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C Balleyguier

Publications and source records attributed to C Balleyguier.

At least 19 recordsLinked to original sources
PubMed2006

Specimen radiography as predictor of resection margin status in non-palpable breast lesions.

AIM: This study aimed to evaluate the role of specimen radiography in predicting margin status for non-palpable breast malignancies. METHODS: We retrospectively reviewed the clinical and pathological data together with specimen radiographs of 164 women with ductal carcinoma in situ, who were referred to our centre between January 1997 and December 2000. In all cases microcalcifications were discovered on mammography. Lesions were localized preoperatively using a guide-wire. Specimen radiography findings and clinicopathological data were correlated with pathological findings. RESULTS: Findings comprised 122 pure ductal carcinomas in situ (74%) and 42 mixed carcinomas, both infiltrating and in situ (26%). On the specimen radiographs, the lesions were close (<1mm) to one edge of the lumpectomy in 34 (21%) cases. Histologically, there were 103 positive resection margins (<1mm, 63%) and only 61 negative margins (> or =1mm, 37%). On univariate analysis, factors associated with positive resection margins were found to be distance from microcalcifications to edge of lesion on specimen radiographs, and radiological multifocality. On multivariate analysis (logistic regression), a radiological margin <5mm and multifocality were the only risk factors for close histological margins. Radiological margins were not associated with surgical findings. CONCLUSION: Our results demonstrate that there is a correlation between specimen radiographs and histological results. The clinical relevance of this should be evaluated in a prospective study.

Adult↗
PubMed2005

Breast inflammatory gigantomastia in a context of immune-mediated diseases.

CONTEXT: Localized breast lesions have been described in lupic or diabetic patients. However, the description of breast gigantomastia in women presenting with autoimmune diseases has not been reported. SETTING: The study took place within the Department of Endocrinology and Reproductive Medicine, Necker Hospital, Paris, France. PATIENTS: We describe eight patients with inflammatory gigantomastia, occurring in a context of immune-mediated diseases: myasthenia, chronic arthritis, or thyroiditis. MAIN OUTCOME MEASURES: Together with hormonal, immunological, and breast magnetic resonance imaging (MRI) evaluation, breast histology enabled us to perform immunocytochemical and indirect immunofluorescence studies. Control sera were obtained from patients with (n = 10) and without (n = 7) antinuclear antibodies. RESULTS: Six of the eight patients developed gigantomastia either at puberty or during pregnancy. Neither a hormonal oversecretion nor a specific immunological pattern was observed. All patients except one presented antinuclear antibodies. Histological study revealed a diffuse, stromal hyperplasia and a severe atrophy of the lobules. A rarefaction of adipocytes was also noted, as previously suggested on MRI. There was a perilobular lymphocytic infiltrate made of CD3+ lymphocytes. Study of sera from five of six cases of gigantomastia showed a nuclear immunofluorescence pattern in normal mammary ductal and lobular glandular epithelium, as well as in kidney and intestine epithelial cells. In control sera, a nuclear signal was observed only when antinuclear antibodies were present. CONCLUSIONS: We suggest that breast tissue may be a target tissue in autoimmune diseases, this process being favored by the hormonal milieu. However, the precise mechanism of such association is not individualized. The fact that stromal hyperplasia is the main histological feature justifies the search for the involvement of growth factors in such a process.

Adolescent↗
PubMed2005

Breast radiological cases: training with BIRADS classification.

The American College of Radiology has established guidelines for outcomes monitoring known as the Breast Imaging Reporting and Data System. The last edition of the BIRADS classification includes mammography, but also ultrasonography and MRI. Radiologists must be used to the BIRADS lexicon and the BIRADS assessment, in order to clarify mammography reports and to facilitate communication with the other physicians. This work is a training on 20 mammography cases to be familiar with the BIRADS classification.

Breast Diseases↗
PubMed2005

[Understanding CAD (computer-aided diagnosis) in mammography].

Generalization of breast screening programs requires efficient double reading of mammograms, which allows reduction of false negative interpretations, but it may be difficult to achieve. CAD (Computed Aided Detection) systems are dramatically improving and can now assist in the detection of suspicious mammographic lesions, either suspicious microcalcifications, masses or architectural distortion. Characterization of the lesions is improving as well. CAD mammography might complete or substitute to "human" double reading. The aim of this review is to present the main CAD systems commercially available, review the principles of CAD and discuss the results of CAD mammography. Specifically, the role of CAD within breast screening program, according to the results of recent prospective studies will be discussed.

Breast Diseases↗
PubMed2004

Accuracy of rectal endoscopic ultrasonography and magnetic resonance imaging in the diagnosis of rectal involvement for patients presenting with deeply infiltrating endometriosis.

OBJECTIVE: To compare the accuracy of rectal endoscopic ultrasonography (REU) and magnetic resonance imaging (MRI) for predicting rectal wall involvement in patients presenting histologically proven deeply infiltrating endometriosis (DIE). METHODS: This was a retrospective study of a continuous series of 81 patients presenting histologically proven DIE who underwent preoperative investigations using both REU and MRI. The sonographer and the radiologist, who were unaware of the clinical findings and patient history, but knew that DIE was suspected, were asked whether there was involvement of the digestive wall. RESULTS: Rectal DIE was confirmed histologically in 34 of the 81 (42%) patients. For the diagnosis of rectal involvement, sensitivity, specificity and positive and negative predictive value for REU were 97.1%, 89.4%, 86.8% and 97.7% and for MRI they were 76.5%, 97.9%, 96.3% and 85.2%. CONCLUSION: The sensitivity and negative predictive value of REU were higher than those of MRI suggesting that REU performs better than MRI in the diagnosis of rectal involvement for patients presenting with DIE. Prospective studies with a large number of patients are needed in order to validate these preliminary results.

Adult↗
PubMed2003

Abdominal wall and surgical scar endometriosis: results of magnetic resonance imaging.

Scar endometriosis is a rare disease which is difficult to diagnose. The symptoms are nonspecific, typically involving abdominal wall pain at the time of menstruation. Clinical examination may reveal a painful nodule, if the scar involved is located on the abdominal wall, but is normal, when the lesion is located on the uterine scar. Other means of investigation (transvaginal ultrasonography, computed tomography) may be useful in case of lesions on the abdominal wall, or if the nodule is large, but give no specific results. The diagnosis is frequently made only after excision of the lesion. We report here 4 patients operated for scar endometriosis (two abdominal and two uterine scars) for whom MRI had suggested the diagnosis. Thanks to its very high spatial resolution, MRI enables very small lesions to be detected and can distinguish the hemorrhagic signal of endometriotic lesions. Furthermore, it performs better than the CT scan in detecting the limits between muscles and abdominal subcutaneous tissues.

Abdominal Wall↗
PubMed2003

[CT pelvimetry: a new approach using multi detector CT and volume rendering].

The authors describe a new technique of CT pelvimetry, using multi detector CT. This protocol is able to provide an anatomic view of the bony pelvis as well as classical measurements for pelvimetry. The acquisition is made using low technical parameters allowing the radiation dose to remain similar to that of conventional CT. Helical acquisition with thin slices and interleaved reconstruction provides adequate material for Volume Rendering reconstruction. Presets of the software may give readily available images within seconds, saving time for the radiologist. Although this technique might be performed using single slice helical CT, multi detector CT makes it faster and more accurate as the acquisition time is shorter. Final images are more easily understood by obstetricians and midwives, leading to a better understanding of dystocias. This anatomical information is obviously superior to that of conventional CT. Because it is simple to perform, has no medical time cost for the radiologist if a Volume Rendering software is available, and does not require additional radiation, we believe that this technique should replace conventional CT or conventional pelvimetry.

Female↗
PubMed2003

[Imaging features of endometriosis].

Deep pelvic endometriosis is responsible of a painful syndrome dominated by deep dyspareunia and pelvic pain that recur according to the menstrual cycle. The semiology is directly correlated with the location of the lesions but is not specific. It is essential to investigate (clinically and with magnetic resonance imaging (MRI)) these deep endometriosis lesions and to draw up a precise map, which is the only way to be sure that surgical excisions will be complete. For the diagnosis of deep endometriosis, MRI is more sensitive and specific than endovaginal ultrasonography. Bowel and utero-sacral ligament lesions are often underestimated by clinical examination and ultrasonography. The MR diagnosis of these deep lesions is also difficult and require adapted sequences but may vary following experience of the radiologist. Preoperative endorectal ultrasonography or MRI are reliable techniques to visualize perirectal endometriomas and to assess rectal wall involvement. Surgical management can be based on preoperative imaging diagnosis, the Bladder and ureteral lesions are also underestimated. Renal ultrasonography must be performed in women affected by severe deeply infiltrating endometriosis. MRI does not improve sensitivity nor specificity of the radiologic diagnosis of ovarian endometriomas. Nevertheless, MRI is a reliable technique to visualize deeply infiltrating endometriosis lesions associated with ovarian endometriomas.

Endometriosis↗
PubMed2002

Comparison of magnetic resonance imaging and transvaginal ultrasonography in diagnosing bladder endometriosis.

STUDY OBJECTIVE: To take recent progress in magnetic resonance imaging (MRI) into account to determine its accuracy compared with that of transvaginal ultrasonography (TVUS) in diagnosing bladder endometriosis. DESIGN: Retrospective analysis (Canadian Task Force classification II-2). SETTING: University-affiliated hospital. PATIENTS: Twelve women with histologically proved bladder endometriosis. INTERVENTION: Magnetic resonance imaging with body and endocavitary coils and TVUS. MEASUREMENTS AND MAIN RESULTS: Although TVUS was normal in four patients, MRI enabled endometriotic lesions to be detected in all patients. Magnetic resonance imaging with endocavitary coil established the existence of deep infiltration in three patients when muscularis involvement was not visible with the body coil. In seven women MRI determined how far deep posterior endometriotic lesions extended, whereas with TVUS this was impossible to see. Conclusion. MRI had advantages over TVUS in diagnosing small lesions of associated posterior deep endometriotic lesions. The endocavitary coil gave better results than the phased-array coil for diagnosing deep infiltration. These results are important in that they help guide surgical management.

Adult↗
PubMed2002

[Characterization of renal masses].

The characterization of renal masses relies mainly on CT which remains the gold standard in the diagnosis of renal tumors and cysts. Ultrasound enables to diagnose benign cysts which account for the majority of incidentally detected renal masses. MR imaging is useful in the diagnosis of renal masses that remain indeterminate at CT. Moreover, it is efficient as a substitute when CT is contraindicated. Renal masses include three categories with respect to the size and the gross architecture of the lesion: indeterminate very small masses (less than 10mm in diameter); cystic renal masses and solid renal masses that exhibit postcontrast tumor tissue enhancement. Characterization of cystic renal masses relies mainly on the Bosniak classification which consists of four categories: benign simple cysts (cat I); minimally complicated cysts (cat II); indeterminate cystic renal masses that include cystic renal tumors (multiloculated or not) and complex cysts; cystic renal cell carcinomas (cat IV). Solid renal masses include pseudotumors (normal variants, renal dysmorphisms and inflammatory renal masses) and renal neoplasms among which CT enable to distinct: typical large renal cell carcinomas, typical fat-containing angiomyolipomas and indeterminate renal tumors.

Adult↗
PubMed2001

Ultrasound of renal tumors.

Despite the limitations of US in providing a complete evaluation of renal tumors before treatment planning, initial screening, characterization of renal masses and staging of RCCs can benefit from some recent advances of the technique. One of the most relevant clinical benefits of US is the increased early detection of RCCs. Recent technical improvement of gray-scale imaging has increased US performance in the detection of small renal tumors. Combined gray-scale and color Doppler US findings may strongly suggest the histopathologic nature of a renal tumor with respect to the size, the US attenuation characteristics, and the vascular distribution of the lesion. Ultrasound contributes additional diagnostic information for differential diagnosis of some renal masses that remain equivocal at CT, including: atypical cystic lesions; solid renal tumors with poor vascularity; and angiomyolipomas with minimal fat component. Ultrasound also may provide additional diagnostic information over CT in selected cases of RCCs with venous invasion. In addition to some diagnostic and therapeutic procedures that can benefit from US guidance, intraoperative US remains the only available tool that enables to ensure renal-parenchymal-sparing surgery.

Carcinoma, Renal Cell↗
PubMed2000

[Towards the integration of the digital medical image folder within the computerized patient folder: PACS and image networks].

Medical Images are components of the so-called "Medical Imaging Folder". This folder is a subset of the so-called "Medical Folder", part of the "Patient Folder. The G8 promotes the concept of a "Global Information Society for Health. Within this society, the Patient Folder is seen either from a healthcare organization, from a country or from an international point of view. The Global Patient Folder (Healthcare Folder) is composed of the different Patient Folder instances. Presently, Pacs and Telemedicine are no longer concerned only by storage and transmission issues. The medical images have only meaning associated with their context, the patient healthcare status. This context is rich in information provided by various information systems or healthcare professionals. The different data are linked and time dependant. Therefore, the expert community in the field of patient records argues that the approach must be the integration of Medical Images within the patient folder. It appears clearly that the complete deployment of such an "International Healthcare Folder" needs time and will proceed in several steps. Due to the increase of the people's mobility this deployment is inescapable. Infrastructure must be sized up taking into account the Digital Medical Image spreading and its large data volume which necessitates a large bandwith. In this paper, we detail the Medical Image Folder concept and its position within the Patient Folder and the Healthcare Folder. Then we present PACS, networking and Telemedicine concepts as well as the needs in standards.

Humans↗
PubMed2000

[Value of MR imaging in the diagnosis of benign uterine conditions].

Benign diseases of the uterus can be evaluated by ultrasound, magnetic resonance imaging (MRI), hysterography, hysterosonography and hysteroscopy. The purpose of this review of the literature is to discuss the role of MRI among the different imaging modalities for the diagnosis of mullerian abnormalities of the uterus, endometrial disease, fibroids and adenomyosis. Particular attention is brought to comparative multi-modality studies. The MRI technique, indication and diagnostic criteria for various pathological conditions of the uterus are described. The use of MRI appears to be cost-effective in the diagnosis of complex mullerian abnormalities, endometrial thickening following treatment by tamoxifen, selection of candidates for selective myomectomy and the follow-up of medically treated adenomyosis.

Female↗
PubMed2000

[Renal sinus disorders: imaging findings and pitfalls].

Renal sinus pathology can be classified into 3 groups: intrinsic lesions that arise from the anatomical components of the sinus (fatty tissue, collecting system, arteries and veins, lymphatic vessels, and nerves); extrinsic lesions that develop within the renal sinus from the renal parenchyma; secondary lesions including metastases and retroperitoneal tumors with renal sinus involvement. The diagnosis of renal sinus disorders often relies on a multimodality approach including IVU, doppler-ultrasonography, and CT. The wide variety of renal sinus diseases that may origin either from the renal parenchyma or the retroperitoneum, and the numerous pitfalls mostly due to anatomic variations, may prevent from making a right etiological diagnosis in numerous cases.

Diagnosis, Differential↗