医学影像学简答题1（Medical imaging simplified answer 1）3. Short answergeneral1. Brief description of medical X-ray characteristicsThe X ray is an electromagnetic wave with penetration; Fluorescence effect; Photographic effects and biological effects. Its penetration is related to material density, thickness and wavelength of X ray, and fluorescence effect is the basis of fluoroscopy. Photographic effect is the basis of X-ray photography; The ionization effect, which involves changes in human biology, is the basis of radiological protection and radiotherapy.2. The basic principle of X-ray imaging is describedOn the one hand, it is based on the penetration of the X ray, the fluorescence effect and the photographic effect, and on the other hand, the difference between the density and thickness of the body tissue. When the X rays penetrate various tissues of the human body, it is absorbed in different degrees so that there is a difference in the amount of X on the screen or in the X-ray. This allows for contrast between the black and white contrast on the screen or in the X-ray.Bones, joint systems1. The X-ray performance of acute and chronic suppurative osteomyelitisThe suppurative osteomyelitis is caused by staphylococcus aureus in the bone marrow, good hair in children and juvenile, long backbone epiphysis good hair. The early (2 weeks) may have the following soft tissue changes: 1. Two, subcutaneous tissue and muscle intersections blurred, bone may not have obvious change. Bone changes were seen after 2 weeks. The localized osteoporosis was started in the epiphyseal cancellous bone. Subsequently, most dispersed irregular form of bone destruction. Edge blur. In the future, the bone destruction area may merge into a large area of destruction. And gradually extend to the backbone. Can be accompanied by pathological fracture. Osteocortical destruction can form the subperiosteum abscess and stimulate the periosteum to cause periosteal hyperplasia. The new bone with low density is parallel to the backbone. Later, as the course of illness extended. The new osteogenesis is obvious and can form the shell. Osteonecrosis is caused by the emergence of periosteum and thrombotic arteritis. The X-ray shows the dead bone formed along the axis of the bone, which is very dense. If the lesion is close to the joint, the abscess can destroy the bone cortex of the dry epiphysis and enter the joint synovial card. Cause suppurative arthritis. The X line is the swelling of the joint capsule. The gap in the joint is widened early and even dislocated. Late narrowing. Osteopenia. When acute suppurative osteomyelitis is not treated promptly and adequately. It can be transformed into chronic suppurative osteomyelitis. The X-ray showed a large number of osteogenic hyperplasia, thickening of periosteum and fusion with cortex, which was stratified or lacy, thickening of the bony cortex, and narrowing of the medullary cavity. The backbone thickened. Irregular appearance, if not recovered,can still be seen bone destruction and dead bone.2. Describe the X - ray performance of the spine tuberculosisIt is the most common person of bone and joint tuberculosis. Good for children and young people. With lumbar multiple hair. The X - line performance is mainly osteoporosis and cancellous bone fracture. The attachment is less cumulative. Vertebral bodies often collapse due to bone damage, flattening or wedges. When the lesion is involved in the vertebral body, the lower margin of the bone. The rupture of the intervertebral cartilage plate is caused by the use of the broken cortex. When the intervertebral disc is invaded, the intervertebral space is narrowed. Even disappearing, the adjacent vertebral bodies are embedded and fused. At the same time, the lesion can produce a large number of caseous necrosis material in the destruction of bone, and the cold abscess is formed in the soft tissues around the spinal column.The X line is characterized by the presence of a fusiform soft shadow on both sides of the vertebral body, known as a lateral abscess. In addition, due to pathological fracture. The lateral spine of the spine can be seen to change the curvature of the spine. The post-emergence deformity.3. Test the X-ray performance of vitamin D deficiency ricketsBecause vitamin D is not a cause of calcium and phosphorus metabolism, osteoid tissue in bone is deficient in calcium salt deposits. Systemic metabolic bone disease. The X-ray showed a decrease in bone density in the general bone. Bone trabeculaeare rare, fuzzy, margin roughness, bony cortex thinned, stratified change. In the areas where bone metabolism is more active, such as the occurrence of bone epiphysis, the low density edge is blurred, and the epiphyseal calcification zone is irregular, blurred, thin and disappeared. In the middle of the epiphyses, there is a tortuous deformation in the middle of the epiphysis, with a very irregular margin and a hairbrush shape. The gap between the epiphysis and the epiphysis is widened. The corner of the epiphysis was altered by bone spur. The front of the thoracic ribs is a wide mouth. At the same time, the weight-bearing long bone is often bent and deformed. (O leg, X leg, etc.), a small number of patients can have a blue branch fracture healing X-ray performance: the temporary calcification belt reappears, the cup mouth shape depression and brush change are relieved and disappeared. The epiphyseal space is normal. Bone density increases and bone cortex thickens. Bone epiphysis increases, the density increases, and the bone deformation is prolonged.4. Test the differential diagnosis of benign and malignant bone tumors from the characteristics of X-ray.Benign:No transfer: no transfer.Growth condition: slow growth, non-invasion and adjacent tissues, but can be oppressive.Local bone changes: swelling bone damage, clear line with normal bone, sharp edge, thinning of the bony cortex, andexpansion can maintain continuity.Periosteum hyperplasia: generally no periosteal proliferation, can have a small amount of periosteum hyperplasia after pathological fracture, and periosteal new bone is not damage the surrounding soft tissue changes: no swelling or lump shadow more, if there are any lump, the edge is clear.Angiography: vascular differentiation is normal, and the tumor can be used to compress blood vessels.Malignant:Transfer: transfer.Growth: rapid growth, transsexual and adjacent tissue organs.Local bone changes: invasive bone fracture, blurred boundary and normal bone boundary, uneven edges, irregular fracture and defect, and bone formation of tumor.Periosteal hyperplasia: multiple forms of periosteal hyperplasia, and can be destroyed by tumor.The surrounding soft tissue changes: the growth of the soft tissue is not clear from the surrounding tissue.Angiography: it can be seen that tumor blood vessels are more and more disordered, the tumor staining and arteriovenous fistula, and the blood supply artery thickening and the blood vessel erosion become rigid, and the edge damage and so on.5. Take the femoral neck fracture as an example.1. Delayed healing or non-healing of fracture; X - ray showed delayed bone scab, with few or no presence, delayed or prolonged fracture line.Two, false joint formation: the X ray shows the bone bushy with the end of the bone, and there is a clear line between the two sides of the broken end.3. Fracture deformity healing: X - ray shows bone formation Angle, rotation, shortening deformity.4. After trauma, osteoporosis.5. Bone and joint infection; For acute chronic bone, arthritis X ray performance.6. Bone ischemic necrosis: increased femoral bone density and deformation.7. Joint rigidity: it is caused by adhesion to the joint, often with osteoporosis and soft tissue atrophy.Viii. Degeneration of joints: change after chronic bone injury.9. Ossified myositis: calcification in different degree of soft tissue after fracture.The respiratory system1. What methods are used in chest imaging examination?1. Chest perspective 2, (positive and lateral) 3, high - kilovol-meter 4, body layer photography 5, bronchography 6, CT 7, MRI2. What are the basic X-ray manifestations of lung lesions?A, exudative lesions: show the edge blur, density uniform shape shadow, range from flocculus to big leaf, when lesions involving the big leaf, its shape is in line with lung and sharp edges, air-bronchogram and visible.2. Fibrosis change: the expression is high density, the boundary is clear, walking rigid, irregular shape of the line shape.Iii. Proliferative lesion: localized nodules or petals, with high density, relatively clear edges, and generally no fusion trend.4. Calcified venereal changes: the appearance is sharp, the density is extremely high, the shape is different, the size of the speckle shape or plaque shape.Voids: 1. Wormwood vacuous cavity: manifested in a large number of pulmonary real changes with multiple small permeable areas. The form is irregular, it is wormlike. 2. Thin wall cavity: hollow wall thickness < 3mm, boundary clear, smooth circular light zone. 3. Thick wall hole: wall thickness > 3mm, the holeis round or irregular, peripheral or unreal change area, the inner wall is smooth and neat or concave, the hole can have or airless plane.Six, mass lesions, benign tumor characterized by round or oval, smooth boundary, density uniform spherical density shadow, malignant tumors are lobulated, the boundary is not sharp, can have a short nap or umbilical concave), central necrosis.3. With a solid shadow on one side of the chest, which diseases should be considered? What aspects should be analyzed in the identification?One, a large number of pleural effusion, one side of the lung, the one side of the lung, the one side of the pleural hypertrophy, the one side of the pleural hypertrophy, the one side of the lung, the one side of the lung and the one side of the lungShould note: when identifying a, mediastinal position 2, diaphragmatic level three, five, four, thoracic rib gap width size on a flat piece of six, observe whether air-bronchogram, observe whether the main bronchus is unobstructed in layer 7, combined with clinical data4. What are the direct and indirect X-ray signs of bronchial lung cancer (central type)?1. Lumps, located in the lung area, are rounded or lobule.2. Endobronchial polyps filling defect.3. The bronchial wall thickened and the lumen was narrow or blocked, with rat tail or cup.Ii. Indirect symptoms: 1. Obstructive pulmonary disease,The horizontal and pulmonary masses of the upper lobe of the upper lobe of the upper lobe of the upper lobe.2. Obstructive pneumonia: repeated attacks and slow absorption of exudative lesions.3. Obstructive emphysema: the air volume of the blocked lung is increased, and the brightness is increased.5. Typical X-ray manifestations of large leaf pneumonia?Lobule pneumonia may involve most or all of the lobes. The former is characterized by uniformity of density, and the shadow of the edge is indistinct. The edge is clear, with the interleaf crack as the boundary, its shape with the pulmonary lobe, the contour is consistent, its inside visible bronchi meteorology. Different forms of lobule pneumonia vary.6. Typical X-ray manifestations of acute hemorrhagic disseminated tuberculosis?The early two lung density of the lesion showed a change of hair glass. In about 10 days, the two lungs showed diffuse uniform distribution, the same size, uniform density of miliary nodules. The two lung textures are not clear.The circulatory system1. Simple mitral stenosis X-ray performance?The heart increases, the left atrium and right ventricle are enlarged, and the left heart is often significantly enlarged.The main reason for the reduction of the general aortic ball is the reduction of left ventricle blood elimination, aortic dysplasia or the left rotation of the heart and big blood vessels, and the aortic arch folds.The left ventricle shrank, the apex of the heart moved, the lower part of the heart was straight.4. Mitral membrane calcification, direct sign.5. Pulmonary congestion or interstitial edema, upper pulmonary vein dilation, lower pulmonary veins. Sometimes it can be seen that the diameter of 1 ~ 2mm in diameter can be seen in the lung field, which is composed of hemosiderosis.2. The X line of high blood heart disease is shown as?One, the heart is aortic type, the left ventricle segment increases, becomes round, the heart apex is in the phrenic, the cardiac phrenic horn shows acute Angle, the left ventricle is prominent, overlaps with the spine.Second, the left ventricle is increasing to the left, and the apex of the heart is often under the diaphragm.3. The perspective can be seen that the opposite pulsation.When left heart failure, the left atrium increases, and pulmonary congestion and pulmonary edema appear.5. Severe, the heart is generally enlarged, but the left ventricular enlargement is the main.The aorta has dilation, extension, and circuity.3. X-ray performance of pulmonary heart disease?Changes in pulmonary hypertension and chronic pulmonary diseaseOne, pulmonary hypertension, often occurs before the heart shape changes.Second, the right ventricle enlarges, the heart is in the mitral valve type, the heart rate is more than the normal person not much. Some cases: the heart is smaller than normal, and is related to the low level of the pulmonary emphysema.Three, chronic pulmonary disease, chronic bronchitis, extensive lung tissue fibrosis and emphysema.4. X ray performance of congenital heart disease atrial septal defect?When the defect is small, the size and shape of the heart andshape are normal or change.The heart is of mitral valve type, often moderate increase.Two, right atrium and right ventricular enlargement,The major characteristic changes of atrial septal defect were significantly increased in the right atrium.3. The pulmonary artery protruding, the pulsating enhancement, the pulmonary portal angiectasia. There are often lungmen dancing.In the left atrium, the left ventricle and aorta decreased, while the first left ventricle enlarged.5. Pulmonary hyperemia and later pulmonary hypertension.5. The X ray performance of common Fallot tetralogy?1. The heart is generally not enlarged, the heart is blunt, the upper warped is a sheep's nose, the heart lumbar depression, if there is a third ventricle forming, the heart is flat, or slightly raised.Second, the right ventricle increases.The left ventricle narrowed with decreased blood flow, the left atrium was generally unchanged, and the right atrium was mild to moderate due to increased blood flow and increased right ventricular pressure.4. The lung door shrinks and the lung vessels are slim.The aorta is widened and shifted to the right.The digestive system1. According to what characteristics can the organ of the digestive system be divided into two categories? Where are the organs?According to the characteristic of the digestive organ is the real organ or the hollow viscera, the digestive organ is divided into two categories. The liver and pancreas belong to the substantial organ. Esophagus, stomach, duodenum, large, small intestine and biliary system belong to hollow viscera.2. What kind of inspection methods and imaging methods are used in the two main types of digestive tract and cavity?The liver and pancreas of parenchyma were mainly used for CT, ultrasound and mri. After the general sweep; When necessary, CT iodine contrast agent was enhanced, and magnetic resonance was enhanced with gadolinium contrast agent.The hollow viscera was mainly used for routine X-ray examination, the gastrointestinal tract was radiographed by barium, and the bile was used for the contrast of iodine3. The X-ray signs of benign and malignant ulcers are identified.A benign ulcer protrudes from the gastric cavity. The ulcer is located within the contour of the stomach2. The shape of the shadow: the benign ulcer is relatively small and round, and the malignancy is larger and more shallow.Three, niche mouth: benign ulcer with mucosal edema, width is consistent, sometimes under pressure to change form malignant ulcer niches mouth cancer tissue invasion, forming ring levee involuntary pressure, change or more cancer nodules form refers to the indentation, sharp corners.Iv. Benign ulcer stomach constriction peristaltic direct niches, malignant ulcer is more than 1 cm from the niches, peristalsis disappears.4. Differentiation of esophageal foreign body and trachea foreign bodyTake the coin foreign object as an example, because the diameter of the esophagus is small, the left and right diameters are wider, so the esophageal foreign body is in a circular position, and the lateral position view is striped. The trachea foreign body is opposite, because the trachea half annular cartilage is absent is facing the rear, so the maximum diameter of the foreign body is the front and rear direction. The positive view is long and long, while the lateral position is round.5. Identification of jejunum, ileum and intestinal obstruction? How to diagnose low - level intestinal obstruction based on flatslice?The intestinal mucosa is a fish-bone arrangement perpendicular to the vertical axis of the intestinal tube. The mucosa of ileus is only two intestinal wall lines. The most significant expansion of the obstruction tube diameter is the semilinar fold.The high intestinal obstruction is mainly manifested in the left middle and upper abdominal multiple qi level, the stomach also sees the liquid level, the lower abdomen and the pelvic cavity of the lower abdomen and the lower gas. Low intestinal obstruction, the expression is the whole abdomen several stair - shaped gas levelUrinary system1. Differential diagnosis of urinary calculus. (points)1. Gallstones: the form is polygon, the surrounding density is high, the central density is low, sometimes there is the high density core. Lateral photography is located in front of the spine.Lymph node calcification: form irregular punctate, structure, and has no fixed position, to move a large degree (e.g., mesenteric lymph node calcification) imaging of the renal pelvis can understand outside or in the urinary tract.3. Intestinal contents (coprolites or drugs) : the position is not constant, the repeated photo position can be changed ordisappeared, and the bowel will disappear.Iv. Venous stone (pelvic cavity) : small, round, circular or concentric round dense shadow, the edges are neat, often for both sides and multiple, the position is more than partial, when necessary retrograde contrast imaging is identified.2. X-ray manifestations of renal tuberculosis. (points)Flat slice: the kidney contour area can protrude, terminal form shrinksCalcification: diffuse, cloudy, spottedAngiography: wormhole destruction, renal cortical abscess and vacuous formation, pyelonephrosis, renal pelvis, renal calyx (peripheral imformation, deformed stenosis), renalself-truncation3. The X-ray of typical urinary calculi. (points)Kidney: sliced: mulberry, layered, antlerContrast: density, higher density, filling defect, obstructionUreter: flat slice: the long axis is consistent with the ureterAbdominal segment: side of the lumbar spineThe sacroiliac segment: the sacroiliac jointPelvic segment: roughly parallel to the pelvic rimLower end of ureter: polymorphismContrast: positive, negative and catheter relationship, obstruction of waterBladder calculi: above the symphysis pubis, the midline of the pelvic cavity changes with positionUrethra: the posterior urethra: the symphysis of the pubic bone and the posterior urethra4. Several common radiographic reflux X - ray manifestations.1. Tubule reflux: the radiate dense shadow radiated from the center of the kidney to the cortex.Second, the kidney sinus reflux: it appears as the irregular Angle or band dense shadow around the fornix, and the author appears in an irregular shape.Iii. Circumfluence of the blood vessels: the arch of the arch is shown as the arch of the arch.Iv. Lymphatic reflux: it is shown as a slender, meandering, curved silhouette that walks in the direction of the renal gate.5. Various imaging examinations and USES of urinary system. (points)IVP: the shape of the renal pelvis, renal calices, ureters, and bladder, and the function of the renal excretion2. Retrograde pyelography: used for IVP display (such as renal dysfunction) or not for IVP (such as liver and kidney function, iodine allergy)Bladder angiography: excretory method: the urethral stricture cannot be intubated or at the same time, the upper urinary tract should be examinedRetrograde: observe bladder size, shape, position to diagnose bladder disease4. Urethrography: mostly used for urethral stricture, calculi, congenital malformation, etc5. Retroperitoneal aerated angiography: showing the renal, adrenal profile and retroperitoneal mass and the relationship with the kidney6. Arteriography: diagnosis of vascular lesions and adrenal neoplastic lesionsCentral, five official system1. Evaluation of CT in the treatment of sinus tumors.CT diagnosis of smaller tumors is of great value and can be determined in its origin and scope. Benign tumor margins are clear and orderly, without bone damage. But it is difficult todetermine the pathological nature. The mucous cyst showed an enlarged sinus cavity and increased density. CT is of great value in diagnosis of malignant tumor. In the early stage of osteopenia, there was a shadow of mass in the sinus cavity, and the sinus cavity was seen in the sinus cavity. The sinus wall can be damaged early, and the adjacent structure can be shown as the nasal cavity, the invasion of the orbit and the scope.2. CT manifestations of meningiomas.The CT findings of typical meningiomas are high in density, with clear edges, spherical or subleaf lesions, and cranial bones, which are connected to the cerebellum. There was no edema or slight edema in the oven. The general performance of the enhanced scanning was significantly enhanced.。