上期试题：真菌性肺炎最常见的病原菌是A

A.白假丝酵母菌

B.曲霉菌

C.毛霉菌

D.新型隐球菌

E.卡氏肺孢菌

患者，女，60岁,咳嗽、咳痰20天，青光眼，2型糖尿病，即往每年体检胸片未见明显异常，最近一次为一年前。

CT显示：

左后上侧胸壁见一丘状软组织块影突向胸腔，与胸壁宽基底相连，钝角相交，其密度均匀，瘤肺界面清楚，增强呈明显不均匀强化，内见细条状血管影，局部肋骨未见明显骨质破坏吸收，肋间隙及胸壁软组织无异常改变。肺门及纵膈未见明确肿大淋巴结，两侧胸腔未见胸水。

Leftupperchestwallafterseeadomaltutothechestofthemasses,connectedwithwidechestwallbase,obtuseAngleintersection,theuniformdensity,tumorlungclearinterface,unevenenhancementisobviouslyimproved,seethinstripsinvessels,bonedestructionpartialribsnotseenobviousabsorption,ribsandchestwalltissuewithoutclearancechanges.Noclearenlargedlymphnodeswereseeninthelungandmediastinum,andnochestwaterwasseenoneithersideofthechest.

CT上该类肿瘤均表现为边缘清楚、光滑性肿块影,部分肿瘤可见轻中度分叶,这与大体病理标本所见基本一致。平扫肿瘤常表现为软组织密度影,多数肿瘤密度不均匀,肿瘤内部分病例可见到钙化样密度影及低密度影；注射对比剂后肿瘤明显不均匀强化,其内的低密度区更加明显,低密度影与肿瘤内部出血、液化及坏死有关,动脉期病变内有时可见明显的血管影，三维重建图像更能显示病变内部细微结构及与周围的肺组织、支气管的关系，以及病变与胸膜及纵隔关系。

AllthetumorsonCTshowedaclearandsmoothtumor,andsomeofthetumorsshowedmildandmoderatelobes,whichwerebasicallyconsistentwiththegeneralpathologicalspecimens.Thetumorisusuallycharacterizedbysofttissuedensity,andmosttumordensityisnotuniform,andthedensityshadowandlowdensityshadowofcalcifiedsamplesareseeninsomecasesinthetumor.Tumorobviouslyunevenreinforcedafterinjectionofcontrastagent,whichthelowdensityareaofthemoreobvious,lowdensityassociatedwithinternalbleeding,liquefactionandtumornecrosis,obviousbloodvesselswithinthearteriallesionssometimesvisible,3dreconstructionimagescanshowmorelesionsintheinternalstructureandtherelationshipwiththesurroundinglungandbronchus,andpleurallesionsandmediastinalrelations.

MSCT重建图像有利于发现相邻肺组织的移位和肿瘤边缘变窄，以及受压后明显强化的肺不张，为定位、术前诊断提供更大的帮助。MRI表现:在T1WI及T2WI上多呈低等混杂信号,T2WI常可见到明显的长T2信号区,常位于肿瘤中心及远离肺门侧,病理上与肿瘤内液化坏死相对应；增强扫描肿瘤明显不均匀强化,在动脉期表现更加明显,随时间延迟,信号对比差异缩小；DWI肿瘤实质部分呈稍高信号,反映肿瘤细胞密集,水分子运动受限,与病理表现相一致。

MSCTreconstructionimagesarehelpfultodetectthedisplacementofadjacentlungtissueandthenarrowingofthetumormargins,andtheobviousenhancementofthelungafter







































治疗白癜风专科医院
白癜风能够治好的办法