电子束CT在诊断肺动脉栓塞中的应用

评价电子束ＣＴ（ＥＢＣＴ）在诊断肺动脉栓塞（ｐｕｌｍｏｎａｒｙｅｍｂｌｏｌｉｓｍＰＥ）中的作用。方法对２０例肺动脉栓塞患者进行回顾性分析,年龄２８－７８岁。应用ＩｍａｔｒｏｎＣ－１５０ＥＢＣＴ机,连续容积扫描（ＣＶＳ）或单层序列扫描（ＳＳＭ）层厚３ｍｍ或６ｍｍ     

腹腔动脉与肠系膜上动脉的螺旋CT血管造影初探

探讨螺旋ＣＴ血管造影（ｓｐｉｒａｌｃｏｍｐｕｔｅｄｔｏｍｏｇｒａｐｈｙａｎｇｉｏｇｒａｐｈｙ,ＳＣＴＡ）对腹腔动脉及其分支与肠系膜上动脉干的显示能力及扫描技术。方法腹部ＳＣＴＡ检查结果正常者３０例,平扫后行小剂量试验。取胰体水平腹主动脉为靶血管,以峰值时间为２秒定为最佳延迟扫描时间。ＳＣＴＡ以３．５ｍｌ／ｓ速度经肘前脉注入碘造影剂９０－１１０ｍｌ,由于侧向足侧扫描,扫描参数为螺距１．０层厚３．２ｎ     

电子束CT双期扫描定量估价胰腺增强程度

目的：定量估价电子束ＣＴ双期扫描胰腺的增强程度。材料和方法：１１０例可疑胰腺病变者（２６～７２岁）均行电子束ＣＴ检查。其中胰腺癌１５例，胰腺炎３例，胰腺外伤２例，正常胰腺９０例。应用高压注射器以３．５ｍｌ／秒（８０ｍｌ）和１０ｍｌ／秒（２０ｍｌ）速度注射Ｕｌｔｒａｖｉｓｔ１００ｍｌ，在注射造影剂后１８～２０秒和５５～６０秒，应用ＳＶＳ０．３秒序列扫描胰腺２０层，层厚６ｍｍ。于动静脉期测量胰腺头、体、尾ＣＴ值。结果：在动脉期胰腺增强的ＣＴ值为１０１Ｈｕ±８（标准差），静脉期为８１Ｈｕ±５。其中６１例（５５％）动脉期较静脉期ＣＴ值增高２０Ｈｕ以上；３８例（３４％）增高１０Ｈｕ以上；１１例（１０％）动脉期ＣＴ值低于静脉期。结论：胰腺动脉期扫描较静脉期可提供更详细的解剖结构，可更清楚显示胰腺癌对胰周的浸润，可提高检测胰腺内小病灶的准确性。     

双剂量法螺旋CT胆道造影及三维重建技术的应用评价

目的 评价双剂量法螺旋ＣＴ胆道造影（ＳＣＴＣ０及三维重建技术的临床应用价值。材料与方法 ５０例临床拟诊胆胰疾病患者用５０％胆影葡胺４０ｍｌ加入５０％葡萄糖６０ｍｌ滴注４５分钟滴注开始后６０￣１２０分钟内行螺旋ＣＴ扫描。图像经３Ｄ最大强度投影（ＭＩＰ）及表面遮盖法（ＳＳＤ）后处理。结果 血胆红素定量小于２ｍｇ／ｄｌ（３４μｍｏｌ／Ｌ）,胆系显影率为１００％,小于６８．４μｍｏｌ／Ｌ,大于３４μｍｏｌ     

肝细胞癌螺旋CT扫描时间窗优化

目的 探讨肝细胞癌螺旋ＣＴ扫描ＣＴ征象在不同时相显示的最早时间和最丰富的时间,以便提出一个在时间窗上优化的扫描程序。材料与方法 ４１例确诊为肝细胞癌病例,应用Ｓｉｅｍｅｎｓ Ｓｏｍａｔｏｍ Ｐｌｕｓ ４Ａ螺旋ＣＴ设备,采用１００ｍｌ对比剂,３ｍｌ／ｓ注射速度,于肿瘤靶平面进行动脉期（延迟１４～２１ｓ）同层面动脉扫描,然后行全肝门脉期（延迟８０～８５ｓ）扫描和肿瘤靶平面平衡期（延迟１７０～２８５ｓ）     

电子束CT流动检查评价原发性肝癌

目的 应用电子束ＣＴ（ＥＢＣＴ）流动扫描研究原发性肝癌的时间－密度曲线特点与因供和病理的对应关系,以期提高诊断的特异性和准确性。方法 ３１例肝脏肿块者均行ＥＢＣＴ流动扫描。静脉注射对比剂８０￣１００ｍｌ,速度为６￣８ｍｌ／ｓ,病灶区扫描６层,每层扫描１３次,需时１２０秒。画出时间－密度曲线及测量各参数值。结果 ３１例肝癌均表现为不同程度的增强。小于５ｃｍ的肝癌与大于５ｃｍ肝癌和弥漫型肝癌其增强类型     

CT仿真结肠镜与其他后处理方法检查结直肠息肉的比较研究

目的 比较研究多平面重建（ＭＰＲ）、ＣＴ仿真结肠镜检查（ＣＴＶＣ）,表面遮盖显示（ＳＳＤ）和透明显示（Ｒａｙｓｕｍ）检查结直肠息肉的临床价值。材料与方法 用螺旋ＣＴ机对２３例结直肠息肉病例进行容积扫描,在工作站应用４种后处理方法获取ＭＰＲ、ＣＴＶＣ、ＳＳＤ和Ｒａｙｓｕｍ图像。按息肉大小分３组及总结果进行统计分析。病变均经常规结肠镜检查（ＣＣ）活检和／或手术病理证实。结果 ２３例共５６枚息肉。ＭＰＲ     

脑血管电子束CT(EBCT)成像技术的初步探讨

探讨合理的脑血管电子束的检查模式，材料与方法，选择７例ＥＢＣＴＡ检查结果正常都胡机分组、对照，进行前瞻性研究，采用ＩｍａｔｒｏｎＣ－１５０ＣＢＣＴ扫描仪，连续容积和步进式两种扫血管部位ＣＴ值要高于相同条件下的ＳＶＳ扫描；同一扫     

超高速CT评价心室容积准确性的研究

目的：（１）评价超高速ＣＴ（ＵＦＣＴ）计算心室容积的准确性；（２）比较长轴和短国观计在计算心室容积的差异，材料与方法，采用ＩｍａｔｒｏｎＣ－１５０超高速ＣＴ扫描系统对１４个人的心脏左室铸型和１５个人的心脏右室铸型进行扫描。以修正的面积－长径（Ｓｉｐｍｐｓｏｎ）法计算左右心室铸型的容积。心室铸型的实际容积通过铸型排除水的容量来计算，结果：左、右心室的实际容积分别为５５．５７±２８．９１ｍｌ和６４．２     

电子束CT与常规心血管造影计算左心室容积准确性的比较

目的评价电子束ＣＴ（ＥＢＣＴ）及常规心血管造影计算左心室容积的相对准确性。材料与方法对１４只人的左心室铸型进行了ＥＢＣＴ扫描，并与常规双平面Ｘ线电影结果进行比较。左心室铸型的实际容积由铸型排除的水的容积来测定。结果左心室铸型的实际容积为５５．５７±２８．９１ｍｌ，ＥＢＣＴ长轴扫描的计算容积为６６．５０±３３．０４ｍｌ，ＥＢＣＴ短轴扫描的计算容积为６０．３６±２９．９０ｍｌ；常规双平面Ｘ线电影的计算容积为８２．０９±４０．４０ｍｌ。Ｘ线电影计算的左心室容积明显大于ＥＢＣＴ的左心室容积值及左心室铸型的实际容积值（Ｐ＜０．００１）。相关分析表明，ＥＢＣＴ及双平面Ｘ线造影的左心室计算容积值均与左心室铸型的实际容积高度相关（ｒ均高于０．９８）；但双平面Ｘ线电影对左心室容积值的高估程度较ＥＢＣＴ更高（Ｘ线电影为２６．５２±１６．１１ｍｌ，ＥＢＣＴ短轴扫描为４．７９±６．５９ｍｌ，ＥＢＣＴ长轴扫描为１０．９３±８．１４ｍｌ，Ｐ＜０．０１）。结论在左心室容积计算方面，ＥＢＣＴ较常规心血管造影更精确，其同样可以作为左心室容积计算的金标准。     

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.