新生儿骨矿质含量及影响因素的研究

应用双光子及单光子吸收测定技术，检测了９２名出生３ｄ内的新生儿骨矿质含量，其中巨大儿３０名，正常体重儿３２名，低出生体重儿３０名，其孕龄分别是４０．１±０．７、３９．１±１．５和３７．４±１．２孕周。结果表明，巨大儿、正常体重儿、低出生体重儿的全身骨矿质含量分别是１０１．６±２８．８、８５．２±１９．８、５９．９±２７．２ｇ／ｃｍ２，巨大儿骨矿质含量最高，正常体重儿次之，低出生体重儿最低，差异有显著性（Ｐ＜０．０１）。颅骨、肱骨、股骨的骨矿质含量与全身的骨矿质含量有高度的相关性，相关系数分别是０．９４３、０．８７９和０．７４５（Ｐ＜０．０１）。全身的骨矿质含量与出生体重、孕龄及头围有高度相关性，相关系数分别是０．７５５、０．５９６和０．５５６（Ｐ＜０．０１）。提示颅骨、肱骨及股骨的任一部位均可代表全身的骨矿质含量，肱骨是确定全身骨矿质含量较好的部位，新生儿骨矿质含量受出生体重、孕龄及头围的影响较大。     

Simultaneous Quantification of an Enantiomer and the Racemic Compound of Ibuprofen by X-ray Powder Diffractometry

Purpose. An X-ray powder diffractometric method was developed for the simultaneous quantification of the relative amounts of the racemic compound (±) of ibuprofen (I) and S(+)-ibuprofen (II), when they occur as a mixture. Methods. The X-ray powder diffraction patterns of I and II show pronounced differences. This formed the basis for the determination of the relative amounts of I and II when they occur as a mixture. X-ray lines with d-spacings of 14.41 and 4.37 Å were unique to I and II, respectively. Mixtures containing different proportions of I and II were prepared which also contained lithium fluoride (III) as an internal standard. Results. A linear relationship was obtained when the intensity ratio (intensity of the 4.37 Å line of II/intensity of the 2.01 Å line of III) was plotted as a function of the weight fraction of II in the mixture. Similar results were obtained in the case of I. Using these standard curves, the weight fractions of I and II in 'unknown' mixtures were determined. The experimentally determined analyte concentration ranged between 98 and 104% of the true value. The relative error in the analyses of individual samples was < 10%. The minimum detectable weight fraction of I in II and II in I were 0.032 (3.2% w/w) and 0.034 (3.4% w/w), respectively. The minimum quantifiable weight fractions were 0.136 for I and 0.112 for II. Since the X-ray diffraction patterns of S(+)-ibuprofen and R(–)-ibuprofen are identical, the conclusions drawn regarding mixtures of I and II will also hold true in the quantitative analyses of mixtures of I and R(–)-ibuprofen.     

胸部高分辨率CT检查技术的临床应用

笔者对５０例肺部疾病胸部常规ＣＴ和高分辨率ＣＴ（ＨＲＣＴ）图像进行了对照分析。其中特发性肺间质纤维化（ＩＦＰ）８例，肺转移癌５例，支气管扩张１５例，慢性阻塞性肺气肿１５例，周围型肺癌７例，结果表明：ＨＲＣＴ在ＩＦＰ、支气管扩张和肺气肿的显示明显优于常规ＣＴ（Ｐ＜０．００１），在对肺部原发或转移性肿瘤的显示能提供更多的诊断信息。笔者还讨论了ＨＲＣＴ的检查技术和图像后处理，分析了影响ＨＲＣＴ的若干因素，指出通过缩小视野（ＦＯＶ），减少象素做图像的重建放大显示肺部局部结构更为清楚方便，应灵活运用。     

原发性小肠恶性肿瘤的CT诊断

本文回顾性分析３４例经病理证实的原发性小肠恶性肿瘤的ＣＴ表现。病变包括腺癌１６例，平滑肌肉瘤１２例，淋巴瘤６例。ＣＴ扫描能明确肿瘤向腔内和腔外侵犯的程度，清晰显示肿瘤与邻近结构的关系，有无局部及远处转移等，为临床治疗提供帮助。鉴别诊断应包括小肠良性肿瘤、炎性病变和转移性肿瘤等。     

CT造影剂碘海醇注射液的制备及动物实验

本文报道了非离子型Ｘ－ＣＴ造影剂碘海醇注射液的制备及动物实验结果。磺海醇的最大吸收波长λ＿（ｍａｘ）为２４４ｎｍ。讨论了温度、浓度对磺海醇溶液粘度的影响：粘度随温度的升高而下降，呈负线型相关；粘度随浓度（Ｃ）升高而激剧升高，与浓度的四次方呈线性相关：Ｖ＿（３７℃）＝４７２．５８９［Ｃ］￣４＋１．１２１（ｒ＝０．９９７７）Ｖ＿（３０℃）＝６６３．８１３［Ｃ］￣４＋１．１５２（ｒ＝０．９９９６）Ｖ＿（２０℃）＝１０８２．９５３［Ｃ］￣４＋１．４３３（ｒ＝０．９９８２）使用该注射液进行狗的造影实验，获得了清晰的造影图像。     

Precision of dual-photon absorptiometry

Summary Precision of dual-photon absorptiometry (DPA) measurements was determined in a lumbar spine phantom and in humans. Approximately half of the measurements were made before and half after a¹⁵³gadolinium source change. The phantom was measured with different amounts of acrylic, which simulates human soft tissue, in order to evaluate the influence of body thickness on bone mineral density (BMD). Results of scans analyzed with two software versions from Lunar Radiation Corp., the widely used 08B and a prototype 08C, are compared. DPA with a cold source significantly overestimated BMD in the phantom in the presence of large amounts (more than 25 cm) of soft tissue equivalent with version 08B but not with the newer version 08C. Similiarly, in nine subjects, there was a significant decrease in spine BMD after a source change when scans were analyzed with version 08B (mean difference 0.026 g/cm²,P=0.002) but not with 08C (0.01 g/cm²,P=0.234). No systematic effect of source change on femoral BMD measurements was observed. The SD of the mean difference of two measurements of the nine subjects was 0.019 g/cm² (1.6% of the mean value) for the spine with software version 08B and 0.024 g/cm² (2.0%) with version 08C, 0.03 g/cm² (3.3%) for the femur neck, 0.03 g/cm² (4.0%) for the greater trochanter, and 0.04 g/cm² (4.9%) for Ward's triangle region of the proximal femur. The spine phanton was scanned on two other commercial bone densitometers in order to assess inter-instrument variation. Phantom measurements of L2-4 BMD made on two Lunar Radiation Corp model DP3 scanners which differed by 2% were 10 and 12% higher than those with a Norland Corp. model 2600 scanner.     

197例腰椎间盘膨出和脱出的CT分型

根据１９７例腰椎间盘病变的ＣＴ影像以及手术所见，提出腰椎间盘膨出分为均匀型、不均匀型、局限型；腰椎间盘脱出分为中央型、旁侧型、孔外型、Ｓｃｈｍｏｒｌ结节型。除Ｓｃｈｍｏｒｌ结节型外，上述椎间盘脱出可继续分为隆起型、破裂型、游离型等三个亚型。还讨论了分型的必要性、病理基础与临床关系以及鉴别诊断。     

30例急性单发性球形肺炎的临床与CT特点

目的　通过分析 3 0例急性单发性球形肺炎的临床与CT特点 ,提高与周围性肺癌的鉴别能力。方法　对 3 0例住院患者 ,入院后均行胸片、胸部CT、纤维支气管镜检查及痰涂片、痰细菌培养等检查。结果　痰细菌培养均为细菌感染 ,胸片、胸部CT显示病灶为贴近胸膜或沿支气管血管束分布占 70 .0 0 % ;分布在两肺下叶背段或后基底段占 60 .0 0 %。病灶直径 2 .0～ 4.5cm 2 4例 ,占 80 .0 0 % ,2 5例患者经抗炎治疗病灶完全吸收。结论　抗炎治疗是动态观察单发性球形肺炎病灶变化的一种有效方法。     

新生儿呕吐性疾病的消化道造影研究

目的:研究新生儿呕吐性疾病的造影技术,探讨其影像特征。方法:对比剂引入方式采用吸吮法和插胃管抽液后再注入对比剂两种方法;选用对比剂有6 0 %～80 % (W/V)的硫酸钡混悬液30～4 0ml或30 %泛影葡胺30ml;采用不同体位多轴位观察摄片,并对5 4例造影表现进行分析。结果:5 4例新生儿消化道造影均满足诊断要求,其中先天性幽门狭窄11例(19 6 % ) ,胃食管反流34例(6 3 0 % ) ,环形胰腺9例(16 .7% )。经手术治疗2 0例均与术前X线诊断相一致。结论:传统的上消化道造影是诊断新生儿呕吐病因的有效方法,熟练掌握造影技术和特有的造影征像能够及时地明确诊断。     

原发性骶骨肿瘤病理及影像学表现

目的:分析原发性骶骨肿瘤的病理学分型及影像学表现特点。方法:48例原发性骶骨肿瘤均经手术病理证实,术前均行常规X线平片、CT和/或MR检查,结合病理回顾分析了其影像学表现。结果:原发性骶骨肿瘤以脊索瘤(21例)最多见,其次是巨细胞瘤(7例)、神经源性肿瘤(6例)、软骨肉瘤(4例)、滑膜肉瘤(3例),囊肿(3例),其它相对少见,包括纤维组织细胞癌1例,尤文氏肉瘤1例,梭形细胞癌1例,节细胞神经瘤1例。影像表现包括软组织肿块、骶孔扩大、瘤灶内钙化、骨嵴形成等不同特点。常见原发骶骨肿瘤常有其特征性影像学表现。结论:原发骶骨肿瘤病理分型相对复杂,影像表现多样化,诊断常需综合不同影像检查手段。