脾淋巴瘤的CT影像学特征

目的:探讨脾淋巴瘤的CT影像学特征,为临床分期、治疗和预后判断提供支持。材料和方法:回顾性分析经临床病理证实的16例脾淋巴瘤的CT图像,并做文献复习。结果:16例脾淋巴瘤中,弥漫浸润和粟粒结节型2例,CT表现为弥漫性脾大,密度正常或略低,较均匀强化;多发肿块型6例,表现为脾内多发结节状及类圆形低密度灶,密度均匀,轻度均匀强化;巨块型8例,表现为脾内单发巨大低密度肿块,不均匀强化。10例伴有脾外淋巴瘤表现。结论:脾淋巴瘤的CT表现有一定特征性,结合脾外病变对临床诊断与分期有一定意义。     

脾脏原发性淋巴瘤的CT、MRI表现

目的 探讨脾脏原发性淋巴瘤(PSL)的CT、MRI表现。方法 选取并分析经手术病理证实的17例PSL的临床和CT、MRI表现，探讨其影像学特征。结果 17例PSL均为非霍奇金淋巴瘤，其中弥漫浸润型4例，表现为巨脾合并脾梗死；粟粒结节型2例，表现为脾脏多发小结节，最大直径<1.0 cm;多发结节型8例，表现为脾脏多个大小不等结节，直径从5.0～10.0 cm不等，增强后部分呈环形强化，部分轻度强化；孤立肿块型3例，表现为脾脏单发巨大肿块，直径>10.0 cm,增强后不均匀强化。结论 PSL的CT、MRI表现具有一定的特征，影像学检查对PSL的分期有一定帮助。     

脾脏淋巴瘤的CT诊断

目的探讨脾淋巴瘤的CT表现及CT诊断价值,以提高对其诊断能力。方法回顾性分析临床病理证实并经CT检查的淋巴瘤15例,并作文献复习。结果根据病理类型,15例脾淋巴瘤中,巨块型5例,均为脾内单发类圆形边缘不规则巨块性病灶;多发结节型8例,多发类圆形或分叶状、边界清晰的结节性病灶,绝大多数病灶密度均匀,增强后呈轻度均匀或边缘强化,少数结节灶密度不均;弥漫粟粒型2例,CT表现为脾弥漫性肿大,密度减低,其中1例伴有粟粒小结节状低密度灶。9例伴有脾外淋巴瘤。结论脾淋巴瘤的CT表现有一定特征性,腹内脾外病变CT表现有助于诊断。     

脾脏原发性非霍奇金淋巴瘤的病理学及CT特征

目的探讨脾原发性非霍奇金淋巴瘤的病理、临床和CT影像学特征,旨在加深对该病的认识,提高术前诊断水平。方法回顾性分析经临床病理证实的13例脾原发性非霍奇金淋巴瘤的CT图像、临床及病理资料。结果临床最多见为上腹部隐痛不适(8例),依次为左上腹部肿块和发热(6例),体重下降(5例)等。脾边缘型淋巴瘤6例,表现为脾弥漫性肿大,CT平扫见弥漫性密度减低,增强扫描晚期3例显示弥漫性粟粒结节低密度灶。弥漫大B细胞瘤7例,3例为巨块型,4例为多发肿块型;CT表现为脾内单发或多发混杂密度肿块,增强呈轻中度不均性强化。13例PSL的临床分期,Ⅰ期3例;Ⅱ期2例;Ⅲ期8例。10例存在脾外侵犯,侵犯脾门淋巴结5例,侵犯肝组织5例,另有5例分别表现为腹膜后,肝门及系膜淋巴结、结肠及胰腺侵犯。结论脾原发性非霍奇金淋巴瘤临床、病理及CT表现有一定的特征性,结合脾外病变对临床诊断和分期具有一定的价值。     

脾脏结核的CT诊断

目的 探讨脾脏结核的CT表现及其诊断价值.方法 回顾性分析经病理所证实或经抗结核治疗取得明显疗效而确诊的10例脾结核的CT表现.结果 (1)粟粒型脾结核4例,CT表现为脾脏弥漫性肿大,伴有多发粟粒状低密度灶,增强扫描病灶无明显强化;(2)结节型脾结核4例,CT表现为脾内单发或多发结节状低密度灶或混杂密度结节灶,病灶常伴有粉末状或斑点状钙化,增强后边缘轻度强化;(3)脓肿型脾结核2例,CT表现为多个干酪性结节灶相互融合,液化坏死形成较大的囊性病变,边缘轻度强化,周围可伴有卫星灶.其中6例肝门、胰周及腹膜后淋巴结肿大,部分有融合,增强呈典型环状强化.结论 各种类型脾结核CT表现具有一定特征性,CT对脾结核的正确诊断具有重要价值.     

原发性肺淋巴瘤的螺旋CT表现及病理特点

目的:探讨原发性肺淋巴瘤(PPL)的螺旋CT表现及病理特点,以提高对该病的诊断准确性。方法:回顾性分析11例经病理证实的原发性肺淋巴瘤的螺旋CT及病理资料。结果:11例PPL的CT表现主要分为:结节肿块型6例;肺炎或肺泡型4例;粟粒型1例。11例按照病理结果分为:非霍奇金淋巴瘤9例,其中低度恶性小B细胞淋巴瘤4例(其中3例为肺炎肺泡型)、高度恶性大B细胞淋巴瘤4例(均为结节肿块型)、血管中心性淋巴瘤1例(粟粒型);霍奇金淋巴瘤2例。结论:PPL的螺旋CT表现缺乏特异性,其病理分型与CT表现有一定相关性,最终确诊断主要依靠病理结果。     

淋巴瘤累及腹膜、网膜和肠系膜的CT表现

目的 分析淋巴瘤累及腹膜和/或网膜及肠系膜的CT表现.方法 回顾分析11例经临床确诊且均行腹部CT检查的非霍奇金淋巴瘤患者的CT图像.CT征象包括:腹膜线样或结节样增厚、腹水、网膜肿块、淋巴结肿大、实质性脏器累及、肠道病变等.结果 淋巴瘤累及腹膜、网膜和肠系膜均为非霍奇金淋巴瘤(NHL),以弥漫大B细胞型(n=8)多见.CT表现为腹膜线样或结节样增厚10例;网膜结节或肿块6例;系膜结节、肿块或条形密度影10例;腹水9例;肠道病变5例;腹膜后淋巴结肿大9例;肝肿大2例,脾肿大2例,肝、脾同时肿大2例,肾脏浸润1例.结论 淋巴瘤累及腹膜、网膜和肠系膜CT表现缺乏特征性,遇有腹膜和/或系膜和网膜病变时应想到本病的可能.     

肝脏上皮样血管内皮瘤的CT和MRI表现

目的 总结肝脏上皮样血管内皮瘤(HEHE)的CT和MRI表现.方法 搜集经手术或穿刺活检后病理证实的HEHE 11例,所有的病例均行CT检查,其中5例行CT平扫及双期增强扫描(动脉期+门静脉期),其他6例行CT平扫及三期增强扫描(动脉期+门静脉期+延迟期).11例中有5例加做MRI平扫及动态增强扫描.回顾性分析病变的生长方式、分布特点、密度(信号)特点、强化方式及邻近组织情况.结果 11例均表现为肝内多发病灶,大部分病灶位于肝包膜下,根据生长方式分为三型:结节型(5例),匍匐生长型(1例)和混合型(5例).CT平扫,病灶均呈低密度,直径＞2 cm的病灶内见类圆形更低密度.MRI平扫:病灶呈T1WI低信号、T2WI高信号,直径＞2 cm的病灶信号不均匀(T1WI内见更低信号,T2WI内见更高信号).其他影像学征象包括“棒棒糖征”(6例)、包膜退缩征(6例).增强扫描:病灶直径＜1 cm的表现为轻度较均匀强化;病灶直径为1～2 cm主要表现为轻度较均匀强化;病灶直径＞2 cm的多为不均匀渐进性强化.结论 HEHE的CT和MRI表现具有一定的特征性,其强化方式与病灶的大小相关.     

PET/CT诊断恶性淋巴瘤对肝和(或)脾的侵犯

目的 根据恶性淋巴瘤侵犯肝和(或)脾的PET/CT影像学表现,总结肝和(或)脾内病变累及的特点,为以后正确诊断提供依据.方法 41例累及肝和(或)脾的恶性淋巴瘤患者,共进行52例次全身PET/CT检查,追踪分析这些患者的临床资料及PET/CT影像表现,以期发现恶性淋巴瘤侵犯肝和(或)脾的规律.所有病例均由组织病理学检查证实,其中包括非霍奇金淋巴瘤(NHL)38例,霍奇金淋巴瘤(HL)2例,胃黏膜相关淋巴组织淋巴瘤1例.静脉注射18F-脱氧葡萄糖(FDG) 222～555 MBq 1h后行PET/CT显像.测定肿瘤体积和平均标准摄取值(SUVavg),并与PET/CT检查中单纯CT平扫(41例)结果进行对照.结果 淋巴瘤侵犯肝和脾的表现形式明显不同.(1)有30例(30/41)患者肝受累及,肝侵犯以肝实质内结节或肿块状病变和肝门部淋巴结受累,并形成体积较大的肿块压迫和侵犯邻近的肝实质最为常见.(2)有23例(23/41)患者脾受侵犯,脾侵犯以脾体积明显增大,PET显示整个脾代谢弥漫性均匀性增高为主要表现.(3)除全身淋巴结组织和肝、脾侵犯以外,还有一些少见部位的累及:肺内13例、骨皮质和骨髓内12例、胃9例、胸膜6例、皮下软组织5例等.结论 PET/CT可以较准确地发现恶性淋巴瘤对肝、脾的侵犯,并准确显示病灶大小、形态和分布,为淋巴瘤的诊断和准确分期提供帮助.     

原发性脾脏B细胞淋巴瘤CT特征

目的探讨原发性脾脏B细胞淋巴瘤的CT表现特征。方法回顾性分析11例经病理证实的原发性脾脏B细胞淋巴瘤CT表现。结果左上腹不适8例、隐痛6例、胀痛5例、乏力10例、低热8例、食欲下降7例、体重减低8例,左上腹扣击痛8例、压痛6例。弥漫大B细胞淋巴瘤8例:其中孤立肿块型7例,肿块5.5～12.0cm,平扫呈低密度5例,等密度2例;界限清楚5例,不清楚2例;增强扫描于动脉期轻度强化5例,无强化2例;界限清楚5例,不清楚2例;静脉期轻度强化3例,无强化4例;实质期轻度强化2例,无强化5例。粟粒结节型1例,平扫呈等密度,增强扫描脾脏实质强化,内见直径2.1～2.8cm多发低密度结节。小B细胞淋巴瘤1例(粟粒结节型):平扫示脾脏肿大,内见1.5～2.0cm多发结节状低密度灶,界限不清楚;增强扫描脾脏实质强化,低密度小结节灶无强化,界限清楚。套细胞淋巴瘤1例(多发肿块型):平扫见脾脏增大,肿块呈等密度,增强扫描动脉期显示脾脏实质强化,内见3.5～7.8cm的低密度肿块影,界限清楚,静脉期和实质期肿块边缘模糊。毛细胞淋巴瘤1例(弥漫型):脾脏呈弥漫性增大,平扫和增强均未发现明确肿块及结节灶。结论原发性脾脏B细胞淋巴瘤以孤立巨块型弥漫性大B细胞淋巴瘤多见,CT平扫以低密度或等密度;增强扫描轻度强化或不强化为特征。     

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.