胸部疾病CT诊断的评价

本文通过２６１例Ｘ线与ＣＴ诊断比较，评价胸部ＣＴ在胸部疾病诊断中的价值。结果是（１）弥漫病变ＣＴ诊断正确率为８７．５％，Ｘ线为５８．９％；（２）纵隔肿块ＣＴ诊断正确率为６０．１％，Ｘ线为４８．０％；（３）胸膜肿块ＣＴ诊断正确率为７５．０％，Ｘ线为６６．６％；（４）肺段肺叶阴影ＣＴ诊断正确率为７１．０％，Ｘ线为６８．４％；（５）球块阴影ＣＴ诊断正确率为７３．０％，Ｘ线为７１．０％；（６）斑片阴影ＣＴ诊断正确率为６６．０％，Ｘ线为７２．０％。分析材料表明在Ｘ线检查基础上根据胸部疾病基本影像，在普遍胸部ＣＴ检查上附加高分辨、薄层及增强扫描可提高一些ＣＴ征象发现率，同时可以使胸部疾病ＣＴ诊断水平超过本文报道的水平。     

肾周围脂肪瘤一例

患者 ,男 ,65岁 ,因阵发性心慌、气促 4个月 ,加重 2个月伴咳嗽、咳少量白色粘液痰而入院。体检 :左下肺叩诊较浊 ,未闻及干、湿罗音。心电图检查大致正常。影像学检查　后前位Ｘ线胸片显示 :左下肺野见淡薄致密影 ,其上缘较清 ,且有钙化 ,下缘不清 ,侧位片显示该致密影靠后 ,左侧胸膜肥厚粘连 ,透视下多方位转动体位 ,可见该致密影似有一轮廓 ,所以考虑左下肺占位性病变 ,建议ＣＴ进一步检查。ＣＴ检查 :显示左下肺见一个椭圆形脂肪影 ,大小约 7.6ｃｍ×6.1ｃｍ ,与胸膜不可分 ,边缘钙化 ,ＣＴ值为 -12 4～ -12 2ＨＵ (图1、2 ) ,诊断为胸…     

类风湿性关节炎胸部病变的临床及X线表现

本文就２１４例类风湿性关节炎所摄取的胸部片，总结了胸部病变的临床及Ｘ线表现。其主要Ｘ线表现为：慢性肺纤维化、肺间质性肺炎、肺弥散的颗粒状或小结节病灶、心肌病变，胸膜病变、盘状肺不张。     

肺部病变的X线定位诊断

胸部Ｘ线平片包括胸壁、胸膜、胸腔、肺、纵隔、心血管及横膈等解剖结构。由于解剖结构相互叠加,不同的病变又可有相类似之影像,因此,单纯依靠胸部平片鉴别疾病位于肺、胸腔、纵隔、横膈有一定困难。虽然,ＣＴ检查对胸部病变的鉴别有一定帮助,但目前它尚不能取代普通Ｘ线检查。为了提高对胸部平片的诊断技能,本文就肺部病变的Ｘ线定位诊断知识作一重点介绍。判断病变是否在肺内肺部病变定位应根据胸部不同部位的Ｘ线特点,采用排除法来确定病变是位于肺内或是肺外肺内病变有一重要特点是按肺叶、肺段分布,且肺动脉又与支气管分支相伴行,有时…     

肺淋巴瘤的CT与X线表现

回顾性分析肺淋巴瘤的ＣＴ与Ｘ线表现，以提高对肺淋巴瘤影像学的表现的认识。材料与方法；２１例肺淋巴瘤均经肺或浅表淋巴结穿刺活检或手术证实。常规及薄层ＣＴ扫描法摄胸部Ｘ线正侧位片作对照检查。结果；肺淋巴瘤的影像异常可以分为；肿块有结节型，实变型，肺炎肺泡型，支气管血管淋巴管型，血行播散型，心包及胸膜病变型。     

脊柱转移瘤的CT诊断：附41例分析

笔者报告４１例脊柱转移瘤的ＣＴ表现。原发灶以肺癌、乳腺癌和肝癌较多见。ＣＴ表现主要呈溶骨性（６８．３％），亦可呈成骨性（１４．６％）或混合性（１７．１％）。本组４１例中２０例作平片Ｘ线检查。ＣＴ扫描在发现和估价病变方面较平片Ｘ线检查为敏感，如ｘ线平片发现骨破坏仅为５５％，ＣＴ扫描为１００％；Ｘ线平片显示椎管受累为１４％，ＣＴ扫描为６５％。对脊柱转移瘤的ＣＴ表现、ＣＴ诊断和鉴别诊断价值等进行了讨论。     

支气管多发性异物并自然咯出一例

患者　男 ,2 4岁。在砂石场被砂石掩埋半小时 ,被人救出 ,呼吸微弱 ,意识丧失 ,经送医院抢救 ,意识渐恢复 ,相继咯出砂石异物数枚。Ｘ线检查 :胸部正位片见左主支气管、左肺门区及左叶支气管走行区见多发串珠状、大小不等、形态不一的致密影 ,以左支气管及下叶支气管区为密集 ,右肺野右肺门上部及下野内带区也见少量散在致密影 ,左肺下野透亮度增高 ,纵隔、气管无明显移位 ,无明显阻塞性肺不张及炎性改变(图 1)。左侧位胸片见肺门区及下支气管走行区见多发条袋状致密影堆积 ,心后区肺野透亮度相对增高 ,余无异常 (图 2 )。Ｘ线诊断 :左主支…     

肺内原发性横纹肌肉瘤一例

肺内原发性横纹肌肉瘤一例夏康适，张骏患者男，６３岁。主诉血痰３个月，低热月余。２个月前他院胸部Ｘ线片示右上肺尖４ｃｍ×４．５ｃｍ圆形致密肿块影，外缘光整，肺门纵隔淋巴结不肿大。支气管镜检阴性。遂入本院诊治。图１～３胸片及ＣＴ片示右上肺尖圆形、边缘光整...     

纵隔胰腺异位一例

患者　女 ,2 4岁。胸闷、气短、胸痛 6个月余 ,疼痛向右侧胸部及右前臂部放射。无腹泻等消化道症状。实验室检查无异常。胸部正位Ｘ线片 :右侧中下肺野中内带见一类圆形肿块 ,外缘清楚 ,内缘以宽基底与纵隔不能分开。Ｘ线诊断 :右侧中下纵隔占位 (图 1)。ＣＴ平扫 (纵隔窗 )所见 :右前中下纵隔见一囊实性肿块 ,其大小约为 9 9ｃｍ× 7 7ｃｍ ,密度不均匀 ,ＣＴ值 0 0 5～6 0 5ＨＵ ,推移压迫纵隔 ,与心脏、大血管界面不清楚 ,并伴右侧胸腔后部少量胸腔积液。ＣＴ诊断 :右前中下纵隔肿瘤 ,畸胎瘤可能性大 ,与胸膜、心血管有粘连 ,右侧少量…     

胸部创伤的CT诊断探讨

胸部创伤包括胸壁损伤、胸膜损伤、肺损伤、纵膈损伤，病情多较严重而复杂，CT检查能同时观察胸壁、胸膜、肺及纵膈病变，较普通X线胸片检查具有其优越性。1、一般资料所选28例病例均有创伤性湿肺，男18例、女10例，年龄在13—68岁之间。左肺7例，右肺6例，双肺13例，合并肺撕裂伤8例，肺不张2例，肋骨骨折24例，气胸2例，液胸4例，液气胸11例，纵膈气肿3例，皮下气肿15例，胸椎骨折1例，左主支气管断裂1例，均为车祸碰撞挤压或坠落伤所致。主要临床症状为胸背痛。呼吸困难或急促，咯血或咳血痰。     

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.