鼓室球瘤的影像学表现

目的 探讨鼓室球瘤的影像学诊断价值。方法 回顾性分析10例经手术病理证实的鼓室球瘤的CT和MRI表现，总结其影像学表现特点及其诊断价值。结果 8例行颞骨高分辨率CT检查，2例行常规CT扫描；其中7例轴面及冠状面均能显示鼓室软组织结节影，3例示中耳乳突内充满了略低密度软组织影，CT仅诊断为慢性中耳乳突炎，漏诊了其内的鼓室球瘤，所有病例未见骨质破坏。行MR检查者8例，T2WI显示肿瘤为较高信号（6例）和高信号（2例），增强后以明显强化为特点；3例伴有慢性中耳乳突炎者，T2WI可区分肿瘤的较高信号和周围炎症的高信号，增强MRI亦能显示强化的肿瘤和不强化的周围炎症。结论 MRI对鼓室球瘤的显示优于CT，伴有中耳乳突炎时MRI优势更明显。     

早期鼻咽癌伴中耳乳突炎的MRI诊断及临床意义

目的探讨早期鼻咽癌伴发中耳乳突炎的MRI诊断及临床价值。方法收集40例经病理证实为临床早期鼻咽癌(Ⅰ期和Ⅱ期)又具有中耳乳突炎病例的MRI及临床资料,并对其进行了回顾性分析和总结。结果 40例MRI检查均发现中耳乳突炎征象,共计65只耳部异常,其中左侧13例,右侧18例,双侧34例。40例患者初诊时仅18例MRI提示鼻咽部异常,占45%(18/40),22例鼻咽部未见异常,占55%(22/40),但均有一侧或双侧中耳乳突炎表现,中耳乳突炎显示率100%。结论中耳乳突炎是早期鼻咽癌重要的间接征象;MRI对提高鼻咽癌的早期诊断具有重要临床价值。     

中耳鼓室球瘤HRCT与MRI表现

目的探讨中耳鼓室球瘤的HRCT及MRI影像学特征及诊断价值。方法回顾性分析经手术病理证实的11例中耳鼓室球瘤的影像学表现。11例均行高分辨CT(HRCT)扫描,其中5例增强,均完成冠状面重建;11例均行MRI平扫加增强扫描。结果 11例鼓室球瘤均发生于下鼓室靠近鼓岬。HRCT显示了7例软组织结节,大小4.0~16mm(平均9.2mm),其中2例合并中耳乳突炎,其余4例只显示了中耳乳突炎,11例均未见明确骨质破坏。MRI则显示了全部肿瘤结节,大小4.1~18mm(平均11mm),T1WI上结节呈等信号或稍高信号影,T_2WI呈高信号影,增强呈显著强化。结论中耳鼓室球瘤一般发生于下鼓室靠近鼓岬,影像表现为软组织结节而未见明显的周围骨质破坏。HRCT对独立的肿瘤结节显示较好,但合并中耳乳突炎时检出困难;MRI显示肿瘤结节明确,尤其MRI增强检查血管样强化的结节较有特点,有助于定性诊断。     

自身免疫性疾病相关中耳乳突炎的影像学分析

目的 探讨自身免疫性疾病所致中耳炎的影像学表现,增强放射科医师对该疾病的认识。方法 选取2000年～2019年15例自身免疫性疾病(2例嗜酸性中耳炎、4例Ig G4相关疾病、9例坏死性肉芽肿性血管炎)相关中耳乳突炎患者的影像学资料和临床表现。结果 11例患者为双侧、4例患者为单侧中耳乳突炎,CT表现为鼓室、乳突蜂房和鼓窦内软组织影填充,听小骨和中耳乳突区骨质未见破坏征象,MRI表现为T1WI低信号,T2WI高信号,当分泌物较粘稠时MRI信号混杂。2例嗜酸性中耳炎可见鼻窦术后表现。4例Ig G4相关疾病头颈部异常表现包括双侧腮腺、颌下腺、泪腺肿大;三叉神经分支额神经、眶下神经增粗;鼻窦炎症等。9例坏死性肉芽肿性血管炎头颈部异常表现包括眼眶肌锥外间隙受累、鼻中隔骨质破坏及脑膜增厚强化,双侧或单侧泪腺肿大。结论 多种自身免疫性疾病均可导致中耳乳突炎,每种疾病头颈部伴随的改变各具特点,全面细致的观察视野内所有异常改变,有助于得出正确的诊断。     

中耳乳突炎HRCT表现及其与IL-1相关性研究

目的 :探讨慢性中耳乳突炎的HRCT特征及IL 1在慢性中耳乳突炎中引起骨破坏的作用 ,旨在提高对各型慢性中耳乳突炎的诊断水平。方法 :对 4 8例慢性中耳乳突炎患者 ,行HRCT扫描 ,并与手术病理结果对照分析 ,采用放射免疫分析法检测IL 1在 4 8例慢性中耳乳突炎组织中及患者血清中含量 ,并与 6例正常皮肤组织及 30例正常血清中含量比较。结果 :①高分辨率CT显示胆脂瘤病变大多呈团块状病变 ,常伴有明显的听骨破坏和盾板骨质破坏 ;单纯型、肉芽肿型多数呈片状、条索状或网状病变 ,听骨破坏相对轻 ,少有盾板骨质破坏。②IL 1在中耳乳突炎中表达率为 10 0 % ,与正常皮肤组织、肉芽肿组织相比 ,胆脂瘤组织中IL 1过度表达 ,差异有显著性意义 (P <0 .0 1)。胆脂瘤组织中IL 1与胆脂瘤的骨质破坏程度高度相关 (r =0 .917,P <0 .0 1)。结论 :根据中耳腔软组织影的形态及骨质破坏而非病变的密度改变 ,大多数中耳乳突炎患者可籍HRCT扫描准确诊断 ;组织中IL 1与胆脂瘤型中耳乳突炎CT上骨质破坏程度高度相关 ,IL 1在胆脂瘤中的过度表达是中耳乳突炎导致骨破坏最重要因素之一。     

MSCT及MRI在耳部疾病诊断中的临床应用价值

目的:研究多层螺旋CT(MSCT)及磁共振成像(MRI)在耳部疾病诊断中的临床应用价值。方法:对23例(46耳)疑是耳部疾病患者行MSCT及MRI检查,利用图像重建技术对耳系统及其周围的血管、神经进行显示。结果:MSCT技术清楚显示骨迷路及听骨链的细微结构;MRI技术清楚显示膜迷路及内耳周围的血管与神经,并清楚显示各结构之间的关系。在本组病例中,检出听骨链关节融合2例,听骨链炎性溶解、破坏2例,内耳附近血管形态、走行异常1例,耳蜗及半规管发育异常2例;炎症7例;其余未见异常。结论:MSCT与MRI技术能清楚显示耳部超微结构及其周围的血管与神经,MSCT与MRI检查技术对耳部疾病的诊断具有重要临床应用价值。     

自身免疫性胰腺炎多种影像学比较分析

目的 探讨多种影像学检查对自身免疫性胰腺炎(AIP)的诊断价值.方法 回顾性分析我院2008年4月至2011年12月17例AIP患者的临床及影像学资料,男性13例,女性4例,年龄48～68岁,17例均行CT平扫及增强扫描;12例行磁共振成像(MRI)及磁共振胰胆管造影(MRCP)检查,9例行经内镜逆行胰胆管造影(ERCP)检查且7例同时行胆总管支架置入术.结果 CT、MRI既可以显示胰腺形态改变;也可以发现胰腺周围结构改变,而MRCP和ERCP可显示胰胆管结构改变.结论 自身免疫性胰腺炎影像学表现具有一定的特征性,结合多种影像学检查早期诊断和治疗对预后有重要意义.     

胸部脂肪瘤的影像学诊断(附14例报告)

目的探讨胸部脂肪瘤的影像学表现及检查方法优选. 资料与方法搜集胸部脂肪瘤14例资料,包括肺脂肪瘤2例,胸壁脂肪瘤4例,纵隔脂肪瘤3例,胸腺脂肪瘤3例,横膈脂肪瘤1例,右心房脂肪瘤1例,全部病例均有胸部正侧位片,12例进行了CT检查,1例进行了MRI检查,对全部患者的影像学表现进行分析. 结果胸部正侧位片病灶发现率78.6%,漏诊原因与肿瘤密度过低,肿瘤沿胸壁深部肌间隙浸润生长或肿瘤位于平片上较隐蔽的部位有关.CT检查不仅可进行精确的定位诊断和分类诊断,而且能作出定性诊断,但应常规摄脂肪窗片.MRI对这类肿瘤最敏感,它对病变的发现、定位、分类诊断及定性诊断有决定性意义. 结论胸部正侧位片是胸部脂肪瘤的首选检查方法,但病变的分类诊断与定性诊断需依赖胸部CT与MRI,其中MRI是该类疾病的最佳检查方法.     

原发性腹膜后肿瘤及肿瘤样病变的影像诊断

目的：探讨各种影像学检查对原发性腹膜后肿瘤及肿瘤样病变的诊断价值。方法：对13例经手术病理证实的腹膜后肿瘤的X线、CT、MRI及超声表现特点进行分析。结果：超声、CT及MRI的定位诊断准确率分别为75％、90％和100％。良性与恶性肿瘤的大小无显著差异。Cr与MRI能较直观显示肿瘤的大小、形态、成分及与周围组织的情况。结论：超声、Cr、MRI均具较高的定位诊断价值。CT及MRI可较好地显示肿瘤的境界及质地，对腹膜后肿瘤及肿瘤样病变的定性诊断有重要的价值。     

颅底沟通性肿瘤的临床特点及其CT、MRI诊断价值比较

目的 :探讨颅底沟通性肿瘤的临床特点及其CT、MRI诊断价值。方法 :回顾性分析我院经CT、MRI和组织病理学确诊的颅底沟通性肿瘤64例,比较不同病变部位患者的一般临床资料、CT和MRI特点,以及CT和MRI对颅底沟通性肿瘤、侵犯周围骨质、侵犯周围软组织诊断符合率的差异。结果:颅底沟通性肿瘤沟通部位位于前颅窝32例(50.00%),中颅窝26例(40.62%),后颅窝6例(9.38%);等密度45例(70.31%),稍高密度13例(20.31%),高密度6例(9.38%);信号均匀13例(20.31%),不均匀41例(64.06%),混杂10例(15.62%);中等强化49例(76.56%),高度强化15例(23.44%);钙化或骨化35例(54.69%)。CT对颅底沟通性肿瘤的诊断准确率与MRI差异无统计学意义(P0.05)。CT对颅底沟通性肿瘤侵犯周围骨质及周围软组织的诊断符合率与MRI比较差异均有统计学意义(均P0.05)。结论:CT、MRI能准确显示颅底沟通性肿瘤的病变特征,两者在诊断准确率和符合率方面各有优势。     

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.