骨关节影像学诊断基础知识_精品文档.ppt

1、骨关节影像学基础知识骨关节影像学基础知识 1骨关节影像学检查方法骨关节影像学检查方法2恶性纤维组织细胞瘤Plain film3CT恶性纤维组织细胞瘤4MR恶性纤维组织细胞瘤5Angiography恶性纤维组织细胞瘤6Plain filmFracture7CTOsteomyelitisChondrosarcoma8MRChondrosarcoma9骨关节正常影像学表现骨关节正常影像学表现10Nerve root Vertebral arteryTransverse foramenIntervertebral foramen The vertebral artery goes through th

2、e sixth to the first transverse foramen;There in the seventh transverse foramen is the root of brachial plexus.111213141516骨骨基本病变的种类基本病变的种类n n1 1、骨质疏松、骨质疏松 n n2 2、骨质软化骨质软化 n n3 3、骨质破坏骨质破坏 n n4 4、骨质增生硬化骨质增生硬化 n n5 5、骨膜增生骨膜增生 n n6 6、骨与软骨内钙化骨与软骨内钙化 n n7 7、骨质坏死骨质坏死 n n8 8、矿物质沉积；矿物质沉积；n n、骨胳变形；、骨胳变形；n n、

3、周围软组织病变、周围软组织病变。17n n是指一定单位体积内正常钙化的骨组织减少。n n组织学变化是骨皮质变薄，骨小梁减少，哈氏管扩大。n nX线表现：骨密度减低，骨皮质变薄，骨小梁减少。n n常见于老年人，骨结核，类风湿，甲旁亢 骨质疏松18骨质疏松正常甲旁亢正常19正常老年性骨质疏松204 岁.骨结核骨质疏松NormalOsteoporosis denotes that the disease is chronic and so that is benign.正常21骨质疏松Normal甲旁亢Normal22甲旁亢NormalOsteoporosisNormal骨膜下骨吸收 23骨质疏松（

4、hypercortisolism）Cushing 综合征24Normal骨质疏松Normal类风湿25OsteoporosisNormal老年骨质疏松Normal26 骨质软化1.定义定义 一定单位体积内骨组织有机成分正常，而矿物质含量减少。一定单位体积内骨组织有机成分正常，而矿物质含量减少。组织学变化：骨小梁中央部分钙化，外周未钙化组织学变化：骨小梁中央部分钙化，外周未钙化 2.X线表现线表现 骨密度减低（腰椎和骨盆最明显），骨小梁模糊，变形骨密度减低（腰椎和骨盆最明显），骨小梁模糊，变形-下肢下肢弯曲、骨盆畸形、假骨折线弯曲、骨盆畸形、假骨折线3.原因原因 骨软化症（成人）骨软化症（成人）

5、佝偻病（生长期）佝偻病（生长期）27佝偻病Normal28佝偻病Normal29佝偻病30佝偻病Normal31佝偻病骨质软化症32Normal骨质软化症33 骨质破坏骨质破坏骨质破坏骨质破坏骨质破坏是局部骨质为病理组织所替代而造成的骨组织消失，可见于炎症，结核，肿瘤，肿瘤样病变，缺血坏死，内分泌疾病等34骨质破坏Normal 骨巨细胞瘤Normal35骨质破坏Normal骨转移瘤Normal36骨质破坏 脊椎结核NormalNormalNormalNormal37骨质破坏Normal骨髓炎Normal38甲旁亢骨质破坏NormalNormal39恶性纤维组织细胞瘤Bone destructi

6、on40Bone destruction非骨化性纤维瘤平片CT41Bone destructionNormal骨肉瘤Normal42NormalNormal多发性骨髓瘤Bone destruction43NormalNormalBone destruction骨转移瘤44NormalNormalBone destruction骨转移瘤45骨质坏死骨质坏死(necrosis of bone)n n是骨组织局部代谢的停止，坏死的骨质称为死骨（sequestrum)。n n死骨可见于化脓性骨髓炎、结核、缺血坏死、外伤、恶性骨肿瘤；以前者多见。46 sequestrum骨髓炎Died of hemat

7、osepsis NormalNormal47骨髓炎 死骨NormalNormalNormalNormal48 死骨慢性骨髓炎49NormalNormal 死骨慢性骨髓炎50骨结核 死骨CT51 死骨骨结核52 死骨骨脓肿骨脓肿53 sequestrum股骨头缺血坏死54Normal舟骨缺血坏死 sequestrumNormal55是指一定单位体积内骨质数量增多，变致密。是指一定单位体积内骨质数量增多，变致密。骨质硬化的原因很多。骨质硬化的原因很多。骨质硬化骨质硬化56Osteosclerosis骨样骨瘤NormalNormalNormalNormal57Osteosclerosis骨样骨瘤58

8、骨肉瘤骨转移Osteosclerosis59腰椎成骨转移 Osteosclerosis60石骨症 Osteosclerosis“layer cake”sign61石骨症 Osteosclerosis62Osteosclerosis骨肉瘤63慢性骨髓炎Osteosclerosis64慢性骨髓炎Osteosclerosis65 甲旁减NormalNormalOsteosclerosis66强直性脊柱炎NormalNormalOsteosclerosis67骨膜反应68Periosteal reactionFracture69Periosteal reaction骨髓炎70Periosteal re

9、action疲劳骨折71尤文氏肉瘤Periosteal reaction72骨肉瘤Periosteal reaction73Periosteal triangle骨肉瘤74骨膜三角（Codman三角）X-ray filmMRI-TIWISpecimen75骨膜下血肿Periosteal triangle76静脉曲张 Periosteal triangle77梅毒Periosteal reaction78骨与软组织内钙化79Ossification in bone and cartilage软骨肉瘤80骨梗死81Ossification or calcification in bone and

10、cartilage骨梗死82Ossification or calcification in bone and cartilage骨梗死83Ossification or calcification in bone and cartilage骨梗死84Ossification or calcification in bone and cartilage软骨瘤85Ossification or calcification in bone and cartilage软骨瘤86Ossification or calcification in bone and cartilage软骨肉瘤87Ossif

11、ication or calcification in bone and cartilage骨软骨瘤88 矿物质沉积89铅中毒 Deposit of mineral salt90 Deposit of mineral salt慢性磷中毒concentric circles91 氟骨症Deposit of mineral salt92 骨骼变形93 Metamorphose of bone慢性骨髓炎佝偻病94 Metamorphose of bone95骨纤维异常增殖症 Metamorphose of bone96骨周围软组织病变97Lesions of soft tissue around the bone98Lesions of soft tissue around the bone99Lesions of soft tissue around the bone骨化性肌炎100Lesions of soft tissue around the bone骨化性肌炎101Lesions of soft tissue around the bone血管瘤102Lesions of soft tissue around the bone恶性纤维组织细胞瘤103女，47岁，发现骶部肿块2月。脊索瘤脊索瘤Lesions of soft tissue around the bone104