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Biomedical subjects

C Matos

Publications and source records attributed to C Matos.

At least 55 records · Page 3Linked to original sources

[Imaging of acquired pathologies of the thoracic aorta].

For many years, imaging of thoracic aorta has been dominated by angiography. Development of new imaging modalities has modified the diagnostic approach to thoracic aortic pathology. The knowledge of the advantages and limitations of each technique enables a better choice for patient evaluation, in particular under emergency conditions. This study is based on a review of the literature and reports the authors' experience.

Aortic Dissection↗

Atypical and equivocal sonographic features of the spinal cord in neonates.

Thanks to the wider use of sonography to examine the spinal content in the neonate, normal anatomy and anomalies may be detected easily. Yet, unusual sonographic patterns are also observed. These must be differentiated from true pathologies. During a prospective study of 103 neurologically asymptomatic neonates, atypical sonographic patterns were found in 16 patients, corresponding to normal variants in 13. Nine of these 13 patients presented with a widening of the distal part of the central echo complex (one had a dilated ventriculus terminalis). Nerve roots of the cauda equina were disposed asymmetrically in three patients; the spinal cord movements were still present. In two of these babies, this distribution was associated with thin arachnoid pseudocysts. One patient presented with transitorily hyperechoic and narrow subdural spaces, probably related to neonatal dehydration. None of the 13 patients showing normal variants required any treatment. The other 3 patients (of 16) presented with equivocal entities of unknown evolution: sonographic tethered cord, fibrolipoma of the filum terminale and epidural varices. Sonography is highly accurate in evaluating the spinal cord content and aids differentiation of normal and normal variants from equivocal or pathological entities.

Diagnosis, Differential↗

Hyperechoic thickened ependyma: sonographic demonstration and significance in neonates.

In the neonate, hyperechoic thickening of the ependyma is believed to be related to ventriculitis. Yet, in our experience, this sign is much more often observed in association with subacute intraventricular hemorrhage (IVH), without infection. Sixty premature neonates were prospectively studied. The observations of transfontanellar sonograms (intracranial hemorrhage, ependymal echogenicity, and ventriculomegaly) were correlated with the results of MRI, lumbar punctures and clinical work-up. Intracranial hemorrhage was detected in 28 patients, and hyperechoic thickening of the ependyma was observed in 21 of them, all of whom had IVH. In 9 of these 21 patients IVH was diagnosed retrospectively thanks to the visualization of the hyperechoic ependyma. In all but one, this sign persisted for at least 2 months after disappearance of other signs of IVH. MRI demonstrated the presence of hemosiderin and ferritin in ependymal or subependymal location only in patients with hyperechoic ependyma. One of our patients had in utero diagnosis of IVH owing to the visualization of the same hyperechoic aspect of the ependyma. Nine of the neonates with hyperechoic ependyma developed ventriculomegaly, and three underwent surgery. Hyperechoic thickening of the ependyma in prematures often results from a subacute IVH. It is related to hemoglobin catabolites which can be detected by MRI. It does not require immediate potentially harmful diagnostic punctures. The presence of this hyperechoic rim allows a retrospective diagnosis of IVH and indicates a clinical and sonographic follow-up in newborns at risk for secondary hydrocephalus.

Cerebral Hemorrhage↗

Lipomyeloschisis associated with thoracic syringomyelia and Chiari I malformation.

Co-existence of Chiari I malformation and myelomeningocele is uncommon. Syringomyelia, when associated with a Chiari I malformation, classically involves the cervical spinal cord. Intramedullary extension of lipoma is unusual in lipomyeloschisis. A patient with lumbar lipomyelomeningocele with tethered cord, lower thoracic syringomyelia and Chiari I malformation, shown by MRI is reported.

Arnold-Chiari Malformation↗

Gadodiamide injection as a contrast medium for MRI of the central nervous system: a comparison with gadolinium-DOTA.

The tolerance and diagnostic efficacy of a new nonionic, intravenous MRI contrast medium, gadodiamide injection (Omniscan) are reported and compared with those of gadolinium-DOTA after completion of a double-blind, randomized, parallel study in 60 patients using a dose of 0.1 mmol/kg. Two patients were excluded from the statistical analysis after trial entrance since no contrast medium was injected. The indications for the MRI examination were known or suspected CNS lesions. Vital signs, chemical and haematological parameters were monitored. No significant abnormalities were observed, confirming the excellent tolerance of both contrast media. The usefulness of gadolinium-containing contrast media was again documented, since in 8.6% (5/58) of the patients the lesion(s) could be seen only after injection. Contrast enhancement was seen in 87.8% (43/49) of the patients with abnormal findings, and provided additional diagnostic information in 24.5% (12/49). Lack of contrast enhancement in 12.2% (6/49) of patients with abnormal findings was a significant negative finding.

Brain↗

Gadolinium enhancement of vertebral endplates following lumbar disc surgery.

Gadolinium enhancement may be normal in the vertebral endplates adjacent to previously operated intervertebral discs. To determine the frequency of this finding and to differentiate this normal healing process from early lesions due to focal infection, we studied 135 patients who had undergone surgery for herniated lumbar disc, and compared them with 249 unoperated patients with radicular symptoms and 15 with known spondylodiscitis. Hypointense foci which enhanced with gadolinium were identified in the endplates of 25 (18.5%) of the operated patients, 9 of whom required a second operation for recurrent disc herniation, at which time the absence of infection was confirmed. Gadolinium enhancement within the endplates adjacent to the operated disc occurs during normal healing after surgery. Care should be taken before invoking a diagnosis of focal infection or secondary spondylodiscitis.

Adult↗

Pineal cyst: normal or pathological?

Review of 500 consecutive MRI studies was undertaken to assess the frequency and the appearances of cystic pineal glands. Cysts were encountered in 2.4% of cases. Follow-up examination demonstrated no change in these cysts and they were considered to be a normal variant. Size, MRI appearances and signs associated with this condition are reported in order to establish criteria of normality.

Adolescent↗

Stereotactic indications for neuroradiological differential diagnosis.

The modern neurodiagnostic techniques of MR imaging, CT scanning and angiography provide valuable morphological information that, although highly sensitive to tumour localisation, still lacks comparable specificity as to the exact histological nature of those lesions demonstrated. Biopsy remains necessary. To patients with potentially inoperable lesions or lesions best treated by chemotherapy or irradiation, modern techniques of neurosurgery now offer the option of precise stereotactic biopsy through small twist-drill burr holes as opposed to open biopsy. The interrelationships between MR, CT, angiography and stereotactic biopsy and their respective roles in the establishment of a definitive diagnosis are discussed.

Biopsy↗

Hydrosyringomyelia-Chiari I complex. Prospective evaluation of a modified foramen magnum decompression procedure: preliminary results.

A modified foramen magnum decompression procedure, designed to respect the subarachnoid spaces as much as possible, was prospectively evaluated in eight consecutive patients with a progressive clinical syndrome related to hydrosyringomyelia-Chiari I complex. This evaluation included quantitative clinical and magnetic resonance follow-up of at least 1 year in the first six patients and 6 months for the last two. Magnetic resonance scans at 6 months or more confirmed a persistent reduction of the hydrosyringomyelic cavity in all cases, which was associated with obvious subjective improvement. All patients have maintained this improvement. The operative technique and methods of clinical and radiological follow-up are discussed.

Adolescent↗

Fracture of the posterior aspect of the lateral tibial plateau: radiographic sign of anterior cruciate ligament tear.

Plain radiographs obtained in 25 patients with acute anterior cruciate ligament (ACL) tears detected with magnetic resonance imaging were retrospectively evaluated to identify associated bone lesions. Fracture of the posterior part of the lateral tibial plateau (LTP) was seen in 11 patients, impacted fracture of the lateral femoral condyle (LFC) in two, lateral tibial rim fracture (Segond fracture) in three, and avulsion fracture of the tibial attachment of the ACL in two. The latter three fractures have been associated with an ACL tear. Conversely, fractures of the posterior part of the LTP have not been associated with ACL tear and are recognizable on plain radiographs. Impaction of the LFC on the LTP and avulsion of the posterior tibial capsular junction may account for the association of the fracture of the LTP with the acute ACL tear. This type of fracture represents the most frequent indirect sign of ACL tear seen on plain radiographs.

Adolescent↗

Characterization of mouse monoclonal antibodies against common and repeated epitopes of different developmental stages of Schistosoma mansoni.

Eight IgM monoclonal antibodies (mAbs) obtained from a Schistosoma mansoni chronically infected mouse immunized twice with adult worms butanolic extract (BE) and soluble egg antigen (SEA) were characterized by immunochemical methods. An intense cross-reactivity between different developmental stages was observed by indirect immunofluorescence assay (IIFA) with five anti-SEA mAbs. These mAbs appeared to recognize glycosidic residues, as suggested by 1) the inhibition of their reactivity by periodate oxidation of SEA, 2) the multiple polypeptide recognition in radioimmunoprecipitation and immunoblot assays and 3) reactivity with KLH. Anti-SEA mAbs were able to mediate in vitro killing of schistosomula but they were not consistently able to mediate passive transfer immunity in vivo. Three of anti-SEA mAbs were suitable for the performance of a sandwich ELISA for antibody detection in S. mansoni infected patients, allowing an increase in the signal to noise ratio as compared to the direct ELISA SEA method. Three anti-BE mAbs showed a more stage restricted pattern of antigen recognition by IIFA. Only one out of three seemed to be directed against glycan residues, but the other mAbs showed a plural pattern of polypeptide recognition on BE immunoblot, suggesting that repeated epitopic motifs are also present in different proteins within the same parasite developmental stage.

Animals↗

MRI of acute disseminated encephalomyelitis after coxsackie B infection.

Acute disseminated encephalomyelitis (ADEM) is a rare demyelinating condition of the central nervous system, usually developing after a viral infection or vaccination. We report a case of ADEM predominantly affecting the spinal cord in an 8-year old boy evaluated by MRI. The radiographic picture consisted of multiple focal lesions of the spinal cord, a left posterior thalamic lesion and a subcortical right posterior parietal lesion. These lesions regressed several weeks after corticosteroid treatment. The clinical presentation, the laboratory results and the radiological findings suggest the diagnosis of ADEM secondary to viral infection by Coxsackie B.

Brain↗

Transverse geniculate ligament of the knee: appearance and frequency on plain radiographs.

The aims of the study were to determine the frequency of visualization of the normal transverse geniculate ligament (TGL) of the knee on lateral plain radiographs with magnetic resonance imaging (MRI) as a reference, and to determine features that make this ligament apparent on plain radiographs. 50 consecutive lateral plain radiographs and sagittal T1-weighted images of corresponding knees were evaluated prospectively. A TGL was considered visualized on plain radiographs when an opacity of soft-tissue density was apparent in the posterior part of the Hoffa's fat pad. The TGL was identified in 29 of the 50 (58%) sagittal MR images; a TGL was observed on the lateral plain radiographs of six patients (12%). Correlation with the MR images showed that, when visualized on plain radiographs, the ligament is at least 3 mm thick and completely surrounded by fat. Our study shows that the TGL is a normal variant that can be recognized frequently on lateral plain radiographs of the knee.

Adolescent↗

[Neonatal pilonidal sinuses and screening by medullary ultrasonography: preliminary results].

The authors report on their preliminary experience with ultrasound as a screening examination in neonates presenting pilonidal sinuses. Of the 100 patients examined over the 2 previous years, three pathological cases were found (1 tethered cord, 1 lipoma of the filum terminale and one localized hydromelia). Abnormal or doubtful cases were confirmed or further investigated by magnetic resonance. Ultrasound seems to be an accurate technique for the detection of malformation of spinal canal content in neonates under one month of age.

Humans↗