上腹部CT扫描调节骨窗肺窗的意义

目的 :探讨上腹部CT扫描调节骨窗肺窗的意义。材料和方法 :在影像工作站 ,有无癌症病史者各 10 0例的CT图像进行骨窗肺窗的调节。结果 :调窗后 ,癌症病史组 ,病变特性或特征增加及实质性影响最后诊断的变化有显著性差异 ;无癌症病史组 ,病变特性或特征增加及实质性影响最后诊断的变化无显著性差异。癌症病史组的差异大 ,无癌症病史组的差异小。结论 :CT多窗宽窗位调节可增加病变特性的显示和诊断的准确性 ;上腹部CT扫描 ,癌症病史阳性者或临床有高度可疑指数者进行多窗宽窗位调节可提高诊断效益 ,无癌症病史者或临床无可疑指数者不需要进行多窗宽窗位调节。     

CT窗口技术在诊断恶性骨肿瘤的应用

目的 研究不同窗宽窗位在恶性骨肿瘤诊断中的价值。材料与方法 分别在骨窗、软组织窗及中间窗下,对28例经手术病理证实的恶性骨肿瘤患者的CT表现进行回顾性统计学分析,比较不同窗口条件下CT对恶性骨肿瘤的诊断率。结果 骨窗能明确反映骨肿瘤骨密度异常的区域,而软组织窗及中间窗对显示肿瘤周围软组织和骨皮质受侵犯以及水肿等更敏感。结果 窗口技术对骨肿瘤的定性和分期具有重要的诊断价值。     

无膈下游离体中空脏器穿孔的CT诊断

目的：探讨CT对腹腔内中空脏器穿孔的诊断价值。材料和方法：CT检查24例无膈下游离气体的腹部中空脏器穿孔患者（23例手术,1例随访证实）。采用腹窗（窗宽300Hu,窗位20Hu）及纵隔窗位（窗宽600Hu,窗位－300Hu）成像技术。结果：CT确诊穿孔21例（87．5％）。游离气体分布依次为前腹壁下、小网膜囊、后腹膜及肠系膜间等部位。21例中CT作出穿孔脏器（定位）诊断者13例（61．9％）。病因（定性）诊断者12例（57．14％）。结论：常规腹部CT扫描结合纵隔窗位成像,对中空脏器穿孔后少量游离气体的确认及穿孔部位和病因的判断有价值。     

腹部闭合性损伤的CT诊断(附50例分析)

目的:探讨腹部闭合性损伤的CT表现及其诊断价值。方法:收集我院50例腹部闭合性损伤患者的临床资料及CT资料进行回顾性分析,重点分析损伤脏器的CT表现及其诊断价值,同时对CT检查技术进行总结。结果:CT扫描发现腹部实质性脏器损伤41例,其中肝、脾、肾及胰损伤分别为10,23,7,1例。空腔脏器损伤3例,其中十二指肠损伤2例、膀胱破裂1例。多脏器损伤4例,腹后壁损伤2例。扫描结果可清楚地显示脏器损伤及其并发出血的程度和范围,对于后腹膜腔、腹壁及骨骼等的损伤,CT检查具有独到之处。结论:CT能迅速、准确、有效且无创伤地检出腹部脏器的损伤及其程度,为临床治疗方案的选择提供重要依据。     

CT窗宽技术对原发性大网膜梗死的诊断价值

目的探讨CT窗宽技术对腹部原发性大网膜梗死的诊断价值。方法选取并分析22例临床确诊为腹部原发性大网膜梗死患者的腹部CT资料,固定窗位为50 HU,分别使用窗宽135 HU、250 HU(腹部)、350 HU(纵隔)、500 HU分析比较病变检出率。结果窗宽为135 HU、250 HU(腹部)、350 HU(纵隔)、500 HU对腹部网膜病变的检出率分别为13.64%(3例)、63.64%(14例)、100%(22例)、100%(22例),但是500 HU对腹部肠管及实质脏器显示较350 HU差。结论综合图像质量认为350 HU(纵隔)窗宽是诊断原发性大网膜梗死的理想窗宽。     

CT窗技术在急性胰腺炎诊断中的作用

目的探讨CT窗技术在急性胰腺炎诊断中的作用。资料与方法搜集经临床、实验室检查及手术证实的50例急性胰腺炎患者的影像资料,由两名高年资影像诊断医师采取盲法进行软读片,同时采用常规腹部窗宽、窗位和适当调节窗宽、窗位技术观察胰腺周围改变,以胰周脂肪间隙混浊、胰周胰外积液、胰包膜掀起、肾前筋膜增厚等为阳性指征,将调节组中阳性率高于常规组的诊断结果分别与常规组进行配对χ2检验。结果经比较,窗宽100～200HU、窗位-60～-40HU组阳性率最高,且与常规组诊断结果比较阳性率差异有统计学意义(χ2=8.1,P<0.05)。结论在常规腹部窗宽、窗位的基础上适当缩窄窗宽、降低窗位进行观察,有利于发现急性胰腺炎胰腺周围的阳性征象,提高CT在临床诊断急性胰腺炎中的辅助作用。     

CT诊断肺栓塞中的显示窗设置

目的 评价CT窗技术对肺栓塞(pulmonary embolism,PE)的诊断价值.资料与方法 搜集26例临床确诊为PE的多层螺旋CT肺动脉造影资料,应用下列7种显示窗,统计26例患者检出的PE阳性血管数:(1)常规窗(窗宽350 HU,窗位40 HU);(2)调节窗(窗宽1000 HU,窗位400 HU);(3)调节窗+常规窗及文献中4种专为诊断PE而设的显示窗.不同显示窗诊断结果差异性比较采用成对样本t检验,以P＜0.05为统计学意义.结果 使用常规窗+调节窗诊断PE检出阳性支数最多(347支),与其他6种窗设置比较差异均有统计学意义(P＜0.01),单独使用常规纵隔窗或调节窗将会发生7%～9%的漏诊率.结论 在PE的CT诊断中,联合应用窗宽较宽、窗位较高的窗设置技术可提高对PE的诊断水平.     

64层螺旋 CT 三维重建在腹部寄生胎中的诊断应用

目的：探讨64层螺旋C T三维重建（3D ）在腹部寄生胎中的诊断价值。方法回顾性分析经手术病理证实的15例腹部寄生胎患者的临床及C T影像资料,15例均行64层螺旋C T平扫及三维重建。结果15例中,女性9例,男性6例,年龄1个月10天～60岁。肿块位于腹膜后8例,腹腔内7例。C T 横断面表现为混杂密度肿块,境界清楚,内见轴骨系统、脂肪密度、软组织密度等结构,邻近组织脏器受压、移位,肠管积气。冠状面及矢状面最大密度投影（M IP ）清晰显示肿块内脊椎骨、四肢骨及肋骨等骨性结构,容积再现（V R ）完整显示寄生胎内骨性结构全貌。结论64层螺旋C T 平扫及三维重建技术是一种快速、准确、可靠的检查方法,能为临床医师提供直观、真实可靠的影像学诊断依据,可作为腹部寄生胎患者的首选影像学检查手段。     

3.0T MR THRIVE技术在腹部疾病中应用价值

目的探讨3.0TMR THRIVE(T1high resolution isotropic volume examination)技术在腹部疾病中应用价值。方法采用THRIVE序列对67例腹部疾病进行扫描,分析其应用价值。结果THRIVE技术发现肝、胆、胰、脾病变45例,肾及肾上腺病变10例,腹主动脉瘤2例,原发性腹膜后肿瘤5例,盆腔内卵巢及阴囊肿瘤各1例,胃癌和结肠癌各1例,腹腔脓肿1例。阳性率约为97.1%。有2例在THRIVE技术中病灶没能显示,阴性率约为2.9%。结论MRI THRIVE技术在腹部疾病检查中能够满足临床的诊断需要。     

CT检查中窗技术的合理应用对提高肝内病灶检出率的意义

目的评价在传统软组织窗基础上加用肝组织窗对提高肝内病灶检出率的意义。方法接受腹部CT增强扫描的859例患者的895张顺序编号的CT片是由两位有经验的放射学医师评价的。所有的肝脏成像均采用两种窗技术进行，即起初软组织窗和随后肝组织窗。逐例记录了两种技术检出的病灶数与符合率。确定了利用肝组织窗有新增病灶的患者比例。对两种窗技术在检出病灶数方面的差异进行了统计学分析。结果在859例中，205例（24％）患者在软组织窗和肝组织窗上有肝脏病灶，其中，40例（14．6％）患者随着肝组织窗的加用，检出的病灶数亦增多。这40例中的14例患者具有在软组织窗上看不见的新增病灶。两种窗技术的病灶检出率有统计学差异（P〈0．05）。结论 单一的软组织窗不足以全部发现肝内病灶，因此，有些病灶容易漏诊，而肝组织窗的加用，可有效提高肝脏病灶的检出率与诊断准确性。     

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.