PubMed Health⌕ Search

Biomedical subjects

D Revel

Publications and source records attributed to D Revel.

At least 91 records · Page 5Linked to original sources
PubMed1990

Pulmonary lymphangiomyomatosis and tuberous sclerosis: comparison of radiographic and thin-section CT findings.

Chest radiographs, thin-section computed tomographic (CT) scans, and results of pulmonary function tests in nine women with pulmonary lymphangiomyomatosis and two women with pulmonary tuberous sclerosis were retrospectively evaluated. In all patients, CT demonstrated thin-walled cysts less than 20 mm in diameter scattered at random in all parts of the lungs. In eight patients, cysts larger than 20 mm in diameter were also present. Lung tissue between cysts appeared normal in all 11 patients, except one with septal lines and dependent alveolar areas of attenuation. CT showed cysts in three patients whose radiographs were normal, and it demonstrated that many lesions that appeared reticular on plain radiographs were actually cysts. CT findings correlated better with the diffusion capacity of the lungs for carbon monoxide than did the plain radiographic findings. CT was more sensitive and more precise than radiography at showing the presence and morphology of lung abnormalities.

Adult↗
PubMed1990

Reliability of phlebography in the assessment of venous thrombosis in a clinical trial.

In the frame of a multicenter controlled study comparing the efficacy of low-molecular-weight heparin to standard heparin in the prevention of postsurgical thrombosis, 94 phlebograms were centrally evaluated by two independent radiologists. Three months after the first central evaluation, a new reading was performed with the same radiologists, and discrepancies were adjudicated by a senior radiologist. The number of discrepancies between the first and the second evaluation was high: 33 interpretations (35%) had a least one difference, including 14 (14.9%) discrepancies regarding the main issue, i.e. the presence of venous thrombosis. After the adjudication by the senior radiologist, this number decreased but was still large: 22 films (23.4%) with at least one discrepant item in all and 11 related to the presence of venous thrombosis. This report shows that venous thrombosis assessed by phlebography, which is usually considered as a golden standard in clinical trials, deserves a thorough quality control procedure.

Double-Blind Method↗
PubMed1990

[Perforation of a loop of the small intestine by a Kim-Ray Greenfield endocaval filter. Report of a case].

Kim-Ray filter complications are usually benign, such as angulation or slight migration. We report and compare with the literature one case of vena cava perforation associated with a small bowel lesion. The follow-up with regular abdominal plain X-rays allows detection of filter angulation, the first step before vena cava perforation. Cavography or CT scan depicts this perforation. Complete or partial surgical removal of the filter may be necessary.

Adult↗
PubMed1990

[Surgical treatment of aortic dissection. Value of echocardiography and MRI for long-term follow-up].

Twenty-five patients aged 31 to 74 years (average 50 years) operated for type A aortic dissection (type I: 19 cases, type II: 6 cases) were included in this study. Surgical repair only concerned lesions of the ascending aorta. The hospital mortality was 20 per cent (5 cases), and usually secondary to extension of the dissection. With the exception of 2 late deaths, all patients were followed up for an average of 3.5 years. A late assessment including nuclear magnetic resonance imaging of the thoracic aorta was obtained in 17 of the 18 survivors. These investigations confirmed the good result of repair of the ascending aorta, the uselessness of systematic aortic valve replacement and the palliative nature of repair of type I dissection as 80 per cent of patients had a persistent patent false lumen in the distal aorta.

Adult↗
PubMed1990

[Alveolar proteinosis. Prolonged favorable course after total pulmonary lavage].

We report the outcome in a case of alveolar proteinosis diagnosed histologically in a 43 year old female. The increase in dyspnoea and the deterioration in the pulmonary function tests have lead to the realisation that a total pulmonary lavage was required under general anaesthesia. This was performed in two stages. A biochemical analysis of the lavage liquid showed an accumulation of phospholipids, proteins, and LDH. A subjective improvement was obtained in a few weeks followed by a slow radiological improvement as well as on CT scanning, and in respiratory function. Radiological and blood gas improvement was noted 19 months after total bilateral pulmonary lavage. Broncho-alveolar lavage is thus able to induce long-term improvement in pulmonary alveolar proteinosis.

Adult↗
PubMed1989

Bone marrow metastases in small cell lung cancer: detection with magnetic resonance imaging and monoclonal antibodies.

The detection of bone marrow involvement might be of prognostic value and may influence therapeutic decisions in small cell lung cancer. By unilateral bone marrow aspiration and biopsy, evidence of bone marrow metastases is seen in 15-30% of patients with this disease. Since magnetic resonance imaging of the lower body and immunostaining with monoclonal antibodies have recently been shown to be very sensitive detection methods, we investigated the value of these two techniques in detecting bone marrow involvement in 35 consecutive patients with small cell lung cancer. The results were compared to those obtained with conventional cytohistological analysis. In all cases when cytology and/or bone marrow biopsy were positive, monoclonal antibodies immunostaining and magnetic resonance imaging also detected malignant cells. Furthermore, evidence of bone marrow involvement was shown with magnetic resonance imaging and/or immunostaining in 10 of 26 cases (38%) where routine procedures were unable to detect malignant cells. In one of these 26 patients, magnetic resonance imaging and immunostaining provided the only evidence of metastatic disease. These data suggest that the rate of bone marrow metastases is underestimated by routine procedures. Further investigation is needed to determine whether or not these new non-invasive methods have prognostic value or affect therapeutic choices in small cell lung carcinoma.

Antibodies, Monoclonal↗
PubMed1989

[Automatic quantitative analysis of vascular stenosis. Experimental study of a digital angiography system applied to cardiology].

The purpose of this study was to test the measurement reliability of the automatic stenosis quantitation program present in a digital angiography system (DG 300 General Electric CGR SA). The experimental study was performed on models mimicking circular, elliptic and irregular stenoses; it made it possible to measure the percentage of stenosis by geometric and densitometric methods. The parameters studied were the size and shape of the stenoses, the contrast medium concentration, the positioning of the stenosis in relation to the image intensifier, the number of Kvp and the angle of projection of X-ray beams in the case of elliptic and irregular stenoses. The results showed a perfect linear correlation between the thickness traversed by the X-ray beams and the value in grey level at the output of the optico-radiological chain (r between 0.987 and 0.997, p less than 0.001), using different Kvp (65 Kvp, 85 Kvp, 90 Kvp) and different X-ray doses (1 milliRoentgen and 80 microRoentgen). With all concentrations of contrast medium (320 mg I/ml to 5 mg I/ml), the values of the circular stenoses measured were very close to real values (75 p. 100) for vessels of all diameters, except those of 1.5 mm in a 22 cm field. When 16 cm and 11 cm fields were used, the results were very close to the 75 p. 100 real value (3 to 4 p. 100 of relative error), even with the 1.5 mm diameter. The values of elliptic stenoses measured by densitometry were very close to real values (1 to 4 p. 100 of relative error) with contrast medium concentrations ranging from 320 mg I/ml to 20 mg I/ml) and with three angles of projection (0 degrees, 30 degrees, 60 degrees). In contrast, the geometric method gave very different results with the three angles of projection. In the case of irregular stenosis (17 percentages of stenosis ranging from 26.2 p. 100 to 77.1 p. 100) the real values correlated very well with the estimated values (r = 0.999, p less than 0.0001). Some of the results were compared with those obtained with a digital cineradiology system (Pie Data) and were found to be equivalent.

Angiography↗
PubMed1989

[Pediatric angiocardiography. Randomized, controlled study of 2 iodinated contrast media: iopromide 300 and ioxaglate 320 mgI/ml].

Thirty-one children were included in a prospective randomized trial comparing a new non-ionic contrast medium, iopromide 300 and the ionic low osmolar contrast medium, ioxaglate 320 mgI/ml in pediatric cardiac catheterisation. There were fewer adverse effects with iopromide but no statistically significant difference was demonstrated in this small population, with a very low incidence of allergoïd reactions; this tendency was confirmed by meta-analysis of the multicentre study.

Angiocardiography↗
PubMed1989

[Specific and non-specific contrast media for MRI of tumors. Experimental study of human breast carcinoma].

MRI has been shown as an adapted non-invasive modality for the detection of tumours in humans. The development of paramagnetic contrast agents could add to the MRI diagnosis. With an experimental model of human breast (MX-1) carcinoma developed in nude mice, two different classes of contrast medium were tested. The first class includes the well-known Gd-DTPA and a new nitroxide compound on going development, representing non specific contrast agents. The specific contrast agents are represented by a metalloporphyrin Mn-TPPS4. Non specific contrast agents can add to the differentiation between well vascularized viable tissue and necrotic areas of tumors. While specific contrast agents may specifically target tumorous tissue.

Animals↗
PubMed1989

[Rapidly developing benign teratoma of the mediastinum in the adult].

Benign mediastinal teratomas are rare entities, representing 8 to 18% of all mediastinal tumors. Two cases of benign teratomas with a rapid growth suggesting malignancy are reported. CT and MR allowed precise characterization of the multi-tissue composition of the tumor (various CT densities were noted corresponding to adipose, cystic, calcified and hemorrhagic components), and definition of the extension of the process before surgical removal. The per-operative pathological analysis in one patient confirmed the benign nature of the lesion based on the absence of immature tissue, allowing complete surgical removal. The final pathological examination showing mucus secretion by bronchial glandular tissue and intra-tumoral hemorrhage may explain the rapid growth of this kind of lesion. The post-operative follow-up of these benign teratomas is favourable.

Adult↗
PubMed1988

Canine acute myocardial infarction. In vivo detection by MRI with gradient echo technique and contribution of Gd-DOTA.

This experimental study was designed to evaluate the sensitivity of MRI in the detection of acute myocardial infarction, determine the utility of fast gradient-echo (GE) imaging and study possible improvements in diagnostic efficacy using a paramagnetic contrast agent (gadolinium-DOTA). Myocardial infarcts were induced in 11 dogs by semidistal embolization and imaged using spin-echo and/or GE pulse sequences, short TRs (250 to 450 ms) and cardiac gating. After the dogs died, the heart was imaged under the same conditions as in vivo. Blind comparisons between precontrast, postcontrast (0.1 mM/kg and 0.5 mM/kg), postmortem images and anatomic findings (triphenyl-tetrazolium-chloride staining) were recorded. This study shows that infarcted areas can be detected on plain MRI images in the form of a hypersignal, probably attributable to increased proton density, with better efficiency of GE compared with spin-echo imaging; injection of gadolinium-DOTA allows better delineation of infarcted areas, especially for 10 minutes after administration.

Animals↗
PubMed1988

[The concept of critical arterial stenosis: value of a model of measures obtained by an angiographic method and the Doppler technic before and after transluminal angioplasty of the iliac arteries].

INTRODUCTION: Numerous studies in the literature have proven the fact that a critical size appears during the stenosis evolution. The work presented is a non invasive approach of this value, with correlation to the invasive results. The study was realized on a homogeneous group of 23 arteriopathic patients, selected for iliac artery angioplasty procedure. MATERIAL AND METHODS: Patients selection: twenty-three patients including 24 angioplasty procedures have been selected on a 21 month time study. Invasive data: two measurements are realized during angioplasty: trans-stenotic pressure gradient before and after angioplasty. stenosis calibration: both diameter and section have been calculated on radiological films. Non invasive data: a standard Doppler test is performed on lower limbs. Two parameters are compared with the invasive data: the ascending time of velocity curve at the common femoral level. the systolic pressure index (peripheral pressure/radial pressure). RESULTS: 1) Critical stenosis--invasive techniques (fig. 1): trans-stenotic pressure gradient versus stenotic measurements shaw an hyperbolic correlation. The critical stenotic level is found to be 60% in diameter and 80% in section. 2) Critical stenosis--non invasive techniques: stenotic measurements compared to ascending time (fig. 2) as well as pressure index at rest (fig. 3) shaw the same type of curve. The critical stenotic level is found to be the same than with invasive techniques. DISCUSSION: Some discordant results open the discussion about angioplasty as a "gold standard", specially with a geometrical analysis. Bad precision in non regular stenosis. Hemodynamic consequences of turbulent stenosis are not evaluated. Clinical interest of critical stenotic notion is underlined.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Radiologic diagnosis of early complications following kidney transplantation].

Postoperative complications after renal transplantation, such as hematomas, abscesses, urinomas, lymphoceles and obstruction of the ureter, can be diagnosed by means of sonography. Early vascular complications, such as venous thrombosis and arterial occlusion or stenosis, can be recognized by duplex sonography and accurately depicted by angiography to allow planning of surgical intervention. Stenosis of the renal artery is amenable to treatment by percutaneous angioplasty. Parenchymatous complications (acute tubular necrosis, acute rejection, cyclosporin-A-toxicity) can cause changes in the intrarenal flow patterns at duplex sonography, but this examination does not allow accurate diagnosis and differentiation of these changes. Magnetic resonance imaging is a very promising method for the differential diagnosis of parenchymatous complications.

Humans↗
PubMed1988

[New imaging technics in dissection of the thoracic aorta].

The multiplicity of imaging for investigation of the thoracic aorta requires that the physician choose a strategy adapted to the disorder involved: this is the case, for example with dissection of the aorta. A critical study of the new methods available which include digital angiography; echocardiography; CT scan; magnetic resonance imaging (MRI), should be compared to "the" reference technique of conventional methods: aortography and two-dimensional cineangiography. In addition, the decision must take into account specific characteristics of the disorder: natural history of the disease and anatomopathological form which are useful for the surgeon in case surgery is decided upon. The strategy proposed remains faithful to two-dimensional cineangiography during the first 72 hours of acute dissection because this disorder is a true surgical emergency at this stage if the ascending aorta is involved. Later, or if the ascending aorta does not appear to be involved, MRI has now proven this efficacy as a first-line diagnostic procedure. The judiciousness of preoperative aortography is still the subject of debate.

Aortic Dissection↗