低场磁共振梯度回波序列在骨挫伤中的诊断价值

目的初步评价FE T2WI序列在骨挫伤中影像表现及诊断价值。方法100例骨挫伤均行X线平片、SE T1WI、SE T2WI和FE T2WI序列检查,35例另行CT检查。结果MRI检查共有124个骨挫伤病灶,其形态为斑片状或地图状及不规则状改变,信号不均匀。SE T1WI上发现105个病灶(85%),呈低信号;SE T2WI发现48个病灶(39%),呈高信号改变;FE T2WI序列发现120个病灶(97%),呈明显高信号改变;X线平片及CT未发现一个病灶。FE T2WI序列病灶检出率高于SE T1WI(0.025相似文献   

膝关节骨挫伤的MRI诊断及其随访研究

目的:探讨膝关节骨挫伤的MRI表现及其随访特征.方法:回顾性分析112例膝关节外伤后普通X线检查膝关节未发现明显异常而MRI检查发现骨挫伤的患者,所有病例均行膝关节T1WI、T2WI、STIR序列扫描,着重分析骨挫折的MRI表现.结果:112例膝关节骨挫伤发现病灶235个,在MRI表现为不规则的斑片状、地图状的异常信号区域,病灶在T1WI上表现为不均匀低信号,在T2WI上表现为混杂高信号,在STIR序列上表现为明显高信号区,其中99例伴有不同程度的膝关节其他损伤.235个骨挫伤病灶中,在T1WI上显示209个,在T2WI上显示病灶203个,在STIR上全部显示,而且病灶边界和范围较T1WI、T2WI显示更清楚.15例进行了MR随访复查,2例膝关节骨挫伤在24周尚未完全吸收.结论:MRI是早期诊断和定期随访膝关节骨挫伤的重要影像学方法.     

骨梗死MRI影像学表现

目的探讨骨梗死的MRI影像学表现及其特点。方法回顾性分析经临床随访及病理证实的9例骨梗死的MRI影像特点。结果病变主要累及股骨的下段及胫骨的上段,很少累及膝关节面。骨梗死MRI影像表现为病灶呈现斑片状不规则的异常信号,及"地图样"改变,病灶中央于T1WI序列上呈现近似于等或稍低信号,于T2WI序列上呈现近似于等或稍高信号,边缘于T1WI序列上呈现花边样的低信号,于T2WI序列上内层为高信号,外层为低信号的"双信号带",于STIR序列上病变呈中央低信号,周边高信号改变。最后MRI呈长T1短T2信号,为坏死组织被肉芽组织和纤维组织替代而发生纤维化和钙化或骨化。结论 MRI是诊断早、中期骨梗死最有效的影像检查方法,于MRI影像上有其特征表现,能提供更多的病区信息,可以较早地发现病变,作出相应的诊断,为临床提供更有价值的治疗信息。     

肝脏孤立性坏死结节的CT、MRI表现与病理对照研究

目的:探讨肝脏孤立性坏死结节(SNN)的CT、MRI表现及其分型诊断价值和病理基础.方法:分析经临床和病理证实的肝孤立性坏死结节29例(所有病例均行MR检查,其中15例行CT检查),探讨SNN的CT、MRI表现及其分型诊断价值和病理基础.结果:①单纯凝固性坏死型(14例),T1WI、T2WI上均呈低或低-等信号,增强扫描病灶内凝固性坏死无强化,周围包膜呈延迟强化.其中8例行CT检查,CT平扫呈低或等密度,增强扫描无强化,5例可见包膜呈延迟期环形强化.②伴液化性坏死型(5例),T1WI上呈低信号,较大病灶内可见更低信号;T2WI上病灶呈低-等信号,其内液化性坏死呈点片状更高信号;增强后病灶无强化,周围包膜呈轻-中度强化.CT检查3例,CT平扫呈低或等密度,增强扫描无强化,2例周围包膜呈延迟期环形强化.CT不能反映病灶内液化性坏死.③多结节融合型(10例),T1WI呈低信号,其内可见低-等信号分隔;T2WI病灶以等-稍高信号为主,其内可见等或略高信号分隔,其中6例合并液化性坏死还可见裂隙状高信号.增强扫描病灶无强化,其内分隔及周围包膜呈轻-中度强化.CT检查4例,其中3例为低或等密度融合结节,增强扫描内部分隔及周围包膜呈延迟期强化.CT不能显示内部液化性坏死和病灶全部分隔.结论:CT、MRI能较好反映肝脏孤立性坏死结节的分型及各型的病理特征,MRI在多结节融合型和伴液化坏死型的诊断价值明显优于CT.     

MRI对微波固化治疗肝癌疗效的评价

目的评价1.5TMRI平扫和动态增强对肝癌微波固化治疗后表现和疗效随访的价值。方法回顾性分析26例32个病灶肝癌微波固化治疗后MRI表现,并与AFP和DSA结果进行对照。结果微波固化治疗3天后的MRI平扫表现,T1WI呈相对高信号,T2WI呈相对低信号,病灶周围可见长T1,长T2水肿带。微波固化治疗1月后的MRI表现①单独行微波固化治疗的19个病灶以凝固性坏死为主,平扫T1WI呈相对等高信号,T2WI呈相对低信号或等信号,动态增强扫描无强化;②多种介入方法联合应用的5个病灶,特别是与TACE联合治疗的病灶,以凝固性坏死、液化性坏死合并存在,表现为局部T1WI呈相对低信号,T2WI呈相对高信号,但动态增强扫描无强化;③8个病灶不完全坏死:在T1WI上呈相对高信号的病灶周边有低信号结节或同时伴新月形低信号带,在T2WI上则表现为等低信号病灶周边出现相对高信号结节或新月形高信号带,在动态增强扫描时呈快进快出强化表现。结论 MRI平扫和动态增强评价微波固化的疗效可靠、准确,微波固化术后定期MRI随访具有重要意义。     

不规则骨骨巨细胞瘤的MRI诊断

目的:分析不规则骨骨巨细胞瘤的MRI征象,提高对不规则骨骨巨细胞瘤影像学表现的认识及鉴别诊断水平.方法:结合文献对7例经手术病理证实的不规则骨骨巨细胞瘤的MRI影像表现进行分析.结果:MRI主要影像表现为膨胀性改变、溶骨性破坏及软组织肿块.病变在T1WI呈等或低信号,T2WI为低到高不均匀信号.结论:MRI检查对不规则骨骨巨细胞瘤的诊断和鉴别诊断具有明显的价值,并为临床手术提供可靠的资料.     

四肢关节隐性骨损伤的影像学评价

目的 :探讨四肢关节隐性骨损伤的影像学表现并评价X线平片及MRI检查的价值。方法 :搜集 3 4例有外伤史且临床检查提示有四肢关节骨损伤的病例。所有患者外伤后 1天内行X线摄片检查。随后行MRI检查 ,2周内行MRI检查 5例 ,2周后行MRI检查 2 9例。采用矢状位T1WI (TR 45 0msTE 12ms)、矢状位T2 WI加FS (TR 3 0 0 0msTE 96ms)及冠状位ME 2D (TR 775msTE 2 7ms)等序列成像 ,层厚为 4mm ,层间距为 0 .1mm。结果 :所有 3 4例患者 ,常规X线检查结果均为阴性。MRI检查 3 4例患者共发现 44个骨挫伤病灶 ,其中T1WI上 3 1个病灶 ( 70 .5 % )为较低信号 ,T2 WI加FS上 44个病灶 ( 10 0 % )全部表现为高信号 ,ME序列上 44个病灶 ( 10 0 % )全部表现为稍高或高信号。结论 :在隐性骨损伤的诊断中 ,MRI是目前最佳的检查方法。对于外伤后X线平片表现为阴性 ,而临床上仍疑诊为骨损伤者 ,有必要进行MRI检查 ,以T2 WI加FS和ME序列对隐性骨损伤的诊断最具价值。     

三角籽骨综合征的MRI诊断价值

目的:探讨MRI对三角籽骨综合征(OTS)的诊断价值。方法:回顾性分析经临床证实的21例OTS患者的临床和MRI资料。结果:三角籽骨形态:16例呈三角形,3例呈圆形,1例呈椭圆形,1例呈碎裂样多结节。内部信号特征:12例T1WI、T2WI均呈等信号,9例T1WI呈低信号,T2WI呈高信号。其他征象:三角籽骨内囊变2例;三角籽骨周围积液20例;单纯踇长屈肌腱鞘膜积液8例,单纯踝关节腔积液2例,两者皆有积液7例;踝后三角结构软组织肿胀17例;距骨后缘骨髓水肿7例,距骨软骨磨损1例。结论:OTS的MRI表现具有一定的特征性,MRI对该病的诊断具有重要的临床价值。     

早期股骨头缺血坏死的低场MRI研究

目的研究低场MRI对早期股骨头缺血坏死的诊断价值和影像学表现。方法回顾性分析56例的78个股骨头经临床证实为早期缺血坏死的X线、CT、低场MRI影像学改变,进行等级秩和检验和敏感性对照。结果78个股骨头X线平片表现为正常19个;I期38个,表现为骨质疏松及骨硬化;Ⅱ期21个,表现为骨硬化和囊状透亮区。CT表现为正常4个;I期47个,表现为星芒状结构变形,骨硬化,骨疏松;Ⅱ期27个,表现为骨硬化和囊状透亮区。MRI表现为I期21个,表现为斑点状T1WI低信号;Ⅱ期37个,为T1WI、T2WI序列上斑片状或不规则形低、等、高混杂信号;Ⅲ期20个,表现为T1WI、T2WI片状低信号,周围有高信号带环绕。经等级秩和检验,以及三者敏感性的两两结果比较,结果显示差异具有非常显著性意义(P<0.01)。结论低场MRI可以准确显示早期股骨头缺血坏死病变,低场MRI的敏感性及诊断价值高于CT和X线平片。     

踝关节骨挫伤的MRI诊断及鉴别诊断

目的:探讨踝关节骨挫伤的MRI诊断及鉴别诊断.材料和方法:总结分析11例踝关节外伤性骨挫伤的MR表现,总结其特征.结果:11例病人14个踝关节,17处病灶:胫骨远端7处,距骨滑车5处,胫骨干1处,胫骨内踝2处,腓骨外踝2处.MR形态特点:小碎片状2处;半月形5处;星芒状9处;不规则地图形1处.MR信号特点:9处病灶T1WI为等信号,8处为低信号;11处病灶T2WI表现为稍高信号,另6处病灶为等信号中可见星点状稍低信号;全部17处病灶去脂T2WI均表现高信号.结论:踝关节骨挫伤MR表现特点明确,广泛应用可提高早期诊断率.     

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.