螺旋CT对周围型小细胞肺癌的诊断价值

目的:探讨周围型小细胞肺癌(PSCLC)的CT表现及其诊断价值.方法:回顾性分析53例经皮肺穿刺活检或手术病理证实的PSCLC患者的CT表现.结果:53例中,肺内病灶呈结节状39例,团块状11例,片絮状3例;结节状或团块状病灶表现为边缘清晰的小波浪状或浅分叶状.49例伴有肺门或/和纵隔淋巴结肿大,其中39例肺门或和纵隔肿大淋巴结的大小超过肺内肿瘤,35例肿大的淋巴结融合成块而呈现冰冻纵隔改变.结论:周围型小细胞肺癌的CT表现有一定的特征性,螺旋CT扫描是诊断PSCLC的有效检查方法.     

胸部结节病的多排螺旋CT表现

目的探讨胸部结节病(sarcoidosis)的多排螺旋CT表现,旨在提高对该病的认识及诊断水平。方法回顾性分析经病理或临床随访证实的36例胸部结节病患者的CT和临床资料。结果 36例结节病患者中,仅肺门及纵隔淋巴结肿大者6例,肺门及纵隔淋巴结肿大并肺内浸润者25例,仅见肺内浸润无淋巴结肿大者5例;肺内表现:肺内小结节沿支气管血管束及胸膜下分布者19例,小叶间隔不规则增厚者16例,实变影17例,"磨玻璃影"3例,蜂窝变10例。淋巴结表现:双肺门、上纵隔右下气管旁、气管隆突下分布多见,平扫CT值均匀,增强扫描呈中度以上明显强化。结论双侧肺门淋巴结对称性肿大和/或纵隔淋巴结肿大,以及沿支气管血管束分布的不规则结节影是肺部结节病特征性影像学表现,多平面重组(MPR)图像对该病的诊断有较高的价值。     

67Ga显像对肺结节病的诊断价值

目的:探讨67Ga显像对肺结节病的诊断价值.材料和方法:回顾性分析78例经病理证实为肺结节病病人的67Ga全身显像、X线胸片和CT的影像学表现.结果:具有泪腺和腮腺放射性摄取伴有纵隔和肺门淋巴结肿大者,67Ga全身显像诊断准确性为96.4%(53/55),明显高于X线平片和CT的诊断准确性(83.6%,46/55,P＜0.05).单纯纵隔和(或)肺门淋巴结肿大者,67Ga全身显像诊断准确性为73.7%(14/19),与X线平片和CT的诊断准确性(84.2%,16/19)相近(P＞0.05).肺内病灶伴或不伴有肺门淋巴结肿大者4例,两种诊断方法都没有明确诊断.结论:67Ga全身显像对于以纵隔和或肺门淋巴结肿大的结节病具有重要的诊断价值.     

胸部结节病的CT诊断

目的:分析胸部结节病的CT表现,提高对本病的认识和诊断水平。方法:回顾性分析经活检病理证实或临床治疗观察符合诊断标准的26例胸部结节病的CT表现。结果:26例结节病中,肺门、纵隔淋巴结肿大23例(88.5%),其中肺门或/和纵隔淋巴结肿大8例(30.7%),肺门或/和纵隔淋巴结肿大伴有肺内病变15例(57.7%),仅见肺部浸润性改变而无淋巴结肿大1例(3.8%),肺纤维性改变2例(7.7%)。肺内主要表现为结节影15例,支气管血管束增粗7例,小叶间隔增厚4例,实变影1例,磨玻璃影1例。结论:双侧肺门对称性淋巴结肿大和/或纵隔淋巴结肿大以及沿支气管血管束分布的结节影是胸部结节病的特征性表现;不典型者需密切结合临床检查及治疗后随访。     

40例小细胞肺癌的螺旋CT表现

目的:分析40例肺小细胞肺癌的螺旋CT表现,以提高对该病的认识.方法:收集有CT和临床资料并经病理证实的SCLC 40例,回顾性总结分析CT影像特征.结果:中央型肺癌33例,CT表现为肺门分叶状结节或肿块,伴阻塞性肺炎12例(36.4%),阻塞性肺不张7例(21.2%),30例(90.1%)伴有纵隔淋巴结肿大,8例行CT增强,肿块和淋巴结均匀轻度强化.周围型SCLC 7例,密度均匀,均呈分叶状,CT无特征性表现.结论:小细胞肺癌CT主要征象以肺门区实性肿块为主,多伴有肺门、纵隔淋巴结转移,支气管阻塞征象出现较晚.     

64层螺旋CT在肺部结节病影像学诊断中的价值

目的分析64层螺旋CT肺部结节病的影像学表现,特别是结节病CT强化后的特征性表现,以提高对本病的认识和诊断水平。方法回顾性分析经病理证实及临床治疗符合诊断标准的21例肺部结节病的CT表现。结果 21例结节病中,肺门、纵隔淋巴结肿大20例,肺内病变18例,其中沿支气管血管束分布及胸膜下肺结节13例,5例有磨玻璃影。结论双肺门对称性淋巴结增大、纵隔淋巴结增大以及沿支气管血管束分布的结节影为结节病的特征性表现。需与胸内恶性淋巴瘤、结核及胸部转移瘤的鉴别,可以从纵隔淋巴结的好发部位,强化方式等方面进行鉴别;另外结节病对激素治疗有效。     

中央型小细胞肺癌的CT诊断及鉴别诊断

目的:探讨中央型小细胞肺癌(Small Cell Lung Cancer,SCLC)的CT表现特点,并找出与非小细胞肺癌(NSCLC)、肺结核、结节病、纵隔淋巴瘤的鉴别诊断要点。方法:回顾性分析经病理证实的57例中央型SCLC、60例NSCLC,5例肺结核,2例结节病,3例纵隔淋巴病的胸部平片及CT资料,全部病例均行胸部平片和CT平扫、增强检查。结果:57例中央型SCLC,CT主要表现为沿支气管长轴生长的肺内肿块,肺门与纵隔广泛淋巴结肿大,而肺不张相对少见。NSCLC60例主要表现为肺门肿块,支气管阻塞性改变相对多见。5例肺结核表现为肺内结节和肺门、纵隔淋巴结肿大,伴有同侧和/或对侧肺内结核病灶。2例结节病,表现为双侧肺门对称性淋巴结肿大。3例纵隔淋巴病表现为中前纵隔的弥漫性软组织肿块。结论:沿支气管长轴生长的肺内肿块、肺门及纵隔淋巴结肿大。支气管阻塞改变少见,随访1～2个月,肿块体积增大1倍以上,是中央型SCLC的CT诊断要点,据此特征诊断正确率达80％。结合临床与其他检查方法可与NSCLC、肺结核、结节病、纵隔淋巴瘤鉴别。     

肺淋巴增生性疾病的影像学表现

目的 研究肺淋巴增生性疾病（LPD）的影像表现及诊断价值。方法 分析25例肺淋巴增生性疾病（25例行X线胸片，腹部B超或CT检查，12例胸部CT检查，13例行气管分叉和肺内病灶体层检查，1例行胸部MR检查）的影像，临床与病理所见。结果 2例肺假性淋巴瘤表现为进展缓慢的含支气管气像的双肺多发大片浸润实变，无纵隔，肺门淋巴结肿大。4例肺淋巴交 肉芽肿（LYG）的胸部影像表现为双肺多发大小不等的结节和肿块，2例病变内可见低密度，1例可见支气管气像，3例无肺门，纵隔淋巴结肿大，1例初期未见，而在晚期出现肺门，纵隔淋巴结肿大及大量胸腔积液。16例血管免疫母细胞淋巴结病（AILD）均有肺门，纵隔多组淋巴结肿大，伴有双肺小结节网状改变10例，少，中量胸脸积液5例，双肺多发大小不等的结节2例，肺内单发或多发斑片或实变8例，其中4例证实有明确的继发感染。3例巨大淋巴结增生病的胸部表现为边界光滑的前纵隔肿块，1例表现为纵隔多发淋巴结肿大。15例AILD患者有肝脾肿大，8例AILD患者有明确的腹腔淋巴结肿大，1例LYG有肝脾肿大，1例巨大淋巴结增生病有肝脾及腹腔淋巴结肿大，其余患者腹部B超或CT正常。结论 虽然肺淋巴增生性疾病各类型的临床与影像表现各有特点，最终仍需依靠活检病理确诊。     

胸部结节病:螺旋CT评价

目的 评价螺旋CT在胸部结节病首次检查中的诊断准确性及其在治疗后复查中的作用.方法 回顾性分析具有完整临床及影像资料且经手术、病理或临床治疗证实的胸部结节病25例,所有病例做了胸部X线检查和胸部CT扫描.结果 25例胸部结节病,首次检查正确诊断16例,误诊9例.结节病的典型影像学表现: (1)右侧气管旁、左侧肺门、右侧肺门淋巴结肿大,增强后肿大淋巴结呈均匀、中高度强化;(2) 支气管血管束呈串珠状增粗、两肺多发结节是结节病的肺部典型表现.首诊误诊的9例为不典型结节病,其中误诊为淋巴瘤5例、结核病1例、肺门纵隔淋巴结转移2例、肺部转移性肿瘤1例.结论 螺旋CT对胸部结节病的明确诊断起着不可替代的作用;CT复查能对其治疗效果作出准确客观的评价.     

小细胞肺癌的CT分型与影像特征分析

目的 探讨小细胞肺癌(SCLC)特征性CT表现.方法 回顾性分析经病理证实的53例SCLC患者的CT图像,将SCLC分为肺门肿块(Ⅰ型),肺门肿块伴同侧纵隔淋巴结肿大(Ⅱ型),肿块与淋巴结分界清晰(Ⅱa)或不清晰(Ⅱb),肺门肿块伴双侧纵隔淋巴结肿大(Ⅲ型),肿块与同侧淋巴结分界清晰(Ⅲa)、不清晰(Ⅲb)或与双侧淋巴...     

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.