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Biomedical subjects

B Kastler

Publications and source records attributed to B Kastler.

At least 19 recordsLinked to original sources
PubMed2006

[Ganglion cyst rupture in the retro-femoral fat: a report of two cases].

Ganglion cysts are ubiquitous cystic lesions without synovial wall and inconstant communication with the articular cavity. The later must nonetheless always be carefully looked for. We report two cases of ganglion cyst rupture in the retrofemoral fat simulating phlebitis with thigh cellulitis. To the best of our knowledge, this has not been previously reported in the literature. Familiarity with this entity ensures adequate medical diagnosis and management, avoiding unnecessary imaging and laboratory work-up and inappropriate use of anticoagulant and antibiotic.

Adipose Tissue↗
PubMed2006

[Three-dimensional 3D modeling: First applications in radioanatomy and interventional radiology under CT guidance].

PURPOSE: To model vertebrae in 3D to improve radioanatomic knowledge of the spine with the vascular and nerve environment and simulate CT-guided interventions. METHOD AND MATERIALS: Vertebra acquisitions were made with multidetector CT. We developed segmentation software and specific viewer software using the Delphi programming environment. RESULTS: This segmentation software makes it possible to model 3D high-resolution segments of vertebrae and their environment from multidetector CT acquisitions. Then the specific viewer software provides multiplanar reconstructions of the CT volume and the possibility to select different 3D objects of interest. DISCUSSION: This software package improves radiologists' radioanatomic knowledge through a new 3D anatomy presentation. Furthermore, the possibility of inserting virtual 3D objects in the volume can simulate CT-guided intervention. CONCLUSION: The first volumetric radioanatomic software has been born. Furthermore, it simulates CT-guided intervention and consequently has the potential to facilitate learning interventions using CT guidance.

Algorithms↗
PubMed2005

[Value of the small bowel feces sign at CT in adhesive small bowel obstruction].

PURPOSE: The purpose of this study is to describe the CT features of the small bowel feces sign and to determine its value as a positive criteria of non-severity in adhesive small bowel obstruction. MATERIALS AND METHODS: We performed a retrospective study of adhesive small bowel obstructions diagnosed by CT from January 2001 to December 2002. All CT examinations featuring a small bowel feces sign were included. Clinical follow-up was available for all included patients. RESULTS: Twenty patients were included in this study. Twelve patients underwent successful conservative treatment with nasogastric aspiration. Urgent laparotomy performed in 6 cases and delayed surgical intervention performed in 3 did not show ischemic complication. Surgical management always consisted in lysis of adhesions without intestinal resection. CONCLUSION: Recently described in the radiological literature, the small bowel feces sign appears to be the first criteria of non-severity in adhesive small bowel obstruction.

Adult↗
PubMed2005

[Value of the pubic tubercle as a CT reference point in groin hernias].

PURPOSE: To assess the value of the pubic tubercle as a CT reference point in diagnosing the different types of groin hernia before surgery in patients presenting with mechanical bowel obstruction. MATERIALS AND METHODS: Retrospective review of CT examinations performed for small bowel obstruction in our department during 2003. Twelve cases of groin hernia causing small bowel obstruction were included. All CT examinations were reviewed by 2 abdominal radiologists. The surgical report of all 12 included cases was reviewed for final diagnosis. RESULTS: Twelve cases of groin hernia causing small bowel obstruction were reviewed in our department during 2003. Eight cases corresponded to small bowel obstruction caused by inguinal hernia (4 direct and 4 indirect) and 4 to small bowel obstruction caused by femoral hernia. In each case, the diagnosis suggested at CT using the pubic tubercle as a reference point was surgically confirmed. CONCLUSION: The pubic tubercle is an excellent reference point at CT for diagnosing inguinal and femoral hernias. Preoperative diagnosis is important because it may change the choice of surgical procedure.

Adult↗
PubMed2005

[Magnetic resonance imaging -- guided corticosteroid-infiltration of the sacroiliac joints: pain therapy of sacroiliitis in patients with ankylosing spondylitis].

PURPOSE: To evaluate the efficacy and specific properties of MR imaging-guided corticosteroid infiltration of the sacroiliac (SI) joints in the treatment of therapy-refractory sacroiliitis in patients with ankylosing spondylitis. MATERIALS AND METHODS: In this study, 26 patients were prospectively included. Inclusion criteria were AS with therapy refractory acute sacroiliitis and inflammatory back pain > or = 6 months. The intervention was performed using an open low-field MR-scanner. Inflammatory back pain was assessed on a visual analog scale (VAS). Success of the therapy was defined as an absolute reduction of the VAS score </= 5, a relative reduction of the VAS score > or = 35 % and persisting improvement > or = 2 months. The grade of sacroiliitis was documented using high-field MR imaging. Variables were compared using McNemar test and Wilcoxon test. The mean remission time was calculated using a Kaplan-Meier analysis. A p-value < 0.05 was considered statistically significant. RESULTS: The intervention was technically successfully performed in all patients. Following MR imaging-guided corticosteroid infiltration of the SI joints, the VAS score improved from 8 (5 - 10) points to 4.5 (0 - 8) points (- 44 %) in all patients (n = 26), which was statistically significant (p < 0.001). Of 26 patients, 22 (85 %) fulfilled the predefined criteria for successful therapy. This group had a statistically significant (p < 0.01) improvement of the VAS score from 8 (6 - 10) to 3 (0 - 5) (- 63 %). Improvement was seen after 7 (1 - 30) days. There was a marked reduction of the subchondral bone marrow edema (- 38 %). The mean remission time was 12 (4 - 18) months. CONCLUSION: MR imaging-guided corticosteroid infiltration of the SI joints proved to be an effective therapy of inflammatory back pain in patients with therapy refractory AS. With the ability of multiplanar imaging, precise localization of the bone marrow edema and the lack of ionizing radiation, interventional MR imaging currently represents the superior method for the treatment of the predominantly young patient group presenting with ankylosing spondylitis. Owing to short intervention times, open MR-scanners are ideally suited for MR imaging-guided infiltration of the SI joints.

Adrenal Cortex Hormones↗
PubMed2005

[Pain management in bone metastasis of pulmonary origin: new interventional and metabolic techniques].

Invasion of bone by a metastatic lesion is the most common cause of pain in cancer patients. Pain management in these patients is an important and difficult task. The pain is not always properly controlled by high doses of specific medication, radiation therapy or chemotherapy. When these therapies do not provide adequate pain relief, percutaneous vertebroplasty, cementoplasty, radiofrequency ablation and internal radiotherapy appear to be elegant and efficient complementary alternative pain control methods.

Bone Cements↗
PubMed2004

[Value of MRI in the evaluation of congenital anomalies of the heart and great vessels].

Management of congenital heart diseases (CHD) frequently is a diagnostic challenge. MRI, as a complement to echocardiography, plays an important role in the non-invasive evaluation of these anomalies. MRI allows high resolution anatomical evaluation of these structures in multiple planes as well as functional evaluation. These features are helpful to further characterize extra-cardiac anomalies that may be difficult to assess at US and even angiography. MRI is thus a valuable imaging tool in the evaluation of CHD.

Angiography↗
PubMed2003

[Fluid-fluid level in an intra-osseous ganglion cyst of the talus].

The author report a very rare case of fluid-fluid level in an intra-osseous ganglion cyst of the talus that was detected on CT and MR imaging. Pre-operative diagnosis was suggested by the presence of a communication between the talo-cuboid joint and the cyst, as shown at MR Arthrography.

Adult↗
PubMed2003

[True isolated atherosclerotic aneurysm of the axillary artery].

The true atherosclerotic aneurysm of the axillary artery is a rare condition. It either presents as a pulsatile axillary mass or arterial emboli in the hand and fingers. We report the case of a 70-year-old man with a 5 cm aneurysm of the axillary artery presenting with embolic disease to the hand. Angiography is helpful and provides valuable preoperative anatomic details. Surgery remains the treatment of choice but endovascular treatment can also be considered.

Aged↗
PubMed2002

Mid- and long-term outcome of 166 premature infants weighing less than 1,000 g at birth, all small for gestational age.

This longitudinal study reported the mid- and long-term neurodevelopmental outcome of 166 premature infants born with an extremely low birth weight (<1,000 g), all small for gestational age (<10th percentile birth weight for gestational age). Nine girls were lost to follow-up before 3 years of age, and 6 children were excluded a posteriori because of specific conditions diagnosed in the 1st year of life (severe abnormalities in 5). Of the remaining 151 children, 2% had cerebral palsy, 15% had lesser motor disturbances (reduced to 2% after psychomotor training), 8% had early severe developmental delays, and added mild and moderate delays and increasing cognitive gaps amounted to 28% in the 14th year. Visual deficits increased with age up to 63% of the older children. Seven children had deafness and 13 had hearing losses after otitis media. Language delays were observed at some stage in 31% of cases, as well as behavioral disturbances in 42% (severe problems in 12%). At last evaluation, 34% of the children were normal (12% of the older ones), 51% had minor deficiencies, 18% had moderate and 3% had major disabilities. Children entered the first grade in the 7th year in only 84% of cases, which dropped to 63% at proper level in the second grade; 47% entered high school at the proper age, 7/15 obtained the 'baccalauréat' in the 19th/20th year. The school performance was heavily dependent on the socioeconomic and cultural level of the family.

Delivery, Obstetric↗
PubMed2002

[CT guided neurolysis of the sphenopalatine ganglion for management of refractory trigeminal neuralgia].

The authors present the case of a patient with recurrent trigeminal neuralgia, refractory to medical treatment and ablation of the trigeminal ganglion, who underwent three separate CT guided injections for pterygopalatine ganglion ablation over a two year period. Ablation of the pterygopalatine ganglion may be an effective technique for pain management in patients suffering from atypical facial pain syndrome, cluster headache, or neuritis. The technique used for CT guided ablation using alcohol or radiofrequency is described. The advantages and pitfalls of this technique are reviewed.

Adult↗
PubMed2001

False lumen patency as a predictor of late outcome in aortic dissection.

Aortic dissection (AD) is a disease with a high-risk of mortality. Late deaths are often related to complications in nonoperated aortic segments. Between 1984 and 1996, we retrospectively analyzed the data of 109 patients with acute AD (81 men and 28 women; average age 61 +/- 14 years). All imaging examinations were reviewed, and a magnetic resonance imaging examination was performed at the time of the study. Aortic diameters were measured on each aortic segment. Predictive factors of mortality were determined by Cox's proportional hazard model, in univariate and multivariate analyses, using BMDP statistical software. Follow-up was an average of 44 +/- 46 months (range 24 to 164). Actuarial survival rates were 52%, 46%, and 37% at 1, 5, and 10 years, respectively, for type A AD versus 76%, 72%, and 46% for type B AD. Predictors of late mortality were age >70 years and postoperative false lumen patency of the thoracic descending aorta (RR 3.4, 95% confidence intervals 1.20 to 9.8). Descending aorta diameter was larger when false lumen was patent (31 vs 44 mm; p = 0.02) in type A AD. Furthermore, patency was less frequent in operated type A AD when surgery had been extended to the aortic arch. Thus, patency of descending aorta false lumen is responsible for progressive aortic dilation. In type A AD, open distal repair makes it possible to check the aortic arch and replace it when necessary, decreases the false lumen patency rate, and improves late survival.

Adult↗
PubMed2001

[Stellate ganglion radiofrequency neurolysis. Report of a case followed over a 3-year period].

We present the case of a patient who experienced residual ischemic symptoms and invalidating chronic pain after an injury where three fingers of his left hand were sliced off by a chain saw. He underwent 5 stellate ganglion RF neurolysis over a two year period, followed by progressive and complete pain relief. We will underscore the value of CT guidance during needle placement and the efficacy of RF neurolysis.

Adult↗
PubMed2001

[Thoracic aortic coarctation: MRI evaluation and follow-up].

PURPOSE: Report our experience in the evaluation and follow-up of thoracic aortic coarctation with MRI and describe its role to estimate trans-stenotic flow. MATERIAL AND METHODS: 43 MR examinations were performed in 30 patients (age range 15 days to 73 years) referred to our institution in the last 7 years. RESULTS: MRI visualized the ascending, horizontal and descending portions of the aorta and the supra-aortic vessels in 42/43 patients. MRI clearly identified preoperatively an aortic coarctation in 11/12 cases confirmed by surgery. Postoperatively MRI depicted 4 restenosis and one aneurysm. In 5 patients MRI demonstrated pseudo-coarctation. A significant correlation was established between the maximal trans-stenotic pressure gradient when measured by Doppler US or angiography and the size of the signal void measured on cine-MR images (r=0.72; p<0.01). CONCLUSION: MRI is a reliable non invasive investigation method for the diagnosis and semi-quantitative evaluation of aortic coarctation particularly when colour Doppler US is not satisfactory.

Adolescent↗