【医学知识】你不知道的事：放射学的秘密（9）
《Radiology Secrets Plus》是由宾夕法尼亚大学E. Pretorius和Jeffrey Solomon博士主编的以问答形式深入浅出的介绍相关放射性与影像诊断学内容的图书。该书总结了影像诊断学在实践过程中需要注意的100个知识要点，本公众号将持续推送翻译介绍。上一期我们介绍了：核医学等辅助性影像诊断方法以及儿科影像。本期推送的主要内容涉及儿科辅助影像、日常护理与急救时的影像指证和妇科影像，敬请期待!
81. 儿童干骺端角骨折常作为虐待儿童的特异性证据。
Metaphyseal corner fractures are highly sensitive and specific for child abuse.
图为小儿胫骨远端干骺端骨折伴骨骺滑脱
82.受虐待儿童最常见的死因是中枢神经系统的损伤。
The most common cause of death of an abused child is injury to the central nervous system
83.如果肺部浸润不能随着治疗时间的推移而消除，此时应怀疑潜在的支气管肺泡细胞亚型肺癌。
If a pulmonary infiltrate does not resolve over time despite treatment with antimicrobial agents, be suspicious of a potential bronchoalveolar cell subtype of lung carcinoma.
84. 间质性肺水肿是生活中最常见的肺间质性异常，通常是由充血性心力衰竭引起。
Interstitial pulmonary edema, usually due to congestive heart failure, is the most common interstitial abnormality encountered in daily practice.
85.无症状纵隔肿瘤的大多数为良性，而大多数有症状的纵隔肿瘤为恶性。
The majority of patients with asymptomatic mediastinal tumors have benign tumors, whereas the majority of patients with symptomatic mediastinal tumors have malignant tumors.
图为纵隔畸胎瘤（良性）
86. 如果胸片可见呈现纵隔向健侧移位和患侧膈肌下降的气胸，立即通知医生照顾病人，因为可能存在张力性气胸。张力性气胸需要紧急治疗以防止快速死亡。
If you see a pneumothorax on chest radiography that is associated with contralateral mediastinal shift and inferior displacement of the ipsilateral hemidiaphragm, immediately notify the physician caring for the patient because a tension pneumothorax may be present. This requires emergent treatment to prevent rapid death.
图为右侧肺严重张力性气胸伴有右侧肺不张，可见纵隔向左移位，右侧膈肌下降。
87. 如果可见局灶性卵圆形透亮影环绕气管插管（ETT）或气管切开管相邻的气管壁隆起，应当高度怀疑过度充气并立即通知临床工作人员。
If you see focal ovoid lucency surrounding an endotracheal tube (ETT) or a tracheostomy tube with an associated bulge in the adjacent tracheal walls, suspect overinflation of the cuff and notify the clinical staff immediately.
图为气管插管，气管内条索状影为插管。
88.如果影像下可见鼻、口胃饲管延伸到远端支气管、肺或胸腔空间，应当立即通知医护人员并建议放置引流管后在床边行管脱除，以防止气胸加重。
If a nasogastric, orogastric, or feeding tube is seen to extend into a distal bronchus, lung, or pleural space, notify the clinical staff immediately and suggest that tube removal be performed only after a thoracostomy tube set is at the bedside in case a significant pneumothorax develops.
图为鼻胃管走形的三维重建图像
89. 在输液管放置或使用过程中怀疑有空气栓塞时，患者应立采取左侧卧位，以保持空气滞留于右心房，并补充氧气，监测生命体征。
When air embolism is suspected during line placement or use, the patient should immediately be placed in the left lateral position to keep the air trapped in the right heart chambers, supplemental oxygen should be administered, and vital signs should be monitored.
90. 在正常妊娠早期，超声下卵黄囊期孕囊平均直径：经阴道探查值为8毫米，腹外探查值为20毫米。同样，胚胎期孕囊平均直径：经阴道探查值为16毫米，腹外探查值为25毫米。
In a normal early pregnancy, the yolk sac should be visible sonographically by a mean gestational sac diameter of 8 mm transvaginally and 20 mm transabdominally. Similarly, an embryo should be visible sonographically by a mean gestational sac diameter of 16 mm transvaginally and 25 mm transabdominally.
图为B超下的孕囊影像