骨骼正常与基本病变7.pptVIP

骨骼和肌肉系统Musculoskeletal System 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 bones, 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, excellent 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 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. Lumbar spine 血管造影(angiography ) For vascular diseases and bone tumor 关节造影(arthrography) For joint diseases, very few used now Computed Tomography plain scan Include bone window and soft tissue window enhancement - For differential diagnosis CT myelography Knee: CT soft tissue window and bone window Magnetic Resonance Imaging plain 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. Ultrasonography Ultrasonography is noninvasive and painless to the patient. 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 p