Tạp chí Điện quang & Y học hạt nhân Việt Nam

CHARACTERISTICS OF AORTIC VALVE CALCIFICATION AND EPICARDIAL DIPOSE TISSUE ON CARDIAC COMPUTED TOMOGRAPHY ANGIOGRAPHY IN PEOPLE AT HIGH CARDIOVASCULAR RISK

BS Đặng Minh Phương — 2024-12-30

VASCULAR ANATOMY CHARACTERISTICS OF THE PANCREATICODUODENAL REGION IN MULTIDETECTOR CT SCANNER IN BACH MAI HOSPITAL

BS Nguyễn Thị Ngọc — 2024-12-30

Objective: To describe vascular anatomy characteristics of the pancreaticoduodenal region in multidetector CT (MDCT) scanner in Bach Mai Hospital). Methods: Select good quality images among patients having abdominal MDCT in Bach Mai Hospital until 9/2023. Categorize these patients into different types of pancreaticoduodenal vascular anatomy. Calculate the number and percentage of those types. Results: Out of 431 selected cases: the rate of visualization for great vessels, the inferior pancreaticoduodenal artery (IPDA), first jejunal vein (FJV) was 100%, 77,9%, and 86,1% relatively. Replaced left hepatic artery (LHA) arising from the left gastric artery is the most common variant (10.4%), the second variant is replaced right hepatic artery (RHA) arising from the superior mesentery artery (SMA) (4.6%). IPDA has its common trunk that arose from the first jejunal artery (J1A), SMA, and two branches arose from different origins, in 59.2, 26.8, and 14% of cases, respectively. Meanwhile, IPDA has its origin on the dorsal, right, and left aspects of the SMA in 56.6, 23.5, and 19.9% respectively. The trajectory of the first jejunal trunk (FJT) related to the SMA was anterior in 24% of cases, posterior in 60.5% of, and first and second jejunal vein (J1V and J2V) with an anterior and posterior trajectory in 15.5% of cases. Conclusion: MDCT scanner enables visualization of small vessels in the pancreaticoduodenal region with high sensitivity.

ULTRASONOGRAPHIC CHARACTERISTICS AND COMPARING WITH FINE-NEEDLE ASPIRATION CYTOLOGY RESULTS OF SUBACUTE GRANULOMATOUS (DE QUERVAIN'S) THYROIDITIS CASES

BS Nguyễn Thị Thu Hằng — 2024-12-30

Purpose: To describe the ultrasound imaging characteristics of subacute thyroiditis and compare them to fine needle aspiration thyroid cytology results. Materials and methods: A retrospective and prospective cross-sectional descriptive study on patients diagnosed with subacute thyroiditis, who underwent ultrasound, and had fine–needle aspiration results at the Radiology Center, Bach Mai Hospital from January 2020 to April 2023. Results: The study was conducted on 65 patients with fine needle aspiration results as subacute thyroiditis, 90.8% female, and 63.1% in middle age (40 to 60 years old). Clinical symptoms including neck pain, low-grade fever, and increased metabolism were observed in 63.1% of cases. 67.7% of cases had heterogeneous hypoechoic lesions, with illdefined margins. In 45 cases Doppler color ultrasound was performed, 44 cases (66.2%) hypovascularity, and only 1 case (1.5%) hypervascularity. 35.4% of cases had hypoechoic thyroid nodules, of which 10.8% were classified as TIRADS 4 and 24.6% were classified as TIRADS 5. Conclusion: Subacute thyroiditis can present as hypoechoic nodules, which can easily be confused with malignancies, challenging in differential diagnosis. Fine-needle aspiration thyroid cytology is an essential procedure in atypical cases. Clinical coordination with imaging and cytology will help achieve an accurate diagnosis.

MAGNETIC RESONANCE IMAGING FINDINGS FEATURES FOR DIFFERENTIATING TUBERCULOUS AND PYOGENIC SPONDYLODISCITIS

BS Đậu Thị Phương Nhi — 2024-12-30

Objectives: Differentiating tuberculous spondylodiscitis (TBSD) from pyogenic spondylodiscitis (PSD) remains a diagnostic challenge due to the low positivity rates in microbiological and histopathological tests. This study aimed to determine MRI imaging features that can help distinguish between TBSD and PSD. Methods: A retrospective study was conducted on patients diagnosed with SD (either by microbiological, histopathological findings, or treatment response), who had undergone contrast-enhanced MRI scans of the spine before treatment. Imaging features on MRI were described and compared between TBSD and PSD group. Results: A total of 65 patients were studied, including 23 (35.4%) with TBSD and 42 (64.6%) with PSD. Of the 13 MRI features analyzed, 8 showed significant differences between the two groups (p<0.05). Features indicative of TBSD: Thoracic spine involvement (OR=8.073), vertebral body destruction >50% height loss (OR=21.867), presence of intraosseous abscess (OR=4.604), disc preservation (OR=8.217), thin and smooth-walled paravertebral abscess (OR=11.511). Features indicative of PSD: Lumbar-sacral spine involvement (OR=5.681), epidural abscess formation (OR=7.752), thick and irregular-walled paravertebral abscess (OR=21.739). Conclusion: Several MRI features can help differentiate between TBSD and PSD, guiding appropriate treatment selection, particularly when microbiological confirmation is unavailable.

RADIOFREQUENCY ABLATION IN THE TREATMENT OF OSTEOID OSTEOMA: A CASE SERIES

BS Nguyễn Thị Huyền — 2024-12-30

Objective: Radiofrequency ablation (RFA) has emerged as a minimally invasive therapeutic option for osteoid osteoma (OO). Although extensively studied worldwide, data on its effectiveness and safety in Vietnam remain limited. This study presents a case series evaluating the technical success, clinical outcomes, and complications of RFA in OO treatment. Materials and Methods: Four male patients with OO underwent RFA over a three-month period. Lesions were located in the femur (n = 2) and tibia (n = 2). Two patients underwent primary RFA, while two received RFA after failed surgical treatment. Pain relief, recurrence rates, and complications were assessed over a 2-4 month follow-up period. Results: Three out of four patients achieved complete pain relief without recurrence or complications. One patient experienced recurrent pain four months post-procedure. Conclusion: RFA is a safe and effective minimally invasive treatment for OO, offering immediate symptom relief with a low recurrence rate. Further studies with larger sample sizes and longer follow-up are warranted to confirm these findings.

A RARE CASE OF ADULT-TYPE GRANULOSA CELL TUMOR OF THE OVARY

PGS Vũ Đăng Lưu — 2024-12-30

Adult granulosa cell tumor of the ovary (AGCT) is a rare malignant ovarian neoplasm, which represents 2% of all ovarian tumors and is the most common sex cord-stromal tumor of the ovary [1–3]. It is also associated with clinical estrogenic manifestations and is usually diagnosed between 50 and 54 years of age [4]. Although it shows malignancy, the AGCT usually demonstrates a better prognosis than the other types of ovarian cancer. In this article, we present a case report of an early AGCT with the features of ultrasound, CT scan, and MRI.

CASE STUDY ON EBSTEIN’S ANOMALY AND THE VALUE OF CARDIAC MRI IN PREOPERATIVE DIAGNOSIS

BS Lương Quang Huy — 2024-12-30

Ebstein’s anomaly (EA) is a rare congenital heart disease characterized by downward displacement of the septal and inferior tricuspid valve leaflets, redundant anterior leaflets with a sail-like morphology, and atrialization of the inlet portion of the right ventricle. The clinical manifestations of EA are not specific and range from asymptomatic to severe as dictated by the degree of tricuspid valve displacement, the severity of tricuspid regurgitation, effective right ventricular volume, and the presence of associated malformations such as an atrial septal defect, arrhythmias. We report a case of a 42-year-old female patient with a history of EA diagnosed many years ago, with irregular treatment. Three months prior to admission, the patient began experiencing progressively worsening shortness of breath, leading to hospitalization at Bach Mai Hospital, where she was stabilized with medication and assessed for surgery. The echocardiogram report showed changes in the description of the morphology and attachment sites of the valve leaflets across different examinations. The patient underwent a pre-surgical cardiac magnetic resonance imaging (CMR). She was then surgically treated with the Cone technique for tricuspid valve repair. After surgery, her condition significantly improved.

LARYNGEAL PARAGANGLIOMA: A CASE REPORT

TS Lê Văn Khảng — 2024-12-30

Paragangliomas correspond to tumors of neuroendocrine origin of chromaffin and non-chromaffin in the paraganglia of the sympathetic or parasympathetic nervous system. Laryngeal and thyroid paragangliomas that arise from the laryngeal paraganglia are extremely rare. Diagnosing two kinds of paragangliomas preoperatively is challenging due to non-specific cytology, pathology, and imaging features, and overlaps with many other neoplasms. Complications in surgery of laryngeal and thyroid paragangliomas may be associated with significant intraoperative bleeding and excision with adherence to nearby structures, including the recurrent laryngeal nerve.

CARDIAC STRAIN MRI: PRINCIPLE, TECHNIQUE AND CLINICAL APPLICATIONS

TS Nguyễn Ngọc Tráng — 2024-12-30

Cardiac strain MRI is an advanced imaging technique that quantifies myocardial deformation, providing comprehensive insights into cardiac function. The principle behind this method is based on tracking the motion of tissue features. Clinically, cardiac strain MRI is used to detect early signs of myocardial dysfunction and management in various conditions such as ischemic heart disease, cardiomyopathies, chemotherapy-induced cardiotoxicity,… With its ability to provide precise and detailed information about the myocardium, cardiac strain MRI is becoming an essential tool in cardiovascular diagnostics and research.