医学影像深度解析：原理与质量提升指南

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《医学图像手册》是一本由各领域专家编纂的重要参考资料，涵盖了医学图像学的核心内容，旨在帮助医疗专业人员理解和应用各种成像技术。该书的主编团队包括Jacob Beutel、J. Michael Fitzpatrick、Steven C. Horii、Yongmin Kim、Harold L. Kundel、Milan Sonka和Richard L. VanMetter等知名学者，他们分别来自Vanderbilt University、University of Pennsylvania Health Systems、University of Washington等知名学府以及东芝柯达公司，体现了深厚的学术背景和实践经验。该手册首先介绍了医学图像成像原理，这包括了X射线、MRI（磁共振成像）等多种成像技术的基本工作机制和理论基础。读者可以在这里学习到不同成像方法如何捕捉人体内部结构的信息，并理解这些信息对诊断和治疗决策的重要性。书中特别提到了一张膝盖受伤后的对比图，通过X射线和MRI的展示，强调了两种成像方式在显示骨骼和软组织损伤方面的差异，以及它们各自的优势。章节12（第671页）深入探讨了“解剖结构对信号检测的影响”，由Ehsan Same、Wam Eyer和Lsa Baron撰写，这部分内容对于优化图像解析和解读至关重要，有助于识别和解释不同解剖结构对信号复杂性的影响，从而提高图像质量和准确性。此外，《医学图像手册》还涵盖了影像系统在医学中的应用，包括但不限于图像处理、重建技术、质量控制和标准化操作流程，以确保图像的稳定性和一致性。书中包含丰富的实践指南和案例分析，便于读者将理论知识转化为临床实际操作。《医学图像手册》不仅提供了全面的理论知识，还关注了医学图像技术的实际应用和最新进展，是医学影像工作者、放射科医师、影像科学家和医学生不可或缺的参考工具。通过学习本书，读者能够提升医学图像分析能力，促进医学诊断和治疗水平的提升。

xvi Introduction to Part I

the availability of diagnostic imaging thereby completing the transition to a to-

tally digital medical imaging environment where image information will be better

utilized to guide patient care.

Concurrent with all of these changes, our understanding of imaging science,

largely derived from information theoretic considerations developed during the

1950s, has developed to the point where it can effectively guide system opti-

mization. This initially allowed conventional x-ray imaging systems to be opti-

mized well beyond their prior capabilities. Now with the separation between im-

age capture and image display enabled by digital imaging technology, we pursue

the heretofore unavailable opportunity of independently optimizing these two sub-

systems. This will bring image quality closer than ever before to the currently un-

derstood fundamental limits.

As we begin the new century, this volume provides a snapshot of our current

understanding of the physics of medical imaging written by authors who have con-

tributed signiﬁcantly to its development. The ﬁrst three chapters describe the fun-

damental physics and imaging science on which x-ray projection radiography is

based. Together these provide the basis for the ongoing improvements and new

developments aimed at optimizing the performance of these imaging systems. The

unifying signal-to-noise concepts described are now accepted as the technology-

independentabsolute criteria by which progress is measured for all imaging modal-

ities. These lead naturally to a discussion of the exciting developments in detector

technology for digital radiography. Therefore, the next two chapters describe the

most recentdevelopmentsin ﬂat panel detectorsfor digital mammographyand gen-

eral projection x-ray imaging. The most exciting imaging technologies to emerge

in this information age allow us to fully visualize the three-dimensional structure

of human anatomy. They are the focus of the ﬁnal three chapters in Part I. Of

these, the ﬁrst two describe current practices incorporating the latest developments

in magnetic resonance imaging and computed tomography. They are followed, in

the ﬁnal chapter, by a description of recent developments in volume ultrasound

imaging.

Jacob Beutel

Richard L. Van Metter

X-ray production 3

1.1 X-ray production

1.1.1 Deﬁnitions and mechanisms

Xraysandγ rays are forms of electromagnetic radiation that are energetic

enough that when interacting with atoms, they have the potential of liberating elec-

trons from the atoms that bind them. When an atom or molecule is stripped of an

electron, an ion pair forms, consisting of the negatively charged electron (e

−

)and

the positive atom or molecule. X rays and γ rays, therefore, are forms of ionizing

radiation, and this feature fundamentally distinguishes these rays from the rest of

the electromagnetic spectrum.

An electromagnetic wave of frequency ν has an energy proportional to ν, with

the constant of proportionality given by Plank’s constant, h:

E =hν, (1.1)

where h =4.135 ×10

−15

eV-s. For diagnostic medical x-ray imaging, the range

of x-ray energies incident upon patients runs from a low of 10,000 eV (10 keV) to

about 150 keV. In terms of wavelengths:

λ =

, (1.2)

where c is the speed of light (2.997925 ×10

m/s). The range of wavelengths cor-

responding to diagnostic imaging span from about 0.1 nm (at 12.4 keV) to 0.01 nm

(at 124 keV), compared to the visible spectrum spanning from about 400 nm (vio-

let) to 650 nm (red). The electromagnetic spectrum is illustrated in Figure 1.1.

Xraysandγ rays have different spectral characteristics, but fundamentally

an x ray of energy E is exactly the same as a γ ray of energy E. By deﬁnition,

γ rays originate from the nucleus of the atom, whereas x rays originate at the

atomic level of the atom. Gamma rays are given off by radioactive isotopes such as

technetium 99m, thallium 201, and iodine 131. A complete discussion of γ rays,

which are the rays of interest in nuclear medicine imaging, is beyond the scope of

this chapter.

X rays can be produced by several different methods, such as by synchrotrons,

by channeling sources, by free electron lasers, etc. The most common x-ray pro-

duction technology used in the vast majority of the radiology departments around

the world, however, is the standard x-ray tube which emits bremsstrahlung as well

as characteristic x rays. These processes are discussed below.

1.1.2 Bremsstrahlung radiation

According to classical theory, if a charged particle is accelerated it will radiate

electromagnetic energy. When energetic electrons are incident upon a metal target

(as in an x-ray tube), the electrons interact with the coulomb ﬁeld of the nucleus

of the target atoms and experience a change in their velocity, and hence undergo

deceleration. Bremsstrahlung radiation (“braking radiation”) is produced by this

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