骨肌系统影像英文

WhatisRadiology.Radiation(usesanddangers)TypesofimagingmodalitiesKnowledgeofAnatomy,physiology,pharmacology,clinicalmedicineimportant.Physiology,pharmacology,anatomy,pathologytoexplainchangesonX-raysWhydoneedtoknowaboutradiologyYouasaphysicianwillneedknowledgeofallmodalitiesforpatientssymptoms.AsasubspecialtycareerImagingofmusculoskeletalsystem☻

Youallwillhavegraduatedandbecomephysicians☻Patientswillvisityouinyournewoffice.☻Theywillhaveallkindsofsymptoms!SeveralYearsLaterVisitingaphysicianforfollowingreasons:1:Yearlycheckup2:Surveillancefordetectingdiseaseearly

(e.g–bonetumor)3:Chronicsymptoms

(e.g-chronicbackpain)4:Acutesymptoms

(e.g-fracture)WhypatientvisitsadoctorInvestigatingpatient'ssymptomsX-rayInvestigations“IhavediscoveredsomethinginterestingbutIdonotknowwhetherornotmyobservationsarecorrect”.WilhelmConradRoentgen,1895ThediscovererofX-RAYSWhatareX-Rays?

Aformofelectromagneticradiationwithshortwavelength(between10-2and10nm)X-raysaregeneratedbyusingahighvoltagecurrenttoaccelerateelectronswithinevacuatedglasstubes,towardsatungstentargetcathodeAnode阳极evacuatedglasstube真空球管X-raysX线tungstentarget钨靶electronbeam电子束18952010TheX-rayLabThen&NowRoentgen’sFirstLabX-rayLabof2010TheFamousFirstRadiographRadiographbyRoentgenon22December19851895TheradiographofMrs.Roentgen'shand.Radiographofhand2010Photographofahandduringprogressiveradiationexposureresultinginnecroses.EffectsofRadiation

X-RAYS

ULTRASOUND

COMPUTEDTOMOGRAPHY(CT)

NUCLEARMEDICINE

ANGIOGRAPHY

MAGNETICRESONANCEIMAGING(MRI)

POSITRONEMISSIONSCANNING(PET)TYPESOFIMAGINGINRADIOLOGYDEPARTMENTHowisanX-rayImageobtainedTheX-rayspassthroughthebodyandaredetectedonphotographicfilmplacedbehindthepatientX-raycassette暗盒(withfilm)X-rayTubeX-rayphotonsHowandwhydoradiographsappearblack&whiteItstartedwiththeX-rayfilm(GELATINWITHSILEVRBROMIDEcyrstals)Filmhassilverhalide卤化物

X-raybeamhitthesilverbromide溴化银turnsintoblackwhendevelopedWhennox-rayphotonstrikesthefilm,itremainswhiteTheBlackandWhiteofRadiographsleadbariumsulfatebonemuscleliver(eg)fatairX-rayfilmWHATFACTORSDETERMINETHEBLACK&WHITEDifferentmaterialsabsorbX-raystodifferingdegreesDependsontheatomicnumberofelementWhatisUltrasound?WhyUseUltrasound?

CheaperthanCTorMRI

Patientisnotexposedtoionizingradiation

Equipmentisveryportable,thereforecanbeusedonpatientstoosickorinjuredtobemovedfromtheirbedsUltrasoundofthefetalhead(inutero)WhatisComputedTomography?AnX-raybasedtechniqueTheX-raytube,alongwithanarrayofdetectors,arerotatedinaplanearoundthepatientgantryX-raytubedetectorarraydirectionofrotationpatient(doesn’tmove)X-raybeamCTSCANOFTHEPELVISWhatisNuclearImaging?AradioactiveisotopeandinjectedintothepatientTheisotopeistakenupbytheorganortissueofinterest(physiologicexamination)TheisotopeemitsgammarayswhicharethendetectedbyagammacameraAtechnetium锝-99bonescanWhatisMagneticResonanceImaging?

InvolvesmeasuringthebehaviourofprotonsindifferentchemicalenvironmentswhenexposedtoamagneticfieldPatientsarenotexposedtoionizingradiationMid-saggitalMRscanoftheheadTheBenefitsofMRITheidealmodalityforimagingsofttissuesProtonpossesspositivechargeMagneticfieldsApplyingexternalstrongmagneticfieldtoprotonsMagneticResonanceImagingBasicprinciplesMRI:Femur&QuadricepsmuscleTRICKSOFTHETRADE

Usuallyit’sallinBLACK&WHITE!Whatdoyousee?Therearetwowomen,ayoungandoldone“YouseewhatyoulookforYourecognisewhatyouknow”Whatdoyouseehere?MRIScanSHEEPDOGWhatIsaw!GlutealmaximusmuscleRectumSacrumLowerbackmusclesMRIofthebuttocks

LearnyouranatomywellImportantininterpretingradiographicstudiesYoumaywanttobecomearadiologistANATOMY!ANATOMY!ANATOMY!AcuteConditionsClinicalScenarioCaseHistory:YoungpatientplayingbaseballinjuredelbowwhileslidingathomeplateWhattypeofX-raywouldyouorder? -CTscan -Plainfilmoftheelbow -MRIPATIENTELBOWNormalelbowLATERALVIEWSOFELBOWHumerusRadiusUlnaHumeralcondylesFracturedislocationoftheelbowjointHowwouldyoutreatthispatient?1:DoCTscanofelbow2:Putacast3:CallOrthopedicsurgeon4:SendpatienthomeComplicationofelbowfracturedislocation-Brachialartery臂动脉injury(Especiallywithfracturesinthearea)Treatment:PatientwentstraighttosurgeryThedislocationwasreducedChronicConditionsClinicalScenarioCaseHistory:YoungweightlifterwithsuddenonsetofneckpainPossibleDiagnosis:1:Fracturedcervicalbone骨折2:Slippedvertebraldisc椎间盘滑脱3:Musclesprain扭伤

4:Spinalcordtumor肿瘤NextInvestigations1:Seeasportsspecialist2:X-rayofthespine3:CTofthespine4:MRIofthespineDoctorfirstorderedCervicalspinex-rayLateralviewoftheC-spineLateralviewoftheC-spineSpinousprocessDiscspaceVertebralbodyC2C3C4C7C6C5OccipitalbonemandibleMovietongueVertebralbodySpinalcordMRIoftheCervicalSpineSmalldiscprotrusionsesp.atC5-6levelDiscspaceDiscprotrusionC2C3C4C7C6C5CONCLUSIONS:1:X-RAYexamswhichusesradiation: -Plainfilm -CT -Nuclearmedicine

2:X-RAYstudiesthatDONOTuseradiation: -Ultrasound -MRI0510152025ChestSkullBrainCTThoracicspineKUBLumbarspineIVPUGIBariumEnemaCTchestCTAbdomenAPracticalApproachEffectiveDose(mSv)EffectiveRadiationdosesinRadiologicexaminationshttp://qmec..au/radiology/principles/radsaftx.htmlCONCLUSIONS:Imagingofmusculoskeletalsystem206bones.fiveorfourgroupsLongbones

长骨

Shortbones短骨

Flatbones

扁骨

Sesamoidbones

子骨

Irregularbones不规则骨2神经孔6椎小关节APviewLateralview

4髂嵴4肩峰突5关节窝6喙突12滑车13肱骨小头7三角肌粗隆8内上髁脊15冠状窝8豆9钩LateralAPObliqueNormalvariationSesamoid子骨SesamoidBoneIsland骨岛AccessoryBones附骨AccessoryBonesFractureBoneIslandBoneIslandLumbarSacralization腰椎骶化Lumbarization骶椎腰花PermanentOsteoepiphyte永存骨骺

Diseaseisabnormalandoralteredanatomy

LEARNYOURANATOMYWELLNOW!!!

Itwillpayofflater!!!

Especiallyifyouplantobearadiologist.FINALPEARLPHYSICSOFRADIOLOGYPHYSICSOFRADIOLOGY

X-rayfilmsareblackandwhite

CTscanimagesaremadeupofmanydots

EachdotrepresentsaCTnumbercalledHOUNSFIELDnumberleadbariumsulfatebonemuscleliver(eg)fatairX-rayfilmWhatareX-Rays?DifferentmaterialsabsorbX-raystodifferingdegreesLeadBariumBoneMuscleLiverFatAir+1000HUTherangeofHounsfieldUnits