三维对比增强MR血管成像在头颈部的临床应用

目的:探讨三维对比增强MR血管成像(3DCE-MRA)在头颈部的临床应用价值。材料和方法:应用3D小角度激发快速梯度回波序列,对76例临床疑头颈部血管疾病患者进行3DCE-MRA检查。结果:76例3DCE-MRA均获成功,3DCE-MRA图像明确显示了病变部位及范围。结论:3DCE-MRA快速、准确,有利于头颈部血管疾病的诊断和治疗。     

三维对比增强MR血管造影技术及临床应用

目的探讨三维对比增强MR血管造影(3DCE-MRA)技术及其临床应用价值。资料与方法应用3D小角度激发快速梯度回波序列(3D FLASH),对32例临床疑血管疾病患者行3DCE-MRA,重建方法为最大密度投影(MIP)及多平面重建(MPR),并对两种方法进行评价。结果32例3DCE-MRA均获成功,其中26例经手术病理或DSA证实,3DCE-MRA图像明确显示了病变部位及范围;在显示血管病变方面,MIP及MPR各有其优势。结论3DCE-MRA快速、安全、有效,有利于血管疾病的检出,可以为临床提供更丰富的信息。     

透视触发技术在椎动脉三维增强磁共振血管成像的应用分析

三维增强磁共振血管造影（three dimension con：rast enhanced MR angiography.3D CE-MRA）利用对比剂造成血管组织间的对比进行血管成像．因其具有简便易行、图像清晰的特点在临床上应用越来越广。在椎动脉3DCE-MRA中,为了捕捉到椎动脉显影最佳时相并减少静脉重叠,     

静脉套管针在磁共振血管造影技术中的应用

一种无创的检查手段[1],三维增强磁共振血管造影(3DCE-MRA)是目前用于体部血管检查的最先进的MR技术之一。在血管造影过程中对比剂的注射方式直接影响成像质量,特别是对于下肢动脉硬化闭塞症的患者,在扫描过程中由于床位的不断进出,使针头易刺破血管,造成液体渗漏,增加患者不必要的痛苦和费用。为此我们选用静脉套管针进行穿刺,提高了磁共振血管造影的成功率。现报告如下。1材料与方法1.1临床资料2005年1月~2006年3月共做3DCE-MRA 862例,其中男446例,女416例,年龄17~85岁。将其分为套管针组及头皮针组。1.2检查设备和对比剂采用Siemen…     

颅内动脉瘤 3D DCE-MRA与DSA对照研究

目的 探讨三维动态增强MR血管造影(3D DCE-MRA)在颅内动脉瘤诊断中的价值. 资料与方法 对39例临床拟诊动脉瘤和常规MRA可疑动脉瘤的患者行3D DCE-MRA,随后行DSA,比较两种方法 对颅内动脉瘤的显示情况. 结果 34例动脉瘤患者中共有动脉瘤41个,3D DCE-MRA对动脉瘤诊断的敏感性为95%,特异性为80%,准确性为85%,3D DCE-MRA与DSA比较,差异无统计学意义(P>0.05). 结论 3D DCE-MRA是一项无创、安全、简便和可靠的诊断颅内动脉瘤的方法,对于颅内较大血管的动脉瘤的显示,可以取代DSA.     

三维动态增强MR血管造影对颅内动脉瘤的诊断价值

目的 评价三维动态增强磁共振血管造影(3D DCE-MRA)在颅内动脉瘤诊断中的价值。方法 对54例高度怀疑有颅内动脉瘤的病人行3D DCE-MRA检查，随后行DSA造影及可行的血管内栓塞治疗。3D DCE-MRA用超快速三维梯度回波序列(3D FISP)(钆喷替酸葡甲胺0．2mmol／kg,1次扫描时间10s)，工作站上三维重建，比较3D DCE-MRA及常规DSA在显示动脉瘤、瘤颈及与载瘤动脉关系上的优劣，及对血管内栓塞治疗的价值。结果 39例脑动脉瘤患者共45个动脉瘤，3D DCE-MRA对动脉瘤的敏感度为96％，特异度73％，准确度90％。3D DCE-MRA对动脉瘤细节及瘤颈的显示明显优于常规DSA，尤其是颈内动脉海绵窦部及椎动脉近小脑后下动脉的动脉瘤，可指导DSA显示动脉瘤方向及预先制定治疗方案。但对周边部及动脉分岔处小动脉瘤的诊断应谨慎。结论3D DCE-MRA能无创有效地诊断颅内动脉瘤，所提供的三维信息对治疗方案的制定具有极大帮助。当诊断有怀疑时，应结合DSA检查。     

透视跟踪技术3DCE-MRA在诊断下肢动脉病变中的应用

目的探讨透视跟踪技术三维动态增强磁共振血管造影(3DCE-MRA)在下肢动脉病变中的临床应用价值。方法在161例疑有下肢血管病变做下肢3 D CE-MRA的患者中随机抽取50例,对其成像表现及均值曲线(mean curve)进行回顾性分析。结果当靶血管感兴趣区(腹主动脉腹腔干水平)对比剂信号强度mean值上升到40～60范围内开始触发扫描,也就是感兴趣区有造影剂显影第4～6s触发扫描能准确地观察3段(下腹及盆腔、大腿、小腿)动脉血管,3段血管充盈饱满并且静脉干扰少。结论透视跟踪技术3 DCE-MRA能较好地显示下肢动脉病变的范围和程度,具有操作简便、快捷、节省造影剂用量等优点,而触发扫描时间点的正确选择更有利于动脉病变的检出,可为临床诊断提供更准确的信息。     

抑脂三维动态增强磁共振血管成像对胰腺癌胰周血管侵犯的手术可切除性评价

目的 探讨抑脂三维动态增强磁共振血管成像(3D DCE-MRA)判断胰腺癌胰周血管侵犯的敏感性与特异性,并评价其临床价值.方法 收集临床怀疑胰腺癌病例65例,依据增强扫描方法的不同分为A、B 2组.对A、B组中经手术及病理证实的22例和21例胰腺癌患者,统计SE T1WI、DCE FMPSPGR、3D DCE-MRA及横断面MRI(包括SE T1WI+延迟期DCE FMPSPGR)图像上血管累及条数,同手术病理结果相对照,并计算各自对胰腺癌胰周血管侵犯判断的敏感性、特异性、阳性预测值及阴性预测值,并行统计学检验.结果 在胰腺癌侵犯胰周血管的评价中,3D DCE-MRA的敏感性和特异性分别为85.7%、97.1%.MRA+MRI同MRI之间在判断血管可切除性上有统计学差异.MRA+MRI与SE T1WI+DCE FMPSPGR相比,在胰周血管受侵的判断上,前者优于后者,但无统计学差异.结论 3D DCE-MRA在胰腺癌侵犯胰周血管的手术可切除性评价中具较重要临床价值,结合横断面图像可进一步提高判断的准确率.     

磁共振弥散成像与血管成像在短暂性脑缺血发作中的应用

目的 评价磁共振弥散成像(DWI)与血管成像(TOF-MRA、3DCE-MRA)对短暂性脑缺血发作(TIA)的应用价值.方法 对176例临床证实为TIA患者行MRI(FLAIR)、DWI、TOF-MRA及3DCE-MRA检查.结果 176例TIA患者中,48.9%病例DWI显示有超早期小血管梗塞灶,18.2%病例T2WI发现相应病灶.颅动脉检查中,TOF-MRA显示动脉狭窄及闭塞76例(43.2%),其中假阳性与过度评价20例;3DCE-MRA发现颅内动脉狭窄及闭塞69例(39.2%);两者均发现动脉瘤3例及动静脉畸形2例;颈部3DCE-MRA发现动脉狭窄及闭塞38例(21.6%).结论 DWI和MRA检查有助于TIA患者超早期小梗塞灶的发现及动脉病变的评估.     

透视触发法3DCE-MRA在肾动脉血管病变中的应用

目的：探讨透视触发法三维对比增强磁共振血管成像技术及其在诊断肾动脉狭窄中的临床应用价值。方法：对69例疑有肾动脉狭窄的患者,行肾动脉3DCE-MRA检查,然后进行最大信号强度投影重建和多层面重建。结果：69例均获得清晰的血管图像,其中13例未见异常;共有145支肾动脉显影,其中53支狭窄,另有3支完全闭塞。结论：透视触发法三维对比增强磁共振血管成像技术简便易行,副作用小,成像效果与DSA相仿,在诊断肾动脉狭窄方面具有广泛的临床应用价值。     

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.