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[儿童胸部X线的特殊特征:放射科医生的基础]

[Specific characteristics of chest X‑ray in childhood : Basics for radiologists].

作者信息

Schneider K

机构信息

Pädiatrische Radiologie, Dr. von Haunersches Kinderspital, Klinikum der Universität München, Lindwurmstr. 4, 80337, München, Deutschland.

出版信息

Radiologe. 2018 Apr;58(4):359-376. doi: 10.1007/s00117-018-0374-8.

Abstract

The radiographic technique of pediatric chest X‑rays is substantially different from that in adults. In nearly all cases ap/pa X‑rays are sufficient and lateral radiographs are rarely needed. In the first years of life the thymus may overshadow the heart, the great vessels and the lung hila. The most important anatomical structures essential for diagnosing pathological findings of the lungs and mediastinum are the trachea with the bifurcation and the main bronchi with the adjacent great vessels. For the assessment of distended lungs and intrathoracic consolidations, fundamental knowledge of the anatomy in childhood and malformations which can involve the airways, the lungs, the heart, as well as systemic and pulmonary vessels are indispensable. Diseases of the pleura and the chest wall should always be investigated by ultrasound. Malignant disorders are rare in children, except for lymphomas. Optimized computed tomography (CT) and/or magnetic resonance imaging (MRI) are crucial in the diagnostic workflow of complex congenital heart diseases, complex lung and airway malformations, pulmonary complications in cystic fibrosis and the diagnostics of all tumors in order to make the right treatment decisions.

摘要

小儿胸部X线摄影技术与成人有很大不同。几乎在所有情况下,前后位/后前位X线片就足够了,很少需要侧位片。在生命的最初几年,胸腺可能会遮挡心脏、大血管和肺门。对于诊断肺部和纵隔病理表现至关重要的最重要解剖结构是带有分叉的气管以及带有相邻大血管的主支气管。为了评估肺扩张和胸腔内实变,了解儿童时期的解剖结构以及可能累及气道、肺、心脏以及体循环和肺血管的畸形的基本知识是必不可少的。胸膜和胸壁疾病应始终通过超声进行检查。除淋巴瘤外,儿童恶性疾病很少见。优化的计算机断层扫描(CT)和/或磁共振成像(MRI)对于复杂先天性心脏病、复杂肺和气道畸形、囊性纤维化的肺部并发症以及所有肿瘤的诊断工作流程至关重要,以便做出正确的治疗决策。

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