肋骨（及胸壁）的影像诊断课件.pptVIP

肋骨(及胸壁)的病变较少见，文献以个例报道较多。俺这种老骨头有时也不知从何下口!鉴于大家对马哥系列疑难病例不太感兴趣,俺只有给弟兄们换换口味了! 本帖病例及图片来源于国内外专业杂志、书籍及相关网站，俺就不一一注明。谨在此致谢！！！欢迎大家跟帖丰富内容！！ Rib Lesions肋骨病变分类（俺已翻译成中文） - Rib tumor Primary Malignancy: chondrosarcoma, plasmacytoma, lymphoma, osteosarcoma, MFH Benign: osteochondroma, enchondroma, osteoblastoma, osteoid osteoma,  chondroblastoma, hemangioma Metastasis, direct invasion- Infectious disease Osteomyelitis abscess; fungal, tuberculosis, actinomycosis, other bacteria- Others Fibrous dysplasia, Langerhans cell histiocytosis, Paget disease, renal  osteodystrophy, hemoglobinopathies- 肋骨病变分类：——肋骨肿瘤原发性 恶性：软骨肉瘤、浆细胞瘤、淋巴瘤、骨肉瘤、MFH  良性：骨软骨瘤、软骨瘤、骨母细胞瘤、骨样骨瘤、软骨母细胞瘤、血管瘤 转移瘤，直接侵犯——感染性疾病 骨髓炎或脓肿、真菌性、结核、放线菌（actinomycosis）、其他细菌——其他 纤维结构不良、嗜酸性肉芽肿、Pagets disease、肾性骨营养不良、血红蛋白病  肋骨正常解剖和变异： 肋骨正常解剖： a：胸骨角水平Rib counting at CT with the sternal angle as an anatomic landmark. Sequential axial chest CT scans of the ribs and sternum show identification of the sternal angle with the second costal cartilage and rib (2) followed by the counting of the third, fourth, and fifth ribs (3–5) in numeric order . The fifth rib is traced as the reference rib in sequential planes (b–d). Note that the rib moves slightly anterior in the caudal planes. The target rib with the metastatic lesion (arrowhead in d) is identified by counting ribs in numeric order from fifth (5) to fourth (4) in the same axial plane.  肋骨正常解剖： b：剑突水平Rib counting at CT with the xiphoid process as an anatomic landmark. Axial CT scan shows the xiphoid process , the seventh rib (7), and the relative position of the lower ribs (6–9). It is important to identify the transverse portion of the costal cartilage (arrows), at which point one stops counting down and starts counting up (ie, moves from medial to lateral). 5 = fifth rib.  肋骨正常解剖： c：肋骨伴随影Rib companion shadows. Posteroanterior chest radiograph (magnified view) shows rib comp