超声弹性成像、萤火虫成像及CDFI在乳腺癌诊断中的应用

目的 :探讨超声弹性成像、萤火虫成像技术及CDFI对乳腺癌的诊断价值。方法 :回顾性分析拟诊为乳腺癌并行乳腺肿块切除的180例(194个肿块)女性患者,术前均行二维灰阶超声、萤火虫成像、CDFI及超声弹性成像,以组织学病理结果为金标准,探讨上述方法对乳腺癌的诊断价值。结果:194个肿块中,良性19个,恶性175个。弹性成像与萤火虫成像、CDFI联合应用诊断乳腺癌的特异度为90.2%,与组织学病理检查结果高度相关。结论:超声弹性成像与萤火虫成像、CDFI联合应用对乳腺良恶性肿块具有较好的诊断价值。     

乳腺癌47例超声探讨

本文对经手术及病理证实的乳腺癌47例进行声像图分析,旨在探讨其超声图像在其诊断中的价值。1材料与方法47例乳腺癌患者,全部来自近2年我院外科住院的女性患者,年龄22~81岁,平均49岁。应用Agilent Sonos 5500型彩色超声诊断仪。探头频率7·5MHz,选用乳腺常规检测程序。患者取仰卧位,二维切面观察肿块位置、大小、形态、边界、内部回声及有无钙化灶,后方衰减及纵横径比值等,然后观察彩色多普勒血流(CDFI)显示情况。2结果47例乳腺癌术前超声与术后病理对照,符合诊断者42例(符合率89·4%),其中浸润性导管癌28例,导管内癌4例,单纯癌5例,髓样…     

超声诊断乳腺肿块89例分析

本文回顾分析了我院2000年3月~2003年2月间,经手术及病理证实的89例乳腺肿块的超声诊断资料,目的在于探讨超声检查对乳腺良、恶性肿块的诊断价值和临床意义。1材料与方法本组病例均为女性患者,年龄18~75岁,平均42岁。因自查或查体发现乳腺肿块来我院就诊。使用美国GELOGIQ400MD     

年轻女性乳腺癌的影像表现和组织病理学特征分析

目的 :总结35岁以下年轻女性乳腺癌患者的影像表现及组织病理学特征。方法 :回顾性分析经手术病理证实的261例年轻组(≤35岁)女性乳腺癌患者的乳腺X线摄影、超声检查及组织病理学资料,分析总结乳腺X线摄影及超声检查中病变的形状、边缘、密度、钙化形态、钙化分布、后方回声特点、血流信号等;对病变的组织学级别及淋巴结转移数量等进行分析,并选择同期经手术病理证实的部分中年组(36~60岁)及老年组(≥61岁)乳腺癌患者进行比较。结果:乳腺X线摄影:年轻组椭圆形、等密度肿块的比例大于老年组(均P0.05),肿块边界清楚的比例大于中年组和老年组(均P0.05),不定形钙化的比例大于中年组和老年组(均P0.05)。超声检查:年轻组椭圆形肿块的比例大于老年组(P=0.011),病变边界清楚、纵横比1的比例大于中年组和老年组(P0.05)。年轻组乳腺癌患者淋巴结转移数量较中年组和老年组更多,组织学级别较中年组和老年组更高(P0.05)。结论:年轻女性乳腺癌患者的X线摄影及超声检查表现为良性病变特征的比例大于中年组和老年组。年轻女性乳腺癌患者的淋巴结转移数量更多,组织学级别更高。     

高频超声对乳腺小肿块鉴别诊断的价值

目的:评价高频超声二维征象及彩色多普勒血流指标在乳腺小肿块鉴别诊断中的价值。方法:使用高频超声诊断仪观察196个长径小于2 cm的乳腺肿块的二维超声特征(包括病灶形态,病灶内部,病灶后方有无衰减及有无微小钙化灶),然后使用彩色多普勒对病变进行多普勒血流参数测定(包括血流丰富度、PSV、RI、PI)。比较二维超声征象及彩色多普勒血流参数在乳腺良、恶性肿块中的差异并对其诊断敏感性、特异性加以分析。结果:病灶形态、病灶内部、病灶后方及有无微小钙化灶良、恶性病变间均有显著性差异。恶性肿块PSV、RI、PI值均明显高于良性肿块。结论:彩色多普勒超声血流参数测定对乳腺良、恶肿块的鉴别诊断具有重要的参考价值,与肿块的二维声像图征象相结合可提高乳腺肿块的超声诊断准确率。     

常规超声在乳腺病灶良恶性鉴别中的临床应用价值

目的 探讨常规超声在乳腺病灶良恶性鉴别中的临床应用价值.方法 对94例乳腺肿块患者进行超声检查,将所得的二维及彩色多普勒声像图特征与手术病理检查结果进行对比分析.结果 对超声检查方法与病理诊断符合情况分析发现,超声检查发现良性肿块61例,诊断符合率为88.41％（61/69）;超声检查发现恶性肿块23例,诊断符合率为92.00％（23/25）;对良性组和恶性组的诊断符合率进行统计学分析发现两组的诊断符合率无统计学差异（x2=0.39,P＞0.05）.良性组和恶性组在二维超声声像图方面有明显不同,其中良性组的二维超声声像图多以界限清楚,有包膜,形态规则,内部回声较均匀,后方无衰减,而恶性组的二维超声声像图则多以边界欠清楚或不清楚,无包膜,形态不规则,内部回声不均匀,后方存在衰减.结论 彩色多普勒超声对乳腺良、恶性病变的形态学检查有重要鉴别诊断价值,二维灰阶声像图的特征是乳腺肿块的首要诊断依据.     

超声检查与MR在乳腺癌诊断中的临床应用分析

目的：探讨两种影像学诊断方法在乳腺癌诊断中的应用效果。方法收集56例乳腺肿块患者分别采用超声与磁共振成像（magnatic resonance imaging ,M RI）进行手术前诊断,并将两种影像学方法的诊断结果进行对比分析。结果超声检查：乳腺良性肿瘤和乳腺恶性肿瘤在二维超声声像图方面有明显不同,其中乳腺良性肿瘤的二维超声声像图多以界限清楚,有包膜,形态规则,内部回声较均匀,后方无衰减,而恶性组的二维超声声像图则多以边界欠清楚或不清楚,无包膜,形态不规则,内部回声不均匀,后方存在衰减。以术后病理检查结果为金标准对超声检查结果进行分析显示其敏感性52．50％、特异性79．27％、准确性70．49％。M RI检查：乳腺癌多与正常组织分界不清,乳腺内有异常信号的肿块,形状不规则,可表现为分叶状或“毛刺征”。M RI平扫时,乳腺癌 T1 WI常呈较低的信号,T2 WI一般呈高信号或稍高信号。增强扫描时病变出现明显的均匀或不均匀的强化。以术后病理检查结果为金标准对M RI检查结果进行分析显示其敏感性78．26％、特异性97．37％、准确性90．16％。采用x2检验对比两种影像学诊断方法的敏感性、特异性、准确性进行比较发现M RI检查的敏感性、特异性、准确性均明显高于超声检查。结论超声及M RI是目前乳腺检查的主要手段,两者相对而言,M RI诊断乳腺癌有较高的敏感性、特异性、准确性;但超声操作方便、可重复检查。     

多普勒超声在乳腺小肿块诊断及鉴别中的应用

目的:评价多普勒超声在乳腺小肿块诊断与鉴别诊断中的应用价值。方法:应用彩色多普勒、能量多普勒及脉冲多普勒超声对123例直径小于2cm的乳腺肿块进行检查。结果:72例良性肿块有57例检出血流信号,51例乳腺癌有45例检出血流信号,二者无显著差异。以0~Ⅰ级为少血流信号,Ⅱ~Ⅲ级为多血流信号,对乳腺癌与良性肿块的血流信号多少进行对比分析,二者有显著差异(P<0.01),良性肿块以0~Ⅰ级为主,乳腺癌以Ⅱ~Ⅲ级为主。良性肿块Vmax为9.14±3.25cm/s(-x±SD),乳腺癌Vmax为14.33±3.31cm/s(-x±SD)(P<0.01),良性肿块阻力指数为0.60±0.21(-x±SD),乳腺癌阻力指数为0.71±0.24(-x±SD)(P<0.05),两组数值均有显著性差异。结论:乳腺良性小肿块与乳腺癌在血流丰富程度及血流动力学指标方面有明显差异,多普勒超声在乳腺小肿块诊断及鉴别中有重要作用。     

重症乳腺增生症的彩色多普勒超声声像图分型与病理组织类型的关系

目的 探讨重症乳腺增生症的彩色多普勒超声声像图分型与病理组织类型的关系.方法 采用彩色多普勒超声对乳腺癌和乳腺增生症的诊断及鉴别诊断,并将超声声像图与病理结果进行对照分析.结果 乳腺癌组与乳腺增生组在二维声像图的形态、边界、内部回声、钙化灶、后方回声、组织侵润、纵横比等7项指标中的表现有明显差异,且差异具有统计学意义（F/x2=38.78、10.35、88.17、15.64、14.38、103.35、67.81,P＜0.05）.乳腺癌组的Vmax和RI均明显高于乳腺增生组,且差异具有统计学意义（t/x2 =9.33、3.35,P＜0.05）.另外,乳腺增生组血流信号明显低于乳腺癌症组,多为0或Ⅰ级,而乳腺癌组则以Ⅱ～Ⅲ级为主,且差异具有统计学意义（x2=69.42,P＜0.05）.75例乳腺癌患者经彩色多普勒超声诊断与病理结果符合率为100％.结论 重症乳腺增生症的彩色多普勒超声声像图与病理学组织类型对照具有特征性表现.     

彩色多普勒与二维超声结合在诊断早期乳腺癌中的价值

目的　探讨彩色多普勒血流显像（CDFI）与二维超声结合诊断早期乳腺癌的价值。方法　对45例乳腺肿块（≤2cm）进行CDFI与二维超声检查。结果　乳腺癌21例,其中20例CDFI显示有丰富血流,阻力指数0.70±0.06,明显高于乳腺良性肿块。24例良性肿块中,仅有7例检出血流信号,RI为0.60±0.06(Ρ＜0.01)。结论　CDFI与二维超声结合可明显提高早期乳腺癌诊断的敏感性、特异性和诊断准确率。     

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.