64层CT诊断阑尾粘液性肿瘤的临床价值

阑尾粘液性肿瘤病理学分为粘液囊肿、粘液性囊腺瘤、粘液性囊腺癌,占阑尾切除标本的0.43%[1,2]。本病临床上无症状,或主要表现为慢性非转移性右下腹疼痛,以及右下腹包块,容易误诊为卵巢囊肿、阑尾炎、盲肠肿瘤等。术前作出正确诊断有助于防止术中破裂引起腹膜假粘液瘤[1]。多     

阑尾粘液性囊腺瘤的CT表现

目的 探讨阑尾粘液性囊腺瘤的CT特征及诊断价值,提高对其诊断的准确率.方法 回顾性分析11例经手术病理证实的阑尾粘液性囊腺瘤的临床资料及CT表现.结果 病灶位于右下腹近回盲部或右侧盆腔内,呈大小不等囊性肿块,8例呈类圆形、长管状,2例呈“逗号”征,1例呈分叶状.囊壁均匀或厚薄不均,4例囊壁有钙化.病灶均未见分隔,内容物CT值10～30HU.7例增强扫描中5例囊壁有强化,2例强化不明显,囊内容物无强化.10例病灶周围结构清晰,其中1例合并肠套叠突入盲肠内,1例与盲肠分界不清,周围并见淋巴结.结论 右下腹与盲肠相连类圆形、长管状或“逗号”样单房或多房囊性肿块,囊壁厚薄均匀或不均,肿瘤周围系膜正常,术前可提示阑尾粘液性囊腺瘤诊断.     

卵巢囊腺瘤的CT诊断(附22例报告)

目的 确定CT对卵巢囊腺瘤的诊断价值。方法 对超声诊断不满意的21例卵巢囊腺瘤的CT表现进行回顾性分析，并与手术病理所见进行了对照。结果 22例卵巢囊腺瘤患中，浆液性囊腺瘤见于15例，粘液性囊腺瘤5例，交界性粘液性囊腺瘤2例。与术后病理结果对照，CT正确诊断了22例中的21例(95％)。CT探测单侧单发性卵巢囊腺瘤病变的准确率为100％(n=22／22)。结论 CT在卵巢囊腺瘤的诊断中，能清晰显示其内部特征及其病变与周围组织的关系，因而，它是一神可靠、有效的诊断方法。但是，CT对交界性卵巢囊腺瘤和卵巢囊腺瘤的恶变难以做出准确的定性诊断，多数情况下需经手术病理证实。     

肝胆管及胰腺粘液性囊腺肿瘤的CT影像与病理对照研究

目的：研究肝胆管或胰腺粘液性囊腺肿瘤的CT表现。方法：选取本院1989年1月～2002年6月间经手术病理证实的肝胆管或胰腺粘液性囊腺肿瘤12例，对其CT图像进行回顾性研究。结果：肝胆管囊腺肿瘤5例，其中囊腺瘤3例，囊腺癌2例；胰腺囊腺肿瘤7例，其中囊腺瘤4例，囊腺癌3例。钙化2例，腹腔及／或腹膜后淋巴结肿大2例，伴有其他脏器转移1例。结论：肝胆管或胰腺粘液性囊性肿瘤的CT表现具有一定的特征性，并为临床治疗提供指导。     

阑尾黏液性囊腺瘤的MSCT诊断价值

目的 探讨阑尾黏液性囊腺瘤的MSCT影像表现。方法 选取经手术病理证实的17例阑尾黏液性囊腺瘤的临床及CT影像资料,其中6例平扫,11例增强扫描,所有17例均行CT薄层重建。结果 阑尾黏液性囊腺瘤多表现为右下腹长茄状、类圆形、不规则状液性低密度,边界清晰,囊壁稍增厚、可见毛糙,囊壁见蛋壳样、结节状、斑点状钙化,囊壁、分隔及壁结节轻度强化。少见表现为腹膜腔假性黏液瘤、肠套叠、囊壁明显增厚以及囊壁明显强化。结论 阑尾黏液性囊腺瘤具有一定CT特征性表现,MSCT更有利于对其作出准确诊断及鉴别。     

阑尾黏液性囊腺瘤CT表现及文献复习

阑尾黏液性囊腺瘤临床少见,据文献报道其发生率占阑尾切除标本的0.43％[1-2].本病临床上无特异性症状,或主要表现为慢性非转移性右下腹疼痛以及右下腹包块,术前诊断困难,易误诊为阑尾炎、阑尾周围脓肿、回盲部肿瘤、卵巢囊肿等疾病.随着多层螺旋CT的广泛应用及普及,薄层扫描及多平面重组(multiplanar reconstruction,MPR)等重建技术能从不同角度整体观察阑尾及其周围情况,做到观察的连续性和完整性,大大提高阑尾疾病术前诊断准确率[3].现对本院经病理诊断的5例阑尾黏液性囊腺瘤进行回顾性分析,并对国内外相关文献进行复习,旨在提高对该病CT表现的认识及诊断能力.     

卵巢良性肿瘤的MRI诊断与鉴别诊断

目的：探讨卵巢良性肿瘤典型与不典型的MRI征象,提高卵巢良性肿瘤诊断及鉴别诊断的水平。方法：搜集经手术和病理证实22例盆腔肿块,所有病例均行MRI平扫及增强检查,回顾性分析其MRI征象。结果：22例中,浆液性囊腺瘤10例,粘液性囊腺瘤8例,囊性畸胎瘤3例,卵巢纤维瘤1例。浆液性囊腺瘤表现为：囊壁薄且规则,无分隔或分隔薄且均匀。粘液性囊腺瘤表现为瘤壁和间隔厚薄不均匀;囊内信号不均匀。囊性畸胎瘤主要表现为瘤体内均见脂肪成分。结论：卵巢良性肿瘤由于组织成分不同,MRI表现具有一定的特征。     

阑尾黏液性囊腺瘤的CT诊断价值

目的：探讨阑尾黏液性囊腺瘤CT表现,提高其术前正确诊断水平。方法：经手术病理证实的7例阑尾黏液性囊腺瘤均行16层螺旋CT检查,常规行CT平扫加动态增强扫描。回顾性分析其CT表现。结果：所有患者术前CT均未能做出正确诊断,7例均表现为右侧髂窝处边缘光整的椭圆形、类圆形囊性肿块,MPR图像上表现为长椭圆形或类圆形,囊壁均匀薄壁4例,囊壁厚度不均并见乳头状突起及囊内分隔3例;动态增强扫描呈中等程度强化3例,无明显强化4例。阑尾管壁增厚、肿块邻近脂肪模糊1例,伴有腹腔内多发囊性肿块及腹腔积液1例。结论：当CT检查发现右侧髂窝处囊性肿块,囊壁厚度不均伴或不伴有囊内分隔及乳头状突起等CT表现时,影像科医师应考虑到阑尾黏液性囊腺瘤的诊断,从而避免发生医源性腹腔假性黏液瘤。     

阑尾黏液性囊腺瘤的CT表现

目的:探讨阑尾黏液性囊腺瘤的CT诊断价值。方法:回顾性分析经手术病理证实的6例阑尾黏液性囊腺瘤CT平扫和增强表现。结果:6例中4例阑尾囊状膨胀,4例密度不均匀,3例有曲线状壁的钙化,2例出现小壁结节,2例壁厚度大于3mm,6例瘤体直径大于15mm,5例出现环形壁强化及2例壁结节强化。结论:阑尾黏液性囊腺瘤CT表现为阑尾囊状扩张,密度不均,曲线状钙化壁,小壁结节,增强后瘤体边缘及壁结节强化。     

卵巢囊腺瘤的CT诊断

目的:提高对卵巢囊腺瘤CT诊断及鉴别诊断能力。方法:回顾性分析手术病理证实的27例卵巢囊腺瘤的CT表现。结果:浆液性囊腺瘤5例,单房4例,多房1例,密度均匀,囊壁可薄可厚或厚薄不均。粘液性囊腺瘤9例,单房3例,密度均匀,囊壁厚,多房6例,密度不均匀,内见多发大小不等子囊。交界性(6例)和恶性变(7例)13例,其中浆液性3例,粘液性10例,12例为多房改变,囊壁及分隔增厚且边缘模糊,部分呈囊实性及壁结节改变,2例恶性变者伴有大量腹水。结论:单房浆液性囊腺瘤及多房粘液性囊腺瘤具有较典型CT表现,CT易于诊断及鉴别诊断,当病变呈囊实性改变,出现壁结节,或囊壁分隔不规则增厚模糊时,提示交界性或恶性变。     

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.