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D Régent

Publications and source records attributed to D Régent.

At least 37 records · Page 2Linked to original sources

[Imaging of the intrahepatic biliary tree with thick slice MR cholangiography].

PURPOSE: To assess the value of single shot fast spin echo MR sequence (SS-FSE) in the evaluation of the normal and pathologic intrahepatic biliary tree. MATERIAL AND METHODS: 418 consecutive patients (457 examinations) referred for clinical and/or biological suspicion of biliary obstruction underwent MR cholangiopancreatography (MRCP). All patients were imaged with a Signa 1.5 T GE MR unit, with High Gradient Field Strength and Torso Phased Array Coil. Biliary ducts were imaged with SS-FSE sequence, coronal and oblique coronal 20 mm thick slices on a 256 x 256 matrix. Total acquisition time was 1 second. Source images were reviewed by two radiologists blinded to clinical information. In case of disagreement, a third radiologist's opinion was requested. In all cases, MRCP results were compared with direct biliary tract evaluation, other imaging studies and clinical and biological follow-up. RESULTS: In all cases, MRCP produced high quality images. Numerous branch of division were observed although the peripheral intrahepatic ducts were well seen in more than 90% in an area 2 cm below the capsule. The number of division was statistically higher when mechanical obstruction was present. Intrahepatic calculi or peripheral cholangiocarcinoma were well detect by MRCP. For the detection of cholangitis, MRCP sensitivity was 87.5% but the positive predictive value was only 57.7% because of a high number of false positive. The diagnosis of primary sclerosing cholangitis must be made only on strict criteria and slightly dilated peripheral bile ducts unconnected to the central ducts in several hepatic segments were a characteristic MR sign of primary sclerosing cholangitis. CONCLUSION: MRCP can be proposed as a first intention imaging technique for the evaluation of intrahepatic ducts.

Adolescent↗

[Imaging of intraductal papillary mucinous tumor of the pancreas: literature review].

Intraductal papillary-mucinous tumor (IPMT) is defined as a syndrome consisting of dilatation of the main pancreatic duct and/or branch ducts associated with mucin overproduction. The purpose was to evaluate the usefulness of different imaging techniques (CT, EUS, ERCP) for determination of tumor invasion and pancreatic extension. Diagnosis often is delayed because it is confused with chronic pancreatitis or cystic neoplasms of the pancreas. It is difficult to rule out invasive malignancy. MRCP can be an essential imaging modality because it is a non-invasive technique. Intraductal ultrasound or pancreatoscopy could become in the future an additional useful preoperative procedure. A high frequency of invasive carcinoma in patients operated for pancreatic IPMT is observed. Surgical resection should be extended until a normal tissue margin is encountered.

Adenocarcinoma, Mucinous↗

[Bladder candidosis after renal transplantation: contribution of ultrasonography].

Candidosis of the ureter and the bladder is an infrequent complication after renal transplantation. A case occurring early after kidney transplantation is reported in a patient presenting with candiduria. Ultrasound examination detected several fungal bezoars, presenting as a proliferating, avascular lesions, located within the ureter and the bladder. It allowed to demonstrate the rapid extension of lesions, in spite of a medical treatment, leading to a successful endoscopic removal of fungus balls.

Aged↗

[Quid?].

Explore the source record for details and available documents.

Adult↗

[Computed tomography study of the sigmoid colon: discriminating diagnostic criteria and interobserver correlations].

PURPOSE: To assess the value of pericolonic findings at CT in the evaluation of the sigmoid colon. MATERIALS AND METHODS: A total of 210 CT examinations were retrospectively reviewed by 3 blinded radiologists. Data was analyzed to determine the interobserver correlation and the value of pericolonic and colonic wall findings in diagnosis of sigmoid colon pathology. RESULTS: The interobserver correlation for pericolonic findings was equal to or superior to that for colonic wall findings. The presence of abnormal pericolonic fat was the most sensitive (88%) and specific (93%) sign to differentiate a diseased sigmoid colon from a normal one or from sigmoid diverticulosis. Wall-thickening was less sensitive (82%) and specific (76%). Findings suggesting malignancy over diverticulitis included acute zone of transition, focal fatty infiltration, and lymph nodes. Symmetrical and circumferential wall thickening, target-like enhancement, and local fatty proliferation were findings suggesting colitis over diverticulitis. Wall thickening more than 15 mm, involvement of 15 cm or less, asymmetrical involvement, acute zone of transition, and homogeneous or heterogeneous enhancement were findings suggesting malignancy over colitis. CONCLUSION: To render a diagnosis, the evaluation of the fat infiltration must prevail on the parietal thickening appreciation.

Adipose Tissue↗

[Single shot fast spin echo sequence MRI cholangiopancreatography].

PURPOSE: To assess the value of single shot fast spin echo MR sequence (SS-FSE) in the morphological analysis of the biliary tree and pancreatic ducts and to compare its accuracy with other imaging methods. MATERIAL AND METHODS: 95 consecutive patients referred for clinical and/or biological suspicion of biliary obstruction were explored with MR cholangiopancreatography (MRCP). All patients were explored with a Signa 1.5 T GE MR unit, with High Gradient Field Strength and Torso Phased Array Coil. Biliary ducts were explored with SS-FSE sequence, coronal and oblique coronal 20 mm thick slices on a 256 x 256 matrix. Total acquisition time was 1 second. Native pictures were reviewed by two radiologists blinded to clinical information. In case of disagreement, a third radiologist's judgement was requested. In 88 cases, MRCP results were compared with direct biligraphy methods. RESULTS: In all cases, MRCP produced high quality images without MIP or other post-processing methods. For detection of biliary tree distensions, the concordance value of MRCP was over 91% (Kappa 0.82). For detection of biliary tree and/or pancreatic duct obstruction, MR sensitivity was 100% and specificity 91%. The overall diagnostic concordance value of MRCP was > or = 93%. Difficulties in MRCP were caused by functional diseases or benign stenosis. MRCP accurately diagnosed all lithiasic obstructions starting from a stone size of 3 mm. CONCLUSION: MRCP produces fastly high-quality images. As it is totally safe, it can be proposed as a first intention method in biliopancreatic duct explorations.

Adolescent↗

[Comparative value of MR-angiography, helical CT and digital angiography in the preoperative assessment of abdominal aortic aneurysms].

PURPOSE: To compare helical CT with MR angiography in pre-operative assessment of abdominal aortic aneurysm (AAA). MATERIAL AND METHODS: Twenty patients with AAA underwent helical-CT, MR-angiography and digital angiography. All exams were interpreted independently by two groups of observers. Kappa and rho were calculated to assess correlations. Sensitivity and specificity were calculated to compare each method with the "gold standard" digital angiography. RESULTS: Inter-observer correlation was excellent. There was a very good agreement between both methods in the assessment of the maximal diameter and the proximal neck of the aneurysm. There was no significant difference in the assessment of stenoses of the visceral and iliac arteries, the number of renal arteries, and iliac extension. CONCLUSION: Helical CT and MR angiography are equivalent in pre-operative assessment of AAA.

Aged↗

[The role of percutaneous drainage in acute calculous cholecystitis. Apropos of 27 cases].

Surgery is the treatment of acute calculous cholecystitis. Mortality and morbidity are considerable for patients with anesthetic risk factors. In this context, ultrasound-guided percutaneous drainage seems to be a alternative to urgent surgery. The place of this technic and its results have not been determined with certainty. We report our experience of percutaneous drainage in acute calculous cholecystitis, based on a series of 27 patients treated between May 1992 and May 1996. A favorable course was observed after drainage in 26 patients, one patient was operated urgently for purulent peritonitis on D1. One drain migrated into the gallbladder and required cholecystenterostomy en D30. Seventeen patients underwent cholecystectomy after the acute episode. Surgery was contra-indicated in light patients: two presented recurrence of acute calculous cholecystitis and six remained asymptomatic. The aim of this study was to define the place of this technic in the treatment of acute calculous cholecystitis, and estimate the results in terms of mortality, morbidity and recurrence.

Acute Disease↗

[Which is the best performing imaging method for demonstrating residual renal calculi?].

OBJECTIVES: To compare the results of plain abdominal films, tomography, ultrasonography and spiral computed tomography in the detection of residual stone fragments after extracorporeal lithotripsy or percutaneous nephrolithotomy. MATERIAL AND METHODS: Prospective study on 31 patients and 40 renal units comparing the results obtained by plain abdominal films, tomography, ultrasonography and spiral CT. RESULTS: This study demonstrates the superiority of spiral CT over the other examinations for detection of renal stones (sensitivity of 100% for spiral CT, 89.2% for tomography, 82.1% for plain abdominal films and 67.8% for ultrasonography), determination of their number (n = 68, 58, 60 and 27, respectively) and demonstration of millimetric stones (100%, 69.4%, 67.8% and 2.7%, respectively). CONCLUSION: Spiral CT is the method of renal stone imaging which provides the most reliable diagnosis of radiopaque, non radiopaque, millimetric or centimetric stones, regardless of local anatomical conditions.

Adult↗

[Diagnostic imaging of idiopathic segmental infarct of the greater omentum. Diagnostic and physiopathologic considerations].

Primary infarction of the greater omentum is a rare cause of acute abdominal syndrome. Rate of occurrence may nevertheless be underestimated. We report a series of six cases observed over a 30-month period with US and CT imaging. We assessed early signs and their course. CT-scans depicted fatty oval-shaped masses below the right anterior or anterolateral parietal wall, associated with a thickening of the anterior parietal peritoneum, explaining symptom pathogenesis. Torsion can be identified, but has no specific impact on prognosis. Follow-up CT scan may evidence spontaneous, but sometimes slow, resolution.

Abdomen, Acute↗

[Radiologic aspects of infarction of the appendix epiploica].

Clinical, US, CT and MR findings were reviewed in 5 patients with primary epiploic appendagitis (3 men, 2 women, mean age 38 years, age range 29-62 years) seen between December 1994 and December 1997. Diagnosis was reached in all cases with CT, with US in 3 and with MR in 1. Follow-up CT was performed in 2 cases and clinical follow-up in 4. One patient underwent surgery. Initial US, CT or MR examinations revealed a fatty oval-shaped nodule located anteriorly or anterolaterally to the left colon. The greater diameter ranged from 20 to 30 mm. Perinodular lesions with strands of periappendicular fat and thickened parietal peritoneum were visualized in all cases without any other inflammatory process in the abdomen. Symptoms resolved within 4 days in all patients. Signs of fatty inflammatory processes resolved in the 2 patients who had follow-up CTs. Primary epiploic appendagitis has characteristic US, CT and MR features which help guide medical treatment.

Adipose Tissue↗

[Drug-induced stenosis of the small bowel. Value of enteroclysis].

The purpose of this study is to characterize radiographically drug-induced ulcerated stenosis of the small bowel and to determine the contribution of enteroclysis in the diagnosis of this rare entity. The clinical pathologic and radiographic findings of 12 patients with drug-induced stenosis (non steroidal anti-inflammatory drugs or potassium salts) evaluated by enteroclysis were reviewed. Three radiological features of strictures were differentiated: diaphragm like stricture, short stricture and stenotic ulceration with girdle aspect. All formulation of NSAIDS and potassium salts are capable of causing the same radiographic and pathologic patterns. Enteroclysis improves the detection of these lesions since intestinal overdistension and correct filling of the loops increase the visualization of small obstructive stenosis and the detection of superficial ulcers. Thus, any patient who has an abnormality of the small bowel should be asked about use of drugs, especially when diaphragm-like strictures are found.

Aged↗

[Imaging of osteoarticular diseases of the anterior chest wall].

The purpose of this paper is to present a pictorial display of osseous and articular lesions of the anterior chest wall. The role of CT and MR imaging in such disorders is emphasized. Imaging of the anterior thoracic wall by plain films is particularly difficult. However numerous disorders may be encountered. They include inflammatory hyperostosis and sclerosis of the clavicle and the sternum, condensing osteitis and post-traumatic osteolysis of the clavicle, radiation osteitis of the sternum and the ribs, septic arthritis of the sternoclavicular joint, primary and secondary tumors of the sternum and the ribs. We illustrate a spectrum of such lesions in which CT and MR imaging provides acute evaluation of both soft tissue and bone details.

Clavicle↗