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Author | orthopedics of orthopedics of Guangdong Provincial Hospital of Traditional Chinese Medicine, Luo Junhua
Painting | Ye Siting, Orthopedic Department of Guangdong Hospital of Traditional Chinese Medicine
Audit of the Department of Orthopedics from the Orthopedic Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine
In the diagnosis of orthopedic diseases, imaging examinations occupy an important part.
X -ray, CT, MRI, ultrasound …
In the face of dazzling examinations, patients often have some confusion:
"Is this check?"
"Why am I doing this?"
"Is it more expensive to check?"
Today, Dr. Ye Manting of the "Soul Paintinger" of the Orthopedic Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine uses a hand -painted method of comics to unveil the mysterious veil of these inspection projects.Not much to say, let’s take a look together ~
X -ray examination
X -ray examination, also known as "X -ray inspection", "old friend" in our orthopedic examination.Often a few photos can take our bone structure at a glance.How is this realized?
01 Imaging Principles: Right Perspective Watch
The density thickness of the body structure has different degrees of blocking X -ray.In the process of filming, X -rays can penetrate muscles but cannot penetrate the bones. Therefore, the rays projected on the negatives can form images that show the overall skeletal shape after processing.
02 Scope of application: Establishment of orthopedic disease
When orthopedics, X -ray is often used as a means of first screening. Whether it is observation of the overall structure or the evaluation of bone conditions, clinicians can quickly assist clinicians to make diagnosis.Especially the evaluation of external trauma, such as fractures, joint dislocation, etc., the imaging is intuitive, clear, and has strong significance to clinical guidance.Even if there is no major problem, the diagnosis of doctors is a reference support.
03 Overall evaluation
Advantages: cheap price, fast inspection, good imaging overall, small radiation, etc.
Disadvantages: Organizational images overlap each other, lack of evaluation of details, and can only provide very few soft tissue information.
CT examination
CT examination, like X -ray, is also used by X -rays.
The difference is that its imaging is three -dimensional, not plane.
01 Imaging Principles: Slip Perspective Watch
The imaging of the CT examination is "slicing" imaging. It can be imaged from the front/side/horizontal surface according to the condition, so as to obtain multiple "slices" and then combine into a three -dimensional bone three -dimensional structure diagram to clearly distinguish the fine damage.Observations for details are more comprehensive.
02 Scope of application: Further clarifying the osteo structural lesions
CT examination also focuses on the imaging of the bones. Compared with the overallness of X -ray, CT is better at the presentation of details.The formulation of diagnosis and treatment plans has an important guiding role.In addition, it can also reflect soft tissue lesions to a certain extent.
Ask is also a bone structure. Why do you sometimes make X -rays and CT?
Compared with the X -ray single appearance after the overlap of all structures, CT can scan the overall structure layer by layer. Each cut surface can form a corresponding image.The lesion position, and can carefully and comprehensively observe its morphological changes and the impact on peripheral tissue from the lesion position, which can enhance the blood supply condition of the lesion position.
Therefore, in the case of preliminary judgment of the bone structure of X -rays, but not clearing the details, CT can provide doctors with more diagnostic information.
03 Overall evaluation
Advantages: accurate osteo structured portrait, multi -plane imaging, which has good effect on details.
Disadvantages: The radiation of CT is slightly larger, and the soft tissue state display effect is not good.
MRI check
MRI examination, also known as MRI.
In the diagnosis and treatment of many orthopedic diseases, MRI examinations are often indispensable.
Due to the different imaging principles, CT and MRI have better imaging of CT and MRI compared to X -ray films.
01 Imaging Principles: Slip watching the atomic movement
The human body contains a lot of water. Even if it is a hard bone, it is inseparable from water. Magnetic resonance is used to imagine the hydrogen atom contained in water.
When performing MRI examinations, it is equivalent to exercising in the magnetic field under the influence of the magnetic field. It can collect the motion information of the hydrogen atom from the front/side/horizontal section according to the condition, and then perform a combined imaging.
Similar to the method presented by CT, the MRI examination is also a "section" type, and then combined into a three -dimensional structure.
02 Scope of application: Check the nervous system and soft tissue lesions
MRI can be better divided into various tissue components of the human body, such as the nervous system (brain and spinal cord and peripheral nerves) and soft tissue imaging (muscle, ligament, cartilage, etc.). ThereforeThe diagnosis of highlights such as protruding, rotating cuff injury, knee ligament and half -moon plate injury is indispensable.
Ask for X -ray and CT, can you see the structure clearly?Why do you still do MRI?
X -ray and CT imaging is faster than MRI, mainly providing bone information;
MRI’s soft tissue resolution is higher than X -ray and CT, which can provide richer and more detailed soft tissue information, such as cartilage, ligaments, etc., and diagnose the diagnosis of X -ray, CT, CT, CT, and CTCertain.
For example, in the diagnosis of spinal cervical spondylosis, on the basis of the X -ray tape to understand the entire cervical spine structure, the degree of spinal cord compression and spinal cord injury need to be judged by MRI examination.
03 Overall evaluation
Advantages: No radiation, the best imaging effect of soft tissue can distinguish the differences in the component in the tissue;
Disadvantages: The cost is relatively high, the examination time is long, and those with metal implants in the body are limited.
Ultrasonography
Ultrasonic examinations are relatively rare in orthopedic examination, but it also has important diagnosis and treatment for orthopedic diseases.
01 Imaging Principles: Look in the cut surface
When the ultrasonic penetrates the human body, it generates a reflex wave, collects the reflected wave information for imaging, reflects the structure in the cut surface, and the probe can be checked with any cut surface.
02 "Navigation instrument" in the scope of applicable scope
Ultrasonic is also an "slicing" imaging, but the ultrasound uses probe to use the local imaging, with high resolution, and is good for local cortex, subcutaneous fascia, peripheral nerves and small lesions in the muscles.
Especially ultrasonic operating and instant imaging for artificial real -time operation. During the examination, patients can perform dynamic observations in the state of exercise.The use of maturity in the diagnosis of crickets and other diseases is a common "navigator" in the diagnosis and treatment process.
Ask MR and ultrasound for soft tissue imaging. How should the two choose?
MRI shows that the overallness of the tissue is better, which can evaluate the overall nerve and soft tissue of the tissue, and ultrasound can only be used for local appearance.
However, the resolution of ultrasound on superficial tissue can reach 3 times or higher of the MRI. Seeing a slightly fine lesions, it can be achieved in different postures in different postures. In the treatmentEssence
03 Overall evaluation
Advantages: no radiation, good soft tissue appearance, dynamic real -time imaging, can guide treatment;
Disadvantages: It can only reach the surface of the bone, the overallness of the appearance is low, and the more blurred, and it is affected by the experience of the inspector.
Is these inspections safe?
The amount of radiation is within the scope of safety and does not need to panic.
The X -ray examination and CT examination are completed with the help of radiation. The radiation amount of a chest X -ray is 0.1MSV. The effective dose of a typical CT scan is about 10msv.Studies have shown that only in a short period of time, the amount of radiation of more than 100msv in a short time will increase the probability of human cancer.
Therefore, there is no scientific basis for fear or escape from the low doses of medical imaging inspection.
Ask pregnant women if they can perform imaging?
At present, domestic women, especially pregnant women, should try to avoid X -ray and CT examinations in the first three months of pregnancy.
If the pregnant woman needs to perform X -ray or CT inspections without the case, there is no need to worry too much. The Guide of the American Academy of Obstetrics and Gynecological Sciences on the X -ray examination during pregnancy shows that in general, the X -ray irradiation below 50MSV will not cause fetal injuryOr terators.
Summarize
In the first diagnosis of osteopia, choose X -ray for examination in most cases;
When the skeletal problem is complicated and the lesion is difficult to be clear, CT examination needs to be added;
Suspected of muscle, ligament, nerve injury, etc., MRI examinations need to be added;
If dynamic imaging is required and guided therapy, you can choose to increase B -ultrasound.
The above suggestions are for reference only. For specific inspection items, you still need to choose according to the advice of the main doctor.
End
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Some pictures are derived from the Internet. The article is for reference and learning. All the patient’s own situation and the diagnosis of professional doctors shall prevail.
