PubMed Health⌕ Search

Biomedical subjects

Celso Matos

Publications and source records attributed to Celso Matos.

17 recordsLinked to original sources
PubMed2006

Magnetic resonance imaging in the detection of pancreatitis and pancreatic neoplasms.

This article presents current magnetic resonance imaging techniques for the diagnosis of acute and chronic pancreatitis and pancreatic neoplasms. It emphasises the need for a comprehensive protocol combining imaging sequences of the pancreatic parenchyma with magnetic resonance angiography and secretin-enhanced magnetic resonance cholangiopancreatography in order to evaluate the full range of pancreatic inflammatory and neoplastic conditions. Imaging characteristics that may indicate a specific diagnosis are discussed.

Humans↗
PubMed2006

Evaluation of somatostatin inhibitory effect on pancreatic exocrine function using secretin-enhanced dynamic magnetic resonance cholangiopancreatography: a crossover, randomized, double blind, placebo-controlled study.

OBJECTIVES: Somatostatin inhibitory effect on the exocrine pancreas has been demonstrated by clinical and experimental studies performed with invasive investigative methods. The aim of this study was to quantify the inhibitory effect of low doses of somatostatin (62.5, 125, and 250 microg) on secretin-stimulated pancreatic exocrine secretions using magnetic resonance cholangiopancreatography (MRCP). METHODS: Ten healthy volunteers underwent 4 MRCP at a 1-week interval. At each MRCP, 1 of the 3 doses of Somatostatin or the placebo was given by the intravenous route for a period of 40 minutes. After 20 minutes from the beginning of drug infusion, secretin was injected (0.3 CU/kg). MRCP was performed before and every 30 to 45 seconds for 15 minutes after secretin administration. Pancreatic exocrine secretions were quantified by the measurements of pancreatic flow output and total excreted volume, derived from a linear regression between MRCP calculated volumes and time. RESULTS: For the 3 doses of somatostatin, pancreatic flow output was significantly reduced compared to placebo (P < 0.05). Total excreted volume was significantly reduced only for the doses of 62.5 and 250 microg. No statistical significant differences were observed among the 3 doses. CONCLUSIONS: Low doses of somatostatin inhibit pancreatic exocrine secretions as demonstrated noninvasively with MRCP.

Adult↗
PubMed2005

Pineapple juice labeled with gadolinium: a convenient oral contrast for magnetic resonance cholangiopancreatography.

The aim of our study was to prepare in vitro a pineapple juice (PJ) solution labeled with a minimal gadolinium concentration working as a negative contrast agent in heavily T2-weighted imaging and to assess that solution in vivo as a negative oral contrast agent for magnetic resonance cholangiopancreatography (MRCP). Three PJs were compared in vitro according to their T2. Increasing concentrations of gadolinium (Gd)-DOTA in PJ were assessed in vitro for T2 reduction. Single-shot turbo spin echo T2-weighted MR cholangiopancreatograms were obtained for 35 patients with suspected biliopancreatic duct disease, before and after ingestion of the PJ/Gd-DOTA solution. Signal intensity (SI) measurements of gastroduodenal lumens, pancreatobiliary ducts, and image quality scores were obtained systematically before and after contrast ingestion. The in vitro selected Gd-DOTA concentration in the PJ was 2.76 mmol/l. Ingestion of 180 ml of PJ labeled with 1 ml of Gd-DOTA eliminated efficiently the gastroduodenal SI in MRCP, improving significantly the rates of complete visualization of the pancreatobiliary ducts (P<0.01) and the MRCP image quality scores (P<0.05). All patients easily ingested the contrast solution and found the solution palatable. PJ labeled with gadolinium constituted an efficient and convenient negative oral contrast agent for MRCP.

Administration, Oral↗
PubMed2005

Endoscopic therapy for main pancreatic-duct rupture after Silastic-ring vertical gastroplasty.

BACKGROUND: Acute pancreatitis with pancreatic-duct rupture and fluid collections is a rare complication after Silastic ring vertical gastroplasty. It can be attributed to pancreatic trauma occurring during surgery. METHODS: Endoscopic therapy with transmural drainage of collections was performed in 4 patients who had undergone Silastic ring vertical gastroplasty and who had presented with acute pancreatitis with main pancreatic-duct rupture at the body of the pancreas. OBSERVATIONS: All patients had successful transmural drainage with cystogastrostomy, followed by stent insertion. Only one patient had a late recurrence because of stent migration. The major difficulty was related to positioning of the endoscope and the possible need of pneumatic dilation of the outlet channel to reach the puncture site. CONCLUSIONS: Endoscopic therapy is useful in acute pancreatitis with pancreatic-duct rupture after Silastic-ring vertical gastroplasty and, although technically difficult, could be considered as a first-line approach in the management of these patients.

Adult↗
PubMed2005

MR cholangiography with manganese dipyridoxyl diphosphate in the evaluation of biliary-enteric anastomoses: preliminary experience.

OBJECTIVE: The purpose of our study was to assess the usefulness of manganese dipyridoxyl diphosphate (Mn-DPDP)-enhanced T1-weighted MR cholangiography for evaluating patients with biliary-enteric anastomoses. CONCLUSION: Mn-DPDP-enhanced T1-weighted MR cholangiography may provide useful functional information and may aid in the assessment of the patency of biliary-enteric anastomoses.

Adult↗
PubMed2004

Endoscopic management of pancreatic fistula after pancreatic and other abdominal surgery.

Post-operative pancreatic fistulae represent a challenge for all the actors in gastroenterology: for surgeons, because they want to prevent and treat conservatively this complication since re-operation is associated with high morbidity and mortality rates; for radiologists, because they have to provide the best staging and informations without any additional risk; and for endoscopists, because endoluminal treatment is emerging as a safe and effective procedure provided it is performed in highly experienced tertiary centres in the setting of a multidisciplinary approach. Herein, we review the definitions, the causes, the staging and the possible options to prevent or treat post-operative pancreatic fistulae. Special attention is paid to the endoscopic management of this complication: including the relief of ductal obstructions, the stenting of leakages and the drainage of bulging or non-bulging fluid collections. Practical problems and issues are clearly outlined as well as the need for future improvements in staging and management of the patients having such complications.

Cholangiopancreatography, Magnetic Resonance↗
PubMed2004

Endoscopic technique for the management of pancreatitis and its complications.

Therapeutic endoscopy is now increasingly used to treat gallstone pancreatitis, acute pancreatitis of other aetiologies, chronic pancreatitis and complications associated with acute or chronic pancreatitis. This chapter is a brief review of the endoscopic interventions currently performed in patients with acute or chronic pancreatitis. These interventions include biliary and pancreatic endoscopic sphincterotomy at the major or minor papilla, stricture dilatation on the common bile duct or main pancreatic duct, stent placement in the biliary or pancreatic ducts, stone extraction with or without extracorporeal shock wave lithotripsy, and transmural or transpapillary drainage of pancreatic fluid collections. As most of the studies reported were uncontrolled and retrospective, uncertainties persist with regard to the best approaches for treating the patients concerned. Appropriate patient selection, adequate expertise, and a supporting multidisciplinary infrastructure are essential prerequisites of a high success rate in improving the clinical condition of these patients.

Acute Disease↗
PubMed2004

Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis.

BACKGROUND & AIMS: This study aimed to compare the accuracy of magnetic resonance imaging (MRI) with computed tomography (CT) in assessing acute pancreatitis (AP) and to explore the correlation between MRI findings and clinical outcome. METHODS: Patients with AP were investigated by contrast-enhanced CT and MRI on admission and 7 and 30 days thereafter. MRI was performed with intravenous secretin and contrast medium. Balthazar's grading system was used to measure CT and MRI severity indices (CTSI and MRSI, respectively). RESULTS: Thirty-nine patients (median age, 47 years; range, 15-86) were studied. AP was of biliary etiology in 19 patients (49%). On admission, AP was assessed clinically as severe in 7 patients (18%). A strong correlation was demonstrated between CTSI and MRSI on admission and 7 days later. MRSI on admission correlated with the following: the Ranson score, C-reactive protein levels 48 hours after admission, duration of hospitalization, and clinical outcome regarding morbidity, including local and systemic complications. Considering the Ranson score as the gold standard, MRI detected severe AP with 83% (58-96, 95% CI) sensitivity, 91% (68-98) specificity vs. 78% (52-93) and 86% (63-96) for CT. Magnetic resonance cholangiopancreatography after i.v. secretin injection showed pancreatic duct leakage in 3 patients (8%). CONCLUSIONS: MRI is a reliable method of staging AP severity, has predictive value for the prognosis of the disease, and has fewer contraindications than CT. It can also detect pancreatic duct disruption, which may occur early in the course of AP.

Acute Disease↗
PubMed2004

Treatment of osteonecrosis of the femoral head with implantation of autologous bone-marrow cells. A pilot study.

BACKGROUND: Aseptic nontraumatic osteonecrosis of the femoral head is a disorder that can lead to femoral head collapse and the need for total hip replacement. Since osteonecrosis may be a disease of mesenchymal cells or bone cells, the possibility has been raised that bone marrow containing osteogenic precursors implanted into a necrotic lesion of the femoral head may be of benefit in the treatment of this condition. For this reason, we studied the implantation of autologous bone-marrow mononuclear cells in a necrotic lesion of the femoral head to determine the effect on the clinical symptoms and the stage and volume of osteonecrosis. METHODS: We studied thirteen patients (eighteen hips) with stage-I or II osteonecrosis of the femoral head, according to the system of the Association Research Circulation Osseous. The hips were allocated to a program of either core decompression (the control group) or core decompression and implantation of autologous bone-marrow mononuclear cells (the bone-marrow-graft group). Both patients and assessors were blind with respect to treatment-group assignment. The primary outcomes studied were safety, clinical symptoms, and disease progression. RESULTS: After twenty-four months, there was a significant reduction in pain (p = 0.021) and in joint symptoms measured with the Lequesne index (p = 0.001) and the WOMAC index (p = 0.013) within the bone-marrow-graft group. At twenty-four months, five of the eight hips in the control group had deteriorated to stage III, whereas only one of the ten hips in the bone-marrow-graft group had progressed to this stage. Survival analysis showed a significant difference in the time to collapse between the two groups (p = 0.016). Implantation of bone-marrow mononuclear cells was associated with only minor side effects. CONCLUSIONS: Implantation of autologous bone-marrow mononuclear cells appears to be a safe and effective treatment for early stages of osteonecrosis of the femoral head. Although the findings of this study are promising, their interpretation is limited because of the small number of patients and the short duration of follow-up. Further study is needed to confirm the results.

Adult↗
PubMed2004

Magnetic resonance imaging of acute pancreatitis: the pancreatogram.

CONTEXT: Acute pancreatitis has been reported in many cases after therapeutic ERCP. CASE REPORT: We report the case of a 65 year man old who, after ERCP, manifested biologically acute pancreatitis. The patient was observed using dynamic MR pancreatography with secretin administration before and after the ERCP. The dynamic MR pancreatography prominently displays a radiological sign of early chronic pancreatitis: the pancreatogram. CONCLUSION: Our case demonstrates a new sign of biologically acute pancreatitis in dynamic MR pancreatography: the pancreatogram.

Acute Disease↗
PubMed2003

Implications of SENSE MR in routine clinical practice.

Sensitivity encoding (SENSE) uses multiple MRI receive coil elements to encode spatial information in addition to traditional gradient encoding. Requiring less gradient encodings translates into shorter scan times, which is extremely beneficial in many clinical applications. SENSE is available to routine diagnostic imaging for the past 2 years. This paper highlights the use of SENSE with scan time reduction factors up to 6 in contrast-enhanced MRA, routine abdominal imaging, mammography, cardiac and neuro imaging. It is shown that SENSE has opened new horizons in both routine and advanced MR imaging.

Contrast Media↗
PubMed2003

Endoscopic management of chronic pancreatitis.

Endoscopic management of CP is generally safe, minimally invasive, and often effective for years, does not hinder further surgery, and can be repeated. It should be applied as a first-line approach to improving the clinical condition of patients with this chronic disease. The best results are obtained when endoscopic treatment is performed early in the course of CP. Proper patient selection, adequate expertise, and a supporting multidisciplinary infrastructure are essential. New technologies will continue to be developed and to extend the scope of therapeutic pancreatic endoscopy.

Algorithms↗
PubMed2002

Endoscopic cystenterostomy of nonbulging pancreatic fluid collections.

BACKGROUND: A prerequisite for endoscopic drainage of pancreatic fluid collections without EUS is the presence of a visible bulge in the GI wall. Our experience with endoscopic cystostomy of nonbulging pancreatic fluid collections is described. METHODS: Thirty-three patients underwent 34 endoscopic attempts at transmural drainage of nonbulging pancreatic fluid collections over a 2-year period. The etiology of the nonbulging pancreatic fluid collections was chronic pancreatitis in 26 cases and acute pancreatitis in 7. Indications for drainage included one or more of the following: abdominal pain, infection, biliary obstruction, and external fistula. The diameter of the collections ranged from 20 to 160 mm (median 52 mm). RESULTS: Thirty-two of 34 drainage attempts were successful (94%). Eighteen cystostomies were performed under fluoroscopy alone and 14 by EUS together with fluoroscopy. Procedure-related complications occurred with 3 of 34 attempts (8%). Surgery was not required for treatment of the complications and there were no deaths from the procedure. Follow-up was available for 31 patients (median 21 months, range 9 to 40 months). One nonbulging pancreatic fluid collections recurred 7 months after drainage. CONCLUSIONS: Endoscopic cystenterostomy of nonbulging pancreatic collections is feasible, and the results of the procedure are similar to those of cystenterostomy for bulging collections.

Acute Disease↗
PubMed2002

MR urography in children.

Thanks to the development of rapid sequences with better resolution, applications of uro MR have rapidly increased in children. Difficulties that remain are related to the variable ages of the patients. It is therefore mandatory to standardize as much as possible the techniques that are used in order to obtain reproducible results. In this review, the examination protocols will be explained. In a second part the current applications in children will be illustrated and discussed, especially in comparison with the other imaging techniques.

Child↗
PubMed2002

EUS-guided pancreaticogastrostomy.

BACKGROUND: The pain of chronic pancreatitis can be caused by pancreatic ductal hypertension, and endoscopic drainage of the main pancreatic duct can provide relief. When transpapillary access to a dilated portion of the main duct cannot be obtained, conventional endoscopic drainage is not possible. The use of interventional EUS to perform a pancreaticogastrostomy in such cases is described. METHODS: Four patients presented with pain and a dilated main pancreatic duct proximal to a complete obstruction. EUS was used to access the dilated duct and create a pancreaticogastrostomy. Patency of the latter was maintained by placement of a pancreaticogastric stent. OBSERVATIONS: EUS-guided pancreaticogastrostomy was performed without major complication. Three of 4 patients had satisfactory relief of pain at a median follow-up of 1 year. CONCLUSION: EUS-guided pancreaticogastrostomy may be a promising new technique for pancreatic drainage and pain relief when conventional transpapillary access to the pancreatic duct is not possible.

Adult↗
PubMedDate not supplied

MR imaging of the pancreas: a pictorial tour.

Magnetic resonance (MR) imaging of the pancreas has undergone a major change because of its capability of providing noninvasive images of the pancreatic ducts, cross-sectional images of the parenchyma analogous to computed tomography (CT) images, and angiographic depiction of blood vessels. Recent technical issues include the use of half-Fourier T2-weighted pulse sequences and the administration of secretin for MR cholangiopancreatography (MRCP). Secretin improves pancreatic duct and side-branch delineation and the detection of anatomic variants such as pancreas divisum. It allows monitoring of pancreatic flow dynamics and evaluation of pancreatic exocrine function. Although contrast material--enhanced CT is still considered the standard of reference in severe acute pancreatitis and for the detection of calcifications in chronic pancreatitis, in patients referred for suspicion of pancreatic disease or with recurrent acute pancreatitis, MR imaging and secretin-enhanced MRCP are useful after unenhanced CT suggests the cause of disease. In advanced inflammatory disease, MR imaging and secretin-enhanced MRCP are useful for planning surgery or therapeutic endoscopy and for follow-up studies after therapy. MR imaging in combination with secretin-enhanced MRCP and MR angiography is useful in identifying pancreatic malignancies and in establishing resectability.

Cholangiopancreatography, Endoscopic Retrograde↗