超声造影与增强CT对肝脏良恶性病变的诊断价值研究

目的：比较超声造影和增强CT对肝脏良恶性病变的诊断价值。方法：对同时接受肝脏超声造影和增强CT检查的肝内局灶性病变48例进行分析,重点对肝内局灶性病变良恶性判断的敏感度、特异性、预期准确度及病理符合率进行比较。结果：超声造影对肝脏局灶性病变良恶性判断的敏感度为96．7％,特异性为94．1％,预期准确度96．8％,病理类型符合率为84．7％;增强CT则分别为90．7％、92．8％、0.96．7％和86．9%。结论：超声造影对肝脏局灶性病变有较高诊断价值,与增强CT相结合可进一步提高病理诊断符合率。     

超声造影鉴别肝脏局灶性病变良恶性的临床意义

目的评价超声造影技术在鉴别良恶性肝脏局灶性病变中的临床意义,并与常规超声比较。方法 83例经穿刺活检及手术或临床证实的肝脏局灶性病变(38例恶性和45例良性)均经常规超声和超声造影检查,对肝脏局灶性病变在造影检查中的强化型式与时相特征逐例进行了观察与记录,并用卡方检验比较了两种方法对肝脏局灶性病变的诊断效能。结果肝脏局灶性病变随其良性与恶性而表现为不同的强化型式与时相特征。超声造影正确诊断34例恶性和43例良性病变,其诊断敏感性、特异性和准确性分别为89.5%、95.6%和92.8%,而常规超声正确诊断23例恶性和22例良性病变,其诊断敏感性、特异性和准确性分别为60.5%、48.9%和54.2%。两种方法诊断效能比较有统计学差异(P<0.01)。结论超声造影技术在肝脏局灶性病变良恶性鉴别诊断中具有重要的临床应用价值,并可取代常规超声。     

超声造影检查肝脏局灶性病灶的临床价值分析

目的探讨超声造影在肝脏局灶性病变良恶性临床鉴别与诊断中的应用价值。方法对收治的肝脏局灶性病变患者分别采用常规超声和实时超声造影(contrast-enhanced ultrasound,CEUS)进行检查,以手术病理确诊结果为金标准进行两种方法的诊断效果进行对比分析。结果病理确诊病灶类型:肝细胞肝癌38例,血管瘤8例,局灶性结节性增生3例,不均匀脂肪肝5例,硬化结节6例,结核球2例,术后包裹性积液1例,肝转移癌5例。常规超声诊断肝脏局灶性病变的敏感性为65.12%,特异性为72.00%,准确性为67.65%;超声造影诊断肝脏局灶性病变的敏感性为88.37%,特异性为92.00%,准确性为89.71%;经统计学分析发现发现超声造影对肝脏局灶性病变诊断的敏感性为、特异性、准确性明显高于常规超声,且差异具有统计学意义。恶性组的开始增强时间、增强峰值时间、消退时间及峰值强度与良性组比较存在明显差异,且差异具有统计学意义。结论应用时间-强度曲线取得的超声造影定量参数变化特征能够反映肝肿瘤微小血管血流分布情况及灌注量,对鉴别诊断肝脏局灶性病变具有较高的临床应用价值。     

实时超声造影在肝脏局灶性病变诊断中的应用

目的:评价实时超声造影技术在肝脏局灶性病变诊断中的作用及意义.方法:采用实时超声造影技术,对我院269例肝脏局灶性病变进行超声造影检查.结果:92.4%恶性病变动脉相呈现回声增强.病灶动脉相呈现高增强或等增强、延迟相消退为低增强或无增强,在良性病变中占13.8%(19/138),恶性病变中为94.7%(124/131);实时超声造影诊断肝脏局限性病灶的敏感度89.6%,特异度97.5%,诊断符合率93.2%.结论:实时超声造影可显示肝局灶性病变的血流灌注特点,对肝局灶性病变的分类诊断有重要的应用价值.     

超声造影对良恶性肝脏局灶性病变的鉴别诊断价值

目的：探讨超声造影（CEUS）对良恶性肝脏局灶性病变（FLL）的鉴别诊断价值。方法：应用超声造影反向脉冲谐波显像（PIH）技术实时观察52例（57个病灶）FLL血流灌注增强方式,并通过TIC定量参数对FLL血流灌注进行定量评估。结果：37个恶性病灶与20个良性病灶比较,各参数（始增时间、达峰时间、峰值强度、始消时间、消退后强度、峰值强度与延迟期强度差值）差异均有统计学意义（P〈0.05）。当将病灶峰值强度与消退后的差值为7dB作为鉴别诊断良、恶性病灶的区分点时,诊断良、恶性病变的符合率分别为91%和90%。结论：肝脏局灶性病灶峰值强度和消退后强度的差值对于FLL的良恶性鉴别诊断有重要价值。     

超声造影定量分析在肝内局灶性病变定性诊断中的应用价值

超声造影技术(contrast-enhanced ultrasound,CEUS)是本世纪初在欧洲发端,2004年引入我国,其中经验最成熟的是以肝脏为主的局灶性病变的定性诊断。超声造影能反映肝脏局灶性病变的真实灌注状态,通过分析造影剂灌注特点来达到定性诊断的目的[1,2],为肝脏肿瘤的良恶性鉴别提供了很好     

超声造影与CT增强扫描对肝占位性病变的诊断价值比较

目的 :对比超声造影与CT增强扫描在肝占位性病变中的诊断价值,为临床诊断肝占位性病变提供参考依据。方法 :回顾性分析71例肝占位性病变患者的临床资料,比较超声造影与CT增强扫描的诊断阳性率,对比2种检查方法的诊断价值。结果:超声造影对肝癌、肝血管瘤及肝局灶性结节增生的诊断阳性率分别为83.33%、88.00%及82.14%,而CT增强扫描分别为88.89%、92.00%及85.71%,2种检查方法的诊断阳性率比较差异无统计学意义(P0.05)。此外,2种检查方法对肝癌、肝血管瘤及肝局灶性结节增生均具有较高的诊断效能(P0.05)。结论:超声造影与CT增强扫描对肝占位性病变的诊断价值相当。     

实时超声造影技术诊断肝脏微小局灶性病变的价值

目的:探讨肝脏微小局灶性病变(最大径≤2cm)的实时超声造影诊断价值。材料和方法:对205个≤2cm肝脏局灶性病变分别进行实时超声造影及常规超声检查,将诊断结果分为良性、恶性和不能确定,最终诊断经病理学、同期其他影像及实验室检查证实,并随访10~30个月。结果:恶性肿瘤65个病灶,良性病灶140个。与病理诊断比较,超声造影诊断的敏感性、特异性及准确性分别为85.0%、90.5%及88.5%,常规超声分别为40.0%、47.6%及42.6%。病灶动脉期高增强及门静脉期或延迟期低增强为诊断恶性的重要指标。结论:实时超声造影技术对鉴别诊断肝脏微小(≤2cm)局灶性病变具有重要的临床应用价值。     

常规超声、超声造影及弹性成像在甲状腺结节良恶性鉴别中的价值

目的探究常规超声、超声造影及弹性成像对甲状腺恶性结节鉴别诊断的价值。方法选取80例甲状腺结节患者(共113个结节)作为研究对象,均进行常规超声、超声造影以及超声弹性成像检查,以手术病理结果为金标准,比较常规超声、超声造影以及弹性成像超声诊断甲状腺结节良恶性的灵敏度、特异度及符合率。结果常规超声检查显示甲状腺良恶性结节的边界、形态及内回声等声像表现存在明显差异(P0.05)。超声造影检查显示甲状腺良恶性结节的边界是否清晰、形态是否规则、是否为均匀增强及灌注缺损的等方面存在明显差异(P0.05)。弹性成像检查结果显示甲状腺良性、恶性结节的弹性评分存在明显差异(P0.05)。超声造影以及弹性成像超声诊断的灵敏度、特异度及符合率较常规超声有明显差异(P0.05)。超声造影及弹性成像超声诊断相比较(P0.05)。结论常规超声可根据结节边界、形态及内回声等特征对甲状腺良恶性结节进行初步判断,而结合超声造影、超声弹性成像诊断与鉴别价值更高。     

超声造影与彩色多普勒超声诊断肝实质性肿块对照研究

 目的 比较彩色多普勒超声和实时超声造影对肝实质性肿块的诊断价值.方法 应用彩色多普勒超声及超声造影技术对常规二维超声难以定性的27例共31个肝实质性肿块进行检查,结果与手术及病理结果相对照.结果 31个肿块中原发性肝细胞性肝癌24个,肝血管瘤3个,肝脏局灶性结节增生3个,肝孤立性坏死结节1个.彩色多普勒超声在肿块内部或肿块周边能检测到动脉血流频谱者共19例21个肿块;超声造影除一例肝孤立性坏死结节外,其余30个病灶均在不同时相出现不同程度强化现象.如以动脉相呈高回声而门脉相及延迟相呈低回声为恶性肿块的诊断标准,则超声造影对肝癌诊断的准确率为91.67%;如以肿块内部检测到动脉样血流频谱为诊断恶性肿块的诊断标准,则彩色多谱勒超声诊断肝癌的准确率为75%.超声造影诊断肝实质性肿块准确率为93.54%,彩色多普勒超声诊断肝实质性肿块准确率为64.52%.二者差别有统计学意义(P＜0.05).结论 实时超声造影显著提高肝内实质性肿块的诊断准确性,对肝脏实质性肿块良、恶性的诊断及鉴别诊断具有重要价值.     

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.