no.13 2014.4.15 骨骼正常与基本病变.pptx

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 TechniquesX-ray Plain film, fluoroscopy, angiographyCT： plain scan, enhancementMRI： plain scan, enhancementX-rayPlain 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. Knee of anteroposterior and lateral views 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 angiographyComputed Tomographyplain scanInclude bone window and soft tissue windowenhancement - For differential diagnosisCT myelography L4-5 CT soft tissue window and bone window Knee: CT soft tissue window and bone windowMagnetic 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.Lumbar spine sagittal view (T1WI,T2WI)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 biop