耻骨神经鞘瘤一例

患者　女 ,1 6岁。无意中发现右耻骨包块 4天入院。查体 :右耻骨局部轻度隆起 ,可扪及一 2 .0cm× 3.0cm大小的肿块 ,质硬 ,固定 ,边界清 ,有轻度压痛 ,局部软组织无红肿 ,腹股沟区未扪及肿大淋巴结。实验室检查未见异常。X线平片检查 :右耻骨膨隆 ,其内可见多个不规则形的透亮区及粗网格状结构 ,呈膨胀性改变 ,骨皮质变薄 ,病变累及整个耻骨 ,约 5 .0cm× 1 0 .0cm ,未见骨膜反应及软组织肿块影。X线诊断 :右耻骨骨巨细胞瘤 (图 1 )。CT检查 :平扫示右耻骨约 5 .0cm× 5 .2cm× 1 0 .5cm大小的膨胀性低密度区 ,其内呈软组织密度 ,CT值为…     

读片窗

患者　女 ,5 1岁。右下腹隐痛 4天。右侧近端升结肠癌切除断端吻合术后 5年。查体 :右下腹压痛 ,反跳痛 ,右侧麦氏点稍外可触及一约 5cm×4cm× 5cm大小包块 ,位置深 ,活动较好 ,基底不清 ,质韧 ,触痛明显 ,妇科检查无异常。CT扫描示子宫及双侧卵巢未见异常 ,右下腹腔内可见一 5cm×4cm× 6cm大小密度均匀的包块 ,CT值 12HU左右 ,可见完整包膜 ,厚度不均 ,靠近回盲区肠管处壁较厚 ,与邻近肠管局部分界不清 (图 1) ;增强扫描包膜强化 ,内容物未见改变。冠状位、矢状位重建 ,囊性肿块周围脂肪间隙清楚 ,上端与肠管无分界 ,下端与盆腔内肠管…     

卵巢纤维瘤CT诊断二例

例 1　女 ,39岁。因体检发现右下腹包块 3天入院。妇检 :子宫右侧触及一约 7.0cm× 5 .0cm大小包块 ,质硬 ,表面光滑 ,活动度差。血CA12 5、199均为阴性。CT平扫示右附件区一混杂密度肿块 ,大小约 7.0cm× 6 .5cm× 5 .0cm ,为软组织密度伴大量不规则钙化 ,CT值 4 5 .4HU、74 8HU ,与子宫右壁及直肠前壁间分界不清 (图 1)。增强扫描非钙化区有中度强化 ,CT值 78.8HU ,少量腹水 (图 2 )。手术见少量腹水呈淡黄色 ,右卵巢肿块约 8.0cm× 6 .0cm× 5 .0cm大小 ,包膜完整 ,实性质硬 ,与直肠前壁粘连。病理诊断 :右卵巢纤维瘤。例 2　女 ,5…     

输卵管积水CT误诊1例报告

患者女,25岁,因婚后3年未孕,下腹部疼痛4d入院,有输卵管炎病史1年,月经规律。妇科检查:阴道通畅,宫颈光滑,宫体前位,子宫大小正常,右侧附件区可触及一鸡蛋大小囊性包块,边界清,可移动,有压痛。B超:右附件区囊性包块。CT检查:CT平扫右侧附件区见一4.5cm×4.6cm×3.2cm混杂密度影(图1),中心为囊性密度,CT值为18HU,边缘为软组织密度影,CT值35HU,病灶边缘不清,与周围肠管分界不清,病灶周围见少量积液,与子宫分界欠明确。病人对碘过敏,故未增强扫描。CT诊断:右侧附件区囊性占位。手术所见:右侧附件区被大网膜包裹形成一5cm肿块,松解粘连的…     

同源异位甲状腺腺瘤一例

患者男,30岁。发现颈部包块近1年．近2个月来增大明显。颈部B超示：甲状腺右叶见一4.2cm×3.6cm不规则肿块,内回声区欠均匀。在该肿块后外方,．另见一2.5cm×2.0cm类圆形肿块,与前方甲状腺肿块分界模糊。CT扫描示：颈右前方见一4.5cm×3.8cm不规则肿块,与正常甲状腺组织分界欠清晰,内密度不均匀,CT值38～41HU。在该病灶后外方,右颈总动脉后方,右胸锁乳突肌内侧见一椭圆形肿块,与前方甲状腺肿块不相连,内密度均匀,周围分界清（图1）。增强扫描,甲状腺肿块呈不均匀强化,内见条带状分隔,低密度部分与正常腺组织分界清,后方病…     

阑尾黏液腺癌一例

患者　男 ,48岁。因右下腹包块半年余入院。查体 :右下腹可触及 3.0cm× 4.0cm包块 ,压痛 ,移动度小 ,大小便无异常。实验室检查 :WBC 8.9g/L ;G 0 .72 ;L 0 .2 5 ;M 0 .0 3;RBC 4.44× 10 12 /L ;HGB 141g/L ;PLT 2 6 5g/L。腹部CT平扫 :右下腹阑尾区见 3.1cm× 3.4cm× 4.0cm的软组织密度灶 ,形态不规则 ,呈分叶状 ,肿块边缘毛糙 ,其内密度不均匀 ,CT值 2 9～ 36HU ,与周围肠管及右前腹壁粘连 ,分界不清 (图 1)。增强扫描 :肿块呈不均匀性环状强化 ,壁厚薄不均 ,其内可见液体密度灶分布 ,CT值 36～ 5 3HU ,未见腹水 (图 2 )。…     

阴囊巨大良性间叶瘤并发腹股沟斜疝1例

患者男,60岁,14年前发现右侧腹股沟区有一核桃大小包块,站立时明显,平卧时消失,未曾进行治疗,后包块逐渐增大,降至阴囊且不能还纳,久站及行走时该包块胀痛明显,门诊以"腹股沟疝"收入院. CT检查:右侧阴囊内可见巨大混杂密度肿块,约20 cm×22 cm×17 cm大小,其内见多发大小不等软组织结节、条索状间隔及脂肪密度影,双侧睾丸分辨不清,右侧腹股沟区可见囊袋状脂肪密度影沿精索突入肿块内,与肿块分界不清(图1～4).     

颈部恶性血管内皮瘤伴肺转移一例

病例资料　患者 ,男 ,65岁。左颈部隐痛、左上臂上抬困难一周 ,发现左颈部包块3天。体检 :左颈部扪及 2cm× 2cm大小包块 ,质硬 ,边界不清 ,形态不规则 ,轻压痛 ,局部皮肤无红肿。血常规阴性 ,胸透见右肺上野可疑小片状阴影。CT检查 :左颈部胸锁乳突肌内侧见一不规则软组织密度肿块 ,大小约 3 .3cm×4.0cm× 4.5cm ,边界不清 ,密度不均匀 ,CT值 43HU、2 5HU(图 1a) ,增强后实质部分中度强化 ,低密度坏死区无强化 ,CT值76HU、2 6HU ,邻近肿块的第 5颈椎可见骨质破坏 (图 1b) ,双肺可见多发小片状密度增高影 (图 2 )。CT诊断 :左颈部恶…     

腹腔多发胚胎型横纹肌肉瘤1例报告

患者　男 ,3 5岁。腹胀 1月 ,发现右下腹包块 5d就诊。体查 :肥胖体质 ,右下腹可扪及约 18cm× 8cm大小的包块 ,边缘光滑 ,质硬 ,压痛明显 ,无反跳痛及肌紧张。实验室检查 :血常规 ,肝、肾功能正常。B超 :右下腹实性包块 ,考虑肠系膜肿瘤。CT所见 :腹腔内见多个大小不等、形态不规则、边界较清的软组织肿块 ,且于右下腹见一大小约 2 4cm× 8cm的巨大肿块 ;其内密度较均匀 ,CT值 12HU ,肿块上达脐上 5cm ,下抵盆腔内髂窝 ,呈弥漫分布 (图 1)。增强扫描示肿块呈不均匀轻度强化 ,CT值 18～ 62HU ,边界清楚 ,其内未见分隔 (图 2 )。诊断 :…     

腹膜后内胚窦瘤一例

患儿　女 ,2岁。因腹胀、腹痛 5天 ,加重伴进食后呕吐 ,黑便 2天 ,以肠套叠收住院。查体 :全腹膨隆 ,肠壁静脉曲张 ,全腹压痛 ,无反跳痛。中下腹似触及一包块 ,肛周溃烂。B超 :双侧肾盂积水 ,输尿管上段扩张 ,中下腹见低回声肿块 ,大小为 6 .2cm× 6 .7cm ,形态不规则 ,无包膜。X线平片 :满腹肠管积气 ,扩张 ,未见阶梯状液气面。CT检查 :中下腹见一 8.0cm× 9.0cm大小肿块 ,密度不均匀 ,边界不规则 ,与周围结构分界不清 ,子宫直肠凹见4 .6cm× 3.5cm肿块 ,左臀部肌肉内见一软组织块影 ,大小为3.5cm× 3.5cm ,右侧骶骨及第 2腰椎左侧椎弓呈…     

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.