CT在獸醫(yī)的應(yīng)用-課件

Computedtomography(CT)inveterinarymedicine

CT(計(jì)算機(jī)體層攝影)

在獸醫(yī)醫(yī)學(xué)上的應(yīng)用H.vanBree&I.GielenDepartmentMedicalImagingFacultyofVeterinaryMedicineGhentUniversity1編輯版pptComputedtomography(CT)inveRadiologyComputedTomography(CT)X-rays2編輯版pptRadiologyX-rays2編輯版pptDrawbacksofconventionalradiology

傳統(tǒng)放射學(xué)回顧Threedimensionsbecomingtwo 三維變成二維Superposition疊影Distortionoftheimage 圖像的失真Limitedsofttissuedifferentiation 軟組織分辨率有限3編輯版pptDrawbacksofconventionalradCT:what?什么是CT？Isaformofradiographyinwhichabeamofx-raysisdirectedtothepatientfrommanydifferentangles. 是一種X-rays，光束可以沿不同角度直接照射病人。Thefractionaltransmissionofthex-raysthroughthepatientismeasuredwithelectronicsensors.X-rays

x-rays可以分次穿過(guò)病人，并可以用電子感受器測(cè)量。Thesignalsareconvertedtodigitalform+senttoacomputer. 信號(hào)被轉(zhuǎn)變成數(shù)字的形式，并輸入電腦。4編輯版pptCT:what?什么是CT？IsaformoSetofDisconnectedData間斷的數(shù)據(jù)設(shè)置

Seriesofcontiguous2-Daxialimagesofspecifiedthicknessarerequired.一系列特殊厚度的2維軸圖像ConventionalCT

傳統(tǒng)CTSingle-SliceSpiralCT單層螺旋CT

ContinuousVolumeofData數(shù)據(jù)連續(xù)

Spiralpatternofvolumetricdataacquired旋轉(zhuǎn)模式獲得數(shù)據(jù)“StepandShoot”GantryRotation間斷照射掃描架旋轉(zhuǎn)Gantrycontainingx-raytubeanddetectorsreturnedtostartingpositionafterone360-degreerotation,patientadvancedfixeddistancethroughgantry.掃描架包括X-rays電子管和檢測(cè)器，旋轉(zhuǎn)360度后，再回到正常位置，因?yàn)椴∪讼惹氨还潭ㄔ趻呙杓苌稀?ContinuousGantryRotation連續(xù)掃描架旋轉(zhuǎn)Gantryhousingx-raytubeanddetectorsrotatesuninterruptedaroundthepatientwhilepatientcontinuouslyadvancedthroughgantry當(dāng)病人連續(xù)的通過(guò)掃描架時(shí)，有X-ray電子管和檢測(cè)器的掃描架繞病人持續(xù)旋轉(zhuǎn)。TechnologicalComparisonofCTScanners

CT掃描儀在技術(shù)上的對(duì)比5編輯版pptSetofDisconnectedData間斷的數(shù)據(jù)設(shè)ComparisonofSingle-SliceCTandMultisliceCT

單層螺旋CT與多層螺旋CT的比較Single-SliceSpiralCT單層螺旋CTMultisliceSpiralCT多層螺旋CT

OneDetectorRow一個(gè)檢測(cè)面

Radiationpenetratingthroughpatientisregisteredbyonerowofdetectors

穿過(guò)病人的射線是被一排檢測(cè)器記錄。FourDetectorRows四個(gè)檢測(cè)面

Radiationpenetratingthroughpatientisregisteredbyfourrowsofdetectors穿過(guò)病人的射線被四排檢測(cè)器記錄。OneSlice一層

Spiralpathtracedaroundpatientyieldsoneslicepergantryrotation

掃描架每旋轉(zhuǎn)一圈，產(chǎn)生一層斷面圖像FourSlices四層

Spiralpathtracedaroundpatientyieldsfourslicespergantryrotation掃描架每旋轉(zhuǎn)一圈，可產(chǎn)生四層斷面圖像6編輯版pptComparisonofSingle-SliceCTSlicewidth斷層厚度Tissuevoxel組織容量成分Imagepixel成相像素Matrix短陣7編輯版pptSlicewidthTissuevoxelImagepSpatialresolutionandpixel

空間（立體）的分辨和像素8編輯版pptSpatialresolutionandpixel

空Grayscale灰尺Air–1000空氣-1000Softtissuestructuresareusuallydisplayedwithinthisrange.軟組織通常呈現(xiàn)在這個(gè)區(qū)域+150-1500Bone+1000骨+1000White白色Black黑色windowWidth窗口寬度windowLevel窗口水平面CTimagesportraydifferencesprimarilyinphysicaldensity,ratherthaninatomicnumber. CT主要是根據(jù)物理密度而不是電子數(shù)鑒別組織的差異的。Thesedifferencescanbeaccentuatedintermsofshadesofgreyintheimagebymanipulatingthewindow. 這些差異可通過(guò)操作窗口成像的灰色陰影而明顯化9編輯版pptGrayscale灰尺Air–1000空氣-1000SoDifferentwindows

不同的窗口Softtissuewindow:WW400;WL60Bonewindow:WW3500;WL50010編輯版pptDifferentwindows

不同的窗口SofttiAdvantages:優(yōu)點(diǎn)Avoidingsuperimpositionofsurroundingstructures. 避免環(huán)繞結(jié)構(gòu)形成重影Superiortissuecontrast-densitydifference. 優(yōu)異的組織對(duì)比密度差異Possibilityofreconsindifferentplanes(2D,3D). 對(duì)不同平面進(jìn)行遠(yuǎn)程操作（2D，3D）Measurementspossible(density,surface,size). 可以測(cè)量（密度，表面積，大小）Disadvantages:缺點(diǎn)Radiationhazard. 射線的危害Highcost? 高成本？Accesstoequipment? 有權(quán)使用設(shè)備否？Generalanaesthesia. 全身麻醉Learningcurvedealingwithaxialpictures. 學(xué)會(huì)處理軸線圖像的曲線(Dis)advantagesofCT

CT的優(yōu)缺點(diǎn)11編輯版pptAdvantages:優(yōu)點(diǎn)Disadvantages:缺點(diǎn)(RadiationdosefromCT

CT射線的放射劑量DatafromNRPB199212編輯版pptRadiationdosefromCT

CT射線的放射1cran.caud.RUHSagittalreconstructions弧矢重建CT:2D-reconstructions

CT：二維重建13編輯版ppt1cran.caud.RUHSagittalreconstCT:3D-reconstructions

CT：三維重建14編輯版pptCT:3D-reconstructions

CT：三維重建CTartefacts

CT誤差Mostcommon:最常見(jiàn)Streakartefacts紋理Partialvolumeartefacts 局部體積15編輯版pptCTartefacts

CT誤差Mostcommon:最Beamhardening射束硬化16編輯版pptBeamhardening射束硬化16編輯版pptWhyCT?為什么要做CT？Anysituationwheresuperimpositionshouldbeavoided. 被檢結(jié)構(gòu)不受鄰近器官重疊干擾17編輯版pptWhyCT?為什么要做CT？AnysituatioAnysituationwheresuperimpositionshouldbeavoided. 被檢結(jié)構(gòu)不受鄰近器官重疊干擾Anysituationwheretheextensionofaprocessshouldbeevaluated. 評(píng)估病程的進(jìn)展。WhyCT?為什么要做CT？18編輯版pptAnysituationwheresuperimposAnysituationwheresuperimpositionshouldbeavoided. 被檢結(jié)構(gòu)不受鄰近器官重疊干擾Anysituationwheretheextensionofaprocessshouldbeevaluated. 無(wú)論什么情況都要評(píng)估病程進(jìn)展。CTguidedbiopsies. CT可以引導(dǎo)活組織檢查。Evaluationoftreatment/follow-up. 評(píng)估治療效果/追蹤觀察WhyCT?19編輯版pptAnysituationwheresuperimposWhenCTinsmallanimals?

小動(dòng)物何時(shí)做CT？Affectionsoftheskull顱部受影響B(tài)rain腦Splanchnocranium咽顱Nasalcavity鼻腔Spinalproblems脊柱問(wèn)題Orthopaedics矯形外科Detectionoffragments碎片檢測(cè)Elbow肘Tarsus跗節(jié)Other其他20編輯版pptWhenCTinsmallanimals?

小動(dòng)物何Asymmetrylatventricles=“mass-effect”

側(cè)腦室不對(duì)稱=“腫塊影響”Contrastenhancement對(duì)比增強(qiáng)Brainpathology腦部病理21編輯版pptAsymmetrylatventricles=“maIndicationsforCT

CT的應(yīng)用Affectionsoftheskull 顱部受影響B(tài)rain腦Splanchnocranium咽顱Nasalcavity鼻腔Spinalproblems脊柱問(wèn)題Orthopaedics整形外科Detectionoffragments 碎片檢測(cè)Elbow肘Tarsus跗節(jié)Other其他22編輯版pptIndicationsforCT

CT的應(yīng)用AffectIndicationsforCT

CT的應(yīng)用Affectionsoftheskull 顱部受影響B(tài)rain腦Splanchnocranium咽顱Nasalcavity鼻腔Spinalproblems脊柱問(wèn)題Orthopaedics整形外科Detectionoffragments 碎片檢測(cè)Elbow肘Tarsus跗節(jié)Other其他23編輯版pptIndicationsforCT

CT的應(yīng)用AffectCTtarsocruralOCD

分離性骨軟骨炎，跗腕部骨軟骨炎的CTDistallesion遠(yuǎn)端損傷Dorsallesion背側(cè)損傷Proximallesion近端損傷Exactlocation精確定位Size+extend尺寸+擴(kuò)大Numberoffragments碎片數(shù)量24編輯版pptCTtarsocruralOCD

分離性骨軟骨炎，跗腕部Inflammation炎癥Softtissueswelling軟組織腫脹25編輯版pptInflammation炎癥SofttissueswelLocalextensionofneoplasm

螯生物的局部增大26編輯版pptLocalextensionofneoplasm

螯生Metastases轉(zhuǎn)移灶27編輯版pptMetastases轉(zhuǎn)移灶27編輯版ppt28編輯版ppt28編輯版pptFollow-up追蹤觀察29編輯版pptFollow-up追蹤觀察29編輯版pptCThorse

CT檢查馬Limitations:局限Size大小Weight體重30編輯版pptCThorse

CT檢查馬Limitations:局限IndicationsforCThorse

馬CT的應(yīng)用Skull顱部Dentalproblems牙齒問(wèn)題Sinusproblems鼻竇問(wèn)題Etmoidproblems篩骨問(wèn)題(Brain)腦部Extremities四肢Fragments?Navicular,anybodypart 碎片？足舟骨炎，其他部位Complexfractures復(fù)合骨折31編輯版pptIndicationsforCThorse

馬CT的應(yīng)Sinusitis鼻竇炎32編輯版pptSinusitis鼻竇炎32編輯版pptDentalproblems牙齒問(wèn)題Toothfracture

牙齒斷裂BilateralfractureM1Foodsinusmaxillaris33編輯版pptDentalproblems牙齒問(wèn)題ToothfrIndicationslimbsCThorse

馬四肢CT的應(yīng)用Feet/distallimb(tillcarpus?-tarsus?): 腳/肢遠(yuǎn)端（到腕？-跗部？） fracture(spiral)螺旋骨折 fragments碎片 OCD分離性骨軟骨炎 sesamoids籽骨 navicularbone足舟骨炎 softtissues??…….軟組織？34編輯版pptIndicationslimbsCThorse

馬四肢SpiralP1fracture

螺旋狀P1骨折35編輯版pptSpiralP1fracture

螺旋狀P1骨折35編輯SpiralP1fracture

螺旋狀P1骨折36編輯版pptSpiralP1fracture

螺旋狀P1骨折36編輯PET-CT

正電子發(fā)射計(jì)算機(jī)斷層顯像儀

37編輯版pptPET-CT

正電子發(fā)射計(jì)算機(jī)斷層顯像儀37編輯版pptPET－CTpositronemissiontomography 正電子發(fā)射計(jì)算機(jī)斷層顯像技術(shù)γ-raysMetabolism 新陳代謝computedtomographyCT

計(jì)算機(jī)X線斷層攝影術(shù)X-raysAnatomy 解剖學(xué)38編輯版pptPET－CTpositronemissiontomogrPET-CT39編輯版pptPET-CT39編輯版pptLocalisationofActivity定位Imagefusion圖象融合Combinedsystems復(fù)合系統(tǒng)CT/MRI/SPECT:dataacquiredatthesamescanningsession:nomotion!

CT/MRI/SPECT:：掃描過(guò)程中同期獲得數(shù)據(jù)（無(wú)需移動(dòng)）Imagefusionwithsoftwareprograms

Manual-automatical人工-自動(dòng)CT,TCT:anatomicallocalization自動(dòng)定位

40編輯版pptLocalisationofActivity定位ImLocalisationwithTransmissionComputedTomography:TCT

透射式計(jì)算機(jī)斷層的定位

41編輯版pptLocalisationwithTransmissionZürichUniversityRadiotherapy放射治療42編輯版pptZürichUniversityRadiotherapyKeyPointsCT

CT關(guān)鍵點(diǎn)RXCT

Bone骨Withoutsuperimposition無(wú)重影的形態(tài)圖象=morphologicalimagingNoideaaboutfunctionality 功能性無(wú)價(jià)值NoideaAbouthistology組織學(xué)無(wú)價(jià)值BIOPSY! 活組織檢查43編輯版pptKeyPointsCT

CT關(guān)鍵點(diǎn)Bone骨WithouComputedtomography(CT)inveterinarymedicine

CT(計(jì)算機(jī)體層攝影)

在獸醫(yī)醫(yī)學(xué)上的應(yīng)用H.vanBree&I.GielenDepartmentMedicalImagingFacultyofVeterinaryMedicineGhentUniversity44編輯版pptComputedtomography(CT)inveRadiologyComputedTomography(CT)X-rays45編輯版pptRadiologyX-rays2編輯版pptDrawbacksofconventionalradiology

傳統(tǒng)放射學(xué)回顧Threedimensionsbecomingtwo 三維變成二維Superposition疊影Distortionoftheimage 圖像的失真Limitedsofttissuedifferentiation 軟組織分辨率有限46編輯版pptDrawbacksofconventionalradCT:what?什么是CT？Isaformofradiographyinwhichabeamofx-raysisdirectedtothepatientfrommanydifferentangles. 是一種X-rays，光束可以沿不同角度直接照射病人。Thefractionaltransmissionofthex-raysthroughthepatientismeasuredwithelectronicsensors.X-rays

x-rays可以分次穿過(guò)病人，并可以用電子感受器測(cè)量。Thesignalsareconvertedtodigitalform+senttoacomputer. 信號(hào)被轉(zhuǎn)變成數(shù)字的形式，并輸入電腦。47編輯版pptCT:what?什么是CT？IsaformoSetofDisconnectedData間斷的數(shù)據(jù)設(shè)置

Seriesofcontiguous2-Daxialimagesofspecifiedthicknessarerequired.一系列特殊厚度的2維軸圖像ConventionalCT

傳統(tǒng)CTSingle-SliceSpiralCT單層螺旋CT

ContinuousVolumeofData數(shù)據(jù)連續(xù)

Spiralpatternofvolumetricdataacquired旋轉(zhuǎn)模式獲得數(shù)據(jù)“StepandShoot”GantryRotation間斷照射掃描架旋轉(zhuǎn)Gantrycontainingx-raytubeanddetectorsreturnedtostartingpositionafterone360-degreerotation,patientadvancedfixeddistancethroughgantry.掃描架包括X-rays電子管和檢測(cè)器，旋轉(zhuǎn)360度后，再回到正常位置，因?yàn)椴∪讼惹氨还潭ㄔ趻呙杓苌稀?ContinuousGantryRotation連續(xù)掃描架旋轉(zhuǎn)Gantryhousingx-raytubeanddetectorsrotatesuninterruptedaroundthepatientwhilepatientcontinuouslyadvancedthroughgantry當(dāng)病人連續(xù)的通過(guò)掃描架時(shí)，有X-ray電子管和檢測(cè)器的掃描架繞病人持續(xù)旋轉(zhuǎn)。TechnologicalComparisonofCTScanners

CT掃描儀在技術(shù)上的對(duì)比48編輯版pptSetofDisconnectedData間斷的數(shù)據(jù)設(shè)ComparisonofSingle-SliceCTandMultisliceCT

單層螺旋CT與多層螺旋CT的比較Single-SliceSpiralCT單層螺旋CTMultisliceSpiralCT多層螺旋CT

OneDetectorRow一個(gè)檢測(cè)面

Radiationpenetratingthroughpatientisregisteredbyonerowofdetectors

穿過(guò)病人的射線是被一排檢測(cè)器記錄。FourDetectorRows四個(gè)檢測(cè)面

Radiationpenetratingthroughpatientisregisteredbyfourrowsofdetectors穿過(guò)病人的射線被四排檢測(cè)器記錄。OneSlice一層

Spiralpathtracedaroundpatientyieldsoneslicepergantryrotation

掃描架每旋轉(zhuǎn)一圈，產(chǎn)生一層斷面圖像FourSlices四層

Spiralpathtracedaroundpatientyieldsfourslicespergantryrotation掃描架每旋轉(zhuǎn)一圈，可產(chǎn)生四層斷面圖像49編輯版pptComparisonofSingle-SliceCTSlicewidth斷層厚度Tissuevoxel組織容量成分Imagepixel成相像素Matrix短陣50編輯版pptSlicewidthTissuevoxelImagepSpatialresolutionandpixel

空間（立體）的分辨和像素51編輯版pptSpatialresolutionandpixel

空Grayscale灰尺Air–1000空氣-1000Softtissuestructuresareusuallydisplayedwithinthisrange.軟組織通常呈現(xiàn)在這個(gè)區(qū)域+150-1500Bone+1000骨+1000White白色Black黑色windowWidth窗口寬度windowLevel窗口水平面CTimagesportraydifferencesprimarilyinphysicaldensity,ratherthaninatomicnumber. CT主要是根據(jù)物理密度而不是電子數(shù)鑒別組織的差異的。Thesedifferencescanbeaccentuatedintermsofshadesofgreyintheimagebymanipulatingthewindow. 這些差異可通過(guò)操作窗口成像的灰色陰影而明顯化52編輯版pptGrayscale灰尺Air–1000空氣-1000SoDifferentwindows

不同的窗口Softtissuewindow:WW400;WL60Bonewindow:WW3500;WL50053編輯版pptDifferentwindows

不同的窗口SofttiAdvantages:優(yōu)點(diǎn)Avoidingsuperimpositionofsurroundingstructures. 避免環(huán)繞結(jié)構(gòu)形成重影Superiortissuecontrast-densitydifference. 優(yōu)異的組織對(duì)比密度差異Possibilityofreconsindifferentplanes(2D,3D). 對(duì)不同平面進(jìn)行遠(yuǎn)程操作（2D，3D）Measurementspossible(density,surface,size). 可以測(cè)量（密度，表面積，大?。〥isadvantages:缺點(diǎn)Radiationhazard. 射線的危害Highcost? 高成本？Accesstoequipment? 有權(quán)使用設(shè)備否？Generalanaesthesia. 全身麻醉Learningcurvedealingwithaxialpictures. 學(xué)會(huì)處理軸線圖像的曲線(Dis)advantagesofCT

CT的優(yōu)缺點(diǎn)54編輯版pptAdvantages:優(yōu)點(diǎn)Disadvantages:缺點(diǎn)(RadiationdosefromCT

CT射線的放射劑量DatafromNRPB199255編輯版pptRadiationdosefromCT

CT射線的放射1cran.caud.RUHSagittalreconstructions弧矢重建CT:2D-reconstructions

CT：二維重建56編輯版ppt1cran.caud.RUHSagittalreconstCT:3D-reconstructions

CT：三維重建57編輯版pptCT:3D-reconstructions

CT：三維重建CTartefacts

CT誤差Mostcommon:最常見(jiàn)Streakartefacts紋理Partialvolumeartefacts 局部體積58編輯版pptCTartefacts

CT誤差Mostcommon:最Beamhardening射束硬化59編輯版pptBeamhardening射束硬化16編輯版pptWhyCT?為什么要做CT？Anysituationwheresuperimpositionshouldbeavoided. 被檢結(jié)構(gòu)不受鄰近器官重疊干擾60編輯版pptWhyCT?為什么要做CT？AnysituatioAnysituationwheresuperimpositionshouldbeavoided. 被檢結(jié)構(gòu)不受鄰近器官重疊干擾Anysituationwheretheextensionofaprocessshouldbeevaluated. 評(píng)估病程的進(jìn)展。WhyCT?為什么要做CT？61編輯版pptAnysituationwheresuperimposAnysituationwheresuperimpositionshouldbeavoided. 被檢結(jié)構(gòu)不受鄰近器官重疊干擾Anysituationwheretheextensionofaprocessshouldbeevaluated. 無(wú)論什么情況都要評(píng)估病程進(jìn)展。CTguidedbiopsies. CT可以引導(dǎo)活組織檢查。Evaluationoftreatment/follow-up. 評(píng)估治療效果/追蹤觀察WhyCT?62編輯版pptAnysituationwheresuperimposWhenCTinsmallanimals?

小動(dòng)物何時(shí)做CT？Affectionsoftheskull顱部受影響B(tài)rain腦Splanchnocranium咽顱Nasalcavity鼻腔Spinalproblems脊柱問(wèn)題Orthopaedics矯形外科Detectionoffragments碎片檢測(cè)Elbow肘Tarsus跗節(jié)Other其他63編輯版pptWhenCTinsmallanimals?

小動(dòng)物何Asymmetrylatventricles=“mass-effect”

側(cè)腦室不對(duì)稱=“腫塊影響”Contrastenhancement對(duì)比增強(qiáng)Brainpathology腦部病理64編輯版pptAsymmetrylatventricles=“maIndicationsforCT

CT的應(yīng)用Affectionsoftheskull 顱部受影響B(tài)rain腦Splanchnocranium咽顱Nasalcavity鼻腔Spinalproblems脊柱問(wèn)題Orthopaedics整形外科Detectionoffragments 碎片檢測(cè)Elbow肘Tarsus跗節(jié)Other其他65編輯版pptIndicationsforCT

CT的應(yīng)用AffectIndicationsforCT

CT的應(yīng)用Affectionsoftheskull 顱部受影響B(tài)rain腦Splanchnocranium咽顱Nasalcavity鼻腔Spinalproblems脊柱問(wèn)題Orthopaedics整形外科Detectionoffragments 碎片檢測(cè)Elbow肘Tarsus跗節(jié)Other其他66編輯版pptIndicationsforCT

CT的應(yīng)用AffectCTtarsocruralOCD

分離性骨軟骨炎，跗腕部骨軟骨炎的CTDistallesion遠(yuǎn)端損傷Dorsallesion背側(cè)損傷Proximallesion近端損傷Exactlocation精確定位Size+extend尺寸+擴(kuò)大Numberoffragments碎片數(shù)量67編輯版pptCTtarsocruralOCD

分離性骨軟骨炎，跗腕部Inflammation炎癥Softtissueswelling軟組織腫脹68編輯版pptInflammation炎癥SofttissueswelLocalextensionofneoplasm

螯生物的局部增大69編輯版pptLocalextensionofneoplasm

螯生Metastases轉(zhuǎn)移灶70編輯版pptMetastases轉(zhuǎn)移灶27編輯版ppt71編輯版ppt28編輯版pptFollow-up追蹤觀察72編輯版pptFollow-up追蹤觀察29編輯版pptCThorse

CT檢查馬Limitations:局限Size大小Weight體重73編輯版pptCThorse

CT檢查馬Limitations:局限IndicationsforCThorse

馬CT的應(yīng)用Skull顱部Dentalproblems牙齒問(wèn)題Sinusproblems鼻竇問(wèn)題Etmoidproblems篩骨問(wèn)題(Brain)腦部Extremities四肢Fragments?Navicular,anybodypart 碎片？足舟骨炎，其他部位Complexfractures復(fù)合骨折74編輯版pptInd