螺旋CT在喉部病变的临床应用

目的探讨螺旋CT在喉部病变中临床应用价值.方法29例喉部病变进行螺旋CT扫描、多平面三维重建及CT仿真内窥镜成像,并与纤维喉镜及病理对照研究.结果螺旋CT轴位图像薄层重建、多平面三维重建、CT仿真内窥镜所见病变的形态学改变、与周围组织的关系及气道狭窄情况与纤维喉镜及术后病理相符合.结论螺旋CT薄层重建分辨率明显提高,图像更加清晰.对观察病变的部位、与周围组织关系及气道狭窄,多平面三维重建是对轴位图像的很好补充.CT仿真内窥镜可分别从头端或足端入内观察喉腔结构,是纤维喉镜的辅助手段.     

MSCT薄层扫描-平面重建技术在早期股骨头缺血性坏死中的诊断价值

目的探讨MSCT薄层扫描-多平面重建技术在诊断早期股骨头缺血性坏死中的应用价值。方法对临床高度疑诊早期(Ⅰ^Ⅱ期)股骨头缺血性坏死的100例患者进行股骨头区域的薄层扫描及进行多平面重建。结果使用此技术明确诊断者为75例,确诊率75%,普通CT扫描确诊率为57%(P<0.05);未确诊25例患者后经病理或随访证实;其中6例普通CT扫描轴位观察诊断为正常。结论对临床高度疑诊早期股骨头坏死患者,运用MSCT薄层扫描-多平面重建技术,能更好地明确诊断,提高诊断正确率,减少漏诊、误诊。     

多层螺旋CT重建技术在脊柱骨折病变中的应用

目的 探讨多层螺旋CT在脊柱骨折病变中的临床应用价值：方法收集40例脊柱骨折病例，应用GR Light Speed QX／I多层螺旋CT扫描仪行薄层扫描并行三维重建和多平面重建，进行观察：结果螺旋CT三维重建和多平面重建可以更全面、立体地观察骨折全貌及其伴随病变的特征，弥补了X线平片和轴位CT扫描的不足，为临床治疗方案的制订提供了可靠的依据。结论多层螺旋CT重建技术在诊断脊柱骨折病变中有很高的临床应用价值，可提高脊柱损伤病变的诊断准确性。     

螺旋CT三维和多平面重建在髋臼骨折中的应用

目的：探讨螺旋CT三维（3D）和多平面重建（MPR）在髋臼骨折中的临床应用价值。方法：27例髋臼骨折的病人先经营骨盆螺旋CT薄层扫描，并在工作站上作髋臼三维和多平面重建。注重观察髋臼骨折的以及CT表现特征。结果：27例病人共计31个髋臼骨折。除1个T形骨折用三维和多平面重建判断为横行骨折外，其余30个骨折轴位CT、三给和多平面重建均显示。三维和多平面重建能更直观的显示病变的具体情况。结论“螺旋CT三维和多平面重建是轴位CT扫描的有价值的补充手段，在髋臼骨折中有很高的应用价值。     

双层螺旋CT重建技术在诊断髋关节疾病中的应用

目的探讨螺旋CT及其重建技术对髋关节疾病的诊断价值。方法应用SIEMENS双层螺旋CT机,对93例经手术及临床证实的髋关节疾病患者,进行轴位薄层、冠、矢状位多平面重建（MPR）以及容积重建（VR）,并对全部患者的CT表现进行回顾性分析。93例患者均在CT扫描前行X线拍片。结果93例中,CT显示髋关节骨折60例,股骨头缺血性坏死15例（其中双侧5例）,先天性髋关节脱位5例,结核6例,退行性关节病3例,骨肿瘤4例。轴位薄层结合MPR可任意平面显示髋关节不同病变内部微细结构,并对复杂骨折、关节脱位与病变周围软组织情况了解更清楚;VR能直观地显示髋关节的立体结构,对髋臼发育不良、复杂性骨折及股骨头脱位的分型等更有价值。结论合理利用几种不同成像方法可提高髋关节疾病的诊断准确率,为临床治疗方案的确定与疗效判定提供可靠依据。     

螺旋CT多平面重建技术的临床应用

目的　探讨螺旋CT多平面重建图像临床应用价值。方法　对250例不同感兴趣区及不同病种的患者用1～5mm层厚,1～3mm重建间隔进行螺旋CT扫描和多平面重建。结果　所有病例MPR图像均能多方位地显示病变及其毗邻关系,绝大部分病例能帮助更好地确定病变部位、范围。结论　尽管轴位CT在显示正常和病变解剖方面有明显优势,但通过扫描数据重组的冠状位、矢状位、斜位、曲面MPR图像有助于对复杂病例的全面理解,它是对轴位CT的良好补充。     

喉部螺旋CT三维成像技术的应用价值

目的：评价喉部螺旋CT多平面重建及仿真内镜技术，结合轴位对喉部病变的诊断意义和临床应用价值。方法：本组31例经手术病理证实的喉部病变采用东芝Asteion螺旋CT检查，扫描参数为准直3mm，螺距1．O，重建间隔3mm，仿真内镜重建间隔1mm，利用工作站进行图像后处理，选择多平面重建、仿真内镜进行观察。结果：螺旋CT轴位片对病变的敏感性为100％，特异性96．8％，轴位所见均与手术吻合，MPR重建及CT仿真内镜，相互补充可显示更多细节，但诊断符合率并无差别。结论：常规CT轴位结合MPR及CT仿真内镜，使喉部病变的细节显示得到了很大提高，病变定位定性的准确对临床制定治疗方案有重要意义和价值。     

多层螺旋CT重建技术在髋关节疾病中的临床应用

目的:利用多层螺旋CT重建技术对115例髋关节疾病进行研究,探讨CT重建技术对髋关节病变的临床应用价值.方法:收集自2001年4月至2006年6月115例手术及临床证实的髋关节疾病,应用Marconi Mx8000、 Siemens Somatom Sensation Cardiac 16和64层CT扫描机,主要采用3D表面遮盖显示法(Shaded surface disply, SSD)、容积显示技术(volume rendering technique; VRT)和多平面重建(multiple planar reformation, MPR)技术.结果:手术证实的45个髋臼发育不良,43个髋臼发育不良的三维CT表现与手术相同;CT全部显示髋关节骨折57个并准确分型;结核5髋,色素沉着绒毛结节性滑膜炎2髋,肿瘤6髋.结论:三维CT可以客观地反映髋关节各骨的立体结构,对髋臼及股骨头的分离重建并360°空间观察,明显的优势在于清晰显示髋臼的病变,如:髋臼发育不良的类型,髋臼复杂性骨折的分型等;结合MPR可任意平面显示髋关节的细微结构,无疑提高了髋关节疾病的诊断率,为手术方案的确切制订提供了客观依据.     

16排螺旋CT多平面重建成像在鼻咽癌颅底骨破坏的应用

近几年来16排及64排螺旋CT应用临床,使CT在疾病检查诊断方面有了更广泛用途.多排CT由于具有更高的空间分辨率和时间分辨率,扫描时间更短,层面更薄,使得病变显示更清楚,经过重建处理后获取多平面图像显示的颅底结构更加清楚逼真.本院采用16排螺旋CT多平面重建技术用于鼻咽癌颅底骨破坏诊断,取得很好诊断效果,现报告如下.     

横断多平面重建CT图象对肺野小结节性病变的研究

横断多平面重建CT<(Axial MultiplanerRecomstruction CT,AMPR-CT)是将多平面扫描的CT 图像为基础,实时重建成任意平面的横断层面象,连续显示在监视器上的程序CT 图象。作者对19例经手术证实的肺野小结节性病变的AMPR-CT 作了分析,并与常规CT 及计算机X 线摄影体层(CR-tomo)对照。肿瘤平均直径19mm,发病部位在左上叶9病变,左下叶3病变,右上叶5病变,右中叶及右下叶各1病变,其中原发性肺癌12例,肉芽肿3例,结核瘤2例,转移性肺癌及错构瘤各1例。结果AMPR-CT 对支气管、肺动脉及肺静脉显示率为100%。常规CT 为94%,81%     

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.