PubMed Health⌕ Search

Biomedical subjects

D Vanbeckevoort

Publications and source records attributed to D Vanbeckevoort.

At least 19 recordsLinked to original sources
PubMed2006

Ovarian torsion in a premenarcheal girl: MRI findings.

Adnexal torsion is an uncommon cause of severe lower abdominal pain in women and is often difficult to distinguish from other acute abdominal conditions. However, adnexal torsion should be considered in premenarcheal girls admitted with acute abdominal pain and evidence of an ovarian mass. Accurate and early radiological diagnosis is mandatory immediately after onset of clinical symptoms in order to preserve the viability of the ovary. Ultrasound (US) is usually the first line examination performed in an emergency setting, but computed tomography (CT) and magnetic resonance imaging (MRI) can be useful in case of ambiguous US findings, especially in patients with sub-acute symptoms and a suspected adnexal mass. This case report describes the additional value of MRI in a premenarcheal girl with sub-acute right fossa pain.

Abdomen, Acute↗
PubMed2005

Actinomycosis, a rare and unsuspected cause of anal fistulous abscess: report of three cases and review of the literature.

Primary perianal actinomycosis is rare. Sporadic cases, with lesions varying in extent have been reported. The infection is caused by the bacterium Actinomyces, which often is a saprophyte. Male gender and diabetes are risk factors, but the exact pathogenic mechanism remains speculative. The diagnosis is a challenge and often delayed, with a protracted history of masses and sinuses extending into the gluteal and genital region. The treatment, a combination of surgery and antibiotics, is poorly standardized. We report three cases and compare their characteristics to those of published cases, found by a computerized literature search (1968-2002). The lesions, a simple fistula-in-ano or a mass, were diagnosed in an early stage in all three patients. The infection always spread into the scrotum. There were no risk factors other than gender, except in one patient. The diagnosis was suspected by the observation of draining sulfur granules and promptly confirmed by histology in the three cases. All patients healed with antibiotics in addition to simple surgical procedures. Treatment consisted of amoxicillin for two weeks in two cases and more extended antimicrobial treatment in the third. These findings are contrasting with the classic picture of perianal actinomycosis. It is concluded that perianal actinomycosis can occur in the absence of risk factors and that early diagnosis requires a high degree of suspicion. An infection with Actinomyces should be suspected in the presence of lesions containing watery purulent material with sulfur granules. The indication for extended antibiotherapy combined with sphincter damaging surgery may need to be revised in the presence of early detection.

Abscess↗
PubMed2004

Transcatheter management of hepatic artery pseudoaneurysm following pancreaticoduodenectomy: a report of three cases.

Pseudoaneurysm formation is a rare, but potentially life threatening delayed complication of major pancreatic surgery. Redo surgery several weeks after pancreaticoduodenectomy can be hazardous, especially in debilitated patients. Percutaneous, transcatheter exclusion of the pseudoaneurysm by means of embolic coils can be an efficient, safe and minimally invasive alternative to open surgery with good mid- and long-term results. We present our experience in Three patients undergoing transcatheter embolization of hepatic artery pseudoaneurysms detected several weeks after Whipple's operation.

Aged↗
PubMed2003

The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis.

The aim of this study was to evaluate the role of MR imaging of the fetus to improve sonographic prenatal diagnosis of congenital anomalies. In 40 fetuses (not consecutive cases) with an abnormality diagnosed with ultrasound, additional MR imaging was performed. The basic sequence was a T2-weighted single-shot half Fourier (HASTE) technique. Head, neck, spinal, thoracic, urogenital, and abdominal fetal pathologies were found. This retrospective, observational study compared MR imaging findings with ultrasonographic findings regarding detection, topography, and etiology of the pathology. The MR findings were evaluated as superior, equal to, or inferior compared with US, in consent with the referring gynecologists. The role of these findings in relation to pregnancy management was studied and compared with postnatal follow-up in 30 of 40 babies. Fetal MRI technique was successful in 36 of 39 examinations and provided additional information in 21 of 40 fetuses (one twin pregnancy with two members to evaluate). More precise anatomy and location of fetal pathology (20 of 40 cases) and additional etiologic information (8 of 40 cases) were substantial advantages in cerebrospinal abnormalities [ventriculomegaly, encephalocele, vein of Galen malformation, callosal malformations, meningo(myelo)cele], in retroperitoneal abnormalities (lymphangioma, renal agenesis, multicystic renal dysplasia), and in neck/thoracic pathology [cervical cystic teratoma, congenital hernia diaphragmatica, congenital cystic adenomatoid lung malformation (CCAM)]. This improved parental counseling and pregnancy management in 15 pregnancies. In 3 cases, prenatal MRI findings did not correlate with prenatal ultrasonographic findings or neonatal diagnosis. The MRI provided a more detailed description and insight into fetal anatomy, pathology, and etiology in the vast majority of these selected cases. This improved prenatal parental counseling and postnatal therapeutic planning.

Adult↗
PubMed2003

The value of magnetic resonance cholangiopancreatography in predicting common bile duct stones in patients with gallstone disease.

BACKGROUND: The application of available predictive scoring systems for the detection of common bile duct (CBD) stones has not reduced the number of patients who undergo unnecessary endoscopic retrograde cholangiopancreatography. The aim of this study was to create a predictive model for CBD stones and to assess the value of magnetic resonance cholangiopancreatography (MRCP) in prediction. METHODS: In 1998, 366 patients with gallstone disease (118 males, 248 females; mean age 57 (range 8-84) years) underwent cholecystectomy. Statistical analysis was performed on patient data obtained at the time of first presentation. RESULTS: CBD stones were demonstrated in 43 (12 per cent) of 366 patients. The predictive model for common duct stones included ultrasonography showing CBD stones or bile duct dilatation, age greater than 60 years, fever, serum alkaline phosphatase level above 670 units/l and serum amylase level above 95 units/l. In patients with a predicted probability greater than 5 per cent, CBD stones were present in 11 per cent, compared with 1 per cent in patients with a probability of 5 per cent or less. MRCP had an observed sensitivity of 95 per cent, specificity of 100 per cent, positive predictive value of 100 per cent and negative predictive value of 98 per cent. CONCLUSION: In patients with a predicted probability for CBD stones of more than 5 per cent, MRCP is recommended in order to confirm the presence or absence of stones and as guidance in further management.

Adolescent↗
PubMed2002

Patient acceptance for CT colonography: what is the real issue?

The aim of this study was to evaluate the discomfort associated with CT colonography compared with colonoscopy and bowel purgation cleansing, and to evaluate patient preference between CT colonography and colonoscopy. In a total of 124 patients, scheduled for multidetector virtual CT colonography and diagnostic colonoscopy, patient acceptance and future preference were assessed during the different steps of the procedure (colon preparation, CT examination, and conventional colonoscopy). Patients who described contradictory findings between the degree of discomfort and their preference regarding follow-up examinations were retrospectively reinterviewed regarding the reason for this discrepancy. Colonoscopy was graded slightly more uncomfortable than virtual CT colonography, but the preparation was clearly the most uncomfortable part of the procedure. Concerning their preference regarding follow-up examinations, 71% of the patients preferred virtual CT colonography, 24% preferred colonoscopy, and 5% had no preference. Twenty-eight percent of the patients preferred virtual CT colonography despite that they thought it was equally or even more uncomfortable than colonoscopy. This was mainly due to the faster procedure (17 patients), the lower physical challenge (14 patients), and the lack of sedation (12 patients) of virtual CT colonography. Factors other than the discomfort related to the examinations play an important role in the patient's preference for virtual CT colonography, namely the faster procedure, the lower physical challenge, and the lack of sedation. Since the preparation plays a major decisive factor in the patient acceptance of virtual CT colonography, more attention should be given to fecal tagging.

Adult↗
PubMed2002

Chronic pancreatitis: diagnostic role of computed tomography and magnetic resonance imaging.

The value of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis and detection of complications in patients with chronic pancreatitis are reviewed. CT and MRI diagnoses are based on changes in the pancreatic duct and parenchyma and on the detection of ductal calculi. Despite technical refinements of these imaging methods, the diagnosis of chronic pancreatitis remains often difficult because of the complexity of the morphologic changes and the false-negative results in the early stages of the disease. This article describes and illustrates the imaging features of chronic pancreatitis classified according to the underlying etiology.

Acute Disease↗
PubMed2001

Ectopic gastric mucosa presenting as a polypoid mass within a Meckel's diverticulum.

A 32-year-old man presented with severe abdominal pain located in the mesogastrium and right hemi-abdomen. A barium transit study showed a tubular structure of 6 cm arising from a bowel loop in the distal ileum, with an intraluminal polypoid mass near the bottom. Diagnosis of a benign lesion within a Meckel's diverticulum was made. Anatomopathology confirmed a Meckel's diverticulum and demonstrated that the polypoid mass was caused by an unusual great ectopic island of gastric mucosa.

Abdominal Pain↗
PubMed2001

Autoimmune pancreatitis associated with primary sclerosing cholangitis: MR imaging findings.

Autoimmune pancreatitis is a relatively rare type of chronic pancreatitis that may be associated with other autoimmune disorders. The imaging features of this entity may be misleading and suggest the presence of a malignant tumour. We present a case in which MR imaging allowed us to diagnose autoimmune pancreatitis associated with primary sclerosing cholangitis, which is another autoimmune-related disease. Typical MR characteristics of autoimmune pancreatitis include focal or diffuse enlargement of the pancreas, the absence of parenchymal atrophy and significant dilation proximal to the site of stenosis, the absence of peripancreatic spread, the clear demarcation of the lesion and the presence of a peripancreatic rim.

Autoimmune Diseases↗
PubMed2001

Virtual colonoscopy: a new screening tool for colorectal cancer?

One of the new forays into the field of medical imaging is the 3-D computer imaging. Thanks to new and more performant computer processing and 3-D rendering methods it is nowadays possible to generate high resolution images of the inner surface of the colon based on CT and MR images. This article reviews the current status and research directions of virtual colonoscopy and its possible eligibility of becoming a new tool for colorectal screening.

Colonography, Computed Tomographic↗
PubMed2001

Colitis cystica profunda.

A 39-year-old woman with inflammatory bowel disease was admitted to the hospital because of cramping abdominal pain and diarrhea. Ultrasound of the abdomen revealed thickening of the wall of the descending colon. At endoscopy mucosa-covered nodules with substenosis were seen. A double-contrast examination showed narrowing in the transition zone between the descending colon and sigmoid with mucosal nodularities and barium spots in between. Examination of the resection specimen revealed colitis cystica profunda. After surgical treatment the history of the patient was uneventful.

Adult↗
PubMed2000

Multiple small pseudoaneurysms complicating pancreatitis: angiographic diagnosis and transcatheter embolization.

We report a case of retroperitoneal hemorrhage due to multiple, small pseudoaneurysms complicating a chronic alcoholic pancreatitis. Cross-sectional imaging with CT and US could not clearly depict these vascular lesions. Selective arteriography of the superior mesenteric and gastroduodenal arteries clearly showed the small pseudoaneurysms and definitive treatment was performed by transcatheter embolization using coils. Eight months after successful embolization, the patient is asymptomatic without any recurrent bleeding.

Aneurysm, False↗
PubMed2000

Breath-hold contrast-enhanced three-dimensional MR angiography of the abdomen: time-resolved imaging versus single-phase imaging.

PURPOSE: To evaluate a technique for time-resolved breath-hold contrast material-enhanced three-dimensional magnetic resonance (MR) angiography of the abdomen. MATERIALS AND METHODS: In a prospective study, 43 patients underwent time-resolved MR angiography (acquisition time per data set, 7 seconds). The patients also underwent single-phase high-spatial-resolution MR angiography (acquisition time, 27 seconds) (n = 6), conventional angiography (n = 7), or both (n = 30). No bolus timing study was performed for time-resolved MR angiography. Image quality (presence of artifacts, ability to prevent venous overlap on arterial phase images, contrast enhancement) and demonstration of anatomic variants (renal arterial and venous variants, vena caval anomaly, visceral arterial variants) and vascular diseases were assessed. RESULTS: Time-resolved MR angiographic images were characterized by fewer and less severe artifacts, less overlap of enhancing veins, and better contrast enhancement than were single-phase MR angiographic images (P < .05). The mean sensitivity and specificity were 90% (nine of 10) and 100% (1 73 of 1 73), respectively, for detection of arterial anatomic variants and 93% (28 of 30) and 100% (324 of 325), respectively, for detection of disease. The technique also proved to be reliable for demonstration of venous disease. CONCLUSION: In comparison with current non-time-resolved MR angiographic techniques, time-resolved MR angiography is more robust and easier to perform and allows simultaneous evaluation of arterial and venous disease.

Abdomen↗