彩色多普勒超声诊断急性胰腺炎的临床价值

目的探讨彩色多普勒超声对急性胰腺炎诊断的临床价值。方法对94例急性胰腺炎病例的彩色多普勒超声诊断资料进行回顾性分析,总结其超声声像图特点,并与CT、术后病理及临床最终诊断结果进行对照。结果 94例急性胰腺炎,彩色多普勒超声检出率为93%,CT检出率为96%,其中,急性水肿型胰腺炎81例,急性出血坏死型胰腺炎13例。结论彩色多普勒超声诊断与CT检查比较检出率无太大差异,且价格低廉、安全易行,是临床诊断急性胰腺炎的首选检查手段。     

彩色多普勒超声联合CT诊断结节性甲状腺肿合并甲状腺癌的临床价值

目的探讨彩色多普勒超声联合CT检查对结节性甲状腺肿合并甲状腺癌的诊断价值。方法收集选择结节性甲状腺肿合并甲状腺癌患者124例,对彩色多普勒超声、CT检查进行对比。结果联合应用诊断效果显著优于彩色多普勒超声或CT检查(P0.05)。彩色多普勒超声与CT检查无显著性差异(P0.05)。联合应用检查结节性甲状腺肿并甲状腺癌具有较高的敏感性、特异性以及准确性,阳性预测值以及阴性预测值均较高,而假阳性率以及假阴性率均较低。结节性甲状腺肿并甲状腺癌的彩色多普勒超声主要表现为:结节形态不规则,边缘与周围组织不清楚,有毛刺征;结节有钙化病灶;以Ⅱ～Ⅲ级的血流为主;部分患者有颈部或锁骨淋巴结转移。CT表现主要为:结节形态不规则,密度不均,边界不清,结节内有钙化病灶;无包膜或包膜中断不完整;增强扫描可以形成"强化残圈征",病灶内部不均匀强化;部分患者有颈部或锁骨淋巴结转移。结论彩色多普勒联合CT检查能提高结节性甲状腺肿合并甲状腺癌的诊断准确性。     

彩色多普勒联合超声造影对肾盂癌诊断价值分析

目的:探讨彩色多普勒联合超声造影(CEUS)对肾盂癌临床诊断的价值。方法:选取29例有完整临床资料的患者,对其肾脏行彩色多普勒、CEUS及CT增强扫描,并与病理结果进行比较。结果:常规彩色多普勒检查诊断肾盂癌的敏感性为51.72%(15/29);彩色多普勒联合CEUS的敏感性为79.31%(23/29);CT敏感性为82.76%(24/29)。CT诊断准确性明显高于常规超声,差异有统计学意义(P<0.05),但与彩色多普勒联合CEUS比较,二者差异无统计学意义(P>0.05)。8例肾盂癌CEUS的血流灌注方式:6例呈"同增早退",2例呈"早增早退";肿块显影高峰强度:4例等同于肾实质,4例稍低于肾实质。结论:彩色多普勒联合CEUS可以提高诊断肾盂癌的敏感性。     

超声和CT在诊断新生儿颅内出血中的价值

目的探讨新生儿颅内出血中超声和CT的诊断价值。方法回顾性分析从2014年11月～2017年8月在我院出生并收治儿科ICU室临床怀疑颅内出血患儿568例,超声于生后1～7天内检查,CT于14天内检查,观察比较二者诊断价值。以MRI结果为标准或根据新生儿颅内出血的诊断标准,分别计算超声和CT的敏感性、特异性和准确性。结果 568例患儿经临床证实为颅内出血的有556例,其中,室管膜下出血340例,蛛网膜下腔出血86例,硬膜下出血51例,脑实质合并脑室内出血79例。超声诊断颅内出血506例,其中室管膜下出血340例,蛛网膜下腔出血54例,硬膜下出血40例,脑实质合并脑室内出血72例。误诊1例,漏诊51例。诊断的敏感性为90. 8%,特异性为91. 7%,准确性为90. 8%; CT诊断颅内出血534例,其中室管膜下出血318例,蛛网膜下腔出血86例,硬膜下出血51例,脑实质合并脑室内出血79例。误诊0例,漏诊22例。诊断的敏感性为96. 0%,特异性为100%,准确性为96. 1%。结论早期颅内出血超声可作为筛查手段;超声对室管膜下出血敏感性高于CT,可作为首选检查方法;对于蛛网膜下腔出血、少量脑实质出血及硬膜下出血,CT优势于超声。     

多层螺旋CT和彩色多普勒超声对诊断新生儿颅脑损伤的有效性分析

目的 探讨多层螺旋CT和彩色多普勒超声对诊断新生儿颅脑损伤的有效性.方法 选取2019年10月至2020年10月收治的新生儿颅脑损伤患者60例,均接受多层螺旋CT和彩色多普勒超声检查,对比2种检查方式的有效率,观察2组检查方式的影像学表现,所有患儿均经MRI最终确诊为颅脑损伤.结果 多层螺旋CT对新生儿颅脑损伤诊断准确...     

超声联合应用对新生儿颅脑疾病诊断价值分析

目的探究高低频超声联合应用对新生儿颅脑疾病诊断价值分析。方法选择我院收治的180例新生儿(均伴随颅脑疾病)作为研究对象,均行高、低频超声联合检查,比较高、低频超声及两者联合的颅脑疾病检出率,并进行3个月随访。结果早产儿的超声阳性诊断率96.72%明显高于足月儿的70.69%,180例颅脑疾病患儿,低频超声检出61例(33.89%)、高频超声检出140例(77.78%)、两者联合检出169例(93.89%)。颅脑疾病类型主要为脑白质病变、颅内出血、室管膜下出血/囊肿及缺氧缺血性脑病等。低频超声、高频超声检出率明显小于两者联合检出率,差异具有统计学意义(P0.05)。结论采取高低频超声联合诊断新生儿颅脑疾病,无辐射、操作简单、可重复性强,临床诊断效果好,为新生儿临床治疗提供可靠参考依据。     

超声造影在肝癌病灶诊断及引导射频消融治疗中的应用价值

目的探讨超声造影（CEUS）在肝恶性肿瘤病灶诊断及引导射频消融（RFA）治疗中的应用价值。方法对经病理确诊并经RFA治疗的56例肝癌患者资料进行回顾性分析,术前比较增强cT、普通彩色多普勒超声（二维＋多普勒）和超声造影对肝癌（原发及转移）的检出率,观察二维及超声造影病灶图像差异及特点。对普通彩色多普勒超声引导组（62个病灶）和超声造影引导组（so个病灶）在术中引导RFA的消融效果进行对比并利用超声造影观察射频消融术后疗效。结果56例肝癌患者,112个病灶（原发灶36个,转移灶76个）。超声造影对肝癌病灶检出率为94．6％（106／112）,增强CT对肝癌病灶检出率为96．4％（108／112）,两者检出率比较差异无统计学意义0（x^2=0．42,P〉O．05）。普通彩色多普勒超声对肝癌病灶检出率为74．1％（83／112）,其与超声造影的检出率差异有统计学意义0（2=16,P〈0．05）。在普通彩色多普勒超声引导下进行RFA完全消融率为69％（43／62）,超声造影引导下完全消融率为84％（42／50）,两者的完全消融率差异无统计学意义舒=1．6,P〉0．05）。结论超声造影在RFA术前对肝脏肿瘤的诊断,术中对病灶的准确定位及实时引导穿刺,术后对手术疗效的随访观察都具有重要的应用价值。     

肝脏胆管囊腺癌影像学诊断的价值

目的:探讨彩色多普勒超声和介入超声技术及其他影像学检查在肝脏胆管囊腺癌(HBCAC)诊断中的价值。方法:回顾性分析1995年~2005年6例临床材料完整且经病理证实的HBCAC。结果:HBCAC患者的临床表现和实验室检查缺乏特异性;影像学表现为肝内单发或多发囊性病灶,囊壁明显增厚,囊壁上可见结节回声,囊内探及分隔回声,囊壁及囊内分隔探及血流信号,囊壁结节探及血流信号,无肝内外胆管扩张。二维及彩色多普勒超声和介入超声技术结合CT及MRI对HBCAC的诊断符合率较高。结论:彩色多普勒超声技术应作为诊断HBCAC的首选方法,增强CT、MRI检查、超声引导下穿刺或病灶囊液抽吸涂片检查具有确诊断值。     

新生儿缺氧缺血性脑病的超声诊断

探讨新生儿缺氧缺血性脑病(HIE)的二维超声特点和脑血流的血流动力学变化。材料和方法应用二维 及彩色多普勒超声对28例HIE患儿进行检测,经临床及CT证实,并与80例正常新生儿进行对比。结果二维超声可清 晰显示颅内结构,病变部位范围,彩色多普勒血流显像示脑血流速度降低。结论超声对HIE诊断有操作简单、准确、无 创、无并发症特点,值得临床进一步推广应用。     

超声联合MRI诊断凶险型胎盘植入的临床价值

目的分析彩色多普勒超声联合MRI诊断凶险型胎盘植入的临床价值。方法收集来我院检查的16~37周孕妇共2.14万例,其中发现高危胎盘植入疑似病例48例,48例产前均接受彩色多普勒超声及MRI检查,诊断结果与产后手术病理进行对比分析,比较彩色多普勒超声与超声联合MRI的临床诊断价值。结果彩色多普勒超声单用与联合MRI诊断的敏感性、阴性预测值及阳性预测值比较,无显著差异(P>0.05);彩色多普勒超声联合MRI的特异性高于彩色多普勒超声单用(P<0.05);彩色多普勒超声单用与联合MRI诊断率、误诊率比较,无显著差异(P>0.05);彩色多普勒超声单用的漏诊率明显高于联合MRI(P<0.05)。结论彩色多普勒超声技术的诊断敏感性较高,特异性较低,联合MRI能够进一步提高诊断准确性,具有临床推广价值。     

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.