Evaluation of the early efficacy of radiofrequency ablation for benign thyroid nodules in symptomatic patients SUMMARY Objective: To evaluate the early efficacy of radiofrequency (RF) ablation for treatment of benign thyroid nodules, which causes symptoms in the Department Radiology- Bach Mai Hospital. Methods: We evaluated 51 benign thyroid nodules from 43 patients treated with RF ablation between 10/2016 and 4/2017. The procedure began with examining and diagnosing an benign thyroid nodules which causes symtoms by clinical physicians. The patients were diagnosed with a benign thyroid nodule according to the TIRADS classification combined with at least two appropriate results of cytology or biopsy by radiologists. The patients were then considered and performed radiofrequency ablation treatment for benign thyroid nodules. The follow-up examinations took place 1 month after RF ablation. Results: (1) 94% of the tumors needed only one time of RFA; (2) One treatment duration of RFA lasted an average of 21.8 minutes, (3) 76% of the tumors decreased by 30-50% volume, 11 % decreased by > 50% volume. (4) 100% of the treated individuals will reduce perfusion. (5) 96.4% of patients reduced or lost their symptoms. (6) There were no major complications during treatment, minor side effects (neck pain, bleeding,voice change …) restored after 2 weeks maximum. Conclusion: Radiofrequency ablation is a minimally-invasive method and an effective treatment for symptomatic thyroid nodules that are confirmed benign. Keywords: Thyroid nodule, benign thyroid nodule, symptomatic thyroid nodule, treatment for thyroid nodules, radiofrequency ablation.

SUMMARY Objectives: The aim of this work was to evaluate the outcomes after the endovascular interventions for chronic venous insufficiency of the lower limbs. Methods: This study was conducted on 60 patients diagnosed with chronic venous insufficiency of the lower limbs at the Radiology Center, Bach Mai Hospital, 2018 – 2019. Convenience sampling technique was used for this study. Results : Endovenous laser ablation was indicated for 40 patients and endovenous radiofrequency (RF) ablation was for 20 patients, showing all patients were removed from the reflux line. For the patients with laser ablation, the mean Venous Clinical Severity Score (VCSS) were 3,67 ± 3,58 (0-11) before the treatment; 1,22 ± 2,03 (0-6) at 1 month; and 0,41 ± 1,01 (0-4) at 12 months. For the patients with RF ablation, the mean VCSS were 3,62 ± 3,45 (0-10) before the treatment; 0,15 ± 0,55 (0-2) at 1 month; and 0,08 ± 0,28 (0-1) at 12 months. 18 cases were recorded the complications after the intervention (30.00%), including dark skin, and paresthesia. 2 cases had the positions with varicose veins after 12 months (3.33%). There were no significant differences in the efficacy and complications amongst endovenous laser ablation and endovenous radiofrequency ablation (p >0.05). Conclusions : Endovascular intervention is minimally invasive safe effective method that improves long-term better symptoms.

Evaluation of erlier outcome of treatment embolization for ruptured brain arterionous malformation in children with onyx SUMMARY Objective: The manifestation of clinical symptom, CT scanner, DSA imaging and evaluated earlier results of treatment embolization for ruptured brain arteriovenous malformations (bAVM) in children with Onyx. Methods: A prospective study was performed at National Children Hospital with treatment of ruptured bAVM by Onyx during the period from March 2017 to July 2019, including 45 patients. Results: Twenty-Five boys and Twenty Girls with a mean age of 8.7 years,. Result in on CT: cerebral hemorrhage on Supratentorial was 77.8%, infratentorial 11.1%, intraventricular hemorrhage 57.8%. DSA: according to Spetzler – Martin grading system: grade 1: 2.2%, grade 2 60%, grade 3 33.4%, grade 4 4.4%, 57 interventional sessions of embolization were performed, 1 to 3 sessions/patient with an average of 1.2 sessions/ patient, Complete obliteration of the AVM with Onyx was achieved in 26 of 45 patients (57,7%). Partial obliteration (>60%) was 17of 45 patients (37.7%), there were 8 patients with complications including hemorrhages and infarctions during embolization and good recovered, no died patient. Conclusion: Endovascular treatment of ruptured bAVMs with Onyx in children seems safe and effective with low complication rates. Key words : Arteriovenous malformation, Embolization, children

Plug-assisted retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage in patients with liver cirrhosis SUMMARY Objective: To evaluate the feasibility, safety, and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) to treat gastric variceal hemorrhage in patients with portal hypertension. Methods: From 2/2017 to 3/2019, 37 patients (8, with history of gastric variceal hemorrhage; 6, active bleeding; 28, risk rupture; 5, ineffective endoscopic interventions) who underwent PARTO using a vascular plug and a gelfoam pledget were retrospectively analyzed. Conclusion: Plug-assisted retrograde transvenous obliteration is technically and clinically effective for the treatment of gastric varices. Results : Plug-assisted retrograde transvenous obliteration procedures were technically successful in all 37 patients. There are two cases of combining PARTO with downstream intervention through the portal vein. There are 2 cases of drug release outside the blood vessels during the intervention. 100% of cases use only 1 plug, 3 patients use additional coil (due to large shunt diameter). There were no cases of variceal bleeding during the follow-up. Keywords: cirrhosis, gastric varices, Plug-assisted retrograde transvenous obliteration.

A study on the role of arterial spin labeling technique (ASL) in the grading of astrocytoma SUMMARY Objective : Assessing the role of perfusion in grading astrocytoma with arterial spin labeling. Studying the value and correlation between relative cerebral blood flow (rCBF) and with the grade of astrocytoma. Method: A descriptive study was carried out at Cho Ray Hospital from March 2017 to June 2018. All MR imaging examinations were performed on a 3 Tesla MR imaging system Skyra (Siemens, Germany). Pulsed ASL technique was acquired for all the patients. For each patient, relative CBF values of the lesions were obtained by dividing the CBF values of tumors to the normal appearing symmetric region on the contralateral hemisphere. The value and correlation between rCBF and the grade of astrocytoma were studied. Result: 19 cases with histopathologically proven gliomas were studied (7 male, 12 female; age range = 21 to 66 years, mean age = 44,16 years). Hide-grade astrocytomas were 78,95% and low-grades were 21,05%. With a cut-off value of 3,095, rCBF predicts high grade astrocytoma with sensitivity of 93,33%, specificity of 100%, PPV of 100%, NPV of 100%, accuracy of 94,74%. rCBF correlated positively with the grade of astrocytoma (r = 0,613, p < 0,01). Conclusion : The rCBF plays an important role in predicting low and high grade astrocytoma. rCBF correlated positively with grade astrocytoma. Keyword : Astrocytoma, relative cerebral blood flow (rCBF), correlation, low and high grade of astrocytoma.

Prosthetic heart valve assessment with 640-Slice MSCT: Initial Experience with 36 Prosthetic heart valv es SUMMARY Objectives: Multislice CT(MSCT) has shown potential for prosthetic heart valve (PHV) assessment. We assessed the image quality of different PHV types to determine which PHV are suitable for MSCT evaluation and accuracy of 640-Slice MSCT for PHV dysfunction assessment. Subjects and methods: Cardiac 640- Slice MSCT examinations performed at the Medic medical center since 6/2013 to12/2016 were reviewed for the presence of PHVs. Image quality of the supravalvular, perivalvular, subvalvular and valvular regions was scored on a four-point scale (1=non-diagnostic, 2= moderate, 3=good and 4=excellent). Causes of PHV dysfunction were confirmed by surgery. Results : 28 patients with a total of 36 PHVs (4 monoleaflets, 25 bileaflets and 7 biological PHVs) in the aortic(n=22), mitral(n=14) position were included. Median image quality scores for the supra-,peri-and subvalvular regions and valvular detail were 4, 3.7, 3.7 and 3.5, respectively for bileaflet PHVs; 3, 2.6, 2.5 and 1.6, respectively for monoleaflet PHVs and 4, 3.8, 4.0 and 3.7 respectively for biological PHVs. In 3/4(75%) monoleaflet valves with severe artefacts and non - assessment. In 22(17 bileaflets and 5 biological PHVs ) of the 32 PHVs(68,75%) detect PHV dysfunction. In the PHV dysfunction group, the mechanism of dysfunction (pannus, thrombosis , patient prosthesis mismatch , paravalvular leakage, endocarditis and degenerate) was correctly identified by surgery in 100% of the cases. Conclusion : Implanted bileaflet and biological PHVs have good image quality on 640-Slice MSCT and are suitable for 640-Slice MSCT evaluation. Causes of PHV dysfunction were correctly evaluated by 640-slice MSCT in all PHVs except for monoleaflet PHVs.

Preliminary evaluation of F-18 FDG PET findings in pediatric patients with autism SUMMARY Objectives: the purpose of this study was to evaluate F-18 FDG Positron Emission Tomography (PET) findings in pediatric patients with autism. Subjects and methods: This study includes 15 autism pediatric patients who were diagnosed at the Vinmec international hospital from January 2017 to May 2017 and five oncology patients without neurology’s diseases underwent to whole body PET scan (from vertex to midthigh) were selected as control group. All patients underwent PET/CT brain examination in Nuclear Medicine Department, 108 Central Military Hospital. Results: Mean patient age (7.1 ± 0.24). On the PET scans of the 15 patients with autism, 13 (86%) had significantly decreased metabolic activity of both hemispheres. All of the patients had decreased metabolism in temporal, parietal and cingulate gyrus. Mean of Z-scores of autism group showed significantly decreased activity in comparison with Z-score of the control group. There were relations between clinical and grade of hypometabolism of autism. Conclusions : hypometabolism in the brain of autism pediatric patients may present a role in diagnosis and prognosis. Key words : autism pediatric patients, hypometabolism in the brain

Magnetic Resonance Defecography in female patients with pelvic floor dysfunction age from 60 SUMMARY Objective: We describe characteristics dynamic MR defecography in female patients with pelvic floor dysfunction, age from 60. Methods Describing cross-study. 106 patients were indicated magnetic resonance defecography by coloproctologist from 09/2016 to 04/2017, at Thong Nhat Hospital, Ho Chi Minh City. Results Defecatory dysfunction is the most common symptom (83,1%). The prevalence of urinary incontinence and pain is 34% and 59,4%, respectively. There is a significant difference in the ratio of pelvic floor descent between the groups who have and no have children. The ratio of pelvic floor descent of the group who have 1-2 children is significantly greater than the group have more than 3 children. The correlation between age and the degree of pelvic floor descent is weak. The combination of pelvic organ prolapses usually occurs. If there is only one pelvic compartment prolapse, it is the posterior compartment prolapse, which counts for only 5,6%. The degree of all the rectoceles is from the second degree and 83,1% of this still contain ultrasound gel after defecation phase. The prevalence of Anismus is only 3/106 and none of this combine with retocele. Conclusions Age, menopause and childbirth all have influence on the weakness of pelvic floor. In the older group, the combination of pelvic floor organ prolapses usually occurs. Rectocele is also common while Anismus is a uncommon condition. Keywords : MR defecography, pelvic floor dysfunction, female age from 60, rectocele, Anismus.