膝关节色素沉着绒毛结节性滑膜炎的MRI表现与病理对照研究

目的：探讨膝关节色素沉着绒毛结节性滑膜炎（PVNS）的MRI特征与病理变化的关系。方法通过对11例膝关节PVNS的MRI表现与病理结果进行对照分析,评价膝关节PVNS的MRI影像特点。结果11例中,弥漫型10例,局限型1例;不同程度关节腔积液及关节内脂肪垫受侵7例,半月板及交叉韧带受累4例,软骨或骨受累8例。11例MRI影像均有关节滑膜增厚、滑膜内软组织结节表现,结节于T1WI呈等或低信号,于T2WI呈低信号,1例见滑膜结节内出血,表现为T1WI及T2WI高信号。病理均可见数量不等的增生滑膜绒毛结节,有丰富血管和含铁血黄素沉着。结论PVNS绒毛结节内T1WI呈等或低信号、T2WI呈低信号为其特征性表现,与术中及病理相符,MRI对PVNS的诊断和鉴别诊断具有重要的临床价值。     

膝关节色素沉着绒毛结节性滑膜炎MRI分析

目的 探讨膝关节色素沉着绒毛结节性滑膜炎的MRI表现.方法 回顾性分析35例经手术病理证实的PVNS的MRI表现.结果 所有膝关节内均存在滑膜增生及增生的滑膜结节,33例为弥漫型PVNS,2例为局限型PVNS,早期8例,中晚期27例,早期PVNS以滑膜增生、绒毛结节形成及关节腔积液为主要表现,无明显低信号含铁血黄素沉积;中晚期PVNS典型表现为长T1略长T2增生滑膜及滑膜结节及T2 WI低信号含铁血黄素结节,并可伴有骨性关节炎MRI表现.增生滑膜结节主要分布髌下深囊及交叉韧带旁.结论 膝关节色素沉着绒毛结节性滑膜炎具有较特征性MRI表现,MRI能准确反映关节内外受侵组织结构受侵犯的范围和程度,是诊断PVNS的理想检查方法.     

膝关节色素沉着绒毛结节性滑膜炎的病理及MRI表现

目的:探讨膝关节色素沉着绒毛结节性滑膜炎(pigmented villonodular synovitis,PVNS)的病理与MRI表现,提高对该病的认识。方法:回顾性分析9例经手术病理证实的膝关节PVNS患者的临床及影像资料,总结其MRI及病理表现。结果:病理表现:关节滑膜弥漫或结节状增生,均可见结节内含铁血黄素沉着。MRI表现:均可见不同程度关节内积液,8例弥漫型,滑膜呈弥漫结节样增厚,T1WI呈低信号,T2WI呈稍高信号,增生结节内可见点状或小结节状T1WI呈等低信号,T2WI呈低信号;7例可见髌下脂肪垫受侵,表现为髌下脂肪垫形态不规则;1例增生滑膜明显强化,结节内可见点片状无强化区;5例可见关节面软骨破坏。1例局限型,团块状软组织信号与滑膜及腱鞘关系密切,信号类似肌肉组织,其内可见点片状T1WI、T2WI低信号影。结论:PVNS的MRI表现具有特征性,反映了其病理基础,MRI多序列检查有助于该病的诊断和鉴别诊断。     

膝关节色素性绒毛结节滑膜炎的MRI与病理对照研究

目的 :探讨膝关节色素性绒毛结节滑膜炎 (PVNS)的MRI诊断价值及其病理基础。方法 :回顾性分析 10例经病理证实的膝关节PVNS的MRI、X线平片影像资料 ,比较和评价膝关节PVNS的MRI信号特点 ,关节内结构侵犯、关节外侵犯和骨质侵蚀等征象。结果 :10例膝关节PVNS中 ,8例具有典型的含铁血黄素沉着 ,MRI可以准确显示X线平片难以显示的骨质侵蚀、关节内软骨和韧带侵蚀以及关节外侵蚀的范围。PVNS的MRI信号强度可分为 3种类型 :Ⅰ型 ,T1WI高信号 ,T2 WI等信号或高信号 ;Ⅱ型 ,T1WI等信号或低信号 ,T2 WI低信号 ;Ⅲ型 ,T1WI等信号或低信号 ,T2 WI高信号。每种类型分别对应其病理发展过程中的早、中及晚期病理表现。结论 :MRI在膝关节PVNS诊断中具有很高的价值 ,绒毛结节内含铁血黄素沉着所致的T1WI低信号、T2 WI低信号为其特征性改变 ,但并不贯穿PVNS全过程。快速小角度激发扫描优于自旋回波和快速自旋回波扫描。     

膝关节色素沉着绒毛结节性滑膜炎MRI表现与病理对照分析

目的：探讨膝关节色素沉着绒毛结节性滑膜炎（PVNS）的MRI表现与病理变化的关系。方法：对20例膝关节PVNS的MRI影像进行回顾性分析,并与手术病理结果对照。结果：20例膝关节PVNS均为弥漫型,病理特征为滑膜增厚呈结节状或绒毛状,有丰富的血管和大量含铁血黄素沉着。MRI表现均有滑膜增厚、关节内软组织结节,T1WI呈等或低信号,T2WI呈低信号;均有不同程度关节积液;关节内脂肪垫受侵15例;半月板及交叉韧带受累10例;软骨或骨受侵16例。结论：MRI对膝关节PVNS有特征性表现,并敏感显示关节内外组织结构的侵犯程度及范围,MRI是诊断PVNS的理想检查方法。     

膝关节色素沉着绒毛结节性滑膜炎的MRI影像分析

目的:分析膝关节色素沉着绒毛结节性滑膜炎(PVNS)的MRI影像表现,提高对本病的认识。方法:回顾性分析13例经病理证实的膝关节色素沉着绒毛结节滑膜炎,总结其MRI表现特点。结果:13例患者中弥漫型9例,局限型4例。PVNS主要表现为滑膜不规则结节状增生或弥漫性增生,增生的滑膜和结节内沉着含铁血黄素(T1WI、T2WI双低信号)。关节内外结构可受侵。结论:PVNS所致的滑膜增生和含铁血黄素沉着在MRI上具有特征性的表现和信号,对诊断本病具有重要意义。     

磁共振成像诊断膝关节色素沉着绒毛结节性滑膜炎

目的探讨膝关节色素沉着绒毛结节性滑膜炎（PVNS）在磁共振成像（MRI）的表现及病理基础。方法对2007-2011年我院11例经手术及病理证实的PVNS患者进行回顾性分析其MRI及病理表现。结果11例病变中10例为弥漫型,单侧发病,增厚的滑膜T,WI上呈等信号6例,低信号3例,稍高信号2例,T2WI上均呈高低混杂信号,均有不同程度关节积液：软骨或骨质受侵4例,2例可见硬化边或灶周骨髓水肿,髌下脂肪垫受累2例,1例交叉韧带受累．1例在胭窝内可见滑膜结节。1例为局灶型,表现为单个结节,伴有关节积液。结论MRI能清楚显示病变特征及范围,是日前PVNS术前诊断以及术后随访的最佳检查方法。     

膝关节色素沉着绒毛结节性滑膜炎的MRI表现

目的：探讨膝关节色素沉着绒毛结节性滑膜炎的MRI表现。方法：回顾性分析8例经手术及病理证实的膝关节PVNS的MRI影像资料。结果：MRI表现中弥漫型6例,局灶型2例。PVNS主要表现为滑膜不规则结节状增生或弥漫性增生,增生的滑膜内含铁血黄素沉着（T2WI低信号）、邻近半月板和（或）骨侵蚀、关节腔积液等。结论：MRI是本病理想的检查方法。     

膝关节色素沉着绒毛结节性滑膜炎MRI分析

目的:分析膝关节色素沉着绒毛结节性滑膜炎(PVNS)的MRI表现与诊断价值。材料和方法:回顾性分析9例经病理证实的色素沉着绒毛结节滑膜炎,总结其MRI表现特点。结果:局限型3例,弥漫型6例。PVNS主要表现为滑膜不规则结节状增生或弥漫性增生,增生的滑膜内含铁血黄素沉着(T2WI低信号)、邻近半月板和(或)骨侵蚀、关节腔积液等。结论:MRI能为早期诊断膝关节PVNS提供依据,并积极指导手术。     

色素沉着绒毛结节性滑膜炎的MRI表现

目的 探讨色素沉着绒毛结节性滑膜炎(pigmented villonodular synovitis，PVNS)的MRI表现。方法 23例PVNS中膝关节9例，髋关节9例，踝关节3例，肘关节1例，腕关节1例，均经手术和病理证实。23例PVNS均行X线和MR检查，其中4例行CT检查。分析PVNS的影像学表现，着重总结PVNS的MR影像学特点。结果 X线表现：23例均可见关节及软组织肿胀，7例关节内外可出现较致密结节状或分叶状软组织肿块影，19例可见邻近关节骨质侵蚀性小缺损。CT表现：4例中3例可见关节内外结节状或分叶状软组织肿块，增强扫描可见结节样强化，1例CT仅显示关节囊增厚，关节内积液。MRI表现：23例病变部位增生肥厚的滑膜在T1WI上呈中等或中等稍低信号，在T2WI上呈中等稍高信号，其内可见多发散在结节，呈T1WI、T2WI低信号灶；增生肥厚的滑膜在快速梯度回波(FFE)T2WI序列上呈明显结节样低信号。23例病变关节均可见不同程度的关节积液。19例有骨质破坏，表现为凹陷性类圆形骨质缺损，骨缺损区T1、T2WI呈中等信号灶，周围有硬化边，呈T1WI、T2WI低信号。相邻骨髓腔内可见弥漫性反应性水肿灶，呈片状高T2信号。结论 MRI能准确显示PVNS的病变范围和程度，对PVNS有定性诊断价值。     

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.