TÀI LIỆU HỘI NGHỊ KỸ THUẬT ĐIỆN QUANG VÀ Y HỌC HẠT NHÂN VIỆT NAM LẦN 7 (2019) Nguồn: https://hinhanhykhoa.com/

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TECHN.NGUYỄN VĂN KIÊN
DR.TRẦN TIẾN MẠNH
TECHN TRẦN QUỐC TUẤNTECHN.TRẦN QUỐC TUẤN
TECHN. NGÔ XUÂN QUANG
DIAGNOSTIC IMAGING DEPARTMENT
HANOI HEART HOSPITAL
 WHO: incidence 0.5 – 0.8%, no difference between
genders and races.
 According to the Ministry of Health statistics in 2016,
every year our country has 12,000 children with
congenital heart disease. With a rate of 0.8%-1% of
babies are born
 In Europe ‐ America ventricular septal defect 28%,
atrial septal defect 10.3%, pulmonary artery stenosis
9.9%, And ductus arteriosus 9.8%, quadrupular Fallot
9.7%, aortic stenosis 5.1% and 4.9% arterial
hypertrophy.

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Ultrasound is a widely used method of diagnosing congenital heart disease.
DOMINANCE
• Low price.
• High mobility.
• Available at the
hospital
LIMIT
• Artifact due to sound barrier.
•Depends on people doing.
• Use assumptions.
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So which image
diagnostic method
is good?

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 Accurately assess cardiac abnormal  Accurately assess cardiac abnormal
morphology ‐ circuit with high spatial
resolution.
 It does not depend examiner.
N di ti No radiation
 Functional evaluation, perfusion ...
 Contrast media less toxic to the kidneys
 Investigate vascular anatomy in complex congenital heart
disease
Ab lit f A ti A h ( i t t d ti h Abnormality of Aortic Arch ( interrupted aortic arch,
coarctation, vascular rings)
 Arteial blood supply to the lungs(pulmonary artery
anatomy, aortopulmonary collateral arteries)
 Pulmonary vein abnormalities (anomalous connection,
stenosis)
 Quantification of ventricular volume
 Hypoplasia left, right ventricle
 Follow-up after surgery or intervention
 Shunt patency
 Pulmonary artery stenosis

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 3 plans FIESTA
 Vertical Long Axis Localizer: FIESTA Vertical Long Axis Localizer: FIESTA
 Horizontal Long Axis Localizer: FIESTA
 Short Axis Stack
 2 – Chamber View
 4 – Chamber View
 3 – Chamber View
 LVOT, RVOT.
 2D Aortic PC – 2D Pulmonary( Đo Qp/Qs)

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• Contrast media:
gadolinium 0,2 ‐g ,
0,3 mmol/P (kg) .
• Injection time
8-10s

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 Nuber of cases: 31
 14 cases < 15 yrs old 17 cases > 15 yrs old 14 cases < 15 yrs old, 17 cases > 15 yrs old
 Min : 02 months old.
 Max: 43 yrs old
 25/31 cases helpful for surgical planning, treatment
(According to the surgeon, the treating doctor at
Hanoi Heart Hospital).p )
STT CHD Number
1 Ventricular septal defect 3
2 Ventricular septal defect, Stenosis outcome RV 1
3 Auricular septal defect 4
4 Auricular septal defect, Pulmonary vein abnormality 2
5 ccTGA 1
6 Post surgery bất tương hợp nhĩ -thất , thất- đại động mạch 3
7 Pulmonary vein abnormality 2
8 Coronary artery fistula 1
9 Left Coronary from Pulmonary artery 2
10 Artrioventricular septal defect 4
11 Truncus ateriosus 3
12 Post surgery Fallot 1
13 Ebstein 1
14 Post surgery Apso 2
15 Apso 1
Sum 31

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 Long-term shooting is especially important for cardiovascular
patients with physical weakness, shortness of breath.p p y
 Small size and free breathing for children
 Tachycardia, arrhythmia
 The abnormal morphological complex of congenital heart
disease.
 Steel thread after surgery.

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 Adjust technical specifications.
 Coordinate diagnostic methods Coordinate diagnostic methods
 Clinical connection - imaging diagnosis - surgeon.

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LV
Pa
RV
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RV
PA
LV
LA
RA
RV
Qp/Qs = 2.8

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VENC
250
VENC
300
VENC
400
VENCVENC
450
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4CH ?
RA
LA
LV
Localize 4CH
by ventricular
septal flow
LV
RV
RV

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PA
PA
AO LCA
LCA
RCA
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 Heart MRI is a non-invasive, non-X ray imaging
diagnostic method.
P id bj ti i f t di f ti Provide an objective view of anatomy, cardiac function
- circuit, help plan treatment and surgery.
 Development opportunities are not only in Vietnam but
also in the world.
 Big technical challenge.
 Respond of the requirements of clinical doctors and
surgeons, as well as to work closely with the image
diagnosis doctor.