中枢神经系统与头颈部影像诊断-pei课件

Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 中枢神经系统与头颈部影像诊断 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 中枢神经系统 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 总论和概述 中枢神经系统包括 脑和脊髓 中枢神经系统影像学检查方法 X线 CT MRI Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time XX 射射 线线 的的 发发 现现 1893年德国物理学家 伦琴发现了X射线 伦琴利用伦琴利用X X线为其夫人线为其夫人 拍摄了一张手照片 是拍摄了一张手照片 是 世界上第一张世界上第一张X X线照片线照片 19011901年伦琴获得第一个年伦琴获得第一个 诺贝尔物理学奖诺贝尔物理学奖 世人 为了纪念他的功绩 将X 线命名为伦琴射线 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 最早的X光设备主要用于商业和娱乐目的 欧美成立了 众多X光照相馆 1956年选美大赛 获胜选手同时展 示X光照片 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 英国工程师亨斯菲尔德 G N Hounsfield 研制的第一台 CT机 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 西门子单层螺旋CT欢悦 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 西门子128层螺旋CT Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 磁共振进展磁共振进展 磁共振现像磁共振现像 Magnetic resonance Magnetic resonance imaging imaging 是是19461946年 由斯坦福大学年 由斯坦福大学 BlochBloch和哈佛大学和哈佛大学PurcellPurcell同时发现同时发现 19521952年两人因此同获诺贝尔物理学年两人因此同获诺贝尔物理学 奖奖 2020世纪世纪7070年代 年代 MRIMRI技术才与医学技术才与医学 联系起来联系起来 19781978年第一幅人体年第一幅人体MRIMRI图像问世 图像问世 8080年代初用于临床 并得到了迅猛年代初用于临床 并得到了迅猛 发展 发展 Lauterbur MR成像奠基人 1929 2007 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 西门子1 5T 核磁共振 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 常用检查方法 一 X线平片 头颅正侧位像 观察颅骨骨折 颅缝分离 头 颅畸形 颅骨疾病 蝶鞍情况 钙斑等 颅底像 颅底特别是中颅窝骨结构有否破坏 切线像 颅骨凹陷性骨折 病灶与骨板的关系 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 二 脑血管造影 适应证 脑动脉瘤 血管发育异常 血管闭塞 了解肿瘤的供血情况 禁忌证 严重动脉硬化 冠状动脉硬化 心肾 功能不良 造影剂过敏 方法 股动脉导管法 全脑血管造影 颈内外动脉选择性造影 椎动 脉造影 动脉期 静脉期 静脉窦期摄片 常用检查方法 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 三 CT检查 平扫CT 脑血管病 脑外伤 脑积水 脑萎缩 脑先天畸形 增强CT 提高病变组织同邻近组织的密 度差 三维CT 颅骨3DCT 血管3DCT 3D CTA 肿瘤3DCT 常用检查方法 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 四 MR检查 扫描方式 轴 矢 冠状位 扫描序列 T1WI T2WI PDWI 平扫 增强 MRA MRV DWI FLAIR PWI SWI MRS等 常用检查方法 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 正常影像学表现 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 一 头颅平片 方法简单 经济 无痛苦 是基本检查方 法 一般用后前位及侧位 头颅平片有几种诊断的可能 A 明确病变的位置 B 提示病变存在 但不能确诊 C 临床表现明显但无异常发现 这是平 片限度 正常X线表现 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 二 脑血管造影 将有机碘对比剂引入脑血管内以显示脑血 管 颈动脉造影可显示大脑的大部分血管 主要用于诊断 A 脑动脉瘤 B 血管发育异常 C 血管闭塞 正常X线表现 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 正常CT表现 1 颅骨及含气空腔 用骨窗观察 不同层面可观察到不同的 结构 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 2 脑实质 脑窗观察 皮质CT值32 40Hu 髓质CT值28 32Hu Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time 3 含脑脊液的间隙 枕大池 桥池 桥小脑角池 鞍上池 环 池 侧裂池 终板池 四叠体池 大脑大静 脉池 三脑室 四脑室 侧脑室 大脑纵裂 CT值0 20Hu Our greatest weakness lies in giving up The most certain way to succeed is always to try jus