手足口病并发脑炎的临床及头颅MRI分析

目的 探讨儿童手足口病并发脑炎的临床特点及头颅MRI影像特征.方法 对71例临床诊断为手足口病并发脑炎的患儿进行头颅MRI检查,获得T1WI、T2WI图像并分析脑部MRI表现.结果 25例累及脑干,其中23例(92%)累及脑桥被盖,21例(84%)累及延髓,19例(76%)累及相邻小脑中脚,8例(32%)累及小脑齿状核.表现为不同范围的T2WI高信号病变,T1WI多呈等信号,少数(12%)呈低信号.结论 手足口病并发脑炎常累及脑干,MRI表现具有特征性.     

小儿重症手足口病并发脑炎的MRI表现

目的：分析小儿重症手足口病（HFMD）并发脑炎的MRI平扫表现及特征。资料与方法回顾性分析85例经临床确诊为HFMD并发脑炎患儿的颅脑MRI资料。结果85例患儿头颅MRI平扫阴性28例,阳性57例,其中10例为斑点或片状病灶散在分布于大脑半球、胼胝体、丘脑及小脑蚓部,呈稍长或等T1、稍长或等T2信号,T2FLAIR、DWI多数呈高信号。47例病灶位于脑干,以桥脑被盖部及延髓为主,其中17例DWI见脑干被盖部呈对称斑片状高亮信号,T1WI呈低信号或等信号,T2WI及T2FLAIR呈高信号或等信号;30例表现为脑干背侧片状长T1、稍长T2信号,DWI呈等或略高信号,T2FLAIR呈高信号,9例病变对称性向四脑室周围延伸,其中1例累及两侧大脑脚。结论小儿HFMD并发脑炎的MRI表现有一定特征性,病变以脑干被盖部为主;DWI及T2FLAIR序列可提高病灶的检出率。     

小儿手足口病并脑炎的MRI诊断

目的:探讨小儿手足口病并脑炎的MRI影像表现及诊断价值。方法:对52例经临床确诊的手足口病并脑炎患儿行MRI检查。分析手足口病并脑炎患儿脑内病灶的信号特征。结果:52例中有35例可见脑内异常表现,阳性率为67.3%(35/52)。病灶单发者6例,多发者29例;累及大脑灰质29例,丘脑6例,基底核8例,小脑1例,脑干3例。病灶T1WI为低信号21例,等信号14例;T2WI为高信号27例,等信号8例;FLAIR/T2WI为高信号29例,等信号6例;DWI为高信号31例,等信号4例。结论:MRI是小儿手足口病并脑炎的首选影像诊断手段,FLAIR/T2WI和DWI序列是该病的诊断及随访观察的主要扫描序列。     

小儿重症手足口病并发脑炎的MRI表现

目的:探讨小儿重症手足口病(HFMD)并发脑炎的MRI表现.方法:回顾性分析24例小儿手足口病并发脑炎的MRI表现.结果:24例小儿脑部病变共69处病灶.病变多发13例,对称性分布10例,非对称性3例;多发病灶以脑白质病变为主,共37处病变;病变单发11例,其中累及丘脑2例,累及基底节区4例,累及脑干2例,累及颞叶1例...     

小儿手足口病合并脑干脑炎的MRI特征与临床预后评估

目的:探讨MRI对小儿手足口病合并脑干脑炎的诊断、预后评估价值及临床指导意义。方法:回顾性分析42例小儿手足口病合并脑干脑炎的临床及影像资料,对比分析其入院及出院时的MRI表现及临床治疗效果。结果:根据入院时MRI表现,将患儿分为2组:31例病灶边界模糊型和11例病灶边界清晰型。边界模糊型病灶MRI表现为脑干背侧不同厚度T1WI呈等或稍低信号,T2WI稍高信号;出院时复查MRI均表现正常,30例临床完全康复,1例遗留眼球运动障碍。边界清晰型MRI表现为脑干内斑片状或对称性斑点状、条状T1WI低信号,T2WI高信号;出院复查MRI,7例表现正常,6例临床完全康复,4例遗留不同程度后遗症,其中,2例遗留桥脑延髓交界区病灶,1例遗留延髓病灶,1例遗留脊髓前角病灶,1例死亡。结论:小儿手足口病边界模糊型明显比边界清晰型预后好,以MRI表现进行分型有助于临床预后判断。     

小儿流行性乙型脑炎的MRI特征分析

目的 探讨小儿流行性乙型脑炎的MRI特征.方法 回顾性分析40例乙型脑炎患儿的MRI表现,分析病灶的好发部位及其信号特征,数据采用构成比表示.40例(男24例,女16例)均在发病3～30 d期间行头颅常规T1WI、T2WI扫描,其中32例行轴位FLAIR扫描,31例行DWI扫描,7例行钆喷酸葡胺(Gd-DTPA)增强检查.结果 颅内病变主要在T1WI呈稍低信号,在T2WI呈稍高或高信号,在FLAIR序列以稍高信号多见,在DWI上多数呈高信号,部分呈稍高信号.40例中,37例病灶累及丘脑(92.5%),15例累及基底节(37.5%),12例累及大脑脚(30%),8例累及大脑皮层(20%),5例累及脑干(12.5%),2例累及胼胝体(5%).病灶常呈双侧对称性分布,增强扫描病灶均未见明显强化.结论小儿乙型脑炎的MRI的特征以双侧丘脑受累最多见,其次是基底节及大脑脚受累,而大脑皮层、脑干及胼胝体受累较少见.     

森林脑炎的MRI表现

目的 探讨森林脑炎的MRI表现,提高对本病的认识水平及诊断水平.方法 对近期临床确诊森林脑炎并且有MRI资料的38例患者进行回顾性分析.结果 森林脑炎MRI主要表现是单发(5例)或多发(26例)的片状、斑片状T2WI高信号、T1WI略低信号影,其中累及丘脑16例,基底节10例,放射冠8例,岛叶5例,胼胝体5例,脑干5例,颞叶3例,顶叶3例,额叶2例,齿状核2例,局部脑肿胀4例.结论 森林脑炎MRI表现有一定的特征性,是诊断和判断森林脑炎病情的必不可少的检查.     

儿童手足口病并发脑干脑炎的MRI表现

目的分析儿童手足口病(hand-foot-and-mouth disease,HFMD)并发脑干脑炎的MRI表现特征,探讨MRI对于早期诊断该并发症的临床价值。资料与方法回顾性分析18例经临床确诊为HFMD并发脑干脑炎的患儿的颅脑MRI资料,所有病例均行头颅MRI平扫及增强扫描。结果影像表现为单发或多灶性的、部分呈对称性分布的脑损害病灶,18例患儿共有病灶25个,其中脑桥-延髓交界处背侧8个,延髓背侧7个,脑桥背侧5个,中脑2个,丘脑1个,脑室旁白质区1个,小脑齿状核1个。MRI信号主要表现为以下几种:(1)T1WI呈低信号,T2WI呈高信号,边界清晰,液体衰减反转恢复序列(FLAIR)、扩散加权成像(DWI)正常或呈低信号,无强化;(2)T1WI呈稍低信号,T2WI呈稍高信号,边界模糊,FLAIR、DWI正常或呈高信号,部分病灶轻度强化;(3)平扫正常,增强扫描可见斑片状轻度强化。结论脑干脑炎为儿童HFMD的严重并发症之一,颅脑MRI对其诊断有较高敏感性和一定特异性,能明确病灶的部位和范围,可为临床诊治提供可靠的影像学依据。     

小儿手足口病合并脑干脑炎、脊髓炎的MRI表现

目的 探讨小儿手足口病(hand-foot-mouth disease,HFMD)合并脑干脑炎、脊髓炎MRI表现特征,以提高对本病的认识.资料与方法回顾性分析7例有阳性影像学表现的小儿HFMD合并脑干脑炎、脊髓炎患者的MRI特征性表现.结果 4例病灶以桥脑、延脑交界部为主,1例位于桥脑,呈略长T1、长T2斑片状信号.2例病灶在横断位上表现为对称性小斑片状信号.2例病灶均位于脊髓圆锥,呈长条形略长T1、长T2信号,病灶在横断位上表现为对称性小斑片状信号.结论 HFMD合并脑干脑炎、脊髓炎MRI表现有一定特征性.MRI能真实地显示HFMD脑干脑炎、脊髓炎脑部、脊髓受损情况,可对临床治疗提供可靠的影像学依据.     

小儿手足口病脑炎的MRI表现特征

目的：探讨小儿手足口病脑炎的MRI表现特征,提高诊断水平。材料和方法：回顾性分析5例小儿手足口病脑炎的MRI表现。结果：3例病灶局限在脑桥和延脑交界部,1例病灶以脑桥和延脑交界为主向两侧延伸,1例病灶位于脑桥偏背侧。5例病变均呈略长T1、略长T2斑片状信号,边界不清,DWI图呈略高信号。结论：小儿手足口病脑炎MRI表现主要为位于脑桥和延脑交界区斑片状信号,MRI能真实地显示其脑炎脑部受损情况,对临床治疗提供可靠的影像学依据。     

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.