CT诊断特殊征象的蛛网膜下腔出血

目的:探讨蛛网膜下腔出血的特殊CT征象,提高对此病变的诊断率。方法:回顾性分析17例经证实的具有特殊CT表现的蛛网膜下腔出血病例,分析其形成机理,CT表现特征及与硬膜下血肿的鉴别要点。结果:所有病例均含有颅骨内板下新月形高密度影这种酷似硬膜下血肿的CT表现,但具有内缘不锐利,密度较低且不均匀的特征。结论:CT可以诊断具此特殊表现的蛛网膜下腔出血并与硬膜下血肿鉴别。     

急性大脑镰和小脑幕硬膜下血肿的CT及磁共振成像诊断

目的探讨急性大脑镰和小脑幕硬膜下血肿的CT及磁共振成像特征。方法回顾性分析17例急性大脑镰和小脑幕硬膜下血肿的CT及磁共振成像表现。结果 17例急性大脑镰和小脑幕硬膜下血肿中,大脑镰硬膜下血肿5例,小脑幕硬膜下血肿7例,大脑镰并小脑幕硬膜下血肿5例,6例伴有颅盖骨(大脑凸面)部位的硬膜下血肿或脑实质挫裂伤。结论急性大脑镰和小脑幕硬膜下血肿较少见,易误诊为蛛网膜下腔出血、大脑镰钙化,CT和磁共振成像征象具特征性,有助于鉴别。     

非常见部位急性硬膜下血肿CT诊断(附26例报告)

目的　提高对非常见部位急性硬膜下血肿CT表现的认识。方法　头颅外伤后在 2 4h内行CT检查 1 9例 ,2～ 3d内行CT检查 7例。经治疗后在 1～ 4周内复查CT。结果　单纯表现为大脑镰急性硬膜下血肿 7例 ,小脑幕急性硬膜下血肿 5例。额颞底部急性硬膜下血肿 2例。脑挫裂伤、脑内血肿伴有大脑镰急性硬膜下血肿 3例 ,伴有小脑幕急性硬膜下血肿 2例 ,颞顶部急性硬膜下血肿伴有大脑镰急性硬膜下血肿 2例 ,大脑镰、小脑幕急性硬膜下血肿伴有蛛网膜下腔出血 5例。 2 6例大脑镰与小脑幕急性硬膜下血肿均发生在单侧。大脑镰急性硬膜下血肿的形态有的在中线呈细线状 ,有的呈粗线状。血肿厚度 0 .3～ 1 .5cm不等。小脑幕急性硬膜下血肿表现为片状、新月形。结论　大脑镰、小脑幕和额颞底部急性硬膜下血肿是发生在少见部位的特殊类型急性硬膜下血肿 ,只要对此类血肿有所认识 ,CT检查不难确诊 ,但有时需要与蛛网膜下腔出血鉴别     

硬膜下血肿CT诊断的探讨(附55例分析)

本文回顾性分析了55例硬膜下血肿的CT 表现。重点分析了急性期,亚急性期,慢性期血肿的病理演变过程与CT 所见的密度变化关系,以及不明原因的硬膜下血肿的CT 所见。血红蛋白的量和蛛网膜腔的完整性是影响血肿密度的重要因索。同时,对等密度血肿的CT 诊断进行了探讨.     

外伤所致少见部位硬膜下血肿CT分析

外伤性硬膜下血肿是一种常见的病变。根据其好发部位及特征一般不难做出诊断。而发生在大脑镰、小脑幕硬膜下血肿比较少见。由于缺乏对本病的认识易误认为蛛网膜下腔出血。本文收集大脑镰、小脑幕硬膜下血肿25例，结合有关文献对其CT征象进行回顾分析。主要讨论CT诊断与蛛网膜下腔出血的鉴别。现报告如下。     

颅内动脉瘤破裂出血的CT诊断潜能

目的研究CT对颅内动脉瘤破裂出血的诊断潜能。方法对68例动脉瘤破裂的患者的CT表现进行分析,并与金标准DSA对照。结果首发蛛网膜下腔出血38例,脑内血肿11例,蛛网膜下腔出血并硬膜下出血1例,颅内血肿5例,脑室出血2例,脑积液4例,血管痉挛1例;动脉瘤破裂治疗中出现脑血管痉挛18例,脑积液11例。结论CT可显示动脉瘤破裂的一些特征性表现,能够根据不同脑池内积液、脑内血肿的特征性分布大致提示动脉瘤的部位。     

硬膜下诊断的价血肿CT值及限度

硬膜下血肿（Subdural Hernatomas SDH）多由头颅直接外伤引起，间接外伤偶尔亦可导致。硬膜下腔是位于硬脑膜与蛛网膜之间的一个真正而非潜在的腔隙，因蛛网膜无张力，故外伤后致桥静脉渗血，血肿易在硬膜下扩散。根据典型的CT征象，90％以上的病例可以确诊。但对等密度及双侧的病变，CT难以区别，尚需MRI及CT血管造影（CTA）检查。本组123例，重点分析、讨论了等密度硬膜下血肿的间接征象及MRI与CT血管造影的应用价值。     

蛛网膜下腔出血的CT诊断及其漏误诊原因分析

目的探讨蛛网膜下腔出血的CT诊断并分析其误诊、漏诊的常见原因。方法对100例经CT复查证实的蛛网膜下腔出血CT资料进行回顾性分析。结果100例中因出血部位及出血量不同,CT表现为分布于脑沟、裂、池内的线状、带状、片状或铸型高密度影。纵裂池及小脑幕出血灶边缘一般较模糊。出血部位以侧裂池和脚间窝最多,分别为46例及56例,2例纵裂池出血首次误诊为硬膜下血肿;1例四叠体池出血因出血量少首次CT检查为阴性,通过适时CT复查得以确诊。结论CT对蛛网膜下腔出血的诊断价值较高,可避免漏诊及误诊,并对其临床治疗具有重要把寻意义。     

等密度硬膜下血肿CT影像分析

目的：通过分析等密度硬膜下血肿的CT表现，总结具有诊断意义的CT征象。方法：回顾分析29例经手术和保守治疗证实的资料完整的等密度硬膜下血肿的CT表现、临床症状体征。结果：29例等密度硬膜下血肿CT检查出36个血肿灶。单侧24例，双侧5例。左侧15个．右侧21个，病灶分布以额颞顶部为主，其次分布在额顶或顶枕部，血肿呈新月形或半月形，位于大脑凸面，跨越颅缝，密度与脑实质相仿，CT值40-45Hu。同侧脑皮髓质界面内移，脑室受压变形、移位。双侧血肿时，中线结构向血肿小的一侧偏移。血肿较大时可以产生脑疝。CT增强扫描。脑膜及脑表面小血管强化使血肿轮廓变清晰。结论：具有诊断意义的征象有：（1）脑灰白质界面内移，（2）病灶侧脑沟消失。脑回聚拢、内移，（3）侧脑室受压变形及中线结构向健侧或血肿灶较小的一侧移位。（4）大脑镰下疝。CT增强扫描及MRI对发现小血肿及脑疝更有意义。     

非常见部位急性硬膜下血肿26例CT诊断

急性硬膜下血肿多位于颅骨内板下 ,根据血肿形态、密度变化与占位效应等在颅脑外伤急诊ＣＴ诊断中并无困难[1] 。但在实际工作中 ,位于大脑镰、小脑幕或额颞底部等非常见部位的急性硬膜下血肿 ,常被误认为蛛网膜下腔出血等。我们收集此类非常见部位的急性硬膜下血肿 2 6例 ,分析ＣＴ表现 ,以提高对本病的认识。1　资料和方法　1 1　临床资料　 2 6例患者中 ,因头部各类撞击伤、摔伤等在1ｄ内行ＣＴ检查 19例 ,2～ 3ｄ行ＣＴ检查 7例。男 17例 ,女 9例。年龄 19～ 6 7岁 ,平均年龄 37 8岁。 2 4例大脑镰、小脑幕急性硬膜下血肿 ,除 7例因合并…     

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.