目的 探讨多学科协作教学模式在医学影像专业本科生超声诊断学实践教学中的应用.方法 采用实验对照法,选取2018年在哈尔滨医科大学附属肿瘤医院超声科实习的100名医学影像专业本科生为研究对象,将其分为实验组(50人)和对照组(50人),实验组采用多学科协作教学模式,对照组采用传统教学模式.出科前,对两组进行出科考试和教学模式评价问卷调查,评估两组学生的教学效果.结果 实验组出科考试成绩高于对照组,除认可教学模式项目外,实验组教学模式评价问卷结果 均优于对照组.结论 多学科协作教学模式有助于提高学生超声诊断能力,可激发其学习兴趣,提高沟通能力.

The advantage of ultrasonography is noninvasive, no radiation, flexible operation and so on. It has been carried out in all levels of hospitals.However, the number of clinical doctors who can do ultrasound examination is limited.How to cultivate students who can carry out clinical work independently after graduation in a limited time is an important problem for medical educators.The guiding opinions on accelerating the construction of "double first-class" in institutions of higher learning point out that the cross-discipline promotes the development of disciplines.Multi-disciplinary team diagnosis and treatment model has been widely used in clinical work and achieved good results.According to the guiding ideology of the ministry of education and clinical practice, this paper makes an in-depth discussion on how to apply the multi-disciplinary team mode to the practical teaching of ultrasound. It can improve the current teaching mode and the teaching quality, and cultivate high-quality ultrasonic medical talents for the society.

Objective To investigate the application value of 64-slice spiral CT colonography ( CTC) for preoperative location and T staging in colorectal cancers .Methods 59 cases of colorectal cancer patients underwent CTC examination , were analyzed by colon software in the workstation , and compared with surgical pathology results as the standard .We evaluated the accuracy of the preoperative location and T staging of colorectal cancer on CTC .Results In the 59 cases of colorectal cancer patients , there were 3 cases located in the cecum;9 cases located in the ascending colon , 5 cases located in transverse colon , 7 cases located in the descending colon , 14 cases located in sigmoid colon , and 21 cases located in the rectum .The accuracy of CTC for preopera-tive location and T staging in colorectal cancers was 94.9%(56/59) and 88.1%(52/59), respectively.For evaluation of erosa invasion with CTC, the sensitivity, specificity, positive predictive value, negative predictive value of were 97.7%(42/43), 81.3%(13/16), 93.3%(42/45), 92.9%(13/14), respectively.Conclusion 64-slice spiral CTC has a vital value in the di-agnosis of preoperative location and T staging in colorectal cancers .

目的:探讨子宫内膜间质肉瘤的MRI表现特点.方法:回顾性分析7例经手术及病理证实的子宫内膜间质肉瘤患者的临床和MRI资料.所有病例均行MRI平扫.结果:本组7例患者子宫体积均增大.6例病变位于宫腔内,呈息肉状突向宫腔或弥漫性填充宫腔;1例位于子宫肌壁间,类似囊性变性子宫肌瘤.2例囊实混合性占位,5例实性占位.7例ESS病变直径范围为2.5cm-15cm,平均8.8cm.肿瘤在MRI平扫上5例T1WI呈等信号或低信号,T2WI呈稍高信号;2例T1WI呈等及低信号,T2WI呈稍高为主的混杂信号,伴有出血或坏死囊变,其中1例位于子宫肌壁间.6例可见向子宫肌层侵润性生长,子宫T2WI结合带低信号中断或消失,其中1例可见宫颈、双侧输卵管壁、卵巢及膀胱受侵,1例子宫肌层及宫旁可见扭曲条点状流空信号影.4例合并少量盆腔积液,2例合并子宫肌瘤,1例合并卵巢滤泡囊肿,3例合并增殖期子宫内膜.病理示低度恶性ESS 6例,未分化ESS 1例.结论:子宫内膜间质肉瘤好发于宫腔内,也可见于子宫肌壁间,多向子宫肌层浸润性生长,于T1WI呈等或低信号,T2WI呈稍高信号,伴出血或坏死囊变时呈T2WI稍高信号为主的混杂信号,其在MRI上具有一定的信号特点,能为该病的诊断提供帮助.

Objective: To analyze the value of MRI images combined with proton magnetic resonance spectroscopy(1H-MRS) in diagnosis,classification and differential diagnosis of gliomas.Methods: Thirty-four cases of MRI according with glioma patients who were carried out 1H-MRS examination(NAA,Cho,Cr,Lac,Lip and mI wave) were analyzed comprehensively.Results: 1H-MRS showed that,compared with normal brain essence,NAA decreased,Cho increased,and Cr changed little in total,and they had no regularity.The abnormal Lac and(or) Lip peak appeared in part lesions area,mI descended mildly,and Cho increased in tumor surrounding area of lesions area.Conclusion: There is a great value of MRI image combined with 1H-MRS analysis in classification,diagnosis,scope confirmation and differential diagnosis of cerebral gliomas.This technology can effectively improve the diagnosis accuracy of cerebral gliomas.

目的 探讨BI-RADS 3-4级乳腺X线表现与病理诊断的相关性.方法 回顾分析75例患者共88个病灶的X线钼靶评估为BI-RADS3-4级病灶的影像征象,分别统计各影像征象与良恶性之间的关系,运用Logistic回归进一步分析.结果 病变类型、边缘、形态、钙化形态及淋巴结情况与病变良恶性之间均有统计学差异(P＜0.05).腺体型、密度、毛刺、病灶最大径、钙化有无和钙化分布与病变良恶性之间均无统计学意义(P＞0.05).Logistic回归分析进一步得出边缘的OR(1.859)取值最大,95%可信区间(95%CI)1.032~3.347,P=0.039,差异有统计学意义.结论 BI-RADS 3-4级X线表现中病灶的类型、边缘、形态、钙化形态及淋巴结情况对于良恶性的鉴别有意义,其中病灶边缘与良恶性分组显著相关.

目的 探讨乳腺癌钼靶征象与淋巴结转移的相关性.方法 回顾性分析哈尔滨医科大学附属第三医院经过病理证实的乳腺癌病例62例,观察62例乳腺癌患者钼靶影像征象,采用下列5项指标进行分析:(1)病灶的形态;(2)病灶的边缘是否有毛刺;(3)病灶内或病灶邻近是否有钙化;(4)病灶的直径;(5)病灶的位置.统计数据采用SPSS 15.0统计软件包,计数资料用χ2检验,P＜0.05认为差异有统计学意义.结果 62例乳腺癌病例中,病灶边缘毛刺、病灶直径在淋巴结是否转移不同组中,差异均有统计学意义(P＜0.05);而病灶的形态、病灶钙化及病灶位置在淋巴结是否转移不同组中,差异均无统计学意义(P＞0.05).结论 乳腺癌常见的钼靶影像表现中病灶边缘有毛刺、病灶的直径大于等于2cm的患者常出现淋巴结转移,有临床诊断意义;而病灶的形态是否为肿块、病灶内是否有钙化及病灶的位置对于乳腺癌患者是否有淋巴结转移无诊断意义.