• Thứ 3, 02/03/2021
  • (GMT+7)
Chiến lược xử lý cơn đau quặn thận

Chiến lược xử lý cơn đau quặn thận

23/05/2020 12:30:25 | 0 binh luận

Management of renal colic SUMMARY Renal colic is a frequently situation seen in emergency. The pathophysiological mechanisms of pain in acute renal colic is due to increased intrapyelic pressure by ureteral obstruction with renal synthesis of prostaglandin E2. Intrarenal hemodynamic changes by increase the blood’s flow. The pharmacological treatment base on these pathophysiologicals mechanisms. The diagnostic and radiological mission are relatively well codified in all emergency center. For the simple renal colic, the radiograph of the abdomen without preparation can identify the calcifications of stones on urinary tract. The ultrasound can detect the presence of stones in the kidney and in the urinary tract. In somes cases, ultrasound find only indirect sign obstruction of which suspect the migration of the renal stones into urinary tract. For complex colic, considering the sensitivity, the dose of radiation, the cost and quality of the information obtained, the scanner is the test of choice of the initial diagnostic tool. Keywords: Renal colic, ureteral obstruction, simple renal colic, complex colic, radiograph, ultrasound, scanner.
Chẩn đoán thoát vị bịt trước mổ

Chẩn đoán thoát vị bịt trước mổ

22/03/2020 21:15:45 | 0 binh luận

Preoperative diagnosis of obturator hernia SUMMARY The obturator hernia is a very rare type of hernia which usually presents in thin, elderly women with poor clinical signs. The preoperative diagnosis is typically difficult, with non-specific signs and symptoms which result in a delay in the diagnosis. Delayed diagnosis is a cause of increased mortality due to ruptured gangrenous bowel. We report two cases of incarcerated obturator hernia presented with a history of intestinal obstruction and the hernia was diagnosed preoperatively by computed tomography. Keywords: Obturator hernia; diagnosis, computed tomomgraphy scan.
Đặc điểm hình ảnh nang ống mật chủ ở trẻ em trên siêu âm và cộng hưởng từ 1.5T

Đặc điểm hình ảnh nang ống mật chủ ở trẻ em trên siêu âm và cộng hưởng từ 1.5T

31/03/2020 21:43:09 | 0 binh luận

Imaging characteristics of choledochal cysts in children on ultrasound and MRI 1.5T SUMMARY: Purposes: The description of Imaging characteristics of choledochal cysts in children on Ultrasound and MRI 1.5T Material and methods: 44 patients were diagnosed choledochal cysts on Ultrasound and/or had Ultrasound and MRCP from 7/2012 to 9/2013 in National Hospital of Pediatrics. 16 patients with choledochal cysts underwent MRCP using a half –Fourier acquisition single-shot turbo spin-echo sequence. MRCP findings were compared with intraoperative cholangiography. Result: In 44 patients choledochal cysts including 34 girls and 10 boys:age range, 2 months -16 years; mean age 3.4 years. Clinical presentation: abdominal pain is the most common symptom (72.72%), vomiting (63.18%), fever (15.90%), jaundice (13.63%). The type of choledochal cysts (according to Todani): type I (93%), type IVa (7%); Type of dilatation: cystic dilatation (77.27%), fusiform dilatation (22.73%); mean measurement: 39.47mm; stone in cyst (29.5%); intrahepatic duct dilatation (43.18%); gallstone (6.8%). MRCP findings (n=16): with the most common form being typeI 87.5% (14/16), typeIVa 12.5% (2/16); cystic dialatation (93.7%), fusiform dilatation 6.3%. Cystolithiasis (75%); intrahepatic duct dilatation (56,25%). Kappa value was good agreement (k: 0.717-0.738) when compared Ultrasound and MRCP. The presence of the anomalous junction of pancreaticobiliary duct was revealed by MRCP in only 10 cases of 13 cases choledochal cysts with Kappa value was good agreement (k=0.612) when compared with intraoperative cholangiography. Conclusion: Ultrasound and MRI showed overall good accuracy in the detection and the classification of choledochal cysts and revealed associated complications. MR cholangiopancreatography provides information about anomalous pancreaticobiliary ductal union in children with choledochal cyst. Key words : Choledochal cyst, Ultrasound. Magnetic resonance cholangiopancreatography (MRCP).
Đặc điểm hình ảnh của u nguyên bào gan trẻ em trên phim chụp cắt lớp vi tính hai dãy đầu thu

Đặc điểm hình ảnh của u nguyên bào gan trẻ em trên phim chụp cắt lớp vi tính hai dãy đầu thu

31/03/2020 21:48:55 | 0 binh luận

Characteristic of pediatric hepatoblastoma on 2 detector computed tomography SUMMARY: Purpose: to describe the characteristics of hepatoblastoma (HB) on 2 detector computed tomography (CT) images Materials and method: 49 under 15 year-old patiens with pathological results of HB were undergone 2 detector computed tomography from 2010 to 2014. Result: 100% was solid tumor, the average diameter was 8.48mm, most of them were single tumor, located at the right lobe, lobulated and defined margin, heterogeneous structure, 31.5% had calcification, strong contrast enhancement in the arterial phase, less than liver parenchyma in the portal phase. 63% enhanced less than normal liver parenchyma in both aterial and portal phase. Pretext II and III is 81.7%, lung metastasis in 4 cases, portal vein thrombosis in 2 cases, 4 cases infiltrated to extra-hepatic spaces, 1 tumor was ruptured, 2 caseshad hepatic umbilical nodes. Conclusion: HB appears on CT images as a solid tumor, heterogeneous, irregular margin mass, 31.5% had calcification. After injecting the material contrast most of tumors enhance trongly during the arterial phase and less density than the surrounding liver parenchyma in the portal phase. The most common is PRETEXT II and III. It may metastase to lung, lead to portal vein thrombosis, hepatic hilar lymph node. Keywords: hepatoblastoma, liver tumors in children, liver mass in children, hepatoblastoma imaging.
Nhận xét đặc điểm hình ảnh và kết quả chẩn đoán cắt lớp vi tính so với phẫu thuật trong di dạng teo thực quản, rò khí thực quản bẩm sinh

Nhận xét đặc điểm hình ảnh và kết quả chẩn đoán cắt lớp vi tính so với phẫu thuật trong di dạng teo thực quản, rò khí thực quản bẩm sinh

03/04/2020 09:10:39 | 0 binh luận

CT imaging in congenital esophageal atresia, tracheo-esophageal fistula (TEF ) comparing with surgical results SUMMARY: Purpose: To review some CT signs in congenital esophageal atresia, tracheo-esophageal fistula (TEF) and compare the CT findings with surgical results. Materials and Methods: Images, CT diagnostic results were collected and compared with the surgical descriptions in 7 cases TEF from 12/2007-11/2010 at Binh Dinh hospital. Results: Direct signs: atresis image of esophageal was visualized in 100% cases. The image of fistula between proximal esophagus-trachea: true positive is 2/3 cases, true negative is 3/4. The image of fistula distal esophagus-trachea: true positive is 3/6 cases, true negative are 1/1. Indirect signs: pneumonia and esophageal dilatation were visualized in 100% cases. Gaseous distention of the stomach and bowel was visualized in 3/4 cases which exist only lower fistula and 2/2 cases which exist both upper and lower fistula. Conclusion: Between CT with surgery is concordantly in 5/7 cases, nonconcordantly in 2/7. Key words: esophageal atresia, tracheoesophageal fistula, congenital tracheoesophagus
Nghiên cứu giá trị chụp cắt lớp vi tính trong chẩn đoán viêm ruột thừa cấp

Nghiên cứu giá trị chụp cắt lớp vi tính trong chẩn đoán viêm ruột thừa cấp

03/04/2020 09:04:58 | 0 binh luận

Value of CT- Scanner in the diagnosis of acute appendicitis SUMMARY: Acute appendicitis is most common in emergency surgical abdominal pathology. CT- Scanner is usually applied in atypical form of acute appendicitis which making difficult for diagnosis. Prompt CT-Scanner diagnosis can reduce the follow–up time, exclude the wrong so as justify the perforated one. Objective: Imaging description and assess the value of CTScanner in diagnosis of acute appendicitis. Subjects and Methods: Cross-section descriptions of 92 subjects were clinically diagnosed pre-operation. CT scanner was carried out also before surgery. The CT-Scanner results was confronted to results of surgery and anatomopathology. Study performed in the Department of Surgery of Bach Mai Hospital from December 2008 to July 2010. Results: The average diameter of the appendix inflammation was 10.32 ± 0.49 mm (min 5 mm, max 30 mm). Inflamed appendix diameter was more than 6 mm (83.5%) and wall thickness more than 2 mm (85.7%). Fat infiltration and fluid around the appendix was 84.6% and 50.5%, respectively. Appendix high density was compared with caecum (29.7%) and appendix enhancement was 89.0%. Thickness of caecum localized around the base of the appendix (26.4%). Stone of appendix, ganglion mesentericum and perforation complication were seen in 38.5%, 12.9% and 29.7%, respectively. Conclusion: The CT-Scanner was very effective in diagnsosis of appendicitis, especially in difficult cases. It confirmed the location, size and complications of appencitis. The value of this modality is higher than US. Key words: Acute Appendicitis, Acute abdominal pain, CT scanner.
Đánh giá giai đoạn ung thư trực tràng bằng cộng hưởng từ: kết quả 3 năm

Đánh giá giai đoạn ung thư trực tràng bằng cộng hưởng từ: kết quả 3 năm

02/04/2020 15:12:16 | 0 binh luận

Preoperative staging of rectal cancer by pelvic mr imaging: results after 3 years SUMMARY: Introduction: Colorectal cancer is the most common cancer of the gastrointestinal tract. Rectal cancer is the second most common cancer in Vietnam. Preoperative staging of rectal cancer has an important role to select the most appropriate treatment. Purpose: To access the role of pelvic MR imaging in preoperative staging of rectal carcinoma. Materials and methods: Preoperative pelvic MRI of 110 patients with rectal cancer was performed in University Medical Center at HCMC for 3 years. Staging was made by evaluating images obtained and compared with postoperative histopathologic staging. Results: The accuracy of pelvic MR imaging for defining the T stage of rectal cancer was 89%. The accuracy rate to detecting lymph node metastases was 92.5%. Conclusions: Pelvic MR imaging is a promising technique for accurate preoperative staging of rectal cancer. Keywords: Rectal cancer, MR Imaging, colorectal carcinoma
Nghiên cứu đặc điểm hình ảnh và giá trị của cộng hưởng từ trong chẩn đoán sỏi ống mật chủ

Nghiên cứu đặc điểm hình ảnh và giá trị của cộng hưởng từ trong chẩn đoán sỏi ống mật chủ

02/04/2020 16:49:58 | 0 binh luận

imaging characteristic and evaluation of MRI on the diagnosing of extra hepatic biliary stone SUMMARY: Objective: Study of MR imaging characteristic of the extrahepatic CBD & its value about the stone finding. Objet and Method: Retrospectiv of 56 patients having open operation, endo and retrograde endoscopy from 10/2010 - 8/2011 at Bach mai hospital. Means: USG of Philips HD11, MRI units of Siemens Advanto and Essenza 1.5T. Results: Among 56 operated patients for CBD stone, 6 free of stone (4 Oddi stenosis, 1 vater ampulla tumor, 1 unknown cause). MRI detected 49/50, missing 2% . In 49 positiv, 1 having 10 stones (2%), almost 3 (38%), the greatest 20 x 30mm, mainly localized at the III extrahepatic CBD portion (85/153 stones). 1 missing 5mm is at the IV portion, 49% inhomogenous mosaic form,79 strongly hyposignal on T2W. 22 patients (44.9%) associated with lithiasis in right bile duct, left 27 (55.1%), GB 13 (26.5%). Bile duct dilatation up and downward of the stone 23 (46.9%), hepatic abcess 3 (6.1%) Compare USG/MRI. USG: Se 96%, Sp 16.1%, PPV 48%, PPV 48%, Acc 52%. MRI: Se 98%,Sp 83,3%, PPV 98%, NPV 83.3%, Acc 96.4%. Conclusion: MRI is a good means for detecting low CBD stone also for predicting its number, dimension, location and complication also Se, Acc evidently higher than USG.

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