螺旋CT在叶内型肺隔离症诊断中的价值

目的 探讨螺旋CT在叶内型肺隔离症诊断中对异常供血动脉显示的作用和方法。方法 将14例肺隔离症患者的螺旋CT扫描方案分为2组，第1组8例，单层螺旋扫描；层厚3mm，床进4.5mm/s，重建间隔1.5mm者5例，多层螺旋扫描；实际层厚2.5mm，有效层厚3.2mm者3例。对比剂流率2.5ml/s；启动智能扫描探测到腹主动脉上段强化最佳时开始扫描，扫描资料交工作站行三维图像后处理。第2组6例为单层螺旋扫描，其中5例扫描层厚5mm，床进5mm/s；1例扫描层厚10mm，床进10mm/s。结果 病灶位于右下肺2例，左下肺12例，表现肿块者11例，边缘清楚的结节者3例。14例均见异常供血动脉，发自腹主动脉11例，胸主动脉2例，脾动脉1例；其中多层螺旋CT三维图像后处理显示异常供血动脉最佳。上述异常供血动脉均经外科手术证实。引流静脉均未显示。结论 在肺隔离症定性诊断中，多层螺旋CT横断面结合三维图像后处理利于显示异常供血动脉，有可能替代传统的血管造影。     

叶内型肺隔离症的双层螺旋CT诊断

目的 :总结叶内型肺隔离症的多层螺旋CT表现 ,探讨多层螺旋CT在肺隔离症诊断中的价值及扫描方法。方法 :6例肺隔离症患者行多层螺旋CT双期扫描。对比剂注射流率 2 .5ml/s ,扫描延时 2 5s ,层厚 3mm ,螺距 1.0。原始图像经 1.5mm薄层重建后再交工作站行三维图像后处理。结果 :本组中全部病灶均位于左肺下叶后基底段 ,表现为局部不规则肿块 ,其中 3例边缘光整 ,1例边缘不清 ,2例病灶周围血管纹理增粗。 6例均见异常供血动脉 ,发自降主动脉 4例 ,胸主动脉 2例。 6例中仅 4例显示引流静脉。其中多层螺旋CT三维图像后处理能清楚显示异常供血动脉和引流静脉 ,与术中所见完全一致。结论 :多层螺旋CT是肺隔离症定性诊断最为理想的非创伤性检查方法 ,其各种图像后处理技术能较好地显示肺隔离症的异常供血动脉和引流静脉 ,有利于确诊此病和制订手术治疗方案     

多层螺旋CT在肺隔离症诊断中的应用

目的 探讨多层螺旋CT在肺隔离症诊断中的应用.方法 收集经手术及病理证实的32例肺隔离症患者的资料进行回顾性分析,所有检查采用GE Brightspeed 16层螺旋CT扫描机,先行CT平扫,再行双期增强扫描,将图像传输至工作站,进行MPR、MIP、SSD及VR重建.结果 32例肺隔离症均位于下叶后基底段,其中27例位于左下肺,5例位于右下肺.异常供血动脉16例来自胸主动脉,7例来自腹主动脉,3例系膈肌动脉供血,4例为肋间动脉供血,2例为脾动脉供血.CT平扫主要表现为肺内囊肿、结节或肿块,增强扫描病变区血管影增多增粗,呈条状或结节状血管强化影.结论 多层螺旋CT增强及三维重建是诊断肺隔离症最理想的无创性检查方法.     

肺隔离症的多层螺旋CT诊断

目的：探讨肺隔离症的多层螺旋CT（MSCT）征象,以提高对该疾病的认识及临床诊断。方法回顾性分析经手术及病理证实的肺隔离症患者13例,包括临床表现,多层螺旋CT扫描资料,并复习文献;所有患者均行胸部平扫及双期增强容积扫描。结果13例肺隔离症患者中,12例为叶内型,1例为叶外型。12例叶内型均位于肺下叶内后基底段,9例位于左下肺,3例位于右下肺;1例叶外型位于左膈与下叶之间。13例中1例为增多增粗的异常血管结构,4例为实质性肿块,5例为囊实性肿块,3例为囊性肿块。6例病灶周围可见局限性肺气肿,4例病灶周围见渗出性阴影。13例隔离肺的供血动脉均发自体动脉。结论肺隔离症CT征象典型,容积扫描能对其作出准确诊断,并能为外科手术治疗提供重要参考,多层螺旋CT可以作为诊断肺隔离症的首选方法。     

多层螺旋CT在儿童肺隔离症诊断中的应用

目的 探讨多层螺旋CT在肺隔离症诊断中的应用价值.方法 回顾性分析18例经手术病理证实为肺隔离症患儿的多层螺旋CT表现.所有患儿均行CT平扫及增强检查,并行图像后处理.评价各重组方法对肺隔离症及其相关畸形的诊断价值.结果 增强扫描横断面发现异常供血动脉12例,不能确定6例.经多种重组方法处理图像可直观显示全部异常供血动脉,并发现回流静脉13例;肺发育异常及其他系统畸形14例.容积再现(VR)对肺隔离症的异常供血血管及气道显示最佳.结论 多层螺旋CT增强扫描结合图像后处理可清晰显示肺隔离症及异常动静脉及伴发畸形,为儿童肺隔离症的首选检查方法.     

多层螺旋CT三维血管成像对肺隔离症诊断的价值

目的:探讨多层螺旋CT三维血管成像在肺隔离症诊断中的应用价值.方法:收集经手术及病理证实的9例肺隔离症患者的资料进行回顾性分析.所有检查采用GE lightspeed 16层CT扫描机,先行CT平扫,再行双期增强扫描,将图像传输至工作站,进行MPR、MIP、SSD及VR重建.结果:9例肺隔离症均位于下叶后基底段,其中8例位于左下肺,1例位于右下肺.异常供血动脉7例来自于胸降主动脉,2例来自于腹主动脉上段.CT平扫主要表现为肺内囊肿、结节或肿块,局部可伴肺气肿征.增强扫描病变区血管影增多、增粗,呈条状或结节状血管强化影.CT血管成像显示病变由异常体动脉供血.采用MPR和MIP可显示供血动脉整体形态及肺实质的病灶.SSD及VR能显示供血动脉的起源与行程及引流静脉.结论:多层螺旋CT增强及三维重建是诊断肺隔离症最理想非创性检查方法.     

多层螺旋CT在诊断肺隔离症中的应用

目的 评价多层螺旋CT血管成像对肺隔离症的诊断能力。方法 15例经病理（14例）和血管造影（1例）证实的叶内型肺隔离症患者均经多层螺旋CT平扫与增强扫描，并采用容积再现技术，最大密度投影及多平面重建显示异常血管与病灶的关系。结果 15例肺隔离症患者中，14例的病灶位于左下叶，1例的病灶位于右下叶，异常体动脉供血全部来自胸主动脉，其平均直径1．6cm。CT平扫表现为肿块形7例，圆形或卵圆形5例，不规则形3例。增强后15例均显示异常体动脉供血。结论 多层螺旋CT血管成像技术能准确诊断肺隔离症，并可取代其他有创性检查，如数字减影血管造影等。     

多层螺旋CT血管造影诊断肺隔离症的价值

目的评价螺旋CT血管造影诊断肺隔离症的价值。方法对6例经手术和病理证实、影像资料完整的肺隔离症病例进行回顾性分析。全部病例使用多层螺旋CT胸部平扫、增强扫描及病灶多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)。结果6例中,病变位于左下肺后基底段4例,右下肺后基底段2例。呈囊性病灶1例,实性病灶3例,囊实性病灶1例,多结节融合肿块影1例。增强CT扫描及多种重建后处理图像可显示病灶强化特点、异常供血动脉、引流静脉及其与病变结构的关系。结论螺旋CT三维重建血管成像能很好地显示肺隔离症的病变特征。     

HRCT在支气管扩张诊断中的价值分析

目的评价高分辨率CT（HRCT）诊断支气管扩张症的价值。方法对经胸科手术或呼吸科随访观察确诊支气管扩张症的38例患者的8mm层厚的螺旋CT扫描及1．5mm～2mm层厚的螺旋CT薄层扫描图像进行对比分析。结果38例患者中螺旋CT常规扫描（8mm层厚）诊断支气管扩张症20例43个肺段，2mm层厚薄层扫描诊断支气管扩张症38例78个肺段。结论螺旋CT薄层扫描对支气管扩张的检测具有更高的敏感性、特异性及准确性，可作为诊断支气管扩张症的首选检查方法。     

MSCT血管成像对肺隔离症的诊断价值

目的探讨多层螺旋CT三维血管成像在肺隔离症诊断中的应用价值。方法收集经手术及病理证实的9例肺隔离症患者的资料进行回顾性分析。所有检查采用GE公司的64排螺旋CT扫描机,先行CT平扫,再行双期增强扫描,将图像传输至工作站,进行MPR、MIP、SSD及VR重建。结果 9例肺隔离症均位于下叶后基底段,其中7例位于左下肺,2例位于右下肺。异常供血动脉8例来自于胸主动脉,1例来自于腹腔干。CT平扫主要表现为肺内囊肿、结节或肿块,局部可伴肺气肿征。增强扫描病变区血管影增多、增粗,呈条状或结节状血管强化影。CT血管成像显示病变由异常体动脉供血。采用MPR和MIP可显示供血动脉整体形态及肺实质的病灶。SSD及VR能显示供血动脉的起源与行程及引流静脉。结论多层螺旋CT增强及三维重建可以清晰显示肺部病变及异常供血和引流血管情况,是诊断肺隔离症最理想非创性检查方法。     

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.