• Thứ 4, 03/06/2020
  • (GMT+7)
Đánh giá đặc điểm sa trực tràng kiểu túi ở bệnh nhân rối loạn chức năng sàn chậu bằng cộng hưởng từ động

Đánh giá đặc điểm sa trực tràng kiểu túi ở bệnh nhân rối loạn chức năng sàn chậu bằng cộng hưởng từ động

03/31/2020 19:09:28 | 0 binh luận

Evaluation of rectocele in patients with pelvic floor dysfunction by dynamic magnetic resonance imaging

SUMMARY

Objectives: Rectocele is a bulge or a prolapse of the anterior rectal wall into the posterior vaginal wall. It is relatively common with diversified and nonspecific symptoms. Clinical examination is easily confused and/or sometimes omitted the prolapse of other pelvic organs. Imaging to assess the pelvic floor dysfunction is an important and useful diagnostic test, especially dynamic MR.

Methods: Our study was cross-sectional descriptive. Patients with pelvic floor dysfunction were undergone clinical examinations and then were indicated to have dynamic MR scanning at Ho Chi Minh City Medical University by anorectic doctor, urologist and gynecologist.

Results: 1.863 patients were evaluated from January 2008 to June 2012. Most of them are women, middle-aged and used to give birth. The rate of rectocele with its depth from 2 to 4 cm was 77.9%, mainly with the shape of “finger”. The depth of more than 2 cm with the shape of “bag” has the high risk of stagnancy. The factor of age and being used to give birth have a significant relation with rectocele (p<0.001). The rate of rectocele in the group of anismus was 64.2%. The combination of the prolapse of more than one pelvic chamber accounted for 77.4% (p<0.001).

Conclusions: Dynamic MR of the pelvic floor helps to diagnose in details the characteristics of the rectocele and other pelvic organ prolapse, helping clinicians to choose the appropriate treatments.

Vai trò của ADC trong chẩn đoán phân biệt giữa tổn thương lành tính và ác tính ở gan

Vai trò của ADC trong chẩn đoán phân biệt giữa tổn thương lành tính và ác tính ở gan

03/31/2020 15:26:23 | 0 binh luận

summary

Purpose: Assessing the role of Apparent Diffusion Coefficient (ADC) measurement in differentiation of benign and malignant focal hepatic lesions.

Methods and Materials: Retrospectively evaluated the 248 patients cases, executed hepatic MRI at Medic Medical center, from on February 2011 to on February 2013, age range 41 - 78years, with 142 benign hepatocellular lesions (30 FNHs, 9 HCAs, 63 hemangiomas and 40 cysts) and 104 malignant lesions (76 HCC and 28 metastasis) diagnosed, 50 patients had normal liver. All the patients executed Diffusion weighted imaging - MRI with three b values (0, 500, 800 sec/mm2) on the Siemens Avanto 1,5T MRI.

Results: We found difference between ADC of benign lesions compared with malignant lesions (mean ± standard deviation): ADC of normal liver (1.242 × 10−3 mm2/sec ± 0.33), FNH-HCA (1.742 × 10−3 mm2/sec ± 0.40), Hemangiomas (2.084 × 10−3 mm2/sec ± 0.46), Cyst (2.861 × 10−3 mm2/sec ± 0.34), HCC (1.093× 10−3 mm2/sec ± 0.37), Metastasis (1.126 × 10−3 mm2/sec ± 0.48). ADC of benign lesions: (2.327 × 10−3 mm2/sec ± 0.41), compared with malignant lesions: (1.113 × 10−3 mm2/sec ± 0.39).

Conclusion: Mean value of apparent diffusion coefficient (ADC) contribute to differential diagnosis between benign and malignant focal hepatic lesions.

Xoắn dạ dày ở trẻ em đặc điểm lâm sàng và siêu âm

Xoắn dạ dày ở trẻ em đặc điểm lâm sàng và siêu âm

04/03/2020 12:32:30 | 0 binh luận

Gastric volvulus in children: clinical and sonographic findings

summa ry

Objectives: The purpose of this study is to present the clinical and sonographic findings of gastric volvulus in children.

Materials and methods: We reviewed all cases of gastric volvulus operated in our hospital and having preoperative ultrasound from 2008 to 2010.

Results: From 2008 to 2010, there were 13 cases of gastric volvulus, of these, 11 acute and 2 chronic cases. Age ranged from 2 months to 12 years. Male: female was 4:9. Illness duration were 1-10 days for acute volvulus and 6 months to 2 years for chronic cases. Vomiting, abdominal pain and epigastric distension were 100%, 84.6% and 69.2% respectively. Associated anomalies such as wandering spleen, asplenism and diaphragmatic anomaly were 46%, 15.4% and 15.4% respectively. In acute gastric volvulus, ultrasound revealed dilated and fluid-filled stomach in 100%, fluid-fluid level in 90.9% and longitudinal septal sign in 81.8%; Plain radiograph showed single large gas bubble in 91%, one case had bubble in the left hemithorax. In acute cases, ultrasound diagnosed correctly in 84.6%. Two chronic cases that ultrasound and plain radiograph did not detect were diagnosed with UGI study.

Conclusions: Acute gastric volvulus can be diagnosed with specific sonographic findings. Chronic cases can be detected with upper gastrointestinal series.

Keywords: gastric volvulus, children, ultrasound.

Nhân ba trường hợp xoắn lách phụ phát hiện bằng siêu âm và hồi cứu

Nhân ba trường hợp xoắn lách phụ phát hiện bằng siêu âm và hồi cứu

04/03/2020 11:37:41 | 0 binh luận

Torsion of accessory spleen in children: three case reports and literature review

summa ry

Objectives: To present sonographic findings of torsion of accessory spleen.

Methods: Three case reports.

Results: Case 1: A 2-year-old girl presented with a twoday history of left abdominal pain. Ultrasound revealed a solid, hypoechoic and avascular mass below the lower pole of the spleen. Case 2: A 14-year-old boy presented with 10 days of intermittent left upper quadrant pain. Ultrasound showed a solid, heterogeneous and hypoechoic mass below the lower pole of the spleen. This mass had poor vascularity, some small peripheral vessels, whirlpool sign at the hilum and vascular dilatation at the lower pole of the spleen. Case 3: An 8-month-old boy, ultrasound showed a hypoechoic, avascular mass in the right upper quadrant near the main spleen with hyperechogenicity of the surrounding omentum. In all three cases, we diagnosed torsion and necrosis of accessory spleen. Surgical and pathologic results confirmed the diagnosis.

Conclusions: Torsion of accessory spleen is an extremely rare entity. It may manifest as acute or subacute abdominal pain. USG is a simple and exact procedure if we consider it.

Keywords: accessory spleen, torsion, ultrasound, children.

Một số đặc điểm hình ảnh khác biệt của khối sau phúc mạc ngoài thận ở trẻ em trên phim chụp cắt lớp vi tính 128 dãy đầu thu

Một số đặc điểm hình ảnh khác biệt của khối sau phúc mạc ngoài thận ở trẻ em trên phim chụp cắt lớp vi tính 128 dãy đầu thu

03/17/2020 10:33:40 | 0 binh luận

The 128 MSCT imaging differentiations of retroperitoneal extra-renal masses in children

SUMMARY

Perpose: Find out the differrentiation of 128 MSCT characteristics of retroperitoneal extra-renal mass in children

Material and methods: we had 128 MSCT images of 67 children patients in National Children’s hospital from January 2018 to April 2019 with pathologically proven of the retroperitoneal extra-renal masses. The patients was divided into 9 groups: neuroblastoma and ganglioneuroblastoma (n=42), Adrenal non-tumorigentic masses (n = 8 ), teratoma (n = 8), ganglioneuroma (n = 3), hemangioma (n = 1), neurofibroma (n = 1), rhadomyosarcoma (n = 1), undifferentiated pleomorphic sarcoma (n=1), pheochromocytoma (n = 1), york sac tumor (n = 1). We retrospectively reviewed the CT images of 67 children patients to find out the imaging differrentiation compared the enhancement level variations between groups and the enhancing of masses with muscle, liver, spleen.

Results: Age of all groups is from 3 days to 11 years, the age of adrenal non-tumorigentic masses is lowest. No statitistically significant different between male and female in retro-peritoneal extra-renal masses. Diameter of adrenal non-tumorigenntic group is smallest. Neuroblastomas, teratomas, geminoma and sarcoma are usually large. Encasement of vessel, calcification, abdominal lymph nodes and far metastasis findings are common signs in neuroblastoma and ganglioneuroblastoma group. Fatty and calcified CT findings are common in teratoma group. There are statitistically significant different enhancement level variation between groups. If the enhancing of the masses was lower than the muscle, these are usually benign. If the enhancement of the masses was higher than the muscle and lower than spleen, it can be benign or malignant, neuroblastoma is very common in this level. Hemangioma enhancement is higher than spleen.

Conclusions: There are differrentiations of 128 MSCT characteristics of retro-peritoneal extra-renal masses in children.

Keywords: retro-peritoneal extra-renal masses, multiple slices computer tomography (MSCT).

Đặc điểm hình ảnh X quang cắt lớp vi tính của viêm túi thừa đại tràng

Đặc điểm hình ảnh X quang cắt lớp vi tính của viêm túi thừa đại tràng

12/05/2019 08:53:52 | 0 binh luận

The computed tomography scan characteristics of colonic diverticulitis

SUMMARY

Purpose: Describe the computed tomography (CT) scan characteristics of colonic diverticulitis (CD). Classification of colonic diverticulitis the World Emergency Surgery Society (WSES), and to compare computed tomography findings of right vs. left colonic diverticulitis.

Methods: Retrospective studies described case series of patients diagnosed Colonic Diverticulitis at University Medical Center hospital and there was CT scan between January and December 2018. Clinical features, treatmentwere collected and assess the characteristics CT scan of Colonic diverticulitis

Results: There were 104 patients, 75 right CD and 29 left CD. Mean age 46, ratio male/female 1,6. Inflamed diverticulum 89,4%; pericolic air bubbles19,2%; pericolic fluid 51,9%; abscess 1,7%; fistula 1,9%; bowel obstruction 1%. The classification of acute diverticulitis by the WSES, uncomplicated acute diverticulitis and complicated acute diverticulitisstage 1a, 1b, 2 a, 2b respectively of 48% and 39,2%; 6,9%; 4,9%; 1%. None of the complicated diverticulitis stage 3,4. Compare CT findings of right vs. left CD: Mean age (41 vs. 61), inflamed diverticulum (96% vs. 72,4%), pericolic air bubbles(8% vs. 48,3%), pericolic fluid (45,3% vs. 69%), abscess(4% vs. 31%), they differed significantly between the two groups (P < 0,05).

Conclusions: Diverticulitis is often right-sided, mild in severity. Most are uncomplicate and complicated diverticulitis stage 1a by the classification of WSES. Right CD occurs in younger and lower complications compared to left CD

Key words: Colonic diverticulitis,pericolic air, abscess,computed tomography findings, WSES.

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.

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