小肾癌螺旋CT诊断和鉴别诊断

目的:评价螺旋CT三期扫描在小肾癌诊断和鉴别诊断中的价值。方法:回顾性分析经手术、病理证实的8例小肾癌的CT表现特征。结果:8例小肾癌中,平扫6例呈低密度,稍高密度和等密度各1例。增强扫描皮质期6例全瘤范围明显强化,1例轻中度强化。1例小囊性肾癌,增强后皮质期囊壁及囊内分隔明显强化。实质期及肾盂期强化迅速减退,呈“快进快退”改变。结论:螺旋CT三期扫描对小肾癌定性诊断具有重要价值。     

螺旋CT在小肾癌诊断中的应用

目的 评价螺旋CT多期扫描在小肾癌诊断中的价值。方法 分析15例小肾癌的螺旋CT表现及其病理基础。结果 小实性肾癌13例,增强扫描皮质期9例呈明显强化,4例呈轻中度强化;小囊性肾癌2例,增强后皮质期囊壁、壁结节、囊内分隔明显强化。实质期及肾盂期强化迅速减退,呈快进快退改变。病理上所有病例血窦丰富（2例小囊性肾癌囊变明显,但实性部分血窦丰富）。结论 螺旋CT多期扫描在小肾癌的诊断中较常规CT有明显优越性;多数小肾癌皮质期强化明显、实质期强化迅速减退,呈“快进快退”表现,这一强化形式有定性意义;皮质期扫描应纳入小肾癌CT检查的常规步骤。     

螺旋CT扫描在小肾癌诊断中的应用价值(附14例报告)

目的探讨螺旋CT多期扫描在小肾癌诊断中的价值。方法收集经手术病理证实的小肾癌14例,行螺旋CT平扫和皮质期、实质期及肾盂期增强扫描,分析其表现。结果CT平扫病灶呈等密度9例,稍低密度4例,稍高密度1例,2例为囊实性肿块,其中1例伴斑点状钙化。增强扫描皮质期11例呈明显强化,3例呈轻中度强化。肾实质期肿瘤密度迅速减退,肾盂期肿瘤密度进一步减退。结论小肾癌螺旋CT增强多期扫描征象有一定的特征性,对小肾癌的诊断有重要价值。     

螺旋CT三期动态扫描技术对肾癌的诊断价值

目的:探讨螺旋CT三期动态扫描技术对肾癌的诊断价值。方法:搜集2002年以来26例行CT检查并经病理证实为肾癌患者的病例资料,在CT平扫及三期动态增强扫描图像上对肿瘤的大小、强化模式、肾周改变、邻近脏器及静脉的受侵情况和淋巴结转移等征象进行分析和评价。结果:6例小肾癌多呈较均匀等密度灶,其余20例直径>3 cm的肿瘤多呈混杂密度。6例小肾癌中4例于增强扫描时呈快进快出表现。余20例肾癌的强化模式有2种:①肿瘤于CMP 强化明显,NP强化减弱(n=15);②肿瘤于CMP和NP强化程度相近,EP强化程度明显减弱(n=5)。6例小肾癌均无肾周侵犯,其余20例肾癌出现肾周、邻近脏器和静脉的侵犯及淋巴结转移。结论:应用螺旋CT三期动态增强扫描技术能更加准确地对肾癌进行术前诊断和分期。     

螺旋CT多期增强扫描在小肾癌诊断中的应用

目的:评价螺旋CT多期增强扫描在小肾癌诊断中的价值。方法:回顾性分析21例经手术或活检证实的小肾癌(≤3cm)的螺旋CT资料及病理结果。结果:21例小肾癌中实性18例,囊实性2例,囊性1例。增强扫描动脉期(皮质期)15例呈明显全瘤性强化,幅度等于或稍高于肾皮质,其中5例轻中度强化,稍低于肾皮质,5例呈不均匀或分隔状强化或边缘强化,1例呈明显边缘强化。静脉期(皮髓质分界期)强化稍低于肾皮质。髓质期及肾盂期强化迅速减退,呈“快进快退”改变。结论:螺旋CT多期增强扫描在小肾癌的诊断中较常规CT有明显优越性,多数小肾癌动脉期强化明显,实质期强化迅速减退,肾盂期呈更低密度,呈“快进快退”表现,这一强化形式有定性意义;加扫静脉期图像有利于观察小肾癌与正常肾皮质强化模式的区别,避免假阴性或假“驼峰肾”的出现。     

螺旋CT多期扫描在诊断小肾癌中的应用

目的：评价螺旋CT多期扫描在小肾癌诊断中的价值。方法：分析16例均经病理证实的小肾癌在平扫、皮质期、实质期及肾盂期的螺旋CT表现。结果：CT平扫中8例病灶呈稍低密度,5例为等密度,1例为稍高密度,2例为囊实性肿块。增强扫描皮质期明显强化为14例,中度强化为2例。强化为均匀或不均匀。肾实质期扫描肿瘤密度迅速减退,肾盂期扫描肿瘤密度进一步减退。结论：螺旋CT多期扫描在小肾癌的诊断中较常规CT有明显优越性;小肾癌皮质期强化明显,实质期强化迅速减退,呈“快进快退”表现,有重要的定性意义。皮质期扫描应作为小肾癌CT常规扫描。     

多层螺旋CT多期增强扫描在小肾癌诊断中的临床价值

目的:评价多层螺旋CT多期增强扫描在小肾癌诊断中的临床价值.方法:回顾性分析17例经手术病理证实的小肾癌的螺旋CT表现.结果:17例中小实性肾癌15例,小囊性肾癌2例;CT平扫呈低密度12例,等密度4例,稍高密度1例,伴有斑点状钙化2例;增强扫描皮质期13例呈不均匀明显强化,2例呈轻中度强化,另2例小囊性肾癌的囊壁、壁结节及囊内分隔明显强化;实质期、肾盂期扫描所有肿瘤强化均迅速减退,呈"快进快退" 改变;4例可见假包膜.17例MPR/MIP、9例VR重建均能清楚显示肾血管、肿瘤与邻近组织的关系,并发现副肾动脉2例.结论:小肾癌多为富血供肿瘤,多层螺旋CT多期扫描能提高小肾癌的检出能力及定性诊断率;MPR/MIP、VR重建能清楚显示肿瘤及肿瘤与邻近组织、器官的关系,发现肿瘤肾的肾动脉有无先天变异、静脉内有无癌栓,能为外科手术提供所需要的关键信息.     

小肾癌的螺旋CT表现

目的 探讨小肾癌螺旋CT的诊断价值.方法 回顾分析经病理证实的18例小肾癌CT表现.结果 17例小肾癌平扫呈等密度或略低密度,1例呈高密度.16例小肾癌增强皮质期明显强化,2例呈轻中度强化,实质期及肾盂期强化程度明显减退.2例小肾癌边缘可见假包膜.结论 螺旋CT对小肾癌的诊断与鉴别诊断有重要价值.     

16层螺旋CT Sure-Start软件在诊断小肾癌中的价值

目的 探讨16层螺旋CT Sure-Start软件技术在诊断小肾癌中的临床应用价值.方法 12例小肾癌患者先行16层螺旋CT平扫,然后在注入对比剂的同时启动Sure-Start软件进行增强扫描.总结分析12例小肾癌的成像资料.全部病例均经手术病理证实.结果 全部小肾癌患者均准确得到了增强扫描各期的图像,完全显示出小肾癌各期的增强特点,诊断明确.结论 基于Sure-Start软件的16层螺旋CT增强检查,有利于小肾癌的诊断和鉴别诊断,是早期检出小肾癌的最有效手段.     

64层螺旋CT在胰岛细胞瘤中的临床应用

目的 探讨64层螺旋CT三期增强扫描和三维重组在胰岛细胞瘤中的诊断价值.资料与方法 回顾性分析12例经手术病理证实的胰岛细胞瘤患者的64层螺旋CT表现,重点分析动脉期及静脉期强化特点.结果 12例胰岛细胞瘤均为单发,全部位于胰头,平扫8例与胰腺呈等密度,4例可见钙化,部分可见局限性隆起,但与正常胰腺分界不清.增强后动脉期呈明显均匀强化,CT值较正常胰腺平均高75～85 HU,静脉期强化程度较动脉期略下降,CT值较正常胰腺平均高47～57 HU.增强后瘤体边界与正常胰腺分界清晰.结论 64层螺旋CT三期增强扫描及三维重组在胰岛细胞瘤诊断中有重要价值.     

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.