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اسکن ستون مهره ای. آمادگی های بیمار : آمادگی های بیمار : - خروج البسه وپوشیدن گان - خروج اشیاء ( عینک, سمعک, زیور آلات,......) از ناحیه اسکن - در صورت.

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Presentation on theme: "اسکن ستون مهره ای. آمادگی های بیمار : آمادگی های بیمار : - خروج البسه وپوشیدن گان - خروج اشیاء ( عینک, سمعک, زیور آلات,......) از ناحیه اسکن - در صورت."— Presentation transcript:

1 اسکن ستون مهره ای

2 آمادگی های بیمار : آمادگی های بیمار : - خروج البسه وپوشیدن گان - خروج اشیاء ( عینک, سمعک, زیور آلات,......) از ناحیه اسکن - در صورت اسکن باکنتراست, منع مصرف موادخوراکی حداقل 6 ساعت قبل آزمون - بررسی تاریخچه بیماری قلبی, کلیوی, دیابت, آسم, آلرژی, مشکلات تیروئیدی قبل تزریق کنتراست - بررسی احتمال بارداری زنان در سنین باروری - مزایا : - بکمک MSCT امکان تهیه برشهای ظریف ودقیق وپوشش آنا تومیک وسیع در کسری از ثانیه, بازسازی در سطوح مختلف امکان بررسی همزمان ضایعات استخوانی ونسوج نرم ناحیه را فراهم کرده است. - بدون درد وغیر تهاجمی وبواسطه سرعت ودقت بالا درکشف خونریزیها وصدمات جدی نزد بیماران ترومایی در حفظ حیات آنها نقش اساسی دارد.

3 - نزد بیمارانیکه بدلیل داشتن پروتزهای فرومنیتیک امکان MRI نیست براحتی اجرا وبعلاوه نسبت به آن به حرکت بیمار کمتر حساس است. - بکمک ارائه تصاویر پیوسته بهنگام (CT فلورو ) بعنوان ابزاری کار آمد در هدایت بیوپسی, آسپیراسیون در زمان, هزینه وعوارض کمتر نسبت به روشهای تهاجمی چون جراحی مطرح است. - خطرات : - دوز موثر تابشی این اسکن حدود 10 میلی سیورت که معادل تابش زمینه بمدت سه سال است می باشد. - در زنان باردار بجز در مواردیکه نقش اصلی در حفظ حیات مادر وجنین داشته باشد منع شده است. - نزد مادران شیرده بدنبال تزریق کنتراست بمدت 24 ساعت از شیردهی منع می شوند - محدودیتها : بیماران درشت جثه وسنگین وزن - MRI در بررسی طناب نخاعی, صدمات لیگامانها ودیسکهای بین مهره ای برتر است.

4 TITLE/DESCRIPTION:CT Scan - Neuro Routine Cervical SpineProcedure:Check request to ensure Radiologist has reviewed and prescribed the procedure. Call for the patient and confirm identification.Dress the patient as appropriate for examination.Explain the procedure to the patient, including breathing instructions.Position patient supine on the scan table.Enter patient scan details into the computer.Obtain AP and Lateral scout view through the area of interest.Obtain axial scans using a slice thickness of 3mm, FOV 14cm, to cover requested area of interest.Using 'image analysis' acquire a sagittal reformation of the entire area scanned.Film images at appropriate window / level settings. Use 20 on 1 format for axial scans. Use a 6 on 1 format for sagittal reformations. Film the scout view displaying scan lines with a copy of the patient's protocol / ID page.TITLE/DESCRIPTION:CT Scan - Neuro Routine Cervical SpineProcedure:Check request to ensure Radiologist has reviewed and prescribed the procedure. Call for the patient and confirm identification.Dress the patient as appropriate for examination.Explain the procedure to the patient, including breathing instructions.Position patient supine on the scan table.Enter patient scan details into the computer.Obtain AP and Lateral scout view through the area of interest.Obtain axial scans using a slice thickness of 3mm, FOV 14cm, to cover requested area of interest.Using 'image analysis' acquire a sagittal reformation of the entire area scanned.Film images at appropriate window / level settings. Use 20 on 1 format for axial scans. Use a 6 on 1 format for sagittal reformations. Film the scout view displaying scan lines with a copy of the patient's protocol / ID page.

5 CT Scan - Neuro Routine Cervical Spine Procedure:Procedure: Check request to ensure Radiologist has reviewed and prescribed the procedureCheck request to ensure Radiologist has reviewed and prescribed the procedure Call for the patient and confirm identification.Call for the patient and confirm identification. Dress the patient as appropriate for examination.Dress the patient as appropriate for examination. Explain the procedure to the patient, including breathing instructionsExplain the procedure to the patient, including breathing instructions Position patient supine on the scan table.Position patient supine on the scan table. Enter patient scan details into the computerEnter patient scan details into the computer Obtain AP and Lateral scout view through the area of interest. Providing a guide for planning the scanObtain AP and Lateral scout view through the area of interest. Providing a guide for planning the scan Obtain axial scans using a slice thickness of 3mm, FOV 14cm, to cover requested area of interestThin slices to cover the disc spacesObtain axial scans using a slice thickness of 3mm, FOV 14cm, to cover requested area of interestThin slices to cover the disc spaces

6 Using 'image analysis' acquire a sagittal reformation of the entire area scanned. Providing a 3D view of the area scanned.Using 'image analysis' acquire a sagittal reformation of the entire area scanned. Providing a 3D view of the area scanned. Film images at appropriate window / level settings. Use 20 on 1 format for axial scans. Use a 6 on 1 format for sagittal reformationsFilm images at appropriate window / level settings. Use 20 on 1 format for axial scans. Use a 6 on 1 format for sagittal reformations Soft Tissue:Soft Tissue: W: W: L: L: Bone:Bone: W: W:

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8 پوزیشن بیمار برای سی تی اسکن از گردن نمایی از

9 نمای ساجیتال از مهره های گردن

10 مهره ششم گردن دچار شکستگی شده که توسط پلاتین بین مهره 5و7 متصل مانده است

11 سوراخ نای مهره سوم گردن قسمتی از استخوان اسکاپولا

12 تنه مندیبل مهره اطلس ادنتوئید اگسیس کندیلار مندیبل

13 مهره توراسیک که پردازش شده در ان شکستگی وجود دارد

14 Figure 1. (a) Plain lateral radiograph of the cervical spine. Only five vertebral bodies are visualized. (b) Sagittal image showing fracture avulsion of the posterior inferior corner of C6. (c) Sagittal CT scan on the same patient showing unilateral perched facet (left) C6 on C7. (d) Coronal image, same patient, showing fracture of the lateral mass of C7.Figure 1. (a) Plain lateral radiograph of the cervical spine. Only five vertebral bodies are visualized. (b) Sagittal image showing fracture avulsion of the posterior inferior corner of C6. (c) Sagittal CT scan on the same patient showing unilateral perched facet (left) C6 on C7. (d) Coronal image, same patient, showing fracture of the lateral mass of C7.

15 Figure 2. (a) Sagittal plain radiograph of the cervical spine. There is an acute kyphotic angulation at C6/7 and a fracture of C7 with anterior wedging due to collapse of the superior endplate. There is a separated bone fragment from the superior endplate of C7. The C6/7 disc space is widened posteriorly. No other fractures were demonstrated on plain film. (b) Sagittal multislice CT (MSCT) showing fractures demonstrated on the plain radiograph, but in addition there is a retropulsed fragment of the posterior superior part of C7 into the canal. (c) Axial MSCT image of the fractured C7 vertebra showing the retropulsed fragment posteriorly displaced into the canal. (d) Sagittal MSCT image showing fracture of the inferior facet of C6. This was not diagnosed on the plain film. (e) Coronal MSCT showing fractures of the uncovertebral processes of C7. (f) Coronal MSCT image showing additional burst fracture at C6 not demonstrated on the plain radiograph.Figure 2. (a) Sagittal plain radiograph of the cervical spine. There is an acute kyphotic angulation at C6/7 and a fracture of C7 with anterior wedging due to collapse of the superior endplate. There is a separated bone fragment from the superior endplate of C7. The C6/7 disc space is widened posteriorly. No other fractures were demonstrated on plain film. (b) Sagittal multislice CT (MSCT) showing fractures demonstrated on the plain radiograph, but in addition there is a retropulsed fragment of the posterior superior part of C7 into the canal. (c) Axial MSCT image of the fractured C7 vertebra showing the retropulsed fragment posteriorly displaced into the canal. (d) Sagittal MSCT image showing fracture of the inferior facet of C6. This was not diagnosed on the plain film. (e) Coronal MSCT showing fractures of the uncovertebral processes of C7. (f) Coronal MSCT image showing additional burst fracture at C6 not demonstrated on the plain radiograph.

16 پوزیشن بیمار برای سی تی از لومبار

17 نمایی از پوزیشن بیمار برای سی تی از لومبار L1 L5 S

18 نمای اگزیال از مهره لومبار حالب

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20 Figure 5. (a) Plain radiograph (anteroposterior film) showing reduced height of L3 following fracture and widening of the right L2/3 facet joint space. (b) Plain radiograph (lateral) demonstrating fracture of L3. There is collapse of the superior endplate of the vertebral body with anterior wedging. (c) Sagittal multislice CT (MSCT) showing burst fracture of L3 with multiple fragments anteriorly and posteriorly and a fracture of the lamina of L3 not identified on the plain film. (d) Coronal MSCT demonstrates burst fracture of L3 but also fracture of the inferior right corner of L2. The L2 vertebral body is laterally translocated and rotated anticlockwise relative to L3. (e) Coronal MSCT showing disrupted right L2/3 facet joint and fracture of the left lamina of L3 as a result of fracture/rotation of L2 on L3. (f) Three-dimensional MSCT clearly demonstrating fracture of the inferior endplate of L2 and burst fracture of L3. (g) Sagittal T2 weighted MRI showing compression of the cauda equina nerve roots by the retropulsed posterior superior fracture fragment of L3. (h) Sagittal T2 weighted MR image showing severe narrowing of the spinal canal by the retropulsed posterior superior fracture fragment of L3.Figure 5. (a) Plain radiograph (anteroposterior film) showing reduced height of L3 following fracture and widening of the right L2/3 facet joint space. (b) Plain radiograph (lateral) demonstrating fracture of L3. There is collapse of the superior endplate of the vertebral body with anterior wedging. (c) Sagittal multislice CT (MSCT) showing burst fracture of L3 with multiple fragments anteriorly and posteriorly and a fracture of the lamina of L3 not identified on the plain film. (d) Coronal MSCT demonstrates burst fracture of L3 but also fracture of the inferior right corner of L2. The L2 vertebral body is laterally translocated and rotated anticlockwise relative to L3. (e) Coronal MSCT showing disrupted right L2/3 facet joint and fracture of the left lamina of L3 as a result of fracture/rotation of L2 on L3. (f) Three-dimensional MSCT clearly demonstrating fracture of the inferior endplate of L2 and burst fracture of L3. (g) Sagittal T2 weighted MRI showing compression of the cauda equina nerve roots by the retropulsed posterior superior fracture fragment of L3. (h) Sagittal T2 weighted MR image showing severe narrowing of the spinal canal by the retropulsed posterior superior fracture fragment of L3.

21 Figure 6. (a) Normal sagittal thick slice multiplanar reconstruction (MPR) of the thoracolumbar spine mimicking lateral plain radiograph. (b) Coronal thick slice MPR of the thoracolumbar spine mimicking anteroposterior radiograph.Figure 6. (a) Normal sagittal thick slice multiplanar reconstruction (MPR) of the thoracolumbar spine mimicking lateral plain radiograph. (b) Coronal thick slice MPR of the thoracolumbar spine mimicking anteroposterior radiograph.

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