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MR lymphangiography in lymphedema 淋巴水肿的MR淋巴管造影
Pub Date : 2019-07-28 DOI: 10.46475/ASEANJR.2019.04
Sitthiphan Limphanudom, Piyatida Boonsin
Lymphedema is a chronic disorder, defined as progressive and excessive accumulation of protein-rich fluid, inflammation and fibrosis in the interstitial space, resulting from impaired lymphatic drainage. It is vulnerable to misdiagnosis and has been badly reputed as an incurable disease. Nowadays, the lymphovenous anastomosis (LVA) is icrosurgical technique for bypassing the obstructed segment of the lymphatic pathway into the venous system. MR lymphangiography (MRL) is an advance imaging technique using 3D volumetric contrast-enhanced MR angiography with high temporal and spatial resolution, which can evaluate both anatomy and function of the lymphatic system. It is a quick less invasive imaging technique, which aids in diagnosis, preoperative evaluation and follow up. For the experience and technical detail of MRL in PSU will be described in this article.
淋巴水肿是一种慢性疾病,定义为进行性和富蛋白液体的过度积累,炎症和纤维化在间质间隙,由淋巴排水受损引起。它很容易误诊,并被认为是一种不治之症。目前,淋巴静脉吻合术(LVA)是一种绕过淋巴通道阻塞段进入静脉系统的显微外科技术。磁共振淋巴管造影(MRL)是一种先进的成像技术,使用三维体积增强磁共振血管造影,具有高时间和空间分辨率,可以评估淋巴系统的解剖和功能。它是一种快速的微创成像技术,有助于诊断,术前评估和随访。本文将介绍在PSU中使用MRL的经验和技术细节。
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引用次数: 0
Learning history through porcelains: Chinese porcelain bowl exports in the second half of the Ming Dynasty and the shift in domestic production of earthenware in Southeast Asia 通过瓷器了解历史:明朝下半叶中国瓷碗出口与东南亚国内陶器生产的转变
Pub Date : 2019-07-28 DOI: 10.46475/aseanjr.2019.06
Supakorn Yuenyongwannchot
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引用次数: 0
Standard national high-resolution computed tomography (HRCT) Protocol: A Recommendation by The Royal College of Radiologists of Thailand (RCRT) and Thoracic Society of Thailand Under Royal Patronage (T.S.T.) 标准的国家高分辨率计算机断层扫描(HRCT)方案:泰国皇家放射学院(RCRT)和皇家赞助下的泰国胸科学会(T.S.T.)的推荐
Pub Date : 2019-07-28 DOI: 10.46475/ASEANJR.2019.05
Nannapat Trisiripanit, Soraya Suntornsawat, Worapan Phonkaew
Diffuse interstitial lung diseases (ILDs) include more than hundreds of diseases which have different causes or underlying, target groups, signs and symptoms, clinical courses, radiographic appearances, treatments, and prognosis. Among them, idiopathic pulmonary fibrosis (IPF) is the most fatal, with prognosis worse than many cancers. After decades of no specific treatment, new medications that may help slow the progression of the fibrosis have been introduced and approved in some countries. Similar to corticosteroid, anti-inflammatory and immunosuppressive drugs which are used to treat some ILDs; these antifibrotic medications could cause certain side effects. In contrast, the cost of treatment is much higher.To monitor ILDs in terms of incidence, demographic and geographic distributions, and life expectancy; T.S.T. is developing a national ILD database. To ensure that this data base will provide the most accurate information, diagnosis should be as much precise as possible.However, the diagnoses of most ILDs are multidisciplinary. With the facts that surgical lung biopsies are available in patients fewer than 20% in most countries1, HRCT plays important role in showing disease characters and extension. Certain HRCT patterns are accepted to replace surgical lung biopsies (SLB) in some diseases.Unfortunately typical diagnostic HRCT patterns to replace SLB are not possible in all cases; for example, only about half of usual interstitial pneumonia2. Initially, diagnosis could not be made in some cases whose HRCT patterns are not specific and other clinical information is not sufficient. Longitudinal study by following up HRCTs and adding subsequently exhibited clinical data, or even surgical lung biopsy, could eventually establish the diagnosis. These patients need a system that provide regular clinical and HRCT follow up, also the multidisciplinary team to evaluate those newly acquired clinical and radiographic information .As an important role in managing patients with ILDs, standard HRCT is required to ensure that the initial examination will provide sufficient radiographic information, both the initial and follow-up examinations could be compared, the interpretation of all examinations is reproducible, and it could be performed in most institutes.To develop national standard HRCT protocol; current situation of interstitial lung diseases in Thailand,the purpose to develop the protocol, and a probable draft of the standard protocol (made by the committee from RCRT) were presented to a panel consisted of thoracic radiologist experts from all parts of Thailand in a meeting held on 11 January 2019 by Foundation of Orphan and Rare Lung Disease (FORD) and Imaging Academic Outreach Center (iAOC). Knowledge sharing, benefits and disadvantages of the drafted protocol were discussed. Adjustment was done based on feasibility, coverage of all lung diseases, diagnostic accuracy, and radiation safety.The panel provided a standard protocol describi
弥漫性间质性肺疾病(ILDs)包括数百种疾病,它们具有不同的病因或潜在病因、目标人群、体征和症状、临床病程、影像学表现、治疗和预后。其中,特发性肺纤维化(IPF)是最致命的,其预后比许多癌症都差。在几十年没有特异性治疗之后,一些国家已经引入并批准了可能有助于减缓纤维化进展的新药物。类似于用于治疗某些ild的皮质类固醇、抗炎和免疫抑制药物;这些抗纤维化药物可能会产生某些副作用。相比之下,治疗费用要高得多。从发病率、人口和地理分布以及预期寿命等方面监测儿童残疾;T.S.T.正在开发一个全国性的ILD数据库。为了确保该数据库提供最准确的信息,诊断应尽可能精确。然而,大多数ild的诊断是多学科的。在大多数国家,只有不到20%的患者可以进行手术肺活检,因此HRCT在显示疾病特征和扩展方面发挥了重要作用。在某些疾病中,某些HRCT模式被接受代替手术肺活检(SLB)。不幸的是,典型的HRCT诊断模式不可能在所有病例中替代SLB;例如,只有一般间质性肺炎的一半左右。最初,由于HRCT表现不明确,其他临床信息不充分,一些病例无法做出诊断。通过随访hrct并添加随后显示的临床数据,甚至手术肺活检进行纵向研究,最终可以确定诊断。这些患者需要一个系统来提供定期的临床和HRCT随访,也需要一个多学科的团队来评估这些新获得的临床和影像学信息。作为管理ild患者的重要角色,需要标准的HRCT来确保初始检查提供足够的影像学信息,初始和随访检查都可以比较,所有检查的解释是可重复的。它可以在大多数研究所进行。制定国家HRCT标准方案;在孤儿和罕见肺病基金会(FORD)和成像学术推广中心(iAOC)于2019年1月11日举行的会议上,泰国间质性肺病的现状、制定方案的目的以及标准方案的可能草案(由RCRT委员会制定)提交给了由来自泰国各地的胸部放射科专家组成的小组。讨论了协议草案的知识共享、利弊。根据可行性、所有肺部疾病的覆盖率、诊断准确性和辐射安全性进行调整。该小组提供了描述扫描覆盖范围、技术、准直、旋转时间、俯仰、辐射剂量和重建图像的标准方案。标准方案建议对首次HRCT进行强制性采集,对随访或特殊病例进行可选或额外采集。
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引用次数: 1
Appropriateness of pediatric CT utilization in clinical practice 临床应用儿科CT的适宜性
Pub Date : 2019-07-28 DOI: 10.46475/ASEANJR.2019.01
P. Trinavarat, N. Pisuchpen, Sasitorn Petcharunpaisan, D. Sosothikul, J. Deerojanawong, M. Veeravigrom, Jiraporn Amornfa, P. Vejchapipat, M. Riccabona
Background: Justification of imaging investigations is important, particularly in pediatrics underwent investigation using a relatively higher radiation such as CT, due to the higher radiation sensitivity of children. Objective: To assess the difference of viewpoints between pediatric physicians and pediatric radiologists on the appropriateness of pediatric CT utilization in a tertiary-care university hospital with limited MR capacity. Methods: Pediatric medical records of head CT, chest CT, and abdominal CT were retrospectively reviewed in consecutive date of the examination until having 100 head CTs and 100 body CTs with complete clinical and imaging information. The physicians and the radiologists were asked to suggest the imaging modality of choice for each patient according to the given data, regardless of the hospital’s limitation. If the suggested modality of choice was not CT, the CT request would be considered as “inappropriate”. They additionally scored the CT appropriateness, firstly using individual judgement, and secondly using the ACR Appropriateness Criteria. Both scoring methods used the same rating scale from 1 to 9; score 1-3 was considered “inappropriate”. Results: From the viewpoint of the physicians and radiologists, the number of inappropriate CT request was 20% and 54% according to “the modality of choice”, 2.5% and 17% according to “individual judgement”, 12% and 22% according to the “ACR Appropriateness Criteria”. The main difference was not from no indication for imaging but from the selected modality of imaging. The radiologists suggested 52% of head CTs and 64% of abdominal CTs could have been replaced by MRI if available. Conclusion: There are ten-percent disagreement on appropriateness of pediatric CT request between physicians and the radiologists when using the same guidelines and considering the hospital limitation.
背景:影像学检查的合理性是很重要的,特别是在使用相对较高的辐射(如CT)进行检查的儿科,因为儿童的辐射敏感性较高。目的:评价在磁共振能力有限的三级大学医院,儿科医师和儿科放射科医师对儿童CT应用适宜性的看法差异。方法:回顾性分析患儿头部CT、胸部CT和腹部CT连续检查日期的病历,直至获得100张头部CT和100张全身CT,临床和影像学资料完整。医生和放射科医生被要求根据给定的数据为每位患者建议选择的成像方式,而不考虑医院的限制。如果建议的选择方式不是CT,则CT请求将被认为是“不适当的”。他们还对CT适当性进行了评分,首先使用个人判断,其次使用ACR适当性标准。两种评分方法使用相同的评分量表,从1到9;1-3分被认为“不合适”。结果:从内科医生和放射科医生的角度来看,根据“选择方式”,不适当CT请求的比例分别为20%和54%,根据“个人判断”,比例分别为2.5%和17%,根据“ACR适当标准”,比例分别为12%和22%。主要差异不在于无影像学指征,而在于影像学方式的选择。放射科医生建议,如果可以的话,52%的头部ct和64%的腹部ct可以用MRI代替。结论:医生和放射科医生在使用相同的指南和考虑医院限制的情况下,对儿童CT请求的适当性存在10%的分歧。
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引用次数: 1
Learning history through porcelains 通过瓷器学习历史
Pub Date : 2019-07-28 DOI: 10.46475/aseanjr.v20i1.36
Supakorn Yuenyongwannchot
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引用次数: 0
From The Editor 来自编辑
Pub Date : 2019-07-28 DOI: 10.46475/aseanjr.2019.07
W. Tanomkiat
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引用次数: 0
Standard national high-resolution computed tomography (HRCT) Protocol 标准的国家高分辨率计算机断层扫描(HRCT)方案
Pub Date : 2019-07-28 DOI: 10.46475/aseanjr.v20i1.38
Nannapat Trisiripanit, Soraya Suntornsawat, Worapan Phonkaew
Diffuse interstitial lung diseases (ILDs) include more than hundreds of diseases which have different causes or underlying, target groups, signs and symptoms, clinical courses, radiographic appearances, treatments, and prognosis. Among them, idiopathic pulmonary fibrosis (IPF) is the most fatal, with prognosis worse than many cancers. After decades of no specific treatment, new medications that may help slow the progression of the fibrosis have been introduced and approved in some countries.  Similar to corticosteroid, anti-inflammatory and immunosuppressive drugs which are used to treat some ILDs; these antifibrotic medications could cause certain side effects. In contrast, the cost of treatment is much higher. To monitor ILDs in terms of incidence, demographic and geographic distributions, and life expectancy;  T.S.T. is developing a national ILD database. To ensure that this data base will provide the most accurate information, diagnosis should be as much precise as possible. However, the diagnoses of most ILDs are multidisciplinary. With the facts that surgical lung biopsies are available in patients fewer than 20% in most countries1, HRCT plays important role in showing disease characters and extension. Certain HRCT patterns are accepted to replace surgical lung biopsies (SLB) in some diseases. Unfortunately typical diagnostic HRCT patterns to replace SLB are not possible in all cases; for example, only about half of usual interstitial pneumonia2. Initially, diagnosis could not be made in some cases whose HRCT patterns are not specific and other clinical information is not sufficient. Longitudinal study by following up HRCTs and adding subsequently exhibited clinical data, or even surgical lung biopsy, could eventually establish the diagnosis.  These patients need a system that provide regular clinical and HRCT follow up, also the multidisciplinary team to evaluate those newly acquired clinical and radiographic information . As an important role in managing patients with ILDs, standard HRCT is required to ensure that the initial examination will provide sufficient radiographic information, both the initial and follow-up examinations could be compared,  the interpretation of all examinations is reproducible, and it could be performed in most institutes. To develop national standard HRCT protocol; current situation of interstitial lung diseases in Thailand,the purpose to develop the protocol, and a probable draft of the standard protocol (made by the committee from RCRT) were presented to a panel consisted of thoracic radiologist experts from all parts of Thailand in a meeting held on 11 January 2019 by Foundation of Orphan and Rare Lung Disease (FORD) and Imaging Academic Outreach Center (iAOC).  Knowledge sharing, benefits and disadvantages of the drafted protocol were discussed. Adjustment was done based on feasibility, coverage of all lung diseases, diagnostic accuracy, and radiation safety. The panel provided a standard protocol des
弥漫性间质性肺疾病(ILDs)包括数百种疾病,它们具有不同的病因或潜在病因、目标人群、体征和症状、临床病程、影像学表现、治疗和预后。其中,特发性肺纤维化(IPF)是最致命的,其预后比许多癌症都差。在几十年没有特异性治疗之后,一些国家已经引入并批准了可能有助于减缓纤维化进展的新药物。类似于用于治疗某些ild的皮质类固醇、抗炎和免疫抑制药物;这些抗纤维化药物可能会产生某些副作用。相比之下,治疗费用要高得多。从发病率、人口和地理分布以及预期寿命等方面监测儿童残疾;T.S.T.正在开发一个全国性的ILD数据库。为了确保该数据库提供最准确的信息,诊断应尽可能精确。然而,大多数ild的诊断是多学科的。在大多数国家,只有不到20%的患者可以进行手术肺活检,因此HRCT在显示疾病特征和扩展方面发挥了重要作用。在某些疾病中,某些HRCT模式被接受代替手术肺活检(SLB)。不幸的是,典型的HRCT诊断模式不可能在所有病例中替代SLB;例如,只有一般间质性肺炎的一半左右。最初,由于HRCT表现不明确,其他临床信息不充分,一些病例无法做出诊断。通过随访hrct并添加随后显示的临床数据,甚至手术肺活检进行纵向研究,最终可以确定诊断。这些患者需要一个系统来提供定期的临床和HRCT随访,也需要多学科团队来评估这些新获得的临床和放射学信息。HRCT作为治疗ild患者的重要手段,需要标准的HRCT,以确保初始检查能够提供足够的影像学信息,初始检查和随访检查都可以比较,所有检查的解释都是可重复的,并且大多数机构都可以进行。制定国家HRCT标准方案;在孤儿和罕见肺病基金会(FORD)和成像学术推广中心(iAOC)于2019年1月11日举行的会议上,泰国间质性肺病的现状、制定方案的目的以及标准方案的可能草案(由RCRT委员会制定)提交给了由来自泰国各地的胸部放射科专家组成的小组。讨论了协议草案的知识共享、利弊。根据可行性、所有肺部疾病的覆盖率、诊断准确性和辐射安全性进行调整。该小组提供了描述扫描覆盖范围、技术、准直、旋转时间、俯仰、辐射剂量和重建图像的标准方案。标准方案建议对首次HRCT进行强制性采集,对随访或特殊病例进行可选或额外采集。
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引用次数: 0
From The Editor 来自编辑
Pub Date : 2019-07-28 DOI: 10.46475/aseanjr.v20i1.52
W. Tanomkiat
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引用次数: 0
'X-ray gun' identifies sources of Song Dynasty porcelains from a shipwreck in the Java Sea “x光枪”确定了爪哇海沉船中宋代瓷器的来源
Pub Date : 2019-07-28 DOI: 10.46475/ASEANJR.2019.03
ARTHUR E. Brown
The ‘Silk Road’, often thought of as a network of land routes across Central Asia, was complemented by a ‘Maritime Silk Road’ which passed through Southeast (SE) Asian waters as it connected China with South Asia and East Africa. During the Song Dynasty, China exported large quantities of ceramics to generate income used to pay for its imports. Interestingly, the ships which carried this trade were mostly of non-Chinese origin with Indonesians being the master sailors.
“丝绸之路”通常被认为是横跨中亚的陆路网络,而“海上丝绸之路”则穿过东南亚水域,将中国与南亚和东非连接起来。在宋朝,中国出口了大量的陶瓷来赚取收入来支付进口。有趣的是,进行这种贸易的船只大多是非中国血统的,印尼人是主要的水手。
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引用次数: 0
Barium granuloma in peritoneal cavity and right scrotal sac mimicking a germ cell tumor 腹膜腔及右阴囊内钡肉芽肿,形似生殖细胞瘤
Pub Date : 2019-07-28 DOI: 10.46475/ASEANJR.2019.02
S. Kritsaneepaiboon, S. Sangkhathat, Kanet Kanjanapradit
Colonic perforation after barium enema is rare. We present a case of 6-month-old boy with palpable mass at left sided abdomen and right sided scrotum. Ultrasound and computed tomography (CT) showed calcified masses at Cul de sac and right scrotum with intraperitoneal fat infiltration mimicking germ cell tumor. Preexisting colonic wall injury or trauma and exposed to barium enema procedure can help to correct diagnosis and obviate unnecessary surgery.
钡灌肠后结肠穿孔是罕见的。我们报告一个6个月大的男孩,在左侧腹部和右侧阴囊可触及肿块。超声和计算机断层扫描(CT)显示囊尾和右阴囊钙化肿块,腹腔内脂肪浸润,类似生殖细胞瘤。先前存在的结肠壁损伤或创伤,暴露于钡灌肠程序可以帮助正确诊断和避免不必要的手术。
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引用次数: 0
期刊
The ASEAN Journal of Radiology
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