腰椎间盘突出症的X线诊断(附115例X线平片、造影及手术对照分析)

本文介绍了115例(125个病变椎间盘)腰椎间盘突出症患者的平片及脊髓造影的X线征象,并与手术结果对照分析,诊断准确率为91.2％。椎体后缘唇样骨质增生和骨内软骨结节、椎间隙的前窄后宽等征象对椎间盘突出有定位诊断价值。腰骶椎脊髓造影显示硬膜囊和神经根的压迫征象,对于腰椎间盘突出的定位诊断及鉴别诊断均有重要意义。     

腰骶椎椎间盘突出的影像诊断

目的：通过回顾性分析，探讨腰骶椎椎间盘突出的非创性影像诊断及相关问题。材料与方法；报告200例腰骶椎椎间盘突出者的影像学表现，其中67例经手术证实。全部病例摄有X线平片及CT扫描，21例做了MRI检查。结果：对腰骶椎椎间盘突出的诊断，MRI和CT显示优于传统X线检查。但MRI在鉴别诊断方面又比CT稍胜一筹。结论：MRI虽然敏感性高，但检查费用昂贵，故对本症的诊断，应首选CT检查。     

普通CT扫描对腰骶椎椎间盘膨出的诊断价值分析

目的提高CT对腰骶椎椎间盘膨出诊断重要性认识。方法回顾我院89例腰骶椎椎间盘膨出的CT表现。结果89例腰骶椎椎间盘膨出，共有94个椎间盘膨出，CT表现主要为：膨出椎间盘的椎管内膨出块78个，椎管与硬膜囊之间脂肪层消失39个，硬膜囊及恻隐窝受压104个等。89个椎间盘膨出治疗前明确诊断。结论CT对于腰骶椎椎间盘膨出的诊断有很大的价值。     

腰椎间盘突出的影像学诊断

图1　Ｌ45椎间盘突出,右外侧型　图2　Ｌ45椎间盘软组织偏左侧向椎管内突出,超出左侧、侧隐窝,压迫Ｎ根(腰45椎间盘突出,左外侧型)　图3　Ｌ45椎间盘软组织后缘居中向椎管内突出,硬膜囊受压(为中央型,椎间盘突出)　　椎间盘突出症(Ｐｒｏｔｒｕｓｉｏｎ)或称椎间盘疝(Ｈｅｒｎｉａｔｉｏｎ)为常见疾病,本文收集92例平片及ＣＴ检查诊断为椎间盘突出。其中50例为Ｘ线平片诊断,31例为ＣＴ轴位扫描诊断,11例为椎管造影检查。92例均手术证实为腰椎间盘突出。材料与方法　92例中年龄最大79岁,最小17岁,平均年龄38.2岁。男62例,女30例,以30～60岁居…     

腰椎间盘突出108例X线诊断分析

回顾性分析108例经手术证实的腰间盘突出病人的X线平片,椎管造影所见。手术中所见椎间盘突出共125个,其中15例为双节段,1例为3节段。发病部位以腰4～5和腰5骶1最多见。分析了X线平片及造影片的表现。讨论了不同类型的椎间盘突出的造影表现,提出了X线的诊断依据。     

16层螺旋CT与X线平片在腕骨外伤诊断中对比及临床应用研究

目的探讨多层螺旋CT（MSCT）与x线平片在腕骨外伤中的诊断价值。方法31例腕骨外伤患者于受伤后30min-20d分别进行了x线平片、MSCT检查，将cT扫描数据传至工作站进行多平面重组（multiplanar reformation，MPR）、容积再现技术（vdume reformation，VR）和曲面重组（curved—planar reformation，CPR），观察MSCT各种成像方法对腕骨骨折和脱位的显示效果，并与x线平片对比分析。结果31例中，x线平片显示关节脱位6例，腕骨骨折14例，其中假阳性1例；可疑骨折7例，经MSCT确诊4例，排除3例。MSCT共检出28例（37处）骨折，脱位10例。二者腕骨骨折的检出率有统计学差异（x2=16．05，P〈0．05）。结论在腕骨外伤的诊断中，x线平片仍是基础的影像学检查方法；MSCT明显优于x线平片，各种成像方法的综合应用可提高腕骨损伤的检出率。     

歼击机飞行员腰椎峡部裂60例影像学分析（摘要）

目的探讨歼击机飞行员腰椎峡部裂影像学诊断。方法收集改装体检的歼击机飞行员腰椎峡部裂60例（62块病变腰椎）影像学资料,分析X线和部分CT、MRI表现以及其中20例6个月～7年随访复查的影像学变化。结果60例站立位x线腰椎正侧位和双斜位平片均显示峡部裂征象;仅3例x线显示单侧峡部裂,而CT证实为双侧。腰5椎峡部裂51／62块（82．26％）,其次为腰4椎峡部裂5／62块（8．06％）,腰3椎峡部裂3／62块）4．84％）,腰6椎（骶椎腰化）峡部裂2／62块（3．23％）,腰2椎峡部裂1／62块（1．61％）。60例中双侧峡部裂50块,其中伴有前滑脱者31块,     

腰脊柱结构与椎间盘突出症关系的X线研究

目的：用ｘ线平片探讨腰脊柱结构与椎间盘突出症发病的关系。材料和方法：用髂嵴连线，腰骶移行椎，腰骶角三个参数分析２０８例经手术证实的腰椎间盘突出症患者的术前Ｘ线平片。结果：深座骨盆Ｌ５的患者，Ｌ４－５椎间盘突出发病率高，高骑骨盆Ｌ５的患者，Ｌ５－Ｓ１椎间盘突出发病率高；有腰骶移行椎变异者，腰椎间盘突出发病率高于无变异者；腰骶角在椎间盘突出发病中的意义有待进一步探讨。结论：腰脊柱结构与腰椎间盘突出的发病部位有关，相当部分Ｌ５－Ｓ１椎间盘突出，行经皮椎间盘切除术中，不需髂骨翼钻孔。     

年轻士兵腰椎间盘突出症影像学诊断对比分析

目的总结年轻士兵腰椎间盘突出症（LDH）的X线平片、CT及MRI特点,进一步探讨影像学对诊断LDH的价值。方法收集我院32例经临床及影像学确诊的年轻士兵LDH的临床资料,分析其腰椎X线平片、CT及MRI影像特点。结果 32例中,X线平片表现为椎间盘病变8例,CT表现为椎间盘突出29例,MRI均表现为椎间盘突出。结论年轻士兵LDH较轻,X线平片阳性表现少,结合症状、体征可起筛查作用,而CT、MRI检查具有确诊价值,可为临床确诊提供重要的参考依据。     

移行椎合并腰椎间盘突出症的影像学表现及术中定位

移行椎是最常见的腰骶椎先天畸形 ,大约占 10 %左右 ,它包括腰椎骶化、骶椎腰化 ,若合并腰椎间盘突出症时 ,可导致术中定位困难 ,并给诊断治疗带来负面影响。影像学资料对术中准确定位 ,提高手术成功率 ,起到了重要的作用。我院自 1996～ 2 0 0 3年手术治疗腰椎间盘突出症 6 4 0例 ,其中移行椎合并椎间盘突出 4 7例 ,现分析如下。1　材料与方法　　本组男 2 2例 ,女 2 5例 ,术前X线诊断为骶椎腰化 38例 ,腰椎骶化 9例 ,中央型突出 11例 ,侧后方突出 36例 ,4 7例均行手术治疗 ,其中 38例行椎板回植椎管成形术 ;6例行开窗减压 ;另外 3例因术…     

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.