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1、中枢神经系统影像诊断 一 Examinationmethods 1 X rayplainfilm Thismethodisverysimpleandcheap Somelesionscanbefoundbyit Usuallywecannotreachtoanexactdiagnosisonlybythisexamination 2 Tomography Exactdiagnosisstillcannotobtained Themethodcanmanifestedsomeosseousdestructionwhichcannotbeshownbyplainfilm Enhancement 3
2、 CT Todisplaytumors hemorrhage infarction infectionandabnormality Toshowtheabnormalisodensitywhichcannotfoundbytheplainscan Toconfirmthequalityofthelesion Differentialdiagnosisoftumorandedema Plainscan Thecharactersofthelesionincludingsize appearance number position anatomyrelation andsooncanbeshown
3、byit 4 Magneticresonanceimaging Plainscan Enhancement Toshowtheabnormalisodensitywhichcannotfoundbytheplainscan Toconfirmthequalityofthelesion Differentialdiagnosisoftumorandedema MRA Toshowthevascularlesionssuchasaneurysmandarterialvenousmalformation Todisplaytumors hemorrhage infarction infectiona
4、ndabnormality Thecharactersofthelesionincludingsize appearance number position anatomyrelation andsooncanbeshownbyit 5 DSA Toshowthevascularlesionssuchasaneurysm arterialvenousmalformation bloodsupplyofneoplasm 6 Myelography Toshowwhethertherearetumorsandobstructioninspinalcanal Itisalsohelpfultoens
5、urethepositionanddegreeofobstruction 一 Normalmanifestation 一 Plainfilm 1 Cranium Theinnerandouterplatearedenseandthediploeisspongy 2 Skullsuture Allofthesuturesareshownassawtoothshadow 3 Convolutionalimpressions Multipleroundlowdensityinplainfilm 4 Theimpressionofthemiddlemeningealartery Theimpresst
6、ionofthemiddlemeningealarteryispresentedasstreaksshadowandgooutfromwidetonarrow 5 Impressionofdiploicvein 7 TheSella 6 Impressionofpacchioniangranulation 8 Internalauditorymeatus About6mmwide symmetricalcanal Thefrontalparietalirregularhypodensitynearthemidline Thediploicvein simpressappearsasnetlik
7、ehypodensityintheparietalregion 7 16mmlong 7 14mmwideand8 20mmdeep 10 calcificationoffalxcerebri 9 Calcificationofpinealbody 11 Calcificationofchoroidplexus 12Calcificationofpetro clinoidligament Itispresentedasnodularhyperdensityonthelateralskullradiograph Thefrontalviewshowthenormalpositionarepres
8、entedthezonarydenseimageonthemidline Calcificationofchoroidplexusarepresentedtheanomalisticdenseimageandlateraltomidline Thedenseshadowbetweenintheanteriorandposteriorclinoidprocess 1 Whitematter ishypodensetograymatter CTvaluesis20 30Hu 2 Graymatter ishyperdensetowhitematter CTvaluesis30 40Hu 3 Ven
9、tricleandcistern arehypodense CTvaluesis0 10Hu 4 Skull ishyperdense CTvalues 250Hu 5 Physiologicalcalcification Spotorpatchdenseshadow CTvalues 60Hu 二 CTmanifestation 三 MRImanifestation 1 Morphologicalmanifestation Axial coronal sagittalMRIcanclearlyshowtheshapeofbrainandspinalcord suchaswhitematter
10、 greymatter ventricle cerebralfissure brainstem cerebralvessel pituitarybody etal Theefficiencyisclosetogrossspecimen MRIsignalintensity Frontallobe Pituitarybody Centralsulcus Pituitarystalk Opticchiasm Genuofcorpuscallosum Medullaoblongata Clivus Sphenoidsinus Parietallobe Thalamus Occipitallobe M
11、amillarybody Quadrigeminalbody Straightsimus 4thventricle Cerebellartonsil Genuofcorpuscallosum Frontallobe Spleniumofcorpuscollosum 3rdventricle Thalamus Headofcaudatenucleus Globuspallidus Occipitallobe Opticradiations Septumpellucidum Posteriorhornoflateralventricle Anteriorhornoflateralventricle
12、 Interventricularforamen Parietooccipitalsulcus Thalamus Headofcaudatenucleus Globuspallidus Occipitallobe Opticradiations Anteriorhornoflateralventricle Interventricularforamen 3rdventricle Genuofcorpuscallosum Septumpellucidum Spleniumofcorpuscollosum Posteriorhornoflateralventricle Posteriorlimbo
13、finternalcapsule Genuofinternalcapsule Anteriorlimbofinternalcapsule Parietooccipitalsulcus Parietallobe Superiortemporalgyrus Middletemporalgyrus Pons Medullaoblongata Cerebralpeduncle Centrumsemiovale 3rdventricle Inferiortemporalgyrus Petrousridgeoftemporalbone Parahippocampalgyrus Anteriorhornof
14、lateralventricle Lateralfissure Suprasellarcistern Pituitarybody Temporallobe Inerhemispericfissurecistern Corpuscallosum caudatenucleus globuspallidus putamen Opticchiasm Pituitarystalk Cavernoussinus DSAmanifestation Normalcerebralartery anteriorandmiddlecerebralartery graduallytaperoffwithsymmetr
15、icbranchesandsmoothmargin Thearterieshaveinvariablelocationandcorrespondingbraintissue Imageologicdiagnosisofthecommondisease 一 Braintumors havecommoncharacteristicinimageologicmanifestion Glioma astrocytoma Meningioma Pituitarytumor Acousticneuroma Metastasistumor 1 X raymanifestation Increaseofint
16、racranialpressure Increaseanddeepeningofconvolutionalimpressions separationofsutures thinningofbones Tumorlocationsign Destructionofskull enlargementofthesellar displacementofcalcification dilationofInternalauditorymeatus pathologiccacification 2 CTmanifestation Densityabnormality Thetumorsareslightlyhypodensetoisodenseonplainscan Masseffect Displacementofmidline compressionandobstructionofventricle hydrocephalus Edema Hypodensityaroundtumor moresevereinmalignanttumor physiologicalcalcification
