MRI对胎儿肠管扩张的诊断价值

目的 探讨MRI评估胎儿肠管扩张的诊断价值。方法 回顾性分析45例MRI诊断胎儿肠管扩张的影像资料，测量扩张肠管的最大径，记录扩张肠管信号，随访胎儿产后手术或病理结果。采用Spearman相关系数探讨扩张肠管直径和信号与随访结果之间的关系。结果 其中十二指肠梗阻6例，空肠梗阻11例，回肠梗阻17例，结肠梗阻6例，产后正常5例。胎儿扩张肠管T₁WI信号与肠梗阻水平呈显著正相关(P<0.001),扩张肠管T₂WI信号与肠梗阻水平呈显著负相关(P<0.001)。扩张肠管直径与肠梗阻水平呈显著正相关(P<0.001)。结论 MRI能辅助诊断肠梗阻程度以及梗阻水平，为产前诊断、评估预后提供更多有价值的信息。     

胎儿肠管扩张的MRI诊断与临床结局分析

目的 观察胎儿期肠管扩张MRI表现,产后追踪引起肠管扩张的不同病因,探讨MRI对胎儿期肠管扩张的诊断价值。方法 回顾性分析胎儿肠管扩张105例患者资料,胎龄为孕24～40周,均先行胎儿超声检查后再行胎儿MRI平扫。所有图像由两名胎儿MRI诊断医师在不知道最终结果的情况下阅读并评价。记录扩张肠管的内径及信号,梗阻远端肠道情况,以及一些其他异常如腹腔积液、腹腔囊性灶等。结果 105例肠管扩张胎儿中,环状胰腺20例,十二指肠闭锁17例,小肠闭锁36例(其中18例合并胎粪性腹膜炎),回肠狭窄2例(1例合并胎粪性腹膜炎),小肠扭转1例(合并胎粪性腹膜炎),肠系膜囊肿2例,淋巴管畸形1例,另外有26例出生后表现为正常。MRI能清楚显示胎儿肠梗阻部位,观测肠管扩张的程度。根据十二指肠扩张范围预测“双泡征”的梗阻原因,另外可以根据梗阻段信号的改变推测小肠梗阻的水平。结论 胎儿期肠管扩张MRI图像有特征性改变,可以判断梗阻水平、梗阻程度和合并症等,对产前诊断和出生后手术治疗有重要参考价值。     

舌部良性占位性病变的MRI影像表现

目的 通过分析舌部良性病变的MRI表现,提高MRI对舌部良性病变的诊断。方法 选取并分析手术病理证实的43例舌部病变患者术前MRI及临床资料。结果 43例患者,其中血管瘤7例,T₂WI见流空信号;炎性病变11例,呈斑片状长T₂信号;乳头状瘤及良性增生共4例,呈多发斑点状或团块状等T₁长T₂信号;囊肿及囊肿样病变共16例,多位于口底的长T₁长T₂信号;异位甲状腺2例,呈等T₁稍短T₂混杂信号;神经鞘瘤1例,呈T₂WI不均匀等高信号;脂肪瘤1例,压脂序列呈低信号;淀粉样变性1例。结论 MRI检查对于舌部良性病变的诊断与鉴别诊断具有重要价值。     

女性生殖器结核磁共振成像表现

目的 探讨女性生殖器结核的磁共振成像(MRI)特征。方法 回顾性综合分析经临床或病理证实女性生殖器结核7例患者的临床及影像资料,总结其MRI影像特征。结果 7例均有双侧输卵管不同程度扩张,管壁弥漫性增厚,其中3例呈弯曲指状轻度扩张,管腔充满实性病灶;2例呈腊肠样中度扩张,管腔充满实性病灶夹杂少量积液;2例近段呈弯曲管状轻度扩张,管腔充满实性病灶,远段呈囊状重度扩张,囊腔充满液体及液-液平面。增厚的管壁及管腔内实性病灶较子宫肌层呈稍短T₁等T₂信号,扩散加权成像(DWI)呈高信号,增强后管壁明显强化,管腔内实性病灶无强化。2例伴有子宫结合带多处局限性中断模糊。7例均伴有游离性或包裹性、游离性并存腹盆腔积液,其中5例伴有腹膜、网膜增厚、僵硬,盆腔脏器粘连;增厚的腹膜、网膜较子宫肌层呈稍短T₁等T₂信号,DWI呈高信号,增强后明显强化。结论 双侧输卵管扩张,增厚管壁、管腔实性病灶及增厚腹膜较子宫肌层呈稍短T₁等T₂信号、DWI高信号,盆腔包裹性积液,可伴有子宫结...     

小肠磁共振水成像的诊断价值

目的：探讨利用口服液体和肠梗阻的液体行磁共振水成像对小肠疾病的诊断价值。材料和方法：对23例临床怀疑小肠疾病的患者行小肠磁共振水成像检查。其中1例小肠严重梗阻患者直接利用梗阻肠腔的液体行磁共振水成像，其余22例均间断口服2．5％等渗甘露醇共1500ml作为肠道造影剂，并静脉注射山莨菪碱(654—2)20mg以抑制肠蠕动，行带脂肪抑制的冠状面T2WI单次激发快速自旋回波(single—shot FSE，SSFSE)和T1WI快速干扰梯度回波(fast spoiled gradient echo，FSPGR)序列平扫及冠状面和横断面FSPGR序列增强扫描。将MRI诊断结果与手术、病理结果或临床诊断对照。结果：正常小肠9例，克罗恩病(Crohn病)7例，低位小肠梗阻2例(分别由肿瘤和慢性非特异性炎症引起)，十二指肠肿瘤、十二指肠球炎、十二指肠结肠瘘、空肠毛细血管扩张症和小肠旋转不良各1例。1例空肠毛细血管扩张症MRI未发现异常，其余各例的MRI诊断结果均与手术、病理结果或临床诊断一致。本组病例中，MRI对小肠器质性病变诊断的敏感度为93％。结论：磁共振水成像是诊断小肠器质性疾病的一种敏感的检查方法，尤其对诊断小肠克罗恩病、肿瘤以及鉴别小肠梗阻原因具有重要价值。     

宫颈小细胞神经内分泌癌的临床及影像表现分析

目的:总结宫颈小细胞神经内分泌癌的临床及影像表现。方法:回顾性分析经病理学确诊为宫颈小细胞神经内分泌癌的33例患者的临床资料与MRI及CT图像特征。结果:33例宫颈小细胞神经内分泌癌患者中淋巴结转移者占42.4%,HPV阳性者占82.4%。33例患者中81.8%为外生性，18.2%为内生性，外生性肿块中5例呈类圆形及类椭圆形，22例呈不规则形及分叶形。肿块的CT表现呈不均匀的轻度到中度强化，MRI表现呈等T₁稍长T₂信号且T₂信号均匀，病灶DWI呈高信号，ADC值平均值为(0.54±0.11)×10^-3mm²/s。结论:宫颈小细胞神经内分泌癌影像表现多为外生性肿块，CT及MRI增强呈不均匀强化，其中CT多呈轻中度强化，MRI呈等T₁稍长T₂信号，信号较为均匀，DWI明显扩散受限。     

CT联合MRI在华法林致非创伤性自发性小肠壁内血肿的临床应用

目的探讨CT联合MRI在华法林致非创伤性自发性小肠壁内血肿的临床应用。方法选取14例华法林致非创伤性自发性小肠壁内血肿患者的临床资料,分析影像学表现。结果本组14例患者CT原发征象:1)肠壁增厚;2)肠壁密度增高。CT继发征象:1)肠腔狭窄;2)肠壁积气;3)肠周改变及其他伴发征象。MRI表现:T+1黏膜下层高信号,T+2信号不同程度增高,DWI呈弥漫高或稍高信号,T₂^*呈低信号。治疗情况:未经正确治疗的3例复查均表现为原征象无改善或加重。正确治疗的11例复查,10例原征象减轻或消失。结论对正在接受抗凝治疗的患者,突发腹痛伴凝血功能异常,CT显示肠壁增厚及密度增高、腹腔积血,伴肠腔狭窄、肠梗阻、肠周和肠系膜区积血,高度提示本病可能,MRI上T₁WI呈同心环或弹簧样高信号,DWI呈弥漫高信号,T₂^*呈低信号。     

沟槽区胰腺炎的CT和MRI表现特征

目的 探讨沟槽区胰腺炎的CT和MRI表现特征，以提高对该病的认识和诊断水平。方法 选取17例经手术或内镜证实的沟槽区胰腺炎患者的CT、MRI及临床资料，观察沟槽区及临近结构的影像学特征。结果 17例沟槽区胰腺炎CT及MRI表现：胰头与十二指肠降段间占位，CT为低密度，MRI表现T₁WI均为低信号，8例T₂WI为高信号，5例T₂WI为低信号，增强呈延迟强化；17例均有十二指肠降段壁增厚，10例肠壁囊肿形成；3例可见胰管扩张；4例胆总管下段渐进性狭窄；4例可见双管征。结论 沟槽区胰腺炎的CT和MRI表现具有一定的特征性，结合临床有助于明确诊断。     

胎儿腹部异常的MRI诊断及评价

目的分析胎儿几种腹部异常的MRI表现,说明MRI在胎儿异常诊断中的重要补充作用。资料与方法对14例(12例经剖腹产或手术病理证实,2例随访观察)的胎儿腹部畸形的MRI表现进行研究。结果14例中5例为脐部畸形,其中3例为脐膨出,2例小型,囊内为大网膜及小肠成分;另1例为巨型,囊内容物为肝脏及肠腔;2例为腹裂,突出物为肠腔结构。2例为肠系膜囊肿,胎儿腹腔内见囊样占位灶,1例直径约5cm,另1例巨大,直径约10cm。1例为先天性肛门闭锁,MRI表现为全肠腔明显扩张。1例先天性巨结肠,以直肠扩张为主的肠腔扩张。1例为先天性十二指肠闭锁,MRI表现为胃泡明显扩张,胃泡右侧、肝脏下缘见囊样信号灶,呈双泡征表现。1例为环状胰腺、异位胰腺,MRI表现为十二指肠扩张,呈不全性梗阻改变。1例为肝脏囊肿,MRI表现为肝右叶前段包膜下囊性病灶,大小约3.1cm×2.7cm×2.4cm。1例为双肾轻度积水,MRI见双侧肾盂稍饱满,肾盏略增宽。1例为左侧膈疝,MRI见左侧胸腔内正常肺组织消失,呈混杂肠腔信号。结论MRI作为产科胎儿超声检查的一种重要补充方法,对病变多方位的显示具有较高价值,对临床诊断及治疗有重要意义。     

MRI对肝吸虫性肝内胆管细胞癌的诊断价值

目的：探讨MRI对肝吸虫性肝内胆管细胞癌的诊断价值及肝吸虫病与肝内胆管细胞癌的病理机制。方法：收集20例经穿刺或手术病理证实为肝吸虫性肝内胆管细胞癌的MRI表现,主要包括发病部位、大小及形态、信号特点、增强扫描强化方式及周围胆管扩张的特点。结果：①肿块型8例,主要表现为肝内类圆形或椭圆形肿块,T₁WI以低信号为主,部分病灶可夹杂高信号,T₂WI呈不均匀高信号,DWI呈明显高信号,增强扫描病灶呈向心性强化;②腔内型5例,病灶局限于胆管内生长,主要表现为息肉状或乳头状肿块,T₁WI呈低信号,T₂WI呈高信号,DWI呈高信号,增强扫描未见明显强化;③浸润型7例,肿块沿胆管呈浸润性生长,继发局部胆管壁增厚、远端胆管扩张,T₁WI呈低信号,T₂WI呈稍高或混杂信号,DWI呈高信号,增强扫描病灶呈渐进性强化。结论：肝吸虫感染引起局部胆管慢性炎症,是诱发肝内胆管细胞癌的重要因素。MRI不仅可显示肿块,还可显示其引发的周围胆管扩张等特征性改变,对肝吸虫性肝内胆管细胞癌的诊断具有重要价值。     

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.