高原脑水肿的MRI诊断

目的:分析高原脑水肿(high altitude cerebra edema,HACE)的MRI表现,以提高对本病诊断的准确性。方法:对13例高原脑水肿患者行头颅MRI横断位SE序列(T1WI、T2WI)、水抑制(FLAIR)及矢状位SE序列(T1WI)扫描,对其MRI表现进行回顾性分析。结果:高原脑水肿MRI表现:T1WI为低信号,T2WI为高信号,信号较均匀,边缘不清,FLAIR为较均匀高信号。13例双侧大脑半球白质对称性水肿,5例大脑灰质水肿,12例胼胝体水肿,3例丘脑水肿,3例脑干水肿,9例小脑水肿,11例侧脑室变窄,12例脑沟变窄,5例脑裂变窄。结论:高原脑水肿于MRI呈弥漫性改变,大脑、胼胝体、丘脑、脑干、小脑均可受累,以胼胝体为中心,为多种类型并存的脑水肿,有一定的特征性。MRI能正确诊断高原脑水肿提供依据。     

子宫内膜癌的MRI诊断及分期研究

目的探讨子宫内膜癌的MRI表现,评价MRI对子宫内膜癌术前分期的价值. 资料与方法 24例经手术病理证实的子宫内膜癌患者术前均行MRI检查,横断位、矢状位、冠状位 SE T1WI, 横断位、矢状位、冠状位TSE T2WI,Gd-DTPA增强后T1WI横断位、矢状位、冠状位扫描.在MRI上观察肿瘤位置、信号特征及侵犯肌层的深度.MRI所见与手术病理对比. 结果子宫内膜癌的表现:子宫增大,子宫内膜弥漫性不规则增厚,T1WI呈低信号,T2WI为相对高信号,有强化,侵犯肌层时,则T2WI上子宫肌层信号增高,结合带中断,显示不清.MRI对子宫内膜癌分期总的准确度为83.3%. 结论 MRI能多方位清晰地显示子宫内膜癌瘤灶及侵犯范围和深度,明显优于其他影像检查方法;MRI对术前子宫内膜癌分期也明显优于其他影像检查方法,故MRI应成为子宫内膜癌术前常规的影像检查方法.     

肌间血管瘤磁共振成像26例分析

目的探讨肌间血管瘤磁共振成像(MRI)特点。方法采用0.2T永磁型磁共振扫描仪,应用表面线圈,采用SE序列,分别行矢状位、冠状位、横断位T1WI和T2WI扫描。结果T1WI上2例病灶表现为与肌肉组织呈等信号,24例病灶为高信号;26例病灶在T2WI上均显示为不均匀高信号,且在T1WI及T2WI上均可见点状、蚓状及线状低信号影。结论MRI的应用为肌间血管瘤的诊断提供了一项可靠的检查方法。     

神经纤维瘤病I型的MRI研究

目的：回顾神经纤维瘤病I型（NF1）患者MRI表现，分析MR扫描序列及其诊断价值，以建立合适的MR成像方案，为NF1影像诊断提供有价值的依据。方法：对30例临床确诊为NF1患者采用本组MR成像方案进行扫描，主要包括：轴面SE序列T2WI；平扫矢状面SE脉冲序列T1WI；增强轴面或矢状面SE脉冲序列T1WI；轴面或冠状面液体衰减反转恢复（FLAIR）序列，同时分析病变的发病部位、数目、形态、信号的变化和病变的强化情况等。结果：MRI可见下列3种表现：（1）多发性脑内错构瘤：30例中25例在SE脉冲序列T2WI和FlAIR脉冲序列见高信号病灶，病灶主要位于苍白球、小脑和脑干。另外，25例中20例可见海马回、海马旁回等区晕状高信号改变。（2）视通道或下丘脑胶质瘤：视神经、视交叉增粗、扭曲；视交叉或下丘脑肿块，SE脉冲序列T2WI和FlAIR序列表现为不规则分叶状混杂信号肿块，在增强SE脉冲序列T1WI有明显不规则强化。（3）脊柱多发性神经纤维瘤：SE脉冲序列T2WI和脂肪抑制短时反转恢复（STIR）序列显示高信号沿脊神经分布的多发性肿瘤。结论：MRI能够作为1种 常规的影像检查方法对NF1患者进行诊断和追踪。本组MR成像方案能较好地显示NF1的多发性或多灶性病变。     

血肿的MRI诊断及鉴别

一、MRI检查 肌肉损伤在进行MRI检查时，一般只做横断面的扫描，因为横断面扫描能更好地显示解剖结构。必要时可加做矢状面及冠状面扫描。扫描时都应加上脂肪抑制序列。横断面扫描应有4个基本的扫描序列，即T1WI、T2WI、T＊-FE和STIR—FSE。其中T2WI的参数为长TR（4000ms），中等TE（45ms）。STIR—FSE能更好地显示肌肉和临近结构。     

臂丛神经MRI正常表现

目的：分析臂丛神经在MRI不同成像序列中的正常表现。方法：20名正常志愿者行常规及MR新技术检查。观察各序列中臂丛神经的表现。结果：常规T1WI、T2WI臂丛神经呈等信号,STIR上呈高信号。横断面上,显示神经根自椎间孔处穿出,行于斜角肌间隙,后与锁骨下动脉及腋动脉伴行;冠状面上,显示为由C5～T1神经孔旁起始的条索状结构;矢状面上表现为结节状结构,行于斜角肌间隙,围绕锁骨下动脉。3D-FIESTA-c序列显示椎管内神经前后根为脑脊液高信号环绕下的等信号丝状结构。薄层无间隔STIR图像上背景组织信号抑制,椎管外臂丛神经显示为条状高信号结构,3D—FSPGR图像显示神经为条状等信号,同时反应其与邻近组织结构的关系。结论：联合常规及MRI新技术,可全面、清晰地显示臂丛神经。     

MR 3D-FIESTA序列对肩部喙肱韧带增厚的诊断价值

【摘要】目的：探讨磁共振3D-FIESTA序列对肩关节黏连性关节囊炎喙肱韧带增厚的诊断价值。方法：回顾性分析52例肩关节黏连性关节囊炎患者的MRI图像,比较斜冠状面3D-FIESTA序列与FSE T1WI不抑脂序列显示喙肱韧带的差异,并比较3D-FIESTA序列斜矢状面与斜冠状面显示喙肱韧带的差异。结果：斜冠状面3D-FIESTA序列对喙肱韧带的显示率为75.00%,高于斜冠状面FSE T1WI不抑脂序列57.69%的显示率, 差异有统计学意义（χ2值=17.754,P=0.000）。斜矢状面3D-FIESTA序列对喙肱韧带的显示率为90.38%,高于斜冠状面3D-FIESTA序列75.00%的显示率,差异有统计学意义（χ2值=5.974,P=0.015）。结论：斜矢状面3D-FIESTA序列是显示肩关节黏连性关节囊炎患者喙肱韧带的理想序列,当临床怀疑患者有肩关节黏连性关节囊炎时,加扫斜矢状面3D-FIESTA序列很有必要。     

青少年急性单纯膝关节软骨骨折的MRI表现

目的分析青少年急性单纯膝关节软骨骨折的MRI表现，以提高对MRI表现的认识。方法回顾性分析经关节镜手术证实的26例27处急性单纯膝关节软骨骨折的MRI表现，重点观察软骨、软骨下低信号线和软骨下骨髓的改变。26例均采用矢状面和冠状面扫描，矢状面应用快速小角度激发成像序列T1WI加脂肪抑制（FLASH-FS-T1WI）、SE-T1WI和三维稳态进动快速成像序列T2WI加脂肪抑制（FISP-3D-FS-T2WI）序列，冠状面应用多回波数据结合成像序列T2WI（ME-T2WI）和SE—T1WI，有5例还加扫了横轴面ME-T2WI。结果26例27处软骨骨折中髌骨8处，股骨内髁7处，股骨外髁11处，胫骨平台1处。单纯软骨骨折有3种类型，软骨全层缺损（7处，其中髌骨3处、股骨内髁2处、股骨外髁1处、胫骨平台外后髁1处）、裂隙状软骨骨折（3处，其中股骨内髁2处、股骨外髁1处）、软骨部分缺损（17处，其中髌骨5处、股骨内髁3处、股骨外髁9处）。关节镜手术发现2l例有关节内软骨游离体，而MRI仅发现3例。全部患者软骨骨折附近均有骨髓挫伤，软骨下低信号线形态、信号均正常。结论膝关节股骨和胫骨平台软骨骨折采用矢状面FLASH-FS-T1WI、SE-T，WI和FISP-3D-FS-T2WI序列及冠状面ME．T2WI、SE-T1WI，髌骨软骨骨折加扫横轴面ME-T2WI序列可显示急性单纯膝关节软骨骨折的部位、范围和类型，是软骨骨折最好的无创性检查方法。     

急性化脓性骨髓炎的MRI表现

目的：研究MRI在诊断急性化脓性骨髓炎早期病变的价值。方法：12例经临床证实的下肢骨急性骨髓炎患者分别于发病后2-14d在Philips0.5T超导型MR扫描仪下行横轴面、矢状面和冠状面扫描。结果：12例中11例骨髓内呈现异常MR信号，1例发病仅2d者骨髓内无异常信号。病变随时间的推移与正常骨髓间分界逐渐清晰，在T1WI骨髓内病变呈斑片状稍长T1、长T1低信号，在T2WI上病变呈斑片状长T2高信号，在短时反转恢复（STIR）序列上这种信号改变尤其明显。结论：MRI诊断急性化脓性骨髓炎优于其他影像学检查。     

宫颈癌的MRI诊断与分期研究

目的 探讨宫颈癌的MRI表现，前瞻性评价MR成像对宫颈癌术前分期的价值。方法 98例经病理证实的宫颈癌患者行MR检查，其中45例进行了手术，术前3－15d（平均7．5d)内行盆腔的轴面SE T1WI，轴面及矢状面快速自旋回波（TSE）T2WI，冠状面脂肪抑制（SPIR）TSE T2WI以及钆喷替酸葡甲胺（Gd-DTPA)增强后轴面、冠状面、矢状面SE T1WI扫描。在MR图像上观察原发肿瘤的位置、信号特征及侵犯范围。MRI所见与手术病理所进行对比。结果 宫颈癌的MRI表现颇具特征性，T2WI呈较高信号，与宫颈基质低信号及子宫内膜、宫旁脂肪组织高信号有良好对比，T1WI呈等或低信号，Gd-DTPA增强后T1WI可轻度强化。33例出现信号不均匀表现，病理上可为假腺腔、坏死及角化珠。MRI对宫颈癌部位判断的准确度为100％。对宫旁侵犯判断的准确度为88．9％，特异度为90．6％，敏感度为84．6％。对宫颈癌分期总的准确度为88．9％。结论 MRI能多方位清晰显示宫颈癌瘤灶及侵犯范围与途径，明显优于其他影像学检查方法，MRI对术前宫颈癌分期明显优于临床，应成为宫颈癌术前常规的影像检查方法。     

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.