磁共振3D-FIESTA在面肌痉挛诊断中的应用

目的 探讨MR三维稳态进动快速成像（3D-FIESTA）序列在面肌痉挛（HFS）中的诊断价值.方法 23例临床怀疑HFS的患者行3D-FIESTA序列成像并多平面重建,以临床表现为诊断标准,同时检查每一例的每一侧面神经与邻近血管关系.结果 面神经血管接触分别为真阳性20侧,假阴性3侧,假阳性11侧;真阴性12侧,3D-FIESTA诊断有无HFS的差异有统计学意义（P＜0.05）.结论 MR 3D-FIESTA序列可以清晰显示面神经与邻近血管的关系,为临床治疗提供更准确、更全面的影像学诊断依据.     

3D-TOF-SPGR磁共振血管成像在三叉神经痛神经血管压迫诊断中的价值

目的 探讨3D-TOF-SPGR磁共振血管成像(MRA)在三叉神经痛(TN)神经血管压迫临床诊断中的应用价值.方法 三叉神经痛患侧组23例(23侧神经)、正常对照组31例(39侧神经),利用SE-T1WI、FSE-T2WI、MR三维时间飞跃稳态梯度回波序列(3D-TOF-SPGR)MRA图像及MPR斜矢状位、冠状位重组图像,盲法观察3个方位图像,以判定三叉神经与局部微小血管的关系.结果 三叉神经痛患侧组23侧神经,19侧表现为神经血管压迫阳性,占82.6%;正常对照组39侧神经,11侧表现为阳性,占28.2%,TN患者组与正常对照组χ2=17.15,P＜0.005,具有统计学差异.在MRA图像中,TN患者组阳性者微小血管与三叉神经的关系密切,有13侧表现为受压三叉神经不同程度弯曲、变形;正常对照组阳性者微小血管与三叉神经仅表现为横过、平行或密贴,相应三叉神经形态及信号均无明显异常表现.结论 3D-TOF-SPGR序列MRA对神经血管压迫三叉神经痛具有很高的临床诊断价值,并可为微血管减压术提供术前指导.     

三维快速平衡稳态进动MRI对三叉神经痛的诊断研究

目的探讨磁共振三维快速平衡稳态进动（3D-FIESTA）序列对三叉神经痛（trigeminal neuralgia,TN）患者神经血管关系的诊断价值及可靠性。方法对25例正常对照及25例TN患者三叉神经行3D-FIESTA序列成像并多平面重建,记录该序列对神经血管关系的诊断结果,其中15例与手术结果对照。结果正常对照组双侧及TN组患侧神经血管接触或压迫的阳性率分别为24%与87.5%,二者有非常显著性差异（P〈0.001）。3D-FIESTA对15例TN患者诊断的敏感度、准确率分别为93%与67%。结论 3D-FIESTA序列是诊断神经血管关系较为敏感可靠的序列,可作为TN患者的首选序列。     

MRI对明确三叉神经痛患者神经血管关系的诊断意义

 目的 探讨磁共振对三叉神经痛(Trigeminal neuralgia,TN)患者神经血管关系的诊断价值及可靠性.方法 对25例正常对照及25例TN患者三叉神经行三维快速平衡稳态进动(3D-FIESTA)和三维时间飞跃-扰相梯度回波(3D TOF-SPGR)序列成像并多平面重建,分别记录各序列对神经血管关系的诊断结果,其中15例与手术结果对照.结果 正常对照组双侧及TN组患侧神经血管接触或压迫的阳性率分别为24%与87.5%,二者差异有统计学意义(P<0. 001).3D-FIESTA对15例TN患者诊断的敏感度、一致率分别为93%与67%,而3D TOF-SPGR分别为67%和60%.结论 MRI是显示TN神经血管关系的可靠方法;3D-FIESTA序列对神经血管关系诊断的敏感度及一致率高于3D TOF-SPGR,可作为TN患者的首选序列.     

磁共振3D FIESTA-C联合3D-TOF序列对原发性三叉神经痛的诊断价值

目的探讨磁共振3D FIESTA-C联合3D-TOF序列对原发性三叉神经痛的诊断价值。方法分析磁共振3D FIESTA-C及3D-TOF序列扫描的45例三叉神经痛患者,观察正常侧及三叉神经痛侧的神经与周围血管的关系。结果 45侧三叉神经痛侧中,神经与周围血管表现为压迫及接触关系共36侧;正常侧表现为压迫及接触关系12侧。两组间差异有统计学意义(P0.05)。结论 3D FIESTA-C联合3D-TOF序列可清晰显示三叉神经与周围血管的关系,对原发性三叉神经痛具有很高的诊断价值,以指导临床治疗。     

3D-TOF MRA联合3D-FIESTA序列对原发性面肌痉挛微血管减压术术前评估的价值

目的 ：探讨3D-TOF MRA联合三维双激发平衡式稳态自由进动(3D-FIESTA)序列对原发性面肌痉挛(HFS)微血管减压术(MVD)术前评估的价值。方法：回顾性分析49例行面神经MVD的面肌痉挛患者的临床资料,术前3D-TOF MRA联合3D-FIESTA序列图像重建分析面神经与邻近血管关系,比较患侧与健侧的差异,并与MVD结果对比。结果：49例中,41例(83.67%)患侧术前3D-TOF MRA及3D-FIESTA序列重建图像显示神经血管关系密切,明显高于健侧[2例(4.08%)],差异有统计学意义(χ²=59.84,P=0.000)。MVD术中发现43例神经血管关系密切,其中小脑前下动脉20例(46.51%),小脑后下动脉13例(30.23%),椎基底动脉8例(18.60%),小动脉及静脉2例(4.65%)。以面神经MVD术中所见为金标准,3D-TOF MRA序列联合3D-FIESTA序列诊断HFS的敏感度为90.70%,特异度为66.67%,阳性预测值为95.12%,阴性预测值为50.00%。结论：3D-TOF MRA联合3D-FIESTA序列图像重...     

原发性三叉神经痛MR影像学的对照研究

目的对照原发性三叉神经痛(TN)患者及健康者两组MRI影像学资料中三叉神经与责任血管接触的夹角,分析TN患者神经血管接触时夹角的影像学特点。方法 58例单侧TN并行MVD手术证实NVC程度为中重度患者纳入研究组,46例健康者影像学显示NVC程度均中重度作为对照组,两组均完成MR3D-FIESTA与3D-TOF两序列扫描,层厚1mm;在两序列及相关后处理图像上分析三叉神经与责任血管的夹角。结果原发性三叉神经痛患者三叉神经与责任血管的夹角为45°~90°时出现率明显高于健康侧(P0.01)。结论 NVC中重度压迫且神经与责任血管的夹角为45°~90°更易导致三叉神经痛的发生。     

磁共振断层血管成像对原发性三叉神经痛的诊断价值

目的：探讨磁共振断层血管成像(MRTA)对原发性三叉神经痛(ITN)患者神经血管关系的诊断价值及可靠性。方法回顾性分析280例 ITN 患者的临床及 MR 资料,并与手术结果进行盲法对照。结果280例 ITN 患侧神经血管接触、可疑接触或压迫共267例(阳性率95.3%),健侧有66例(假阳性率23.6%);120例手术者,术中发现神经血管接触或压迫118例。患侧与健侧神经血管接触或压迫比较差异有统计学意义(P <0.05)。以手术结果为金标准,MRTA 诊断神经血管接触或压迫的特异度、灵敏度、诊断符合率分别为100%,96.6%,96.7%。结论MRTA 能可靠地显示 ITN 神经血管的关系,其诊断灵敏度和准确率高,对ITN 病因诊断和手术治疗提供客观的依据。     

3T MR三维稳态进动快速成像序列显示脑池段颅神经及其与周围病变的关系

目的探讨3T MR三维稳态进动快速成像(3D-FIESTA)序列显示中、后颅窝颅神经及其与周围病变关系的价值。方法对34例颅内脑外病变的患者行反转恢复SE T1WI、FSE T2WI及3D-FIESTA序列扫描。脑池段颅神经与周围病变的关系情况与手术结果相对照。结果 34例患者中共48处病变,3D-FIESTA序列显示9条神经被周围病变包绕,51条颅神经被压迫,与病变相邻的颅神经有10条,病变累及其邻近25条神经;其中23例患者行手术治疗,手术与MR图像对照,3D-FIESTA显示颅神经与周围病变关系的准确性分别为5/6、26/28、3/3、12/13。结论 3T MR 3D-FI-ESTA序列可以正确显示脑池段颅神经及其与周围病变的关系,对治疗前评估及病变的治疗有重要的应用价值。     

磁共振仿真内镜在三叉神经痛微血管减压术中的应用价值

目的探讨基于3D-FIESTA的磁共振仿真内镜技术在三叉神经痛微血管减压术中的应用价值。方法回顾性分析2011年7月~2018年12月间98例单侧原发性三叉神经痛患者的临床及影像学资料,所有患者均经神经外科微血管减压术治疗确诊。将术前常规的3D-FIESTA和3D-TOF诊断结果作为常规组,将MRVE、3D-FIESTA、3D-TOF三者联合诊断结果作为联合组。结果联合组MRVE、3D-FIESTA、3D-TOF三者联合诊断血管接触的灵敏度、特异度和准确率分别为97.9%、100%及98.0%,灵敏度和准确率要优于常规组的3D-FIESTA和3D-TOF序列诊断,差异有统计学意义。98例患者术后随访6个月~2年,治愈率86.7%,显效率8.2%,有效率3.1%,无效率2.0%。结论磁共振仿真内镜技术可以清楚显示三叉神经和责任血管之间的三维空间关系,联合3D-FIESTA和3D-TOF序列后可以显著提高责任血管判断的灵敏度和准确率,对小动脉和静脉的检出更具优势,是原发性三叉神经痛术前评估的重要方法。     

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.