散射线对CR骶尾椎侧位影像质量影响的研究

目前,CR、DR等摄影技术广泛应用于临床.在骶尾椎侧位的摄影中,由于尾骨的特殊结构,在数字化摄影中,其图像效果无法满足临床诊断要求,已成为CR使用中的一个难题[1].     

骶尾椎侧位在CR摄影中的改进投照法

我院于2003年10月引进美国柯达CR-900成像设备，我们住应用后发现，进行骶尾椎侧位投照时，若按传统投照法，计算机上所显示的图像质量差，或是“斑点”大、或是灰雾度大，不清晰，无法打印X线胶片。我们经过实践操作、总结，探索出了CR摄影中的骶尾椎侧位改进投照法。现介绍如下。     

X线断层融合摄影对骶尾椎骨折的诊断价值

目的:比较X线断层融合摄影与常规DR对骶尾椎骨折的显示率。方法:选择临床怀疑骶尾椎骨折的36例患者,分别行X线断层融合矢状位摄影与常规DR侧位摄影,评价这2种成像技术所获得的骶尾椎骨图像质量及骨折诊断情况。结果:36例骶尾骨常规DR侧位摄影优质图像率为25.0%,阳性诊断率为23.7%;X线断层融合矢状位摄影优质图像率为83.3%,阳性诊断率为63.3%;2种成像技术的检查结果差异有统计学意义(P0.001)。结论:对骶尾骨骨质结构的显示和骨折的检出,X线断层融合矢状位摄影较常规DR侧位摄影具有更好的能力,可作为骶尾骨骨折的首选检查方法。     

CR技术在尾骨侧位摄影中的应用

随着社会生活水平的提高和生活方式的改变,肥胖人群所占人口比例呈不断上升趋势。据我院门诊资料显示,肥胖女性较易发生尾骨骨折。由于尾骨体积较小,周围软组织较厚,进行尾骨侧位摄影时所成影像显示效果一般不尽如人意。随着CR技术的应用,目前情况大有改善。CR技术在成像后可以对图像进行各种调节,使感兴趣的部位得到最优的显示。1研究对象收集我院门诊和住院患者尾骨侧位摄影的片例,普通摄影76例,CR摄影103例。2方法由于尾骨本身及所在部位的特殊性,所以在尾骨侧位摄影时摄影条件以低kV、大mAs为宜。若kV太高,射线的穿透力较强,使尾骨…     

直接数字X线摄影诊断骶尾骨外伤的价值

目的:探讨直接数字X线摄影(d1rect digital radiograph,DR),诊断骶尾骨外伤的价值.材料和方法:88例臀部外伤患者摄DR并行"交响乐"(Multi-Scale Image Contrast Amplification,MUSICA)后处理,其中40例同时摄X线片.根据图像显示骶尾骨结构及其周围软组织和骨折、脱位的情况,探讨二者的质量.结果:88例中,DR图像清晰显示骶尾骨结构及其周围软组织和骨折、脱位分别为64例、47例和29例.40例DR与X线片对比,DR清晰显示骶尾骨结构27例,周围软组织22例,骨折、脱位10例,而X线片仅清晰显示骶尾骨结构8例和骨折、脱位7例,软组织显示不满意,漏诊3例.结论:DR诊断骶尾骨外伤比X线片更为有效.     

自制铝铁泸片在脊柱X线摄影中的应用

目的评价自制铝铁泸片在胸腰椎连接部侧位和骶尾椎侧位X线摄影中的应用价值。方法为使相邻的胸腰椎及骶尾椎在不同对比度情况下，椎体及其附件显示灰雾度近似相同，而骨结构有同样清晰的影像。使用自制铝片和薄铁片分层叠加起来，先做成一个方形的铝片架，将叠加起来的铝片或薄铁片固定在铝架的一侧，然后将铝架扦在球管前方的缩光圈前方，投照时再插入。结果收集了363例患者的363张胸腰椎连接部和骶尾椎的侧位照片。经评估，有338张（占93．1％）符合甲级片要求，20张（占5．1％）乙级片，5张（占1．38％）丙级片，98％以上的照片基本达到诊断要求。结论胸腰椎连接部存在着两种不同的对比度，骶尾椎也是厚薄不一，使用自制铝片和薄铁片吸收了胸椎及尾椎部分X线，使二者照片密度更相互接近，骨质结构显示更清晰，有效地防止漏诊和误诊，不同程度提高了诊断准确性。     

尾骨反弓畸形1例

忠者女性,24岁.尾骨角处间歇性疼痛6年,因卧硬板床加剧3d来我院就诊.体格检查:尾骨角下缘见一骨性隆起,局部压痛明显,皮肤轻度红肿.无特殊病史,其他检查未见阳性体征.X线检查:骶尾骨正侧位片显示第5骶椎与各尾椎骨性融合,未见关节间隙显示,尾骨生理弧度消失,轻度反弓(图l、2).影像诊断:骶尾骨融合畸形、反弓.     

全脊柱DR与CR成像质量的对比分析

目的 探讨直接数字X线摄影(DR)在立位脊柱全长摄片中的应用.方法 177例患者按就诊时间先后分2组分别使用CR和DR技术拍摄全脊柱正侧位片,由放射科经验丰富的医师技师各2名对所有全脊柱影像进行评析.结果 (1)DR摄影成像的密度对比优于CR.(2)DR图像的拼接成功率低于CR.结论 使用DR进行全脊柱摄片,图像质量优于CR摄片.     

直接数字X线摄影诊断骶尾骨外伤的价值

目的：探讨直接数字化摄影（Digital Radiography，DR），诊断骶尾骨骨折的价值。材料与方法：160例臀部外伤患者，80例摄DR并进行“交响乐”（Multi-scale Image Amplification。MUSICA）后处理，另外80例常规X线摄片，根据图像显示骶尾骨骨折结构及周围软组织和骨折脱位的情况．探讨二者的质量。结果：160例中，80例DR与X线平片对比，DR清晰显示骶尾骨结构64例，周围软组织45例，骨折、脱位29铡，而X线片仅清晰显示骶尾骨结构16例和骨折、脱位14例、软组织显示不满意，漏诊3例。结论：DR诊断骶尾骨外伤比常规X线更为有效。     

数字摄影DR在尾骨站立侧位摄影中的应用体会

自我院引进GE公司的revolution XR／d数字放射摄影成像系统（DR）设备后为临床提供丁较好的对比度，适当清晰度图像，图像质量大幅度提高。由于DR处理器有很大的图像处理功能，调整胶片分辨率，对比度，使我们的摄影条件幅度大大放宽，DR对细微病变。骨骼的骨小梁的排列，软组织层次，关节的边缘及间隙，细小的线性骨折都能完分显示，在工作中常常遇到尾骨外伤的病人不方便仰卧配合拍照，我们经过实践操作、总结，用DR来拍摄尾骨站立侧位方法及应用体会，现介绍如下.     

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.