犬肩關節(jié)醫(yī)學影像

Medicalimagingofthecanineshoulderjoint

犬肩關節(jié)醫(yī)學影像DeptMedicalImagingGhentUniversityArticularstructurestobevisualised

可成像的關節(jié)結構Bone

骨Cartilage

軟骨Synovia

關節(jié)液Intraarticulartendons

內關節(jié)韌帶Softtissues

軟組織Imagingtechniques

攝影技術Radiography

放射線攝像技術Arthrography

關節(jié)造影術Computertomography(CT) 計算機斷層掃描攝影術Magneticresonanceimaging(MRI) 磁共振成像Ultrasound

超聲檢查Scintigraphy

閃爍掃描術(Arthroscopy)

關節(jié)鏡檢查Disadvantages:缺點lowspecificity

特異性低lowresolution

分辨率低Skeletalscintigraphy

骨骼閃爍掃描術

Indications:適用Clinicexam?Localisation? 臨床檢查：病灶？Unclearrxfindings

X-線檢查無明顯異常Checkformeta’s

內側位的攝片Radiographictechnique

拍攝技術Mediolateralview內外側位擺位Rx

examination:scapula

X-線檢查：肩胛骨Lateralradiograph外側位攝片Rx

examination:scapula

X-線檢查：肩胛骨Caudocranialview前后位Anterioposterior

view:腹背位Extension

+

30°rotation 可以旋轉30°SHOULDERjoint

肩關節(jié)Tangentialview:bicepsgroove 切面位：二頭肌腱鞘SHOULDERjoint

肩關節(jié)Always2views!!!!

總是拍兩個擺位Calcifications/ossificationcentres

shoulder

肩關節(jié)周圍鈣化/骨化中心4monthsTubsupraglenoidale

肩臼上的Glenoid

肩臼

Glenoid

肩臼

Supraspinatus

岡上Infrapinatus

岡下Bicepstendo

二頭肌肌腱Caudalpouch

關節(jié)囊后位Synovialosteochondromatosis

滑膜性骨軟骨瘤Calcinosis

circumscripta

鄰近組織鈣化Aggressivebonelesions

侵入性骨損傷

Primarybonetumours 原發(fā)性骨腫瘤Multiplemyeloma 多骨骨肉瘤Primarybonetumours

原發(fā)性骨腫瘤

Primarybonetumours

原發(fā)性骨腫瘤

肉瘤肉瘤增生的骨膜骨膜反應Shoulder

OC

肩部軟骨骨瘤OftenRetriever,Beauceron,BelgianShepherds 常見尋回獵犬，法國牧羊犬，比利時牧羊犬Radiographicdiagnosis:

放射學診斷Bilateralrx,>50%bilaterallesions兩側rx，>50%兩側損傷RXhips,oftenHD 髖部rx，常見髖關節(jié)發(fā)育不良Radiographic

signs

X線征象Vacuumphenomenon

真空現(xiàn)象Arthrography

關節(jié)造影術Easytoperforminpractice.易于操作1to4mlofnon-ionic,low-osmolarcontrastmedium.

1~4毫升陽性，低容積滲透分子照影劑Exposures

within5minp.i.暴露5分鐘Arthrography

關節(jié)造影術Roughimageofarticularsofttissues:關節(jié)軟組織的粗像Cartilage軟骨 Synovia

滑液Intra-articular

tendons

內關節(jié)腱Distinction

between

clinicalandnon-clinical

lesions臨床和非臨床的損傷區(qū)別Dicision

makinginclinical

lesions.

損傷確診Arthrography關節(jié)造影術Arthrography

關節(jié)造影術

Detectionofjointmice

withinbicipitaltendon

sheath 造影顯示肱二頭肌腱腱鞘內形成“關節(jié)鼠”Disadvantages缺點Generalanaesthesia全身麻醉Maintenancecosts

維持成本Lessresolutionthanrx 分辨不如X線Radiationhazard

輻射危險Advantages優(yōu)點Avoidingsuperimposition 避免重疊干擾Axialslices

端面圖像Bettersofttissuedifferentiation 軟組織更易分辨Reconpossibilities 可重建CToftheCanineShoulder

犬肩部的CTBicepsproblems

二頭肌問題Inflammation炎癥Partialrupture局部斷裂Completerupture全部斷裂破裂Bicepsproblems

二頭肌問題PlainradiographyX光平片Indirectinformationonarticularsofttissuesstructures關節(jié)軟組織的間接信息

Radiographicfeatures

X線征象Arthrographicfeatures

關節(jié)造影特征NoAbnoBicipitalpathology

二頭肌的病理學Bicipitalpathology

二頭肌的病理學Ultrasoundintheshoulder

肩部超聲波檢查Generalanaesthesia一般麻醉Examinedshoulderup肩上方檢查Assistant:legmaximallystretchedandendorotated注：小腿應最大程度的伸展和旋轉Linearprobe12MHzintransversepositiondistaltoacromion

12MHz的線振探頭，在肩峰末端橫向掃描3cmdepth,2focuspoints

3cm深，兩個焦點Bicepstendon

二頭肌肌腱Effusionintendon

sheath…腱鞘內有滲出液…Not

specific!!!沒有特異性TSGHuTmayorTminorBassil,Great

Dane,M,2y,lame

lefrontafter

trauma大丹犬，2歲，雄性，外傷后前肢跛行

bilateral

lpa

on

radiographs

pv兩側左肺動脈lame

left

foreleg左前肢跛行shoulder

atrofia

le左肩關節(jié)painby

flexion

both

shouders(le>>ri),ri

elbow雙肩部屈曲，疼痛（左>>右），右肘部LeftRightMRIoftheC