脊椎血管瘤的影像诊断（附30例分析）

目的：探讨脊椎血管瘤的影像表现特征及临床意义。材料与方法：结合临床资料回顾性分析３０例脊椎血管瘤的Ｘ线、ＣＴ或ＭＲＩ影像特征。结果：Ｘ线片可见椎体呈典型的栅栏样改变，ＣＴ可见网眼状影像中夹杂着低密度脂肪，在ＭＲＩ Ｔ１加权像上呈等或高低混杂信号，Ｔ２加权像上呈均匀高信号，并见随回波时间延长信号逐渐变亮这一典型血管瘤信号特征，ＭＲＩ可发现脊髓受压变性程度。据ＭＲＩ表现和临床资料，作者提出了脊椎血管瘤     

动脉瘤样骨囊肿的影像学特点及介入技术在其诊疗中的意义

目的探讨动脉瘤样骨囊肿(ABC)的影像学特点及介入法动脉栓塞对该病的临床应用价值。方法回顾性分析18例经手术病理证实的原发性ABC的影像学征象,其中10例曾于术前进行动脉栓塞治疗。结果ABC的X线平片常呈偏心性膨胀性骨破坏;在CT成像中,10例可见液平面,8例出现钙化或骨化;MRI成像表现为分隔状囊性病变区,在T1加权像为不均匀中高信号,在T2加权像数个呈高信号囊腔及低信号的间隔影,12例出现液平面。结论动脉瘤具有一定的影像学特点,介入法是一种有价值的术前辅助性治疗方法。     

脊椎血管瘤综合治疗疗效评价

目的　评价放射治疗和综合治疗在椎体血管瘤治疗中的地位和作用。方法　回顾性分析 2 2例有症状椎体血管瘤临床症状、影像学表现、治疗方法以及治疗后随访情况。结果　本组 2 2例单纯放疗 10例 ,综合治疗 12例 ,治疗后 19例症状完全缓解 ,3例部分缓解 ,无明显并发症及恶性变 ,无治疗后复发。结论　对脊椎血管瘤采用术前介入法栓塞供血动脉并椎体减压术结合术后放疗的综合治疗方法具有快速缓解压迫、减少术中出血、疗效确切的优势。     

脊椎动脉瘤样骨囊肿的影像表现及术前栓塞对减少术中失血的意义

目的 探讨脊椎动脉瘤样骨囊肿(ABC)的影像学特点及术前栓塞对减少术中失血的意义.方法 分析了6例经手术病理证实的原发性脊椎ABC的影像学表现,对其中4例进行了术前选择性动脉造影、栓塞,所用栓塞物为明胶海绵.结果 本组6例脊椎ABC均侵犯椎弓、棘突、横突和椎体后或侧缘,病变凸入椎管,造成硬膜囊和脊髓受压、移位.4例栓塞后血管造影显示染色均较栓塞前减少75%,术中失血700～1500 ml,平均1000 ml.较未经术前栓塞者平均3000 ml术中失血明显减少.结论 对动脉瘤样骨囊肿术前动脉栓塞能够有效地减少术中出血,提高手术治疗的成功率,是一种有价值的术前辅助性治疗方法.     

椎体血管瘤栓塞治疗的临床应用价值

目的：探讨椎体血管瘤的术前栓塞和单纯栓塞的意义，方法：经栓塞治疗的椎体血管瘤18例，方法是先行节段动脉及其他供血动脉造影。经导管注入栓塞剂栓塞，术前栓塞用明胶海绵GS和聚乙烯醇Ivalon，单纯栓塞用Ivalon和无水酒精。结果：术前栓塞后肿瘤染色大部或完全消失者术中出血显著减少，单纯栓塞肿瘤染色大部或完全消失者，临床症状消失，3－6个月后复查平片示病变椎体不同程度增生硬化，2例复查MR未显血管瘤信号，结论：术前栓塞可减少术中出血，单纯栓塞可望治愈椎体血管瘤。     

脊椎骨髓炎的MRI诊断

目的确定MRI对脊椎骨髓炎的诊断价值.方法对26例经临床或手术病理证实的脊椎骨髓炎的MR影像表现进行回顾性分析.MR检查方法为矢状位和轴位常规SE序列T1WI及T2WI,Gd-DTPA T1WI.结果26例患者中,单纯脊椎骨髓炎3例,相邻椎体及椎间盘受累9例,相邻椎体,椎间盘及椎旁软组织受累12例,合并硬膜外脓肿2例.病变椎体和椎间盘MRI表现为长T1、长T2信号,椎旁软组织呈等T1、长T2信号.病变椎体、椎间盘和椎旁软组织影可见不同程度的异常强化.结论MRI对脊椎骨髓炎的早期诊断和指导治疗具有重要意义.     

滑膜血管瘤的影像诊断分析

目的 探讨滑膜血管瘤的影像学表现及临床诊断价值.资料与方法 回顾性分析经病理证实的16例(男9例,女7例)滑膜血管瘤患者资料,其中膝关节14例,肘关节1例,髋关节1例.X线平片检查13例,CT平扫1例,MRI平扫及增强扫描15例,血管造影1例.结果 X线平片可见软组织肿胀、静脉石、软组织肿块表现.CT表现为软组织肿胀及骨质侵蚀.血管造影见毛细血管期及静脉期对比剂滞留.MRI显示肿块T1 WI呈等低信号,T2WI呈"葡萄串"样高信号或不均匀等低信号,其内见条索状或网格状低信号分隔.MRI表现各异由病理组织成分不同所决定.结论 X线平片、CT、血管造影对滑膜血管瘤定性诊断价值有限,MRI 对滑膜血管瘤的定位及定性诊断具有重要价值,是术前诊断的首选方法,对治疗方案的选择具有指导作用.     

Cobb综合征的影像学表现 (2例报告结合文献复习)

目的 分析Cobb综合征的影像学表现。方法 2例患者，均为男性，年龄分别为22和13岁。临床症状为下肢无力，查体见皮肤血管瘤、下肢肌力下降。均行Mm、CT、DSA检查并经手术治疗。结果 MRI显示2例椎体多发血管瘤，T1WI呈高或略高信号，T2WI呈高信号，压脂像(STFIR)呈低信号；相应节段椎管及肌肉内见不规则长T1、长T2信号，有流空现象；增强扫描椎管内病灶呈明显强化。CT平扫仅显示椎体血管瘤，表现为局部骨小梁增粗，呈网眼状，冠、矢状面重建可见栅栏征。DSA示肋间动脉、肋下动脉增粗、紊乱，周围静脉提前显影并增粗迂曲，多个椎体内可见紊乱血管团。结论 MRI能明确显示Cobb综合征椎体、椎管、脊髓、肌肉等组织的病变及其范围，结合皮肤表现对该病有诊断价值。     

脊椎血管瘤的MR表现及诊断

目的：分析脊椎血管瘤的MR表现，评价其诊断价值。方法：收集11例患者共15个脊椎血管瘤病灶的MR资料，其中2例3个病灶有CT资料，进行回顾性分析。结果：MRI所显示的全部15个病灶中，14个病灶为短T1长12信号，1例为稍长T1长12信号：T1W抑脂序列上15个病灶信号均有衰减，呈等或稍低信号；T2W抑脂序列上15个病灶均为高信号，信号衰减不明显；9个病灶冠状位及矢状位表现为典型的“栅栏状”改变，轴位表现为蜂窝状或网眼状改变；6个病灶表现不典型；2个病变椎体形态稍饱满；3个病灶累及椎弓根。3个病灶CT扫描均见栅栏状及蜂窝状改变。结论：脊椎血管瘤在MRI上具有特征性表现；常规T1W及T2W与抑脂序列的联合应用，对脊椎血管瘤的定性诊断具有重要的意义。     

脊椎原发性骨肿瘤的介入治疗

目的研究脊椎原发性骨肿瘤术前化疗及选择性动脉栓塞的安全性、疗效评价标准及临床价值。方法对术前采用化疗及选择性动脉栓塞且术后经病理证实的16例资料完整的椎体肿瘤进行回顾性分析。采用Seldinger技术,将导管超选择性地插入所需栓塞的肿瘤供血动脉,进行化疗,再以明胶海绵颗粒为栓塞材料进行选择性动脉栓塞。结果化疗、栓塞后肿瘤供血动脉大部分阻断,肿瘤染色较栓塞前减少>75%,术中出血量为500～2000ml,平均为810ml,手术切除顺利;术后标本病检肿瘤细胞坏死率为91%～95%;疼痛症状缓解率为95%。本组均未发生严重并发症。结论脊椎肿瘤术前行化疗及选择性动脉栓塞,是一种操作简便,安全可靠的有效方法。     

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.