磁振造影掃描儀(MRI)不具輻射,是非常方便進行人體任何角度切面成像的設備,其最大優點在於提高軟組織的對比度及解析度,並利用不同參數呈現組織的特性。因此磁振造影對於骨骼肌肉系統與骨髓疾病及脊椎方面的病變之判讀,極有助益。此外,藉由磁振造影,亦使有關神經及心臟血管系統等組織結構及功能的研究分析獲突破性進展。
台大醫院放射線科施庭芳副教授在過去幾年中熱心參與教育改革,她在教學時特別重視臨床資料與影像變化的關聯,常與學生就影像變化與病理生理、臨床診療的相關課題做深入討論,激發學生的思維,讓學生找到自動學習的正確方向,是學生心目中極受歡迎的老師。
此次施副教授將教材內容的精華部份加以整理,撰寫成書,書中內容就磁振造影對於脊椎病變的應用,做了精要的闡釋,病例討論的部份尤其適合於醫學生及住院醫師的研習,非常值得推荐。相信本書的出版必能有助於提昇醫學生及住院醫師的影像判讀能力,希望年輕醫師好好利用本書,提高診斷技術,造福病患。
作者簡介:
施庭芳(台大醫院影像醫學部主任)
目錄
第一章 磁振造影之骨髓影像 (M. R. Bone Marrow Imaging)
概論
瀰漫性骨髓病變 (Diffuse Bone Marrow Change):
1-1 骨質疏鬆之骨髓變化 (Bone marrow signal change of osteoporosis)
1-2 多發性骨髓瘤之長骨骨髓變化 (Bone marrow change of multiple myeloma; long bone)
骨髓內水腫 (Bone Marrow Edema):
1-3 暫時性局部骨質疏鬆 (Transient osteoporosis)
1-4 慢性腎衰竭及骨梗塞 (Chronic renal failure and bone infarct)
1-5 代謝性骨髓疾病 (Gaucher disease)
骨髓惡性腫瘤 (Hematological Malignancy):
1-6 急性白血病之骨髓變化 (Bone marrow change of acute leukemia)
1-7 多發性骨髓瘤的腰椎骨髓變化 (Bone marrow change of multiple myeloma; lumbar spine)
1-8 胸腰椎骨轉移 (Metastatic bone lesion of thoracolumbar spine)
治療後的骨髓變化 (Response of Bone Marrow to Therapy):
1-9 放射線治療後之骨髓變化 (Post-irradiation bone marrow change)
1-10 化學治療後之骨髓變化 (Bone marrow change after chemotherapy)
第二章 脊椎壓迫性骨折 (Compression Fracture of the Spine)
概論
非病理性壓迫性骨折 (Non-Pathologic Compression Fracture):
2-1 骨質疏鬆症之壓迫性骨折 (Osteoporotic vertebral fracture)
2-2 急性爆裂性骨折 (Acute burst fracture)
2-3 漸進式缺血性骨壞死 (Osteonecrosis in progress)
病理性壓迫性骨折 (Pathologic Compression Fracture):
2-4 椎體骨髓炎之壓迫性骨折 (Vertebral osteomyelitis and compression fracture)
2-5 肝細胞癌之脊椎轉移 (Hepatocellular carcinoma with spinal metastasis)
2-6 甲狀腺癌之脊椎轉移 (Thyroid cancer with spinal metastasis)
2-7 乳癌之脊椎轉移 (Breast cancer with spinal metastasis)
第三章 退行性脊椎病變 (Degenerative Spinal Disease)
概論
退行性椎間板病變及突出 (Degenerative and Herniated Disc):
3-1 退行性椎間板病變 (Degenerative disc disease)
3-2 偏側椎間板突出 (Eccentric protruding disc)
3-3 偏側椎間板擠出 (Eccentric extruding disc)
3-4 椎間板破裂成為碎片 (Sequestrated or ruptured disc)
3-5 椎間板破裂並卡入神經管道 (Foraminal disc)
退行性脊椎病變 (Degenerative Spinal Disease):
3-6 退行性脊髓腔狹小 (Degenerative spinal stenosis)
3-7 退行性脊椎脫位 (Degenerative spondylolisthesis)
3-8 椎面關節炎引起之滑膜囊腫 (Synovial cyst of facet joint)
3-9 相鄰椎體及椎間板之骨骼軟骨病變 (Osteochondral lesion)
3-10 後縱韌帶骨化伴隨椎間板突出 (Ossification of posterior longitudinal ligament with herniated disc)
第四章 感染性脊椎炎 (Infectious Spondylitis)
概論
化膿性或細菌性脊椎炎 (Pyogenic or Bacterial Spondylitis):
4-1 化膿性或細菌性脊椎炎 (Pyogenic or bacterial spondylitis)
4-2 化膿性脊椎炎之早期變化 (Early change of pyogenic spondylitis)
4-3 化膿性之椎體骨髓炎 (Pyogenic vertebral osteomyelitis)
4-4 多節感染性脊椎炎 (Pyogenic spondylitis with multifoci and multisegments)
4-5 脊柱旁側肌肉內膿腫並進入脊柱腔 (Intramuscular abscess with thecal sac involvement)
4-6 單一節化膿性椎體骨髓炎 (Single segment vertebral osteomyelitis-pyogenic origin)
結核性脊椎炎 (Tuberculous Spondylitis):
4-7 結核性脊椎炎及椎體旁之膿腫 (Tuberculous spondylitis with abscess formation)
4-8 胸椎結核性脊椎炎 (Tuberculous spondylitis in T-spine)
4-9 結核性脊椎炎及椎體旁、硬腦膜外膿腫 (Tuberculous spondylitis with paravertebral and epidural abscess)
4-10 結核性脊椎炎之早期變化 (Early change of tuberculous spondylitis)
4-11 單一節結核性骨髓炎(Single segment vertebral osteomyelitis-tuberculous origin)
4-12 單一節結核性骨髓炎 (Single segment vertebral osteomyelitis-tuberculous origin)
4-13 嬰幼兒結核性脊椎炎並形成椎體旁及硬腦膜外膿腫 (Infantile tuberculous spondylitis with paravertebral and epidural abscess)
黴菌性脊椎感染 (Fungal Spondylitis):
4-14 黴菌性脊椎感染 (Fungal spondylitis)
4-15 黴菌性脊椎感染 (Fungal spondylitis)
頸椎感染及其他 (Infectious Process in C-Spine and Others):
4-16 頸椎結核性脊椎炎 (Tuberculous spondylitis in C-spine)
4-17 咽喉後腔膿腫 (Retropharyngeal abscess)
4-18 外傷性之椎體前血塊生成 (Posttraumatic hematoma in prevertebral space)
4-19 頸椎化膿性脊椎炎及硬腦膜外膿腫 (Pyogenic spondylitis in C-spine with epidural abscess)
4-20 胸腰椎之結核性腦膜炎 (Tuberculous meningitis in T-L spine)
第五章 缺血性椎體骨壞死 (Osteonecrosis of the Vertebra)
概論
5-1 胸椎椎體缺血性骨壞死 (Osteonecrosis) 及不正常液體聚集之空腔 (Avascular, fluid-content space)
5-2 腰椎椎體缺血性骨壞死 (Osteonecrosis) 及不正常之氣體聚集 (Gas collection)
5-3 胸椎椎體缺血性骨壞死,伴隨椎體內氣體及液體聚集 (Osteonecrosis with fluid and gas in vertebral body)
5-4 漸進式缺血性骨壞死 (Osteonecrosis in progress)
第六章 手術後脊椎症侯群 (Postoperative Spine)
概論
6-1 硬腦膜外纖維化 (Epidural fibrosis)
6-2 再發性椎間板突出 (Recurrent herniated disc)
6-3 破裂椎間板碎片於腰椎之側隱窩處 (Residual disc fragment in lateral recess)
6-4 術後之血塊並壓迫神經 (Postoperative hematoma)
6-5 手術後併發之感染性脊椎炎 (Postoperative spinal infection)
6-6 手術後併發感染及硬腦膜沾黏 (Postoperative infection and dural adhesion)
6-7 骨泥和植入骨之位移以及過度增生,並壓迫脊髓腔 (Excessive bone graft dislodgement with thecal indentation)
6-8 植入骨鬆脫並壓迫脊髓腔 (Dislodged bone graft with spinal compression)
6-9 手術後感染併發假性關節的形成 (Post infectious pseudoarthrosis)
6-10 植入骨鬆脫並形成假性關節 (Dislodged bone graft and pseudoarthrosis)
第七章 脊椎腫瘤 (Spinal Tumor)
概論
原發性腫瘤 (Primary Tumor):
7-1 骨樣骨瘤 (Osteoid osteoma)
7-2 骨母細胞瘤 (Osteoblastoma)
7-3 薦椎之巨細胞瘤 (Giant cell tumor of sacrum)
7-4 椎體之瀰漫性血管瘤 (Vertebral hemangioma)
7-5 血管瘤狀骨囊泡 (Aneurysmal bone cyst)
7-6 漿細胞瘤 (Plasmacytoma)
7-7 硬腦膜內脊髓外之神經鞘瘤 (Intradural extramedullary neurilemmoma)
7-8 硬腦膜外神經鞘瘤 (Extradural neurilemmoma)
7-9 神經纖維瘤 (Neurofibroma)
7-10 脊髓內神經膠質瘤 (Intramedullary glioma)
7-11 惡性脂肉瘤 (Liposarcoma)
7-12 原發性惡性原骨腫瘤 (Osteogenic sarcoma)
次發性腫瘤 (Secondary Tumor):
7-13 鼻咽癌薦椎轉移 (Nasopharyngeal carcinoma with sacral metastasis)
7-14 鼻咽癌胸椎轉移 (Nasopharyngeal carcinoma with spinal metastasis)
7-15 乳癌之脊椎轉移 (Breast cancer with spinal metastasis)
7-16 攝護腺癌之瀰漫性脊椎轉移 (Prostate cancer with diffuse metastasis of the spine)
7-17 多發性骨髓瘤及局部腫塊生成 (Multiple myeloma with tumor formation)
第八章 其他 (Miscellaneous)
8-1 薦椎之應力性骨折 (Sacrum insufficiency fracture)
8-2 放射線治療後之椎體骨壞死併發壓迫性骨折 (Radionecrosis with compression fracture)
8-3 僵直性脊椎炎伴隨經椎間板骨折及假性關節 (Ankylosing spondylitis with transdiscal fracture and pseudoarthrosis)
8-4 硬腦膜外血管脂肪瘤 (Epidural angiolipoma)
8-5 先天性脊椎全脫位 (Congenital spondyloptosis)
8-6 結核性脊椎炎併發脊椎後彎 (Tuberculous spondylitis with severe kyphosis)
8-7 Os odontoideum
8-8 脊椎之痛風石沉殿 (Gouty tophi of the spine)
參考文獻
參考書籍
索引
第一章 磁振造影之骨髓影像 (M. R. Bone Marrow Imaging)
概論
瀰漫性骨髓病變 (Diffuse Bone Marrow Change):
1-1 骨質疏鬆之骨髓變化 (Bone marrow signal change of osteoporosis)
1-2 多發性骨髓瘤之長骨骨髓變化 (Bone marrow change of multiple myeloma; long bone)
骨髓內水腫 (Bone Marrow Edema):
1-3 暫時性局部骨質疏鬆 (Transient osteoporosis)
1-4 慢性腎衰竭及骨梗塞 (Chronic renal failure and bone infarct)
1-5 代謝性骨髓疾病 (Gaucher disease)
骨髓惡性腫瘤 (Hematologica...
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