Study the magnetic resonance imaging characteristics in patients with hip joint repiacement indicattion SUMMARY Objectives: 1) Characterization of magnetic resonance images aseptic necrosis of the femoral head in patients with hip replacement appointed. 2) Characterization of magnetic resonance images of the contralateral hip in patients people on. Objects and methods of research: Retrospective study of 60 patients with aseptic necrosis of the femoral head surgery during 2014- 2015 at a hospital in Hanoi Medical University and Hospital Vietnam Germany. Results: The patients having hip replacement appointed two phase III and IV. All patients had femoral head collapse and are mostly seen when patients have hip osteoarthritis secondary (75% stage IV). Hypointense region was 73.3% stage III, stage IV, 93.3%, in line with a high prevalence of bone marrow showing the progression of the disease is> 85%. Rate aseptic necrosis of the femoral head in the contralateral hip joint meeting with the high rate of 80%, occur in all phases. Photos CHT at an early stage (I and II) are more common form hypointense band (77.4%), bone marrow lesions form T1-weighted images are shaped ring (61.3%), lesions of the subclass A (74.2%). Late stage (III and IV) characteristic image is under the cartilage fracture and femoral head collapse, besides that other image: hypointense on T1-weighted images region (70.5%), the image of subclass D (52.9%). Conclusions: MRI allows an accurate assessment stage lesions of clinical help for prognosis and hip replacement decision at the right time, at the same time to detect aseptic necrosis of the femoral head in the contralateral hip though no clinical symptoms, so that early treatment measures or prevent the more severe complications. Keywords: Aseptic necrosis of the femoral head.

SUMMARY Objective : Report results of percutaneous vertebroplasty for treatment of osteoporotic compression fractures in the thoracic spine Methods: There is a retrospective combined prospective study in 40 patients who had fractured thoracic vertebrae due to osteoporosis were performed vertebroplasty at Bach Mai Radiology Center from January 2018 to March 2019. Patient’s pain status was rated with Visual Analogue Scale (VAS) score and Macnab system, pre- and post-operative vertebral heights and Cobb’s angles were measured and complications were noted 1 week, 1 month, 3 months after surgery. Results :40 patients with 56 fractured vertebraes show that there are no complications in the process of puncture needle and system complications, 12,5% cases of cement leakages into peri-vertebrae there is no case of cement cause pulmonary embolism, 5% case of pain post- operative. VAS scores were significantly reduced from 6.95 to 1.72, 86,95% has good and excellent, Cobb angle slightreduced from 14.4±9.1 to 13.2±8.5, the anteriorvertebral height slight increased from 18.5±4.3mm to 19.1±4.1mm, the middle vertebral height increases from 16.7±4.3mm to 17.4±4.3mmwith p<0.05, there is no significant changing in the post vertebral height after 3 months of intervention with p>0, 05. Conclusion: Percutaneous vertebroplasty thoracic spine is a safe and effective method in order to provide rapid pain relief, but is less significant in improving the Cobb angle and vertebral body height. Key words: Percutaneous vertebroplasty thoracic spine, treatment of Thoracic Fracture, pain reduction, change vertebral height.

Imaging characteristics and the role of ultrasound on diagnosis and tracking after surgical treatment carpal tunnel syndrome SUMMARY Carpal tunnel syndrome quite commonly, pinched median nerves can cause muscle atrophy, reduced function and motor of hand. Surgical treatment of carpal tunnel syndrome cut carpal ligament is the most thorough treatment. Ultrasound is one of the means to applied in the diagnosis and tracking after of the disease. Objectives : 1) Describing the characteristic ultrasound images of carpal tunnel syndrome; 2) Analyzing the ultrasound images before and after surgery treatment of carpal tunnel syndrome. Subjects and Method : A prospective study of 33 patients with 37 hands, who underwent open surgical for carpal tunnel syndrome from November 2013 to September 2014 at the hospital in Hanoi medical University. The patients were clinical examination, electromechanics and ultrasonography carpal tunnel before and after the operation. Results: The area of median nerve segment near pronator quadratus muscle in pre-treatment period 6.4±1.3mm2, near proximal carpal tunnel 17.3±7.2mm2, in carpal tunnel 8.3±2.7mm2, outlet carpal tunnel 9.0±2.8mm2. The common signs of neuronal injury median as: swelling of the nerve median positive 94.6%, Notch sign positive 73%, Delta sign S>2mm2 positive 91.9%, the CSA W/F>1.4 positive 89.2%... 02 wrists abnormalities neurosurgeon 6%. Postoperatively the patients had clinical manifestations to immediately reduce, but the nerve median area decreased only after 3 months (p<0.05). Conclusion: Ultrasonography has ability identify nerve median segments injured through the carpal tunnel and other injuries the wrist coordinated, simultaneously ultrasound tracking effective after surgical treatment tunnel syndrome wrists. Keywords : Carpal tunnel syndrome.

Conventional Radiography and MRI for the diagnosis of vertebral metastases SUMMARY Purpose : Describe the imaging characteristics and evaluate the value of conventional radiography and MRI for the diagnosis of vertebral metastases. Material and methods : 62 patients with vertebral lesions suspected metastates were taken biopsy at radiology department in Bach Mai Hospital from November 2011 to August 2013. Result : A total of 42 patients with vertebral metastases,male / female 26/16, the mean age is 57.43 ± 13.29. The percentage of lesions detected on X-ray were 52.4% with the sensitivity of signs of vertebral collapse,condensation of vertebral body, pedicle destruction were 31.8%; 18.7%; 21.4%. MRI: the sensitivity, specificity, accuracy were 97.6%; 75%; 90.3%. Conclusion: Although X-ray is the first method but less valuable in diagnosing vertebral metastases. Magnetic resonance imaging has great value in the diagnosis of vertebral metastases with many special signs.

The result of percutaneous vertebroplasty in treatment of recent osteoporotic vertebral compression fractures SUMMARY Purpose: To assess short-term outcomes in patients with recent osteoporotic vertebral compression fractures treated with percutaneous vertebroplasty. Methods : About 15 patients suffered from recent osteoporotic vertebral fractures underwent the percutaneous vertebroplasty between April 2012 and October 2013 at Radiology Department, Bach Mai hospital. The average age of patients was 75.9 years (14 womens). Measurements of pain and mobility were compared at 1 day, 1 week, 1 month and 3 months after the procedure. Results: Pain scores were significantly reduced compared with before treatment at every follow-up period. The preprocedural mean VAS score was 9.1. At follow-up, mean VAS scores ranged from 2.2 to 4.8. The pre-treatment mean RDQ score was 18.8 and it ranged from 8.9 to 11 at follow-up. Conclusion : Percutaneous vertebroplasty offers significant benefits in relief pain and improve mobility for recent osteoporotic vertebral fractures.

A computed tomographic study of C1, C2 morphology for atlantoaxial screw fixation techniques SUMMARY Purpose : This study is aimed to define the ethnic differences in the radiological measurements on C1 and C2 in Vietnamese population in order to determine the feasibility of implement C1-2 fixation techniques. Study design: Retrospective study. Methods : From October 2017 to April 2018, 120 thin-slide (1 to 3 mm) computed tomography scans of the cervical spine were reviewed. Various dimensions of C1 and C2 were analyzed on axial, sagittal reconstructed CT images. The differences between the right and left sides and between males and females were statistically analyzed using t-test, with a p-value of < 0.05 considered significant. Results: Mean anteroposterior dimension and transverse width of C1 lateral mass were 19.7±2.1 mm and 12.2±1.7 mm, respectively. Mean angle of the screw directed to maximal medial, lateral, cranial and caudal were 36.6±2.80, 28.2±3.00, 49.6±4.10 and 26.4±5.50 respectively. Average isthmus height, internal height and pedicle width of C2 were 5.8±1.0 mm, 4.8±1.3 mm and 5.0±1.3 mm. No significant differences between the right and the left side of C1, C2 parameters and between sex variations. The prevalence of high-riding vertebral artery was 13.8% and narrow pedicle was 17.9%. Conclusions: this study shows that the morphology of C1 and C2 is variable between Vietnamese and other populations. Due to several cases may not be relevant for C1-2 fixation techniques, preoperative anatomy evaluation based on CT data need to be performed for screw placement and trajectory planning. Key word: atlanto-axial trauma, C1 lateral mass dimension, high-riding verebral artery, C2 narrow pedicle.

NỘI DUNG I.MỞ ĐẦU II.ĐỐI TƯỢNG VÀ PHƯƠNG PHÁP NGHIÊN CỨU III.KẾT QUẢ VÀ BÀN LUẬN IV.MINH HỌA CA LÂM SÀNG V.KẾT LUẬN

—Chấn thương khớp vai: Là tổn thương vùng khớp ổ chảo – cánh tay và thành phần xung quanh do lực tác động cơ học Thường gặp chấn thương rách chóp xoay, chủ yếu là rách gân trên gai và dưới gai (~40% ) —Khảo sát khớp vai Siêu âm khớp vai - Siêu âm theo động học gân chóp xoay - Thời gian thăm khám ngắn - Giá thành thấp - Thực hiện được cho mọi bệnh nhân - Thực hiện được ở nhiều cơ sở y tế ban đầu có máy siêu âm Cộng hưởng từ khớp vai - Có thể chụp cộng hưởng từ theo động học nhưng khó thực hiện - Thời gian thăm khám dài - Giá thành cao - Chống chỉ định đối với bệnh nhân có CCĐ chung của CHT - Chỉ thực hiện được tại các cơ sở y tế lớn có máy cộng hưởng từ Đánh giá vai trò của siêu âm so với cộng hưởng từ trong phát hiện tổn thương rách gân chóp xoay do chấn thương