医学影像学诊断3.pptVIP

医学影像学诊断浅谈 长骨 (主要分布于四肢): 骨干 (骨髓腔) 骺 ，关节面 干骺端, 骺软骨, 骺线 嵌入性骨折 impacted fracture 青枝骨折 greenstick fracture 线形骨折 linear fracture 凹陷骨折 depressed fracture 撕脱骨折 avulsion fracture 压缩骨折 compression fracture 粉碎骨折 comminutedpression fracture 多发骨折 骨骺分离 separation of epiphysis 病理性骨折 pathological fracture 应力性骨折 stress（fatigue） fracture Normal intensity signal of bone marrow is the same as the signal of subcutaneous fat. It is hyperintense on T1-weighted images and medium intense on T2-weighted images. Bone bruise on MR is presented as focal abnormal signal of the bone marrow of the femoral condyles or tibial plateaus. It is seen as a reduction of signal intensity on T1-weigted images and augmentation of signal intensity on T2-weighted images. The best appearance of bone bruise is described on STIR sequence where the signal of normal bone marrow is suppressed and bone bruise is characterized by the hyperintensity of the signal. This change in signal intensity is caused by posttraumatic edema which is one of the major pathohistological features of bone bruise. The two others are hemorrhage and microtrabecular fracture. Owing to these pathohistological features, it is considered that bone bruise is one of the causes of a painful knee. Owing to the pathohistological analysis of bone bruise, different degrees of subchondral and articular cartilage changes can be observed . Pathogenesis of bone marrow edema which is characteristic for bone bruise is connected with acute or chronic knee injuries, but bone bruises can be seen with no obvious trauma. Bone bruise of the knee usually lasts weeks, which is much more than previously thought and sometimes can even be seen up to one year after trauma 骨膜增生： 良性骨肿瘤常无骨膜增生，如出现骨膜新生骨则表现均匀致密影，提示恶性可能，恶性骨肿瘤常有广泛的不同形式的骨膜增生，而且骨膜新生骨还可被肿瘤所破坏，形成 Codman三角，这种表现对恶性骨肿瘤有特征性。 周围软组织变化： 良性骨肿瘤多无软组织肿胀，局部肿块，但其边缘与软组织界限清楚。恶性骨肿瘤常侵入软组织，与邻近软组织界限不清。 发病年龄： A、＜1岁：转移性神经母细胞瘤; B、10-20岁：骨囊肿，骨肉瘤, 骨软骨瘤；尤文