脑脱髓鞘性假瘤2例

患者1 男,48岁。因右侧肢体无力伴麻木4天,加重伴头痛、恶心2天,临床疑脑肿瘤收入院。既往无高血压病、冠心病、糖尿病病史,无外伤史及疫区生活史。神经科查体：右侧上下肢肌力均为3级,右侧肢体浅感觉减退,余未见明显异常。MRI检查：入院后首次MRI检查示左额顶叶形态不规则异常信号灶,T1研呈低信号,T2啊呈高信号,横轴位最大截面约3．0cm×2．5cm,病变边界欠清晰,内部信号不均匀,病变周围见水肿带信号,     

脑室内原发性胚胎性癌1例

<正>患者男,10岁。因“头痛伴呕吐5天”入院。患者无明显诱因头痛,阵发性加重,以额部疼痛为著,伴呕吐,呕吐物为胃内容物。入院查体未见明显异常。肿瘤标记物显示游离前列腺抗原降低,脑脊液甲胎蛋白(alpha-fetoprotein,AFP)正常。头颅MRI平扫及增强表现：右侧侧脑室前角内见一类圆形肿块,边界清,大小约4.0 cm×3.7 cm×3.6 cm,T₁WI以低信号为主,其内夹杂片状高信号(图1),     

颅面血管瘤病1例

患者　男 ,18岁。智力低下 ,发作性左侧肢体及颜面部抽搐 10年 ,有时伴意识不清。查体见右侧颜面部及颈部有大片皮肤血管疾 ,未见其它发育异常。头颅ＣＴ扫描 :定位片上见枕顶叶有斑片状钙化。平扫见右侧颞顶枕叶表浅部位脑回样钙化 (图 1) ,右侧蛛网膜下腔增宽 ,右侧颞、顶、枕叶脑皮质明显萎缩 ,中线结构向右侧移位 ,两侧大脑半球不对称 ,且右侧颅壁增厚 (以枕、顶叶为著 )。肘静脉注射 6 0 %的泛影葡胺 10 0ｍｌ(速度为 3ｍｌ/ｓ) ,行增强扫描和ＣＴ脑血管造影 ,显示右侧侧脑室前角及双侧侧脑室后角脉络丛明显强化 ,右侧颞、顶、枕叶软脑…     

颅内真菌感染合并室管膜炎1例

患者 男,44岁.因头痛、呕吐于2006-04-08行MRI检查未见异常.21 d后因头痛加重,伴持续低热再次行MRI检查见左侧侧脑室前、后角旁白质内有斑片样长T1长T2信号影,右侧侧脑室内于体中部出现细条样等T1长T2信号病变;FLAIR像上病灶均呈高信号;DWI左侧侧脑室后角旁病灶信号不增高,另两处病灶信号增高.     

支原体脑炎的磁共振诊断价值

目的:探讨磁共振成像对支原体脑炎的影像学特点及临床诊断价值。方法:对21例支原体脑炎患者行颅脑MRI检查,12例增强扫描。结果:MRI表现异常16例,正常5例。①病变形态及分布:脑白质多发、散在的点状或/及斑片状异常信号8例;两侧大脑半球弥漫性异常信号3例;脑室扩大,侧脑室后角周围异常信号3例;皮层灰质内脑回状异常信号2例;②病变信号:所有病例T2WI及FLAIR序列呈略高或高信号,T1WI呈等或低信号,在DWI(b=1000)像上均呈异常高信号;③增强扫描:12例行增强扫描中,4例呈点状或/及斑片状强化,8例无异常强化。结论:MRI表现具有一定特征性,且有助于诊断支原体脑炎,并可显示支原体脑炎脑实质受累范围和程度,为临床治疗及判定预后提供可靠依据。     

可逆性胼胝体压部综合症的临床表现及MR诊断

目的探讨胼胝体压部综合症的临床表现及MRI影像特点。方法收集18例经临床随访证实的可逆性胼胝体压部综合症患者,回顾性分析临床资料及MRI影像特征。结果 18例患者中,儿童11例,成人7例,病因主要包括感染、惊厥相关和低钠血症。首次MR检查距离发病2~10天不等,影像上,17例患者主要表现为胼胝体压部正中为主孤立性病灶,呈斑片状、圆形或椭圆形,边界清晰或稍模糊,DWI高信号或稍高信号,T_1WI等信号或稍低信号,T_2WI flair为稍高信号,1例幼儿患者,病灶范围自胼胝体压部呈对称性向胼胝体两侧延伸,至侧脑室后角周围。随访后,7例患者复查MRI,病灶异常信号消失或DWI信号明显减低、范围缩小,复查时间距离首次检查天数自6~30天不等,其余11例患者经治疗后临床症状消失,未复查MRI。结论可逆性胼胝体压部综合症的临床症状及病因复杂多变,但是预后良好,MR影像具有特征性,尤其DWI序列突出表现为胼胝体压部为主的可逆性、孤立性高信号病灶,可以明确诊断并指导临床治疗。     

右侧侧脑室内原发性淋巴瘤伴出血1例

<正>患者女性,62岁。因胡言乱语半月入院,无头痛头晕及其他神经系统症状。影像学检查:CT显示透明隔、第三脑室及右侧脑室旁占位伴出血(图1),周围脑实质可见水肿带。MRI平扫显示透明隔、第三脑室及右侧脑室见大小约5.4cm×4.2cm的类圆形短T1、短T2信号,边缘呈分叶状,DWI呈稍低信号,FLAIR呈高低混杂信号,增强后明显强化,透明隔及侧脑室壁亦见强化(图2～7),右侧侧脑室少量积血;双侧半卵圆中心、双侧脑室前后角多发脱髓鞘改变。     

胼胝体发育不全并颅内畸形的MRI诊断

目的 探讨胼胝体发育不全并颅内畸形的MRI诊断价值. 资料与方法 分析18例胼胝体发育不全并颅内畸形的常规MRI颅脑平扫资料. 结果 MRI显示10例胼胝体完全缺如,6例部分缺如,2例变薄.胼胝体发育不全在MRI上表现为半球间裂增宽,与第三脑室前部异常靠近或相连（100%）;两侧脑室前角平直、分离;室间孔分离;侧脑室体部扩大、平行或体部脉络丛夹角缩小;侧脑室枕角扩大;第三脑室扩大、上移.合并灰质异位（3例）、脑裂畸形（2例）、蛛网膜囊肿（2例）、脂肪瘤（4例）、透明隔缺如（1例）、光滑脑（1例）、脑穿通畸形（3例）、丘脑融合（1例）和空洞脑（1例）. 结论 MRI可以直接显示胼胝体形态,是诊断胼胝体发育不全并颅内畸形的最佳方法.     

丘脑间变性室管膜瘤1例

<正>女,37岁,无明显诱因出现头痛20+d入院。实验室检查结果正常。头颅CT平扫示:右侧丘脑见一类圆形混杂高密度影,凸入右侧侧脑室后角(图1)。MRI平扫及增强扫描示:右侧丘脑见团片状混杂T1混杂T2信号(图2,3),DWI示病灶亦呈混杂信号(图4),增强扫描呈明显不均匀强化(图5)。术前影像学诊断:右侧丘脑生殖细胞瘤伴出血。患者于全麻下行开     

中毒性脑病的影像学表现

目的 :探讨不同病因引起的中毒性脑病的MSCT和MRI表现,以提高对该病的影像学认识。方法 :回顾性分析经临床确诊的20例病因明确的中毒性脑病患者,均行MRI检查,其中6例同时行MSCT检查,分析其MSCT和MRI表现。结果:20例MRI检查均有阳性发现,病变主要累及两侧大脑半球白质纤维及部分核团(放射冠17例,两侧基底节8例,丘脑5例,脑干3例,小脑齿状核3例,视辐射3例,胼胝体2例),两侧较对称分布,T1WI呈低或略低信号,T2WI、DWI、FLAIR呈高或略高信号。6例CT检查中,3例无异常,2例累及范围较MRI小,1例与MRI表现一致。结论:中毒性脑病主要累及两侧大脑半球白质纤维及部分核团,呈对称性分布,DWI及FLAIR序列具有较高的敏感性和准确性,对临床正确诊断和及时诊治具有重要价值。     

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.