腮腺少见病变的影像学表现分析

目的:探讨腮腺少见病变的影像学表现,提高对其认识水平。方法:回顾性分析经临床及病理证实的38例腮腺少见病变的CT或MRI资料。结果:嗜酸细胞腺瘤向咽旁间隙生长是其特征性表现;基底细胞腺瘤有双期持续强化特点;肌上皮瘤和肌上皮癌影像表现无特异性;脂肪瘤可见脂肪成分;婴儿毛细血管瘤有血管流空信号;木村病表现为腮腺弥漫性肿大,累及皮肤及皮下组织;表皮样囊肿、皮样囊肿、潴留囊肿病灶内均无强化;钙化性上皮瘤常位于腮腺区外侧皮下,发生部位有一定特点;良性淋巴上皮病变表现为双侧腮腺弥漫性肿大伴多发囊性肿块或小结节;淋巴上皮癌表现为多发囊性肿块时与良性淋巴结上皮病变及转移性鳞癌鉴别困难;腮腺癌2例均为腺泡细胞癌;淋巴瘤常有原发淋巴瘤病史,伴全身多发淋巴结肿大;转移瘤有原发恶性肿瘤病史,影像学表现与原发肿瘤密切相关。结论:部分腮腺少见病变具有一定的影像学特点,有助于鉴别诊断,确诊仍依靠组织病理学和免疫组化。     

腮腺基底细胞瘤的CT影像诊断及鉴别

目的 探讨腮腺基底细胞瘤(BCA)的CT特征及鉴别诊断.方法 回顾性分析经手术病理证实的9例腮腺BCA患者的CT表现;9例均行CT平扫和增强;并与腮腺混合瘤、腺淋巴瘤及黏液表皮样癌的CT表现进行对照.结果 9例患者均为单发.CT平扫均表现为腮腺内稍高密度影,呈类圆形,境界清晰,CT值约34～53 HU;8例病灶体积较小,最大径0.92 ～ 2.74 cm,均位于腮腺浅叶;1例体积较大,最大径3.21 cm,同时累及腮腺深、浅叶;增强扫描,肿瘤实质部分呈明显强化,动脉期CT值约83 ～ 106 HU,静脉期强化不消退.CT平扫时,BCA与混合瘤、腺淋巴瘤及黏液表皮样癌的CT值无统计学差异(P＞0.05);动脉期:BCA肿瘤实质部分的强化程度与腺淋巴瘤无明显差异(P＞0.05),但均高于混合瘤及黏液表皮样癌(P＜0.05);静脉期:BCA肿瘤实质部分的强化程度高于腮腺混合瘤、腺淋巴瘤及黏液表皮样癌(P＜0.05).结论 BCA作为一种相对少见的腮腺良性肿瘤,好发于老年女性;影像学表现为位于腮腺浅叶的单发病灶,密度不均,边缘清晰,增强扫描呈“快进慢出”表现;最终确诊须依靠病理学.     

腮腺原发恶性肿瘤的CT表现

目的：分析腮腺各类型原发恶性肿瘤的CT表现，了解其影像学特点，资料与方法。分析经手术及病理证实的腮腺原发恶性肿瘤19例，包括粘液表皮样癌8例，腺泡细胞癌及腺癌各3例，鳞状细胞癌及恶性混合瘤各2例，腺样囊性癌1例。结果：临床有面神经受累症状者7例，其中6例肿瘤侵及深，浅二叶。19例中，5例肿物呈圆形或椭圆形，14例呈不规则形；6例边缘清楚，13例边缘不清楚并伴有不同程度的周围结构受侵。17例行增强扫描，肿瘤均有不同程度的强化，其中10例明显强化。肿瘤密度均匀2例，不均匀15例，内部有不同形态的低密度区，其中4例中央有大片低密度坏死，9例合并有颈部淋巴结肿大。结论：面神经受累症状为腮腺恶性肿瘤的临床特点，如肿瘤侵及深，浅二叶时诊断更为可靠；肿物边缘不规则，边界不清楚，明显强化，内部密度不均匀以及颈部淋巴结肿大为腮腺原发恶性肿瘤的影像学特点。     

腮腺上皮性肿瘤74例临床病理分析

目的：探讨腮腺上皮性肿瘤患者的发病年龄、各肿瘤所占比例及相关的临床病理学特点,提高对腮腺肿瘤的认识。方法对74例腮腺上皮性肿瘤的临床及病理资料进行分析。结果74例病例中,40岁以上中老年人共56例,占75.68％;74例病例中,良性肿瘤60例,占81.08％,恶性肿瘤14例,占18.92％。其中良性以多形性腺瘤多见,占53.33％,其次为腺淋巴瘤,占40.00％。恶性肿瘤以腺泡细胞癌多见,占35.71％。结论74例腮腺上皮性肿瘤中以良性肿瘤多见,良性肿瘤中以多形性腺瘤居多,腺淋巴瘤次之。恶性肿瘤以腺泡细胞癌多见,其次为腺样囊性癌。腮腺肿瘤好发于中老年人,良性多于恶性。     

腮腺腺淋巴瘤的MSCT表现与病理基础

目的:探讨腮腺腺淋巴瘤的MSCT表现及病理基础。方法:回顾性分析经手术病理证实的34例腮腺腺淋巴瘤的MSCT及其相关病理学表现。结果:34例共45个肿块,单侧单发23例,单侧多发6例,双侧多发5例。病灶CT表现为椭圆形、圆形软组织肿块,密度较均匀或不均匀,边界清楚,部分囊变。增强扫描后动脉期实性部分明显强化,延迟期强化幅度减退;囊变部分无强化。镜下可见瘤体由双层柱状上皮和淋巴样间质2种成分构成,由于肿瘤组织中上皮和淋巴样组织成分的比例不同,CT表现分为实性和囊性表现。结论:由于腮腺腺淋巴瘤病理表现的特点,其CT表现有一定的特征性,结合发病年龄、性别、临床表现及影像学特征等,有助于该病的诊断与鉴别诊断。     

螺旋CT对腮腺恶性肿瘤的诊断价值

目的:分析腮腺恶性肿瘤的CT表现,以及MPR后处理图像对提高诊断率的价值。方法:分析经我院于术病理证实的腮腺原发恶性肿瘤2 2例,包括粘液表皮样癌9例,腺癌及鳞状细胞癌各4例,腺泡细胞癌3例,恶性混合瘤2例。结果:2 2例中肿物呈圆形及椭圆形8例,不规则形14例,边缘清楚9例(在MPR图像上总能发现边缘毛糙、周围脂肪受侵) ,边缘不清楚13例,肿瘤有不同程度的向周围组织浸润。增强扫描显示肿瘤均有不同程度的强化,其中18例明显强化,薄环状强化伴中央大片低密度坏死5例,肿块呈不规则型强化17例。颈部淋巴结转移11例。临床表现有面神经受累9例,其中6例横断位上下颌后静脉增强扫描显示不清;3例下颌后静脉较清晰可见,但在MPR图像上显示受压变形、移位。结论:面神经受累为腮腺恶性肿瘤的临床特点,肿块边缘不规则、边界不清、有明显强化、内部密度不均匀以及颈部淋巴结肿大为原发腮腺恶性肿瘤影像学特点。     

腮腺病变的CT诊断及误诊分析

目的:探讨CT对腮腺良、恶性病变的诊断及鉴别诊断价值。材料与方法:回顾性分析经手术及活检病理证实的80例腮腺病变的影像学表现。结果:腮腺区良性病变70例,恶性病变10例。CT扫描良性病变常表现为形态规则,边界清晰,以混合瘤(20/70)居多,其次为腺淋巴瘤(16/70);恶性肿瘤中以黏液表皮样癌多见(4/10),表现为边界不清晰肿块影,3例腺泡细胞癌均表现为边界清晰肿块。结论:CT扫描对腮腺常见肿瘤的定位、定性诊断具有一定的价值,CT增强检查对于肿瘤的定性有更大帮助。     

气管支气管低度恶性肿瘤CT表现

目的:通过探讨气管支气管低度恶性肿瘤CT表现以提高对该病诊断准确性.方法:回顾性分析经病理证实气管支气管低度恶性肿瘤80例CT表现及临床特征,总结其规律.结果:80例中腺样囊性癌37例,黏液表皮样癌26例及类癌17例.发病部位:腺样囊性癌发生于气管24例,主支气管10例,叶支气管1例,段支气管2例;黏液表皮样癌发生于气...     

多层螺旋CT对腹膜假性黏液瘤的诊断价值

目的 探讨腹膜假性黏液瘤的MSCT表现.方法 搜集经手术、病理证实的腹膜假性黏液瘤11例,回顾性分析其CT表现.结果 腹膜假性黏液瘤的MSCT平扫见腹腔不规则囊实性肿块,CT值18.5～27.6 HU;肝脾等实质脏器边缘扇贝样或结节状压迹,脏器周围、网膜间隙、腹腔、盆腔见大量黏液性腹水;腹膜、大小网膜弥漫性不规则增厚;增强扫描显示囊实性病变仅见囊壁、网膜、腹膜轻度强化,囊内病灶无明显强化.结论 MSCT检查对该病的诊断及鉴别诊断具有重要的价值.     

二维及彩色多普勒超声诊断腮腺肿瘤的临床价值

目的 探讨二维及彩色多普勒超声在腮腺肿瘤诊断中的应用价值.方法 对收治的腮腺肿瘤患者采用二维及彩色多普勒超声检查,分析常见的腮腺肿瘤的声像图表现.结果 68例腮腺肿瘤中良性肿瘤36例,占52.94％,在良性肿瘤中,又以混合瘤多见29例（80.56％）,腺淋巴瘤7例（19.44％）;低度恶性肿瘤10例,占14.71％,其中粘液表皮样癌（高分化型）5例（50.00％）,腺泡细胞癌4例（40.00％）,基底细胞腺癌1例（10.00％）;恶性肿瘤12例,粘液表皮样癌（低分化型）6例（50.00％）,鳞状细胞癌3例（25.00％）,腺样囊性癌2例（16.67％）,恶性混合瘤1例（8.33％）.腮腺肿瘤患者中良性肿瘤与恶性肿瘤在形态、包膜、边界进行比价有明显差异,且差异具有统计学意义（x2＝10.25、23.14、18.56,P＜0.05）.二者在内部回声上比较无明显差异（x2=3.11,P＞0.05）.腮腺肿瘤患者中良性肿瘤的血流信号相对较少,而恶性肿瘤患者的血流信号较丰富;良性肿瘤与恶性肿瘤患者的血流分级情况比较有明显差异,且差异具有统计学意义（x2=10.03、13.75、7.70、23.54,P＜0.05）.结论 二维超声及彩色多普勒诊断腮腺肿瘤操作简单方便、重复性强、无损伤、符合率高.     

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.