淋巴管肌瘤病的CT诊断(附二例报告及文献复习)

目的 描述淋巴管肌瘤病的CT表现。方法 回顾分析2例经病理证实的淋巴管肌瘤病的胸腹CT表现。结果 2例胸部高分辨率CT表现为两肺均匀或不均匀分布的薄壁囊状影，1例伴乳糜胸。腹部CT于2例检出腹膜后淋巴结肿大。1例伴有肾脏及腹膜后血管平滑肌脂肪瘤，另1例伴腹膜后淋巴管肌瘤。结论 淋巴管肌瘤病的胸腹部CT表现有一定特征性。熟悉其胸腹部CT表现有助于该病的诊断，但最终确诊须依靠组织病理学检出。     

淋巴管肌瘤病的影像表现

目的：探讨淋巴管肌瘤病(LAM)的影像学诊断价值。方法 回顾性分析15例经临床和病理证实的LAM胸部X线平片、HRCT,腹部CT和直接淋巴管造影(DLG)及DLG后胸腹部CT扫描等影像资料。结果 15例中,X线胸片上未见异常1例,双肺纹理增多3例,弥漫性小蜂窝状影或网格状影11例,气胸2例,胸腔积液14例。胸部常规CT和HRCT扫描显示15例均具有典型LAM表现,均可见两肺散在囊状影或广泛密布的囊状影。按Avila等肺部疾病程度分级标准：Ⅰ级3例;Ⅱ级5例;Ⅲ级7例。腹部CT显示14例在腹膜后、盆腔可见囊性淋巴管瘤9例,淋巴管肌瘤13例,二者共同存在7例,并发肝脏脂肪瘤和血管平滑肌脂肪瘤、肾脏小错构瘤及子宫肌瘤各1例。DLG检查,除1例淋巴管梗阻部位在腰3水平外,其余14例均可见胸导管不同程度的狭窄、梗阻及颈干和（或）锁骨下干和（或）支气管纵隔干淋巴管反流。DLG术后CT,除3例未显示胸导管出口梗阻外,其余12例显示胸导管出口梗阻情况与DLG基本一致。结论 HRCT对肺淋巴管肌瘤(PLAM)的诊断具有特征性价值,CT可发现腹部LAM,DLG和DLG后MSCT对因LAM引起的胸导管或淋巴管干梗阻部位的显示具有价值,可为手术治疗提供一定的帮助。     

肺淋巴管肌瘤病的CT诊断(附3例报告及文献复习)

目的探讨肺淋巴管肌瘤病的MSCT表现特征,提高诊断正确率。方法回顾性分析3例经活检病理证实的肺淋巴管肌瘤病的临床和CT表现,并结合相关文献加以分析讨论。结果 CT表现为两肺散在分布的大小不等的圆形、类圆形薄壁含气透亮影,其中两肺中下野分布的病灶明显较上肺野多,病灶大小从1.0mm~3.0cm不等,囊壁厚度2mm,并可见血管影走行在囊壁内。其中1例合并有肝脏血管平滑肌脂肪瘤。结论肺淋巴管肌瘤病具有特征性的CT表现,是诊断该疾病重要的影像学检查方法。     

肺淋巴管平滑肌增生症的腹部CT表现

目的探讨肺淋巴管平滑肌增生症腹部病变的CT表现。方法回顾性分析7例经病理证实的肺淋巴管平滑肌增生症，7例均作腹部CT扫描，对其腹部CT表现进行研究分析。结果7例患者中6例有腹部阳性表现：肾血管平滑肌脂肪瘤2例，其中1例合并胸导管增大、胸腔积液；腹膜后淋巴结肿大2例，合并腹水、胸腔积液1例；肝脏血管平滑肌脂肪瘤1例；腹膜后淋巴管肌瘤合并子宫肌瘤1例。结论肺淋巴管平滑肌增生症可并发腹部多脏器病变，CT扫描对发现和诊断其腹部病变具有重要意义。     

肺淋巴管肌瘤病的临床及多层螺旋CT特点分析

目的:探讨肺淋巴管肌瘤病(PLAM)的多层螺旋CT(MSCT)表现,结合临床特点进行分析,以期提高对该病的诊断水平。方法:回顾性分析13例经病理证实的肺淋巴管肌瘤病患者的临床及影像资料。结果:13例均以进行性加重的呼吸困难为主要临床表现,4例伴有反复自发性气胸,3例伴乳糜胸,2例伴咯血,1例合并腹部淋巴管瘤。肺功能检查表现以阻塞性通气功能障碍为主合并弥散功能降低;MSCT表现为双肺弥漫分布大小不等的类圆形囊腔影,薄层重组和HRCT图像可清晰显示囊腔薄壁及常规CT不能显示的小的囊腔,囊壁外可见贴壁的血管影。结论:肺淋巴管肌瘤病的MSCT表现具有一定的特征性,结合临床可对多数病例做出正确的诊断。     

肺淋巴管肌瘤病的HRCT诊断（附17例报告）

目的：探讨肺淋巴管肌瘤病的高分辨率C T （H RC T ）表现,以提高对该病的认识。方法回顾性分析17例经病理证实的肺淋巴管肌瘤病胸部HRCT表现及临床资料,所有病例肺活检前均行胸部 HRCT扫描及腹部B超检查,腹部B超发现异常病例者行腹部C T检查6例。结果17例患者均为育龄期女性,胸部H RC T均表现为两肺弥漫、大小不等圆形薄壁囊状影（17/17,100％）,2例部分融合成肺大泡（2/17,11．8％）,4例合并气胸（4/17,23．5％）,2例伴乳糜胸（2/17,11．8％）。腹部C T检查发现2例伴双侧肾错构瘤（2/17,11．8％）,1例伴右侧肾错构瘤（1/17,5．9％）,1例伴子宫错构瘤（1/17,5．9％）,2例伴肝脏错构瘤（2/17,11．8％）,3例伴腹膜后囊性淋巴管瘤（3/17,17．6％）。结论育龄期女性,胸部HRCT表现为两肺弥漫、均匀分布的圆形薄壁囊状影,应考虑肺淋巴管肌瘤病可能。应常规行腹部CT检查,腹部CT检查发现肝肾错构瘤,腹膜后囊性淋巴管瘤可协助诊断。     

肺淋巴管平滑肌瘤病高分辨率CT影像学分析

目的分析肺淋巴管肌瘤病(PLAM)的临床特征及高分辨率CT(HRCT)表现,进一步提高对该病的认识。方法回顾性分析3例经病理证实并行HRCT检查的LAM患者资料,分析其胸部HRCT特点。结果 3例均以进行性呼吸困难为主要临床表现,1例伴有反复自发性气胸,1例伴乳糜胸及腹膜后淋巴管扩张。HRCT示双肺弥漫囊样影,分布均匀,大小形态较一致,部分囊腔有融合,病变直径为2.0～20.0mm的薄壁囊腔,壁厚1.5～2.0mm,病变早期囊腔之间可见正常肺组织。结论 PLAM主要临床特征是进行性呼吸困难,常伴有乳糜胸、气胸、腹膜后淋巴管扩张、淋巴管瘤等,HRCT对该病的早期诊断、鉴别诊断具有重要价值。     

淋巴管肌瘤病的影像学诊断(附2例报告)

目的　提高对淋巴管肌瘤病的影像学认识。方法　对 2例经病理证实的淋巴管肌瘤病患者的影像学表现及相关文献进行回顾研究。结果　 2例均为女性 ,胸片示双肺弥漫网状结节影。HRCT表现为两肺均匀分布的薄壁囊状影 ,边缘清晰 ,大小不等 ,均伴有后腹膜淋巴结肿大 ,大者约 2 .5cm ,部分融合。 1例伴有右肾血管平滑肌瘤及腹膜后平滑肌瘤 ,呈均匀中等强化。结论　淋巴管肌瘤病是一种罕见的位于淋巴器官的平滑肌细胞病态增生的疾病。两肺广泛均匀分布的薄壁囊状影为其胸部HRCT特征。可同时伴有肾脏及腹膜后血管平滑肌瘤 ,腹膜后淋巴结肿大等     

淋巴管肌瘤病的胸腹盆部影像学表现

目的探讨淋巴管肌瘤病(LAM)的胸部及腹盆部影像学表现。资料与方法分析12例经病理证实的LAM患者胸部及腹盆部影像学表现。结果胸部CT表现为双肺多发直径约0.5～2 cm的无壁或薄壁的小囊腔,其中10例囊状影弥漫性分布,1例散在分布,1例仅有数个小囊腔;伴有气胸、胸腔积液7例;11例(92%)患者腹盆部出现异常,其中腹膜后多发淋巴管肌瘤4例(2例伴有腹腔及盆腔大量积液,其中1例伴有卵巢畸胎瘤、1例伴有双侧卵巢囊肿)、合并肝肾及盆腔多发血管肌脂瘤1例、合并肾血管肌脂瘤1例;此外7例中,子宫肌瘤2例,肝肾多发血管肌脂瘤伴子宫肌瘤、胆囊息肉伴子宫肌瘤、肝多发血管肌脂瘤伴子宫肌瘤、肝脏囊肿、腹腔积液各1例。结论 LAM是一种多系统的疾病,其胸部及腹盆部病变影像学有一定特征性。     

肺淋巴管肌瘤病的CT表现（附4例分析）

目的: 探讨肺淋巴管肌瘤病CT表现,提高其诊断水平.材料和方法: 回顾性分析4例经病理证实的肺淋巴管肌瘤病CT表现.结果: 4例均行胸部常规CT及HRCT扫描,其中1例行腹部CT扫描. 常规胸部CT均可见两肺密度减低,偶见囊状影,相应水平HRCT清晰显示全肺囊状影,无分布差异.随病程进展,囊状影数目增多,部分融合成肺大泡或气胸.1例伴右肾错构瘤及后腹膜淋巴结肿大,随访3年腹部病灶无明显改变.结论: 肺淋巴管肌瘤病肺部改变,CT常规扫描表现为两肺密度减低、体积增大,HRCT能清晰显示呈特征性的两肺广泛分布的囊状影,其出现率100 %,合并肺外表现不少见.     

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.