螺旋CT及重组技术对粪石性肠梗阻的诊断价值

目的:评价螺旋CT及重组技术对粪石性肠梗阻的定位、定性的诊断价值.方法:对35例经手术证实为粪石性肠梗阻的螺旋CT表现及重组技术进行回顾性分析.结果:螺旋CT对粪石性肠梗阻的定位诊断35例(100%)均正确:空肠5例,空回肠交界处17例,回肠13例;32例(91.4%)定性诊断正确,1例粪石误诊为肠套叠,2例误诊为肿瘤.主要征象有:肠梗阻(35/35,100%),类圆柱形或椭圆柱形相对低密度灶(31/35,88.6%),病灶内呈筛状结构和"气泡征"(27/35,77.1%)及肠壁强化征(27/35,77.1%).结论:粪石性肠梗阻有典型的CT表现,螺旋CT及MPR、STS-MIP重组对粪石性肠梗阻的定性、定位诊断具有重要的临床价值.     

小肠粪石性梗阻的多层螺旋CT诊断

目的 探讨小肠粪石性梗阻的多层螺旋CT(MSCT)诊断.方法 回顾性分析经手术证实的16例小肠粪石性梗阻的MSCT表现及临床资料.结果 小肠粪石性梗阻位于空肠3例、回肠13例.粪石长径3~10 cm(平均5.5 cm±1.8 cm),15例粪石CT表现为蜂窝状气泡征,1例呈稍高密度结节.粪石单发者10例,多发者6例.4例可见少量腹水.其中6例行MSCT增强检查,梗阻端肠壁明显强化,2例可见双环征.粪石均无强化.结论 蜂窝状气泡征为小肠粪石性梗阻特征性MSCT表现.全腹CT检查是其术前定位、定性诊断的重要方法.     

植物粪石性急性小肠梗阻的CT诊断

目的:探讨植物粪石性急性小肠梗阻(SBO)的CT表现和诊断价值。方法:回顾性分析经外科手术证实的12例植物粪石性急性SBO患者的临床资料和CT表现。结果:12例小肠植物粪石均为单发,其中3例同时伴有胃内粪石。小肠粪石大小3 cm×3.5 cm～4.2 cm×5 cm,在CT上均表现为一个边缘清楚的卵圆形或圆形含有气泡的斑点状软组织肿块,位于梗阻部位的管腔内,其中位于十二指肠1例,空肠4例,回肠7例。所有病例均显示粪石近段小肠扩张(管径>3 cm),远侧小肠突然萎陷。结论:小肠植物粪石具有特征性的CT表现,CT检查是诊断植物粪石性急性SBO的最佳方法。     

多层螺旋CT在粪石性肠梗阻中的诊断价值

目的观察粪石性肠梗阻的多层螺旋CT(MSCT)图像特点,并评估MSCT的诊断价值。方法回顾性分析我院5例粪石性肠梗阻患者的CT图像。结果手术取出粪石6枚,其中5枚位于回肠,1例患者同时发现胃粪石。粪石长径3~7 cm,所有粪石的共同CT特征为筛孔状气泡征及类圆形或卵圆形肿块,增强均出现梗阻部位肠壁强化;3例出现少量胸腹腔积液,3例复查粪石游走。结论 筛状气泡征是小肠粪石性肠梗阻的特征性表现。术前MSCT对粪石性肠梗阻的诊断很有价值,为临床外科手术提供依据。     

64排螺旋CT对急性肠梗阻定位与定性诊断的准确性

目的分析64排螺旋CT对急性肠梗阻的诊断价值。方法 42例手术病理证实的急性肠梗阻患者均行腹部CT扫描,分析其影像表现并与手术结果对照。结果梗阻部位包括:小肠26例,回盲部4例,结肠10例,直肠4例。与手术结果对照,CT对梗阻的定位诊断准确率为95.2%(40/42),定性诊断正确率为81%(34/42)。结论 CT可以清晰显示梗阻部位,对肠梗阻的定性诊断也有一定价值。     

小肠腺癌的MSCT诊断

目的:探讨小肠腺癌(SBA)的多层螺旋CT(MSCT)表现及其诊断价值.材料和方法:回顾性分析56例经手术、小肠镜、病理确诊的小肠腺癌病人(除外壶腹部、壶腹部周围腺癌及转移癌)MSCT资料.结果:56例SBA病例,发生于十二指肠29例,空肠18例,回肠9例.MSCT定性诊断准确率为(51/56,91.1%),定位诊断准确率为(53/56,94.6%),根据病人的CT表现,可分为4型:缩窄型、溃疡浸润型、息肉肿块型、弥漫型,共有45例SBA行手术治疗,比较术前CT及与术后病理分期,Kappa检验表明两种分期方法有较高的一致性,另有2l例同时行MSCT小肠造影及推进式双气囊小肠镜检查,两者术前定性、定位准确率均较高.结论:CT小肠造影对SBA术前定位、定性及分期诊断的准确率较高,可作为小肠疾病诊断的首选方法,掌握小肠腺癌MSCT表现,有助于提高SBA的影像学诊断水平.     

MSCT对评估粪石性小肠梗阻保守治疗可通过性的价值研究

目的 探讨多层螺旋CT(MSCT)及其重组技术对粪石性小肠梗阻保守治疗可通过性的评估价值.方法 搜集本院经手术及临床证实的50例粪石性小肠梗阻患者,根据保守治疗后粪石是否通过,分为通过组和非通过组,所有患者均在治疗前1天内行全腹MSCT扫描,并根据MSCT图像追溯粪石梗阻的部位,测量粪石短径、粪石长径、粪石平均CT值、...     

MSCT及多平面重建技术在柿石性小肠梗阻中的诊断价值

目的分析柿石性小肠梗阻的CT表现,提高对本病的诊断水平。方法回顾性分析经手术证实的26例柿石性小肠梗阻的CT图像,分析其CT特征。结果 26例柿石性小肠梗阻病例中,9例柿石位于空肠,17例位于回肠。病灶为圆形的6例,椭圆形20例。最小柿石为2.7cm×2.1cm,最大为6.2cm×3.3cm。所有小肠内的柿石均为单发,其中3例伴有胃内柿石。柿石含较多气体呈筛状或蜂窝状的21例,呈均匀软组织密度伴少部分气泡影的5例;边缘见薄环形高密度影呈"胶囊壁"改变的22例;所有病灶在MPR重建时均表现为"瓶塞"样改变,嵌顿于小肠肠腔内。所有行增强CT检查的病变均无强化;病灶远段肠管突然萎陷的23例。结论柿石性小肠梗阻的CT表现具有特征性,MSCT及MPR技术对柿石性小肠梗阻的诊断具有重要价值,结合进食柿子病史及季节性发病,可作出明确诊断。     

64层螺旋CT曲面重组技术对胆管梗阻的诊断价值

目的：研究胆管梗阻64层螺旋CT曲面重组（CPR）技术的操作方法、临床应用价值及其局限性。方法：搜集本院2008年7月～2009年3月阻塞性黄疸患者资料47例,全部采用GE公司Light Speed64层螺旋CT行上腹部平扫及四期增强扫描,后将其0.625mm薄层扫描轴位源像（ASI）传到工作站进行后处理,行扩张胆管曲面重建成像,作任意曲面以清晰显示梗阻部位及梗阻上段胆管的扩张情况,对胆管梗阻原因进行定位和定性诊断,并与手术所见及术后病理结果进行对比。结果：10例肝外胆管结石患者,术前64层螺旋CT曲面重组（CPR）技术定位、定性诊断准确率达到94%及87%。37例胆管、胰头肿瘤或先天性疾病患者（25例为肝门部、肝外胆管癌或胆管炎症,3例为壶腹部癌,胰头癌8例,先天性胆总管囊肿1例）中,36例准确定位,32例得到正确诊断,术前64层螺旋CTCPR定位、定性诊断准确率分别达到97%及86%。结论：64层螺旋CT曲面重建技术（CPR）能直观显示胆管病变,对诊断胆管梗阻具有重要价值。     

多层螺旋CT对小肠梗阻病因的诊断价值

目的:评价多层螺旋GT对小肠梗阻病因的诊断价值.方法:41例小肠梗阻病例进行了上下腹部CT平扫加增强扫描,利用工作站获得重建图像,并将CT结果与手术病理对照.结果:41例小肠梗阻患者均经手术证实,其中良性病变29例(包括胆石性梗阻,腹外疝或腹内疝,粘连性肠梗阻,肠气肿,炎性纤维性息肉,粪便纤维素性梗阻,肠套叠伴良性病变,小肠克罗恩病),恶性病变12例(包括胃癌术后转移,原发性或继发性小肠恶性肿瘤,结肠恶性肿瘤,肠套叠伴恶性病变).多层螺旋CT正确诊断梗阻病因39例(95.1%),误诊漏诊2例.结论:多层螺旋CT是诊断小肠梗阻病因的有效且较准确的方法.     

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.