螺旋CT诊断原发性输尿管癌的价值

目的:探讨原发性输尿管癌螺旋CT扫描及三维重建的影像特点和诊断价值.材料和方法:回顾性分析14例经手术病理证实原发性输尿管癌的螺旋CT影像表现,分析其特点.14例患者中13例行增强扫描,1例为逆行性尿路造影后CT平扫,14例均行MPR/CPR重建,4例同时行MIP重建及VE检查.结果:CT增强轴位扫描及MPR/CPR重建能够清晰地显示肿瘤的大小、形态、范围及其与周围组织的关系;MIP重建能很好地显示肿瘤引起的输尿管管腔不规则狭窄或截断改变;VE检查则能够从管腔内观察肿瘤的形态.结论:螺旋CT容积扫描及三维重建能够多平面、多方位、立体地显示病变,使病变定位、定性诊断更加准确,为临床手术治疗提供帮助.     

多层螺旋CT诊断原发性输尿管癌

目的：探讨多层螺旋CT在原发性输尿管癌诊断中的价值。方法：16例原发性输尿管癌患者行多层螺旋CT扫描,并在工作站行多平面重组（MPR）、曲面重组（CPR）,分析原发性输尿管癌的多层螺旋CT表现,并与手术病理结果对照。结果：16例原发性输尿管癌CT平扫表现为病变段输尿管壁增厚或结节状软组织密度影,MPR、CPR显示更清晰。增强扫描动脉期、静脉期病变持续强化,接近肾实质强化。延迟期强化程度减退,低于肾实质强化。病变以上输尿管不同程度扩张。结论：多层螺旋CT诊断原发性输尿管癌具有重要价值。     

原发性输尿管癌与输尿管转移癌的螺旋CT诊断

目的 探讨原发性输尿管癌与输尿管转移癌的多层螺旋CT诊断及鉴别诊断要点.资料与方法 回顾性分析经病理证实的12例原发性输尿管癌患者及8例输尿管转移癌患者的多层螺旋CT资料,所有病例常规进行CT平扫及3期增强扫描,并采用CT尿路成像(CTU)、多平面重组(MPR)、曲面重组(CPR)等方法重组,观察输尿管癌和转移癌的影像特点、强化方式及两者的CT表现差别.结果 12例输尿管癌多数发生于左侧;病理为移行细胞癌11例,鳞癌2例;CT表现为输尿管梗阻端管腔内软组织肿块影,增强扫描以静脉期强化较明显,MPR及CPR显示输尿管腔内充盈缺损或管腔中断,并伴有梗阻端以上输尿管、肾盂的轻中度扩张积水;8例输尿管转移癌表现为输尿管管壁增厚或管腔中断以及输尿管周围软组织肿块影,部分病例可合并有管腔内充盈缺损征象,其梗阻上方输尿管明显扩张;增强扫描病变段输尿管的强化程度与原发肿瘤基本一致,CTU显示对比剂通过困难或不能通过,病变输尿管僵硬.结论 多层螺旋CT 3期增强扫描结合CTU、MPR、CPR等后处理技术在原发性输尿管癌及输尿管转移癌的诊断和鉴别诊断方面具有一定的临床应用价值.     

肾盂输尿管移行细胞癌的螺旋CT诊断

目的 评价螺旋CT扫描及三维重建技术对肾盂输尿管移行细胞癌的诊断与鉴别诊断以及临床意义。资料与方法 对27例经临床证实的肾盂输尿管移行细胞癌CT表现、特点进行回顾性分析,所有病例均常规进行平扫,肾皮质期、实质期及排泄期增强扫描,并进行多平面重建（MPR）、曲面重建（CMPR）及容积重建（VR）、最大密度投影（MIP）和仿真内镜（VE）等重组及三维重建。结果 术前CT对25例肾盂输尿管移行上皮癌做出正确诊断。诊断准确率92．59％,对肿瘤分期准确率84％。三维重建有助于明确病变范围、肿块与周围组织的关系,使得病灶形态显示更为全面和直观。结论 螺旋CT扫描及三维重建对于肾盂输尿管移行上皮癌的诊断、鉴别诊断和肿瘤分期有较高的准确性,可为临床制订治疗方案提供依据。     

多层螺旋CT在原发性输尿管癌中的应用

目的:探讨多层螺旋CT在原发性输尿管癌诊断中的价值。方法:搜集7例经手术病理证实的原发性输尿管癌的资料,分析其CT特点。结果:CT增强轴位扫描及MPR/CPR重建能够清楚地显示病变大小、形态、范围及其与周围组织地关系。结论:多层螺旋CT容积扫描及MPR/CPR重建能较好显示病变,使病变定位、定性诊断更加准确,为临床手术治疗提供帮助。     

64层螺旋CT在诊断输尿管病变中的应用价值

目的探讨64层螺旋CT扫描及三维重建技术在输尿管病变中的应用价值。方法回顾分析经手术、病理证实的28例输尿管病变。所有病例均用64层螺旋CT进行平扫和双期增强扫描及延迟扫描，进行曲面重建（CPR）、多平面重组（MPR）、容积重建（VR）。结果28例输尿管病变中，输尿管肿瘤15例，炎性病变6例，结石2例，先天畸形2例，输尿管外病变3例。结论64层螺旋CT扫描及三维重建在输尿管病变诊断中具有较高的应用价值。     

原发性输尿管癌的螺旋CT诊断

目的:探讨原发性输尿管癌的CT表现及螺旋CT三维重建的诊断价值。方法:分析8例经病理证实的原发性输尿管癌的螺旋CT表现。其中6例行平扫及增强扫描,1例平扫,1例逆行尿路造影后行CT平扫。结果:平扫肿块呈轮廓不清的软组织影,增强扫描更清晰;肿块纵向蔓延范围大于横向,MPR或CPR显示更直观。结论:螺旋CT平扫及增强扫描是确诊原发性输尿管癌的必不可少的影像检查方法。     

16层螺旋CT诊断输尿管病变的价值

目的:探讨16层螺旋CT及后处理多种成像技术诊断输尿管病变的价值.材料和方法:对30例输尿管病变患者行螺旋CT泌尿系检查,图像传至ADW4.2工作站,获得容积再现(VR)、多平面重建(MPR)及曲面重建(CPR)等三维重建后处理图像.结果:30例患者中,输尿管结石16例、肿瘤6例、肾及输尿管重复畸形2例、先天性狭窄4例、迷走血管压迫1例和炎症1例.VR、MPR及CPR图像能清晰显示输尿管走行、腔内改变、梗阻部位及原因,还可以同时显示双侧肾及输尿管情况.结论:16层螺旋CT对输尿管病变具有较高的诊断价值.     

多层螺旋CT诊断输尿管移行细胞癌的价值

目的:探讨多层螺旋CT及其三维重建在输尿管移行细胞癌诊断中的价值。方法:总结分析21例经手术病理证实为输尿管移行细胞癌患者的多层螺旋CT(MSCT)资料,进行回顾性分析,所有病例常规进行多平面重建(MPR)、曲面重建(CPR)、部分病例加用容积重建(VR)、最大密度投影(MIP)、仿真内镜重建(VE)。结果:①发生部位:肿瘤发生右侧输尿管12例,左侧输尿管9例,其中发生于上段输尿管3例,中段3例,同时累及中下段6例,下段9例;②6例肿瘤生长方式:肿瘤向管腔内外浸润生长,形成软组织肿块,15例肿瘤沿输尿管内壁爬行生长;③强化特征:肿瘤呈中度强化,CT值较平扫增加约20～30HU;④伴随征像:病变侧肾盂输尿管扩张,肾脏输尿管显影延迟19例,腹膜后淋巴结肿大2例。结论:MSCT可准确显示输尿管移行细胞癌的发生部位、病变范围、形态、病侧输尿管积水扩张和周围侵犯情况,增强扫描间接评价患侧肾脏及对侧肾脏肾功能情况,为外科手术方案选择提供指导依据;MPR和CPR图像在显示病变全貌上具有显著优势。     

多层螺旋CT诊断输尿管病变的价值

目的:探讨多层螺旋CT(Multi-slicespiral CT,MSCT)各种重建技术对输尿管病变的临床应用价值。材料和方法:回顾性分析27例经临床和手术病理证实的输尿管病变的MSCT(平扫12例,多期增强扫描15例)和二维的多平面重建(MPR)、曲面重建(CPR)和三维的最大密度投影(MIP)、遮盖容积重建(SVR)等的表现并评估其诊断价值。结果:27例MSCT扫描并结合后处理技术均能很好地显示输尿管病变的部位、大小、分布范围及其梗阻情况。输尿管病变的MSCT表现与手术所见基本一致,延时期、排泄期采用MPR更清晰地显示输尿管癌和输尿管息肉(11例)。结论:MSCT能更精确、更可靠地显示输尿管病变并为诊断和治疗提供更多的信息,有希望成为输尿管病变的首选检查。     

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.