垂体少见病变的MRI诊断

目的 分析垂体少见病变的MRI表现.方法 回顾分析20例垂体少见病变的MR表现,其中颅底型垂体瘤8例、垂体单纯出血5例、垂体脓肿5例及淋巴细胞性垂体腺炎2例.全部病例均行MRI平扫,除垂体出血外其余均行MRI增强扫描.结果颅底型垂体瘤呈等T1稍长T2信号影向鞍下及蝶窦内发展,并可见部分残留垂体;垂体单纯出血表现为垂体内呈片状短T1长T2信号影,垂体显示不清;垂体脓肿表现为垂体内长T1长T2信号影,增强扫描呈环形强化;淋巴细胞性垂体腺炎表现为蝶鞍不扩大,垂体腺明显增生肥大向鞍上发展.结论 MRI平扫加增强扫描是垂体少见病变的首选影像学检查方法.     

垂体瘤卒中的MRI影像学表现分析

目的:回顾分析垂体瘤卒中(PA)的MRI表现,探讨MRI对PA的诊断价值.方法:对手术和病理证实的28例PA患者进行回顾性分析,均行MRI检查常规扫描+增强扫描.结果:28例均为垂体大腺瘤合并出血和/(或)坏死.其中15例鞍区显示T1WI等信号合并高信号,T2WI高信号;8例T1WI低信号,T2WI高信号;3例高低混杂信号;2例T1WI等信号环绕中央高信号,T2WI低信号.结论:MRI结合临床表现对PA的诊断具有重要价值,MRI信号的表现与患者的临床特点有一定的联系.     

蝶窦内异位垂体腺瘤的CT和MRI诊断

目的 探讨蝶窦内异位垂体腺瘤的CT和MRI表现,并评价2种影像检查方法的临床应用价值.方法 回顾性分析8例经组织学证实蝶窦内异位垂体腺瘤的影像学资料.8例患者均经CT和MR检查.结果 8例垂体瘤均位于蝶窦,与鞍内垂体不相连;3例呈卵圆形,不规则形5例,病灶最大径20～46 mm,边界均较清楚.CT表现:与脑灰质比较,平扫呈等密度7例,稍低密度1例,其中2例增强呈较均匀中度强化;病变周围的骨质不同程度受压、变形、硬化,其中5例并可见局部侵蚀状破坏;鞍底骨质完整3例,骨质破坏5例.MRI表现:与邻近脑厌质比较,在T1WI呈稍低信号2例,等信号6例,T2WI呈稍高信号2例,等信号6例,病变信号不均匀,内散在小泡状、细条状长T1、长T2信号,对应组织学上扩大的腺泡;增强后病变不均匀低中度强化,外观近似筛网状.2例行MR动态增强扫描,时间-信号强度曲线均为速升缓降璎.5例伴有空蝶鞍,5例包绕邻近海绵窦,与邻近颈内动脉分界不清,4例侵及斜坡.结论 T2WI小泡状、细条状高信号和增强后T1WI筛网状外观是该病的特征性表现.CT和MRI联合使用能够对该病的诊断、治疗提供更全面的信息.     

垂体卒中的MRI诊断与手术、病理对照研究（附52例分析）

目的探讨垂体卒中的MRI不同表现及鉴别诊断.材料和方法对52例垂体卒中患者行常规TSE序列/Gd-DT-PA MRI增强扫描、CT扫描,并与手术和病理结果进行对照.结果94.2%的垂体卒中发生于垂体巨大腺瘤或大腺瘤,65.4%的病例MRI表现为T1高信号或等、高混杂信号,T2高信号或等、高混杂信号,MRI诊断垂体卒中准确率达100%.结论MRI对于垂体卒中的诊断价值优于CT,MRI平扫即能明确诊断.     

垂体腺瘤MRI与病理对照研究

目的分析垂体腺瘤的MRI表现与手术、病理关系.材料与方法对242例垂体腺瘤的MRI特征性表现进行分析,并与手术病理对照.结果大腺瘤(高度＞10 mm)161例,MRI平扫T1WI等信号101例,略低信号21例,混合信号39例,T2WI等信号112例,高信号11例,混合信号38例,增强后肿瘤实质部分均有强化,出血、囊变、坏死和钙化区无强化,微腺瘤(高度＜10mm)81例,MRI平扫表现为T1WI略低信号53例,等信号28例,T2WI等信号42例,高信号39例,注射Gd-DTPA后立即成像,77例呈相对低信号,4例呈等信号.手术和病理发现,T1WI等或略低信号区为肿瘤实质,T1WI低信号、T2WI高信号区为坏死或囊变区,T1WI、T2WI均呈高信号区为出血,手术和病理发现钙化6例,术前MRI未发现.结论MRI能清晰显示垂体瘤的大小、形态、轮廓和与周围结构的关系,可为制定手术方案提供重要依据.     

鞍区囊性病变的MRI鉴别诊断

目的：探讨鞍区囊性病变的MRI表现，以提高对此类病变的鉴别诊断水平。方法：13例经病理证实的囊性病变包括垂体大腺瘤囊变1例、垂体大腺瘤囊变伴出血3例、垂体微腺瘤囊变伴出血2例、垂体微腺瘤囊变2例、颅咽管瘤3例、蛛网膜囊肿1例、表皮样囊肿1例、Rathke＇s囊肿1例。结果：鞍区病变以垂体瘤常见，以长／短T1．长T2信号为著，一般为厚壁且内壁不规则呈环形强化为主要表现；蛛网膜囊肿各序列呈脑脊液信号：颅咽管瘤、Rathke＇s囊肿信号较复杂。结论：应充分利用MRI软组织分辨率高、可多体位成像、多种序列扫描从病变生长部位、形态、生长方式、信号特点及其与周围组织的关系和临床表现进行综合分析，才能进行正确的诊断与肇别诊断。     

垂体大腺瘤的MRI影像分析

目的:探讨垂体大腺瘤的MRI影像特征。方法:回顾性分析过去10年经临床病理证实17例垂体大腺瘤的MRI平扫及增强表现。结果:垂体大腺瘤表现为鞍区肿块,T1WI呈等或略低信号,T2WI呈等或略高信号,正常垂体未见显示。海绵窦侵袭性垂体腺瘤3例,2例伴有出血,“腰身”显示6例。结论:MR对垂体大腺瘤有定性诊断价值.术前可有效地观察其形态大小信号及与周围组织关系。     

垂体Rathke氏囊肿的MRI诊断

目的 :探讨MRI诊断垂体Rathke氏囊肿的价值。材料和方法 :收集经病理证实的垂体Rathke氏囊肿的病例共18例 ,均行常规及增强MRI检查 ,其中 9例加扫反转恢复 (IR)序列。结果 :所有 18例Rathke氏囊肿MRI均显示鞍内或向鞍上发展的圆形或椭圆形肿物。 5例伴有液平面形成。病变直径小于 1cm者 4例 ;1～ 3cm者 12例 ;大于 3cm者 2例。MR呈短T1信号者 14例 ,其中长T2 9例 ,短T2 5例 ;MR呈长T1长T2信号者 4例。增强扫描 ,其中有 7例于囊肿边缘出现环形强化。囊壁病理学检查结果显示 ,17例为单层立方或柱状上皮细胞 ,其中 2例含有杯状细胞 ;1例混有假复层鳞状上皮细胞 ;1例合并有嗜酸性细胞垂体腺瘤。结论 :MRI对于本病的诊断和鉴别诊断有一定的价值。     

侵袭性垂体瘤的MRI和病理研究

目的 分析侵袭性垂体瘤的MR影像学特点。材料与方法 1997年10月－2000年5月经手术病理证实的27例侵袭性垂体瘤,在1．5T MR机上采用常规矢状位、冠状位增强前后T1WI检查,并与手术病理资料对照分析。结果 27例腺瘤包括泌乳素瘤11例,促生长激素腺瘤5例,促生长激素和泌乳素混合腺瘤1例,促甲状腺激素腺瘤1例,促肾上腺皮质激素腺瘤1例,无功能性腺瘤8例。MR影像学特点为鞍底受侵下陷,部分肿瘤突入蝶窦;颈内动脉包绕;海绵窦受累,鞍隔突破等。结论 垂体腺瘤属良性肿瘤,但部分腺瘤的生物学行为却表现出非良性肿瘤的特征,如何邻近组织结构浸润生长,导致手术全切机率下降,是术后复发的主要原因。因此,术前正确评估肿瘤的生长特点和周围结构的关系,对手术方式和术后治疗措施的选择有直接指导作用。     

垂体Rathke囊肿的MRI表现

目的:分析垂体Rathke囊肿的MRI表现,提高该病的诊断水平。方法:收集经手术及病理证实的垂体Rathke囊肿16例,均行常规及动态增强MRI检查。结果:2例囊肿位于鞍内,14例位于鞍内及鞍上,多呈圆形或椭圆形。根据囊肿内容物的不同表现为多种MRI信号,其中9例呈短T1、长T2信号,3例呈短T1、等T2信号,2例呈长T1、长T2信号,2例呈等T1、长短混杂T2信号;增强扫描仅1例囊肿边缘轻度强化。结论:垂体Rathke囊肿虽然少见,但仔细分析其MRI表现,有助于该病的正确诊断。     

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.