四脑室区肿瘤的CT和MRI诊断

本文收集了１９８８～１９９３年间经华山医院手术和病理证实的四脑室区肿瘤共４９例。作者分析讨论了其ＣＴ和ＭＲＩ特征，以及与肿瘤来源和病人年龄的关系，结果表明，四脑室区肿瘤的诊断须结合ＣＴ和ＭＲＩ表现、肿瘤来源及病人年龄综合判断，其中肿瘤来源对诊断尤为重要。     

成人第4脑室肿瘤的MRI表现及诊断价值

分析成人第４脑室肿瘤ＭＲＩ特点及其诊断价值。方法搜集经手术病理证实的２５岁以上第４脑室肿瘤１８例,其中男１１例,女７例,行横断、冠状及矢状面ＭＲ ＳＥ序列扫描,并作钆喷替酸葡甲胺增强扫描。结论成人第４脑室肿瘤的ＭＲＩ表现较具特征性,结合其他表现有望确诊肿瘤性质。     

副鼻窦及鼻腔的上皮性肿瘤

本综述了副鼻窦及鼻腔上皮性肿瘤的ＣＴ，ＭＲＩ，临床表现及其诊断意义。ＣＴ和ＭＲＩ能够较好的显示肿瘤侵犯范围及其周围颅内外的细微结构变化，可为临床提供可靠的诊断，治疗依据。     

CT、MRI及MR脑脊液电影对脑室型囊虫病诊断价值的探讨

目的：探讨ＣＴ、ＭＲＩ与ＭＲ脑脊液电影在脑室型囊虫病诊断中的价值。材料与方法：回顾性研究自１９８５－０８～１９９５－１２经手术、组织病理学证实的２６例脑室型囊虫病例的ＣＴ、ＭＲＩ及ＭＲ脑脊液电影资料。比较三种检查方法在脑室型囊虫病诊断上的可靠程度。结果：ＭＲＩ与ＭＲ电影在组织分辨力、安全性、无创性以及诊断可靠性上明显优于ＣＴ扫描。在无ＭＲ检查设备的地区，脑室造影后ＣＴ扫描是可靠的诊断方法。结论：了解和掌握脑室型囊虫病的ＣＴ、ＭＲＩ及ＭＲ脑脊液电影特征将有助于作出正确、全面的诊断。对高度怀疑脑室内囊虫病的患者，ＭＲ脑脊液电影应作为首选诊断方法。     

胃瘘并发Wernicke脑病一例

患者男，２３岁。１９９４年５月２日入院。入院前３个月因腹部外伤引起胃瘘，瘘口一直未能愈合。入院第９天视物不清，表情淡漠，双侧外展神经麻痹，眼球震颤，步态不稳。血常规、脑脊液检查未见异常。给予抗生素、激素等治疗未见好转。入院后第１０天病人意识朦胧、嗜睡。ＣＴ未见异常。ＭＲＩ平扫于第３、４脑室旁及导水管周围、乳头体见长Ｔ１、长Ｔ２信号，脑室壁模糊；增强扫描示上述部位明显强化（图１～３）。ＭＲＩ诊断：Ｗｅｒｎｉｃｋｅ脑病。入院后第１２天病人图１～３　Ｗｅｒｎｉｃｋｅ脑病ＭＲＩ增强扫描，示第３、４脑室旁…     

第三脑室肿瘤的CT和MRI诊断

本文回顾了１５例病理证实的第三脑室肿瘤的ＣＴ和ＭＲＩ表现，包括６例星形胶质细胞瘤，３例胶样囊肿，２例颅咽管瘤，２例畸胎瘤，１例室管膜瘤，１例神经母细胞瘤，讨论了它们的影像学特征及其鉴别诊断。ＣＴ显示钙化敏感，对肿瘤诊断帮助很大，ＭＲＩ具有多维成像能力，可准确确定肿瘤的位置及范围。     

中脑导水管与第四脑室上部室管膜囊肿一例

中脑导水管与第四脑室上部室管膜囊肿一例王廷昱患者男，４１岁。头痛，视力下降伴行动迟缓２４年。体检：神经系统检查无阳性体征。ＭＲＩ表现：中脑背侧导水管区与第四脑室上部见一２ｃｍ×３ｃｍ类圆形异图１颅脑矢状面Ｔ１ＷＩ。中脑导水管区与第四脑室上部见一类圆形...     

四脑室机位置磁共振成像的临床定量研究

目的：用ＭＲＩ测量正常国人各性别、年龄组及Ｃｈｉａｒｉ畸形患者的第四脑室顶高距与水平距,以探讨其正常值范围及四脑室顶位置的发育规律。材料与方法：在颅脑（旁）正 矢状在ＳＥＴ１ＷＩ上测量３１７例正常国人和４２例Ｃｈｉａｒｉ畸形及可疑病人的第四脑室顶高距及水平距。正常组按性别、年龄分为１６组,每组２０例,ＭＲＩ应用１．０Ｔ全身ＭＲ机,用ｔ检验作统计分析。结果：四脑室顶高距女性为３０．０ｍｍ±１．９ｍｍ     

腮腺及其周围间隙MRI解剖标志对肿瘤定位的价值

目的评价腮腺及其周围间隙ＭＲＩ解剖标志对肿瘤定位的价值。方法１１０例累及腮腺及其周围间隙的肿瘤均行ＳＥ序列检查，１０７例经手术和病理证实，３例颈动脉体瘤经血管造影证实。用Ｔ１加权作为观察ＭＲＩ解剖标志的主要方法。结果翼内肌、咽旁间隙、颈内动脉和颈内静脉移位方向可作为嚼肌间隙、咽旁间隙、颈动脉间隙肿瘤的定位标志；腮腺深部与肿瘤之间有无脂肪平面是鉴别腮腺深部内外肿瘤的较可靠方法；腮腺内面神经及其主导管和下颌后静脉等经路上的解剖标志对肿瘤深、浅部定位的正确率为９４．９％；跨间隙生长的肿瘤均为恶性。结论腮腺及其周围间隙内的ＭＲＩ解剖定位标志对判断肿瘤的来源及手术计划的制定具有重要价值     

颅内多发原发性肿瘤的CT与MRI诊断

目的：报道１５例颅内多发原发性肿瘤的ＣＴ和ＭＲＩ表现，并评价ＣＴ与ＭＲＩ的诊断价值。方法：１５例颅内多发原发性肿瘤均行ＣＴ检查，其中４例行ＭＲＩ检查，均经手术病理证实。结果：多发胶质瘤４例，其中恶性室宫膜瘤３例，表现为脑室内及额顶叶脑实质内实质性肿块或囊性病变，多发星形细胞瘤１例，病变分别位于额叶及小脑蚓部；双侧听神经瘤及多发脑膜瘤各３例、ＣＴ和ＭＲＩ表现均较典型；脑膜瘤合并胶质瘤３例、脑膜瘤合并听神经瘤１例和垂体瘤合并胶质瘤１例。结论：结合肿瘤的ＣＴ和ＭＲＩ表现特点，可对大多数颅内多发原发性肿瘤作出正确诊断，ＭＲＩ对脑膜瘤的诊断优于ＣＴ。     

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.