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1、CXR#1–CONSISTENTWITHARDSThisisanexampleofapatientwithbilateralinfiltratesconsistentwithpulmonaryedema.Thelefthemidiaphragmisvisible,arguingagainstleftlowerlobeatelectasis.TypicalorclassicradiographicfindingsofARDShavebeencharacterizedasbilateralconfluentopacitiesasdemonstratedinthisr
2、adiograph.However,theAECCdefinitionexpandedthescopeofradiographicopacitiesthatareconsistentwithARDStoincludebilateralopacitiesthataresimplyconsistentwithpulmonaryedema,evenifpatchyandinhomogeneous.這是與肺水腫一致雙側浸潤的患者的一個例子。左側膈肌可見,在反對左下葉肺不張。急性呼吸窘迫綜合征的典型或經(jīng)典的X線表現(xiàn)已被定性為如本胸片雙側融合陰影。然而,AECC定義擴大放射
3、線陰影是急性呼吸窘迫綜合征一致,以包括,雙邊陰影是簡單地與肺水腫一致,即使片狀和不均勻的范圍。符合ARDS,兩肺浸潤影符合肺水腫。CXR#2–INCONSISTENTWITHARDSTheopacitiesintherightlowerlobearelikelyduetoapleuraleffusion,whilethereisevidenceofeitheratelectasisintheleftlowerlobeoraleftpleuraleffusion.Thereisnoconvincingevidenceofopacitiesinthemid-orup
4、per-lungzonesconsistentwithpulmonaryedema.在右下葉的陰影可能是由于胸腔積液,同時有肺不張或者在左下肺葉或左側胸腔積液的證據(jù)。有在中間或上肺區(qū)有肺水腫一致陰影沒有令人信服的證據(jù)。不符合ARDS,右下葉為胸腔積液,左下肺為肺不張或者胸腔積液。CXR#3–INCONSISTENTWITHARDSAlthoughthischestx-rayisunderpenetrated,theopacificationsofbothlowerlobesarelikelyduetopleuraleffusionsand/oratelectas
5、is.Theredoesnotappeartobeconvincingevidenceofbilateralopacitiesconsistentwithpulmonaryedema.雖然這個胸部X射線underpenetrated,無論下葉的opacifications可能是由于胸腔積液和/或肺不張。似乎沒有要與肺水腫一致的雙邊陰影有說服力的證據(jù)。不符合ARDS,兩下肺顯示胸腔積液或肺不張。CXR#4–EQUIVOCALFORARDSThischestx-raydemonstratessomeequivocalfindingsforbilateralinfil
6、tratesconsistentwithpulmonaryedema.Theremaybeopacificationsinleftmid-lungfieldconsistentwithedema.Lossofthelefthemidiaphragmmaybeduetoleftlowerlobeatelectasisorpleuraleffusion.Theopacitiesandabnormalitiesintherighthemithoraxmaybeprimarilyduetoapleuraleffusion.Giventheequivocalnatureo
7、fthischestx-ray,thecontext(e.g.,medicalhistory,presenceofriskfactors)andevolutionofthepatient’sclinicalconditionandchestx-rayovertime(e.g.,8-12hours)maybehelpfultoascertainwhetherthereareopacitiesconsistentwithpulmonaryedema.Dependingonthemechanismofactionandrisksofaconsideredinterve
8、ntion,clinic