脊髓纵裂畸形的MRI诊断

探讨脊髓纵裂畸形的分型和ＭＲＩ诊断价值。材料与方法：男１０例，女１４例，年龄６个月至５２岁，１５岁以下者２０例。２４例脊髓纵裂共累及２５段脊髓，均有病变区脊柱Ｘ线平片，平扫ＣＴ和ＭＲＩ。脊髓纵裂分为有隔刺的Ｉ型和无隔刺的Ⅱ型，Ⅰ型分为有完整隔刺的Ｉａ型和不完整隔刺的Ｉｂ型。Ⅱ型分为完全纵裂的Ⅱａ型和不全纵裂的Ⅱｂ型。     

椎管内脊膜囊肿的MR诊断

分析椎管内脊膜囊肿的ＭＲ表现特点,并对其发生和ＭＲ表现特点及鉴别诊断进行讨论。方法本组３９例,男２１例,女１８例,年龄８－６７岁,平均３９．７。采用ＭＲＴ１ＷＩ矢状面及Ｔ２ＷＩ矢状面和轴面扫描。６例加做ＭＲ增强扫描。结果３９例均经手术证实,并按Ｎａｂｏｒｓ方法分为Ⅰ、Ⅱ和Ⅲ３型,Ⅰ型又分２个亚型,Ⅰａ和Ⅰｂ型。其中椎管内硬膜外脊膜囊肿（Ⅰａ型）９例,骶管内脊膜囊肿（Ⅰｂ型）２２例,根性囊肿（Ⅱ型）     

眼内异物MRI临床应用研究

目的：通过分析４２例５５枚眼内异物的ＭＲＩ表现，并与ＣＴ和Ｘ线平片比较，探讨了ＭＲＩ对眼内异物的诊断价值。材料与方法：男３３例，女９例，年龄５～４５岁。５５枚眼内异物中非磁性异物５３枚，铁磁性异物２枚。每例均在术前１个月内完成Ｘ线平片、ＣＴ和ＭＲＩ检查。结果：（１）ＭＲＩ对５５枚眼内异物检出率（９４％）和ＣＴ（９１％）相仿（Ｐ＞０．２５），均明显高于Ｘ线平片（４２％）（Ｐ＜０．００５）；（２）ＭＲＩ对眼内异物相关并发症的显示优于ＣＴ，而其对巩膜异物的显示差于ＣＴ；（３）ＳＥ序列Ｔ２ＷＩ和ＰＤＷＩ（质子密度加权成像）是检出眼内异物的优选序列；（４）非磁性异物ＭＲＩ呈信号缺失区，无伪迹产生；而铁磁性异物产生大量伪迹，并可致眼部额外损伤。结论：ＭＲＩ是检出眼内非磁性异物的有效方法，特别适用于Ｘ线平片和ＣＴ不能显示的少数非金属异物。眼内铁磁性异物不适于ＭＲＩ。     

周围肺结节的磁共振成像评价

本文对２５个ＣＴ诊断困难的直径＜３ｃｍ的周围型肺结节进行了ＭＲＩ扫描。１３个恶性结节在ＭＲＩＴ２，加权像（Ｔ２－Ｗｅｉｇｈｔｅｄｉｍａｇｅ，Ｔ２ＷＩ）上表现为高信号，且Ｇｄ－ＤＴＰＡＴ１ＷＩ呈显著增强（２个）。４个结核结节在Ｔ２ＷＩ上表现为中等信号，两者在Ｔ２信号上的差异有统计学上的显著性意义（χ２检验，Ｐ＝０．００３）。尽管ＭＲＩ对于观察周围肺结节的边缘不如ＣＴ，但ＭＲＩ对于鉴别恶性结节与其它良性结节是有意义的，同时也能提供一些ＣＴ所不能提供的有价值的诊断信息。     

脑干胶质瘤的磁共振诊断

分析脑干胶质瘤的ＭＲＩ特征及与肿瘤分级的关系。材料和方法：搜集１９８８－１９９４年间经手术与病理证实２４例和活检证实１例，其中内生型２１例（８４％）（局限型１１例、弥漫型９例、延颈型１例）；外生型３例；播散型１例。２５例作ＭＲＩ平扫，６例还作Ｇｄ－ＤＴＰＡ静脉注射后ＭＲ成像。结果：ＭＲＩ上，脑干胶质瘤呈局限性膨胀或弥漫性增粗；在Ｔ１ＷＩ肿瘤多呈低、略低信号（５６％），Ｔ２ＷＩ多呈高信号（９３％），增强后实质部分强化，囊变区不强化；肿瘤包裹基底动脉并使之前移（６４％）；环池和桥小脑角池变窄或闭塞（９２％）。７３％局限型为Ⅰ级，８９％弥漫型为Ⅱ－Ⅲ级。结论：ＭＲＩ对全面显示肿瘤及脑干邻近解剖结构十分有效，术前定位诊断正确率达１００％，定性诊断正确率为９２％，分型正确率为８４％。肿瘤分型与病理分级显著相关（Ｐ＜０．０１）。     

脊髓多发硬化与特发急性横贯性脊髓炎MRI鉴别诊断

目的：探讨脊髓多发硬化（ＭＳ）和特发急性横贯性脊髓炎（ＩＡＴＭ）的ＭＲＩ特点及鉴别诊断的可能性。方法：对比分析了１６例ＭＳ和７例ＩＡＴＭ的临床表现和ＭＲＩ特点。ＭＲ基本扫描序列为ＳＥ序列Ｔ１ＷＩ、Ｔ２ＷＩ矢状位和Ｔ２ＷＩ轴位，７例行Ｇｄ－ＤＴ－ＰＡ强化。结果：１６例ＭＳ脑脊液寡克隆带阳性８例，７例ＩＡＴＭ病前发烧３例，余临床表现相似。两者ＭＲ信号特点相似，均为Ｔ１ＷＩ稍低或等信号，Ｔ２ＷＩ高信号，但ＭＳ表现病灶多发（９３％）、长度不超过２个椎体（８８％），主要分布在白质区（９３％）的特点，而ＩＡＴＭ以病灶单发（５７％）、长度大于２个椎体（７１％）、全脊髓分布或灰质分布为主（７１％）。结论：ＭＲＩ对脊髓ＭＳ和ＩＡＴＭ的诊断和鉴别诊断有重要作用。综合分析ＭＲ表现、临床特点、脑脊液检查等有助于正确诊断     

1047例骨转移瘤的影像学诊断

目的：分析１０４７例骨转移瘤Ｘ线、放射计算机体层摄影（ＥＣＴ）、ＣＴ及ＭＲＩ表现，并比较其敏感性及特异性。材料和方法：原发肿瘤主要为肺癌（２８．７５％），乳腺癌（１２．０３％）及鼻咽癌（５．０６％）等，２７．０３％来源不明。Ｘ线诊断９８８例，ＥＣＴ检查１２６例，ＣＴ扫描９７例，ＭＲＩ扫描４７例。结果：Ｘ线显示骨转移部位为脊椎、肋骨、四肢近段及颅骨。ＥＣＴ表现多骨多处浓集灶（８２．５４％）或单发浓集灶（１６．６７％），仅１例表现为稀疏病灶。ＭＲＩＴ１ＷＩ表现低信号（８０．８５％）或其他异常信号（１９．１５％）；Ｔ２ＷＩ呈高信号（６８．８５％）或其他异常信号（３１．１５％）。结论：ＭＲＩ及ＥＣＴ敏感性高于ＣＴ和Ｘ线。ＭＲＩ、ＣＴ及Ｘ线特异性高于ＥＣＴ。骨转移瘤首选ＥＣＴ并结合Ｘ线检查，必要时做ＣＴ或（和）ＭＲＩ检查。     

脑膜瘤－脑组织界面MRI表现及其病理基础

目的：探讨脑膜瘤－脑组织界面ＭＲＩ表现及其病理基础。材料和方法：分析３６例手术病理证实脑膜瘤之肿瘤－脑组织界面ＭＲＩ表现，并对部分病例进行ＭＲＩ－病理对照研究。结果：１１例（３０．６％）肿瘤周边显示Ｔ１ＷＩ、Ｔ２ＷＩ均为低信号环影（Ｉ型界面）；１１例（３０．６％）肿瘤周边显示Ｔ１ＷＩ低信号，Ｔ２ＷＩ高信号环影（Ⅱ型界面）；７例（１９．４％）肿瘤周边无明确环影（Ⅲ型界面）；７例（１９．４％）显示混合型（Ⅳ型界面）。结论：脑膜瘤周边Ｔ１ＷＩ、Ｔ２ＷＩ低信号环影代表纤维结缔组织包膜；脑膜瘤周边强化环系肿瘤包膜纤维结缔组织排列较为稀疏且包含丰富的毛细血管所致：脑膜瘤周边Ｔ１ＷＩ低信号、Ｔ２ＷＩ高信号环影代表脑脊液间隙。     

鞍隔胺膜瘤的CT,MRI诊断（附18例报告）

提高对鞍隔脑膜瘤的影像学诊断水平及其临床意义。方法鞍隔脑膜瘤１８例，１７例经ＣＴ检查，其中６例同时行ＭＲＩ检查，１例单纯行ＭＲＩ检查。全部经手术病理证实。将影像检查结果与手术病理进行对照分析。结果１８例例肿瘤位于鞍上及鞍内，１７例ＣＴ平扫表现为均匀等密度或稍高密度１５例、不均匀高密度２例，明显均匀增强１４例、环形增强３例；ＭＲＩ（７例）Ｔ１ＷＩ为均匀等信号６例，略低信号１例；Ｔ２ＷＩ略高信号６例，     

鼻咽癌放疗后放射性脑病的MRI诊断

作者观察了８４例鼻咽癌放疗后放射性脑病（ＲＥＰ）。其ＭＲＩ表现：病变主要位于双侧颞叶、脑干及小脑，Ｔ１ＷＩ病灶以低信号为（８１．３％），Ｔ２ＷＩ均为高信号，占位征象占２７．４％，萎缩征象占９．５％。还讨论了ＲＥＰ与脑梗塞、脑干胶质瘤及脑转移瘤的鉴别诊断。并提出了ＲＥＰ的ＭＲＩ分型，可分为颞叶型、脑干型、小脑型和混合型。作者还强调了ＭＲＩ显示ＲＥＰ，特别是显示脑干、小脑和颞叶底部的病灶，为ＣＴ及其他     

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.