16层螺旋CT尿路三维重建在泌尿系梗阻性疾病诊断中的价值

目的:探讨16层螺旋CT低剂量尿路三维成像在泌尿系梗阻性病变诊断中的价值.方法:参照IVU检查方法,对 91例B超、KUB及IVU未明确病因的泌尿系梗阻性病变病例,行16层螺旋CT扫描,利用后处理技术对扫描资料进行三维重建处理.结果:16层螺旋CT尿路造影清晰显示泌尿系的解剖结构,以及病变和尿路之间的空间关系.91例患者中,泌尿系结石51例,肾盂输尿管重复畸形10例,肾位置异常6例,巨输尿管1例,腔静脉后输尿管3例、输尿管良性狭窄11例,前列腺囊肿伴右肾缺如1例,输尿管结核4例,腹膜后肿瘤压迫输尿管4例,结石和肿瘤病例均经手术或病理证实.CT诊断与临床诊断符合率100%.结论:16层螺旋CT尿路三维成像对显示泌尿系梗阻性病变快捷、安全可靠,可作为诊断泌尿系梗阻性疾病的首选影像学方法之一.     

256层CTU尿路造影对输尿管梗阻性病变的诊断价值

目的 探讨多层螺旋CT尿路造影(CTU)在诊断输尿管梗阻性病变中的临床价值.方法 收集本院2011年5月～2012年6月的输尿管梗阻性病变30例,均行腹盆腔多层螺旋CT容积扫描,1 mm薄层重建图像传输至Vitrea2工作站,对所获得图像进行容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)等方式后处理.结果 本组术前CTU诊断正确28例,另2例术前怀疑输尿管肿瘤,后经手术病理证实为输尿管结核,CTU的诊断准确率为93%(28/30).CTU成功率100%,图像清晰,诊断准确率高.结论 CTU通过VR、MIP、MPR、CPR后处理,能清晰显示输尿管扩张的整体形态,明确梗阻部位、病变性质、病灶与周围组织的解剖关系,对输尿管梗阻病变的诊断有很高的临床应用价值.     

16层螺旋CT诊断输尿管病变的价值

目的:探讨16层螺旋CT及后处理多种成像技术诊断输尿管病变的价值.材料和方法:对30例输尿管病变患者行螺旋CT泌尿系检查,图像传至ADW4.2工作站,获得容积再现(VR)、多平面重建(MPR)及曲面重建(CPR)等三维重建后处理图像.结果:30例患者中,输尿管结石16例、肿瘤6例、肾及输尿管重复畸形2例、先天性狭窄4例、迷走血管压迫1例和炎症1例.VR、MPR及CPR图像能清晰显示输尿管走行、腔内改变、梗阻部位及原因,还可以同时显示双侧肾及输尿管情况.结论:16层螺旋CT对输尿管病变具有较高的诊断价值.     

非增强螺旋CT三维重建在输尿管病变中的应用

目的：探讨16层螺旋CT三维重建技术在输尿管梗阻诊断中的应用价值。材料和方法：35例输尿管梗阻患者行腹盆部16层螺旋CT非增强扫描，在ADW4．2工作站上完成图像后处理，应用曲面重建、多平面重建、容积重建及仿真内镜成像技术显示输尿管。结果：输尿管成像均清楚地显示输尿管。根据梗阻处CT值、病变累及范围和尿液的良好对比，发现23例结石位于输尿管腔内并显示结石大小、形状、位置和输尿管梗阻扩张程度；12例非结石，输尿管成像清楚地显示输尿管狭窄程度及其周围组织结构。结论：非增强螺旋CT输尿管重建可获得良好的输尿管成像，对临床手术路径的选择和手术预后具有非常重要的作用。     

128层螺旋CT血管追踪技术在输尿管非结石病变中的应用

＿目的：探讨128层螺旋CT血管追踪技术在输尿管非结石病变诊断中的应用价值。方法：65例输尿管非结石病变患者行尿路CT造影（CTU）。对增强延时扫描后输尿管管腔内呈连续性强化者采用血管追踪技术（VTT）后处理。结果：65例患者输尿管不全梗阻,输尿管全程显影,重建图像质量优异,所见病变经手术或临床追踪证实完全相符。其中32例为输尿管癌,12例膀胱癌侵犯输尿管末端,盲肠癌及直肠癌术后复发侵犯输尿管各4例,8例输尿管炎性粘连,5例肾输尿管畸形,病变显示率100％。结论：多层螺旋CT的CTU检查,当输尿管内对比剂达到一定程度,采用VTT来展示输尿管病变可获得优异的输尿管整体成像,对输尿管梗阻性病变诊断及鉴别诊断具有重要临床价值。     

螺旋CT诊断原发性输尿管癌的价值

目的:探讨原发性输尿管癌螺旋CT扫描及三维重建的影像特点和诊断价值.材料和方法:回顾性分析14例经手术病理证实原发性输尿管癌的螺旋CT影像表现,分析其特点.14例患者中13例行增强扫描,1例为逆行性尿路造影后CT平扫,14例均行MPR/CPR重建,4例同时行MIP重建及VE检查.结果:CT增强轴位扫描及MPR/CPR重建能够清晰地显示肿瘤的大小、形态、范围及其与周围组织的关系;MIP重建能很好地显示肿瘤引起的输尿管管腔不规则狭窄或截断改变;VE检查则能够从管腔内观察肿瘤的形态.结论:螺旋CT容积扫描及三维重建能够多平面、多方位、立体地显示病变,使病变定位、定性诊断更加准确,为临床手术治疗提供帮助.     

输尿管病变的螺旋CT评价

目的探讨螺旋CT各种成像方法在评价输尿管病变中的临床应用价值。方法应用螺旋CT对110例经临床和病理证实的输尿管病变做平扫及四期增强扫描，并作多平面重建(MPR)和三维重建，观察螺旋CT各种成像方法显示和诊断病变的能力，并与其他检查技术及手术病理结果进行比较。结果107例患者螺旋CT轴面结合曲面MPR能很好地显示输尿管病变的部位、大小、形态和分布范围及尿路梗阻的情况，曲面MPR更为直观；81例手术患者，输尿管病变在螺旋CT图像上的表现与手术所见有很好的一致性。三维重建可获得类似于X线尿路造影的图像，能立体显示病变的状况。螺旋CT扫描能很好地弥补其他影像学检查的不足。结论螺旋CT扫描范围大，分辨率高，对输尿管病变的显示和诊断有优越性，尤以曲面MPR价值最大，具有很高的临床应用价值。     

多排螺旋CT纵剖面重建对输尿管梗阻性疾病的诊断价值

目的探讨多排螺旋CT纵剖面重建对输尿管梗阻性疾病的诊断价值。方法应用Lightspeed16螺旋CT机,对34例输尿管梗阻性病变的病人进行轴位面扫描,并对所得数据进行纵剖面重建。所有病例除2例腹膜后淋巴管转移致输尿管受压外,均经手术病理证实。结果34例患者中,输尿管结石22例,输尿管炎症2例,输尿管癌3例,肾盂输尿管连接处狭窄3例,输尿管囊肿1例,下腔静脉后输尿管1例,腹膜后淋巴结转移压迫输尿管者2例。CT纵剖面重建可显示输尿管腔内结石22处,输尿管管壁增厚者5例。增强扫描的5例病人中,CT值增加约20～35HU,延迟扫描18例表现为轻度积水,6例表现为中度积水,2例表现为重度积水,1例无积水。结论纵剖面重建图像对输尿管梗阻性病变的诊断具有较高的临床应用价值。     

非增强螺旋 CT 输尿管重建诊断输尿管结石

目的：评价非增强螺旋CT输尿管重建对输尿管结石诊断的价值。方法：39例患者,行腹盆部非增强螺旋CT扫描。输尿管成像方法为选取冠状面进行曲面重建。结果：39例输尿管成像均清楚地显示输尿管全程,其中33例示结石位于输尿管腔内同时显示结石大小、形状、位置和输尿管梗阻扩张程度及范围。非结石6例,输尿管成像清楚地显示输尿管及其周围组织结构,有助于鉴别诊断。结论：非增强螺旋CT输尿管重建可获得良好的输尿管成像,在输尿管结石诊断和鉴别诊断方面具有重要的临床价值。     

多层螺旋CT在输尿管病变诊断中的价值

目的:探讨多层螺旋CT输尿管成像(MSCTU)对输尿管病变的诊断价值。方法:对32例输尿管病变的患者行CT平扫和增强扫描,应用最大密度投影、多平面重组、曲面重建及容积重建等方法,获得完整的肾-输尿管-膀胱图像。结果:32例患者均获得明确诊断。17例输尿管内高密度结石并显示输尿管壁增厚、狭窄。12例输尿管肿瘤,显示管壁局限增厚,管腔鼠尾状狭窄,有异常强化。2例输尿管结核,见输尿管壁广泛不均匀增厚,1例肾盂输尿管结合部狭窄,并清晰显示狭窄部位、程度、肾盂积水情况。结论:多层螺旋CT能明确诊断输尿管疾病的部位、病因及肾盂积水程度。     

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.