循环系统影像诊断学ppt文档1

心脏大血管影像诊断学正常表现与基本病变放射学院于广会[e-mail]tyTaishanmedicaluniversityReviewTaishanmedicaluniversityTaishanmedicaluniversityReviewCoronaryartery:leftmain开口于升主动脉左冠状窦左主干行走于左心耳与肺动脉主干起始部之间，长度6～10mm前室间沟分为前降支和左回旋支，也可发出中间支前降支与回旋支形成夹角，40°～150°，半数为直角前降支•前降支（LeftAnteriorDescending，LAD）•左主干的直接延续，从左主干发出，沿室间沟走行，绕过心尖，终止于心脏的膈面•分支分别向三个方向发出左室前支右室前支前室间支LeftCircumflex•左旋支（leftCircumflexBranch，LCX）•几呈直角起自左主干，沿左房室沟走行，先向左，然后从前绕向后，止于心脏膈面•分支•左缘支（ObtuseMarginalBranch，OM）•左室前支（Leftanteriumventricularbranches）•左室后支（Leftposteriorventricularbranches）•左房支（Leftauticularbranches）RightCoronaryArtery•开口于升主动脉右冠窦内，行走于右房室沟内，在肺动脉起始部与右心耳之间向下行走，通过心脏右缘至心脏膈面。在后室间沟与房室沟的交叉点附近分为后室间支和右旋支•窦房结支•后室间支•右旋支•右房支影像学检查方法X线检查造影检查和DSACTMRIUSTaishanmedicaluniversityＸ线摄影位置•后前位：远达片，靶片距2m•右前斜位：后前位左旋45～60°，服钡。观察左心房，肺动脉段，右心室漏斗部•左前斜位：自后前位右旋60°，观察各个房室和主动脉弓的全貌•左侧位：TaishanmedicaluniversityＸ线诊断的价值•肺血管纹理的异常、增多、减少•肺源性心脏病肺内病变的情况•胸部其他异常心包、胸膜、纵隔、骨骼、血管及瓣膜钙化TaishanmedicaluniversityTaishanmedicaluniversity心胸比率测量Taishanmedicaluniversity胸部X线正常表现：右前斜位胸部X线正常表现：左前斜位胸部X线正常表现：左侧位正常心脏外形体型、横膈位置、心胸比率、夹角Taishanmedicaluniversity影响因素性别年龄体位呼吸其它：妊娠、心动周期Taishanmedicaluniversity再回首TaishanmedicaluniversityTaishanmedicaluniversityLeftventricleangiography1房室间隔2漏斗间隔3二尖瓣后联合4前乳头肌5后乳头肌34125TaishanmedicaluniversityTaishanmedicaluniversityCT检查正常解剖血管成像冠状动脉冠脉钙化积分CT冠脉后处理AscendingAorta升主动脉DescendingAorta降主动脉PulmonaryArtery肺动脉SuperiorVenaCava上腔静脉LeftCoronaryArtery(LCA)左冠状动脉LeftMainArtery(LMA)左主干LeftAnteriorDescending(LAD)左前降支LeftMarginalBranch(LMB)左边缘支LeftCircumflex(LCX)左回旋支RightCoronaryArtery(RCA)右冠状动脉PosteriorDescendingArtery(PDA)后降支ConusBranch动脉圆锥支LeftAtrium左心房RightAtrium右心房LeftVentricle左心室RightVentricle右心室CardiacVein心脏静脉MitralValv二尖瓣CoronarySinus冠状窦CardiacAnatomy主动脉弓上层面主动脉弓层面主肺动脉窗AscendingAortaPulmonaryArteryDescendingAortaAscendingAortaPulmonaryArteryDescendingAortaCT平扫图象CT增强图象CardiacAnatomyAscendingAortaPulmonaryArteryDescendingAortaSuperiorVenaCavaAscendingAortaPulmonaryArteryDescendingAortaSuperiorVenaCavaCT平扫图象CT增强图象CardiacAnatomy小于29mmSuperiorVenaCavaSuperiorVenaCavaLMALMAAscendingAortaAscendingAortaDescendingAortaDescendingAortaLADLeftMarginalBranchLADLeftMarginalBranchCT平扫图象CT增强图象CardiacAnatomySuperiorVenaCavaAscendingAortaDescendingAortaLADLeftMarginalBranchLMALCXSuperiorVenaCavaAscendingAortaDescendingAortaLADLeftMarginalBranchLMALCXPulmonaryArteryPulmonaryArteryCT平扫图象CT增强图象CardiacAnatomySuperiorVenaCavaSuperiorVenaCavaDescendingAortaDescendingAortaPulmonaryArteryPulmonaryArteryLADLCxLCxLMBLMBLADLeftAtriumLeftAtriumCT平扫图象CT增强图象CardiacAnatomySuperiorVenaCavaSuperiorVenaCavaDescendingAortaDescendingAortaPulmonaryArteryPulmonaryArteryLADLCxLCxLMBLMBLADLeftAtriumLeftAtriumCT平扫图象CT增强图象CardiacAnatomyDescendingAortaLCxLMBLADLeftAtriumDescendingAortaLCxLMBLADLeftAtriumRightAtriumLeftVentricleLeftVentricleAscendingAortaAscendingAortaRightAtriumCT平扫图象CT增强图象CardiacAnatomyRCARCALeftVentricleLeftVentricleRightVentricleRightVentricleLeftAtriumLeftAtriumRightAtriumRightAtriumLCxLMBLCxLMBCT平扫图象CT增强图象CardiacAnatomyRCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMBRCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMBDescendingAortaDescendingAortaCT平扫图象CT增强图象CardiacAnatomyRCARCALeftVentricleLeftVentricleRightVentricleRightVentricleLeftAtriumLeftAtriumRightAtriumRightAtriumLCxLMBLCxCardiacVeinLMBCardiacVeinCT平扫图象CT增强图象CardiacAnatomyRCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMBRCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMBAorticValveDescendingAortaDescendingAortaCT平扫图象CT增强图象CardiacAnatomyRCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMBRCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMBAorticValveCardiacVeinCardiacVeinCT平扫图象CT增强图象CardiacAnatomyRCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMBRCALeftVentricleRightVentricleLeftAtriumRightAtriumLMBDescendingAortaDescendingAortaCT平扫图象CT增强图象CardiacAnatomyConusBranchConusBranchMitralValveRCALeftVentricleRightVentricleLeftAtriumRightAtriumLMBRCALeftVentricleRightVentricleLeftAtriumRightAtriumLMBCardiacVeinCardiacVeinCT平扫图象CT增强图象CardiacAnatomyRCALeftVentricleRightVentricleLeftAtriumRightAtriumLMBRCARightVentricleLeftAtriumRightAtriumLeftVentricleMitralValveDescendingAortaDescendingAortaCardiacVeinCardiacVeinCT平扫图象CT增强图象CardiacAnatomyRCALeftVentricleRightVentricleLeftAtriumRightAtriumRCALeftVentricleRightVentricleLeftAtriumRightAtriumDescendingAortaDescendingAortaCT平扫图象CT增强图象CardiacAnatomyDescendingAortaDescendingAortaRCALeftVentricleRightVentricleRightAtriumRCALeftVentricleRightVentricleRightAtriumCoronarySinusCoronarySinusCT平扫图象CT增强图象CardiacAnatomyRCALeftVentricleRightVentricleRightAtriumRCALeftVentricleRightVentricleRightAtriumDescendingAortaDescendingAortaCoronarySinusCoronarySinusCT平扫图象CT增强图象CardiacAnatomyRCALeftVentricleRightVentricleRightAtriumRCALeftVentricleRightVentricleRightAtriumDescendingAortaDescendingAortaCT平扫图象CT增强图象CardiacAnatomyRCALeftVentricleRightVentricleRCALeftVentricleRightVentricleDescendingAortaDescendingAortaCT平扫图象CT增强图象CardiacAnatomyRCALeftVentricleRightVentricleRCALeftVe