Unlike CT, which works quietly, MRI works as if a whole demolition team is dismantling the machine with a sledgehammer. Different scanning sequences produce completely different loud noises, and the only thing that is common is that the noise from these sequences is frighteningly noisy.

Qin's father and Qin's mother looked at their daughter through the glass with a worried expression. Sun Lien dragged Feng Ming and said in a low voice, "Don't be nervous, it's going to be fine." ”

"Lying in there is my girlfriend, my fiancée, someone who is going to spend the rest of my life with me. Feng Ming smiled bitterly and shook his head, "If it were you, would you not be nervous?"

Sun Lien glanced at his good brother helplessly, "I don't have a girlfriend, I'm nervous." ”

In the sound of ding ding, the two chatted in a low voice. 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 Lien shook his head and said, "People are looking at your face." Although I am quite familiar with Brother Luo, my face is not as big as your ophthalmology. ”

It's all brothers who have lived together for five years, and they know what you're going to fart as soon as they lift their butts. Feng Ming directly blocked Sun Lien's remaining words, "Less fart, I'm an outpatient ophthalmologist who is still interning, what face can I have in the eyes of the imaging doctor in the emergency department?"

"Maybe people are blind?" Sun Lien watched Feng Ming finally relax a little, and he secretly breathed a sigh of relief. Although he seemed to be calm, since he pushed Qin Ya to settle down, until just now, Feng Ming's hands were shaking.

Even if he didn't need the help of the status bar, Sun Lien could see that Feng Ming was nervous to death. Nervousness is a contagious emotion, especially in a hospital setting, where a nervous doctor can even trigger mass hysteria. Whether it was out of brotherhood or the doctor's responsibility to the patient's family, Sun Lien had to let Feng Mingxian relax a little.

"I'm staring here, you go back to the rescue room first. Xu Yourong walked up to Sun Lien and said, "You are the deputy class today, right?"

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

Xu Yourong nodded, "Now you are the boss." Although the words were not finished, the meaning was already clearly expressed - before the boss went home to rest, it was indeed inconvenient for the subordinates to go first. And Xu Yourong, who works in the same treatment team as Sun Lien, also bears more important responsibilities - she is the only one in the entire team who has the right to prescribe. If she goes back to rest first, then Sun Lien will have to become a regular trainee again. After all, Director Liu has been on duty in the hospital for more than 24 hours. The old man must go back and rest at noon.

Sun Lien didn't think there was anything wrong with him returning to the regular training post, he said apologetically, "I forgot that the duty routine of the supernatural doctor is different from the emergency department...... Why don't you go back and rest first? I'm staring here. ”

From yesterday to now, Xu Yourong has performed two difficult surgeries. Although she slept in the lounge for a while, she was indeed in a bad spirit. After a moment's hesitation, she nodded, "Then let's do it first." I went back and asked Director Liu when the new duty schedule would come out. ”

The two were discussing the work arrangement, and Brother Luo, who was staring at the screen, suddenly spoke, "Xiao Sun, come and take a look at this." ”

Sun Lien walked quickly to the side of the screen and looked at the slightly blurry image on the screen, "Where should I look?"

"This part. Brother Luo tapped with his hand at the location of the signal displayed on Qin Ya's basal ganglia on the screen. "These signals are hyperplastic vascular tissue, and this location...... he changed the image, "although the degree is not very severe, but there is extensive brain atrophy." ”

Sun Lien was a little blind, he really couldn't understand what this image meant, so he could only turn to Xu Yourong for help, "Take a look?"

Xu Yourong frowned and looked at it for a while, "There is no normal brain tissue mixed in the hyperplasia blood vessels, just simple compensatory hyperplasia. Look here. She pointed to the location of a blood vessel on the screen, "The middle cerebral artery is narrowed, and the surrounding compensatory hyperplasia is obvious, in addition to systemic lupus erythematosus, moyamoya disease should also be considered." ”

"MOYAMOYA?" SAID ROGUE IN A SOMEWHAT STRANGE JAPANESE ACCENT, WHICH WAS THE JAPANESE NAME FOR MOYAMOYA SICKNESS. He pushed his glasses and looked at the image again, "Don't say it, it's possible." ”

"How's the condition of the new striatum?" Sun Lien was still a little uneasy, "Is there a lesion?"

"As with the rest of the site, there is some slight atrophy. Luo Ge hesitated, "The neostriatum is supplied by the middle cerebral artery, and now the middle artery is narrowed, and there must be insufficient blood supply." Other organic lesions...... Can't tell. ”

The neostriatum is inadequate, which is consistent with the condition of a transient ischemic attack. Sun Lien nodded, and turned to Xu Yourong and asked, "If it's moyamoya disease, can I have surgery?"

"The most direct means is to use superficial temporal artery-MAC branch anastomosis. Xu Yourong pondered for a while and proposed a solution, "Peel off the superficial temporal artery from above the parotid gland, then open the cerebral blood barrier, and sew the branches of the superficial temporal artery into the main trunk of the middle cerebral artery." The surgery is relatively mature and the risks are controllable. ”

"You are going to do it?" Sun Lien trusted Xu Yourong's level very much, "If I can, I will transfer people to Shenwai for elective surgery." ”

Xu Yourong's eyes widened, "But it's not like moyag syndrome ......."

"It's moyamoya for sure. Sun Lien shook his head, "When you hear the sound of horses' hooves, you should think of horses, not zebras." This sentence is the basic principle that doctors should follow when making clinical diagnoses - they should consider common diseases first, rather than going down the road of incurable diseases and rare diseases from the beginning. First common, then rare, first consider treatable diseases, and then consider incurable terminal diseases. This is a fundamental matter of principle for clinical diagnosis.

Xu Yourong said dissatisfied, "But compared to lupus erythematosus, moyamoya disease is a zebra, right?"

The incidence of systemic lupus erythematosus is about 23 out of 100,000 people, compared to only 2 out of 100,000 people. From an epidemiological point of view, Xu Yourong is indeed right.

"If you just analyze the case from an epidemiological point of view, you don't need a radiologist. Sun Lien retorted stiffly, "The sound of horses' hooves now is not her symptoms, but these MRI images." If you start from the image, it is clear that the probability of systemic lupus erythematosus is much smaller. ”