胰腺实性假乳头状瘤的CT及MRI表现

目的 :探讨CT及MRI对胰腺实性假乳头状瘤(SPTP)的诊断价值。方法 :回顾性分析21例经病理证实的SPTP的CT及MRI资料。结果 :21例均为单发病灶,其中位于胰头7例,胰尾11例,胰体3例;囊实性肿块16例,完全囊性2例,完全实性3例;18例病灶有完整包膜、边界清楚,1例低度恶性病灶包膜不完整,2例较小完全实性病灶未见明显包膜;5例肿瘤有钙化,3例肿瘤术后病理证实病灶内陈旧性出血;增强扫描后囊性部分无强化,实质部分及包膜渐进性强化。结论 :多数SPTP的CT及MRI表现具有特征性,全面分析影像学资料,结合临床资料,可以作出定性诊断。     

胰腺囊实性乳头状瘤临床分析及CT、MRI诊断

目的 探讨胰腺囊实性瘤(SCPTs)CT和MRI表现.方法 经手术及病理证实SCPTs 8例,均经CT平扫及增强扫描,3例MRI检查,其中2例MRI增强扫描.结果 肿瘤位于胰体、尾部7例,1例位于胰头部.肿瘤最大径平均7.6 cm.肿瘤界限清楚,包膜完整,CT平扫呈不均匀囊实性,实性结构为不规则状或呈乳头状,中心囊性部分密度较低.增强扫描肿瘤实性成分动脉期轻度强化,实质期呈中等或明显强化.肿瘤壳状及结节样钙化5例,1例肿瘤自发性破裂出血,1例胰管轻度扩张.MRI检查显示胰腺边缘清楚囊实性肿物,T1WI呈不均匀等-低混杂信号,1例瘤体内高信号,为亚急性出血.T2WI呈不均匀混杂高信号中,可见低信号区.增强扫描肿瘤实性和乳头状组织及囊壁强化.结论 SCPTs具有一定的临床,CT及MRI影像学特点,可以帮助作出正确的诊断.     

胰腺实性-假乳头状瘤的CT诊断与病理分析

目的:分析胰腺实性假乳头状瘤(SPTP)的CT表现,并与病理结果对照分析,旨在提高对该病的认识和诊断.方法:回顾性分析6例经手术和病理证实的胰腺实性假乳头状瘤的临床及CT表现,将CT表现与临床及病理对照.结果:SPTP好发于20～40岁女性,胰头及胰尾为好发部位,影像学表现为境界清楚的圆形或类圆形胰腺肿块,瘤体通常比较大(>5cm).平扫主要表现为囊实性混杂密度影,实性结构边缘分布为主,部分呈乳头状或壁结节样突起.动态增强后实性部分早期轻度强化,后期呈渐进性强化,6例肿瘤均有包膜,多伴有出血及囊变,所有病灶无论大小及在胰腺中的位置,均未见胰管及胆管扩张,腹腔淋巴结肿大及远处转移罕见.结论:胰腺实性假乳头状瘤影像学表现具有相对特征性,CT对其诊断有重要价值.     

胰腺实性-假乳头状瘤的CT诊断和鉴别诊断

目的 描述胰腺实性-假乳头状瘤的CT表现，探讨CT对该肿瘤的诊断价值。方法 回顾分析经手术、病理证实的11例胰腺实性-假乳头状瘤的CT表现和诊断。结果 (1)肿瘤内有实性和囊性结构，CT平扫实性结构呈低或等密度，造影后动脉期呈轻度强化，门静脉期呈明显强化，囊性部分在增强前后扫描均呈低密度。(2)囊实性结构比例相仿的肿瘤7例，囊性结构为主者3例，其CT表现分别为囊实部分相间分布或实质部分呈附壁结节。(3)实性结构为主的肿瘤1例，其CT表现为囊性部分位于包膜下。(4)肿瘤绝大多数来源于胰腺，呈圆形、椭圆形，多有完整包膜，增强后强化明显，与胰腺分界清晰。(5)不伴有胆总管和胰管扩张。(6)8例术前诊断为良性、3例诊断为低度恶性肿瘤。结论胰腺实性-假乳头状瘤CT表现有一定特征，且CT诊断有其重要价值，需与黏液性或浆液性囊腺瘤、囊腺癌、胰腺癌囊变、胰性假性囊肿等进行鉴别。     

胰腺实性假乳头状瘤的CT诊断价值

目的探讨胰腺实性假乳头状瘤(SPTP)的CT表现特点,提高对其术前诊断的准确率。方法回顾性分析经手术病理证实的SPTP 20例。术前均行常规CT平扫及增强检查。结果病灶位于胰头7例,5例位于胰颈,8例位于胰体尾部。肿瘤直径2～14.3cm,15例包膜显示清晰,5例包膜显示欠清晰。15例呈囊实混合型,2例以囊性成分为主,3例以实性成分为主。11例病灶内可见钙化。18例病灶实行成分呈渐进性延迟强化,2例以囊性成分为主病灶,动脉期包膜及壁结节即明显强化,延迟期持续强化。结论大多数SPTP具有典型的MSCT特点,结合临床特点可以对绝大多数病变做出正确的术前诊断。     

胰腺实性假乳头状瘤的CT表现(附12例报告并文献复习)

目的探讨胰腺实性假乳头状瘤(SPTP)的CT影像特征。方法回顾性分析12例经手术病理证实的SPTP患者的临床及CT资料,并复习文献。结果 11例患者为女性,1例为男性,年龄13~52(34.6±2.0)岁。均为单发病灶,其中胰头部4例,胰颈2例,胰体尾部6例。肿瘤体积较大,平均直径约(6.5±1.6)cm,形态规则,边界清晰。CT影像呈外生性生长的囊实性肿块,密度不均匀,6例见钙化,2例见出血。增强动脉期,门静脉期及延迟期实性成分强化逐步增强,呈渐进性强化方式,强化程度低于正常胰腺实质,囊性成分无强化,并见较明显均匀强化的纤维包膜。12例均未见胰管及胆管扩张。结论胰腺囊实性病灶,伴钙化、出血,增强呈渐进性强化,包膜明显强化的CT表现特征,结合临床资料,可提高SPTP的正确诊断。     

胰腺实性假乳头状瘤的CT征象分析

目的：探讨胰腺实性假乳头状瘤（SPTP）的CT征象,提高对本病的诊断能力。方法：回顾性分析经手术和病理证实的10例SPTP患者的CT资料,其中女8例,男2例,年龄12-54岁,平均27.2岁。10例患者术前均行螺旋CT胰腺平扫与增强扫描。结果：10例SPTP均表现为孤立肿物,其中5例位于胰头,4例位于胰尾,1例位于胰体。3例肿块呈类圆形,4例呈卵圆形,3例呈不规则形,肿块最大径2.1-8.6 cm,平均6.5 cm。肿瘤全部由实性和囊性成分构成,以实性组织为主者5例,囊、实结构比例相近3例,以囊性结构为主者2例。动态增强扫描实性部分呈渐进性强化,囊性部分无强化。5例肿瘤的实体部分可见线形、小结节或斑块状钙化。1例肿瘤内可见液体-碎屑平面及＂浮云征＂。1例囊性为主肿瘤CT平扫囊性成分中见片状高密度影,术后病理证实为陈旧性出血。7例肿瘤有完整包膜,增强后强化明显,3例包膜不完整,手术见与周围组织有粘连,其中1例镜下可见侵犯邻近下腔静脉旁脂肪组织及十二指肠壁。肿瘤引起胰管增宽与肝管扩张各1例。所有病例均未见腹腔淋巴结肿大及远处脏器转移。结论：胰腺实性假乳头状瘤主要见于青年女性,具有相对特征的CT表现,即胰腺较大囊实性肿物,边缘清晰,实性部分呈渐近性强化,少数伴出血、钙化。     

胰腺实性假乳头状瘤的影像学分析

目的:分析胰腺实性假乳头瘤的影像学表现.提高其术前诊断率.方法:回顾性分析经手术、病理证实的5例胰腺实性假乳头瘤的影像表现和特征.结果:肿瘤绝大多数来源于胰腺,呈圆形、卵圆形.多有完整包膜,与胰腺分界清晰.CT、MRI表现为肿瘤内有实性结构和囊性结构.根据囊实性结构成分的比例可分为3型.CT平扫呈不均匀囊实性,实性结构为不规则状或乳头状,中心囊性部分密度较低.增强扫描肿瘤实性部分动脉期轻度强化.实质期呈中等或明显强化,呈渐进性强化.肿瘤斑线样外周钙化2例.MRI扫描显示胰腺边缘清晰囊实性肿物,T1WI上呈不均匀等一低混杂信号,T2WI呈不均匀混杂高信号.增强扫描肿瘤实性部分和囊壁强化.结论:SPTP具有一定的临床、CT及MR影像学特征,有助于医师做出正确诊断.     

胰腺实性假乳头状瘤的超声及CT表现

目的分析胰腺实性假乳头状瘤(SPTP)的超声及CT表现。方法回顾性分析经手术病理学检查证实的11例胰腺实性假乳头状瘤的影像资料,11例均接受超声检查,8例同时行CT扫描。结果超声显示6例呈囊实性,含纤维包膜,与周围正常胰腺分解清楚; 5例呈实性,无包膜; 4例显示钙化;多普勒超声显示4例有少量至中量血流。同时行CT检查的患者,CT平扫显示5例为囊实性混杂密度肿块,3例为实性,2例显示钙化,动脉期实性部分呈现轻度强化,静脉期及延迟期实性部分、壁结节及包膜进一步强化,囊性部分无强化。结论胰腺实性假乳头状瘤的超声及CT表现具有一定的特征性,熟悉这些影像表现有助于准确诊断。     

小甲状腺癌的CT表现分析

目的 分析小甲状腺癌的CT表现,探讨其CT征象.方法 对40例CT平扫及增强扫描后经手术病理证实的直径在1.0～2.0 cm的小甲状腺癌的CT表现进行回顾性分析.结果 (1)38例为单发癌灶,2例为双侧双发癌灶;2例合并对侧结节性甲状腺肿,1例合并对侧甲状腺腺瘤;(2)边缘光整,包膜完整者8个病灶;边缘不光整,包膜不完整者34个病灶,但未见明显周围软组织及重要器官侵犯;(3)病灶平扫密度均匀或较均匀,未见明显出血或坏死囊变区;病灶内伴钙化者30个病灶,钙化形态各异,以砂粒状多见(20个病灶),也可见不规则结节状、蛋壳状或桑椹状钙化;(4)增强后41个病灶明显强化(强化幅度＞40 HU,CT值在90～140 HU之间),其中38个病灶均匀强化,3个病灶中央强化明显,边缘可见一环形低密度影,呈镶嵌征;(5)伴颈部淋巴结肿大者24例(60.0%),可呈实性、囊实性或囊性,增强后可呈均匀明显强化、不规则环形强化或壁结节样强化;8例淋巴结内可见砂粒状、结节状或蛋壳状钙化.结论 砂粒状钙化、甲状腺包膜不完整、强化明显的甲状腺实性结节及伴钙化、囊变、实性部分明显强化的颈部肿大淋巴结为小甲状腺癌较为特征性的CT表现.     

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.