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Biomedical subjects

B Roger

Publications and source records attributed to B Roger.

At least 55 records · Page 3Linked to original sources

[Validity and diagnostic value of magnetic resonance imaging in traumatic menisco-ligamentous pathology of the knee. Prospective study of 22 knees].

Twenty-two patients were prospectively examined by magnetic resonance imaging to determine the diagnostic validity of the method in the assessment of traumatic lesions of the menisci and ligaments of the knee. All the patients had their lesion verified by arthrotomy with or without arthroscopy. The accuracy of magnetic resonance imaging in the detection of lesions of the medial menisci, lateral menisci and cruciate ligaments was respectively 82, 91 and 100 per cent. Its specificity for lesions of the same structures was 92, 100 and 100 per cent. Lesions of the articular cartilage and of the peripheral ligaments were detected with an accuracy of 100 and 95 per cent and a specificity of 100 per cent. Thus magnetic resonance imaging presents a high level of reliability in the detection of ligamentous and cartilaginous lesions. It is less reliable for the detection of meniscal lesions because of the number of false positives and false negatives, which is not negligible. However its demonstrable diagnostic value will increase with improved knowledge of the pathology of imaging and with technical improvements. Its three-dimensional features and the fact that it is totally non-invasive give to this method a great future in the field of the traumatic pathology of the knee. In the steps leading to the diagnosis of meniscal and ligamentous lesions of the knee, magnetic resonance imaging has an interesting place in the field of recent lesions and may avoid the need for hospitalization.

Adult↗

Retroperitoneal lymph node aspiration biopsy in staging of pelvic cancer: a cytological study of 228 consecutive cases.

Knowledge of the status of the pelvic lymph nodes is important for accurate staging and adequate treatment of patients with genitourinary tract cancer (bladder and prostatic carcinoma, testicular tumors, and uterine carcinoma). A total of 228 consecutive patients underwent preoperative evaluation of the lymph node status by lymphangiography combined with fine-needle aspiration biopsy. A lymphadenectomy was performed in 94 patients. The overall diagnostic accuracy was 93%. There were 5% false-negative results and no false-positive diagnoses. Fine-needle aspiration biopsy is an inexpensive method with which to detect the presence of metastatic lymph nodes visualized by bipedal lymphangiography. It is also a safe and well-tolerated method, with a low morbidity and no mortality. The various cytological features are described as are some possible pitfalls.

Adenocarcinoma↗

[Value of computed medical imaging in the surveillance of neo-adjuvant chemotherapy of osteogenic osteosarcoma in children and adolescents. 51 patients seen from 1984 to 1986].

The value of quantitative bone scintigraphy, digitised angiography, CT scanning and magnetic resonance imaging in the follow-up of neo-adjuvant chemotherapy for osteogenic osteosarcoma was assessed in 51 patients between 1984 and 1986. Bone scintigraphy was a very sensitive method of detecting bone metastases but of limited value in assessing the response to preoperative chemotherapy. CT scanning was very useful in small and medium sized tumours with predominantly non-calcific involvement of the soft tissue. At present, digitised angiography seems to be the best investigation for following up these patients as shown by the close histo-angiographical correlations. However, magnetic resonance imaging is a very promising method and may in future replace the more invasive aforementioned techniques in this indication.

Adolescent↗

[Magnetic resonance imaging in lesions of the plantar aponeurosis].

Exploration of sporting injures to plantar aponeurosis (PA) has up to now been based mainly on clinical examination, from which the diagnosis was established. Imaging technics such as standard radiography and ultrasound scanning have limitations allowing diagnosis to be made usually only by elimination, the lesion being very rarely visualized directly. Ten patients with hyperalgic lesion of plantar arch and functional impotence were explored by MR imaging, and in all cases this examination provided superior data confirmed at operation. The examination is painless and little invasive and can be carried out during the acute phase. The plantar aponeurosis is visualized directly between the muscle mass of the plantar arch and the fatty cushion. All three spatial planes can be investigated, most interesting data being obtained from the sagittal (in the PA axis) and frontal (comparative) planes.

Adult↗

[NMR imaging of the normal wrist. Iconography].

Results of NMR imaging of normal anatomy of wrist using a surface antenna are presented, this new technique providing serial sections, 5 mm thick, of the different carpal joints in 3 different planes. Quality of imaging of carpus showed NMR to be superior for exploration than standard radiography and even CT scan images. Investigation of tumors of wrist, osteonecrosis and compound fractures of this region (currently not simple) will be markedly facilitated by NMR imaging, allowing a precise diagnosis with complete details of possible extension to be established and appropriate therapy applied.

Carpal Bones↗

Influence of vertebral fat content on quantitative CT density.

Single- and dual-energy (85 and 130 kVp) computed tomographic (CT) measurements of bone density were made in 74 lumbar (L-3) vertebral specimens. Single-energy CT densities at 130 kVp consistently underestimated actual ash density by about 25 mg/cm3 in men and 40 mg/cm3 in women. CT densities overestimated age changes by 73% in women and 26% in men. These errors of the single-energy CT approach seemed due to increased marrow fat caused by age. At 130 kVp, there was a large decrease in apparent bone density (13 mg/cm3) for each increase of 100 mg/cm3 in fat content, but the decrease was lower at 85 kVp (11 mg/cm3), suggesting the use of lower energies for quantitative CT. In the vertebrae from the younger subjects (up to age 69), the relative error was 20%-31%, but in the oldest group it amounted to 31%-45%. The 95% confidence interval for an individual determination was +/- 38 mg/cm3. Dual-energy CT greatly reduced the above errors. Ash density was predicted with only a small accuracy error (7 mg/cm3) using a postprocessing dual-energy calculation, but the prediction error was 19 mg/cm3 for determinations at 130 kVp. The large uncertainty in the fat content of marrow (+/- 110 mg/cm3) and the variability in distribution of fat make dual-energy approaches necessary for accurate determinations of vertebral mineral density.

Absorptiometry, Photon↗

Teaching social language to moderately handicapped students.

Three students with moderate handicaps were taught to initiate and expand on conversational topics. The teaching procedure used stimuli generated from actual conversations with nonhandicapped peers. Generalization was assessed by audiotaping conversations between the handicapped students and their peers in natural school contexts without adult supervision. Results indicated that training generalized to natural contexts. These results were socially validated by undergraduate special education students, who rated tapes of two of the students' conversations during training phases as more socially competent than during baseline. Results are discussed in terms of the evaluation of complex social behavior as multioperant behaviors.

Adolescent↗

Cephalic magnetic resonance imaging of boxers. Preliminary results.

A prospective study of 52 boxers, 20-60 years, 13 of them amateurs and 39 professionals, has been made using magnetic resonance imaging (MRI) at 0.15 T. Twelve of the boxers were still active, while the other 40 had retired after about 10 years of boxing. Multi-slices in two planes without gap were performed using T1 and T2 weighted sequences. The findings were correlated to the number of matches, the number of knock outs, the severity of head trauma, the style of the boxer, and to the clinical findings and the findings at EEG. There was a good correspondence between the presence of lesions and the style of the boxer. The changes noted--mainly atrophic--occurred among those with capacity to 'stand punishment'. MRI offers an opportunity to evaluate the effect of trauma and the information obtained may be used to prevent disabilities among boxers.

Adolescent↗

[Magnetic resonance imaging of tumors of the knee using surface coils].

Fourteen patients presenting with a primary bone tumour of the knee have been assessed, in parallel with other imaging techniques, by examination using MRI with surface coils. The first examinations were made before any biopsy was made or chemotherapy given so as not to impair the interpretation of the images and to provide guidance as to the correct site for biopsy. Two sequences were made - a longitudinal sequence made with echo-spin, echo-time = 30 ms, repetition-time = 500 ms, with four impulses and a transverse sequence made with echo-spin, echo-time = 40 ms, repetition-time = 1300 ms with two impulses (+/- multi-echo). Thanks to the excellent spatial resolution using a surface aerial, we have been able to determine not only the intramedullary extent of the tumour and its relationship with healthy muscles and vessels but also, in a much more precise way than previously, evidence of extension to the skin, to the epiphysis, to the articular cartilage and to the synovium, thus allowing an objective assessment to be made of the possibility of a closed block-excision of the joint. A second MRI examination with cranial coil was made pre-operatively at the end of adjuvant chemotherapy to determine the precise progress of the tumour, and in particular, to discover the localisation of the tumour in the femoral and tibial shafts, the investigation being aided by systemic scintigraphy.

Bone Neoplasms↗

[Digital angiography of bone sarcoma in the child].

The authors analyze the results of 50 computed angiographies made for osteosarcoma and Ewing's sarcoma. Better tolerated than conventional angiography computed angiography is also more sensitive in preoperative evaluation of effectiveness of neoadjuvant chemotherapy. Automatic subtraction, direct measuring of tumor size and vascularization density give to angiographic changes after chemotherapy the most predictive value. After conservative surgery or radiotherapy digital angiography provides most reliable local follow up.

Angiography↗

[Modern technics for studying injuries of the lumbo-ischiatic plexus. Apropos of a new case].

A 22 year old patient was admitted with multiple lumbosacral root meningoceles following a motorbike accident. Because of the marked neurologic deficit in left lower limb a radiculographic exploration was completed by a CT scan, with improvement in analysis of images, post-traumatic pseudo-meningoceles being neither an absolute proof nor the unique lesion responsible for the clinical picture. They may be missing whereas the root is absent. Combining these two examinations provides for total screening of lesions and more selective choice of therapy.

Accidents, Traffic↗

[Appearance of the normal knee by MRI using a surface antenna].

NMR imaging of the knee using a surface aerial provides remarkable anatomical detail of this joint without the need for invasive procedures or stressful positioning. Results of the use of this technique on seven normal knees confirmed the precise anatomical details provided, with direct visualization of the femorotibial interline and particularly of the cruciate ligaments, menisci and cartilages. This method allows a new diagnostic approach to the knee, especially for traumatic or tumoral lesions, and greater efficacy of treatment.

Adult↗