腰椎后上缘软骨结节：附10例分析

笔者分析了１０例较为少见的腰椎后上缘软骨结节的临床、Ｘ线及ＣＴ表现。典型的改变为：（１）椎体后上缘类圆形骨质缺损，边缘致密硬化：（２）缺损后方有一骨块突入椎管（游离或部分与椎体相连）；（３）硬膜囊及神经根受压，可伴有椎间盘突出。对发生于椎体后上、下缘的软骨结节的发病机理做了探讨并比较了二者影像学上的异同。     

腰椎椎体软骨结节的CT诊断分析简

腰椎椎体软骨结节是由椎间盘内结构通过断裂的软骨板疝入到椎体而形成的,从广义上来分为椎体前缘软骨结节（椎缘骨）,腰椎许莫尔结节;腰椎椎体后缘软骨结节。由于CT的广泛应用,腰椎椎体软骨结节的发现率不断提高,据我院从2012年10月至2013年9月间共879例临床初步诊断为椎间盘突出的患者腰椎椎间盘扫描,其中共发现有腰椎椎体软骨结节87例,发现率约10％,可见腰椎椎体软骨结节不是少见病,由于腰椎椎体软骨结节的位置不同而产生不同的临床症状,越来越被临床重视。对87例腰椎椎体软骨结节的临床症状和CT表现进行分析,现报告如下。     

腰椎后缘骨内软骨结节MSCT研究

目的探讨腰椎后缘骨内软骨结节CT诊断作用。方法回顾45例共48个腰椎后缘骨内软骨结节的CT表现。结果腰椎后缘骨内软骨结节在椎管内的位置、数目、大小、形态及与母椎的联系有一定特征,尤其软骨结节与母椎骨缺损同存、两者可匹配及髓核阶的出现率均为100%。结论初步认为本文提出的"匹配征"对腰椎后缘骨内软骨结节CT诊断具有重要意义。     

腰椎椎体后缘软骨结节的CT诊断

目的：探讨腰椎椎体后缘软骨结节(LPMN)的CT诊断价值。方法：回顾性分析18例LPMN的临床表现、CT特征。结果：典型的影像改变为：①椎体后上缘或后下缘类圆形骨质缺损，边缘致密硬化17例；②缺损后方骨块突入椎管，完全游离或部分与椎体相连7例；③硬膜囊及神经根受压18例；④伴有椎间盘突出并造成椎管狭窄18例。结论：CT检查能明确诊断腰椎椎体后缘软骨结节，并为制订治疗方案提供可靠依据。     

骶1后缘软骨结节（附23例CT—X线分析）

骶_１后缘软骨结节（附２３例ＣＴ－Ｘ线分析）刘红光，曹庆选，杨丽君，龙坤山胸、腰椎后缘骨内软骨结节已有报道，但尚未见骶骨后缘骨内软骨结节（Ｓａｃｒａｌｐｏｓｔｅｒｉｏｒｍａｒｇｉｎａｌｉｎｔｒａｏｓｓｅｏｕｓｃａｒｔｉｌａｇｉｎｏｕｏｎｏｄｅ，ＳＰＭ?..     

腰椎后缘软骨结节的CT和MRI诊断价值

目的　分析腰椎后缘软骨结节的ＣＴ和ＭＲＩ表现,探讨其发病机理及其与椎间盘突出的关系。材料和方法４９例ＬＰＭＮ行ＣＴ检查,其中１９例行ＭＲＩ检查,均经手术证实。结果　本组好发年龄２０～４０岁,以Ｓ１和Ｌ５后上缘最常见。软骨结节的形态以类圆形最多见,多有硬化边缘;裂隙形或边缘无硬化者可能为本病早期改变。软骨结节下多形成骨性突起,造成椎管矢状径变小。软骨结节常使椎体终板变形后膨,导致椎体侧隐窝狭窄。结论　ＣＴ是较好的检查手段,能清楚显示软骨结节和其后骨块的形态及大小。软骨结节与邻近椎间盘相连续且信号变化一致,是ＭＲＩ的特征表现。本病可能是在椎体终板发育相对薄弱的基础上,加上扭曲外力使椎间盘疝入椎体终板内而形成。     

腰椎体后缘软骨结节椎管狭窄的CT诊断

目的 :探讨腰椎后缘软骨结节 (LPMN)椎管狭窄的CT诊断价值。材料和方法 :回顾性分析 2 7例腰椎后缘软骨结节的临床及CT表现。结果 :LPMN的CT表现为 :( 1)椎体后上缘或下缘局限性骨缺损 ,缺损区周围骨质硬化 ;( 2 )缺损区后突入椎管内的骨块 ;( 3 )在矢状位上见骨块“翘起”征 ,缺损区呈“V”形或类三角形 ;( 4 )椎管狭窄 ,多伴有椎间盘突出。结论 :CT能明确诊断LPMN导致的椎管狭窄 ,并为手术治疗提供可靠依据。     

腰椎椎体后缘骨内软骨结节所致腰椎管狭窄症的影像诊断

目的　总结腰椎椎体后缘骨内软骨结节 (LPMN)所致腰椎管狭窄症临床、影像诊断 ,探讨有关的发病因素。方法　对经手术证实的 16例PLMN所致腰椎管狭窄症的临床表现、影像学特征、手术方式进行回顾性分析总结。结果　典型的影像改变为 :( 1)椎体后上缘类圆形骨质缺损 ,边缘较致密硬化 ;( 2 )缺损后方有一骨块突入椎管 (游离或部分与椎体相连 ) ;( 3)硬膜囊及神经根受压 ,可伴有椎间盘突出。结论　影像学检查能明确诊断腰椎椎体后缘骨内软骨结节 (LPMN)所致腰椎管狭窄症 ,并为制订治疗方案提供可靠依据。     

3D-UTE评价腰椎间盘软骨终板缺损与椎间盘退变的相关性

【摘要】目的：采用磁共振超短回波成像（3D-UTE）技术评价腰椎软骨终板缺损与腰椎间盘退变的相关性。方法：本研究共招募志愿者50例,共扫描腰椎椎间盘250个,腰椎软骨终板500个。受检者行常规腰椎MRI检查评价椎间盘Pfirrmann分级,以3D-UTE序列显示腰椎间盘终板软骨完整性。按照有无邻近软骨终板缺损将腰椎间盘分为4组,分别为无邻近终板软骨缺损组（A组）、只有头侧终板软骨缺损组（B组）、只有尾侧终板软骨缺损组（C组）及头尾侧终板软骨皆缺损组（D组）。评价软骨终板完整性与椎间盘Pfirrmann分级的相关性。结果：A组有椎间盘53个,其中PfirrmannⅠ级49个,Ⅱ级4个;B组有椎间盘62个,其中PfirrmannⅠ级6个,Ⅱ级55个,Ⅲ级1个;C组有椎间盘70个,其中PfirrmannⅠ级6个,Ⅱ级63个,Ⅲ级1个;D组有椎间盘65个,其中PfirrmannⅡ级39个,Ⅲ级26个。Kendall等级相关检验显示椎间盘终板软骨缺损程度越严重,腰椎间盘退变程度越重（H=0.67,P<0.01）。结论：3D-UTE可以显示腰椎间盘软骨终板的完整性,椎间盘终板软骨缺损与腰椎间盘退变程度密切相关。     

腰椎退变性滑脱症的CT诊断及临床意义

目的：探讨腰椎退变性滑脱症的ＣＴ诊断依据和对硬膜囊、神经根的影响。材料和方法：回顾性分析了５８例腰椎退变性滑脱症（前滑脱４６例，后滑脱１２例）的ＣＴ表现、好发部位及其原因。结果：滑椎下缘相邻间盘均显示有相对性前、后膨出，椎小关节均有半脱位，硬膜囊均有受压，另外，在前滑脱中因１６例椎间盘向后上方突出，２３例椎小关节突明显增生肥大而压迫神经根。结论：ＣＴ不仅能诊断腰椎退变性滑脱症，而且还能显示硬膜囊和神经根的改变。     

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.