SUMMARY Objective: Correlation between preoperative computed tomography, endoscopy with postoperative histopathology in the staging of laryngeal cancer. Methods: Cross- sectional study of patients with cancer larynx who were taken a preoperative neck CT scan. Classify T stage by blinded reading of CT combined with laryngoscopy, compared with surgical results, histopathological T-stage. Analyzing the sensitivity and specificity of CT, endoscopy to staging T. Results: There were 105 patients including 96 male patients and 9 female patients. Patients were aged from 38 to 87 (mean, 61 years). 16 (15%) patients had hypopharyngeal tumor, where's 89 (85%) had pharyngeal tumor.Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT in staging T were 68%, 93%, 70%, 92% , 88% Conclusion: MSCT could serve as a powerful auxiliary method for staging T laryngeal cancer, special in the evaluation of T3 and T4 tumors. Combinate information from MSCT and laryngoscopy makes improve sensitivity, specificity of preoperative staging T Keywords: Laryngeal cancer, multislice computed tomography, laryngoscopy, T-stage.

SUMMARY Aims: To describe the morphology of normal appendix on abdominal contrast-enhanced computed tomography (CECT). Materials and methods: A cross-sectional study was conducted on all patients ≥ 18 years who underwent abdominal CECT for various indications from 04/2019 to 07/2020. Exclusion criteria include previous history of appendiceal diseases, appendicectomy, clinical manifestations suspected appendicitis, and other gastrointestinal-related comorbidities. All appendiceal morphology (length, diameter, wall thickness, intraluminal contents, location of base and tip) were documented. Results: 186 patients (54.8% male) with the mean age of 51.6 ± 13.4 years were enrolled in the analysis. The mean maximal diameter, mean length and mean wall thickness of the appendices were 6.7 ± 1.3 (range, 3.6 – 11.7 mm), 82.1 ± 24.8 (range, 20.5 – 138.2 mm) and 2.1 ± 0.4, respectively. The mean diameter measured on axial view was significantly lower than that of on coronal view (p <0.05). Appendicoliths were identified in 5.9% of cases. The most common locations of the appendiceal tip were subcecal and retrocecal (22.6% each). Conclusion: A new threshold should be proposed, clinical manifestations and multi morphological factors correlation are strongly recommended when diagnosing appendicitis on CECT. Normal appendices can contain air, fluid and appendicolith with an incidence that varies among individuals. Keywords: normal appendix, computed tomography, appendix location.

SUMMARY Objective: The objective of the study was to evaluate the value of CT in preoperative staging of tongue cancer according to AJCC 8th Methods: Cross-sectional study. We did indicate CT for 66 patients with tongue cancer at Ung Buou Hospital from 5/2019 to 5/2020. Preoperative stages on CT and histopathological stages were compared. Results: DOIs on CT were larger than the pathological DOI ( p<0.001). DOIs on CECT correlated well with pathological DOI (r=0.79, p<0.001). The correlation between CT and pathology in T staging was 0,63. In the evaluation of metastatic nodes, the sensitivity of CT was 80,9%, the specificity was 91,1%. The correlation between CT and pathology in N staging was 0,58. In the evaluation of ENE, the sensitivity of CT was 75%, the specificity was 81,8%. Conclusions: CT can determine the DOI value accurately. The correlation between CT and pathology is good in T staging and moderate in N staging. Keywords: tongue cancer, CT, AJCC 8th staging, DOI.

SUMMARY Objective: To determine the proportion of bone metastasis and whole-body scintigraphy with 99mTc-MDP in neuroblastoma (NB) in children. Subjects and Methods: A retrospective descriptive combined prospective study was conducted on 86 patients under 15 years old, diagnosed with NB according to the standards of Pediatric Oncologists Conference in 1988 and had whole-body scintigraphy with 99mTc-MDP at Vietnam National Children's Hospitalfrom January 2018 to March 2020. Results: The proportion of detection metastasis was 33.7%. There are 55.2% patients with bone metastases without clinical manifestations (without bone pain). 100% cases of bone metastases on whole-body scintigraphy have images of increased radioactivity. Most of the patients were about 2 - 4 years old 58.6%, lower limb position 62.1%, multifocal lesions 72.4%, of which 58.6% patients had over 5 lesions. Conclusions: Whole-body scintigraphy with 99mTc-MDP is a valuable technique for detecting bone metastases on NB in the early stage when absence of clinical manifestations of bone metastases. Keywords: Neuroblastoma, whole-body scintigraphy, 99mTc-MDP.

SUMMARY Objective: The aims of this study were to determine the value of the semi-quantitative parameters obtained by dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) in differentiation between benign and malignant breast lesions. Methods: A retrospective study was performed on 63 females (with 72 breast lesions) underwent DCE-MRI before treatment at Cho Ray hospital from Jan 2019 to Feb 2020. The value of semi-quantitative parameters (signal intensity slope (SIslope), maximum slope of increase (MSI), percentage of peak enhancement (Epeak)) were evaluated. The diagnostic value of the time intensity curve according to 5th edition ACR (2013) was compared with the value based on semi-quantitative methods. The results of each DCE-MRI parameter were correlated with histopathology. Results: There were 63 patients with 72 breast lesions including 40 benign lesions and 32 malignant lesions. The area under the ROC curve of SIslope, MSI and Epeak were 0,908; 0,702 and 0,734, respectively. The sensitivity, specificity and accuracy of the time intensity curve according to ACR and semi-quantitative methods were 68,8% and 87,5%; 87,5% and 85%; 79,2% and 86,1%, respectively. Conclusion: Our study reinforces the importance of the semi-quantitative parameters of DCE-MRI in distinguishing between benign and malignant breast lesions. Semi-quantitative analysis of the time intensity curve helps to increase the diagnostic accuracy compared with the methods of ACR. Key words: breast lesions; semi-quantitative parameters; time intensity curve.

SUMMARY Background: Anterior communicating artery aneurysms (Acom) accounts for 23 - 40% of ruptured intracranial aneurysms. A ruptured cerebral aneurysm is a medical and neurological emergency that requires early diagnosis and prompt management to reduce mortality and sequelae. Material and method: Retrospective description of 40 patients who were diagnosed of ruptured anterior communicating aneurysms based on the clinical characteristics, imaging and results of endovascular treatment. Clinical outcomes were evaluated on a modified Rankin scale. Results: Patients suffering from ruptured Acom aneurysms presented headache (100%), thunderclap headache (45.0%), vomiting with or without nausea (60%), nuchal rigidity (67.5%). Aneurysms’s size was under 5mm, 5-15mm and over 15mm accounting for 52.4%, 45.0% and 2.5% respectively; None of the patients had giant aneurysms. Dome and neck ratio of <1.2 ; 1.2 - 1.5 and ≥1.5 account for 37.5%; 32.5% and 30.0% respectively. Diameter of Acom ruptured aneurysm’s neck under and above 4mm accounted for 80.0% and 20.0%, respectively. Successful coiling embolization of Acom ruptured aneurysms without complications achieved in 80.0%. The patient had a good clinical recovery of 92,5% after 3 to 6 months follow-up. Conclusion: Coiling embolization of Acom ruptured aneurysms were effective and safe. Keywords: Anterior Communicating Artery Aneurysms, coiling, intervention. *

SUMMARY Abstract: Gastrointestinal bleeding due to rupture of esophageal varices and gastric varices in cirrhosis is quite common and has a high mortality rate if untreated. Gastric varices are difficult to control under endoscopy, intravascular intervention is a highly effective method. In patients who don't have or an inappropriate gastrorenal shunt, antegrade transvenous obliteration method is the preferred method of treatment. Purpose: To evaluate the initial results in antegrade transvenous obliteration method in cirrhotic patients with gastric varices. Material and methods: 13 patients diagnosed with cirrhosis of the liver had gastric varices from June 2020 to June 2021 received an antegrade transvenous obliteration intervention. The varices were assessed by endoscopy and MSCT before treatment, immediate effect after intervention on DSA imaging and clinical improvement. Results: 13 cirrhosis patients with gastric varices performed antegrade transvenous obliteration, of which 3 patients were treated with a combination of both PARTO and ATO. Results 12/13 patients were occluded from all branches, there was no case of acute gastrointestinal bleeding within 3 days after intervention account for 92,31%. 1/12 patients with complete occlusion of the feeding branches had recurrent gastrointestinal bleeding during the follow-up period > 3 months account for 8,33%. There were 3 patients who went to the examination again after 3 months, endoscopy or MSCT scan showed reduction of phlegmon dilated, no gastrointestinal bleeding. Conclusion: antegrade transvenous obliteration intervention is an effective method in patients with gastric varices rupture but without gastrorenal shunt or modified gastrorenal shunt cannot perform simple PARTO method. Keyword: Gastric varices, antegrade transvenous obliteration, retrograde transvenous obliteration, gastrorenal shunt

Danh sách học viên đã hoàn thành bài test đủ điều kiện cấp CME Chủ đề “Siêu âm tim đánh dấu mô cơ tim trong bệnh động mạch vành"