Ultrasonic role in diagnosis gallstones and acute cholecystitis summa ry Objectives: Assess the role of ultrasound through the determination of the sensitivity, specificity, accuracy, positive and negative predictive value in the diagnosis of gallstones, acute cholecystitis (compared with the results of the surgery and the pathology). Methods: Retrospective, cross-sectional description. Results : From January to June 2012, 239 patients were included in the study. Ultrasound diagnosis of 184 patients with gallbladder stone, 81 acute cholecystitis. Postoperative diagnosis 192 patients with gallbladder stones, acute cholecystitis 95 patients. Anatopathologic result get 39 acute cholecystitis. Conclusions: Ultrasound diagnosis of gallbladder stone had a Sn of 95.31%, Sp 98.87%, Acc 95.81%, PPV of 99.46% (in comparison with surgery).Ultrasound diagnosis of acute cholecystitis had a Sn of 87.18% , Sp of 76.50%, Acc 78.24%, PPV of 41.98% (in comparison with anato- pathology). Key words : Ultrasound, gallstones, cholecystitis.

Application TACE in primary hepato-cellular carcinoma summa ry Objectiv and methode: Transcatheter Arterial Chemo- Embolization(TACE) for 23 patients suffered from HCC (Hepato- Cellular Carcinoma) with 34 times of embolization. Results : The tumoral diameter is decreased after 1, 3 months but no statically significant. The intra-tumoral hypervascularity is changing corresponding to the AFP level and the Lipiodol deposition. Some serum biochemical index such as GOT, GPT and Bilirubin are decresed but not statistically significant. Postembolization syndrome appeared in short time. Mean survival time is 15,25 ± 9,04 months. Life standard quality is improved. Conclusion : TACE is a palliativ treatment method however it can offer good result such as prolonging survival time and improving life standard quality.

Assessment of uterine cavity and Fallopian tube patency by sonohystero graphy with saline solution summa ry Introduction : Fallopian tube damage is a common cause, accounting for 30 - 40% of infertile women. Assessment of uterine cavity and Fallopian tube patency is a routine indication with hystero-salpingo graphy (HSG). This technique potentially has risk of allergy, X-ray exposure and specificity is not optimal. This research aims to evaluate the application of vaginal ultrasound combined pumping saline solution into the uterus to examine Study design: cross-sectional descriptive study in 115 cases with infertility examined at Hue University Hospital through clinical examination, gynecological transvaginal ultrasound, pumping normal saline into the uterus and then did HSG at the same period. Results : The abnormalities detected in 30.4% (35/115) cases of infertility. In 11 cases have abnormal uterine cavity diagnosed by ultrasound, HSG detected only 5 cases. The rate of abnormal sonohysterography results are quite good compared to HSG (19.1% vs 17.4%). However, ultrasound can not determine the position occlusion of tube. A number of factors such as age over 35 (p = 0.02; OR = 2.87; CI95%: 1.11 to 7.48), urban residents (p = 0.01), secondary infertility (p = 0.001; OR = 4.21; CI95%: 1.82 to 9.76), chlamydia infection (p = 0.01, OR = 13.17; CI95%:) and high pressure pumping (p = 0.00; OR=17.11) increased the rate of abnormal sonohysterography scan. The rate of complications caused by ultrasound is lower than by HSG. Disadvantages of sonohysterography with saline is impossible to identify the position of tubal occlusion if it does not pass through the end of tube. Conclusion : HSG with saline is a simple method, inexpensivepensive and very effective to assess the uterine cavity and tubal patency in cases with infertility, with similar results compare to HSG and even offer further detection of genital abnormalities which are missed by HSG.

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. Conclusion s: Acute gastric volvulus can be diagnosed with specific sonographic findings. Chronic cases can be detected with upper gastrointestinal series. Keywords: gastric volvulus, children, ultrasound.

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. Conclusion s: 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.

The height of the Pituitary Gland in Vietnamese summa ry Purpose: To clarify the normal Pituitary Gland in Vietnamese with the age and sex related changes. Methods: Reviewed Sagittal T1WI MRI in 1000 subjects, > 10 yaer olds, Head MRI with GE 1.5 T machine, to analyse the size of the Pituitary Gland. Results: The data were analyzed for different age ranges, sex related differences were statistically significant only in the 10 - 19, 20 - 29, 30 - 39, 40 - 49, 50 - 59, 60 - 69 and more 70 year old age groups. There are the differences between male and female. The pituitary height in male subjects maen 4.74 and 5.24 for female. The pituitary height peaked in the 20 - 29 year old age groups and tended to decline with age. Conclusion : The Pituitary gland height may reflect differences between younger and older subjects and between male and female subjects. Keywords: Pituitary gland, MRI of the pituitary grand.

Ttudy the feasibility of acoustic radiation force impulse (ARFI) imaging in the diagnosis of thyroid nodules summa ry Purpose : To assess the feasibility of acoustic radiation force impulse (ARFI) imaging (VTQ and VTI) for differentiation of benign and malignant thyroid nodules. Materials and methods: A total of 130 thyroid nodules underwent conventional ultrasound, including Color Doppler ultrasound using a 7.5MHz linear transducer; ARFI imaging was performed at 4MHz using Siemens Acuson S2000 B-mode- ARFI combination transducer; and FNAC (Fine needle aspiration cytology) assessment of thyroid nodule as reference criteria. Results: 130 nodules were analysed. 103 nodules were benign, 23 nodules were malignant and 4 follicular lesions. The median velocity of ARFI imaging in the normal nodule-free thyroid gland, as well as benign and malignant thyroid nodules was 1.41m/s (range 0.84 - 3m/s); 2.15m/s (range 0.8 - 4.04m/s) and 3.2m/s (range 0.9 - 9.22m/s), respectively. At cut-off 2.16m/s, a sensibility of 79.4% and specificity of 53.7% of VTQ could be achieved (AUROC = 0.731). The difference between VTQ of normal thyroid tissue and thyroid nodule (benign, malignant) has the sensibility of 79.5% and specificity of 51% at the cut-off of 0.63 (AUROC = 0.72). A significant difference was found between VTI on the one hand and benign or malignant thyroid nodules on the other hand, a = 0.001. Conclusions: VTQ and VTI of ARFI can be useful in the assessment of benign and malignant thyroid nodules. These novel quantitative and qualitative elastography method should be combined to give a more reliable result. Further investigations are needed to compare these baseline findings in thyroid nodules in healthy thyroid tissue with those in thyroid diffuse diseases.

Prediction intra- infarct hemorrhage by blood brain barrier indice on perfusion CT scanner in acute ischemic stroke patient summa ry Background: Haemorrhagic transformation is the leading cause of early neurological deterioration in patients with acute ischaemic stroke. Early prediction of this complication is important for selecting appropriate treatment methods, preventing and planning for the complication. Existing predictors of haemorrhagic transformation remain limitations in prognosis accuracy, clinical practicality and radiation safety. The aim of this study is assess the role of blood-brain barrier permeability in prediction of haemorrhagic transformation. Methods: Blood-brain barrier permeanility was obtained using perfusion CT data with implication of the Gjedde-Patlak plot. The obtained permeability value was used to predict occurrence of haemorrhagic transformation. Results : mean blood-brain barrier permeability in lesions developed haemorrhagic transformation was found significantly higher than the value obtained in the lesion without complications. There were a significant relationship between increased permeability and occurence of haemorrhagic transformation. The threshold of 2.7ml/100g/min was established, above that stroke patients are at high risk of having haemorrhagic transfomation. Conclusion : Increased blood-brain barrier permeability is onf of the factor related to haemorrhagic transformation in patients with acute ischaemic stroke. The perfusion CT obtained permeability is proven as a predictor of haemorrhagic transformation. Together with other clinical and imaging findings, pattern of blood-brain barrier permeability is recommended to be included into initial perfusion CT analysis. This may improve prediction, prevention and planning for medical nanagement in patients with acute ischaemic stroke.