X0016:[转帖]Chest Radiography and Pulmonary Embolus

rjbjl

atelectasis and parenchymal densities are quite common.
the areas of atelectasis are more common
in the lower lobe as are the areas of parenchymal density.

[本贴已被 翁志蓬 于 2004-4-23 16:45:57 修改过]

[本贴已被 rjbjl 于 2004-4-23 17:06:03 修改过]

rjbjl

most of these densities   are caused by pulmonary
hemorrhage and edema  and can be confused
with infectious infiltrates or malignant masses.

[本贴已被 rjbjl 于 2004-4-23 17:05:33 修改过]

rjbjl

pleural effusions are common and most often
unilateral despite the fact that most clots are bilateral.
these effusions are usually visible when the
patient seeks medical attention.  
they are almost always small,
occupying less than 15% of a hemithorax and
rarely increase in size after 3 days. any increase
in size after 3 or 4 days should raise the suspicion
of a pulmonary infection or re-embolization.

rjbjl

pleural based opacities with convex medial margins
are also known as a hampton&#39；s hump.  
this may be an indication of lung infarction. however,
that rate of resolution of these densities is
the best way to judge if lung tissue has been infarcted.
areas of pulmonary hemorrhage and edema resolve
in a few days to one week. the density caused
by an area of infarcted lung will decrease slowly over
a few weeks to months and may leave a linear scar.

rjbjl

a diaphragm may be elevated,
reflecting volume loss in the affected lung.

rjbjl

the central pulmonary arteries may be prominent
either from pulmonary hypertension or the
presence of clot in those arteries.

rjbjl

a westermark&#39；s sign implies an area of decreased vascularity and
perfusion accompanied by an enlarged central pulmonary
artery on the affected side.  

rjbjl

cardiomegally is a non-specific finding but may imply an
enlarged right ventricle as seen in the patient
who presented with large bilateral pulmonary emboli.

rjbjl

pulmonary edema is an uncommon finding in this group.
this patient was originally diagnosed as suffering
from pulmonary edema but in fact had multiple areas of infarction.

in conclusion, the chest x-ray can be normal
in a minority of cases and abnormalities,
when present, are often non-specific.

rjbjl

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