四肢关节结核影像诊断与鉴别胡俊华课件.pptx

1、 BEA Confidential.|215432四肢关节结核四肢关节结核BEA Confidential.|4四肢关节结核病理四肢关节结核病理早期滑膜明显充血、肿胀，表面有纤维素或者干酪样坏死物覆早期滑膜明显充血、肿胀，表面有纤维素或者干酪样坏死物覆盖盖进一步发展纤维素增生导致滑膜明显增厚，关节渗液缺少蛋白进一步发展纤维素增生导致滑膜明显增厚，关节渗液缺少蛋白溶解酶，关节软骨破坏较晚溶解酶，关节软骨破坏较晚晚期关节软骨破坏，侵蚀关节骨质级关节内组织，关节间隙狭晚期关节软骨破坏，侵蚀关节骨质级关节内组织，关节间隙狭窄，脓肿形成，部分伴有肌肉萎缩窄，脓肿形成，部分伴有肌肉萎缩2、病例来源：郑州大

2、学第一附属医院任翠萍老师结果：左胫骨上段结核结果：左胫骨下段结核病例来源：聊城市第二人民医院葛英霖老师BEA Confidential.|10病例三、男性，左膝关节疼痛数月病例三、男性，左膝关节疼痛数月左膝关节骨质密度减低，关节间隙狭窄，胫骨上段及股骨下段见左膝关节骨质密度减低，关节间隙狭窄，胫骨上段及股骨下段见多发点状、小片状低密度影，边界模糊，关节面不规则（提示软多发点状、小片状低密度影，边界模糊，关节面不规则（提示软骨侵蚀），未见明显骨膜反应，关节腔见积液、积脓，周围软组骨侵蚀），未见明显骨膜反应，关节腔见积液、积脓，周围软组织肿胀并见脓肿形成，其内见多发点状钙化。织肿胀并见脓肿形成，其

3、内见多发点状钙化。BEA Confidential.|11BEA Confidential.|12BEA Confidential.|13BEA Confidential.|14BEA Confidential.|15BEA Confidential.|16BEA Confidential.|17BEA Confidential.|18鉴别诊断化脓性关节炎：患者临床症状明显（高热、疼痛、功能障碍），骨质破坏为持重部位，骨膜反应较明显。幼年性关节炎：16岁以下儿童发病，女性多见，不规则发热、贫血、关节肿痛，晚期关节畸形，早期双手近端指间关节肿胀，在软骨尚未破坏之前即可有骨化中心疏松、增大或变小，

4、密度不均匀。晚期关节纤维性/骨性强直类风湿关节炎：色素沉着绒毛结节性滑膜炎：MR表现为滑膜弥漫性结节状增生，内可见含铁血黄素沉积所致的双低信号，此为PVNS的特征性表现，无明显死骨，骨质疏松不明显夏科氏关节痛风鉴别诊断鉴别诊断2.小骨巨细胞病变：小骨巨细胞病变呈膨胀性改变，内无明显死骨，MR表现T1WI稍低信号，T2WI呈高/混杂信号，增强扫描明显强化 BEA Confidential.|28影像表现（影像表现（X X线）线）BEA Confidential.|29影像表现（影像表现（X X线）线）BEA Confidential.|31影像表现（影像表现（X X线）线）BEA Confide

5、ntial.|32影像表现（影像表现（CTCT、MRMR）CTCT：MR：BEA Confidential.|33鉴别诊断鉴别诊断脊柱化脓性感染脊柱化脓性感染：BEA Confidential.|34Example of a DiagramService InfrastructureServices ManagementService BusCommon ServicesInformation Access ServicesPresentation ServicesShared Business ServicesComposite ApplicationsBEA Confidential.|3

6、5BEA Confidential.|36Slide Animation GuidelinesThe purpose of slide animation and builds is to enhance the message,not detract from itBecause of this,it is important to use slide animation sparingly and only when necessaryTo adjust the slide animations,select“Custom Animation”under the Task PaneUse“

7、Appear”option for the animationBEA Confidential.|37Saving This Template as Your Default Design TemplateColor Palette and Sample ChartsBEA Confidential.|39Color PaletteR:0G:114B:234R:101G:174B:255R:0G:60B:12R:32G:195B:30R:138G:202B:136R:36G:124B:34R:182G:70B:184R:210G:144B:212R:117G:45B:119R:255G:0B:

8、42R:255G:91B:91R:158G:0B:26R:178G:180B:179R:211G:211B:211R:122G:128B:131BEA Confidential.|40Flow Diagram Using Corporate ColorsStep 1Step 2Step 3Supporting bullet copy hereSupporting bullet copy hereSupporting bullet copy hereSupporting bullet copy hereSupporting bullet copy hereSupporting bullet co

9、py hereSupporting bullet copy hereBEA Confidential.|41Sample Bar ChartInstructions:The color palette has been set in this chart.To create a new chart,copy this chart onto your slide.To update the data,double-click on the chart to bring up the PPT chart editor.For additional information on working wi

10、th the PPT charting feature,follow this linkoffice.microsoft/en-us/assistance/CH063509351033.aspxBEA Confidential.|42Sample Pie ChartInstructions:The color palette has been set in this chart.To create a new chart,copy this chart onto your slide and update the data to suit your needsBEA Confidential.

11、|43Row HeadHeadHeadHeadColumn HeadDataDataDataColumn HeadDataDataDataColumn HeadDataDataDataColumn HeadDataDataDataColumn HeadDataDataDataColumn HeadDataDataDataColumn HeadDataDataDataInstructions:This table was created using PowerPoints built-in table program.The table will dynamically adjust to th

12、e content.To enter or edit the data,simply click on the table.Keep format colors as is.Sample Table SlideBEA Confidential.|44Row HeadHeadHeadHeadColumn HeadDataDataDataColumn HeadDataDataDataColumn HeadDataDataDataColumn HeadDataDataDataColumn HeadDataDataDataColumn HeadDataDataDataColumn HeadDataDa

13、taDataSample Table Slide With HighlightStandard Boxes,Arrows,and ShapesBEA Confidential.|46w/shadowStandard Blue Box StylesBox w/ShadowBEA Confidential.|47Standard Green Box Stylesw/shadowBox w/ShadowBEA Confidential.|48Standard Purple Box Stylesw/shadowBox w/ShadowBEA Confidential.|49Standard Gray

14、Box Stylesw/shadowBox w/ShadowBEA Confidential.|50Example of a DiagramService InfrastructureServices ManagementService BusCommon ServicesInformation Access ServicesPresentation ServicesShared Business ServicesComposite ApplicationsBEA Confidential.|51PhotographyUse of photography should be minimalNe

15、ver mix-and-match black and white and color images on the same pageNever use clipartA defined collection of stock photography is available at inweb.beasys/marketing/resource/graphics/Right click on the URL,select Open Hyperlink to open the Photo Library in the browserBecause Liquid naturally calls t

16、o mind strong visual imagery,there might be a desire to use different types of water imagery(e.g.,waves,rivers,waterfalls,droplets,etc.).However,in order to maintain a consistent look-and-feel,we recommend not using this type of imagerySpecial NeedsBEA Confidential.|53Template for Special EventYou c

17、an use this layout for special events which require designation,but do not require a custom templateInsert a text box with the name of the event to the Title Master as shown in the screenshot and the bottom of the Slide Master as shown belowName of the Event(min.14 pt.)Thank YouSpeaker and/or DateQuestionsBEA Confidential.|55