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A Rahmouni

Publications and source records attributed to A Rahmouni.

11 recordsLinked to original sources
PubMed1992

[Clinical symptomatology and radiological aspects of primary cancers of the liver].

Hepatocellular carcinoma is a malignant tumor derived from hepatocytes. It is the most frequent of primary liver cancers. In 90% of the cases, it occurs in a cirrhotic liver and is now more and more detected by ultrasonographic screening of cirrhotic patients. Hepatocellular carcinoma can also be diagnosed at a more advanced stage, when complications, such as ascites, jaundice or digestive hemorrhage, occur. CT scan and magnetic resonance imaging are useful to confirm ultrasonographic findings, but angiography with infusion of Lipiodol in hepatic artery followed by CT scan remains the most sensitive method for diagnosis. Intrahepatic cholangiocarcinoma is derived from intrahepatic bile duct cells and does not occur in a preexisting cirrhotic liver. Diagnosis is usually late. Clinical features are those of hepatic malignancy with jaundice and abdominal pain. Morphological examination of the liver shows an intrahepatic tumor, sometimes associated with a dilatation of the surrounding bile ducts. Other primary malignancies are very rare. Fibrolamellar carcinoma presents as an abdominal mass occurring in a young adult with a non cirrhotic liver. Prognosis is better than that of hepatocellular carcinoma. Cystadenocarcinoma is a cystic tumor of bile ducts that can develop in a preexisting cystadenoma. Angiosarcoma is a highly malignant tumor derived from sinusoidal endothelial cells. Exposure to various carcinogens is found in 30% of the cases. Epithelioid hemangio-endothelioma differs from angiosarcoma by its occurrence in young adults and a more favorable prognosis.

Angiography↗
PubMed1992

Value of CT and sonography in the conservative management of acute splenoportal and superior mesenteric venous thrombosis.

Acute splenoportal and superior mesenteric venous thrombosis were diagnosed on sonography and computed tomography (CT) in six patients. Sonography demonstrated the presence of echoic material filling the involved vessels in all patients. Precontrast CT scans demonstrated an increased, intra luminal density of the clots in four patients with splenoportal thrombosis. However, in two cases of superior mesenteric venous thrombosis, no hyperdensity was observed within the lumens. Nevertheless, the clots were always visualized as low-density regions in the vessel lumens after bolus injection. Intravenous anticoagulant therapy was started immediately after the diagnosis. All patients were evaluated twice a week with sonography and/or CT until recanalization occurred. The patency of the previously involved vessels was assessed from 6 days to 4 weeks after the acute episode (average time of recanalization: 17 days) without development of collateral pathways. It is concluded that, in the absence of clinical signs of a life-threatening process, a conservative management of acute splanchnic thrombosis can be successfully achieved by (1) early diagnosis, (2) efficacious intravenous anticoagulant therapy, (3) careful imaging follow-up of these patients by sonography and/or CT during the acute phase and, finally, (4) by an extensive search for a hypercoagulable state.

Acenocoumarol↗
PubMed1992

Fast magnetic resonance imaging in the evaluation of tumoral obstructions of the inferior vena cava.

A prospective study was conducted on 9 patients with suspected obstruction of the inferior vena cava on ultrasonography, dynamic computerized tomography and/or inferior venacavography during the course of a retroperitonal tumor to assess the value of magnetic resonance imaging with gradient echo sequences. The findings on gradient echo magnetic resonance imaging were compared with the other imaging modalities and surgical or necropsy results. Our results suggest that gradient echo magnetic resonance imaging is the most appropriate imaging modality to diagnose and delineate the extent of inferior vena caval obstruction.

Adult↗
PubMed1992

Can portable chest x-ray examination accurately diagnose lung consolidation after major abdominal surgery? A comparison with computed tomography scan.

PURPOSE: To prospectively quantify the degree of accuracy of portable chest x-ray film examination in the detection of postoperative lung consolidations. STUDY: Nineteen patients had a chest x-ray film and computed tomography (CT) scan the day before and 48 h following elective abdominal aortic replacement. RESULTS: The diagnosis of lung consolidations by x-ray film examination showed sensitivity of between 0.33 and 1.00, depending on the lung zone considered (lower at the lung bases). Specificity always was greater than 0.79. Radiologic lung volume decreased 16 percent postoperatively (p < 0.01) on average and noninflated parenchyma increased by a factor of 3 (p < 0.0001). Postoperatively, PaO2 correlated with the amount of condensed lung by CT scan (p < 0.002). CONCLUSION: In postoperative conditions, x-ray film examination is a method which presents good specificity but poor sensitivity in the diagnosis of lung consolidations.

Abdomen↗
PubMed1992

[X-ray computed tomography of thoracic injuries. Apropos of 40 cases].

On chest radiographs, the precise assessment of thoracic injuries consecutive to blunt trauma is often compromised by the nonspecific appearance of many lesions. Furthermore, significant injuries are frequently overlooked. However, the management of the patients with chest trauma is still often based primarily upon clinical and radiographic findings and Computed Tomography (CT) is often performed secondarily on the basis of unexplained clinical signs or suspected radiographic abnormality. Some authors have reported that CT was a highly sensitive method for detecting thoracic lesions frequently not seen or underestimated on conventional supine chest radiographs. However, the value that these new CT findings could have in the therapeutic management of these patients, have not been systematically investigated to our knowledge, except in a limited series suggesting that the course of critically ill patients could be substantially altered after thoracic CT. In order to estimate the role of early CT in the management of patient care, we report the therapeutic consequences of CT findings in forty patients who we report the therapeutic consequences of CT findings in forty patients who had a thoracic CT within few hours following a chest injury. We showed that early thoracic CT scan in patients with blunt trauma detected significantly more lesions than did chest X-Ray and appreciably modified the treatment modalities in 70% of our patients. We then recommend that all the patients admitted in ICU after chest trauma undergo a thoracic CT scan as soon as possible in order to optimize their treatment modalities.

Adolescent↗
PubMed1992

Asymptomatic renal-vein thrombosis in adult nephrotic syndrome ultrasonography and urinary fibrin-fibrinogen products: a prospective study.

OBJECTIVES: The diagnosis of renal vein thrombosis (RVT), a frequent complication of adult nephrotic syndrome (NS), is generally made by means of invasive methods, i.e. renal venography, venous time of renal arteriography and, more recently, computed tomography (CT). We undertook a prospective study to evaluate the use of Doppler ultrasonography (DUS) and urinary fibrin-fibrinogen degradation products (FDPU) for the diagnosis of asymptomatic RVT. METHODS: Thirty-one adult NS with non proliferative glomerulonephritis were studied. Reference procedures [(selective renal arteriography (n = 18) and renal vein CT (n = 13)] were performed blindly within a few days (48 hours in 17 patients) of renal vein DUS (search for a lack of venous flow) and measurement of FDPU (5 micrograms/min) (in 24 patients). RESULTS: DUS was not interpretable in one patient and positive in nine. Of these 9 patients, RVT was detected by reference methods in only two (sensitivity: 1, specificity: 0.75; positive predictive value: 0.22; negative predictive value: 1). Increased FDPU was observed in 4 patients, 2 of whom had an RVT (sensitivity: 1, specificity: 0.9; positive predictive value: 0.5; negative predictive value: 1). CONCLUSION: We conclude that DUS and FDPU are helpful for screening of RVT in asymptomatic NS patients; their negativity allow further radiological investigations to be avoided while positive results must be confirmed by reference methods.

Adolescent↗
PubMed1991

[Gradient echo sequences in the diagnosis of inferior vena cava thrombosis].

The capability for studying noninvasively vessels has been dramatically improved with the use of gradient echo sequences. Twenty-one patients presenting a suspected inferior vena cava obstruction on cavography underwent MR examination with axial, sagittal and coronal gradient echo images. Eighteen patients were also imaged with ultrasound and/or CT. Gradient echo sequences visualized a thrombus in 19 cases and a normal vein in the remaining 2 cases. The potential MR pitfalls are illustrated and the two cases of false positive on cavography are discussed. Gradient echo sequences allow a fast and performant examination of the vessels.

Adolescent↗
PubMedDate not supplied

Castleman disease mimicking liver tumor: CT and MR features.

We report the CT and MR features of two localized abdominal forms of Castleman disease mimicking hypervascular liver tumors due to their unusual location in the porta hepatis and the portacaval space. The MR appearance of Castleman lymph nodes is emphasized, including their characteristics on dynamic turbo-fast low angle shot (FLASH) sequences after Gd-DOTA bolus injection. Our report suggests that the CT and MR features of Castleman lymph nodes in these locations cannot enable their differentiation from other hypervascular masses such as benign liver tumors.

Adult↗
PubMedDate not supplied

Accuracy of in-vivo assessment of prostatic volume by MRI and transrectal ultrasonography.

More accurate noninvasive estimation of prostate size is important in therapeutic trials for benign prostatic hyperplasia. The accuracy of MRI and transrectal ultrasound (TRUS) in assessing prostate weight was evaluated in 48 patients who underwent radical prostatectomy for stage A or B cancer. The volume derived from the wet weight of the freshly excised specimen was used as a reference. We compared that volume with volume estimates derived from the three-axis linear dimension measurement by MRI and TRUS using a tissue density of 1.05 g/cc and the standard formula for an ellipsoid object. Prostate and seminal vesicle volumes were also computed by contouring T2-weighted 5 mm thick contiguous MR images using a semiautomatic edge detection program and pixel summation. Three-axis volume MRI method versus volume from wet weight has slightly less scatter than TRUS three-axis method (r = 0.85 vs r = 0.81). Contoured MR volume method has the least scatter r = 0.93, statistically better than the linear axis method. Contoured MRI volumetric analysis appears superior to linear MRI or TRUS methods in estimating true prostate volume.

Adenocarcinoma↗