• Thứ 7, 11/07/2020
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Đánh giá hiệu quả bước đầu trong điều trị ung thư biểu mô tế bào gan bằng phương pháp nút mạch sử dụng hạt vi cầu phóng xạ YTTRIUM-90

Đánh giá hiệu quả bước đầu trong điều trị ung thư biểu mô tế bào gan bằng phương pháp nút mạch sử dụng hạt vi cầu phóng xạ YTTRIUM-90

03/30/2020 14:45:16 | 0 binh luận

The results of Y90 radioembolization in treatment of hepatocellular carcinoma

SUMMARY

Background: Hepatocellular carcinoma (HCC) is aggressive primary malignancy of the liver that most commonly presents late in the disease course. As a result, the majority of patients are not candidates for curative therapies. Locoregional therapies including Yttrium-90 (Y-90) radioembolization play an important role in management of the vast majority of patients with HCC.

Methods: Patients with unnresectable HCC (n=41) treated with Y-90 radioembolization from 2013 to 2016 were evaluated retrospectively. Data was abstracted from medical records including patient charts, laboratory data, and imaging.

Results: The most common clinical toxicity among all patients was fatigue (58.5%). A clinical benefit, defined as patients achieving PR was seen in 95.13% of cases; was seen complete reponse (CR) in 4.87%. The mean overall survival from the time of diagnosis was 18.4 months.

Conclutions: For patients with HCC, Y-90 radioembolization is a safe and well-tolerated procedure. Our experience suggests that a significant percentage of patients achieve clinical benefit including many with PR. Prospective, randomized data is required to compare radioembolization with other therapies including chemoembolization and systemic therapy with sorafenib.

Keywords: Radioembolization, Yttrium-90 microspheres, SIR-spheres, Hepatocellular carcinoma, Transarterial radioembolization, SIRT.

Các tiến bộ kỉ thuật cộng hưởng từ trong hình ảnh u não và ứng dụng tại bệnh viện Chợ Rẫy

Các tiến bộ kỉ thuật cộng hưởng từ trong hình ảnh u não và ứng dụng tại bệnh viện Chợ Rẫy

03/31/2020 17:07:38 | 0 binh luận

Advanced MR techniques in brain tumor imaging and the application at Choray hospital

SUMMARY

MRI is the imaging modality of choice for brain tumours. Advanced MRI techniques have significantly developed and used clinically in imaging of brain tumor such as: diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), diffusion-tensor imaging (DTI) and magnetic resonance spectroscopy (MRS). Conventional MR imaging (MRI) provides mainly anatomic or structural information about the brain and tumor. Unlike conventional imaging, advanced MR techniques also provide physiological information concerning tumor cellularity, white matter invasion, metabolism and hemodynamics.These techniques can be used to diagnosis, differential diagnosis, grading, surgical planning, and monitoring of therapeutic response of brain tumors.

A principles of the physiology, techniques, and clinical applications of these techniques is provived. Some experience of using these technique in the domain of brain tumor at Choray Hospital were also presented in this article.

Key words: Advanced MR techniques, brain tumor, diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), diffusion-tensor imaging (DTI) and magnetic resonance spectroscopy (MRS), conventional MRI.

Nghiên cứu đặc điểm hình ảnh và giá trị của cộng hưởng từ 1.5 Tesla trong đánh giá sống còn cơ tim ở bệnh tim thiếu máu cục bộ

Nghiên cứu đặc điểm hình ảnh và giá trị của cộng hưởng từ 1.5 Tesla trong đánh giá sống còn cơ tim ở bệnh tim thiếu máu cục bộ

03/31/2020 16:00:33 | 0 binh luận

Imaging characteristics on and value MRI of myocardial viability in patients with chronic ischemic heart disease

summary

Purposes: 1. To describe the imaging characteristics on CMR of myocardial viability in patients with chronic ischemic heart disease; 2. To define the relationship between myocardial viability on magnetic resonance imaging (MRI) with the stenosis degree of coronary artery on invasive coronary angiography (IVA).

Materials and Methods: 37 patients with chronic ischemic heart disease were enrolled in this cross-sectional prospective study. All patients were performed cardiac MRI and IVA during a period from 12/2011 to 8/2012 at Bach Mai Hospital. The data analysis by using the SPSS 18.0 (Chicago, United States).

Results: 37 patients/ 27 males (73%) with mean age: 60.11 ± 11.74 year (35 - 81). Mean left ventricular systolic function (EF): 45.83 ± 12.83% (ranged 16.6 - 72%). 64.9% had EF decreased moderate to severe. 73% had reduction of ventricular contraction. 35 patients (94.6%) had late enhancement, of which 67.6% segments supplied by LAD, 64.8% had extent myocardial scar > 50%. Sensitivity and specificity of late enhancement at coronary artery stenosis ≥ 50% were 97.1%, 33.3% respectively.

Conclusion: The extent of myocardial scar had good relationship with the stenosis degree of coronary artery.

Key word: Cardiac MRI, Chronic ischemic disease, coronary artery.

Điều trị can thiệp nội mạch hẹp tĩnh mạch gan sau ghép gan từ người cho sống ở trẻ em: Nhân một trường hợp

Điều trị can thiệp nội mạch hẹp tĩnh mạch gan sau ghép gan từ người cho sống ở trẻ em: Nhân một trường hợp

04/15/2020 20:54:05 | 0 binh luận

Endovascular treatment of hepatic vein stenosis following liver transplant in a child: a case report

SUMMARY

Liver transplantation is the major therapeutic option for end-stage liver disease as recent improvement in surgical technique, immune-suppressant contribute to better post-transplant outcome. However, significant graft failure as a result of vascular complications is still noted, especially in partial liver transplant with living donor graft and complications is higher risk in children compared with adults. The incidence of hepatic vein stenosis in pediatric liver transplant is 6% with living donor graft. A first case of pediatric liver transplant with living donor graft which performed in Viet Duc hospital have complication of hepatic vein stenosis and success with balloon angioplasty and stent placement.

Key word: Living donor transplants, hepatic vein stenosis.

Vai trò can thiệp nội mạch trong điều trị ho ra máu nặng

Vai trò can thiệp nội mạch trong điều trị ho ra máu nặng

04/14/2020 23:19:28 | 0 binh luận

The role of endovascular treatment for massive hemoptysis

SUMMARY

Objectives: To assess the safety and effectiveness of arterial embolization in patients with massive hemoptysis.

Subjects and Method: All patients were diagnosed massive hemoptysis and treated endovascular intervention in Cho Ray Hospital from January 2016 to March 2017. Some variants were asscessed: etiologies, important angiographics findings, the clinical success, complications and follow-up outcomes within 1 month.

Results: 35 patients were treated by endovascular intervention. Massive hemoptysis was caused by bronchiectasis (37,1%), pulmonary tuberculosis (20%), pulmonary aspergilloma 14.3%). A total of 69 bleeding arteries were found, an average of four arteries per patient. Important angiographics findings were: vascular hypertrophy and tortuosity (80,0%), neovascularity and hypervascularity (85,7%), shunting (25,7%), aneurysm formation (8,5%) and active extravasation (5,7%). Immediate clinical success achieved was 97,1% (34/35 patients) and 11,7% of patients had recurrent over 1 month; aspergilloma and shunting were asociated with early recurrent (p<0,05). No serve complications were reported and the most common complication was trasient chest pain (28,6%).

Conclusion: Endovascular treament is an effective and safe procedure in the management of massive hemoptysis.

Keywords: massive hemoptysis, embolized arteries, clinical success, early recurrent.

Kết quả bước đầu can thiệp nội mạch điều trị phình động mạch não lớn và khổng lồ bằng STENT thay đổi dòng chảy tại bệnh viện Chợ Rẫy

Kết quả bước đầu can thiệp nội mạch điều trị phình động mạch não lớn và khổng lồ bằng STENT thay đổi dòng chảy tại bệnh viện Chợ Rẫy

04/14/2020 23:08:55 | 0 binh luận

Initial results of endovascular neurointervention using flow - diversion stent for treatment of large and giant intracranial aneurysms at Choray Hospital

SUMMARY

Objectives: Currently, interventional neuroradiology using coiling technique for embolization of intracranial aneurysms has been becoming a standard method, can be an alternative method for surgical clipping. However, for wide-necked, fusiform, dissecting and giant aneurysms, incomplete occlusion and recanalization were still main limitations for long-termed outcomes. The development of flow-diversion stents has been leading to the possibility of complete occlusion of aneurysms due to change of blood flow into aneurysms, resulting in thrombogenesis inside the aneurysms.

Subjects and methods: Interventional neuroradiology using flowdiversion stent performed at Department of Radiology, Choray Hospital, from 01/2015 to 06/2017, the technique as follows: digital subtraction angiography, inserting of mirocatheter over the aneurysm neck, deploying the flow-diversion stent over the aneurysm neck. The efficacy and safety were evaluated by variants: complete and partial occlusion rates, procedural success rate, clinical improvement, procedural complication.

Results: 24 cases of large and giant intracranial aneurysms treated with flow-diversion stents, technical success rate 21/24 (87.5%), 03 cases failed to be performed had to change to other treatment or follow-up, 01 case of abrupt death during follow-up.

Conclusion: Using flow – diversion stent is a new technique, may be effectively alternative method compared to conventional aneurysmal coiling, especially in treatment of large and giant intracranial aneurysms.

Key words: Large and giant intracranial aneurysms, flow – diversion stent, interventional neuroradiology

Bước đầu đánh giá hiệu quả điều trị suy tĩnh mạch mạn tính bằng phương pháp đốt laser nội mạch

Bước đầu đánh giá hiệu quả điều trị suy tĩnh mạch mạn tính bằng phương pháp đốt laser nội mạch

04/14/2020 22:52:33 | 0 binh luận

Evalation the primary efficacy of endovenous laser ablation in chronic venous insufficiency

SUMMARY

Objective: To evaluate the efficacy of the treatment chronic venous insufficiency in lower extremity by endovenous laser ablation at Radiology Department in Bach Mai hospital.

Subjects and Methods: Prospective cohort on 20 patients with chronic venous insufficiency in lower extremity treated at Radiology Department in Bach Mai hospital from August 2016 to May 2017.

Results: The occlusion rate of great saphenous vein was 95,6%, mild complications included ecchymosis (26,1%), pain postprocedure score at 3,4 point (according to VAS). Revised VCSS at 1-month-post procedure was improved evidently (VCSS pre- and post treatment, 8.7±3.0 and 1.9±2.6).

Conclusion: Endovenous laser ablation is a mini-invasive and safe therapy, improved clinical symptoms for patients.

Keyword: chronic venous insufficiency, endovenous laser ablation.

Điều trị giãn tĩnh mạch tinh bằng can thiệp nội mạch sử dụng kỹ thuật SANDWICH tại bệnh viện Bạch Mai

Điều trị giãn tĩnh mạch tinh bằng can thiệp nội mạch sử dụng kỹ thuật SANDWICH tại bệnh viện Bạch Mai

04/12/2020 22:43:19 | 0 binh luận

The treatment of varicocele endovascular intervention using the sandwich technique at Bach Mai Hospital

SUMMARY

Purpose: Evaluating the result of varicocele endovascular intervention by sandwich technique combining Coils and glue (histocryl).

Methods and objectives: 78 patients were diagnosed and treated successfully at Bach Mai hospital from 5/2009 to 5/2017, they were examined, performed semen analysis and ultrasound at before and after 6 months of embolization.

Result: The average age of 22.6 years old, the hospitalized reasons is mainly scrotal pain, with 76.9%. After 6 months of treatment, all patients have pain reduction, the pain scores decreased from 6.7 points to 1.2, p < 0.05. Increasing sperm concentration from 10 million/ml to 21 million/ ml, sperm mobility increased from 27% to 55%, p <0.05. Spermatic vein diameter returns to normal limits and have no reflux line after 6 months. No major or minor complications during the intervention and 6 months after intervention

Conclusion: Embolization of spermatic vein with technique sandwich combined Coils and glue to treat varicocele is safe and high effective.

Key word: varicocele, varicocele endovascular intervention, sandwich technique

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