胸腰椎骨折的影像学课件

《胸腰椎骨折的影像学课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、ImagingofThoracicandLumbarSpineFracturesFracturesofthethoracicandlumbarspinearecommoninpatientswhohavesustainedhigh-energyspinaltrauma,andareassociatedwithinjurytothespinalcordinupto50%ofcases.[1]Accurateearlyassessmentisessentialbecausedelayindiagnosismayresultinthedevelopmentofneurologicco

2、mplications.Clinicalassessmentofthesepatientsisoftenchallenging,andasaresult,diagnosticimagingusuallyplaysacentralroleinourmanagement.1.DiazJJetal.Practicemanagementguidelinesforthescreeningofthoracolumbarspinefracture.Trauma63:709-718,2007Thepurposeofthisslidesistoexplorethisrolebyanswering

3、thefollowing4questions:(1)Whataretheimagingoptions?(2)Whoshouldbeimaged?(3)Howshouldtheybeimaged?(4)Whataretheimagingfindingsforthemostcommontypesofthoracolumbarfractures?1.Whataretheimagingoptions?RadiographyRadiographyistypicallythefirstmodalityusedtoevaluatethethoracolumbarspineaftertraum

4、a.Inthethoracicspine,anterposterior(AP)andlateralviewsareusuellysupplementedwithaswimmer`slateralview(y)Inthelumbarregion,APandlateralviewsaretypicallysufficient.Arrowheads:leftparatrachealstripeBlackarrow:interdediculatedistanceWhitehead:C7vertebraNormallumbarspineComputedTomographyTheadven

5、tofcomputedtomography(CT)hasrevolutionizedspineimaging.Thistechniqueallowsforveryrapidscanningandresultsintheacquisitionofacontinuousdatasetthatcanbeusedtocreateextremelythinaxialslicesaswellasexquisitereconstructedimagesinanyplane.AnadditionaladvantageofthistechniqueisthatdatafromCTscanofth

6、echest,abdomen,andpelvisobtainedtoevaluateforvisceralinjurycanbeuesdtosimultaneouslygeneratereconstructedimagesofthespinewithouttheneedforrescanningthepatient.CTisclearlysuperiortoradiographsfordemonstratingfracturesofthethoracolumbarspinewithasensitivityof94%-100%comparedwith33%-73%forradio

7、graphys.[2]CTisalsomoreaccuratethanMRIfordetectingfactures2.BerryGEetal:Areplainradiographysofthespineneccessaryduringevaluationafterblunttrayma?AccuracyofscreeningtorsoCTinthoracic/lumbarspinefracturediagnosis.JTrauma59:1410-1413,2005Analysisofima