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Biomedical subjects

A De Schepper

Publications and source records attributed to A De Schepper.

At least 37 records · Page 2Linked to original sources

[Magnetic resonance imaging of soft tissue tumors of the hand and wrist].

We will discuss the imaging characteristics of soft tissue tumors of the hand and wrist, especially the magnetic resonance imaging findings, since MRI has proven to be the gold standard for characterization of soft tissue tumors. Our series consists of 71 tumors of the hand and wrist, that were examined by magnetic resonance imaging. Fourty-four lesions were benign, 7 malignant, and 20 lesions were pseudotumoral masses. The signal characteristics often allow to make a correct diagnosis or to narrow down the list of differential diagnoses. It also allows to determine the extent of the lesion more accurately.

Adolescent↗

The place of helical CT scanning in acute pulmonary embolism.

Pulmonary embolism is a relative common, potentially fatal disorder that clinicians have difficulty detecting and difficulty diagnosing. Deep venous thrombosis (DVT) is the most important source of thrombi. Early and accurate diagnosis is essential for efficient therapy. Therapy is based on long-term anticoagulation and has an important impact on the mortality and morbidity of pulmonary embolism. For the diagnosis of pulmonary embolism, the ventilation/perfusion (V/Q) scan is still the first examination in many instances. A normal V/Q scan or the combination of a low probability scan and a low clinical suspicion are associated with a prevalence of pulmonary embolism of 4%. The combination of a high-probability V/Q scan and a strong clinical suspicion has a prevalence of pulmonary embolism of 96%. All other results should be considered as non-diagnostic. However, the number of non-diagnostic V/Q examinations can be as high as 70%. Nevertheless, an additional pulmonary angiography will be performed in only in 15% of these cases. In the low pre-test probability group (poor clinical suspicion, absence of risk factors and no medical history) the V/Q scan is useful as a screening test ("rule-out" strategy). When the pre-test probability is higher or in other cases in which early diagnosis is necessary ("rule-in" strategy), a contrast-enhanced spiral CT of the pulmonary arteries (possibly in combination with ultrasonography of the lower limbs) is the most accurate examination.

Acute Disease↗

Hypertrophy and pseudohypertrophy of the lower leg following chronic radiculopathy and neuropathy: imaging findings in two patients.

Enlargement of the ipsilateral muscle compartment is an exceptional finding in patients with chronic radiculopathy, peripheral nerve injury, anterior horn cell diseases, or acquired peripheral neuropathy. We report radiographic, ultrasonographic, CT and MRI findings in a patient with chronic S1 radiculopathy and another with chronic neuropathy of the common fibular nerve (L4-S2), both presenting with painless enlargement of the calf muscles.

Adult↗

Pfeiffer's syndrome.

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Acrocephalosyndactylia↗

Sarcoidosis.

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Biopsy↗

Diagnosis and nonsurgical management of bile leak complicated by biloma after blunt liver injury: report of two cases.

We report on two patients with biliary tract injury and associated biloma following blunt abdominal trauma. Both patients underwent emergency surgery because of hemodynamic instability and bloody peritoneal aspiration. Computed tomography in the postoperative days showed severe hepatic parenchymal injury and the presence of hypodense collections with intraparenchymal and subcapsular extension, suggestive for biloma, but otherwise failed to demonstrate the exact location of the bile duct injury. One of them underwent temporary percutaneous drainage. Bile duct injury was well demonstrated on endoscopic retrograde cholangiography (ERCP) and treated by endobiliary stent placement. This report advocates the use of ERCP and endobiliary stenting in the management of biliary injury resulting from liver trauma.

Abdominal Injuries↗

Splenic rupture as a complication of P. falciparum malaria after residence in the tropics. Report of two cases.

Splenic rupture is an uncommon complication of malaria, which requires urgent medical investigation, close follow-up and adequate treatment. Until present, this complication was reported more often in P. vivax infections than in infections with other species. Rupture can happen spontaneously or as a result of trauma, which may be minor and unnoticed. The diagnosis is made by physical examination, ultrasound and CT-scan. Especially in malaria endemic areas the management of splenic rupture in malaria should be focused on splenic preservation. We describe two cases of splenic rupture during a P. falciparum infection, both requiring finally splenectomy.

Abdominal Injuries↗

Temporal lobe abscess as a complication of cholesteatoma: sequential radiological findings.

Temporal lobe abscess is a rare but known complication of petrosal bone cholesteatoma. We present a case with clinical history, diagnostic imaging and sequential radiological findings of the abscess from the early temporal cerebritis phase till the late full encapsulated abscess. We also succeeded in visualizing the fistula through the tegmen tympani on MR-images.

Bone Diseases↗

An unusual case of maxillary ameloblastoma.

We report a case of malignant maxillar ameloblastoma. A review of literature is presented. The unusual clinical behavior and the non specific presentation on CT of our case are discussed.

Ameloblastoma↗

Magnetic resonance imaging of localized giant cell tumour of the tendon sheath (MRI of localized GCTTS).

The objective of this study was to evaluate the appearance of localized giant cell tumour of the tendon sheath (GCTTS) on unenhanced and Gd-enhanced MR images. MR images of 13 histologically proven cases of localized GCTTS were evaluated for mean size, location, homogeneity and signal intensity (SI) on both T1- and T2-weighted images, and enhancement pattern. All lesions except 1 affected young adults. On T1- and T2-weighted images, lesions showed predominantly low SI equal to or slightly higher than skeletal muscle. On Gd-enhanced T1-weighted images, strong homogeneous enhancement was seen. These findings reflect the underlying histological composition of the lesion; haemosiderin deposition in xanthoma cells, shortening T2-relaxation time, and abundant collagenous proliferation are responsible for low SI on T1- and T2-weighted images. Strong homogeneous enhancement originates from numerous proliferative capillaries in the collagenous stroma. We conclude that these characteristic MR features, together with clinical information, are a valuable diagnostic tool in offering a correct preoperative diagnosis.

Adolescent↗

Imaging of primary tumors and tumor-like conditions of the lumbosacral osseous spine.

Primary tumors of the osseous spine are rare. This article illustrates some aspects of imaging of tumoral pathology of the osseous spine. Plain film and CT scan still remain the initial imaging modalities in the work-up of tumoral pathology of the osseous spine. MR imaging however has proven its potentials in the detection of lesions in areas with superimposing structures which hamper reliable reading of the plain films or in areas with a complex bony anatomy such as the sacrum. MR imaging is exquisite in determining the local extent of tumoral lesions and in defining the relationship to adjacent central nervous system structures. In some tumors or tumor-like lesions, MR imaging allows to make a correct tissue-related diagnosis or to strengthen the diagnosis made on plain film/CT observations. In other case MR imaging only has a role in staging or may have definitely no role at all.

Adult↗

A patient with congenital short small bowel associated with malrotation.

A case of congenital short small bowel associated with malrotation and malabsorption in a baby girl is presented. Clinical manifestations developed in the first days after birth and consisted of diarrhea, vomiting and poor weight increase. Congenital short small bowel was suspected on radiological examination, which showed an associated malrotation. The diagnosis was confirmed by exploratory laparotomy. The length of the small intestine was only 50 cm. The intensive work of maintaining nutrition and controlling infection is described.

Body Weight↗

Subcutaneous diffuse neurofibroma of the neck: a case report.

A case of a rare and unusual variant of neurofibroma, diffuse neurofibroma (paraneurofibroma), in a young patient is presented. The clinical, radiological and histopathological features of this case are reported. The magnetic resonance imaging (MRI) features of the diffuse neurofibroma are comparable with those described in other neurofibromas.

Child↗

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↗