• Thứ 6, 29/05/2020
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Di căn hạch của u mô đệm dạ dày ruột (GIST). Tổng quan tài liệu và nhân một trường hợp

Di căn hạch của u mô đệm dạ dày ruột (GIST). Tổng quan tài liệu và nhân một trường hợp

03/30/2020 15:44:08 | 0 binh luận

Lymph node metastasis in GIST. Literature overview and case report

SUMMARY

GIST is considerd as rare tumor coming from Cajal cell. Due to poor clinical manifestations or vague symptoms, the disease is seen at late phase, some can be earlier by hazardous examination. The late comming with great dimension and existing metastatic lymph node generally having bad prognose. Lymph node metastatic is rare and not to be concentrated as liver and peritoneal metastasis. Absence of lymph node pre- post operation, intervention combining with adjuvant therapy is also difficult to prognose but generally can have 5 year survival. A case presenting in this paper with good prognose after treatment though lymph node metastasis after 4 years.

U mô đệm dạ dày ruột ( GIST) từ siêu âm đến cộng hưởng từ

U mô đệm dạ dày ruột ( GIST) từ siêu âm đến cộng hưởng từ

03/30/2020 15:26:06 | 0 binh luận

Gastrointestinal Stromal Tumor: from ultrasound to MRI

SUMMARY

Gastrointestinal Stromal Tumor: From ultrasound to MRI. Former GIST was considered as leiomyoma, shwannoma, epithelioma. Histoimmuno logy determined with Protein KIT CD117 and the presence of interstitial cell Cajal. GIST is not rare but not be early diagnosed. Conventional X Ray, USG, CT scanner, MRI and PET can find. Though almost discovered hazardly during screening examination, we use USG for detection then CT Scanner detail study.

Comment and Results: 6 cases was noted, 4 hazardly, operation and histology affirmed. Sex M/F 2/6, 4 cases under 3 cm as dimension, unique cas 30x40 cm. Metastase not yet found. All are healthy after 3 years.

Conclusion: The affection is hazardly found. All imaging modalities can detected. 5 year survival depend on tumor dimension. Metastasis often to liver, mesentery but late. USG and CT is used also to follow up after interventional and target therapy. Early diagnosis rely on screening control and community care.

Key words: Gastrointestinal stromal tumor, GIST, Ultrasound, CT scanner, MRI.

Xạ trị trong chọn lọc điều trị ung thư gan bằng vi cầu phóng xạ Y-90 tại bệnh viện Bạch Mai

Xạ trị trong chọn lọc điều trị ung thư gan bằng vi cầu phóng xạ Y-90 tại bệnh viện Bạch Mai

04/01/2020 16:14:00 | 0 binh luận

Theo nguồn gốc xuất phát ung thư gan (UTG) được chia làm hai loại. UTG nguyên phát, tế bào ung thư xuất phát từ tế bào nhu mô gan và UTG thứ phát là do di căn ung thư khác vào gan. Ung thư biểu mô tế bào gan nguyên phát (HCC) chiếm tỷ lệ khoảng 90% các tổn thương ác tính trong gan, có tỷ lệ mắc và tỷ lệ tử vong cao, đứng thứ 2 trong các loại ung thư ở nam giới và ở nữ giới đứng thứ 3 sau ung thư vú và cổ tử cung. Các phương pháp điều trị ung thư gan hiện nay bao gồm: phẫu thuật (cắt phần gan mang u hoặc gép gan), phá hủy u tại chỗ (đốt sóng cao tần-RFA, siêu âm hội tụ- HIFU, đông lạnh-CRYO, tiêm cồn), điều trị tại vùng (tắc mạch hóa dầu TACE…), các liệu pháp điều trị toàn thân (hóa trị, thuốc điều trị đích phân tử nhỏ -TKI). Trên lâm sàng, tùy theo giai đoạn bệnh,tình trạng bệnh nhân cụ thể mà lựa chọn phương pháp điều trị thích hợp. Xạ trị trong chọn lọc (Selective Internal Radiation Therapy: SIRT) điều trị ung thư gan là phương pháp đưa các hạt vi cầu gắn đồng vị phóng xạ Y-90 chọn lọc vào động mạch nuôi khối u ác tính trong gan. Tế bào ung thư sẽ bị tiêu diệt bởi bức xạ ion hóa tập trung với cường độ caocủa Y-90 phát ra. Kỹ thuật này đã được nghiên cứu, áp dụng điều trị cho các bệnh nhân UTG tại Bệnh viện Bạch Mai. Mục tiêu nghiên cứu: - Xây dựng và hoàn thiện quy trình kỹ thuật xạ trị trong chọn lọc UTG bằng hạt vi cầu Y-90. - Đánh giá kết quả ban đầu điều trị UTG bằng hạt vi cầu phóng xạ Y-90 tại Bệnh viện Bạch Mai.
Nghiên cứu đặc điểm hình ảnh cắt lớp vi tính đa dãy đầu thu và phân loại LUNG-RADS các nốt mờ phổi

Nghiên cứu đặc điểm hình ảnh cắt lớp vi tính đa dãy đầu thu và phân loại LUNG-RADS các nốt mờ phổi

03/30/2020 14:36:19 | 0 binh luận

MDCT images and The ACR Lung Imaging Reporting and Data System (Lung-RADS™) of Pulmonary nodules - Research in Hue National Hospital and Hue Medic Clinic

SUMMARY

Objective: Solitary pulmonary nodule may be benign or malignant. The purposes of this study is to illustrate the clinical characteristics, describe the images characteristics of chest X-ray and MSCT, classification of lung nodules by The ACR Lung Imaging Reporting and Data System (Lung-RADS™) then offer management and monitor strategies for this disease at Hue National Hospital and Hue MEDIC clinic.

Methods: The study design was cross-sectional descriptive. Describe the clinical characteristics and images of lung nodules on chest X-ray and MSCT with LungCAD software to determine the nodular lesions during 1 year (5 / 2015-5 / 2016), in 2 centers (Hue National Hospital and Hue MEDIC clinic).

Results: In our study, there was 49 patients with pulmonary nodules. Male was 38/49 (77.6%), more than female. Mean age was 57 ± 2 years old. Smallest nodule is 5mm, average size is 18.7 ± 9mm. There was 31/49 (63.3%) patients with lung size 15-30mm. MSCT has higher sensitivity than X-ray in detecting nodules <6mm and ground glass nodule. Base on The ACR Lung RADS classification, Lung - RADS 4B was seen most with 19/49 (38,8%) patients. Number of patients with Lung - RADS 4X was 8 (16.3%), including 5 patients who underwent surgeries, 3 of them had malignant pulmonary nodules.

Conclusions: Patients with pulmonary nodules should be evaluated by estimating the probability of malignancy, be performed imaging tests to characterize the lesions better, be assessed the risks and benefits of different management strategies (biopsy, surgery and observation with serial imaging tests). Lung - RADS classification is simple, easy to apply and make appropriate recommendations for the management of solitary pulmonary nodules.

Keywords: Solitary pulmonary nodule. Lung - RADS.

Biến thể giải phẩu động mạch gan trên 300 trường hợp chụp mạch máu số hóa xóa nền

Biến thể giải phẩu động mạch gan trên 300 trường hợp chụp mạch máu số hóa xóa nền

03/30/2020 14:11:17 | 0 binh luận

Variant Hepatic arterial anatomy in 300 patients underwent digital subtraction angiography

SUMMARY

Objective: to evaluate and describe the prevalence of hepatic arterial variants seen at digital subtraction angiography.

Materials and methods: data were collected at Interventional Unit in Diagnostic Imaging department of Viet Duc hospital from May 2015 to May 2016.

Results: 300 cases underwent at least one visceral angiographic examination during the study period. 232 (77.3%) cases had standard hepatic arterial anatomy. 14 (4.7%) cases had replaced left hepatic artery. 11 (3.7%) cases had replaced right hepatic artery. 2 (0.7%) cases had variant anatomy involving replacement of both left hepatic artery and right hepatic artery. 16 (5.3%) cases had accessory left hepatic artery. 3 (1%) cases had accessory right hepatic artery. 1 (0.3%) case had both left and right accessory hepatic artery. 12 (4%) cases had replaced common hepatic artery. 3 (1%) cases had double hepatic artery. 1 case had replaced common hepatic artery and accessory left hepatic artery at the same time. 1 case had right hepatic artery arises from aorta and left hepatic artery arises from left gastric artery.

Conclusion: in this study the percent of standard hepatic artery is larger than previous published study while the percent of cases had other variants of hepatic artery is smaller. In 2 cases, we saw uncommon variants which weren’t described in previous study. However we didn’t see some other uncommon variants which were described in other study.

Keyword: Hepatic artery, anatomy, variant, DSA.

Gía trị của X quang và siêu âm trong sàng lọc ung thư vú ở phụ nữ từ 40 tuổi trở lên

Gía trị của X quang và siêu âm trong sàng lọc ung thư vú ở phụ nữ từ 40 tuổi trở lên

03/30/2020 13:17:54 | 0 binh luận

Value of mammography, ultrasound in breast cancer screening with women ≥40 years old

SUMMARY

Objective: To research the value of mammography, ultrasound in breast cancer screening with women ≥ 40ys.

Methods: Including of the study was 1319 women (age ≥40) in the range of six months with breast cancer screening at University Medical Center, Hochiminh city, from 1 June 2014 to 31 May 2016. Mammography and ultrasound were performed using BI-RADS (The Breast Imaging and Reporting Data System) of the American College of Radiology. Breast cancer was determined by histopathological results.

Results: The proportion of breast cancer was 1.67% (22/1319). Among 22 cancers detected, 19(14.4/1000) with mammography, 18(13.65/1000) with ultrasound. The sensitivity, specificity of mammography respectively were 86.36% (IC 95%: 65.09-97.09), 99% (98.29-99.47) higher than ultrasound: 81.82% (59.71-94.81); 95.45% (94.18-95.52). When combined two tests, the sensitivity and specificity respectively were 100% (IC 97.5%:84.56-100), 95.37% (94.09-96.45); PPV was decreased (26.83%) (17.63-37.75) compared to mammography (59.38%) (40.64-76.3); NPV was increased (100%)(IC 97.5%: 99.7-100) compared to mammography (99.77%) (99.32-99.95)or ultrasound alone (99.68%)(99.18-99.91).

Conclusions: The sensitivity and specificity of breast cancer screening with mammography were higher than ultrasound alone. When combined two tests, it was increased the sensitivity, decreased the specificity compared to mammography alone.

Keywords: breast cancer screening, mammography, ultrasound.

Bước đầu đánh giá hiệu quả ngắn hạn của phương pháp tiêm thẩm phân chọn lọc rễ thần kinh vùng thắt lưng dưới hướng dẫn cắt lớp vi tính

Bước đầu đánh giá hiệu quả ngắn hạn của phương pháp tiêm thẩm phân chọn lọc rễ thần kinh vùng thắt lưng dưới hướng dẫn cắt lớp vi tính

03/30/2020 11:44:19 | 0 binh luận

Primary result: the short - term efficacy of selective nerve root block for lumbar radicular pain under ct guidance

SUMMARY

Purpose: Evaluating the short-term efficacy and the safety of SNRB method in treating lumbar discal herniation pain.

Methods:prospective, 24 patients with lumbar disc herniation treated by SNRBfrom February to June 2016, the contrast media is used to identify the nerve root before ịnjecting compound of Corticosteroid and Lidocain under CT guidance. Measurements of pain (with pain scale Visual Analogue Score - VAS) and mobility (Disability Index OSWESTRY - ODI) were compared at 1 day, 2 week, 1 month and 3 months after the procedure.

Results: 27 roots are blocked/24 patients, pain scores were significantly reduced compared with before treatment at every follow-up period. The preprocedural mean VAS score was 5.9. At follow-up, mean VAS scores ranged from 1.9 to 2.4. The pretreatment mean ODI score was 43,6 and it ranged from 9,8 to 19 at follow-up, none grave complication.

Conclusion:S.N.R.B for lumbar radicular pain is a simple and safe procedure, but its effect is quite high. It is recommended to perform before surgery.

Keywords: SNRB, discal herniation.

Nghiên cứu chẩn đoán giai đoạn trước phẩu thuật của ung thư dạ dày trên chụp CLVT đa dãy

Nghiên cứu chẩn đoán giai đoạn trước phẩu thuật của ung thư dạ dày trên chụp CLVT đa dãy

03/30/2020 13:05:11 | 0 binh luận

Preoperative starging of gastric cancer by multiple detector computed tomography

SUMMARY

Objective: The aim of this study was to evaluate the accuracy of multiple detector computed tomography (MDCT - BRIVO CT 385-GE Japan) in the preoperative staging of gastric cancer, prospectively comparing CT findings with pathological findings confirmed at biopsy during upper endoscopyand at surgery. A total of 74 consecutive patients with primary cancer recruited between December2015 to July 2016 were submitted to preoperative MDCT staging according to a standard protocol. All diagnostic procedures were performed by two dedicated radiologists who were unaware of the final pathological results. All patients were diagnosed with primary gastric cancer, confirmed at biopsy during upper endoscopy. CT results for T and N staging were in agreement with pathological findings,with overall accuracy of 83,8% (62/74) and 81,1% (60/74%, respectively. Higher specificity for T and N earlier stages (both 100%). Higher accuracy and sensibility for all T and N stages (78,9-94,6% for T and 80,9-96,6% for N). Our findings show a good performance of the diagnostic staging TNM performed with MDCT.

Keywords: Gastric Cancer, MDCT, Staging, Oncologic Imaging.

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