CT和MRI在肺栓塞诊断中的应用及进展

ＣＴ和ＭＲＩ在肺栓塞诊断中的应用及进展ＴｈｅＡｐｐｌｉｃａｔｉｏｎａｎｄＰｒｏｇｒｅｓｓｏｆＣＴａｎｄＭＲＩｉｎＤｉａｇｎｏｓｉｓｏｆＰｕｌｍｏｎａｒｙＥｍｂｏｌｉｓｍ宋云龙①综述刘玉清②审校肺栓塞（ＰｕｌｍｏｎａｒｙＥｍｂｏｌｉｓｍ，ＰＥ）又称肺动...     

医学影像存档与通讯系统的开发与初步应用

目的 通过组建简便医学影像存档与通讯系统（ｐｉｃｔｕｒｅ ａｒｃｈｉｖｉｎｇ ａｎｄ ｃｏｍｍｕｎｉｃａｔｉｏｎ ｓｙｓｔｅｍｓ,ＰＡＣＳ）实现影像诊断设备的网络化,诊断报告书写计算机化,标准化。方法 ＣＴ,ＭＲＩ和Ｓｕｎ Ａｄｖａｎｔａｇｅ Ｗｉｎｄｏｗｓ１２．０工作站连接成医学数字影像传输（ＤＩＣＯＭ）网络;ＤＩＣＯＭ 与各图像浏览及诊断报告书写终连接成以太网网络;二者再通过集线器连接成ＰＡＣ     

Alzheimer病与血管性痴呆的SPECT

目的：研究脑ＳＰＥＣＴ在诊断及鉴别Ａｌｚｈｅｉｍｅｒ病（ＡＤ）和血管性痴呆（ＶＤ）方面的作用。材料和方法：分别选择符合《精神障碍诊断和统计手册》第４版（ＤＳＭ—ＩＶ）中ＡＤ或ＶＤ诊断标准的患者各１７例和１２例，进行ＳＰＥＣＴ检查，兼作ＣＴ（或ＭＲＩ），并作神经心理测定及其它相关量表评分。将ＡＤ、ＶＤ和ＳＰＥＣＴ结果，以及ＳＰＥＣＴ和ＣＴ（或ＭＲＩ）的结果进行比较。结果：ＡＤ的ＳＰＥＣＴ以颞、顶叶低灌注为典型表现，ＶＤ以局灶性低灌注为主。在右颞下回和右枕叶，ＡＤ组ＳＰＥＣＴ放射性计数比值显著低于ＶＤ组（Ｐ＜０．０５，Ｐ＜０．０１），而在左顶叶显著高于ＶＤ组（Ｐ＜０．０５）。两组左半球的放射性计数比值普遍低于右半球，但ＶＤ的左右不对称性明显重于ＡＤ，以左顶叶最为突出（Ｐ＜０．０１）。ＭＲＩ结果与ＳＰＥＣＴ有较多的一致性。各量表评分除Ｈａｃｈｉｎｓｋｉ缺血指数外，均无显著差异。结论：ＳＰＥＣＴ在诊断和鉴别ＡＤ与ＶＤ方面有一定实用价值     

SPECT和PET对脑肿瘤的诊断

ＣＴ和ＭＲＩ已成为现代脑肿瘤检查的重要形态学检查内容,ＳＰＥＣＴ和ＰＥＴ利用不同的药物对肿瘤内部的生化及代谢活动进行显像,从而可得到ＣＴ,ＭＲＩ解剖结构显像以外的代谢等功能性信息,用于ＳＰＥＣＴ脑肿瘤显像的药物有＾２０１Ｔｌ和＾９９ｍＴｃ标记的ＭＩＢＩ、ＤＭＳＡ（Ｖ）、Ｔｅｔｒｏｆｏｓｍｉｎ,＾１２３Ｉ标记的ＩＭＴ,＾１１Ｉｎ标记的生长抑素受体类药物（Ｏｃｔｒｅｏｔｉｄｅ）等。针对肿瘤的葡萄糖代谢     

肝脏小病变和微小病变:病理基础及非侵入性影像学诊断

肝脏小病变 (≤ 3ｃｍ)和微小病变 (≤ 1.5ｃｍ)已成为影像学研究的重点。常见占位病变有小肝癌 (ｓｍａｌｌｈｅｐａｔｏｃｅｌｌｕｌａｒｃａｒｃｉ ｎｏｍａ ,ｓＨＣＣ)和微小肝癌 (ｍｉｃｒｏｈｅｐａｔｏｃｅｌｌｕｌａｒｃａｒｃｉｎｏｍａ ,ｍＨＣＣ)及相关结节 ,小血管瘤和小转移瘤等。肝脏病变的检出和诊断有多种影像学方法 ,根据其创伤程度分为非侵入性和侵入性检查两大类。非侵入性检查包括ＵＳ、ＣＴ、ＭＲＩ等 ,侵入性检查采用ＣＴＡ、ＣＴＡＰ、ＤＳＡ、术中ＵＳ等。绝大多数病变都可经影像学检查检出并获得正确诊断 ,其中非…     

海绵窦病变的影像学诊断

海绵窦(ｃａｖｅｒｎｏｕｓｓｉｎｕｓ,ＣＳ)的病变可在直视手术下进行治疗,术前明确诊断,并了解病变与邻近结构的解剖关系至关重要。对此,ＣＴ与ＭＲＩ可发挥其影像学优势。本文对22个头颅标本作了ＣＳ的冠状断面及横断面的断面解剖观察,对50例临床及影像学检查确证无ＣＳ病变的ＣＴ与ＭＲＩ表现和1996年1月～1997年12月间102例ＣＳ病变的ＣＴ和ＭＲＩ进行了观察与分析。旨在提高对ＣＳ断面解剖和正常ＣＳ与ＣＳ病变的ＣＴ与ＭＲＩ表现的认识,并评估ＣＴ与ＭＲＩ对ＣＳ病变的诊断价值。ＣＳ的影像学解剖ＣＳ是鞍旁两层硬膜间的静脉丛,有颈…     

颅内巨大蛇形动脉瘤的影像学特征及血管内治疗（附四例报告？…

目的 描述颅内巨大蛇形动脉瘤（ｇｉａｎｔ ｓｅｒｐｅｎｔｉｎｅ ａｎｅｕｒｙｓｍ,ＧＳＡ）ＣＴ、ＭＲＩ和ＤＳＡ的典型特征,讨论血管内治疗方法的有效性。方法 回顾性研究过去２年中收治的４例ＧＳＡ,４例行ＤＳＡ和ＣＴ检查,１例行ＭＲＩ和ＭＲＡ检查,２例接受载瘤动脉可脱球囊栓和栓塞前颅内－颅外动脉搭桥,结合文献进行讨论。结果 ４例ＧＳＡ临床表现为颅内高压、出血和占位效应。ＣＴ显示规则、不规则的球形或梨形     

脑弥漫性轴索损伤的实验性研究

目的：探讨急性期脑弥漫性轴索损伤（ｄｉｆｕｓｅａｘｏｎａｌｉｎｊｕｒｙ，ＤＡＩ）的病理改变及与ＣＴ、ＭＲＩ特征的相关性。材料和方法：本实验应用自行设计的“损伤加速机”对２２只猫按两种大小不等的角加速度损伤，首次应用猫建立了ＤＡＩ动物模型。结果：急性期（７２小时内）ＤＡＩ的病理表现为轴索的扭曲、肿胀、断裂及间质水肿。ＣＴ可见弥漫性脑肿胀、皮层下及脑深部小出血灶、蛛网膜下腔及脑室内出血。ＭＲＩ可见弥漫性脑肿胀（脑白质在Ｔ１加权像上信号减低及脑沟、脑裂消失）和单发或多发脑白质小灶性损伤（脑白质在Ｔ２加权像上可见单发或多发小灶性高信号影）。离体脑白质磁共振波谱（ｍａｇｎｅｔｉｃｒｅｓｏｎａｎｃｅｓｐｅｃｔｒｏｓｃｏｐｙ，ＭＲＳ）检查发现损伤后脑白质游离水相对含量明显高于正常对照组，损伤后结合水相对含量明显低于正常对照组，二者Ｔ１值均较正常对照组延长。结论：ＭＲＩ对ＤＡＩ的诊断价值明显优于ＣＴ。通过对ＣＴ、ＭＲ图像分析，可以间接推测ＤＡＩ的病理改变及程度，有利于做出正确、全面的诊断和制定恰当的治疗方案。     

Gd—DTPAMRI在心绞痛中的作用

目的：探讨Ｇｄ－ＤＴＰＡ增强ＭＲＩ在心绞痛中的作用。材料和方法：２２例心绞痛作Ｇｄ－ＤＴＰＡ增强前后ＭＲＩ检查,其中１６例作冠状动脉造影检查,１１例作ＳＰＥＣＴ检查。结果：增强ＭＲＩ上,１８例（８２％）可见局部异常强化信号,其部位与临床ＥＣＧ吻合,与ＣＡ、ＳＰＥＣＴ所示心肌缺血部位一致。在ＭＲＩ上的异常强化信号与冠状动脉狭窄、ＳＰＥＣＴ显示灌注缺损密切有关。结论：Ｇｄ－ＤＴＰＡＭＲＩ为心绞痛的诊断提供有价值的依据。     

累及咽旁间隙的肿物的影像学特征

目的：分析累及咽旁间隙肿物的影像学特征。材料与方法：总结分析了１９例经手术病理证实的累及咽旁间隙肿物的ＭＲＩ、ＣＴ、ＭＲＡ和ＤＳＡ表现。包括腮裂囊肿４例、颈静脉球瘤３例、颈动脉体瘤４例、神经鞘瘤３例、鼻咽癌侵入咽旁间隙５例。１５例行ＭＲＩ检查、９例行ＣＴ扫描、３例行ＭＲＡ检查、５例行ＤＳＡ检查。结果：ＭＲＩ对肿块的大小、形态、位置、与周围组织的关系及继发改变能清晰显示，并可见具有特征性的副神经节瘤瘤内纡曲、匍行的低信号血管影。颈静脉球瘤的ＣＴ特征性表现是颈静脉孔的扩大和骨质破坏。ＭＲＡ和ＤＳＡ对肿瘤血管的显示十分清楚。结论：ＭＲＩ对累及咽旁间隙肿物的诊断优于ＣＴ，若能结合ＣＴ、ＤＳＡ、ＭＲＡ等其他影像学技术，能更准确地评估病变的部位和性质。     

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.