Tan soi mat qua da . bs binh. bv dai hoc y ha noiNguyen Thai Binh
Tán sỏi mật trong và ngoài gan qua da bằng laser. Phương pháp can thiệp tối thiểu trong điều trị sỏi mật.
BS Nguyễn Thái Bình
Khoa Chẩn đoán hình ảnh
Bệnh viện ĐH Y Hà Nội
Bộ môn Chẩn đoán hình ảnh - Trường ĐH Y Hà Nội
Gauze can be used to put pressure on cuts to stop or control bleeding. Disposable gloves should be worn to prevent contact with blood and blood borne pathogens. Scissors can cut clothing away from injuries so wounds can be treated directly.
This lecture discusses the management of saddle nose deformities. The speaker classifies saddle nose deformities into 5 types from mild to severe. For mild cases, the goal is to "finish the job" by minimally reducing the hump. For moderate cases, a balanced approach of reducing bone and using it as an onlay graft is recommended. More severe cases may require rib or ear cartilage grafts. The most severe cases require total reconstruction using rib grafts to build a new nasal scaffold. Sharp instruments, conservative grafting, and considering vascularization are important for successful reconstruction of saddle nose deformities.
Tan soi mat qua da . bs binh. bv dai hoc y ha noiNguyen Thai Binh
Tán sỏi mật trong và ngoài gan qua da bằng laser. Phương pháp can thiệp tối thiểu trong điều trị sỏi mật.
BS Nguyễn Thái Bình
Khoa Chẩn đoán hình ảnh
Bệnh viện ĐH Y Hà Nội
Bộ môn Chẩn đoán hình ảnh - Trường ĐH Y Hà Nội
Gauze can be used to put pressure on cuts to stop or control bleeding. Disposable gloves should be worn to prevent contact with blood and blood borne pathogens. Scissors can cut clothing away from injuries so wounds can be treated directly.
This lecture discusses the management of saddle nose deformities. The speaker classifies saddle nose deformities into 5 types from mild to severe. For mild cases, the goal is to "finish the job" by minimally reducing the hump. For moderate cases, a balanced approach of reducing bone and using it as an onlay graft is recommended. More severe cases may require rib or ear cartilage grafts. The most severe cases require total reconstruction using rib grafts to build a new nasal scaffold. Sharp instruments, conservative grafting, and considering vascularization are important for successful reconstruction of saddle nose deformities.
This document provides information about a rank improvement batch course for students who appeared for MHT-CET 2012 but did not achieve their highest expectations. The course will help prepare students for MHT-CET or other state entrance exams through focussed teaching and regular tests. It will identify weak areas and work to improve student performance and scores. The course fees are Rs. 33,708 and must be paid in full at admission, which will be on a first come first basis for MHT-CET 2012 repeaters. Students must submit documents and 120 tests plus 20 prelims will be conducted according to board exam patterns.
Orphan works are copyrighted creative works like books, music, films, etc. whose owners cannot be located. Works can become orphaned for reasons such as the owner not registering the copyright, the owner selling rights without registering the transfer, or the owner passing away without heirs being found. Four factors are used to determine fair use: the purpose of the use, the nature of the work being used, the amount of the work being used, and the effect of the use on the market for the original or permissions. A checklist can help ensure uses adhere to standards of fair use and copyright.
The document discusses endangered animals and species. It notes that over 2,500 animal species are currently endangered. Some key reasons that animals become endangered are discussed, including habitat loss, disease, and human impacts. Endangered means a species is at risk of extinction due to low numbers. The document requests help in protecting endangered animals and getting them to safer places away from threats.
Wirtualna karta stemplowa Frankie's - manualfrankieswroc
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Manchester United's conference and events business needed its own identity to stand out. A new brand, "United Events", was created along with the proposition "where greatness begins". This helped highlight the inspiring atmosphere of Old Trafford while distinguishing the business from the football club. Targeted marketing increased sales and repeat business, and new products like corporate boxes as meeting spaces were developed.
Dokumen tersebut membahas tentang konsep sehat dan sakit menurut beberapa ahli. Keadaan sehat dan sakit dipengaruhi oleh interaksi individu dengan lingkungan serta keberhasilan adaptasi. Asuhan keperawatan bertujuan untuk membantu pasien beradaptasi dengan kondisinya, mengenali penyebabnya, serta mendukung dukungan emosional.
Vango Adventure tents are ideal for those trips off the beaten track. Great for wild camping, motorcycle touring, festivals and Duke of Edinburgh.
These tents use features established on the class leading Force Ten models to bring expedition performance at a great price.
Tán sỏi thận qua da và Tán sỏi tiết niệu bằng ống soi mềmBs Đặng Phước Đạt
Nhờ sự phát triển không ngừng của khoa học kỹ thuật, các dụng cụ, trang thiết bị phẫu thuật nội soi trong tiết niệu ngày càng hiện đại và tiện dụng, đi kèm với đó là các nguồn năng lượng để công phá sỏi ngày càng mạnh mẽ hơn và an toàn hơn.
A 9-year-old male presented with abdominal pain and fever. Imaging showed a large cyst in the spleen. CT and ultrasound findings were consistent with an epidermoid cyst based on the solitary, well-defined mass with thin walls and septations, fluid density, and lack of enhancement or calcification. Differential diagnoses included splenic cyst from prior trauma, lymphangioma, or abscess, but features were most consistent with a congenital epidermoid cyst.
1) The document reports on MRI findings for two patients. For the first patient, a 5-year-old boy, the MRI found bilateral schizencephaly and corpus callosum hypoplasia.
2) For the second patient, a 15-month-old boy with a history of subarachnoid hematoma, the MRI found a giant saccular aneurysm of the left middle cerebral artery and posterior communicating artery that had hemorrhaged and thrombosed, leading to hypoplasia of the left middle cerebral artery and left fronto-temporal lobe.
3) The document also provides background information on schizencephaly, describing it as clefts in the brain paren
This report describes a 22-month old female patient presenting with an abdominal tumor. CT scans revealed a large heterogeneous mass arising from the left suprarenal region, measuring 122x120x82mm with areas of necrosis, calcification and hypodensity in the liver. The mass enhanced heterogeneously, surrounded and engulfed nearby blood vessels. No lung or bone metastases were seen. The diagnosis was neuroblastoma with liver metastases, a type of childhood cancer that most commonly arises in the adrenal gland.
A 5-year-old male presented with a 1 month history of headache and vomiting. Imaging showed a hyperintense solid mass in the fourth ventricle with surrounding edema and hydrocephalus. MRI revealed a heterogeneous mass in the posterior fossa filling the fourth ventricle and invading the vermis, with areas of necrosis and decreased diffusion. The mass strongly enhanced with contrast. Based on these findings, the diagnosis was medulloblastoma, a highly malignant pediatric brain tumor originating in the cerebellum.
A 4-year-old male presented with abdominal pain, mild fever, vomiting and a palpable abdominal mass. An MRI revealed a large cystic mass in the abdomen measuring 12.5 x 5.8 cm. The mass displayed multiseptations and compressed nearby bowel loops. A diagnosis of mesenteric cystic lymphangioma was made based on imaging and clinical findings. Mesenteric cystic lymphangioma is a rare cyst arising in the mesentery, most often seen in children and young adults. Surgical excision is typically the treatment with a good prognosis.
This document summarizes medical imaging findings and provides a diagnosis for an 8 month old female patient presenting with high fever, cough, and wheezing. Chest x-ray and CT scans revealed a large heterogeneous mass in the left upper lobe filling and compressing the lung, with associated pleural effusion. Based on these findings and the patient's young age, the diagnosis was determined to be a type II pleuro-pulmonary blastoma, a rare and aggressive malignant tumor of the pleural lung mesenchyme occurring in early childhood. Differential diagnoses including rhabdomyosarcoma and Ewing sarcoma were considered and ruled out.
A 5-year-old female presented with coughing and vomiting blood. Imaging showed an oval mass in her right posterior mediastinum compressing her right lung and superior vena cava. CT and ultrasound imaging characterized the mass as well-defined, homogeneous and hypoechoic without calcification or necrosis. She was diagnosed with ganglioneuroma, a benign sympathetic ganglion tumor most common in older children.
A 4-year-old female presented with visual disturbance and headache. An MRI found a 22x24x34mm suprasellar and intrasellar mass with cystic and solid parts, including calcification. The mass displaced the chiasm and enlarged and compressed the sella turcica. Post-contrast imaging showed heterogeneous enhancement of the solid portion and strong enhancement of the cyst wall. The diagnosis was craniopharyngioma, a benign epithelial tumor arising from the pituitary gland that is most common in children aged 8-12 and typically appears cystic with calcification and enhancement of the cyst wall on imaging.
This imaging report summarizes the findings of a CT scan for a 10-year-old boy who was in a traffic accident 2 weeks prior and was experiencing abdominal pain and vomiting. The CT scan showed evidence of grade 2-3 pancreatic injury and grade 2-3 duodenal injury, though ductal injuries could not be confirmed. There was also possible active bleeding from the superior mesenteric vein. The report provides background on pancreatic and duodenal trauma, outlines the imaging protocols and findings, and describes the American Association for the Surgery of Trauma classification system for pancreatic and duodenal injuries.
Biliary atresia is a condition where the bile ducts outside and inside the liver are damaged, leading to cirrhosis and liver failure. It is characterized by obstruction of the extrahepatic bile ducts. The primary treatment is surgical. Diagnosis involves ultrasound to detect gallbladder abnormalities and the triangular cord sign near the portal vein, hepatobiliary scintigraphy to check for bile excretion, and cholangiography to directly image the bile ducts. The definitive treatment is a Kasai portoenterostomy surgery in infants under 3 months of age.
This document discusses myelin and its development and appearance on MRI scans. It begins by defining myelin as the insulating phospholipid layer surrounding neuron axons, produced by oligodendrocytes in the CNS and Schwann cells in the PNS. Myelin is 80% lipid and 20% protein. It wraps around axons to increase impulse propagation speed.
Normal myelination progresses from caudal to cephalad, dorsal to ventral, and central to peripheral areas of the brain. On MRI, myelinated white matter appears hyperintense on T1-weighted images and hypointense on T2-weighted images. The document then outlines the typical timing and appearance of myelination in various brain structures from
This report discusses imaging findings for a 19-month-old female patient being evaluated for a suspected lung abscess. The imaging shows a hiatal hernia where part of the stomach protrudes through the diaphragm. Specifically, it appears to be a paraesophageal type hernia where the gastroesophageal junction remains in the normal position but part of the stomach herniates into the chest. The report further describes the diagnosis and types of diaphragmatic and hiatal hernias seen on various imaging modalities like ultrasound, chest radiograph, CT and MRI.
1. Congenital neck masses are abnormal growths present from birth between the clavicles and mandible. The most common congenital neck mass is a thyroglossal cyst, which forms from a persistent thyroglossal duct during development.
2. Other congenital neck masses include branchial cysts, dermoid cysts, cystic hygromas, hamartomas, and teratomas.
3. Evaluation of congenital neck masses involves inspection, imaging like ultrasound or CT to determine if the mass is solid or cystic in nature, and biopsy if needed to arrive at a definitive diagnosis. Surgical excision is usually the treatment for congenital neck masses.
Magnetic resonance spectroscopy (MRS) provides biochemical information about metabolites in tissues. It differs from MRI in that it analyzes spectra rather than anatomy. Common nuclei analyzed include hydrogen (proton MRS), which is most common. MRS can detect metabolites like N-acetylaspartate, creatine, choline, myoinositol, and lactate. Abnormal levels of these metabolites can indicate conditions like tumors, infections, demyelination, and more. MRS is used to study many neurological diseases and assess treatment response. It provides a non-invasive way to analyze brain chemistry.
A 5-year-old male presented with swelling of the frontal and temporal bones bilaterally for 1 year. CT and MRI findings revealed an expansive bone lesion involving the frontal, orbital, sphenoid wings, and zygomatic bones, with hyperintensity compared to normal bone. Following contrast administration, strong and diffuse enhancement was seen. The diagnosis was craniofacial fibrous dysplasia, a rare abnormal bone growth where normal bone is replaced with fibrous bone tissue. There is no known cure, though treatment may include surgery for visual loss or deformity, medication to strengthen bones or manage pain, and treatment for associated conditions.
1. CĐHACĐHA hệ tiết niệu-sinh dục trẻ emhệ tiết niệu-sinh dục trẻ em
một số phương pháp không dùngmột số phương pháp không dùng
tia Xtia X
Ths Trần phan NinhThs Trần phan Ninh
Bs Lê Văn TámBs Lê Văn Tám
Khoa CĐHAKhoa CĐHA
Bệnh viện Nhi TWBệnh viện Nhi TW
2. Các phương pháp CĐHACác phương pháp CĐHA
• Siêu âm:
• Cystography: Đánh giá đường tiểu dưới
• UIV: đánh giá hình thái và chức năng
• Uro-CT
• Uro-IRM
• Xạ hình thận (SPECT)
3. Các phương pháp CĐHACác phương pháp CĐHA
• Siêu âm:
• Cystography: Đánh giá đường tiểu dưới
• UIV: đánh giá hình thái và chức năng
• Uro-CT
• Uro-IRM
• Xạ hình thận (SPECT)
4. Siêu âm: tầm soát trước và sauSiêu âm: tầm soát trước và sau
sinhsinh
• Thực hiện thường quy trong thai kỳ: tuần 12
• Giãn đài bể thận
• Chiếm 15% bất thường trước sinh
• Phần lớn tự hồi phục
• Kiểm tra sau sinh: nếu kéo dài >3 tháng
• Echo-> SPECT hoặc Cystography
5. Siêu âm: kỹ thuậtSiêu âm: kỹ thuật
• Chuẩn bị bệnh nhân
• Kỹ thuật
• Chú ý
• Bể thận ngoài xoang
• BQ quá căng->giãn niệu quản
6. Siêu âm: thận bình thườngSiêu âm: thận bình thường
• Kích thước
• Sơ sinh: 4-5cm
• <1 tuổi: 6cm
• <5 tuổi: 8cm
• <10 tuổi: 10cm
7.
8.
9. Siêu âm: bờ thậnSiêu âm: bờ thận
• Hình thùy múi dạng phôi thai ở trẻ nhũ nhi
• Bên trái: hình yên lạc đà
• Phần trước cực trên có dải echo dày
• 1/3 trẻ sơ sinh có hìh ảnh echo dày vùng
tháp thận thoáng qua
10.
11.
12.
13.
14.
15.
16.
17.
18.
19. Siêu âm: cấu trúc thậnSiêu âm: cấu trúc thận
• Cấu trúc âm
• <3 tháng: tủy < gan < vỏ < xoang
• >3 tháng: tủy < vỏ < gan < xoang
• Phân biệt tủy vỏ rõ
• 90% trẻ < 6 tháng không có tăng âm xoang thận
• Dày bể thận: 2-3mm
• Phì đại cột Bertin
• Chỉ số RI động mạch nhu mô thận cao hơn
20. Siêu âm: bàng quangSiêu âm: bàng quang
• Cần thăm khám trước tiên
• Thành mỏng, đều
• 0,4-2,7mm (BQ đầy)
• 1,6-3,9mm (BQ vơi)
• Dòng phụt nước tiểu
24. Siêu âm: tuyến thượng thậnSiêu âm: tuyến thượng thận
• Trẻ sơ sinh:
• Có thể thấy rõ (V=1/3 thận)
• Tủy tăng âm, vỏ giảm âm
• Trẻ lớn:
• Khó quan sát thấy trên SA (1/30 thận)
25.
26.
27. Siêu âm: sinh dục nữSiêu âm: sinh dục nữ
• Bàng quang cần phải căng
• Âm đạo hình trụ
• Tử cung thay đổi theo tuổi
Tuổi Hình thái Kích thước
Sơ sinh Hình ống 4cm
Tiền dậy thì Giọt nước Dài 4cm
Dầy 0,1-1cm
Dậy thì Quả lê Dài 5-8cm
Dày 2-4cm
28.
29. Siêu âm: buồng trứngSiêu âm: buồng trứng
• Sơ sinh: Nằm cao và di động
• <3 tháng: 0,8cc,
• 2 tuổi: 1cc
• 12 tuổi: 2cc
• Dạy thì: 5cc
• Xuất hiện vài nang noãn nhỏ khoảng 6
tuổi (<2cm).
30.
31. Các phương pháp CĐHACác phương pháp CĐHA
• Siêu âm:
• Cystography: Đánh giá đường tiểu dưới
• UIV: đánh giá hình thái và chức năng
• Uro-CT
• Uro-IRM
• Xạ hình thận (SPECT)
32. Cộng hưởng từCộng hưởng từ
• Chụp mạch thận
• Khối u thận
• Di căn
• Trào ngược bàng quang niệu quản
33. CHT: chụp mạch thậnCHT: chụp mạch thận
• Đánh giá cấp máu của thận người cho
trước khi ghép thận.
• Trước phẫu thuật cắt thận bán phần.
• Phát hiện mạch máu đi bất thường gây
hẹp chỗ nối bể thận niệu quản
34. CHT: u thậnCHT: u thận
• Thay thế CLVT khi bệnh nhân suy thận
hoặc dị ứng với thuốc cản quang chứa
iod.
• Độ nhạy tương đương CLVT trong phát
hiện các khối u thận
• Ưu điểm quan sát trên nhiều hướng cắt
khác nhau.
35. CHT: u đường bài xuấtCHT: u đường bài xuất
• Giúp phân độ tổn thương.
• Độ nhạy cao khi đánh giá mức độ xâm lấn
bàng quang của khối u
36. CHT: luồng trào ngược bàng quangCHT: luồng trào ngược bàng quang
niệu quảnniệu quản
• Phát hiện luồng trào ngược
• Đánh giá chức năng từng thận
• Phát hiện sẹo thận.
37. Các phương pháp CĐHACác phương pháp CĐHA
• Siêu âm:
• Cystography: Đánh giá đường tiểu dưới
• UIV: đánh giá hình thái và chức năng
• Uro-CT
• Uro-IRM
• Xạ hình thận (SPECT)