest pain, low-grade fever, night sweats, fatigue, loss of appetite, and significant weight loss
Diagnosis: Mycobacterium tuberculosis was found in sputum examination, sputum culture was positive, and tuberculosis lesions were found in bronchoscopy
Pathology: mainly exudation, proliferation, and deterioration
Classification
Primary tuberculosis (type I)
Initial infection, common in children, rarely seen in young people
primary syndrome
Primary lesion, local lymphangitis, associated lymphadenitis
image
X-ray
Cloudy/round-like shadow with increased density, blurred edges, mostly seen in the lower part of the upper lobe or the upper part of the lower lobe near the pleura, dumbbell-shaped
CT - can clearly show the primary syndrome and can show the atelectasis of the lung lobes and segments caused by enlarged lymph nodes compressing the bronchus, etc. and can sensitively detect pleural changes adjacent to the primary lesion
intrathoracic lymph node tuberculosis
When the primary lesion is completely absorbed, the mediastinal and hilar lymph nodes are enlarged
image
X-ray
Inflammatory type: high-density shadow extending outward from the hilus, with blurred edges
Nodular type: a prominent round/oval high-density shadow with clear boundaries in the hilar area, more common on the right hilus
CT
Lymph node plain scan: unclear boundary with surrounding tissue, enhanced ring enhancement
Blood group disseminated pulmonary tuberculosis (type II)
Enters the bloodstream via lymphatic vessels via the thoracic duct
Acute miliary tuberculosis (Sanjun)
image
X-ray
Diffuse miliary nodules in both lungs, 1 to 2 mm in diameter, independent of bronchial shape "Three Uniforms" (even distribution, uniform size, uniform density) clear edges
CT
HRCT shows three uniform
Subacute/chronic blood group disseminated pulmonary tuberculosis (three uneven)
image
X-ray
Three uneven
Secondary tuberculosis (type III) (Most common)
Mostly in the lung apex, subclavian area, lower lobe lung segment
Videography
X-ray
Exudation and infiltration type is the main type
Most of them are patchy or cloudy, with blurred edges.
Cheese-based
tuberculosis balls
Predilection: posterior section of upper leaf tip, dorsal section of lower leaf
Scattered proliferative/fibrotic lesions and satellite lesions are seen in adjacent lung fields
Spot-like/annular calcifications can be seen in some tuberculosis balls
Visible thick-walled voids
Caseous pneumonia
Moth-eaten/wallless cavities, air bronchial phenomena
Cavity-predominant type (fibrosis)
The main source of infection of tuberculosis
Due to fiber contraction, the ipsilateral hilus lifts up and the lung texture is vertically drooping like a willow.
The ipsilateral thorax collapses, the adjacent intercostal space narrows, the mediastinum shifts to the affected side, and the costophrenic angle becomes blunt.
CT
Tuberculous pleurisy (type IV)
Commonly seen in children and adolescents, it is divided into dry and exudative tuberculous pleurisy
Dry
Slight pleural effusion and thickening
exudative
Pleural effusion, long course of disease causes pleural thickening, adhesions, and calcification
Videography
X-ray
free pleural effusion
A small amount of effusion and blunting of the costophrenic angle
Fluid at the base of the lungs
interleaf effusion
encapsulated effusion
Other extrapulmonary tuberculosis (type V)
Pulmonary mycosis
Pulmonary aspergillosis (most common fungal disease)
Pathogenic bacteria: Aspergillus fumigatus
Videography
X-ray
air half moon sign
Cavity/intracavitary spherical nodule/mass
CT
Air half-moon sign, halo sign
Pulmonary cryptococcosis
Pathogenic bacteria: Cryptococcus neoformans
Causes: Inhalation of soil, milk, pigeon droppings, rotten fruits
Pulmonary parasitic disease
Schistosomiasis
paragonimiasis
Pulmonary hydatidosis/hydatid disease
X-ray CT
Cysts are round/oval in shape, often found in the lower lung field, and are more common in the lower lung field of the right lung. The density is uniform, the edges are smooth and clear, and there are ring-shaped calcifications on a few edges.
External capsule rupture, crescent-shaped radiolucent zone
Internal and external capsule rupture, air-fluid level
Separation of internal and external capsules, floating lotus sign
cyst rupture
Contents spilled out
annular thin-walled cavity that is then completely closed
secondary infection
The edges are blurred, flaky, and lose their original shape.
into the chest
Formation of pneumothorax and hydropneumothorax
lung tumor
Lung malignant tumors
central lung cancer
Occurrence of segmental and above-segment bronchi, more common in squamous cell carcinoma
Growth mode: Intratube type, outside tube type, tube wall type
X-ray
Early stage: diameter less than 2cm, no abnormality, obstructive emphysema, obstructive pneumonia Middle and late stage: mass in hilar area, obstructive atelectasis
Direct signs: mass (hilar area, there may be eccentric cavities), bronchial changes (body CT)
Indirect signs: obstructive emphysema, obstructive pneumonia, obstructive atelectasis, reverse S sign, transverse S sign
Signs of metastasis: lymph node enlargement, cancer thrombus formation, bone destruction
CT
Indirect signs: mucobronchial sign, digital sign
peripheral lung cancer
Early stage: solitary nodular lesions less than 2cm, small flakes of ground-glass opacity
X-ray
Nodular shadows/small patches of ground glass shadows, cavities (eccentricity), calcifications
CT
Can be round or irregular in shape, vesicle sign, air bronchus sign
Intrapulmonary mass lobulation sign, spiculation sign
Pleural indentation sign, vascular clustering sign
tumor enhancement
diffuse lung cancer
CT
Enhancement: air bronchial sign, angiographic sign
Other malignant tumors
Pulmonary metastasis (hematogenous metastasis is the most common)
Choriocarcinoma>Breast cancer>Liver cancer>Gastric cancer>Osteosarcoma>Thyroid tumor
CT
Hematogenous metastasis: multiple or single nodules, clear and smooth edges, halo sign during bleeding
Lymphatic metastasis: bead-like changes or irregular thickening, with hilar lymph node enlargement
Direct spread to adjacent organs
Air bronchogram, irregular narrowing, twisting and stiffness, disappearance of small branches and fragmentation, enhanced angiographic sign
benign lung tumors
hamartoma
Abnormal development of endoderm and mesoderm
clinical pathology
Central hamartoma: compresses the trachea, causing cough, sputum production, fever, chest pain, and may be accompanied by atelectasis
Central hamartoma: cartilage, fibrous tissue, smooth muscle, fat
image
X-ray
Central type: obstructive pneumonia, atelectasis and other manifestations
Peripheral type: solitary nodule with clear and smooth edges, lobulated shape, and may have popcorn-like calcification.
CT
Peripheral type: round/quasi-round, with clear and smooth edges, lobulation, no spiculation sign, spotted popcorn-like calcifications
Pneumoconiosis (pneumoconiosis)
image
Small shadow is less than or equal to 10mm
Round shape: silicosis
Irregular: asbestosis, atypical silicosis
Large shadow larger than 10mm
Frequent: upper lobes of both lungs
Long strip/eight shape, typical silicosis
small shadow gathering
Pleural spots
Commonly seen in asbestosis
Changes in lung texture
hilum
eggshell calcification
Silicosis/silicosis
Clinical: Asymptomatic/cough in early stage; dyspnea, cyanosis, hemoptysis in late stage
X-ray
Lung texture
In the early stage, it increases and thickens, in the late stage, emphysema worsens and lung texture decreases.
Silicon nodules and fusion
A 3mm solitary nodule, which after fusion is seen in the outdoor areas of both upper lungs, is a large nodule that is symmetrical and wing-shaped in both lungs.
hilum
Enlargement and thickening, lymph nodes, eggshell calcification, advanced hilar upward movement, stump sign
Emphysema
pleura
Early costophrenic angle blunting/disappearance, early pleural thickening and calcification
merged nodules
Located at the apex of the lung/supraclavicular area
idiopathic pulmonary fibrosis
sarcoidosis
Wegener's granulomatosis
Tracheal and bronchial lesions
congenital bronchial cyst
The edges are smooth and sharp, and a few cyst walls have arc-shaped calcifications.
bronchiectasis
It is more common in children and adolescents, and is more common in the lower lobe of the left lung, the lingual segment of the left lung, and the lower lobe of the right lung.
Clinical and Pathological
Cough, expectoration, hemoptysis Chronic inflammation destroys the bronchial wall causing dilation and deformation
columnar bronchiectasis
The far end is approximately equal to the near end
cystic bronchiectasis
Distal > proximal, the distal end is balloon-shaped
Varicose veins
The bronchi are irregular in shape, resembling varicose veins
Imaging manifestations
X-ray
More severe: increased lung texture, thickening, and disordered arrangement Cystic bronchiectasis: cystic/honeycomb shape, multiple round/oval lucencies, visible air-fluid level
CT
First choice for confirmed diagnosis: HRCT
Column: orbit sign, signet ring sign, finger set sign
Cystic: Grape cluster shadow
Varicose veins: beaded
MRI
chronic bronchitis
Chronic non-specific inflammation, more common in the elderly
Clinical and Pathological
4 (cough, phlegm, asthma, inflammation) 3 (at least three months every year) 2 (more than two consecutive years)
Imaging manifestations
X-ray
Increased, disordered, twisted and deformed lung texture
Orbit sign
knife-shaped
pulmonary hypertension
CT