CT对等密度硬膜下血肿占位征象的分析

本文分析了我院CT轴位平扫诊断的43例等密度硬膜下血肿(ISDH),经与正常对照组(40例)、肿瘤组(41例)进行分组对比研究,测得各种CT征象,发现:(1)中线结构的特征性偏移;(2)表面脑沟回聚拢内移征;(3)脑灰白质界面内移;(4)有无脑白质水肿;(5)侧脑室变形和脑—脑室指数变小,对ISDH 的诊断及鉴别诊断有重要意义。     

等密度硬膜下血肿CT影像分析

目的：通过分析等密度硬膜下血肿的CT表现，总结具有诊断意义的CT征象。方法：回顾分析29例经手术和保守治疗证实的资料完整的等密度硬膜下血肿的CT表现、临床症状体征。结果：29例等密度硬膜下血肿CT检查出36个血肿灶。单侧24例，双侧5例。左侧15个．右侧21个，病灶分布以额颞顶部为主，其次分布在额顶或顶枕部，血肿呈新月形或半月形，位于大脑凸面，跨越颅缝，密度与脑实质相仿，CT值40-45Hu。同侧脑皮髓质界面内移，脑室受压变形、移位。双侧血肿时，中线结构向血肿小的一侧偏移。血肿较大时可以产生脑疝。CT增强扫描。脑膜及脑表面小血管强化使血肿轮廓变清晰。结论：具有诊断意义的征象有：（1）脑灰白质界面内移，（2）病灶侧脑沟消失。脑回聚拢、内移，（3）侧脑室受压变形及中线结构向健侧或血肿灶较小的一侧移位。（4）大脑镰下疝。CT增强扫描及MRI对发现小血肿及脑疝更有意义。     

双侧慢性硬膜下血肿的CT诊断(附43例分析)

目的：本文报告43例双侧慢性硬膜下血肿的CT诊断。方法：回顾分析43例双侧慢性硬膜下血肿的CT检查资料。结果：43例共86个血肿，血肿呈混杂密度42个，等密度32个，低密度12个；血肿呈新月形66个、半月形15个、3字形5个；伴脑灰白质界面内移43例，侧脑室变窄41例，中线结构移位17例。结论：双侧慢性硬膜下血肿多见于老年男性患者，CT检查是诊断本病最简单而可靠的方法。     

老年性等密度慢性硬膜下血肿CT诊断

目的：分析等密度慢性硬膜下血肿的CT表现，探讨其价值。方法：对23例等密度慢性硬膜下血肿CT表现进行了回顾性分析。结果：CT颅骨内板下方可见新月形或半月形等密度影，脑室系统，脑中线受压向对侧移位，颅内板下方无脑回、脑沟和脑灰白质界面向内移位。结论：CT对正确诊断等密度硬膜下血肿、经济、快速无创伤性，为临床提供治疗方案有重大意义。     

皮质内移征在鉴别脑内与脑外占位性病变中的价值

目的:探讨皮质内移征对鉴别脑内、外病变的价值。方法:对55例脑外占位性病变,包括21例硬膜下血肿、10例硬膜下积液1、1例硬膜外血肿1、3例脑膜瘤和32例脑内胶质细胞瘤,其中21例星形细胞瘤、4例少支胶质细胞瘤、7例幕上室管膜瘤行CT平扫及增强扫描图像资料进行回顾性分析。结果:55例脑外占位性病变中49例出现脑皮质内移征,包括硬膜下血肿21例、硬膜下积液10例、硬膜外血肿11例和脑膜瘤7例;而32例脑内胶质细胞瘤,包括星形细胞瘤21例、少支胶质细胞瘤4例、幕上室管膜瘤7例均未显示脑皮质内移征。结论:皮质内移征对鉴别脑内与脑外占位性病变具有很大的价值。     

等密度硬膜下血肿的CT诊断(附15例报告)

等密度硬膜下血肿(ISDH)系指CT上硬膜下血肿的密度与邻近脑实质,主要是脑皮质密度相近,边界不清,其临床上外伤史不明确或仅有轻微外伤史,症状与体征均不典型,容易误漏诊.CT检查在确立本病诊断方面具有重大价值.笔者复习了我院经手术证实的15例ISDH的CT资料,讨论其CT表现及形成机制以提高对本病的认识.     

快速吸收的急性硬膜下蛛网膜下腔混合出血的CT特征

目的 探讨快速自行吸收的急性硬膜下蛛网膜下腔混合出血的CT特征.方法 对17例常规CT表现为不典型急性硬膜下血肿及蛛网膜下腔出血的颅脑损伤病人进行了短时间CT复查,并对其结果进行回顾性分析.结果 17例均表现为类似急性硬膜下血肿的新月形混杂高密度影.病灶特点:①病灶吸收很快,在动态CT监测下,病灶多在短时间(1～7 d)内吸收.②病灶密度混杂,可见不规则形或带状低密度区.③病灶临近脑池脑沟密度升高.④病灶多位于额颞部.⑤部分病灶可沿蛛网膜下腔"游动"(血肿重分布).结论 快速自行吸收的急性硬膜下蛛网膜下腔混合出血具有一定的CT特征,由于硬膜下腔及蛛网膜下腔沟通,加速了出血的吸收,应归属于蛛网膜下腔出血,准确诊断及严密观察可避免患者的手术之苦.     

脑表面强化的CT表现

作者以14例CT 表现为基础,讨论了脑表面强化的三种形式。一、边缘状或线状强化:大脑半球凸面出现线状强化影提示脑外积液,可为脓性或血性、新鲜或陈旧的、位于硬膜外或硬膜内。1.积液的密度:脑外血肿数天内呈高密度;数周呈等密度;数月呈低密度。脑外积脓数天后均呈低密度。2.异常轮状强化:硬膜外积液时,为向内移位的正常硬膜,而硬膜下积液时,刚为向内移位的蛛网膜。3.诊断重要     

急性硬膜下血肿的非典型CT所见

作者回顾性分析了71例急性硬膜下血肿,其中28例(39％)的CT所见不具典型性。表现为混合密度影,有三种类型:边缘型——高密度血肿的内或外侧有低密度区,多近似脑脊液密度;不规则型和线条型——高密度血肿内可见不规则或线条样低密度影,多类似脑皮质密度。这种混合密度的血肿,其平均最大厚度为18.1mm,平均中线移位16.5mm;而典型的高密度硬膜下血肿,其平均最大厚     

等密度硬膜下血肿的CT诊断

等密度硬膜下血肿(简称ISDH)，是硬膜下血肿中的常见类型，由于该血肿的密度与脑实质密度接近，且与脑实质分界不清，部分病人可有或无明确颅脑外伤，有时诊断较难。甚至有可能造成漏诊或误诊，本文回顾性分析经临床证实的46例等密度硬膜下血肿病例，旨在进一步提高对本病的认识     

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.