骨肌系统影像英文

.,1,ImagingofmusculoskeletalsystemNormalimagingandvariation,骨肌系统影像学：正常及变异医学影像学教研室吴仁华,.,2,WhatisRadiology.Radiation(usesanddangers)TypesofimagingmodalitiesKnowledgeofAnatomy,physiology,pharmacology,clinicalmedicineimportant.Physiology,pharmacology,anatomy,pathologytoexplainchangesonX-raysWhydoneedtoknowaboutradiologyYouasaphysicianwillneedknowledgeofallmodalitiesforpatientssymptoms.Asasubspecialtycareer,Imagingofmusculoskeletalsystemimagingmodalities,.,3,YouallwillhavegraduatedandbecomephysiciansPatientswillvisityouinyournewoffice.Theywillhaveallkindsofsymptoms!,SeveralYearsLater,.,4,Visitingaphysicianforfollowingreasons:1:Yearlycheckup2:Surveillancefordetectingdiseaseearly(e.gbonetumor)3:Chronicsymptoms(e.g-chronicbackpain)4:Acutesymptoms(e.g-fracture),Whypatientvisitsadoctor,.,5,Investigatingpatientssymptoms,1:Historytaking2:Physicalexamination3:Laboratorytests(e.g.bloodwork)4:X-rayinvestigations5:Treatment(medicalorsurgical),.,6,X-rayInvestigations,1:WhatareX-rays2:Differenttypesofradiologictests3:Examplesofclinicalscenarios&radiologicinvestigations,.,7,“IhavediscoveredsomethinginterestingbutIdonotknowwhetherornotmyobservationsarecorrect”.,WilhelmConradRoentgen,1895ThediscovererofX-RAYS,.,8,WhatareX-Rays?,Aformofelectromagneticradiationwithshortwavelength(between10-2and10nm)X-raysaregeneratedbyusingahighvoltagecurrenttoaccelerateelectronswithinevacuatedglasstubes,towardsatungstentarget,.,9,1895,2010,TheX-rayLabThen&Now,RoentgensFirstLab,X-rayLabof2010,.,10,TheFamousFirstRadiograph,RadiographbyRoentgenon22December1985,1895TheradiographofMrs.Roentgenshand.,Radiographofhand2010,.,11,Photographofahandduringprogressiveradiationexposureresultinginnecroses.,EffectsofRadiation,Radiosensitiveorgans-Ovaries,testis软巢睾丸-Thyroid甲状腺-Fetus胎儿-GItract胃肠道RadiationdamageisDosedependentFactorstoreducedoseReduceunnecessarystudiesUsenon-radiationstudiesUltrasound,MRI,.,12,X-RAYSULTRASOUNDCOMPUTEDTOMOGRAPHY(CT)NUCLEARMEDICINEANGIOGRAPHYMAGNETICRESONANCEIMAGING(MRI)POSITRONEMISSIONSCANNING(PET),TYPESOFIMAGINGINRADIOLOGYDEPARTMENT,.,13,HowisanX-rayImageobtained,TheX-rayspassthroughthebodyandaredetectedonphotographicfilmplacedbehindthepatient,X-rayTube,X-rayphotons,.,14,.,15,Howandwhydoradiographsappearblack&whiteItstartedwiththeX-rayfilm(GELATINWITHSILEVRBROMIDEcyrstals)Filmhassilverhalide卤化物X-raybeamhitthesilverbromide溴化银turnsintoblackwhendevelopedWhennox-rayphotonstrikesthefilm,itremainswhite,TheBlackandWhiteofRadiographs,.,16,WHATFACTORSDETERMINETHEBLACK&WHITE,DifferentmaterialsabsorbX-raystodifferingdegreesDependsontheatomicnumberofelement,.,17,WhatisUltrasound?,SoundwaveswithfrequenciesabovetherangeofhumanhearingultrasoundAnarrowbeamofhighenergysoundwavesisdirectedintothepatientsbodyThemannerinwhichthesoundisreflectedbackfromvarioustissuesisrecorded,.,18,WhyUseUltrasound?,CheaperthanCTorMRI,Patientisnotexposedtoionizingradiation,Equipmentisveryportable,thereforecanbeusedonpatientstoosickorinjuredtobemovedfromtheirbeds,Ultrasoundofthefetalhead(inutero),.,19,WhatisComputedTomography?,AnX-raybasedtechnique,TheX-raytube,alongwithanarrayofdetectors,arerotatedinaplanearoundthepatient,.,20,CTSCANOFTHEPELVIS,.,21,WhatisNuclearImaging?,Aradioactiveisotopeandinjectedintothepatient,Theisotopeistakenupbytheorganortissueofinterest(physiologicexamination),Theisotopeemitsgammarayswhicharethendetectedbyagammacamera,Atechnetium锝-99bonescan,.,22,WhatisMagneticResonanceImaging?,InvolvesmeasuringthebehaviourofprotonsindifferentchemicalenvironmentswhenexposedtoamagneticfieldPatientsarenotexposedtoionizingradiation,Mid-saggitalMRscanofthehead,.,23,TheBenefitsofMRI,Theidealmodalityforimagingsofttissues,.,24,Protonpossesspositivecharge,Magneticfields,Applyingexternalstrongmagneticfieldtoprotons,MagneticResonanceImaging,Basicprinciples,.,25,MRI:Femur&Quadricepsmuscle,.,26,TRICKSOFTHETRADEINRADIOLOGY,UsuallyitsallinBLACK&WHITE!,.,27,Whatdoyousee?,Therearetwowomen,ayoungandoldone“YouseewhatyoulookforYourecognisewhatyouknow”,.,28,Whatdoyouseehere?,MRIScan,.,29,SHEEPDOG,WhatIsaw!,.,30,Glutealmaximusmuscle,Rectum,Sacrum,Lowerbackmuscles,MRIofthebuttocks,.,31,LearnyouranatomywellImportantininterpretingradiographicstudiesYoumaywanttobecomearadiologist,ANATOMY!ANATOMY!ANATOMY!,.,32,AcuteConditions,.,33,ClinicalScenarioCase,History:YoungpatientplayingbaseballinjuredelbowwhileslidingathomeplateWhattypeofX-raywouldyouorder?-CTscan-Plainfilmoftheelbow-MRI,.,34,PATIENTELBOW,Normalelbow,LATERALVIEWSOFELBOW,.,35,Humerus,Radius,Ulna,Humeralcondyles,Fracturedislocationoftheelbowjoint,.,36,Howwouldyoutreatthispatient?1:DoCTscanofelbow2:Putacast3:CallOrthopedicsurgeon4:Sendpatienthome,.,37,Complicationofelbowfracturedislocation,-Brachialartery臂动脉injury(Especiallywithfracturesinthearea),.,38,Treatment:PatientwentstraighttosurgeryThedislocationwasreduced,.,39,ChronicConditions,.,40,ClinicalScenarioCase,History:Youngweightlifterwithsuddenonsetofneckpain,.,41,PossibleDiagnosis:1:Fracturedcervicalbone骨折2:Slippedvertebraldisc椎间盘滑脱3:Musclesprain扭伤4:Spinalcordtumor肿瘤,.,42,NextInvestigations1:Seeasportsspecialist2:X-rayofthespine3:CTofthespine4:MRIofthespine,.,43,DoctorfirstorderedCervicalspinex-rayLateralviewoftheC-spine,.,44,LateralviewoftheC-spine,Spinousprocess,Discspace,Vertebralbody,C2,C3,C4,C7,C6,C5,Occipitalbone,mandible,.,45,Movie,tongue,Vertebralbody,Spinalcord,MRIoftheCervicalSpine,Smalldiscprotrusionsesp.atC5-6level,Discspace,Discprotrusion,C2,C3,C4,C7,C6,C5,.,46,CONCLUSIONS:,1:X-RAYexamswhichusesradiation:-Plainfilm-CT-Nuclearmedicine2:X-RAYstudiesthatDONOTuseradiation:-Ultrasound-MRI,.,47,0,5,10,15,20,25,Chest,Skull,BrainCT,Thoracicspine,KUB,Lumbarspine,IVP,UGI,BariumEnema,CTchest,CTAbdomen,APracticalApproach,EffectiveDose(mSv),EffectiveRadiationdosesinRadiologicexaminations,.au/radiology/principles/.au/radiology/principles/radsaftx.html,.,48,1:TherearemanyX-raytestsavailableforptssymptoms2:Choosetherightonethatwouldgivethediagnosisearly3:Alwaysconsultaradiologistforadviceonwhichtestisappropriateforyourpatient.,CONCLUSIONS:,.,49,ImagingofmusculoskeletalsystemNormalimagingandVariation,.,50,.,51,206bones.fiveorfourgroupsLongbones长骨Shortbones短骨Flatbones扁骨Sesamoidbones子骨Irregularbones不规则骨,.,52,.,53,.,54,.,55,2神经孔,6椎小关节,.,56,.,57,.,58,APview,Lateralview,4髂嵴,.,59,.,60,4肩峰突,5关节窝,6喙突,.,61,12滑车,13肱骨小头,7三角肌粗隆,8内上髁脊,15冠状窝,.,62,.,63,8豆9钩,.,64,.,65,.,66,Lateral,AP,Oblique,.,67,.,68,Normalvariation,.,69,Sesamoid子骨,.,70,Sesamoid,.,71,BoneIsland骨岛,.,72,AccessoryBones附骨,.,73,AccessoryBones,.,74,Fracture,.,75,BoneIsland,.,76,BoneIsland,.,77,LumbarSacralization腰椎骶化,.,78,Lumbarization骶椎腰花,.,79,PermanentOsteoepiphyte永存骨骺,.,80,DiseaseisabnormalandoralteredanatomyLEARNYOURANATOMYWELLNOW!Itwillpayofflater!Especiallyifyouplantobearadiologist.,FINALPEARL,.,81,PHYSICSOFRADIOLOGY,.,82,PHYSICSOFRADIOLOGY,Testyourknowledge,X-rayfilmsareblackandwhiteCTscanimagesaremadeupofmanydots,EachdotrepresentsaCTnumbercalledHOUNSFIELDnumber,.,83,WhatareX-Rays?,DifferentmaterialsabsorbX-raystodifferingdegrees,.,84,Lead,Barium,Bone,Muscle,Liver,Fat,Air,+100