I can see the status bar

Chapter 69 The sound of hooves and the horse

Unlike CT, which works quietly, when MRI works, it seems that a whole demolition team is demolishing the machine with a sledgehammer.Different scan sequences produce completely different loud noises, but the only thing they all have in common is that the noise they make is horribly loud.

Qin's father and Qin's mother looked at their daughter worriedly through the glass.Sun Lien tugged Feng Ming, and said in a low voice, "Don't be nervous, nothing will happen."

"The person lying there is my girlfriend, my fiancée, the person who will spend the rest of my life with me." Feng Ming smiled wryly and shook his head, "If it were you, wouldn't you be nervous?"

Sun Li'en looked helplessly at his good brother, "I don't have a girlfriend, so I'm so nervous."

In the clanging and 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, "I'm looking at your face. Although I know Brother Luo very well, I don't have as much face as your ophthalmologist."

They are all brothers who have lived together for five years, and they know what you are going to fart as soon as you lift your ass.Feng Ming immediately blocked the rest of Sun Lien's words, "Don't fart, I am an outpatient ophthalmologist who is still in practice, what face can I have in the eyes of the imaging doctor in the emergency department?"

"Maybe he's blind?" Sun Li'en watched Feng Ming finally relax a little bit, and he also secretly breathed a sigh of relief.Although he seemed calm, Feng Ming's hands were shaking ever since Qin Ya pushed An Ding until just now.

Even without the help of the status bar, Sun Lien could tell that Feng Ming was nervous to death.And nervousness is a contagious emotion, especially in the hospital environment, a nervous doctor may even cause mass hysteria.Whether it was out of brotherhood or the doctor's responsibility to the patient's family, Sun Li'en had to let Feng Ming relax a little.

"I'll be watching over here, you go back to the emergency room first." Xu Yourong walked up to Sun Lien and said, "Are you the assistant class today?"

"I don't know what class is today." Sun Lien shrugged his shoulders, "Anyway, as long as Director Liu doesn't bombard me, then I will stay here. But you..." Sun Lien suddenly remembered something, "You were on duty last night gone?"

Xu Yourong nodded, "Now you are the boss." Although he hadn't finished speaking, the meaning was clearly expressed - before the boss went home to rest, it was really inconvenient for the subordinates to leave first.Moreover, Xu Yourong, who works in the same treatment team as Sun Lien, also bears more important responsibilities - she is the only one in the whole team who has the right to prescribe.If she went back to rest alone, then Sun Lien would have to become a Gui Peisheng again.After all, Director Liu has already been on duty in the hospital for more than 24 hours.The old man must go back to rest at noon.

Sun Li'en didn't think there was any problem with his return to the regular training position. He apologized, "I forgot that the duty schedule of a doctor outside of God is different from that of an emergency department... why don't you go back and rest first. I'll keep an eye on it here. "

From yesterday to now, Xu Yourong has already undergone two difficult surgeries.Although she slept in the lounge for a while, her spirits were indeed a little low.After a moment of hesitation, she nodded and said, "Let's do this first. I'll go back and ask Director Liu to see when the new duty schedule will come out."

The two were discussing work arrangements when Luo Ge, who was staring at the screen, suddenly said, "Xiao Sun, come over and take a look at this."

Sun Li'en walked quickly to the side of the screen, looking at the slightly blurred image on the screen, "Where should I look?"

"This part." Luo Ge tapped the signal position displayed on Qin Ya's basal ganglia area on the screen. "These signals are hyperplastic vascular tissue, and this location..." He changed another image, "Although the degree is not very serious, there is extensive brain atrophy."

Sun Li'en was a little bit blind, 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, "There is no normal brain tissue mixed in the proliferating blood vessels, but pure compensatory hyperplasia. Look here." She pointed to the position of a blood vessel on the screen, "The middle cerebral artery is narrow, The surrounding compensatory hyperplasia is obvious, in addition to systemic lupus erythematosus, moyamoya disease should also be considered."

"MOYAMOYA?" Luo Ge uttered a sentence in Japanese with a somewhat strange tone. This is the Japanese name for moyamoya.He pushed his glasses, and carefully looked at the image again, "Don't tell me, it's possible."

"How is the condition of the new striatum?" Sun Lien was still a little worried, "Is there any disease?"

"Same as other parts, it is slightly atrophied." Luo Ge hesitated, "The new striatum is supplied by the middle cerebral artery, and now the middle artery is narrowed, and there must be insufficient blood supply. Other organic diseases... see not come out."

Insufficient blood supply to the neostriatum corresponds to the state of a transient ischemic attack.Sun Li'en nodded, then turned to Xu Yourong and asked, "If it's moyamoya disease, can we have surgery?"

"The most direct method is to use superficial temporal artery-MAC branch anastomosis." Xu Yourong pondered for a while, and proposed a solution, "Strip the superficial temporal artery from above the parotid gland, and then open the brain-blood barrier to separate the superficial temporal artery." The branch is sutured into the trunk of the middle cerebral artery. The operation is relatively mature and the risks are controllable.”

"You do it?" Sun Lien trusted Xu Yourong's level very much, "If possible, I'll transfer him to Shenwai for elective surgery."

Xu Yourong's eyes widened, "But it's not sure it's smog disease..."

"It must be moyamoya." Sun Lien shook his head, "When you hear the sound of hooves, you should think of horses, not zebras." This sentence is the basic principle that doctors should follow when making clinical diagnosis - first consider common diseases , instead of going on the road of intractable diseases and rare diseases from the beginning.Common first, then rare, first consider curable diseases, and then consider untreatable terminal diseases.This is the fundamental principle of clinical diagnosis.

Xu Yourong dissatisfied, "But compared with lupus, moyamoya disease is a zebra, right?"

The incidence of systemic lupus erythematosus is about 10 per 23 people, while only two per 10 people have moyamoya disease.From an epidemiological point of view, what Xu Yourong said was indeed correct.

"If you only analyze the case from the epidemiological point of view, then you don't need a radiologist." Sun Li'en retorted stiffly, "The current horse's hooves are not her symptoms, but these MRI images. If we start from the images, Systemic lupus is clearly much less likely."

(End of this chapter)