山東大學(xué)斷層解剖學(xué)雙語課件01剖面解剖學(xué)導(dǎo)論

1、The medical college of shandong universityThe introduction of sectional anatomyWhere is the direction of medicine ！？The forestclinicianFollow me ！clinicianimaging doctorMedical image period !E hospital !The history and status of sectional anatomythe first stage(16-18 century): da Vinci, A.Vesaliusth

2、e second stage (19-20 century ): Pirogoff 和 Eycleshymer & Schoemakerthe third stage ( since the 70age of 20century):the sectional anatomy be get great developmentda Vinci（1452 -1519）The picture is painted by da VinciThe A.Vesalius is dissecting in church （1514-1564）The definition and feature of sect

3、ional anatomy the sectional anatomy is the science of studing the shape、position、adjacent and functions in series section of human beeing.it,s task is serveing CT、 MRI 、US. it differents from systematic anatomy and regional anatomy： 1. to keep the structure in originenal position； 2. to perform the

4、three-dimensional reconstruction by sectional structure ；the three-dimensional reconstruction of cerebral vesselsthe three-dimensional reconstruction of heartthe three-dimensional reconstruction of coronary arteryCE-MRAdissection of aortaCE-MRAabdominal aneurysmthe three-dimensional reconstruction o

5、f blood vesselthe three-dimensional reconstruction of bonethe three-dimensional reconstruction of bones of footthe three-dimensional reconstruction of scapulathe three-dimensional reconstruction of axisthe three-dimensional reconstruction of small intestinethe three-dimensional reconstruction of blo

6、od vesselthe three-dimensional reconstruction of fascia3. to combine with the medical image closely.the transverse plane pass through10th thoracic vertebra (superior view )the transverse plane pass through10th thoracic vertebra (inferior view )The sagittal section of cranium (left view)The coronal s

7、ection pass through ascending aortaSupraorbitomeatal line Infraorbitomeata line（Reid ,s base line）Canthomeatal lineHorizontal lineThe scanning by vertical axis AC-PC line Talairach 坐標(biāo)系 The structure of cranium is very complex, so we want get the clear image ，to apply scanning lines as below:1. Supra

8、orbitomeatal line midpoint of external auditory meatus supraorbital margin2. infraorbitomeata line （Reid ,s base line） midpoint of external auditory meatus infraorbital margin3. Canthomeatal line midpoint of external auditory meatus lateral angle of eye4.Intercommissural line (AC-PC line) Anterior c

9、ommissure posterior commissureThe CT is scanningThe transverse scan of cranium by MRIT1The transverse scan of cranium by MRIT2MRI T1 WIThe median sagittal scan by MRMRI T2 WIThe median sagittal scan by MRThe coronal section pass through internal capsuleThe sectional specimenMRI T1MRA 磁共振腦纖維束成像 八十年代初

10、，國、外便開始顱內(nèi)水?dāng)U散成像的生化研究。該技術(shù)成為活體上測量水分子擴散運動與成像的唯一方法，最常用的是: 擴散加權(quán)成像（DWI）和 擴散張量成像（DTI）， DTI可三維顯示正常腦纖維束的走行、年齡變化，因病變造成的纖維束受壓、移位、變形、浸潤與破壞。較常規(guī)MRI能更好地觀察腫瘤與周圍纖維束的關(guān)系，用于診斷腦纖維束潰變、腦白質(zhì)疏松、腦缺血性病變、顱內(nèi)腫瘤等。 The internal capsuleThe fornixThe corpus callosum腦fMRI 腦fMRI原理是生理刺激下腦區(qū)神經(jīng)元激活，引起鄰近血管床的血流量和血流容積增加，血氧飽和度增加，氧合血紅蛋白增加而脫氧血紅蛋白相

11、對減少。脫氧血紅蛋白為順磁性物質(zhì)，產(chǎn)生局部梯度磁場，使質(zhì)子快速去相位，具縮短T2的作用，在腦激活區(qū)局部T2或T2*相對延長，在T2WI或T2*WI上相應(yīng)區(qū)信號強度增強。將這一信號差別經(jīng)過后處理，獲得激活腦區(qū)神經(jīng)元興奮活動的成像圖。 利用內(nèi)源性血紅蛋白作對比劑，通過血氧飽和度的對比變化而成像的方法稱為血氧水平依賴(blood oxygenation level dependant，BOLD)功能磁共振成像。 磁共振波譜（MRS）的基本原理 在理想均勻的磁場中，同一種質(zhì)子(如1H)理論上應(yīng)具有相同的共振頻率。事實上，當(dāng)頻率測量精度非常高時會發(fā)現(xiàn)，即使同一種原子核處在相同磁場中，不同的化學(xué)環(huán)境，它們

12、將具有不同的共振頻率。如在MRS中，水、NAA(N-乙酰天門冬氨酸)、Cr(肌酸)、Cho(膽堿)、脂肪的共振峰位置不同，這種現(xiàn)象就稱為化學(xué)位移(Chemical Shift)。在正常組織中，代謝物以特定的濃度存在，當(dāng)組織發(fā)生病變時，代謝物濃度會發(fā)生改變。 MRS主要是對水和脂肪中的氫質(zhì)子共振峰進行測量和脂肪中的氫質(zhì)子共振峰進行測量，使這些微弱的共振峰群得以顯示。 The research of sectional anatomy content:1.the sectional anatomy2.the sectional image：CT, MRI, SPECT, US, PET人體斷面數(shù)據(jù)

13、獲取專用SKC500型數(shù)控銑床 The transverse scan of pulmonary window by CTThe transverse scan of mediastinal window by CTThe sagittal scan of uterus by MRIthe ultrasonic wave scan pass through second porta hepatisthe ultrasonic wave scan pass through first porta hepatisthe three-dimensional reconstruction of ult

14、rasonic wave scan (foetus)the three-dimensional reconstruction of ultrasonic wave scan (foetus) PET Positron emission computed tomography 正電子發(fā)射計算機控制X線體層攝影術(shù) to inject the radio-labelled glucose to blood vessel，and then useing the PET machine to scan,to get the image (red, yellow, green, blue area) It

15、 is indicated , the more, the brain cells absorb radio-labelled glucose , the higher, its energy . the red area is highest. for example : useing the PET scan can diagnose the malignant tumor, Because the blood circulation is fastest ,the energy of absorbability is highest in malignant tumor. PET CT 18 氟-脫氧葡萄糖( 18 F-FDG) 正電子發(fā)射計算機體層攝影 對肺癌診斷、分期、治療及療效監(jiān)測 有極高的臨床應(yīng)用價值 PET MRI？！hearingReading SpeakingWriteing the three-dimensional reconstruc