Perfusion mri in differentiation of glioblastoma multiforme from solitary brain metastasis SUMMARY Objective : Objective of this study is to describe the value of Perfusion MR Imaging in the differentiation of glioblastoma from solitary brain metastasis. Material and Methods : Between 06/2015 and 04/2017, a descriptive cross-sectional study involved 58 patients with solitary brain tumor (26 solitary brain metastases and 32 glioblastomas) underwent preoperative conventional MR Imaging, Perfusion MR Imaging and histopathologically determined glioblastomas or metastases after stereotactic biopsy or partial resection. The conventional MR Imaging and Perfusion MR Imaging in these patients were analysed. Relative cerebral blood volume (rCBV) was calculated and receiver operating characteristic (ROC) analysis was performed. To obtain the cut-off value of rCBV presenting a statistical difference between the two tumors groups. Results :Tumoral rCBV ratio presented no significant different between two tumor groups. Peritumoral rCBV ratios of glioblastomas (1,44 ± 0,52) significantly differentiated from those of solitary brain metastases (0,63 ± 0,31) (p = 0,935). The cut-off value was taken as 1,045 in the peritumoral rCBV ratio provided sensitivity, specificity, PPV and NPV of 90,6 %, 92,6%, 96,67% and 89,92%, respectively. Conclusion: Perfusion-weighted MR imaging enable distinction between glioblastoma and solitary brain metastasis. Keywords : Glioblastoma, Solitary brain metastasis, Perfusion MR Imaging.

SUMMARY Nitrous oxide gas (N2O), known as laughing gas, is widely used in medicine for the purpose of pain relief. However, nowadaysN2O are abused for recreational purposes and causes several harmful effects, especially neurological damages. In two cases of patients with nitrous oxide toxicity, we would like to make some remarks about the characteristic features of myeloneuropathy caused by N2O abuse Key word : metabolic, N2O, nitrous oxide, toxic

Evaluating the imaging characteristics of thoracic - lumbar spine injury according to the tlics classification SUMMARY The study was carried out with the purpose of evaluating the visual characteristics of the thoracolumbar spine injury according to the TLICS classification (The Thoracolumbar Injury Classification and Severity Score). From September 2016 to July 2017, at Viet Duc hospital, 80 patients with thoracolumbar spinal injury had been diagnosed using CT scanner and MRI, as well as receiving treatment at the hospital. The result was that 43 patients received preservative treatment, and 37 patients were operated upon, 14 of whom had TLICS < 4 point. With the use of MRI for evaluating PLC (posterior ligamentous complex), in comparision with post-operative results, the aforementioned methods showedthe sensitivity level of 96% and the specificity level of 100%. Keywords: thoracolumbar Injury, TLICS Classification, ligamentous complex.

Noninvasive evaluation of glioma grade using perfusion and multivoxel 3d proton mr spectroscopy SUMMARY The purpose of this study was to clarify the usefulness of perfusion and multivoxel 3D proton MR spectroscopy in glioma grading. Study included 85 patients underwent preoperative conventional MR Imaging, multivoxel proton MR spectroscopy and histopathologically determined gliomas after stereotactic biopsy or partial resection. Receiver operative characteristic (ROC) curve analyses were performed to asscess the cutoff of rCBV and metaboite parameters of which the sensitivity and specificity are highest.A cut-off value of 2,56 for rCBV resulted in sensitivity, specificity of 86,54%, 75,76%, respectively. The cut-off value was taken as 2,76 in the Cho/NAA ratio provided sensitivity, specificity of 89,66%; 88%, respectively. The combination of rCBV and Cho/NAA ratio provided sensitivity, specificity of 71,15%; 78,79%, respectively. rCBV and Cho/NAA can increase the ability of glioma grading preoperatively. Key word : glioma, perfusion MR, spectroscopy MR

The imaging of cerebral palsy on MRI in children SUMMARY Objective : Description the image on MRI 3T of cerebral palsy and the correlation between imaging and clinical findings. Methods: From 01/2015 to 12/2016, 496 patients were diagnosed as cerebral palsy, have been done cerebral MRI in Diagnostic Imaging service. Results: 496 patients with age average 6.04 ± 4.08, youngest was under 1 year old and oldest was 15 years old. MRI shows the periventricular leukomalacia (white matter lesion) is the most popular position in CP which found in hypoxie in prenatal or perinatal, especially postnatal. The patients who had long term - hyperbilirubin have some lesion in the globus palidus and some basal ganglias. Abnormal formation of the brain, including cortical dysplasia, polymicrogyria, lissencephaly, pachygyria, schizencephaly, polymicrogyria and agenesis of the corpus callosum, have a significant rate 7.7 %. Normal MRI finding was noticed with 17.14%. Conclusion: Cerebral MRI is useful tool in confirming the degree of cerebral palsy and provides some correlation between imaging and clinical. Keywords : cerebral palsy, imaging of cerebral palsy.

Imaging characteristics and diagnostic value of SPECT myocardial perfustion scintigraphy with combined supine - prone acquisition in diagnosis of coronary artery diseases SUMMARY Abstract: The aim of the study is to determine the imaging characteristics and diagnostic values of the combined supine - prone myocardial perfusion SPECT in comparison with supine alone acquisition. Methods : 59 CAD suspected patients were underwent Tc-99m sestamibi ECG - gated myocardial perfusion SPECT with combined supine - proneacquisition protocol to reduce attenuation defects in supine images. The results of MPI were compared with the coronary angiogram. Results: The sensitivity and specificity of the combined acquisitionprotocol were 76%, 94.1% respectively. There is no significant difference in the sensitivity between the two patient’s position acquisition. However, specificity was significantly improved in the combined acquisition (94.1% vs. 70.6%), especially in male (96.4% vs. 71.4%) and overweight patient’s groups (BMI> 23) (94.4% vs 61.1%). Conclusions : The combined supine - prone acquisitionprotocol did significantly improved the specificity ofmyocardial perfusion SPECT, especially in the overweight and males. Key words: combined supine - proneacquisition ,myocardial perfusion SPECT

Evaluation the result of flouroscopy-guided sclerotherapy in treating superficial venous malformation SUMMARY Purpose : Describe imaging characteristics of superficial venous malformation (VM) on flouroscopy and evaluate effectiveness of foam sclerotherapy. Method: Prospective cohort from november 2015 till may 2017 on 26 patients with VM treated by flouroscopy-guided sclerotherapy. Results: 26 patients with VM were involved in our study: 15,4% type I; 61,5% type II; 7,7% type III and 15,4% type IV. Malformation dimensionwere reduced by mean of 41,3%, VM type I had 62,5% size reduction; pain score were decreased by mean of 2,9 points (48,5%). VM type IV had 26,7% dimension reduction and 30,8% painful ease. No complication were noted. Conclusion: Flouroscopy-guided sclerotherapy is a safe procedure to reduce size and pain for patient with VM, particularly the most dimension reduction in type I, the most pain ease in type II . Keywords: venous malformation, sclerotherapy, flouroscopy-guided

Initial results of ct-guided percutaneous bone biopsy using an arrow oncontrol bone access system at Cho Ray Hospital SUMMARY Background: Computed tomography (CT)-guided percutaneous bone biopsy has been widely performed at big hospitals in Vietnam, but these techniques were done by using bone biopsy handle needle. Procedural time was usually prolonged, pain level of patients increased, especially osteopetrosis lesion, risk of not receiving samples. Therefore, the purpose of our study was to assess the initial effectiveness of CT-guided percutaneous bone biopsy using Arrow Oncontrol bone access system. Materials and methods: All the patients were performed CT- guided percutaneous bone biopsy at Cho Ray hospital from February 2016 to June 2017, 58 patients using Arrow Oncontrol bone access system. The techniques include: local anesthesia, confirming accurate lesion by CT scan, inserting 11G needle and 13G coaxial needle with Arrow Oncontrol bone access system putting into lesion, checking again by CT scan, drilling to take core sample. The efficacy, safety, pain level and procedural time were evaluated by variants: technique success rate, accuracy of histopathology, pain level, procedural time and complications. Results : 58 patients were performed with CT-guided percutaneous bone biopsy using drilling Arrow Oncontrol system. Technique success rate was 96.5%, diagnostic accuracy histopathology was 87.9%, the correlation was strong (r = 0.95) between histopathological diagnosis and discharge diagnosis, low pain score (mild pain) 82.7%, technical median time 11 minutes, there were no complications. Conclusions: CT-guided percutaneous bone biopsy using Arrow Oncontrol drill-assisted system had high technique success rates, high diagnostic accuracy of histopathology, mild pain level, fast and safe procedure. Key words: CT-guided bone biopsy, Arrow Oncontrol bone access system.