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Biomedical subjects

A Gangi

Publications and source records attributed to A Gangi.

At least 37 records · Page 2Linked to original sources
PubMed1996

Primary hepatic pheochromocytoma.

Pheochromocytomas are uncommon tumors that represent a potentially curable cause of hypertension. They are usually located in the adrenal glands, but 10% arise from extra-adrenal sites, located along the paravertebral sympathetic chains. We report a case of primary hepatic pheochromocytoma responsible for a severe hypertension in a 24-year-old man. Echotomography showed a lightly heterogeneous mass located in the segment 8 of the liver. Iodine 131-metaiodobenzylguanidine scintigraphy showed a large hepatic concentration of the tracer and no other localization. This tumor appeared highly vascularized on enhanced CT scan and on aortic angiography. Magnetic resonance imaging revealed a hepatic tumor with a high signal intensity on T2-weighted images and with a signal isointense to the liver on T1-weighted images. The hepatic venous sampling contained the highest catecholamine level, whereas the adrenal venous sampling was normal. After surgical resection of the hepatic tumor, the tension level and catecholamines plasmatic level normalized. No recurrent symptoms appeared during a 3-year follow-up.

3-Iodobenzylguanidine↗
PubMed1996

Vertebral haemangiomas with spinal cord compression: the place of preoperative percutaneous vertebroplasty with methyl methacrylate.

We report on cervical and two thoracic vertebral haemangiomas with neurological disturbance successfully treated by percutaneous vertebroplasty followed by decompression surgery. Vertebroplasty consolidates the vertebral body and reduces the risk of haemorrhage. Subsequent surgery may be limited to decompressive laminectomy and resection of the epidural extension of the haemangioma. embolisation was also carried out in one case. Complete neuroimaging workup, including CT, myelo-CT and MRI, is necessary prior to treatment.

Bone Cements↗
PubMed1996

Percutaneous laser disk decompression under CT and fluoroscopic guidance: indications, technique, and clinical experience.

The aim of percutaneous laser disk decompression (PLDD) is to vaporize a small portion of the nucleus pulposus of an intervertebral disk, thereby reducing the volume and pressure of a diseased disk. This minimally invasive technique can be performed in patients who need surgical intervention for disk herniation with leg pain. PLDD is usually performed under fluoroscopic guidance with or without diskoscopy. However, it can also be performed under dual computed tomographic (CT) and fluoroscopic guidance as an outpatient procedure. CT and fluoroscopic guidance increases the safety and accuracy of PLDD, with high precision of instrument guidance, direct visualization of nucleus pulposus vaporization, and reduced risk of complications. Of 119 patients with lumbar disk herniation treated with PLDD under CT and fluoroscopic guidance, 91 (76.5%) had a good or fair response. PLDD performed with CT and fluoroscopic guidance appears to be a safe and effective treatment for herniated intervertebral disks.

Adolescent↗
PubMed1996

Interventional radiologic procedures with CT guidance in cancer pain management.

Reduction of pain without systematic side effects can be achieved in advanced stages of cancer with precise percutaneous techniques guided with computed tomography (CT). CT guidance allows exact needle positioning, reducing complications and improving the results. Regional analgesia with neurolytic block (neurolysis) is achieved by injection of alcohol or phenol and involves intentional destruction of a nerve or nerves to interrupt nociceptive pathways for weeks or months. Percutaneous alcoholization of bone metastasis is indicated in patients with painful, severe, osteolytic bone metastasis if conventional anticancer therapy is ineffective and high doses of opiates are necessary to control pain and when rapid pain relief is necessary. Bone packing with acrylic glue (methyl methacrylate) is used to prevent pathologic fractures and pain in patients with vertebral body tumors and acetabular metastasis. With these techniques, the radiologist is able to play an active role in pain management and in improving the quality of life of patients with malignancies.

Bone Cements↗
PubMed1996

[Interventional MRI. Value of low field strength and very fast 3D steady state imaging sequences for the guidance of a "non" ferromagnetic needle].

PURPOSE: The excellent tissue differenciation provided by MRI in the three directions and the lack of ionizing radiations make it ideal for interventional procedures. Many problems must still be solved: the access to the patient, the size of the artefact produced by interventional instruments and the acquisition time. In this study, we evaluated the influence of field strength for standard imaging sequences on the MRI artefact of a non ferro-magnetic biopsy needle. Then, we developed very fast sequences on a opened 0.1 T dedicated magnet to test in vitro and ex vivo the potential ability of this system in the guidance of the needle. MATERIAL AND METHODS: The biopsy needle was a new stainless steel needle made of 49% Nickel. The needle artefact's size measurements were made at 0.1 T, 0.5 T and 1 T on a bicompartmental phantom (one compartment with a long T1 and another with a long T2), with standard gradient echo (400/12/90 degrees) and spin echo (500/25) sequences. At 0.1 T, we optimized very fast steady state 3D FAST (T1 weighted) and 3D CE-FAST (T2 weighted) sequences to reduce the acquisition time, preserving good image contrasts for a field of view reaching 38 mm and 48 x 64 or 24 x 32 matrix. RESULTS: The larger needle artefact observed on gradient echo images varied from 3.6 mm at 0.1 T to 8.6 mm at 1 T. The shortest acquisition time for 4 contiguous slices of 2mm with a 1.2 mm/pixel resolution and a 24 x 32 matrix was 1.5 s for the 3D FAST (16/9/65 degrees) sequence and 3 s for the 3D CE-FAST (29/22/65 degrees) sequence. We realized a complete MRI guided abdominal puncture on a cat cadaver with 4 series of 15 s 3D FAST images (16/9/65 degrees, 4 slices, 5 excitations, 1.2 mm/pixel, FOV = 77 mm). Besides the cat positioning and the image reconstruction time, the whole puncture lasted 1 min (4 x 15 s). CONCLUSION: Low field MRI (0.1 T) combined with very fast 3D steady state sequences is adapted for the real time guidance of biopsy needles.

Biopsy, Needle↗
PubMed1995

An in vitro study at low field for MR guidance of a biopsy needle.

The aim of this study is to demonstrate in vitro that low field strength can be used for MR interventional procedures. At 0.1 T, we developed 3D, T1-, and T2-weighted fast steady state sequences and measured the artifact created by an MR biopsy needle (22 gauge, 0.7 mm diameter) on a bicompartmental phantom. The artifact generated by the needle placed perpendicular to B0 did not exceed 3.6 mm for 3D steady state sequences and acquisition times reaching 1.5 s. Corresponding artifacts at higher field strength were 7.6 mm for 0.5 T and 8.6 mm for 1 T. Low field MRI proved to be potentially adaptable for the guidance of MR biopsy needles.

Artifacts↗
PubMed1995

[Contribution of the cervical scanner with injection in the diagnosis of vertebral artery dissection].

Vertebral artery dissection is the first diagnosis that must be suspected by a 40 years old patient with posterior fossa ischemic signs. CT data from six cases of spontaneous or post-traumatic vertebral artery dissections are reviewed. Cervical CT is performed after contrast medium injection from C7 to C0 with 1.5 mm thick slices and a 2 mm gap or with a spiral mod including millimetric reconstruction. The enhancement of the vascular wall, the hypodense hematoma surrounding a stenotic and eccentric lumen, and the enlargement of the artery are typical for a vertebral artery dissection. CT findings were correlated with angiography that is still considered to be the gold standard for this diagnosis. Among noninvasive technics including MRI, duplex scanning and CT, the latter appears very accurate to diagnose vertebral artery dissection.

Adult↗
PubMed1994

Intracranial alveolar echinococcosis: CT and MRI.

Intracranial alveolar echinococcosis is uncommon. We report a patient with right frontal lobe and palpebral lesions secondary to a primary hepatic focus with secondary lesion in the lung. The intracranial and palpebral cystic masses were totally removed and both proved to be alveolar hydatid cysts. An unusual feature in this case is CT and MRI demonstration of dural and bony extension.

Brain Diseases↗
PubMed1994

Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy.

We describe the technique of percutaneous vertebroplasty using methyl methacrylate. We injected under the guidance of CT and fluoroscopy a group of 10 patients with back pain caused by a variety of vertebral lesions including severe osteoporosis (n = 4), hemangiomas (n = 5) and metastasis (n = 1). Over varying periods of follow-up (ranging from 4 to 17 months) none of the injected vertebral bodies demonstrated compression. All patients had relief of back pain; none had complications related to the technique. We emphasize that the efficacy of this technique in preventing vertebral collapse could not be evaluated in this small sample; a well-controlled study would be required to determine the proper indications and efficacy of this treatment.

Adult↗
PubMed1992

Neurofibromatosis with dural ectasia and bilateral symmetrical pedicular clefts: report of two cases.

We present two cases of bilateral, symmetrical pedicular clefts associated with dural ectasia in von Recklinghausen's disease (neurofibromatosis). In one case the pedicular cleft was at the T12 level, while in the other it was at L4, and was responsible for spondylolisthesis. Two hypotheses are advanced to explain the cleft: (1) a congenital, dysplastic osseous defect and (2) bilateral stress fractures related to thinning of the pedicle caused by dural ectasia.

Adult↗
PubMed1992

Contribution of MRI in supracardiac total anomalous pulmonary venous drainage.

A case of supracardiac total anomalous pulmonary venous drainage (TAPVD) in an infant aged 2 1/2 months is presented. Diagnosis was established non invasively by magnetic resonance image (MRI). Not only did MRI precisely depict the anomalous venous pathway but it moreover securely excluded pulmonary venous obstruction.

Echocardiography, Doppler↗
PubMed1992

CT, myelography and CT-myelography in the evaluation of common cervicobrachial neuralgia.

The CT technique used to explore intervertebral discs and foramina is described, as are the CT signs of nucleus pulposus (NP) herniation and cervical degenerative lesions. CT with intravenous contrast injection is the most efficient and easiest method to diagnose a radicular compression of discal or degenerative origin. The advent of high-resolution contrast CT will probably make obsolete the use of contrast media. CT measures the width of the vertebral canal, but it does not evaluate the repercussions on the spinal cord of compression caused by NP herniation or osteophytosis: only CT-myelography or, better, MRI can make this evaluation. Conventional CT scans are sometimes inadequate when exploration is hampered by superimposition of the shoulders (C6-C7 and more often C7-T1), when the scanner is of poor quality or when it is misused. Myelography and CT-myelography can then be utilized to resolve the problem posed by C7 or C8 cervicobrachial neuralgia (CBN). CT makes it possible to exclude most of the causes of non-discal CBN in the extradural spaces (e.g. bone tumour, neurinoma, vertebral vascular malformation, paravertebral expansive process, apical lung tumour). The search for an intradural cause (extra- or intramedullary tumour) rests on myelography, CT-myelography and MRI.

Adult↗
PubMed1992

CT and MRI of suprasellar lesions.

The authors report their experience of CT and MRI imaging in the study of suprasellar pathologies. The problems concerning the differential diagnosis between meningioma developed in the suprasellar region and pituitary tumour with suprasellar extension are discussed and illustrated; the demonstration of bone abnormalities (blistering, hyperostosis) is particularly useful for the diagnosis of presellar meningioma. The CT and MRI features of craniopharyngioma are compared; CT, of course, is more reliable than MRI in detecting calcifications; with both methods it may be difficult to visualize the cystic components. Glioma of the chiasma is readily diagnosed by MRI, provided the tumour is not too large. Non-thrombosed suprasellar aneurysms have typical features at CT and MRI. Cystic lesions are easily identified by MRI. The CT and MRI images of inflammatory lesions are not very typical.

Brain Diseases↗
PubMed1990

[Pleurisy in ovarian hyperstimulation syndrome. Apropos of a case].

The syndrome of ovarian hyperstimulation is a little known aetiology of pleural effusion. It should be thought of in young women who are under treatment to induce ovulation. Serous effusions which occur in these cases are a serious sign. The effusions are exudates and not transudates as occurs in Demons-Meigs syndrome. The treatment which will be undertaken ought to consider the possibility that a pregnancy is underway.

Adult↗
PubMedDate not supplied

Percutaneous vertebroplasty in a broken vertebral titanium implant (titanium mesh cage).

We report the case of a percutaneous consolidation of a broken vertebral implant (Surgical Titanium Mesh Implants; DePuy Spine, Raynham, MA, USA) by vertebroplasty. Four years after anterior spondylectomy with cage implantation and stabilization with posterior instrumentation, the patient was admitted for excruciating back pain. Radiographs showed fracture of the cage, screw, and rod. An anterior surgical approach was deemed difficult and a percutaneous injection of polymethyl methacrylate into the cage was performed following posterior instrumentation replacement. This seems to be an interesting alternative to the classical anterior surgical approach, which is often difficult in postoperative conditions.

Breast Neoplasms↗
PubMedDate not supplied

Splenic abscesses in typhoid fever: US and CT studies.

Salmonella typhi splenic abscesses (SA) are traditionally considered to be a rare complication of typhoid fever (TF). Our prospective study in an extensive series of patients was aimed at demonstrating that the incidence of SA was usually underestimated. Four hundred patients were systematically examined by abdominal ultrasound (US) at the time of proven biological diagnosis of TF, which was the 2nd week of admission. Twenty patients with persistent or recurrent symptoms (despite adequate treatment) or with acute lower thoracic pain were followed by US and CT. In eight patients both imaging modalities revealed anomalies compatible with SA.

Abscess↗
PubMedDate not supplied

Fetal shoulder measurements with MRI.

OBJECTIVE: We studied the ability of MRI to predict fetal shoulder width (FSW). MATERIALS AND METHODS: In 30 patients referred for MR pelvimetry, measurement of FSW was performed and compared with caliper measurements at term. We report here the feasibility of a method using axial and coronal MR images oriented to the fetal body axes. RESULTS: Shoulder width by MRI (mean = 12.76 +/- 1.42 cm) correlated significantly with postnatal orthopedic caliper measurements (mean = 12.99 +/- 1.37 cm; r = 0.955, SEE = 4.29 mm, p = 0.00001) and with birth weight (r = 0.63, p = 0.0005). Mean paired differences showed a statistically significant 2.3 +/- 4.2 mm underestimation of FSW by MRI (p = 0.01). This reasonably quick nonionizing technique seems to have the potential for evaluating shoulder dystocia and deserves further evaluation.

Female↗