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Biomedical subjects

A De Schepper

Publications and source records attributed to A De Schepper.

At least 19 recordsLinked to original sources
PubMed1995

High diagnostic performance of CT scan for analgesic nephropathy in patients with incipient to severe renal failure.

Recently, well performing diagnostic criteria for analgesic nephropathy in end-stage renal failure (ESRF) patients were defined by the demonstration of a bilateral decrease in renal volume combined with either bumpy contours or papillary calcifications. In this study, the diagnostic value of computed tomography (CT) scan was compared to the previously used renal imaging techniques (sonography and conventional tomography). In a first study, a cohort of 40 analgesic abusers (defined as daily use of analgesic mixtures during at least 5 years) and 40 controls, all ESRF patients without a clear renal diagnosis, were investigated with sonography, tomography and CT scan without injection of iodinated contrast material, to search for the imaging signs of analgesic nephropathy. Using CT scan, sonography and tomography, renal size could be evaluated with comparable results while CT scan was superior in the detection of papillary calcifications (sensitivity 87%, specificity 97%). In a second controlled study of 53 analgesic abusers with a serum creatinine between 1.5 to 4 mg/dl in the absence of a clear renal diagnosis, a CT scan was performed and scored for the presence of decreased renal volume, bumpy contours and papillary calcifications. It was found that the renal image of analgesic nephropathy on CT scan in an early stage of renal failure is comparable with the observations made in ESRF patients. Particularly the demonstration of papillary calcifications showed a high sensitivity of 92% with a specificity of 100% for the early diagnosis of analgesic nephropathy.

Aged↗
PubMed1995

[Infraclinical breast carcinoma].

Early detection of breast cancer is gaining importance because it leads to reduction of morbidity and mortality rates of this disease. Detection of infraclinical tumors is best accomplished by mammography because of its high sensitivity. Ultrasonography and MR mammography play a complementary role. Ductal carcinoma in situ as well as small invasive tumors can be clinically occult malignant tumors. Preoperative marking should be performed in suspected breast lesions, preferentially by means of a hookwire or carbon. Surgical removal of the lesion is to be verified by intraoperative specimen radiography.

Adenocarcinoma↗
PubMed1994

Bilateral primary synchronous renal cell carcinoma.

We report a case of bilateral primary "synchronous" renal cell carcinoma (RCC) with different differentiation rates. Computed tomography (CT), ultrasonography (US), angiography, and fine needle aspiration biopsy (FNAB) were performed followed by right radical and left partial nephrectomy. Findings on ultrasonography were non-specific, CT scan showed bilateral solid renal mass. On angiography of the right renal artery no tumoral vessels were seen and FNAB yielded a false negative result on the left side. Histological examination revealed a cystic renal cell carcinoma on the right and a multinodular renal cell carcinoma on the left side. We could not find similar report in the current literature.

Aged↗
PubMed1994

Crohn's disease and sclerosing cholangitis: CT and PTC diagnosis, with MR findings.

Computed tomography (CT), percutaneous transhepatic cholangiography (PTC) and magnetic resonance imaging (MRI) findings in a case of sclerosing cholangitis associated with Crohn's disease of the colon and terminal ileum are described. CT gives additional information on dilatation of peripheral bile ducts and confirms findings of PTC, i.e. a decreased arborization of the biliary tree, a nodular appearance of the common bile duct and multifocal bile duct strictures. CT findings could be recognized on MRI which provided no additional information.

Adult↗
PubMed1993

Focal nodular hyperplasia of the liver: radiologic findings.

A retrospective analysis of the results of ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) of 24 cases (28 lesions) of proven focal nodular hyperplasia (FNH) is presented. While US exhibited nonspecific features, CT frequently showed characteristic features: hypodensity on precontrast scans (69%), transient immediate enhancement after bolus injection (96%), and homogeneity (85%). A scar was noted in 31% of the cases. The typical MR triad of isointensity on T1- and/or T2-weighted (T2-WI), homogeneity, and a scar which shows hyperintensity on T2-WI was seen in only 12% of our cases. The most common finding was homogeneity (94%). In two cases the scar was hypointense on T2-WI. To our knowledge, this finding has not been described before. We conclude that the features of FNH, although fairly constant, are at times indistinguishable from those of other hepatic tumors, such as hepatic adenoma (HA), fibrolamellar hepatocellular carcinoma (FLHCC), small hepatocellular carcinoma, and a hyperplastic nodule. Therefore, a multimodality approach is essential for the correct diagnosis in order to prevent unnecessary surgery.

Adult↗
PubMed1993

Three cases of Fusobacterium necrophorum septicemia.

Two cases of necrobacillosis or post-anginal septicemia (Lemierre's syndrome) due to Fusobacterium necrophorum are described. The first case in a young adult was complicated by thrombophlebitis of the internal jugular vein, lung abscesses and skin involvement. The second case was in a 2-year-old child, which is exceptional. The primary focus was possibly otitis media. In a third patient with multiple metastases of colon carcinoma, Fusobacterium necrophorum septicemia was diagnosed during a bout of fever 36 hours before death.

Adolescent↗
PubMed1993

Unusual cystic liver lesions: a pictorial essay.

Cystic liver lesions are being increasingly detected by ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). These lesions produce a wide spectrum of radiological features. Unfortunately their appearance is not always specific and they may resemble and be mistaken for other lesions. Cystic lesions can be classified into congenital, inflammatory, neoplastic and miscellaneous groups. In this pictorial essay a number of unusual cystic lesions are illustrated with a brief analysis of morphological features of the individual lesion and a diagnostic approach for cystic liver lesions is suggested.

Adult↗
PubMed1993

Is it a haemangioma?

A retrospective study of 92 cases of proven haemangiomas is presented. In this study, we evaluated the degree of confidence of the radiologist in differentiating haemangioma by ultrasound (US), computed tomography (CT), angiography (AR), and magnetic resonance imaging (MRI) in an incidental and an oncologic (high risk) population. The diagnosis of haemangioma was confirmed by surgery, by fine needle aspiration biopsy (FNAB) and by long follow-up. Maximum lesions were diagnosed with high confidence by MRI (88-93%) and by angiography (85-91%) in both incidental and oncologic group. 44% of the lesions were confidently diagnosed in incidental group as compared to the 11% of the lesions in oncologic group by ultrasound. Similarly, lesions were diagnosed with maximum confidence in 76% in incidental group as compared to 48% in oncologic group by dynamic contrast bolus CT. Confidence was also evaluated according to the size of the lesions but due to the low number of lesions in < 1.5 cm category, the difference in the confidence levels was not apparent. We conclude that in high risk group, MRI, if available, should be directly performed after US. In the incidental finding group, if the lesion has typical features, US follow-up every 6 months is sufficient.

Adult↗
PubMed1993

A double-blind fluoroscopic study of cisapride on gastrointestinal motility in patients with functional dyspepsia.

Twenty patients with functional dyspepsia were referred for radiologic examination and, upon confirmation of a hypomotile stomach, were given either 10 mg cisapride or placebo in a double-blind manner (10 patients per group). The movement of a 250-ml barium meal was assessed by means of television fluoroscopy performed at regular time intervals. Cisapride significantly improved antral contractility and enhanced gastric emptying compared with placebo. Deep peristaltic waves occurred over the entire small bowel, and motility and small-bowel transit time of the barium meal were significantly increased in the cisapride group compared with the placebo group. The study demonstrates that when a carefully defined protocol is observed, fluoroscopy following barium ingestion offers considerable potential in the assessment of gastrointestinal motility.

Barium Sulfate↗
PubMed1993

Mucinous cystadenocarcinoma of the pancreas with liver metastases. An unusual presentation of a rare tumor.

We present a case of mucinous cystadenocarcinoma of the pancreas with liver metastases. Initially, the patient presented as pancreatitis and pseudocyst which was marsupialised into the stomach in 1983. Eight years later, a tumor with liver metastases was detected. The liver metastases mimicked multiple abscesses. Over a period of forty-four days, CT features changed considerably and there was explosive enlargement of the lesions in the postoperative period. The reason for this dramatic increase in size was the anaplastic component of the tumor. To our knowledge, no such case has been reported in literature.

Adult↗
PubMed1993

Steinert's disease.

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1992

Nerve sheath tumors: evaluation with CT and MR imaging.

Tumors of nerves are classified into benign (schwannoma and neurofibroma) and malignant nerve sheath tumors. Schwannomas almost always occur as solitary lesions, whereas neurofibromas may occur alone or in a greater number, especially in patients with the peripheral form of von Recklinghausen's disease. Benign nerve sheath tumors often present as asymptomatic, slowly growing soft tissue masses. Although malignant nerve sheath tumors are relatively rare, a sudden increase in the size of a lesion, in particular in a patient with neurofibromatosis, should raise the suspicion of malignant change. On computed tomography (CT) and magnetic resonance imaging (MR) a benign nerve sheath tumor usually appears as a well-defined, oval, spherical or fusiform mass with smooth borders and distinct outlines, located in the subcutaneous tissue or centered at the expected anatomic location of a nerve, with displacement of adjacent soft tissues. Generally nerve sheath tumors have a low density on unenhanced CT scans. On MR they are isointense to muscle on T1-weighted images, whereas on T2-weighted images the signal intensity is high. Both on CT and MR the degree of contrast enhancement is moderate to marked and may be homogeneous or inhomogeneous. MR has become the method of choice for evaluating the anatomic location, contour, and relation of a nerve sheath tumor to adjacent neural, vascular, and muscular structures. The imaging criteria for malignant nerve sheath tumors are not specific enough to distinguish them from other malignant soft tissue tumors, so that neither CT nor MR can establish a definite diagnosis.

Adolescent↗
PubMed1992

Imaging and differential diagnosis of synovial sarcoma.

Synovial sarcoma is an uncommon malignant tumor, most frequent in the lower extremity, predominantly in young males. The authors review the clinical history, the different radiographic manifestations and MR appearance of the entity. The MR findings cannot be considered specific for synovial sarcoma. A heterogeneous septated mass located close to a joint, a tendon or a bursa is most indicative of the tumor. The radiographic features of a soft tissue mass with associated calcifications and bony erosions in the lower extremity should suggest a synovial sarcoma. The most likely differential diagnoses are discussed.

Adult↗