No.14 【1】2014.4.22 骨骼正常与基本病变7.ppt
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1、骨骼和肌肉系统 Musculoskeletal System,邹月芬,The diseases of musculoskeletal system are very common and complex. They are included trauma, infection, tumor, degeneration disease, metabolic and endocrine disease, congenital anomalies and so on.,Various imaging examinations are available for the evaluation of b
2、ones, joints, and soft tissues. Some are general examinations used for the patients with many types of disorders. Others have more limited indications. Plain film radiography is routine technique in clinical practice. CT and MRI are used more and more now, because of its cross-sectional display, exc
3、ellent contrast resolution, and ability to measure specific attenuation values.,Examination Techniques,X-ray Plain film, fluoroscopy, angiography CT: plain scan, enhancement MRI: plain scan, enhancement,X-ray,Plain film (basic examination) Routine radiographic evaluation of the bones should consist
4、of anteroposterior (or posteroanterior) and lateral views, which should include one joint and soft tissue Oblique and tangent views may be necessary in specific situations.,Knee of anteroposterior and lateral views,Lumbar spine,血管造影(angiography ) For vascular diseases and bone tumor 关节造影(arthrograph
5、y) For joint diseases, very few used now,angiography,Computed Tomography,plain scan Include bone window and soft tissue window enhancement - For differential diagnosis CT myelography,L4-5 CT soft tissue window and bone window,Knee: CT soft tissue window and bone window,Magnetic Resonance Imaging,pla
6、in scan and enhancement SE,TSE or GRE are basic sequences. Fat suppression sequences and use of intravascular contrast agents further increase the ability to accentuate tissue contrast.,Lumbar spine sagittal view (T1WI,T2WI),Ultrasonography,Ultrasonography is noninvasive and painless to the patient.
7、 Furthermore, it is less expensive, safer, and performed more rapidly than most alternative studies. Because it allows localization of lesions in three dimensions, sonography is a useful technique for guiding percutaneous aspiration or biopsy and for mapping radiation portals.,Normal Imaging Anatomy
8、,Form, structure and develop of bone form:long bone, short bone, tabular bone, unregular bone Structure: compact bone, spongy bone, periosteum, medullary cavity of bone develop:intramembranous ossification (skull, facial bones),endochondral ossification (trunk, limbs, base of skull, ethmoid),ossific
9、ation center,Long bone Developing bone diaphysis:compact bone, medullary cavety metaphysis:spongy bone Epiphysis: secondary ossification center epiphyseal plate: bone age: the age of creating secondary ossification in the epiphyses and the age of combining epiphysis with diaphysis,Matured bone: diap
10、hysis: cortex of bone, spongy bone, Medullary cavity of bone, vascular channel extremities: joint sesamoid bone,CT and MRI,bone window Cortex, trabecula, medullary cavity soft tissue window Muscle, tendons, cartilage,股骨下段CT 骨窗、软组织窗,Headline,SOMATOM Emotion 16 8.5 sec for 102 mm 16 x 0.6 mm Pitch 1.2
11、 Rotation 0.6 sec 130 kV 77 effective mAs,Courtesy of Jiangsu province people hospital / Nanjing, China,Headline,SOMATOM Emotion 16 53.8 sec for 318 mm 16 x 0.6 mm Rotation 1.0 sec 130 kV 123 effective mAs,Bone removal,Courtesy of Jiangsu province people hospital / Nanjing, China,MRI检查,骨骼、关节、肌肉等软组织有
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