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B Mesurolle

Publications and source records attributed to B Mesurolle.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Value of CT guided renal biopsies: retrospective review of 67 cases].

PURPOSE: To assess the value of the CT guided percutaneous biopsy of renal tumors and to promote the interest of this procedure. MATERIAL AND METHODS: We report a retrospective study of 67 patients (average age, 51 years) who underwent CT guided biopsy of a single renal mass. The average size of tumors was 5 centimeters. The biopsy of tumors was carried out with needles between 16 and 21 gauge by using a conventional CT. Two to three passes per tumor were obtained. RESULTS: Biopsy material was sufficient for diagnosis in 48 cases (72%). A renal cell carcinoma was found in 29 (43%) samples of biopsy. The remainder included 13 metastases or lymphomas (18%). A benign lesion was found in 6 cases (9%). 59 patients had a final diagnosis. Accuracy of the biopsy for histopathologic evaluation was 81%. The average lesion size of failed biopsies was 1.5 centimeters. Morbidity occurred in 13% of cases, without immediate life threatening consequence. CONCLUSION: CT-guided renal biopsy is an effective means of obtaining tissue for the diagnosis of focal renal masses. The indications are renal lesions locally advanced, multimetastatic patients, mass in patients with a single kidney and focal lesions in patients with prior history of malignancy.

Biopsy, Needle↗
PubMed2000

Implanted central venous catheter-related acute superior vena cava syndrome: management by metallic stent and endovascular repositioning of the catheter tip.

We describe a case of a 49-year-old woman with stage-IIIB lung adenocarcinoma who experienced an acute superior vena cava syndrome related to an implanted central venous catheter without associated venous thrombosis. The catheter was surgically implanted for chemotherapy. Superior vena cava syndrome appeared after the procedure and was due to insertion of the catheter through a subclinical stenosis of the superior vena cava. Complete resolution of the patient's symptoms was obtained using stent placement and endovascular repositioning of the catheter tip.

Acute Disease↗
PubMed2000

Pulmonary embolism detection: prospective evaluation of dual-section helical CT versus selective pulmonary arteriography in 157 patients.

PURPOSE: To evaluate the accuracy of dual-section helical computed tomography (CT) in acute pulmonary embolism (PE) diagnosis. MATERIALS AND METHODS: Of 204 consecutive patients with clinically suspected acute PE (mean age, 58 years +/- 14 [SD]), 158 were enrolled. All patients underwent dual-section helical CT (2.7-mm effective section thickness) and selective pulmonary arteriography within 12 hours of each other. Each image was analyzed independently by two observers, who determined image quality and presence of PE among arterial segments, including at the subsegmental level. The final diagnosis was made with consensus. RESULTS: Selective pulmonary arteriography was considered optimal in 147 (93%), suboptimal in 10 (6%), and inconclusive in one (0.6%) of 158 patients. Dual-section helical CT findings were considered technically optimal in 140 (89%), suboptimal in 11 (7%), and inconclusive in six (4%). Selective pulmonary arteriography demonstrated PE in 62 patients. Four (6%) of 62 patients had isolated subsegmental PE. The sensitivity of dual-section helical CT was 90%, and the specificity was 94%. The positive and negative predictive values were 90% and 94%, respectively. CONCLUSION: Dual-section helical CT is an improvement in helical CT that offers a high sensitivity and specificity for the depiction of PE, including at the subsegmental level. Dual-section helical CT can replace pulmonary arteriography for the direct demonstration of PE in a majority of patients.

Acute Disease↗
PubMed2000

Abdominal aortic aneurysm: pretherapy assessment with dual-slice helical CT angiography.

OBJECTIVE: The purpose of this study was to evaluate dual-slice helical CT in the pretherapy assessment of abdominal aortic aneurysms. SUBJECTS AND METHODS: Dual-slice helical CT angiography was performed in 47 consecutive patients (mean age, 59 years) with abdominal aortic aneurysm to determine whether we could then evaluate the extent of aneurysm and see associated renal, celiac, mesenteric, and iliofemoral artery disease. Results were compared with those of digital subtraction angiography (n = 47) and surgery (n = 37). RESULTS: The proximal and distal extents of abdominal aortic aneurysm correlated well with surgical findings. Dual-slice helical CT showed all main (n = 102) and accessory (n = 13) renal arteries with a sensitivity of 91% and a specificity of 100% for revealing associated renal artery stenosis exceeding 50%. Sensitivity and specificity of dual-slice helical CT for revealing stenosis exceeding 75% in celiac and superior mesenteric arteries were both 100%. Three of four iliofemoral artery stenoses and two occlusions of the common iliac artery were revealed by dual-slice helical CT. CONCLUSION: Helical CT angiography with dual-slice scanning is a useful and minimally invasive technique that can provide with high accuracy all the necessary information for treatment of abdominal aortic aneurysm.

Adult↗
PubMed2000

[Imaging features of gastric stromal tumors: radiologic-pathologic correlation. Report of 4 cases].

GOAL: This study concerns the new anatomo-pathologic semantics of the ancient gastric leiomyoblastoma that become gastric stromal tumors (GST) and identified as stemming of "pace-maker" cells of Cajal related to the immunohistochemical characterization of the phenotype. MATERIAL: and methods. We limited the study to the mesenchymatous tumors to "pacemaker" cells. For this purpose, we report four documented observations of gastric stromal tumors correlated to the histology and to the immunohistochemical study. RESULTS: Although some signs are often described (exogastric development, heterogeneity with cystic and necrotic component, predominating peripheral enhancement...), radiological aspects of these tumors are not specific because, analogues to the other mesenchymal tumors (leiomyoma or schwannoma). The topographic diagnosis is difficult, realized by echoendoscopy, CT scan and MRI. The irregularity of contours evokes the malignancy as hemoperitoneum. GST do not show lymphophilic behavior that differentiates them from the adenocarcinomas and gastric lymphomas. The surgical treatment is the best treatment, allowing the immuno-histological diagnosis of certainty from the complete operative specimen. CONCLUSION: Some tumors are difficult in classifying despite classic histology necessitating immunohistochemical tests for the identification of muscular, nervous, autonomous nervous system flexion of mesenchymatous tumors with epithelioid or spindle cells of the gastrointestinal tract. Then a radio-clinical follow-up is therefore indicated: the evolution is the alone real marker of malignancy.

Aged↗
PubMed1999

Anomalous origin of the left coronary artery arising from the pulmonary trunk: report of an adult case with long-term follow-up after surgery.

An anomalous origin of the left coronary artery arising from the pulmonary artery is a congenital malformation rarely described in adults. We report the case of a 65-year-old patient with this anomaly. Clinical presentation, imaging identification (coronary angiogram, MRI and electron-beam CT), surgical treatment and angiographic long-term follow-up are described.

Aged↗
PubMed1999

Management of cancer in pregnancy: a case of Ewing's sarcoma of the pelvis in the third trimester.

Ewing's sarcoma of the pelvic bones was diagnosed in a 21-year childbearing woman, raising major medical and ethical problems. The diagnostic and therapeutic approaches during the sixth month of gestation were tailored in order to cure the patient and avoid unnecessary toxicity to the fetus. Ancillary tests included ultrasound and MRI studies of the pelvis. Ifosfamide and adriamycin, premedicated by granisetron, were administered during gestation, and were found to be safe. Cesarean section was the preferred way of delivery since the tumor involved the pelvic bones. The outcome was a disease-free patient and a small healthy baby who is now two years of age.

Adult↗
PubMed1999

[Post-traumatic aneurysmal dissection of the extracranial internal carotid artery; helical computed tomographic and angiographic aspects: a case].

A 20-year-old man presented with mild intracranial bleeding, a Horner's syndrome, and left neck swelling following head injury. Following noncontrast CT of the brain, a contrast-enhanced helical CT was performed through the neck that showed a hematoma in the poststyloid space (carotid sheath) with irregular diameter of the ICA. Selective digital subtraction angiography confirmed the presence of left cervical ICA dissection with pseudoaneurysm formation. The aneurysm was resected and an end-to-end anastomosis was done using an inverted saphenous graft. Histology confirmed a diagnosis of traumatic ICA dissection with pseudoaneurysm formation and there was no evidence of pre-existing pathology. Helical CT is a simple, widely available, and relatively non-invasive imaging technique that correlates well with angiography. It should be considered in the evaluation of patients with suspected cervical ICA dissection.

Accidents, Traffic↗
PubMed1999

Percutaneous gastrostomy for enteral nutrition: long-term follow-up of 176 procedures.

OBJECTIVE: To evaluate the efficacy and safety of percutaneous gastrostomy (PG), using small catheters without gastropexy, to deliver enteral nutrition. METHODS: We reviewed the records of 176 consecutive patients in whom PG was attempted for enteral nutrition. Of these cases, 172 catheters were inserted by the Seldinger technique under fluoroscopic guidance alone, 2 were inserted under computed tomographic guidance, and 2 procedures failed. In primary procedures, 8.5- or 10.2-French catheters were used. RESULTS: The technical success rate was 98.9%. Of the 176 procedures, 2 failed because of the high position of the stomach. Seven-day follow-up was obtained in all patients; 30-day follow-up in 145 patients (83%), and long-term follow-up (30 to 1512 days) in 123 patients (70%). The 30-day mortality rate was 13.2%. One death (0.5%) was directly related to the procedure. Major complications occurred in 4 patients (2.2%), and minor complications in 12 patients (6.9%). No patient required surgery for complications attributable to the gastrostomy procedure. CONCLUSION: PG without gastropexy using small catheters is a simple, safe and effective technique for delivering enteral nutrition.

Adult↗
PubMed1999

[Arterial lipiodol chemoembolization of a left liver metastasis through the right internal thoracic artery].

The purpose of this article is to illustrate the efficacy of the chemoembolization in patients with hypervascular metastases and to describe the post-embolization change in vascularization pattern. Unusual collaterals may develop following embolization. A 59-year-old woman, followed for unresectable small bowel carcinoid tumor since 1991, underwent successful chemoembolization of several liver metastases. Only one liver lesion, located in segment IV, showed interval increase in size. This lesion was supplied by the right internal mammary artery. A branch of the right internal mammary artery was catheterized using a microcatheter and embolization was performed using doxorubicine-Lipiodol (Adriblastine, Lipiodol) and gelfoam (Spongel). No complications occurred after the procedure. The right internal mammary artery should be considered as a possible source of collateral arterial supply to the liver and should be evaluated in patients with local progression of disease.

Antibiotics, Antineoplastic↗
PubMed1999

[Helical computed tomography of the aorta and its branches].

Imaging of the aorta has greatly benefited from the recent development of helical computed tomography. This noninvasive and widespread imaging technique could be considered as a viable alternative to invasive modalities in aortic disease assessment, especially in the acute onset. Radiologists should be familiar with the principles of this technique and its clinical applications. This report develops technical aspects, typical and atypical features of a variety of noncongenital aortic diseases including dissections, aortic trauma, aneurysms, nonaneurysmal atherosclerotic diseases and arteritis. The role of helical CT as noninvasive tool for imaging the aorta and its branches is compared to the other imaging methods.

Acute Disease↗
PubMed1999

[Bronchial and pulmonary vaso-occlusions].

The technique of vaso-occlusion (or embolisation) consists in occluding one or several vessels which are causing haemoptysis. Either of the pulmonary circulations (systemic bronchial or pulmonary) may be the cause and sometimes both are. In systemic pulmonary hypervascularization the pathological issues are affected by high pressure vascularisation at the expense of functional vascularisation and are the source of frequent episodes of bleeding. Bronchial and systemic vaso-occlusion has proven efficacy and safety on condition that strict rules are respected to avoid complications; the detection of potentially dangerous arteries (spinal, coronary and visceral) and a choice of material for embolisation which is adapted to the therapeutic strategy and the clinical and angiographic presentation. The indications for the procedure are dictated by severe or recurrent haemoptysis. Vaso-occlusion of pulmonary arteries which is a rarer indication dominated by conditions such as arteriovenous malformation (MAVP). The technique is adapted to the number, to the size and to the diffusion of MAVP which is characterised precisely by computed tomography. Vaso-occlusion is the treatment of first choice for MAVP only leaving failures of vaso-occlusion to surgery and certain pedicular forms have a very short afferent of large calibre.

Arteriovenous Malformations↗
PubMed1999

[Late solitary metastasis of a renal cancer to the contralateral adrenal gland].

We report a case of metachronous metastasis from renal cell carcinoma to the contralateral adrenal gland detected one year after radical nephrectomy. The initial tumor was incidentally discovered in the setting of acute aortic dissection. A large left adrenal tumor was detected on CT follow-up at two years. Retrospectively, a hypervascular lesion was present on the first yearly CT examination. Adrenalectomy was performed. There is no evidence of recurrent disease at 12 months. The patient was also treated with oral steroids. Because of their location and of the particularities of available therapeutic options, and because these metastases can occur late, long-term sonographic and CT follow-up should be performed. The clinical, imaging, therapeutic and prognostic aspects of these lesions will be discussed.

Adrenal Gland Neoplasms↗
PubMed1997

Late presentation of solitary contralateral adrenal metastasis of renal cell carcinoma.

We report a case of renal cell carcinoma with solitary metachronous contralateral adrenal metastasis occurring 23 years after radical nephrectomy. The patient was treated with adrenalectomy. He is alive with no evidence of disease 1 year postoperatively. Solitary metachronous contralateral adrenal metastases from renal cell carcinoma are rare clinical conditions that may occur very late. Metastasectomy is advocated and is probably beneficial for limited metastatic renal cell cancer.

Adenocarcinoma↗