Unlike CT, which works quietly, when MRI works, it seems like a whole demolition team is dismantling the machine with sledgehammers. Different scanning sequence programs will produce completely different huge noises, and the only similarity is,
The noise caused by these sequence programs is terrifying.
Father Qin and Mother Qin looked at their daughter with worry across the glass. Sun Lien pulled Feng Ming and whispered, "Don't be nervous, nothing will happen."
Sun Lien glanced at his good brother helplessly, "I don't have a girlfriend, I'm so nervous."
Amidst the clanging sounds, the two chatted in low voices. Feng Ming expressed his admiration for Sun Lien's communication skills, "You have only been in the emergency department for two months, and you already have such a good relationship with these imaging departments?"
Sun Li'en shook his head and said, "They only care about your face. Although I'm very familiar with Brother Luo, my face is not as big as your ophthalmologist's."
They are all brothers who have lived together for five years. They will know what you are going to fart as soon as they raise their buttocks. Feng Ming directly blocked the rest of Sun Lien's words, "Stop farting. I am an outpatient ophthalmologist who is still intern.
What kind of face can you have in the eyes of emergency imaging?"
"Maybe he is blind?" Sun Lien watched Feng Ming finally relax a little, and he secretly breathed a sigh of relief. Although he seemed calm, Feng Ming's hand was still there ever since he gave Qin Ya the diazepam.
shake.
Even without the help of the status bar, Sun Lien could tell that Feng Ming was extremely nervous. Nervousness is a contagious emotion, especially in a hospital environment. A nervous doctor may even cause mass hysteria. Whether it is
Out of brotherhood and a doctor's responsibility to the patient's family, Sun Lien had to ask Feng Mingxian to relax a little.
"I'll keep an eye on this. You go back to the emergency room first." Xu Yourong walked up to Sun Lien and said, "Are you the deputy shifter today?"
"I don't know what kind of shift today is." Sun Lien shrugged, "Anyway, as long as Director Liu doesn't scold me, I will continue to stay. But you..." Sun Lien suddenly remembered something, "You were on duty last night
Already?"
Xu Yourong nodded, "You are the boss now." Although he didn't finish his words, the meaning was already clear. Before the boss went home to rest, it was really inconvenient for his subordinates to leave first. Moreover, he and Sun Lien worked together in the same treatment room.
Xu Yourong of the team also bears more important responsibilities. She is the only one in the team who has the right to prescribe. If she goes back to rest alone, then Sun Lien will have to become a regulatory trainee again. After all, Director Liu has already served more than 100 years in the hospital.
24-hour shift. The old man must go back and take a rest at noon.
Sun Lien didn't think there was anything wrong with him returning to the regular training position. He apologized, "I forgot that the duty rules of surgical doctors are different from those of emergency rooms... Why don't you go back and rest first. I'll keep an eye on it here."
"
From yesterday to now, Xu Yourong has undergone two difficult surgeries. Although she slept in the lounge for a while, her energy was indeed a little weak. After a moment of hesitation, she nodded and said, "Let's do this for now. I'll go back.
Go ask Director Liu when the new duty schedule will be released."
The two were discussing work arrangements. Brother Luo, who was staring at the screen, suddenly spoke, "Xiao Sun, come here and take a look at this."
Sun Lien quickly walked to the screen and looked at the slightly blurry image on the screen, "Where should I look?"
"This part." Brother Luo tapped the signal position displayed on Qin Ya's basal ganglia area on the screen with his hand. "These signals are all proliferated vascular tissue, and this position..." He changed
According to an image, "Although the degree is not very serious, there is extensive brain atrophy."
Sun Lien was a little confused. He really couldn't understand what the image meant, so he could only turn to Xu Yourong for help and said, "Take a look?"
Xu Yourong frowned and looked at it for a while, "The proliferated blood vessels are not mixed with normal brain tissue, they are just compensatory proliferation. Look here." She pointed to the location of a blood vessel on the screen, "The middle cerebral artery is narrowed.
The surrounding compensatory hyperplasia is obvious. In addition to systemic lupus erythematosus, moyamoya disease should also be considered."
"Moyamoya?" Luo Ge said in Japanese with a somewhat strange accent. This is the Japanese name for moyamoya disease. He pushed up his glasses and looked at the image carefully again, "Don't say it, it's possible."
"How is the condition of the neostriatum?" Sun Lien was still a little worried, "Are there any lesions?"
"Like other parts, there is some slight atrophy." Luo Ge hesitated and said, "The neostriatum is supplied by the middle cerebral artery. Now that the middle cerebral artery is narrowed, there must be insufficient blood supply. Other organic lesions...see
Not coming out."
The neostriatum has insufficient blood supply, which is consistent with a transient ischemic attack. Sun Lien nodded, then turned to Xu Yourong and asked, "If it is moyamoya disease, can I have surgery?"
"The most direct method is to use the superficial temporal artery-mac branch anastomosis." Xu Yourong pondered for a while and then proposed a solution. "Separate the superficial temporal artery from above the parotid gland, then open the brain-blood barrier, and remove the superficial temporal artery."
The branches are sewn into the main trunk of the middle cerebral artery. The surgery is relatively mature and the risks are controllable."
"Are you going to do it?" Sun Lien had great trust in Xu Yourong's skills, "If possible, I will transfer the person to Shenwai for elective surgery."
"It must be moyamoya syndrome." Sun Lien shook his head, "When you hear the sound of horse hooves, think of horses instead of zebras." This sentence is the basic principle that doctors should follow when making clinical diagnosis. Common diseases should be considered first, and common diseases should be considered first.
It is not necessary to go down the road of difficult and rare diseases from the beginning. First common, then rare, consider treatable diseases first, and then consider untreatable terminal diseases. This is the fundamental principle of clinical diagnosis.
Xu Yourong said dissatisfied, "But compared with lupus erythematosus, moyamoya disease is like a zebra, right?"
The incidence of systemic lupus erythematosus is about 23 out of 100,000 people, while the incidence of moyamoya disease is only two out of 100,000 people. From an epidemiological point of view, what Xu Yourong said is indeed correct.
"If you analyze the case from an epidemiological point of view, you don't need a radiologist." Sun Lien retorted hard, "The sound of horse hooves now is not her symptom, but these MRI images. If we start from the images,
Systemic lupus erythematosus is significantly less likely."