SUMMARY Background : The purpose of the study was to evaluate the characters and efficacy of B Mode and color Doppler ultrasound (CDUS) in diagnosis malignant cervical lymph nodes. Materials and Methods: In this cross-sectional prospective study, during a period of 12 months, performed on 85 patients including two groups: group I includes 63 patients with cervical lymphadenopathy with suspected lymph nodes on US and group II includes 22 patients with clinically suspected lymph nodes (not have any suspicious characteristics in US) were prospectively evaluated with B-mode and CDUS. Statistical analysis was carried out with histopathological or cytological diagnosis as gold standard. Results: We conducted ultrasound in 85 patients,. To compare with the pathology results of the disease, there are 56 metastatic lymph nodes, 04 lymphoma nodes, 01 plasmocyoma lymph node, 18 nonspecific inflammatory lymph nodes, 01 purulent lymph node and 05 granulomatous lymph nodes due to tuberculosis. The sensitivity, specificity, the accuracy of 2D ultrasound method combined with Dopper ultrasound are 95.08%, 79,2 %, 92%, 86% và 90,6%. Conclusions : Within the limitations of this study, B-mode and CDUS evaluations were found to be highly significant with a high sensitivity and specificity. B-mode and CDUS examinations provide a prospect to reduce the need for biopsy/fine needle aspiration cytology in reactive nodes. Keywords: B-mode ultrasound, Doppler color ultrasonography, histopathology, lymph node.

Perinatal testicular torsion clinical and sonographics findings SUMMARY Objective: Perinatal testicular torsion either occurring prenatally in utero or postnatally in the first month of life, is surgical emergency with hope salvaging of testis. A challenge to clinicians and radiologist. With sonographics findings as small size of testis, heterogenous echostructure, thickened tunica albuginea with rim hyperechoic (calcification), to suggest testicular torsion. Methods: Cases report Results : From January 2015 to May 2019, we had 11 patients with perinatal testicular torsion introduced into the study batch. The average age is 8.2 days. One song twists on two sides, on the left 7 shifts. The time of detection after birth, an average of 1.5 days, no cases of prenatal ultrasound were detected. The average time of hospital admission is 17 days. 100% normal birth, full month.Ultrasound signs: testicular big size 7/12 (58.3%), heterogeneous parenchyma structure 11/12 (91.7%), calcareous membrane calcification 2/12 (16.6%), hydrocephalus, heterogeneous fluid, 7/12 fibrin (58.3%), enlarged stalks, edema 3/12 (25%). Mark Whirpool positive 8/12 (67%), central blood loss 11/12 (91.7%). The rate of testicular removal is 10/12 (83.3%). Conclusions: Twisted perinatal testicular, rare surgical emergency, causes purple swelling of the scrotum and requires early diagnosis and surgical intervention. High-value color doppler ultrasound determines testicular twisting and eliminates the causes of swelling and pain in the scrotum. Keywords: testicular torsion, neonate, ultrasound.

Transrectal sonoelastography in detection of prostatecancer: initial assessment of 101 cases SUMMARY Purpose Evaluate the efficiency of transrectal strain elastography (SE) and transrectal B-mode ultrasonography (TRUS) in determining prostate cancer. Material & Methods From 20/6/2015 to 10/9/2015, There are 101 patients with PSA level of higher 4ng/ml have been selected. Abnormal echo regions in prostate were found via conventional TRUS in those patients, then Abnormal echo regions would be evaluated by real-time strain ultrasound elastography. Patients have undergone six core biopsies by transperineal approach. Experimental studies Results Comparising between 3 methods: B-mode TRUS, strain elastography and DRE about sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). (table) Table.Comparising between 3 methods: B-mode TRUS, strain elastography and DRE. Sensitivity (%) Specificity (%) PPV (%) NPV (%) B-mode 88.5 55.1 67.6 81.8 Strain-elasto 94.2 65.3 74.2 91.4 DRE 69.2 98 98 75 Conclusions: Sonoelastographyprovidesmore information to detect prostate cancer and biopsy guidance. SE reached a higher sensitivity and specificity than B-mode US in the detection prostate cancer.Strain ultrasound elastography can be used as routine as colour Doppler. Key words: sonelastography, strain ultrasound elastography, prostate cancer, ultrasound.

Ultrasound of foreign bodies in gastrointestinal tract removed at Children’s Hospital 1 case report SUMMARY Objectives : We reviewed ultrasound features of all cases of foreign bodies in the upper gastrointestinal tract that underwent endoscopic or surgical removal at Children’s Hospital N1 from 1/2018 to 4/2019. Method : retrospective case. Results : From 1/2018 to 4/2019, 7 cases were included. Mean age was 7,9 years old. Boy to girl ratio was 5/2. 5/7 cases were radiolucent foreign bodies, toothpick mostly. The positions were one oesophageal, 2 gastric và 4 duodenal. All cases were diagnosed correctly by ultrasound before intervention. 4/7 cases underwent surgical removal, 3 cases underwent endoscopic removal. The signs of right-side retroperitoneal oedema and fluid collection surrounding right kidney on ultrasound were highly suspected of posterior D3 duodenal wall perforation due to foreign bodies. Conclusion: Foreign bodies in the upper gastrointestinal tract can cause dangerous complications in case of late diagnosis. Ultrasound can help find radiolucent as well as radiopaque objects. We should know typical ultrasound features of some foreign bodies and common sites of complication in order to predict the object and the location exactly to give proper management. Key words : foreign bodies, ultrasound, children.

A comparative study of strain elastography (se) and shear wave elastography (swe) in female breast tumor disease at medic medical center in HCMC in 2019 SUMMARY Objective: Combining B-mode US, BI-RADS classification and applying 2 types of elastography: Strain Elastography (SE) and Shear Wave Elastography (SWE) on RS85 ultrasound scanner (Samsung) in diagnosis of benign/ malignant breast tumors. Detecting diagnostic value for each method and when combining them. Materials and methods: Selecting female breast tumors that classified Birads 3,4,5 by B-mode US, examining elastography at the same time by 2 methods: SE and SWE using L2-9MHz probe on RS85 ultrasound scanner (Samsung) from August to October, 2019 at Medic Medical Center in HCMC. Collecting data of 2 types of Elastography: SE: collecting 3 values: (1) color mapped elastogram according to Tsukuba elasticity score, (2) E/B ratio (the largest transversal diameter that hardest color - coded on the color map / the largest transversal diameter of tumor on B-mode US) (<1 or >1), (3) ratio B/A (A= tumor lesion, B= normal fat tissue above the lesion). SWE: measuring the tissue stiffness (kPa) and shear wave velocity (m/s) (according to color-coded tumor stiffness map, selecting the hardest point that satisfied RMI (reability measurment index) ≥ 0.4. Measuring each method 3 times on the same tumor. Bi-rads 3-4-5 lesions undergone biopsy (FNAC and/ or core biopsy) to have determined diagnosis. Then calculating the diagnostic value of each method and when combining the 2 methods. Using the SPSS 20 software for statistics and analyzing. Results: The study has 84 breast tumors (51 benign and 33 malignant) that have determined diagnosis by cytology and histology. Strain Elastography value: 1.1. Choosing color map according to Tsukuba elasticity score from 1→5 in diagnosis has sensitivity (90%), specificity (88.2%), positive predictive value (83%), negative predictive value (93.8%), accuracy (8.3%)1.2. Choosing the E/B ratio (the largest transversal diameter that hardest color - coded on the color map / the largest transversal diameter of tumor on B-mode US) value (that <1 suspected benign tumor and ≥ 1 suspected malignancy) has sensitivity (87%), specificity (90.2%), positive predictive value (85.3%), negative predictive value (92%), accuracy (89.3%) 1.3. The ratio of mean strain elastography value of malignant and benignbreast tumor / fat tissue are (8.1+/- 3.7) and (2.4+/-1.3) (p<0,001).The ratio at cut-off value (3.2) has the highest sensitivity (97%) and specificity (84.3%) in diagnosing malignant breast tumors. Area under the ROC curve calculated (0.969). Positive predictive value (80%). Accuracy (89.3%). 2. Shear wave elastography (SWE) value: 2.1. Shear wave mean velocity of benign and malignant tumor groups are (3.9 ± 1.1) and (5.9 ± 1.3) (m/s) (p<0,001). Mean ratio at the cut-off value (4.2m/s) has the highest sensitivity (90.9%) and specificity (66.7%) in diagnosing malignant breast tumors. Area under the ROC curve calculated (0.873).Positive predictive value (63.8%). Negative predictive value (91.8%). Accuracy (76.2%). 2.2. Mean stiffness value of benign and malignant breast tumor groups are (49.7 ± 28.2) and (108±4.5) (kPa) (p<0,001). Mean ratio at the cut-off value (50.3 kPa) has sensitivity (90.9%), specificity (66.7%). Area under the ROC curve calculated (0.864), positive predictive value (61.2%), negative predictive value (91.4%), accuracy (73.8%) 3. Combination of SE and SWE value Combining the 2 types of elastography SE and SWE in diagnosing breast tumor by evaluating E/B of SE and shear wave velocity (m/s) of SWE increases the strongly sensitivity (100%), specificity (52,9%) and positive predictive value (57,9%), negative predictive value (100%), accuracy (71,4%), helps to reduce unnecessary biopsied cases. Conclusions: SE and SWE are useful in diagnosing breast tumor. Combining the 2 types of elastography SE and SWE have strongly sensitivity, helps to reduce unnecessary biopsied cases.

summary urpose : To survey ultrasonographic characteristics suggested benign and malignant cervical lymph node metastasized from EC methods (esophagus cancer). To find out the values of FNA in diagnosis of metastatic cervical lymph node from EC. Materials and Methods: 20 patients were diagnosed EC and ultrasound detected suspiciously malignant cervical lymph node, from 4/2012 to 6/2013. The patients were surveyed: Mode 2D, FNA, cytopathology in Hue Central Hospital. We divided the diagnosis into 2 groups: benign and malignant group. Results: In 20 patients with cytology, 8 cases are diagnosed malignant lymph node metastasized from EC. The remains, 12 patients are diagnosed with benign lymph node: lymphadenitis. In our research, the signs suggest malignant lymph node in sonography: hypoechonic, heterogeneous, loss of the fatty hyperechoic hilum, ill-defined border, size about 10mm in diameter (short axis), round-shaped, greater numbers. Se= 80%, Sp= 100%, PPV= 100%, no false negative cas. Conclusion: The combination of ultrasound and FNA is valuable in the diagnosis of suspected malignant lymph node in the neck, metastasized from EC. It is a safe and simple method for selected patients which allows diagnosis and staging in a single step.

Ultrasound characteristics of side-to-end arteriovenous fistula at forearm in chronic renal failureforperiodical hemodialysis SUMMARY Objective: To assess ultrasound characteristics of radiocephalic fistula at 2 and 3weeksafter operation in chronic renal failure with periodical hemodialysis. Methods: This study was conductedon 34 patients with indication of periodical hemodialysis due to chronic renal failure from April, 2016 to July, 2017 at Hemodialysis Department in Hue Central Hospital. These patients were operated to createside-to-end radiocephalic fistula at forearm and examed with ultrasound at week 2 and 3after operation. Results : The mean age was 45,79 ± 14,59 (mean ± SD); 47,10% male and 52,90% female patient. Diabetes was presented in 5,88% of the patients. The mean diameter of vein was 4,96 ± 0,88 mm at week 2 and 5,40 ± 0,99 mm at week 3 (p < 0,05);venous flow volume was 531,33 ± 162,40 ml/p and 666,56 ± 260 ml/p at week 2 and 3, respectively (p < 0,05). The rate of mature fistula at week 3 after operation was 82,35%. Most of the fistula complication was stenosis at the arterio-venous anastomosis and the draining veins. Conclusion : Ultrasound can assess the flow through arteriovenous fistula, detect several early complications which cause abnormal fistulas and help formanagement and treatmentof patients. Key word: radio-cephalic fistula, periodical hemodialysis.

High-frequency ultrasonography for the motor branchesof the musculocutaneous nerve innervating biceps brachii: from the branching location to the distribution in the muscle SUMMARY Purpose: The aim of this study was to investigate the ability of high-frequency ultrasonography in examing the motor branches of the musculocutaneous nerveinnervating biceps brachii in the correlation with anatomical and histological knowledge. We analysed the location where they exit the main nerve trunk, penetrate the muscle epimysium and distribute inside the muscle. Methods: Sixteen healthy volunteers (eight males and eight females, ages 20-60, mean age 35) were examined on both sides of the musculocutaneous nerves and their branches innervating biceps brachii. The 5-18 MHz and 16-23 Mhz multi-frequency transducers along with the latest high-resolution ultrasound systems were used to examine the musculocutaneous nerves slowly and continuously in cross section from the coracoid process of the scapula to the elbow. By analyzing the nerve bundles inside the musculocutaneous nerve and the epimysium of biceps brachii, we observed the position where one nervebranch separated from the main trunk of the nerve, penetratedthe epimysium and distributedinside the muscle.Blood vessels were distinguished with nerves by Doppler ultrasound and compression method. Results: One right arm of a 28-year-old womanwas found with the absence of the musculocutaneous nerve and the median nerve give the motor branches to the biceps brachii. Thirty one musculocutaneous nerves and their motor branches to biceps brachii muscles were detected on ultrasound. Inside the muscle, the nerve branches were located in the hyperechoic bands while the surrounding muscular tissue was hypoechoic. In these hyperechoic bands, the nerves were identified because of hypoechoic structure and thicker than the thickness of the bands. The blood vessels were also foundin these bands. The minimum diameter of the nerve branches inside the muscles can be seen as 0.3 mm. Conclusion: High-frequency ultrasonography can examine very small nervestructure, detemine the position where the motor branches exit from the maintrunk of the nerve, penetrate the muscle epimysium and branching inside the muscle. Keywords : ultrasound, motor branch of the nerve, intramuscular nerve distribution, musculocutaneous nerve, biceps brachii muscle