磁共振短反转时间的反转恢复技术及其临床应用分析

目的:分析磁共振短反转时间的反转恢复技术的原理及特性,探讨其在临床应用中的价值及相关注意事项。方法:回顾性分析经短反转时间的反转恢复技术获得的磁共振脂肪抑制图像50例,对比频率选择饱和法,分析总结出其临床特点。结果:相同条件下短反转时间的反转恢复技术较频率选择饱和法能获得较好的脂肪抑制效果,但某些情况下有可能引起误诊、漏诊。结论:在磁共振脂肪抑制成像的临床应用中应恰当、合理地选择短反转时间的反转恢复技术才能获得最佳的脂肪抑制图像质量,才更利于疾病的诊断与鉴别诊断。     

心脏MR反转恢复序列在心肌梗死中的临床应用

目的分析磁共振反转时间(TI)的反转恢复技术的原理及特性,探讨其在心肌梗死中判断心肌存活的临床应用价值及相关注意事项。方法回顾性分析经反转时间的反转恢复技术获得的磁共振心肌梗死图像30例并总结其图像特点。结果在反转时间的反转恢复技术比较其图像质量及心肌与血池对比程度,显示对于坏死心肌判断TI时间的选择,TI=280～320 ms时图像质量最佳。结论在磁共振心肌活性成像的临床应用中,应恰当、合理地选择反转时间的反转恢复技术才能获得最佳的心肌与血池对比的图像,才更利于心肌梗死的诊断与鉴别诊断。     

MRI脂肪抑制技术在乳腺肿瘤诊断中的应用

目的 评价MRI脂肪抑制技术在乳腺肿瘤诊断中的应用价值.方法 对60例女性乳腺(包括40例恶性和20例良性病变)进行MRI检查,选用频率饱和法压脂或反转恢复成像,30例行压脂三维动态增强扫描,并绘制它们的时间-信号强度动态曲线.结果 MRI脂肪抑制的乳腺图像显示40例46个良性病灶,20例22个恶性病灶.增强扫描MRI 30例显示38个病灶,20个良性,18个恶性.18个恶性病灶对比强化程度较病灶平扫时信号明显增高.乳腺动态增强的时间-信号强度曲线分型流出型14例恶性、2例良性;平台型3例恶性、2例良性;单相型1例恶性、16例良性;两者差异有显著性意义(P《0.01).单相型提示良性,平台型提示可疑恶性,流出型提示恶性.结论 MRI脂肪抑制成像及动态增强扫描是诊断乳腺肿瘤的有效方法.     

IDEAL技术在脊柱病变的应用

目的:对IDEAL技术与频率选择饱和法FSE序列T2 WI脂肪抑制效果进行比较,探讨IDEAL技术在脊柱磁共振成像方面的应用价值.方法:35例脊柱病变患者行常规磁共振检查,频率选择饱和法进行矢状面T2 WI脂肪抑制扫描,采用IDEAL技术行矢状面T2 WI扫描,对两种方法的脂肪抑制效果、图像总体质量评分进行比较,并且比...     

30 d-6°头低位卧床对人下肢脂肪体积的影响

目的 观察模拟失重对人下肢脂肪体积的影响,验证磁共振水脂分离成像技术在测量人下肢脂肪容积中的可行性.方法 14名男性健康志愿者,-6°头低位卧床30 d,使用磁共振水脂分离成像(Dixon)技术采集卧床前后的下肢横断面解剖图像,测量卧床前后下肢脂肪体积.结果 与卧床前相比,卧床后所有志愿者下肢总脂肪体积及大腿段脂肪体积显著增加(P＜0.001);小腿段脂肪体积呈增加趋势,但无统计学差异(P＞0.05).结论 使用MRI水脂分离成像可以清晰地显示卧床前后下肢脂肪体积的变化;-6°头低位卧床30 d后下肢脂肪体积明显增加.     

心脏MR反转恢复序列在判定心肌活性中的临床应用

目的探讨磁共振反转恢复序列以不同反转时间成像在判定心肌活性中的临床应用。方法 32例临床证实无心肌梗死患者均经胸部反转恢复序列磁共振成像。所有患者按不同的反转时间(TI)分为两组,即A组:TI介于280～320ms;B组:TI<280ms和TI>320 ms。获自两组不同TI心肌活性的磁共振成像资料是由两名经验丰富的影像医师综合评价和回顾性分析的。结果两组间图像质量及心肌与血池对比程度比较有显著性差异,A组明显优于B组(P<0.05)。结论在采用反转恢复序列进行心脏磁共振成像中,选择合适的TI(280～320 ms)可获得最佳的心肌与血池对比图像,为临床尽早明确诊断心脏病提供可靠依据。     

不同抑脂序列在3.0 T乳腺MR扩散加权成像中的应用比较

目的 比较4种不同脂肪抑制序列的3.0T MR正常乳腺扩散加权成像(DWI)的图像质量,从而优化和筛选3.0T乳腺MR DWI的最佳脂肪抑制技术.方法 在3.0 T MRI上,分别对44例女性乳腺受检者应用选择性水激励技术(water excitation)、频率选择脂肪饱和技术(Fatsat)、反转恢复技术(IR)、频率选择反转脉冲脂肪抑制技术(Fatsat+ IR)4种不同脂肪抑制序列行DWI,其他参数相同.比较不同抑脂序列的DWI图像质量,测量并计算不同抑脂序列DWI图像的乳腺组织信噪比(SNR),并进行统计学分析.结果 应用water excitation的DWI图像质量平均评分为3.07±0.79,主观质量评分达到3分(可以诊断)及以上者34例,占总检查例数的77.27％;应用Fatsat的DWI图像质量平均评分为2.43±0.82,主观质量评分达到3分及以上者20例,占总检查例数的45.45％;应用IR的DWI图像质量平均评分为1.32±0.60,主观质量评分达到3分及以上者3例,占总检查例数的6.82％;应用Fatsat+IR的DWI图像质量平均评分为2.07±0.99,主观质量评分达到3分及以上者15例,占总检查例数的34.09％.统计结果显示不同抑脂序列的DWI图像质量比较差异有统计学意义(P =0.0001 ＜0.01),两两比较显示应用Water excitation的DWI图像质量明显优于Fatsat、IR及Fatsat+ IR(P值分别为0.002、0.000及0.000).应用water excitation的DWI图像乳腺组织SNR平均为52.28±19.34,应用Fatsat的DWI图像乳腺组织SNR平均为39.93±15.07,应用IR的DWI图像乳腺组织SNR平均为23.00±7.34,应用Fatsat+IR的DWI图像乳腺组织SNR平均为28.55±9.36.统计结果显示不同抑脂序列DWI图像乳腺组织SNR差异有统计学意义(F=90.73,P=0.0000＜ 0.01),两两比较显示应用water excitation的DWI图像乳腺组织SNR明显优于其他3组(P值均为0.000). 结论 在3.0T乳腺MR检查中,应用water excitation抑脂序列有助于改善DWI的图像质量,提高SNR.     

基于磁共振水-脂分离技术的绝经后OP髋部的定量研究

目的利用磁共振水-脂分离成像技术计算骨髓脂肪分数(fat fraction, FF)、通过髋部脂肪含量评估,提示是否骨质疏松(osteoporosis, OP)。方法收集绝经后女性78例,通过双能X线吸收测量法(dual-energy X-ray absorptiometry, DXA)测定骨密度值(bone mineral density, BMD)分为骨量正常组和低骨量组,利用磁共振水-脂分离技术测算FF,比较分析两组的全髋、股骨颈、股骨粗隆、ward三角BMD与FF值。结果通过DXA测量两组全髋、股骨颈、股骨粗隆、ward三角的BMD值,经方差分析,差异具有统计学意义(P0.05),采用MRI水-脂分离技术测量全髋、股骨颈、股骨粗隆、ward三角的FF值,经方差分析,差异具有统计学意义(P0.05),结果提示髋部MRI水-脂分离技术与DXA测量在骨量评估方面有较好的相关性。结论 MRI水-脂分离技术在一定程度上可以作为DXA的辅助,对绝经后OP髋部的评估有较好的临床应用价值。     

磁共振全身弥散加权成像的基本原理及临床应用价值

磁共振全身弥散加权成像(WB-DWI)是近几年来在磁共振常规序列基础上发展起来的一项新技术,其作为一种磁共振功能成像技术,是目前仅有的能够反映人体活体组织中水质子扩散运动的非创伤性技术.它是将MR-DWI与回波平面成像(EPI)及短时反转恢复(STIR)脂肪抑制技术相结合,明显缩短了扫描时间,能够在短时间内完成全身大范围扫描(从颅脑到膝关节),且全身背景信号被充分抑制,突出了病变组织尤其是恶性肿瘤及其转移灶的显示.由于WB-DWI具有检查时间短,覆盖范围大,检查费用低,较高的敏感性及无辐射、无创伤等优点,在临床上有广泛的应用前景.现就WB-DWI的技术原理及临床应用进行阐述.     

水脂分离技术在低场MR前列腺检查中的应用

目的 :探讨水脂分离技术在前列腺检查中的应用价值。方法 :对 5 0例健康志愿者 ,42例前列腺癌 ,73例前列腺增生 ,3 5例前列腺炎的磁共振资料进行回顾性分析。结果 :水脂分离技术在显示前列腺周围解剖结构上优于短TI反转恢复序列 (STIR)、FSET2 WI、SET1WI ,更有利于前列腺癌的分期诊断。结论 :低场MR检查中 ,水脂分离技术可替代STIR在前列腺检查中的应用。     

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.