1.NH GI X HA GAN BNGTC TRUYN M ZONAREL TH QUNH NH, L T PHC, NGUYN THIN HNG, PHAN THANH HI TRUNG TM Y KHOA MEDIC HO HOThnh ph H Ch Minh

2. Gii thiu my Z.one ultra sp - ZONARE Medical System, Inc. , USA- Ti u ha hnh nh nh kh nng t ng iu chnh tc truyn m- c tnh to nh: zone by zone, focus trn mi im nh, t iu chnh gain 3. c tnh to nh ZONE by ZONE 4. Tc truyn m trong m- Mi trng cng cng, tc truyn m cng nhanh- Tc trung bnh ca siu m trong khng kh 330 m/s, m 1540 m/s, xng 4080 m/s- Gan x ha th cng hn gan bnh thng tc truyn m s cao hn Mt phng php xc nh c tnh vt l ca m 5. Cng ngh siu m n hikho st c tnh vt l mStatic: vi ngun kch thch c hc trc tip: Compression elastography hay strain imaging, nh my Philips, GE, Hitachi vi Hitachi Real-Time Tissue Elastography (HiRTE)Dynamic: vi lc bc x (radiation force) gy ra transient elastography. - Transient elastography (nh Fibroscan) - Supersonic Shear Imaging : vi shear wave (nh Supersonic Imagine Aixplorer)- ARFI imaging: vi xung lc bc x m [Acoustic Radiation Force Impulse (ARFI)] (nh Acuson Siemens S2000) 6. p dng Tc truyn m trong m o ha x gan- o cng m gan (tc truyn m trong gan ph thuc c tnh n hi ca m)- Gi tr tham kho: F0F3: 1575 21 m/s, F4: 1594 18 m/s, cutoff value cho x gan 1589 m/s (Bita Boozari et al [Germany]; Evaluation of Sound Speed for Detection of Liver Fibrosis, JUM 2010) 7. Bc u p dng ti Medic- o truyn m trong gan 25 bnh nhn- Mi bnh nhn thc hin o 5 ln, chn ROI nh nht, o cch bao gan 1 cm, trnh mch mu ln- Kt qu: ZSI -30 ZSI +60 tc 1510 m/s 1600 m/s (ZSI: zone speed index, ch s tc vng). 8. Tc truyn m trong gan: ZSI 1020 = 15501560m/s tng ng F0 9. Tc truyn m trong gan: ZSI 50-60 tc15901600 m/s tng ng F4 10. Hn ch+ Kch thc ROI (region of interest) ln, cha c nh, ph thuc nhiu yu t+ Sai s cn ln (mi n v tnh 10 m/s)+ Cha c phn mm t ng tnh tr s trung bnh 11. Kch thc ROI khng c nh 12. KT LUN- Cha c nhiu nghin cu o cng ca m bng o tc truyn m, nhng c nhiu trin vng- L mt phng php n gin, d thao tc, v da trn nguyn l c bn ca siu m- D cn nhiu hn ch nhng nu c thm nhiu nghin cu v nng cp ca nh sn xut th s l mt phng php hiu qu