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Biomedical subjects

B Op de Beeck

Publications and source records attributed to B Op de Beeck.

14 recordsLinked to original sources

Neuroendocrine tumors of the pancreas.

BACKGROUND: The benefits of associating magnetic resonance imaging (MRI) and laparoscopy for localizing and treating neuroendocrine pancreatic tumors (NEPTs) have been poorly documented. METHODS: In a retrospective study, eight patients with a mean age of 48 years were operated on for a NEPT. MRI was used to localize the lesions. In all patients a laparoscopic resection was carried out. Laparoscopic ultrasonography (LUS) was used during most operations. RESULTS: The tumor was clearly localized by MRI in seven patients, and LUS showed the lesion in another patient whose preoperative MRI had been unsuitable. Three enucleations, three spleen-preserving caudal pancreatectomies, and two caudal pancreatectomies with splenectomy were carried out. There were no conversions and the mean operating time was 260 min, with a mean blood loss of 180 ml. The mean hospital stay was 7 days. There were no minor nor major complications during the hospitalization period. However, a pancreatic abscess was diagnosed in one patient 1 month later, requiring an urgent laparotomy. CONCLUSION: MRI as well as LUS are indeed suitable techniques to localize NEPTs. Moreover, the minimally invasive approach ensured an adequate treatment with a more comfortable and short postoperative recovery.

Adult↗

The correlation of preoperative CT, MR imaging, and clinical staging (FIGO) with histopathology findings in primary cervical carcinoma.

The aim of this study was to compare the preoperative findings of abdominal/pelvic CT and MRI with the preoperative clinical International Federation of Obstetrics and Gynecology (FIGO) staging and postoperative pathology report in patients with primary cancer of the cervix. Thirty-six patients with surgical-pathological proven primary cancer of the cervix were retrospectively studied for preoperative staging by clinical examination, CT, and MR imaging. Studied parameters for preoperative staging were the presence of tumor, tumor extension into the parametrial tissue, pelvic wall, adjacent organs, and lymph nodes. The CT was performed in 32 patients and MRI (T1- and T2-weighted images) in 29 patients. The CT and MR staging were based on the FIGO staging system. Results were compared with histological findings. The group is consisted of stage 0 (in situ):1, Ia:1, Ib:8, IIa:2, IIb:12, IIIa:4, IVa:6, and IVb:2 patients. The overall accuracy of staging for clinical examination, CT, and MRI was 47, 53, and 86%, respectively. The MRI incorrectly staged 2 patients and did not visualize only two tumors; one was an in situ (stage-0) and one stage-Ia (microscopic) disease. The MRI is more accurate than CT and they are both superior to clinical examination in evaluating the locoregional extension and preoperative staging of primary cancer of the cervix.

Adult↗

Real time CT-fluoroscopy: diagnostic and therapeutic applications.

The synergetic progression of CT technology and computer hardware has made ultrafast acquisition and image reconstruction possible. This has lead to the availability of CT interactive diagnosis and therapeutic procedures. Making use of our own material (337 intervention procedures during the last 17 months), we have compared our techniques and results to the recent literature data. One of the advantages of the biopsy technique is an improved sensitivity for neoplastic lesions, most certainly in cases of intrapulmonary lesions, surrounded by aerated tissue (now 94% compared to 87% in our previous study). A second advantage is the safety of the technique (only one major complication in our series). Fluid collection drainages, and more complex interventions like local injection of drugs, radio-frequency ablation, wire hook placement and ethanol injection were performed without complication. Yet another interesting feature is the shortening of the procedure time (reduced in average to an 'in-room' time of less than 30 min), which has definite economical implications. Furthermore it increases the patient's comfort and safety, and extends the scope of outpatient procedures (80% outpatient procedures in our material). On the other side the radiation exposure can be raised as an issue, especially when we consider the operator's hands. However, the described technique and the use of dedicated tools can alleviate the problem. As a conclusion, real time CT fluoroscopy has given a new input and broadens the scope of clinical indications of CT-guided diagnostic and therapeutic procedures.

Adolescent↗

Benign liver lesions: differentiation by magnetic resonance.

Optimal hepatic imaging involves both detection and characterization of focal lesions. Detection involves both determination of the presence of lesions and of their segmental extent of liver involvement. In the evaluation of hypervascular lesions, magnetic resonance imaging (MRI) has a greater impact on patient management than ultrasound (US) and computed tomography (CT). Most benign tumors are incidental findings and do not produce clinical symptoms. They must be accurately diagnosed without using aggressive procedures. Knowledge of their imaging features is essential to avoid unnecessary work-up and to minimize patient anxiety. In this article, the MR appearance, vascular and functional behavior of the most common benign liver tumors will be discussed.

Humans↗

Evaluation of a 10-minute comprehensive MR imaging examination of the upper abdomen.

PURPOSE: To determine whether a 10-minute magnetic resonance (MR) imaging examination of the upper abdomen provides sufficiently comprehensive information to replace a longer MR protocol. MATERIALS AND METHODS: Images obtained with selected breathing-independent and breath hold MR sequences, with 2 minutes of total acquisition time and an estimated 10 minutes of total study time, in consecutive MR examinations of the upper abdomen in 72 patients (age range, 23-87 years) were retrospectively reviewed in a blinded fashion by two separate interpreters. Determination was made of major and minor findings, and the two separate retrospective interpretations and the prospective clinical interpretation were correlated by using kappa statistics. Surgical and clinical findings were also correlated with imaging findings. RESULTS: In 61 patients, all major and minor findings were identical in the original clinical interpretation and the two retrospective readings. In 66 patients, the major findings were identical in these three readings. Close agreement was present between the two separate retrospective readings and the prospective clinical interpretation (kappa = 0.49-1.00). CONCLUSION: The findings suggest that the diagnostic information provided by a shortened MR imaging protocol that includes breath-hold and breathing-independent sequences is in close agreement with lengthier MR protocols. The advantages of a shortened protocol include increased patient throughput and decreased study cost.

Abdomen↗

[Computed tomography-guided diagnostic puncture in abdominal pathology].

Technological improvements (short-time acquisition and reconstruction, CT, spiral technique) together with better puncture material and a general trend towards less invasive surgical procedures have had a combined effect to a wider scope of applications for percutaneous punctures under CT-guidance. In this paper, we analyze and discuss recent data in the literature on puncture material, indications and results. The relevant choice of the needle model and its diameter, depending on the organ and suspected pathology, as well as the point of entry and the puncture track are key factors granting procedure safety, ambulatory use and good diagnostic results.

Abdomen↗

MRI of extrapancreatic gastrinomas.

Preoperative diagnosis of gastrinoma--especially extrapancreatic gastrinoma--is very difficult. At the moment octreotide scintigraphy is considered the method of choice to detect gastrinomas. However, MRI may play a major role in the diagnostic imaging of gastrinoma.

Contrast Media↗

MnDPDP for MR imaging of the liver. Results of an independent image evaluation of the European phase III studies.

PURPOSE: To evaluate the diagnostic efficacy of mangafodipir trisodium (MnDPDP, Teslascan) as a new contrast agent for MR imaging of the liver based on an independent evaluation of the MR images from the European phase III studies. MATERIAL AND METHODS: MR imaging of the liver was done at 0.5-2.0 T in 17 European centres and included T1-weighted spin-echo and gradient-echo sequences before and after administration of MnDPDP to patients at a dose of 5 mumol/kg b.w. T2-weighted images were also obtained in all cases before the i.v. injection of the agent. Images of a total of 592 patients were evaluated by 4 independent experienced radiologists who were not involved in the on-site clinical trials. RESULTS: Statistically significantly more lesions were detected (p = 0.0014) in MnDPDP-enhanced T1-weighted MR images than in unenhanced images. T1-weighted gradient-echo sequences were found to be superior to T1-weighted spin-echo sequences after injection of MnDPDP. The post-contrast images were found to be statistically significantly superior to the pre-contrast images in confidence in the presence of a lesion (p < or = 0.0001), quality of lesion delineation (p < or = 0.0001), lesion conspicuity (p < or = 0.0001) and in the confidence in the diagnosis of a lesion (p = 0.001). CONCLUSION: This independent evaluation of the European phase III trials confirmed the superiority of MnDPDP-enhanced MR images over unenhanced images for lesion detection and characterization.

Adult↗

[Spiral CT of vascular liver lesions].

Computed tomography (CT) has an important and undisputed role as a screening modality for suspected focal liver disease. Improvements in CT technology have dramatically increased our ability to detect and diagnose liver abnormalities. Spiral CT allows rapid imaging of the liver, resulting in improved contrast dynamics compared to conventional CT techniques. The timing of contrast administration and scan acquisition has become critical. With inadequate timing, lesions that in optimal conditions are easily visualized, can be ignored. Arterial phase imaging should be used when potential hypervascular neoplasms are suspected, and if possible, should include both arterial and portal venous phase imaging to ensure maximal lesion detection and visualisation of vascular structures. Portal venous phase imaging alone is optimal for evaluating most hypovascular tumors. This article reviews the principles of lesion detection and, to a lesser degree, lesion characterization. Special interest is focused on hypervascular lesions.

Carcinoma, Hepatocellular↗

Inverted Meckel's diverticulum as a leading point for ileoileal intussusception in an adult: case report.

Intussusception due to an inverted Meckel's diverticulum is considered a rare occurrence. We present a case of a 37-year-old male with anemia and melena due to an inverted Meckel's diverticulum at the base of an ileoileal intussusception. To our knowledge, this is the first case in which small bowel enema, computed tomography, and magnetic resonance imaging showed the pathology.

Adult↗

Paraspinal cervical calcifications associated with scleroderma.

Although soft tissue calcifications are well known to occur as a late manifestation in scleroderma, symptomatic paraspinal calcinosis is very rare. Clinically, patients present with focal neck pain, weakness or radiculopathy, and decreased range of motion of the neck. We describe the imaging features of a rare case of cervical paraspinal calcinosis in a 74-year-old woman with long-standing scleroderma. Standard radiography is usually sufficient to confirm the diagnosis, but CT-scan allows a more precise location of the calcifications around the facet joints, sometimes with associated erosions. The advantage of MRI is to evaluate the possible intraspinal extension of the calcifications in case of focal neurological symptomatology.

Aged↗

Recurrent gastrointestinal blood loss of obscure origin: report of an exceptional case.

A 66-year old tailor was admitted because of venous insufficiency of the left lower leg. During the hospital course, recurrent severe gastrointestinal blood loss developed. A classical approach was extended by enteroscopy and radionuclide scanning, followed by exploratory laparatomy with removal of two intra-abdominal sewing needles and a jejunal leiomyoma. After surgery, bleeding did not recur. This case illustrates the difficult diagnostic work-up of obscure gastrointestinal bleeding. It also shows that intra-abdominal sewing needles may migrate in the intestinal tract and remain silent during many years, eventually causing gastrointestinal bleeding.

Abdomen↗