磁共振胰胆道成像在先天性胆管囊性扩张症中的应用

目的：探讨先天性胆管囊性扩张症的磁共振诊断，特别是磁共振胰胆道水成像的诊断价值。材料和方法：回顾分析34例先天性胆管囊性扩张症的MR1及MRCP的影像特点，并与手术结果比较。结果：胆总管呈囊样扩张(Ⅰ型)26例，胆总管憩室(Ⅱ型)1例，胆总管及肝内胆管多发性囊样扩张(ⅣA型)6例，肝内胆管多发性囊样扩张(Ⅴ型即caroli病)1例。MRCP影像与手术结果完全相符合。结论：MR1结合MRCP这一无创的成像技术，在先天性胆管囊性扩张症的诊断中有重要作用。     

先天性胆管扩张的鉴别诊断

目的探讨磁共振胆胰管造影(MRCP)诊断儿童先天性胆管扩张的临床价值。方法回顾性分析78例先天性胆管扩张患儿的MRI和MRCP表现,并与手术病理结果进行对照分析。结果先天性胆管囊肿76例,Ⅰ型33例,Ⅱ型2例,Ⅲ型0例,Ⅳ型41例,Ⅴ型0例,囊肿型胆道闭锁2例;先天性胆管囊肿常合并胆囊扩大(53.9%),胆汁淤积(75%)和结石(42.1%);囊肿型胆道闭锁其胆管扩张局限,肝门部及门静脉周围可见局限斑片状长T_2信号,无胆囊扩大,胆汁淤积和结石等合并症。结论 MRCP能正确诊断先天性胆管扩张,可有效鉴别诊断先天性胆管囊肿和囊肿型胆道闭锁。     

磁共振胰胆管成像在婴幼儿胆管疾患中的应用

目的:探讨磁共振胰胆管成像(MRCP)在婴幼儿胆管疾患的诊断价值.方法:搜集本院2004年4月～2005年9月行MRCP检查并经手术病理证实的47例婴幼儿胆管疾患的病例进行回顾性分析.结果:胆管闭锁22例;胆汁黏稠综合征1例;先天性胆管扩张症24例,其中合并胰胆管合流、胆石症、胆泥沉积症各1例.MRCP能直接显示胆管树及胰管的形态,明确胆管闭锁、扩张、梗阻的部位、范围,定性诊断率达95.6%.结论:MRCP不用对比剂,无损伤,在婴幼儿胆管疾患的诊断中敏感性及定性诊断率高,是首选诊断方法.     

先天性胆管扩张症的影像学诊断(附6例报告及文献复习)

目的 探讨先天性胆管扩张症的影像学诊断价值.方法收集6例先天性胆总管扩张症的临床及影像学(CT和超声)资料,结合文献加以回顾性分析.结果 按照Todani氏胆管扩张症的分型,Ⅰ型胆总管扩张症1例,表现为肝外胆管呈囊状低密度影,管壁薄而光滑;Ⅳ型胆总管扩张症4例,表现为肝外胆管囊状或梭形扩张伴有肝内胆管囊状或串珠状扩张;Ⅴ型胆管扩张症1例,表现为肝内胆管多发囊状扩张,增强可见中心点征.6例超声检查,均能提示肝内外胆管扩张,确诊为胆总管囊肿1例, 4例为提示性诊断,误诊1例.本组中合并胆囊炎和胆囊结石、胆管癌以及肝硬化各1例.结论 CT和B超在诊断先天性胆管扩张症中具有重要价值,是首选的检查方法.     

超声诊断先天性胆管囊状扩张症的价值

目的探讨超声诊断先天性胆管囊状扩张症的价值.材料和方法回顾性分析18例先天性胆管囊状扩张症患者的超声图像,并与CT进行对比.结果超声诊断胆管囊扩张症12例,肝内胆管囊状扩张症(Carol i病)2例,复合型3例,漏误诊1例.结论超声可以很好地显示扩张的肝内外胆管的形态、部位以及周围组织结构,且有操作简便、可重复等优点,对先天性胆管囊状扩张症的诊断有应用价值.     

MRI对先天性胆管囊肿及其并发症的诊断价值

目的:探讨MRI对先天性胆管囊肿及其并发症的诊断价值。方法:回顾性分析45例先天性胆管囊肿患者的MRI及MRCP表现,并与手术结果进行对照分析。结果:本组45例先天性胆总管囊肿根据MRI和MRCP图像,分型结果为Ⅰ型19例、Ⅱ型3例、Ⅲ型0例、Ⅳ型14例Ⅴ型9例,分型结果与手术对比符合率为100%;先天性胆总管囊肿并发症中,MRI正确诊断结石12例(12/16),胆囊炎11例(11/12),胆管炎3例(3/4),胰腺炎1例(1/2),诊断结果与手术对比差异无统计学意义(P>0.05)。结论:联合应用MRI与MRCP有助于先天性胆总管囊肿及其并发症的的诊断及术前评估。     

MRCP与Ture FISP序列对医源性胆管损伤的诊断价值

目的 探讨磁共振胰胆管成像(MRCP)与真稳态进动快速成像(Ture FISP)对医源性胆管损伤的诊断价值. 资料与方法 回顾性分析15例医源性胆管损伤患者的MR影像和临床资料,并与手术结果 对比. 结果 按照Bismuth分型法进行分型,15例中Ⅰ型3例,Ⅱ型7例,Ⅲ型5例.所提供损伤的部位及损伤程度,与术中所见相同.MRCP与Ture FISP序列分型准确15例. 结论 MRCP与Ture FISP序列对医源性胆管损伤部位和程度的判断具有重要价值.     

MRCP 对 Caroli 病的诊断价值

Caroli 病是一种罕见的先天性胆管异常,为常染色体隐性遗传性疾病,主要特征为肝内胆管囊状扩张,又称交通性海绵状肝内胆管扩张症[1]。本文对本院自2009-10—2014-03确诊的19例病例进行回顾性分析,总结并探讨了 Caroli 病的磁共振胰胆管成像(MR cholangiopancreatography,MRCP)表现及其诊断价值。     

影像学检查在术前评估胆总管囊肿胰胆管解剖中作用

目的分析MRCP、CT增强(CE-CT)及术中胆道造影(IOCP)在显示儿童先天性胆总管囊肿(CC)患者胰胆管合流部解剖形态中作用,以期对术前提供可靠的影像资料。方法采用回顾性方法,收集儿童CC患者MRCP、CE-CT及IOCP资料,与囊肿病理组织学相对照,影像资料由两位放射科医师独立分析,然后以协商并达成一致影像诊断结论。结果59例CC中36例为囊性,23例为梭形。CC影像和手术分型:23例为I型,36例为IV型。MRCP、IOCP、CE-CT均能清楚显示肝内外胆管扩张情况,MRCP与IOCP诊断胰胆管合流异常(PBM)明显高于CE-CT,MRCP结合IOCP诊断PBM明显高于单独MRCP或IOCP。CE-CT可以明确显示肝右动脉位置异常。结论术前MRCP结合IOCP能提高CC患者胰胆管解剖结构显示率与PBM诊断率,而CE-CT可发现CC患者肝右动脉变异。     

肝门部胆管癌的磁共振诊断与手术对照研究

目的　探讨磁共振成像(MRI)及磁共振胰胆管成像(MRCP)在肝门部胆管癌诊断中的价值及对手术可切除性估价的指导意义。方法　回顾性分析20例肝门部胆管癌的MRI及MRCP影像特点,并与手术结果进行对照。结果　MRI18例在肝门区可见软组织肿块, 2例未见到肿块,仅表现肝内胆管扩张及管壁增厚。根据MRI与MRCP影像特点,对肝门部胆管癌的分型结果为:Ⅰ型3例,Ⅱ型4例,Ⅲ型6例,Ⅳ型7例,与术中所见对比符合率80%;对肿瘤可切除性进行术前评估,敏感度75%,特异度75%,诊断符合率80%。结论　MRI和MRCP联合应用有助于肝门部胆管癌的诊断、分型及手术可切除性的评估。     

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.