• Chủ nhật, 25/07/2021
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Giá trị của CLVT hai mức năng lượng trong tiên lượng nguy cơ chảy máu não sau lấy huyết khối cơ học

Giá trị của CLVT hai mức năng lượng trong tiên lượng nguy cơ chảy máu não sau lấy huyết khối cơ học

06/05/2021 17:04:08 | 0 binh luận

SUMMARY Purpose: Evaluate the characteristics of Dual-energy CT of the brain performed after mechanical thrombectomy. Acess the capability of iodine extravasation quantification on DECT to predict hemorrhagic complications. Material and methods: Retrospective descriptive study. Thirty consecutive patients who underwent brain dual-energy CT right after mechanical thrombectomy for acute ischemic stroke between July 2019 and September 2020 in Radiology Center, Bach Mai hospital, were included. Maximum iodine concentration was measured. Follow-up CT or MRI examinations performed at 24hrs after intervention were reviewed for intracerebral hemorrhage development. The correlation between dualenergy CT parameters and intracerebral hemorrhage development was analyzed by the Mann-Whitney U test and Fisher exact test. Receiver operating characteristic curves were generated for continuous variables. Result: Nineteen of 30 patients (63.3%) developed hemorrhage in different grades. On postoperative dual-energy CT, parenchymal hyperdensities and iodine extravasation were present in 19 (100%) of the 19 patients who developed intracerebral hemorrhage and in 7 (63.6%) of the 11 patients who did not (P = 0.0012). Signs of bleeding were present in 5 (45.4%) of the 19 patients who developed intracerebral hemorrhage and in none of the patients who did not. Median density of contrast extravasation in hemorrhage and non-hemorrhage is 108.8HU and 33.6HU (P=0.001). Median maximum iodine concentration was 2.9 mg/mL in the patients who developed intracerebral hemorrhage and 0.59 mg/mL in the patients who did not (P = 0.003). Maximum iodine concentration showed an area under the curve of 0.9 for identifying patients developing intracerebral hemorrhage. Conclusion : DECT helps differentiating haemorrhage from contrast extravasation. The presence of parenchymal hyperdensity with a maximum iodine concentration of >1.1 mg/mL may identify patients developing intracerebral hemorrhage with 94.7% sensitivity and 81.8% specificity. Key words: Dual – energy CT, thrombectomy, iodine extravasation.
Giá trị của CLVT hai mức năng lượng trong tiên lượng nguy cơ chảy máu não sau lấy huyết khối cơ học

Giá trị của CLVT hai mức năng lượng trong tiên lượng nguy cơ chảy máu não sau lấy huyết khối cơ học

06/05/2021 15:29:32 | 0 binh luận

SUMMARY Purpose: Evaluate the characteristics of Dual-energy CT of the brain performed after mechanical thrombectomy. Acess the capability of iodine extravasation quantification on DECT to predict hemorrhagic complications. Material and methods : Retrospective descriptive study. Thirty consecutive patients who underwent brain dual-energy CT right after mechanical thrombectomy for acute ischemic stroke between July 2019 and September 2020 in Radiology Center, Bach Mai hospital, were included. Maximum iodine concentration was measured. Follow-up CT or MRI examinations performed at 24hrs after intervention were reviewed for intracerebral hemorrhage development. The correlation between dualenergy CT parameters and intracerebral hemorrhage development was analyzed by the Mann-Whitney U test and Fisher exact test. Receiver operating characteristic curves were generated for continuous variables. Result: Nineteen of 30 patients (63.3%) developed hemorrhage in different grades. On postoperative dual-energy CT, parenchymal hyperdensities and iodine extravasation were present in 19 (100%) of the 19 patients who developed intracerebral hemorrhage and in 7 (63.6%) of the 11 patients who did not (P = 0.0012). Signs of bleeding were present in 5 (45.4%) of the 19 patients who developed intracerebral hemorrhage and in none of the patients who did not. Median density of contrast extravasation in hemorrhage and non-hemorrhage is 108.8HU and 33.6HU (P=0.001). Median maximum iodine concentration was 2.9 mg/mL in the patients who developed intracerebral hemorrhage and 0.59 mg/mL in the patients who did not (P = 0.003). Maximum iodine concentration showed an area under the curve of 0.9 for identifying patients developing intracerebral hemorrhage. Conclusion: DECT helps differentiating haemorrhage from contrast extravasation. The presence of parenchymal hyperdensity with a maximum iodine concentration of >1.1 mg/mL may identify patients developing intracerebral hemorrhage with 94.7% sensitivity and 81.8% specificity. Key words : Dual – energy CT, thrombectomy, iodine extravasation
Vai trò của cộng hưởng từ trong chẩn đoán và theo dõi điều trị lao não, màng não

Vai trò của cộng hưởng từ trong chẩn đoán và theo dõi điều trị lao não, màng não

06/05/2021 15:55:20 | 0 binh luận

SUMMARY Purpose: Characteristic description image and evaluate the role of CHT in diagnosis and follow up and treatment of meningitis tuberculosis. Subjects and methods: Prospective and retrospective description 45 patients meningitis tuberculosis with evidence of TB bacteria in the cerebrospinal fluid undergoing MRI before and after treatment from July 2019 to September 2020. Comparison of lesions on MRI before and after tuberculoma, tuberculosis meningitis treatment. Result: In a total of 45 study patients, the average age is 28.8, male / female = 1.5, the rate of patients developing lesions on MRI before treatment (88.9%), The most common signs of damage in patients with tuberculosis of the brain, the common meningitis before treatment include: sign of meningitis enhancement (84.4%), basal meningeal enhancement (66.7%), Sylvian fissures (6.7%) , meninges of supersellar cistern (17.8%), tuberculoma (44.4%), hydrocephalus (31.1%), cerebral infarction (13.3%). Following 40 patients with meningeal tuberculosis lesions on CHT after treatment, the rate of detecting damage after treatment is 75%, of which: signs of meningitis enhancement (72.5%), basal meningeal enhencement (37.5%), sylvian fissures (2.5%), meninges of supersellar cistern (7.5%), tuberculoma (42.7%), hydrocephalus (20%), infarction cerebral (2.5%). Keyword: tubercoulosis meningitis, tuberculoma, MRI
Vai trò của chụp cắt lớp vi tính mạch máu trong chẩn đoán hẹp tắc động mạch nội sọ ở bệnh nhân đột quỵ do thiếu máu não cấp

Vai trò của chụp cắt lớp vi tính mạch máu trong chẩn đoán hẹp tắc động mạch nội sọ ở bệnh nhân đột quỵ do thiếu máu não cấp

06/05/2021 12:16:52 | 0 binh luận

SUMMARY Background : Diagnosis of intracranial arterial stenooclusive disease and identification of intracranial atherosclerosis related occlusions (ICAS-O) in ischemic stroke patients is extremely important in order to plan a correct therapeutical approach. Few studies to date have examined the role of computed tomographic angiography (CTA) in diagnosing intracranial stenosis and predicting ICAS-related occlusions. Objective: To determine whether there is any correlation between CTA-determined truncal-type occlusion (TTO) and ICAS-related occlusions. To compare CTA to digital subtraction angiography (DSA) for detecting and measuring intracranial arterial stenoocclusive disease. Methods : We reviewed 129 ischemic stroke patients who underwent CTA and DSA. The occlusion and degree of stenosis of each intracranial arteries were calculated by WASID method. Occlusion type was classified as TTO or branching-site occlusion (BTO) on CTA. ICAS-O was detected by evaluating of underlying fixed focal stenosis (FFS) on DSA. Results: A total of 423 intracranial arteries were analyzed. CTA detected intracranial artery occlusion with sensitivity and specificity, and NPV 97,8%, 98,6% và 98,9% respectively. For detection of 50%-99% stenosis, CTA had 89,7% sensitivity and 98,2% specificity. TTO was more frequent in ICAS-O group than in the embolic group (78,1% versus 8,5%, p < 0,001). Conclusions: Compared to DSA, CTA has high sensitivity and specificity for diagnosing intracranial arterial stenooclusive disease. Preprocedural TTO on CTA is related to postprocedural ICAS-O in ischemic stroke patients.
Vai trò của cộng hưởng từ chức năng trong đánh giá vùng vận động bàn tay ở bệnh nhân u não

Vai trò của cộng hưởng từ chức năng trong đánh giá vùng vận động bàn tay ở bệnh nhân u não

06/05/2021 12:02:47 | 0 binh luận

SUMMARY Background: Localizing the brain's functional cortex on functional magnetic resonance imaging (fMRI) plays an important role in brain tumor resection. Objective: To investigate imaging characteristics of the hand motor area on standardized MRI (sMRI) and fMRI in patients with brain tumors. To evaluate the correlation between lesion to motor cortex distance (LMD) on fMRI and preoperative motor deficit. Methods: Standardized and functional magnetic resonance images of 20 patients with rolandic brain tumors were included, all patients underwent tumor resection. Anatomic landmarks related to the hand motor area were interpreted on standardized MRI. Measure the distance between the hand motor area localized on fMRI and the hand motor area localized on standardized MRI. Compare the incidence of preoperative motor deficit of groups of patients with different LMDs Results: The rates of clearly defined anatomical landmarks related to the hand motor area on tumor-affected hemispheres are lower than those on unaffected hemispheres. The distance between the hand motor area localized on fMRI and the hand motor area localized on standardized MRI is 17.01 ± 3.63 mm on average and there are 6 cases where this distance is greater than 20 mm. The incidence of motor deficit in the “LMD<1cm” group, the “LMD from 1 to 2 cm” group and the “LMD>2 cm” group are 75%, 50% and 0% respectively. Conclusions: Standardized MRI should not be use to localize the hand motor area in patients with brain tumors. LMD is correlated with preoperative motor deficit. Keywords: Brain tumor, functional magnetic resonance imaging, hand motor area.
Nghiên cứu giải phẩu chức năng của tiểu não trong trí nhớ làm việc ở trẻ em sau điều trị u nguyên bào tủy

Nghiên cứu giải phẩu chức năng của tiểu não trong trí nhớ làm việc ở trẻ em sau điều trị u nguyên bào tủy

01/04/2020 12:00:28 | 0 binh luận

Anatomo-functional study of the cerebellum in working memory in children treated for medulloblastoma SUMMARY Introduction and Purpose: Medulloblastoma is the most common malignant cerebral tumor during childhood, arising in the posterior fossa. Children treated for medulloblastoma often experience working memory (WM) deficits, affecting their quality of life and school performance. The aim of the present study undertaken to describe the cerebellar involvement in WM deficits observed in these children. Method: Healthy children and children treated for medulloblastoma were included into study. All subjects performed a detailed neuropsychological examination, an anatomical and functional MRI. Stimuli were presented to the participants with alternating sensory modality and nature of communication in a block design during functional magnetic resonance imaging acquisitions. A Mann- Whitney U test was used for analyzing neuropsychological and behavioral data. The SPM8 and the SUIT (Spatially Unbiased Atlas Template) were utilized for anatomical and functional MRI data. Results : The patients had cerebellar lesions locating principally in the left posterior lobe. These patients were significantly reduced intelligence quotient, central executive and visuospatial WM. In healthy children group, fMRI showed robust activations for nonverbal or visuospatial WM in the left posterior cerebellar lobe. Conclusion: This study provides further evidence that the cerebellum plays a role in WM. Lesions of the left posterior cerebellar lobe may lead to nonverbal WM impairment in children. These finding contribute to treatment planning and to rehabilitation for improving the quality of life of children treated for cerebellar medulloblastoma. Keywords: Medulloblastoma, cerebellum function
Nghiên cứu hiệu quả điều trị của phương pháp tạo hình đốt sống qua da phối hợp chỉnh hình bằng tư thế

Nghiên cứu hiệu quả điều trị của phương pháp tạo hình đốt sống qua da phối hợp chỉnh hình bằng tư thế

01/04/2020 09:03:16 | 0 binh luận

Eficacy evaluation of percutaneous vertebroplasty combined with preprocedure orthopaedic positioning SUMMARY Purpose: To evaluate the effectiveness of Percutaneous ertebroplasty combined preprocedure orthopaedic positioning in treating fresh vertebral compression fractures. Methods : From January 2012 to May 2014, the data of 31 patients (23 females, 8 males; mean age, 72 years) with new vertebral compression fractures were prospectively and retrospectively analyzed. At least 6h before vertebroplasty produce, the patients were positioned to straighten the vertebral column. The radiographies of spinal column is face and lateral view before and post produce were analyzed to evaluate the vertebral body height, as well as scoliosis. Effectiveness of pain-relief was evaluated based on Visual Analog Scale (VAS). Results: The body height vertebral of compression fractures in these patients was improved by a mean of 56.2%. We achieved a mean improvement of the wedge angle 5.9o and the cobb angle 4,90 (p < .05). The VAS score is significantly improved (mean 7,8 before and 1,6 after procedure, p < 0,05). Conclusions : The combination between pre-procedure positioning and vertebroplasty brought good results in pain relief and height of vertebral body with low price. Keywords : Percutaneous vertebroplasty, Kyphoplasty, Vertebroplasty versus Kyphoplasty, Vertebral body height in vertebropasty.
Đánh giá hiệu quả bước đầu phương pháp lấy huyết khối cơ học bằng stent Solitaire trong điều trị nhồi máu não tối cấp

Đánh giá hiệu quả bước đầu phương pháp lấy huyết khối cơ học bằng stent Solitaire trong điều trị nhồi máu não tối cấp

31/03/2020 15:16:34 | 0 binh luận

Evaluating the initial results of the thrombectomy using Stent Solitaire in patients with acute ischemic stroke summary Objective : Evaluating the initial results of the thrombectomy using stent Solitaire in patients with super acute ischemic stroke. Method and result: From May 2012 to August 2013, 14 patients suffered from hyper acute ischemic stroke underwent the thrombectomy treatment by using stent Solitaire. There are 5 males and 9 females with mean age 58.2 ± 7.9. Mean interventional time in DSA (digital subtraction angiography) room was 70.7 ± 40.2 mins. Ratio of revascularization was 80%. After 3 months, there are 9 patients with good recovery (64.3%), 3 patients with slow recovery (21.4%), and 2 mortalities (14.3%). Conclusion: Using stent solitaire in thrombectomy for the super acute ischemic stroke patients is a new and potential treatment including revascularization and clinical recovery results.

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