肩关节超声诊断shoulderppt课件

肩关节超声影像诊断肩关节超声诊断shoulder肩关节超声影像诊断肩关节超声诊断shoulder1适应证肩袖病变肩袖撕裂、肩关节撞击综合征非肩袖病变创伤软组织肿块炎症其它肩关节超声诊断shoulder适应证肩袖病变肩关节超声诊断shoulder2肩关节超声要求熟悉重要结构解剖规范的扫查方法动态、双侧对比扫查对骨骼肌肉系统常见疾病的认识肩关节超声诊断shoulder肩关节超声要求肩关节超声诊断shoulder3肩关节解剖肩关节超声扫查方法肩关节常见疾病（肩袖撕裂）肩关节超声诊断shoulder肩关节解剖肩关节超声诊断shoulder4骨性标志肩峰、喙突肩胛下窝、肩胛冈、冈上窝、冈下窝肱骨大结节、小结节、结节间沟肩关节超声诊断shoulder骨性标志肩峰、喙突肩关节超声诊断shoulder5肩关节超声诊断shoulder肩关节超声诊断shoulder6肩关节超声诊断shoulder肩关节超声诊断shoulder7肩袖Rotatorcuff肩胛下肌腱Subscapularistendon(SSC)肩胛下窝至肱骨小结节冈上肌腱Supraspinatustendon（SSP）冈上窝至肱骨大结节上部冈下肌腱infraspinatustendon（ISP）冈下窝至肱骨大结节中部小圆肌腱teresminortendon（TM）肩胛骨外侧缘至肱骨大结节下部肩关节超声诊断shoulder肩袖Rotatorcuff肩胛下肌腱Subscapu8肩关节超声诊断shoulder肩关节超声诊断shoulder9肩关节超声诊断shoulder肩关节超声诊断shoulder10肱二头肌腱长头longheadofbicepstendon（LHBT）三角肌deltoid肩峰三角肌下滑囊Subacromialsubdeltoidbursa（SASD）肩关节超声诊断shoulder肱二头肌腱长头肩关节超声诊断shoulder11肩关节超声诊断shoulder肩关节超声诊断shoulder12肩关节超声诊断shoulder肩关节超声诊断shoulder13肩关节超声诊断shoulder肩关节超声诊断shoulder14肩关节扫查方法肱二头肌长头肌腱肩袖结构其它肩关节超声诊断shoulder肩关节扫查方法肱二头肌长头肌腱肩关节超声诊断shou15肱二头肌长头腱longheadofbicepstendon（LHBT）前臂屈曲，适度内旋，使结节间沟朝前沿结节间沟向肌腱肌腹连接处连续扫查厚约3-4mm，液体一般不超过2mm前臂外旋运动时动态扫查有利于显示关节囊内部分及半脱位的观查肩关节超声诊断shoulder肱二头肌长头腱longheadofbicepste16结节间沟上部窄深，下部宽浅过浅易发生肌腱脱位肱二头肌长头腱鞘内常有少量液体，下部观察关节积液、游离体短轴切面肩关节超声诊断shoulder结节间沟上部窄深，下部宽浅短轴切面肩关节超声诊断should17长轴切面肩关节超声诊断shoulder长轴切面肩关节超声诊断shoulder18肩关节超声诊断shoulder肩关节超声诊断shoulder19肩胛下肌腱屈肘，上臂紧贴胸壁自上述肱二头肌长头肌腱短轴切面向内及肱骨近端移动观察肩胛下肌腱长轴图像 短轴图像内部回声不均匀自上而下全面扫查于上臂外展、内收运动时动态观察 肩关节超声诊断shoulder肩胛下肌腱肩关节超声诊断shoulder20肩关节超声诊断shoulder肩关节超声诊断shoulder21肩关节超声诊断shoulder肩关节超声诊断shoulder22肩关节超声诊断shoulder肩关节超声诊断shoulder23冈上肌腱Supraspinatustendon(SSP)上臂内旋外展（手背贴后腰背或手掌贴同侧后裤袋）自肱二头肌长头腱短轴切面向后外上侧移动相当于肩袖线观察冈上肌腱短轴图像，厚约0.4-0.8cm 自肱二头肌长头腱长轴切面向后上移动观察长轴自上而下、自前而后全面扫查前后运动、内旋外旋多方位动态观察 肩关节超声诊断shoulder冈上肌腱Supraspinatustendon(SSP24肩关节超声诊断shoulder肩关节超声诊断shoulder25肩关节超声诊断shoulder肩关节超声诊断shoulder26鸟嘴样，凸面向上肩关节超声诊断shoulder鸟嘴样，凸面向上肩关节超声诊断shoulder27肩关节超声诊断shoulder肩关节超声诊断shoulder28冈下肌腱及小圆肌腱肩关节超声诊断shoulder冈下肌腱及小圆肌腱肩关节超声诊断shoulder29肩关节超声诊断shoulder肩关节超声诊断shoulder30短轴观冈上肌腱与冈下肌腱相互交织，前部1.5cm约是冈上肌腱。肩关节超声诊断shoulder短轴观冈上肌腱与冈下肌腱相互交织，前部1.5cm约是冈上肌腱31肩袖撕裂肩袖撕裂最常见于冈上肌腱大结节附着处急性创伤、慢性劳损、退变等基础上全层撕裂（肌腱局部缺损或不显示）部分撕裂（局部变薄、滑囊面扁平、关节软骨及骨表面改变、肌腱内异常回声）继发征象：关节积液、滑囊积液肩关节超声诊断shoulder肩袖撕裂肩袖撕裂最常见于冈上肌腱大结节附着处肩关节超声诊断s32肩关节超声诊断shoulder肩关节超声诊断shoulder33肩关节超声诊断shoulder肩关节超声诊断shoulder34肩关节超声诊断shoulder肩关节超声诊断shoulder35肩关节超声诊断shoulder肩关节超声诊断shoulder36肩关节超声诊断shoulder肩关节超声诊断shoulder37pitfalls假阳性各向异性伪像、三角肌间隔、肩袖间隙、肌腱纤维软骨附着处、肌肉肌腱连接处假阴性断端不退缩、滑膜增生、滑囊疝入肩关节超声诊断shoulderpitfalls假阳性肩关节超声诊断shoulder38肩关节超声诊断shoulder肩关节超声诊断shoulder39肩关节超声诊断shoulder肩关节超声诊断shoulder40肩关节超声诊断shoulder肩关节超声诊断shoulder41肩关节超声诊断shoulder肩关节超声诊断shoulder42肌腱炎、肌腱病、腱鞘炎 非感染性、粘液变性 肿胀、回声减低 较对侧厚2mm肩关节超声诊断shoulder肌腱炎、肌腱病、腱鞘炎非感染性、粘液变性肩关节超声诊断sh43超声不能依据LHBT腱鞘内出现液体诊断肌腱炎和腱鞘炎肩关节超声诊断shoulder超声不能依据LHBT腱鞘内出现液体诊断肌腱炎和腱鞘44钙化性肌腱炎肩关节超声诊断shoulder钙化性肌腱炎肩关节超声诊断shoulder45LHBT半脱位肩关节超声诊断shoulderLHBT半脱位肩关节超声诊断shoulder46肩锁关节肩关节超声诊断shoulder肩锁关节肩关节超声诊断shoulder47关节及滑囊积液肩关节超声诊断shoulder关节及滑囊积液肩关节超声诊断shoulder48骨关节炎肩关节超声诊断shoulder骨关节炎肩关节超声诊断shoulder49撕脱骨折肩关节超声诊断shoulder撕脱骨折肩关节超声诊断shoulder50化脓性关节炎肩关节超声诊断shoulder化脓性关节炎肩关节超声诊断shoulder51血肿肩关节超声诊断shoulder血肿肩关节超声诊断shoulder52肩关节超声诊断shoulder肩关节超声诊断shoulder53上述图片取自国外文献及教材仅供个人自学参考肩关节超声诊断shoulder仅供个人自学参考肩关节超声诊断shoulder54肩关节超声诊断shoulder肩关节超声诊断shoulder55