股骨骨旁骨肉瘤的X线及CT表现

骨旁骨肉瘤又称皮质旁骨肉瘤,约占恶性骨肿瘤的1%,可能来自具有生骨能力的骨膜结缔组织,是一种低度恶性原发骨肿瘤.发生在股骨的骨旁骨肉瘤形态各异,有时与骨化性肌炎及骨软骨瘤恶变等难以鉴别.笔者回顾性分析6例股骨骨旁骨肉瘤的X线及CT表现,以期提高其诊断符合率.     

罕见部位特殊表现的骨旁骨肉瘤（附一例介入性治疗）

骨旁骨肉瘤又称皮质旁骨肉瘤，是发生于骨旁的成骨性肿瘤的一种类型，此瘤58－84％发生于股骨下端的Guo窝部，且多为生长缓慢的低度或潜在恶性的骨肿瘤，本文报告4例发生于罕见部位表现特殊的骨旁骨肉瘤。     

骨旁骨肉瘤X线可透性的意义

骨旁骨肉瘤是一种发生于骨表面的低度恶性骨肿瘤,不同病损有不同的 X 线与组织学表现。作者为了证明骨旁骨肉瘤 X 线透亮区的组织学特征,特别是确定透亮区内是否含有间变病灶,从36例有高质量 X 线照片及与照片对应的巨检病理切片的骨旁骨肉瘤中发现18例(50%)有 X 线透亮区。女11例,男7例,年龄16—86岁;15例肿瘤累及股骨远端,3例累及股骨近端;术后随访2—15年。透亮区或在肿瘤内,或在分叶状肿瘤外的叶间裂隙;肿瘤内的透亮区可再分为深部(接近肿瘤与皮质骨分界面)与边缘(接近肿瘤边缘并远离其基底部)二     

皮质旁骨肉瘤（附5例报告）

皮质旁骨肉瘤为起源于骨外膜或骨皮质旁结缔组织，向外生长具有低度恶性或潜在恶性的一种少见骨肿瘤，约占骨肿瘤0．6－1％，骨肉瘤4％（1），1951年Geschickter及Copelan最早报告16例，国外统计至1962年有72例（2），国内约有29例（3），近20年来报告骤增，今将我们20年来经手术及病理确诊的5例作一报告，并着重于X线方面的分析。     

股骨远端硬纤维瘤误诊一例

患者男,56岁.左膝关节不适6个月,腘窝肿块6个月余.患者自觉肿块逐渐增大且出现胀感,无明显疼痛.体检:腘窝上部少隆起,可触及约8.0 cm的肿物,较固定,与股骨相连,触之实性感,无压痛,表面皮肤无异常.实验室检查无异常. 影像表现:X线平片股骨远端示低密度破坏区,边缘可见明显硬化缘(图1、2).CT示股骨远端"地图"状骨破坏区,骨皮质膨胀变薄,在骨皮质破坏区内可见残留的骨嵴形成的粗大骨小梁(图3).病变边缘明显硬化.软组织无明显改变.影像学拟诊:骨旁骨肉瘤.     

原发性跟骨骨肿瘤及肿瘤样病变的影像观察

目的 评价跟骨骨肿瘤及肿瘤样病变的影像学表现,鉴别病变的良恶性.方法 回顾性分析经穿刺和手术病理证实的22例跟骨病变的影像学表现,其中6例良性肿瘤,4恶性肿瘤,12例肿瘤样病变.22例中21例行X线检查,10例行CT检查,3例行MRI检查.结果 22例跟骨病变中,良性骨肿瘤包括4例成软骨细胞瘤、1例骨样骨瘤、1例骨巨细胞瘤;骨肿瘤样病变包括10例骨囊肿和2例动脉瘤样骨囊肿;恶性骨肿瘤包括2例骨肉瘤、1例软骨肉瘤和1例滑膜肉瘤.结论 X线平片、CT及MRI综合表现可做到对跟骨骨肿瘤及肿瘤样病变较为准确的定性分析,特别是良恶性鉴别.     

脊椎旁骨肉瘤的MRI表现

目的:分析原发性脊椎旁骨肉瘤的MRI表现,探讨有关的临床特点和鉴别诊断。方法:回顾性分析6例经手术与病理证实的原发性脊椎旁骨肉瘤病例,其中男2例,女4例,平均年龄35.83岁;颈椎旁1例,胸腰段旁4例,骶椎旁1例。结果:6例原发性脊椎旁骨肉瘤表现为脊椎旁类圆形或肾形不均质异常信号,其内可见囊变、坏死及大片状钙化,呈轻~中度强化,大小4.1~13.4 cm,平均8.19 cm。椎体骨质受累3例,表现为椎体后部成骨性破坏;附件受累5例,椎管受累4例,均未合并脊椎病理性骨折及椎间盘改变。结论:原发性脊椎旁骨肉瘤是一种特殊类型的骨旁骨肉瘤,其MRI表现具有一定的特征性,但是应与脊椎结核、骨母细胞瘤、软骨肉瘤及神经鞘瘤鉴别。     

螺旋CT表面遮盖及多平面重组法在长骨骨肿瘤的应用价值

本文对螺旋ＣＴ三维 (3 -Ｄ)表面遮盖法 (ＳＳＤ)和多平面图像重组 (ＭＰＲ)立体和多方位显示长骨骨肿瘤的情况进行分析讨论 ,旨在探讨其应用价值。1　材料与方法　　经临床及手术病理证实的长骨骨肿瘤共 31例 ,其中男性占 1 8例 ,女性占 1 3例 ,年龄 6～ 61岁 ,平均 40 .4岁。恶性肿瘤 1 9例 ,其中长骨骨肉瘤 1 0例 ,尤文氏肉瘤 1例 ,软骨肉瘤 1例 ,纤维肉瘤 2例 ,恶性骨巨细胞瘤 4例 ,转移瘤 1例 ;良性肿瘤 1 2例 ,其中骨软骨瘤 4例 ,骨巨细胞瘤 3例 ,骨样骨瘤 2例 ,骨旁骨瘤 1例 ,软骨粘液纤维瘤 1例 ,非骨化性纤维瘤 1例。采用德国ＳＩ…     

长骨骨巨细胞瘤二例报告

长骨以溶骨破坏改变的主骨巨细胞瘤文献报道较少,且易误诊为骨肉瘤[1],本文对2例已经手术及病理证实的长骨溶骨型骨巨细胞瘤进行报道如下。例1　女,36岁,干部。因右下肢麻木伴疼痛5个月,加重2天并活动受限就诊。体检:右股骨下段内侧略有肿胀,压痛明显,过伸、过屈时疼痛加剧,局部皮肤温度正常,不红。Ｘ线表现:右股骨下段干骺端可见一类球形宽度减低的骨质破坏区,边缘模糊,密度不均匀,其前部骨皮质有中断,局部软组织肿胀,软组织内有少许骨样组织,未见骨膜反应,病变未及关节。Ｘ线诊断:右股骨下段恶性骨肿瘤(考虑骨肉瘤可能性大)(图1)。手术所…     

生长于长骨表面的骨肉瘤

生长于长骨表面的恶性生骨肉瘤远较生长于骨内的少见,作者将这些肿瘤分为三种亚型:即骨旁性(皮质旁)骨肉瘤、骨膜性骨肉瘤和高度表面骨肉瘤,并研究了80例患者的临床、X线和组织学表现。其中①骨旁性骨肉瘤64例,男28例,女36例,年龄10～80岁,病变小于10cm者15例,大于10cm者26例。②高度表面骨肉瘤7例,男4例,女2例,年龄12～56岁,均发生于骨干(1例同时累及颅骨者除外)。③骨膜性骨肉瘤9例,男6例,女     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.