双源CT诊断成人先天性冠状动脉畸形的价值

目的:评估双源CT诊断成人先天性冠状动脉畸形先天冠状动脉(CCA)畸形的价值.材料和方法:回顾性分析1889名行双源CT冠状动脉成像(DSCTCA)的资料,探讨冠状动脉的起源、走行和终止情况,统计成人先天冠状动脉(CCA)畸形的发生率及CT表现.结果:1889例中,检出各类CCA共291例,检出率为15.4%,其中起源异常24例,检出率1.3%;冠状动脉走行异常261例,均为心肌桥(MB),检出率为13.8%;冠状动脉终止异常6例,均为冠状动脉瘘,检出率0.3%.结论:DSCT能够准确地显示冠脉起源、走行和终止异常,在成人冠状动脉畸形的诊断和预后中有重要的应用价值.     

成人冠状动脉起源变异的64排螺旋CT分析

目的 以64排螺旋CT冠状动脉血管造影(CTA)的方法分析成人冠状动脉起源变异的发生率及主要形式.方法 以5 011例有诊断价值的冠状动脉CTA图像作为研究对象,观察冠状动脉起源变异的发生及表现形式.结果 5 011例病例中,共发现冠状动脉起源变异 32例(0.64%).其中右冠状动脉起源于左冠状动脉窦最多见(21/32).其次为回旋支起源于右冠状动脉窦(7/32),左主干起源于右冠状动脉窦(4/32).结论 冠状动脉起源变异罕见.冠状动脉起源变异的主要形式为右冠状动脉起源于左冠状动脉窦.64排冠状动脉CTA可以准确发现冠状动脉起源异常,是相对无创、精确的检查方法.     

MSCT对冠状动脉变异的诊断价值

目的 :分析多层螺旋CT(MSCT)对冠状动脉变异的诊断价值。方法 :回顾性分析总结 9例患者的MSCT冠状动脉成像资料。结果 :9例冠状动脉变异患者中冠状动脉开口起源异常 4例 ,单一冠状动脉 1例 ,右冠状动脉发育不良1例 ,左回旋支缺如 1例 ,冠状动脉分支起源异常 2例。结论 :MSCT可无创性准确诊断各种冠状动脉变异。     

64层螺旋CT诊断先天性冠状动脉变异

目的:探讨多层螺旋CT(MSCT)在成年人先天性冠状动脉变异诊断中的临床应用价值。方法:回顾性分析726例成年人患者的冠状动脉MSCT造影资料,判断各种先天性冠状动脉变异。结果:726例MSCT冠状动脉造影中检出冠状动脉变异39例,包括冠状动脉开口起源异常11例,单支冠状动脉1例,冠状动脉瘤2例,冠状动脉分支起源异常11例,冠状动脉发育不良13例,冠脉开口处急性扭转走行异常1例。结论:MSCT是一种无创、准确、可重复性强的诊断先天性冠状动脉变异的重要手段。     

双源CT冠状动脉成像在心律失常患者中的初步应用

目的 探讨双源CT冠状动脉成像在心律失常患者中诊断冠状动脉明显狭窄的可行性及准确性.方法 连续选取60例临床高度怀疑或已确诊冠心病的患者,且行双源CT扫描过程中,出现心率变异过大(心率>14次/min)或心律失常,其中30例入院患者在2~3周内行选择性冠状动脉造影检查.以选择性冠状动脉造影为标准,从冠状动脉节段及冠状动脉分支2个角度分别评价双源CT在诊断冠状动脉明显狭窄中的敏感性、特异性、准确性、阳性预测值及阴性预测值.结果 60例出现心电信号异常患者中,心率55~269次/min,平均心率(92.8±31.9)次/min.编辑前图像质量总评分为2.26±1.03,编辑后图像质量总评分为3.50±0.61.其中30例行选择性冠状动脉造影的患者中,以冠状动脉节段为基础双源CT诊断冠状动脉明显狭窄的敏感性、特异性、阳性预测率、阴性预测率、准确性为64.0%、97.14%、76.19%、94.97%、93.0%.以冠状动脉分支为基础双源CT诊断冠状动脉明显狭窄的敏感性、特异性、阳性预测率、阴性预测率、准确性为73.81%、89.61%、79.48%、86.25%、84.03%.经χ2 检验,χ2 值分别为1.75、0.21,P值均＞0.05,双源CT与选择性冠状动脉造影比较,不管从冠状动脉节段角度还是从冠状动脉分支角度分析,两者在诊断冠状动脉明显狭窄时没有统计学意义.结论 双源CT冠状动脉成像在心律失常患者的应用是可行的,经心电编辑后图像质量明显改善,对于冠状动脉明显狭窄的诊断有较高的准确性.     

冠状动脉变异的64层螺旋CT诊断价值

目的 探讨64层螺旋CT(64-MSCT)对冠状动脉变异(CAA)的诊断价值及预后评估.方法 收集我院行64-MSCT心脏检查诊断为冠状动脉变异患者44例,对原始图像进行最大密度投影(MIP)、曲面重建(CPR)、多平面重建(MPR)、立体重建(VR)和血管探针等后处理重建,分析各型冠状动脉变异的形态学特征.结果 冠状动脉起源异常共7例:1例左冠状动脉源于右冠状窦,2例有冠状动脉源于左冠状窦,1例右冠状动脉起源于后冠状窦,2例冠状动脉高位开口于主动脉壁,1例右冠状动脉起源于肺动脉.32例心肌桥-壁冠状动脉(其中1例同时有冠状动脉高位开口);5例冠状动脉发育不良.1例左回旋支未发育.结论 64-MSCT能准确显示冠状动脉变异的解剖细节,对其形态学评价具有突出优势,有重要诊断价值.     

64层CT冠状动脉成像检测冠状动脉畸形价值初探

目的:探讨64层CT冠状动脉成像检测冠状动脉畸形的方法和诊断价值.方法:采用容积再现(VR)、最大密度投影(MIP)以及多平面重组(MPR)等方法分析2672例64层CT冠状动脉成像资料,总结冠状动脉畸形的发生率和CT表现.结果:2672例中发现冠状动脉起源异常18例(0.67%),其中发生于右冠11例(61.11%),左冠7例(38.89%);发现冠状动脉瘘7例(0.26%).结论:64层CT冠状动脉成像能够准确全面地显示冠状动脉的异常起源、走行和终止.     

128层CT冠状动脉成像对冠状动脉变异的诊断价值

目的:探讨128层CT对冠状动脉变异的诊断价值。方法:回顾性分析我院行冠状动脉CTA检查后发现的69例冠状动脉变异患者的图像,对所有图像分别行VR、MPR、MIP和CPR等,观察冠状动脉开口、起源、走行、分布及与周围血管的关系。结果:所有受检者中共发现存在冠状动脉变异69例(82处),右冠状动脉高位开口2例,其中起源变异共32例,走行异常42例,终止异常2例,发育不良或未发育6例。结论:128层CT冠状动脉成像可清晰显示冠状动脉起源、行程及终止的异常,从而为临床提供高质量的影像诊断。     

双源CT血管成像评估冠状动脉异常起源的价值

目的：探讨双源CT血管成像对冠状动脉异常起源的诊断价值。方法：对8375例成人冠状动脉双源CT血管成像中109例显示为冠状动脉异常起源的图像进行回顾性分析。结果：本组中冠状动脉起源异常检出率为1.3%（109/8375）,包括左侧冠状动脉起源异常37例（窦上开口4例,窦后开口4例,回旋支异位开口于右侧冠状窦8例,回旋支独立开口于左冠状窦15例,左冠开口于右冠状窦或右冠状动脉4例,左冠开口于肺动脉1例,回旋支缺如1例）,右侧冠状动脉起源异常61例（高位开口29例,异位开口于左冠状窦24例,圆锥支独立开口8例）,左、右冠状动脉均起源异常11例;109例起源异常中发现伴随冠状动脉肺动脉瘘2例,心肌桥4例。结论：双源CT可以准确诊断冠状动脉起源异常,并可发现其它伴随病变,是一种无创有效的检查方法。     

64层螺旋CT诊断先天性冠状动脉起源异常的价值

目的：探讨64层螺旋CT冠状动脉造影诊断冠状动脉起源异常的临床价值。材料和方法：回顾性总结2005年12月至2006年12月间1800例64层螺旋CT冠脉造影的结果，统计冠状动脉起源异常的发生率。结果：1800例检查者中发现冠脉起源异常51例，发病率2．8％。包括右冠状动脉变异11例（21．6％）、左冠状动脉变异8例（15．7％）、左右冠均发生变异1例（2％）、单支冠状动脉1例（2％）、分支变异28例（54．9％）。结论：64层螺旋CT是诊断冠状动脉起源异常的安全有效方法，对临床治疗有重要的意义。     

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.