原发性肝脏恶性纤维组织细胞瘤的CT诊断及鉴别

目的：探讨原发性肝脏恶性纤维组织细胞瘤的CT诊断及鉴别诊断。方法：回顾性分析5例经手术或活检病理证实的原发性肝脏恶性纤维组织细胞瘤的CT表现。结果：3例肿瘤位于肝右叶,2例位于肝左叶,4例肿瘤边界清楚,1例与周围肝实质分界不清。CT平扫5例肿瘤均表现为不均匀低密度,增强扫描肿瘤强化方式多样,5例肿瘤中,3例车辐状多形性型肝MFH增强扫描动脉期肿瘤实性成分轻中度不均匀强化,另外2例炎症型肝MFH动脉期明显强化,门脉期进一步强化,延迟扫描5例肿瘤均呈低密度,但肿瘤内部实性成分显示更为清晰。5例肿瘤中有4例可见粗大的供血动脉进入肿块内部。结论：肝脏恶性纤维组织细胞瘤CT表现多样,掌握不同病理类型肝MFH的CT表现,可提高其诊断的准确性。     

An analysis in MSCT manifestations and dinico-pathological findings of retroperitoneal stromal tumors

目的:分析腹膜后间质瘤的临床、病理组织学特征及MSCT表现,提高对本病的认识和诊断水平.方法:回顾性分析经手术和病理证实的12例腹膜后间质瘤的临床及MSCT表现.结果:12例患者主要临床表现为腹部肿块和疼痛.12例均表现为腹膜后腔软组织肿块,肿瘤最大直径3.0～21.0cm,平均11.0 cm.肿瘤呈类圆形7例,不规则形5例.CT平扫密度均匀2例,其中1例增强扫描呈均匀强化,1例呈不均匀分隔状强化.平扫密度不均匀10例,均见囊变坏死区,其中钙化2例,出血2例,增强扫描实质部分呈中度以上强化,囊变坏死部分不强化,呈分隔状.病理诊断为良性1例,低度恶性潜能3例,恶性8例,远处转移3例.免疫组化表现为CD117阳性12例,CD34阳性7例.结论:腹膜后间质瘤多见于中老年患者,临床症状少,MSCT表现具有一定特征,能较好地反映病变的病理组织学特点,对本病的诊断及鉴别诊断具有重要价值.     

腹膜后间质瘤的MSCT表现及临床病理分析

目的:分析腹膜后间质瘤的临床、病理组织学特征及MSCT表现,提高对本病的认识和诊断水平。方法:回顾性分析经手术和病理证实的12例腹膜后间质瘤的临床及MSCT表现。结果:12例患者主要临床表现为腹部肿块和疼痛。12例均表现为腹膜后腔软组织肿块,肿瘤最大直径3.0～21.0cm,平均11.0cm。肿瘤呈类圆形7例,不规则形5例。CT平扫密度均匀2例,其中1例增强扫描呈均匀强化,1例呈不均匀分隔状强化。平扫密度不均匀10例,均见囊变坏死区,其中钙化2例,出血2例,增强扫描实质部分呈中度以上强化,囊变坏死部分不强化,呈分隔状。病理诊断为良性1例,低度恶性潜能3例,恶性8例,远处转移3例。免疫组化表现为CD117阳性12例,CD34阳性7例。结论:腹膜后间质瘤多见于中老年患者,临床症状少,MSCT表现具有一定特征,能较好地反映病变的病理组织学特点,对本病的诊断及鉴别诊断具有重要价值。     

肝胰原发性恶性纤维组织细胞瘤的CT诊断

目的:探讨肝胰原发性恶性纤维组织细胞瘤(MFH)的CT表现。方法:回顾性分析经手术和病理证实的4例肝MFH和1例胰MFH的CT表现。病理分型:1例为黏液型,4例为多形性型。5例均采用CT平扫和双期增强扫描,其中2例进行了延迟扫描。结果:5例肿瘤最大径6.8~22.5cm,其中位于肝右叶1例,肝左叶3例,胰尾部1例。CT平扫:1例表现为巨大囊性结构为主的肿块,有包膜,边界清楚;4例表现为不规则形低密度肿块,边界不清。增强扫描:动脉期示肿瘤实质呈轻度~明显强化,2例肿瘤内可见细小血管;静脉期肿瘤呈中度~明显强化,肿瘤内坏死区和肿瘤实质显示清晰,边界清楚;延迟期2例示病灶密度稍低于肝实质。5例中合并肝内转移1例,肝内胆管轻度扩张2例,侵犯膈肌2例,腹膜后淋巴结转移1例。术前CT诊断为恶性肿瘤4例,良性病变1例。结论:肝胰MFH的主要CT表现为肿瘤内坏死显著,局部浸润性强,其CT表现与病理所见有很好的一致性。     

腹部原发性恶性纤维组织细胞瘤的CT表现

目的：探讨腹部原发性恶性纤维组织细胞瘤(MFH)的 CT 表现。方法回顾性分析经手术病理证实的17例腹部原发性 MFH 的 CT 表现及临床病理资料。结果腹膜后6例,肝脏5例,肾脏2例,肠系膜1例,大网膜1例,胃1例,回肠1例。肿块呈椭圆形、分叶状、结节形,体积较大。除2例胃肠道 MFH 呈均匀稍低密度影外,余病灶为稍低密度影内夹杂更低密度坏死区。增强后,腹膜后、大网膜、肠系膜及肝脏 MFH 多表现为实性成分、内部分隔呈渐进性或持续性强化,坏死部分无强化;肾脏病例边界不清,呈轻度持续性强化,程度低于正常肾实质;胃及回肠病变呈均匀持续性强化,对应胃肠黏膜正常。结论腹膜后 MHF 影像表现具有间质性肿瘤的特点,绝大部分病灶呈现渐进性及持续性强化的特征,与相应部位的癌肿影像表现明显不同。     

原发性腹膜后脂肪肉瘤CT表现与病理对照分析

目的:探讨原发性腹膜后脂肪肉瘤(PRL)的CT表现及与病理组织学的关系.方法:搜集经术后病理证实的12例PRL,回顾性分析其CT表现及与病理类型的关系.结果:肿瘤最大径为8~27cm,1例圆细胞型及1例多形性型呈椭圆形,其余10例均呈显著不规则分叶状或铸型生长.CT平扫表现:8例可见脂肪组织,分别为分化型3例、去分化型2例、混合型3例;4例未见明显脂肪组织,其中2例黏液型以液性密度为主,1例圆细胞型及1例多形性型以软组织密度为主;2例混合型肿块内伴有大块致密钙化.CT增强扫描表现:8例行增强扫描,其中2例脂肪瘤型可见软组织密度结节及条索影轻度强化;1例硬化型软组织团块呈轻度强化;2例黏液型可见索条分隔样轻度强化及整体云絮样轻度强化;1例去分化型中的去分化瘤体区域、1例多形性型及1例伴有钙化的混合型中的多形性瘤体区域均可见明显不均匀强化.结论:PRL病理组织学的多样性决定了其CT表现的多样性,不同亚型CT表现具有各自特点,并能反映各自病理类型的特征.     

原发性骨骼恶性纤维组织细胞瘤影像表现与病理对照研究

目的 分析原发性骨骼恶性纤维组织细胞瘤(MFH)影像表现与病理的关系,以提高诊断准确性.方法 回顾性分析经手术病理证实的原发性骨骼MFH 13例,术前分别经X线平片、CT平扫、MR SE T1 WI、T2 WI和增强T1 WI检查,复习影像表现并与手术病理作对照.结果 13例原发骨骼MFH中,11例位于骨端,2例位于骨干,位于骨端者与骨性关节面的距离为1～5 cm.肿瘤呈溶骨性骨质破坏,直径5.3～12.7 cm.其中,破坏区偏心10例,破坏区内见少许分隔7例,周边不连续硬化11例,伪足样突起7例,骨膜增生2例,软组织肿块9例,所有患者软组织肿块体积较小.CT扫描显示肿瘤密度与肌肉密度相仿.在MR T1 WI肿瘤为等低信号,在T2 WI为混杂信号,T2 WI常见片状等低信号,病灶周围常见不完整的低信号环,环外见伪足样突起.动态增强呈进行性延迟强化,强化显著,且较均匀.大体病理显示病灶偏心,膨胀不明显,肿瘤多突破皮质形成范围较小的软组织肿块,呈结节状或假性包裹样,肿瘤内见纺锤形成纤维细胞和胞体较小的组织细胞样细胞,伴有数量不等的胶原纤维,细胞密集呈席纹状或放射状排列.肿瘤微血管丰富.结论 原发骨骼MFH好发于中年患者长骨骨端,T2 WI常见等低信号成分,增强扫描强化显著;MRI表现与病理关系密切.     

周围型肝内胆管细胞癌的CT表现

目的：探讨周围型肝内胆管细胞癌（IHPCC）的CT表现及其诊断价值。方法：收集21例经手术病理证实IHPCC的CT表现进行回顾性分析。结果：21例平扫表现为低密度病灶,多数边界不清,伴病灶周边胆管扩张15例,肝内胆管结石9例,胆总管结石2例;伴肝叶萎缩13例,病灶局部肝轮廓凹陷10例;增强扫描动脉期病灶周边环形、结节状强化19例,内部呈斑片状强化7例,线样强化5例、网格状强化4例,静脉期及延迟10~15min后扫描病灶有进一步强化、充填,呈现渐进性强化的特点。发现肝门周围和后腹膜区淋巴结肿大8例,无弥漫性肝硬化表现及门静脉癌栓形成征象。结论：IHPCC与其它肝肿瘤及非肿瘤性病变有着不同的病理和CT表现特征,螺旋CT动态多期增强扫描对IHPCC的诊断具有重要的临床应用价值。     

腹膜后神经鞘瘤CT、MRI表现

目的 :研究腹膜后神经鞘瘤的CT、MRI表现及良恶性鉴别。方法 :本组经病理证实 13例 ,男 10例 ,女 3例 ,平均年龄45 .0岁。 13例中良性 4例 ,恶性 9例。 11例进行了CT平扫 ,其中CT强化 4例 ;MRI扫描 4例。结果 :肿瘤多见于脊柱旁腹膜后区及侧盆间隙。肿瘤 12 / 13例质地不均匀 ,9/ 13例有明显囊变区 ,未见淋巴结转移。良性者较小 ,边缘光滑 ;恶性者较大 ,呈不规则结节状 ,3/ 9例平扫CT可见钙化 ,4/ 4例CT强化不规则 ,7/ 9例显示侵犯特征 ,3/ 9例术后复发 ,4/ 9例出现转移。结论 :腹膜后间隙发生 ,有明显囊变征象肿瘤应考虑本病诊断 ,影像学表现可鉴别肿瘤良恶性质。     

腹膜后间质瘤的MSCT表现及临床特征

目的:分析腹膜后间质瘤的临床病理特征及MSCT表现,探讨MSCT对本病的诊断价值。方法:回顾性分析经手术和病理证实的7例腹膜后间质瘤的临床及MSCT表现,7例术前均行CT平扫及增强扫描。结果:7例均表现为腹膜后软组织肿块,肿块直径3.8～28.0cm,平均12.3cm。肿瘤呈类圆形1例,分叶状4例,不规则形2例。CT平扫密度均匀2例,其中增强扫描1例呈均匀中度强化,1例分隔样强化。平扫密度不均匀5例,其中钙化1例,出血1例。增强扫描肿瘤实质部分中度以上强化,囊变坏死部分不强化,其中3例呈纵横交错的轨道样强化,3例边缘及肿瘤中心可见肿瘤小血管。病理诊断:低度恶性潜能1例,恶性6例;远处转移2例。结论:腹膜后间质瘤的MSCT表现具有一定特点,能较好地反映其病理组织学特点,对其诊断、鉴别诊断及指导临床治疗有重要价值。     

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.