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皮肤超声诊断学
$56.85
由于高频超声频率不断提高甚至“甚高频”超声出现,超声检查的范围逐渐向浅表方向扩展,使得应用超声影像进行皮肤精准诊断成为可能。本书作者团队在皮肤疾病超声诊断领域进行了大量开创性工作,本书是该团队数年临床研究与实践的结晶。
读者对象:超声科、皮肤科医师。
本书介绍了皮肤超声的基本知识,包括原理、方法、观察指标、图像解读等;正常皮肤及各种皮肤疾病的超声表现和诊断标准;以及基于皮肤超声的全新诊疗模式等。本书文字简明,有大量配图,直观易懂,是有意开展皮肤疾病超声诊断工作的临床医师的优秀工具书。
徐辉雄:同济大学教授,主任医师,博士生导师。
上海超声诊疗工程技术研究中心主任,上海市甲状腺疾病研究中心副主任;
同济大学医学院超声医学研究所所长,同济大学附属上海市皮肤病医院超声医学科学科带头人;
同济大学附属第十人民医院超声医学科学科带头人。
担任中华医学会超声医学分会青年委员会副主任委员、中国医师协会介入医师分会超声介入专业委员会副主任委员、上海市医学会超声医学分会副主任委员等职。任 British Journal of Radiology 副主编。
章·皮肤超声总论001节 · 皮肤超声的发展及概况 002第二节 · 超声波及超声成像 003第三节 · 皮肤超声诊室布局 014第四节 · 皮肤超声检查技术 015第五节 · 超声仪器的清洁及人员防护 028第六节 · 超声新技术在皮肤疾病中的应用 030第七节 · 皮肤超声检查适应证 037
第二章·正常皮肤解剖及超声表现039节 · 正常皮肤解剖 040第二节 · 正常皮肤超声表现 041第三节 · 人员培训及其他 047
第三章·皮肤其他影像学检查049节 · 皮肤镜 050第二节 · 皮肤光学相干层析成像 052第三节 · 皮肤共聚焦激光扫描显微镜 053第四节 · 计算机断层扫描成像 054第五节 · 磁共振成像 055第六节 · 各种皮肤影像学技术的比较 056
第四章·皮肤超声术语、观察指标、图像解读及伪像059节 · 皮肤超声术语、观察指标、图像解读 060第二节 · 皮肤超声伪像 069
第五章·皮肤肿瘤性病变的超声诊断071节 · 良性皮肤肿瘤的超声诊断 072第二节 · 癌前期皮肤肿瘤的超声诊断 114第三节 · 恶性皮肤肿瘤的超声诊断 119第四节 · 血管瘤和先天性血管畸形的超声诊断 156第五节 · 本章小结 161
第六章·皮肤非肿瘤性病变的超声诊断167节 · 炎症性皮肤疾病的超声诊断 168第二节 · 软组织异物的超声诊断 187第三节 · 银屑病及银屑病关节炎的超声诊断 190第四节 · 痛风性关节炎的超声诊断 195第五节 · 本章小结 202
第七章·超声与皮肤衰老及整形205节 · 超声与皮肤衰老 206第二节 · 超声与整形 207
第八章·高频超声在皮肤疾病中的应用前景209节 · 全新诊疗模式的建立 210第二节 · 未来展望 211
附 录217附录一 · 皮肤高频超声报告模板 218附录二 · 皮肤超声检查申请单模板 219附录三 · 常见皮肤病高频皮肤超声诊断专家共识 220
由于人们的健康意识和对疾病认知水平的不断提高,皮肤疾病不再是无足轻重的“疥癣小疾”,反而由于患者众多、影响身心,逐渐成为公众关注的重大健康问题。皮肤疾病高达 6 000 余种,人群患病率近 100%。在美国,每年由于皮肤疾病带来的医疗费用支出高达 750 亿美元。面对庞大的医疗需求,凭借肉眼观察的传统诊断方法虽然简便易行,但难以达到精确诊断的要求。皮肤活检虽然是皮肤疾病诊断的金标准,但其有创、繁琐、耗时、昂贵,增加了医疗成本,难以大规模应用。无创的皮肤影像技术,如皮肤镜、共聚焦显微镜、高频超声等技术陆续涌现,弥补了肉眼观察与皮肤活检的不足,在皮肤疾病的诊疗中扮演了日益重要的角色。其中,超声检查在皮肤疾病的影像诊断技术中起步较晚,尚未受到广泛关注。原因在于传统的高频超声探头频率相对较低(15 MHz),分辨力仅为毫米级,难以显示皮肤浅表而微小的结构。近年来,“高频化”成为超声技术一个重要的革新方向,探头频率从 20 MHz、30 MHz 发展到 50 MHz 甚至 70 MHz,使得超声成像的分辨力达到了微米级,逐步具备了显示皮肤精细结构的能力,成为皮肤影像技术中的热点研究方向。与临床上广泛应用的皮肤镜比较,高频超声在皮肤疾病诊疗中的应用刚刚起步。皮肤镜精于浅表,但难以显示皮肤深层结构。高频超声在皮肤疾病纵向尺度上的成像更有优势,可提供病灶深部的重要信息,因而具有广阔的应用前景。基于我们开展皮肤高频超声诊断数年来的经验,我们深切体会到初学者的不易。皮肤超声诊断技术跨越皮肤病学和超声医学两门学科,两者长期缺乏交集,无形之中提高了皮肤超声的入门难度。纵览国内外文献,皮肤超声相关研究相对缺乏,相关教科书仅有 2013 年出版的 Wortsman 教授编写的 Dermatologic Ultrasound with Clinical and Histologic Correlations,而目前国内尚无有关皮肤超声诊断相关的专业图书。同济大学附属上海市皮肤病医院为国内知名的公立三甲皮肤病专科医院,拥有大量的皮肤病例,病种丰富,皮肤病理诊断水平一流。在医院领导的指引下,我们 3 年前开始涉足此领域,在近年的实践中积累了数千例完整的皮肤疾病超声影像资料,且诊断均有病理证实。特此总结成书,以还原临床病例实况、梳理皮肤疾病诊断思路,达到临床—病理—超声影像的紧密结合。本书能服务于皮肤科、超声医学科、整形科、烧伤科、外科等科室的各级医师和技师,是一本不可多得的工具书。本书获皮肤领域首个国家自然科学基金重大科学仪器项目资助,在上海超声诊疗工程技术研究中心的平台支持下,由同济大学医学院超声医学研究所、同济大学附属上海市皮肤病医院超声医学科、同济大学附属第十人民医院超声医学科和同济大学附属上海市皮肤病医院病理科等单位和科室联合编写。许多中青年医师投入了大量的业余时间整理总结资料、查阅文献,本书的出版凝聚了他们大量的心血。同时,多位专家对我们的工作给予了热情的帮助和指导,在此一并表达衷心感谢。本书建立了符合我国国情与临床特点的皮肤超声应用方法,能更好地为我国皮肤疾病患者服务,必将受到越来越多专家学者的关注。由于很多皮肤疾病的超声诊断标准并未建立,一些常见的皮肤疾病因难以获得病理学诊断依据而没有纳入,且编者水平有限,疏漏之处在所难免,恳请广大读者、专家不吝批评指正。
徐辉雄 郭乐杭 王 撬上海超声诊疗工程技术研究中心同济大学医学院超声医学研究所2020 年 3 月
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