风湿性疾病的肌肉骨骼超声一

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1、Chapter11Equipmentandexaminationtechniquestudyingsmallandsuperficialstructures,suchas1.1Equipmentflexorandextensortendonsinfingers,whichareUltrasound(US)isoneofthebestimagingtech-verydifficulttoassesswithotherimagingtech-niquesinmusculoskeletalradiologybecausei

2、tisniquesbecauseoftheirsuperficiallocation.lowincost,hashighspatialresolution,wideavail-Themostrecentgenerationofultrasoundabilityinhospitals,iswell-toleratedbypatientsandequipmentallowshighlydetaileddepictionofisnotbiologicallyinvasive,asitusessoundwavesstruct

3、ureslocatedjustafewmillimetersfromtheandnonionizingradiation,asinconventionalradi-transducer.ologyorcomputedtomography(CT).Thesefea-Newgenerationtransducersmayreachveryturesmakeultrasoundtheidealtechniqueforthehighfrequencies(upto20MHz),thatallowthediagnosisand

4、followupofmanypathologiesandevaluationofsubmillimetricstructures,suchasrheumaticsyndromesandfortheevaluationofthetendonpulleys(Fig.1.2).effectsoftherapy.TheavailabilityofnewmultifrequencyprobesThehighdiagnosticvalueofultrasoundisallowsthesimultaneousstudyofboth

5、superficialstrictlyrelatedbothtotheoperator’sknowledgeanddeepstructures,grantingagoodpenetrationofofnormalanatomyandtotheeffectivenessofultrasoundwavesthroughthetissues.ultrasoundequipmenttodepictanatomicaldetailsAssistancecanbegivenbyasiliconespaceror(Fig.1.1a

6、-c).byathicklayerofgelwhenusingoldequipmentForthisreason,theequipmentandtransduc-(e.g.transducersunder10MHzfrequency).ers’characteristicsbecomeveryimportantwhenMusculoskeletalsonographyshouldbeper-abFig.1.1a-cEvolutionintheresolutioncapabilityoftendonfibrillare

7、cho-texture.aImageobtainedwithultrasoundequipmentfromtheearly90s:itispanoramicbuthaslowspatialresolution.bImageobtainedusingultrasoundequipmentfromthelate90swithagooddemonstrationofthefibrillarechotexture.cImageobtainedusingthemostrecentgenerationofultrasoundce

8、quipment,showinggreatanatomicaldetail2MusculoskeletalSonographyTDHFig.1.2Fig.1.3HighresolutionlongitudinalUSscanofflexordigitorumcom-EFVUSscanofashoulderthatshowsmostofthehu