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Biomedical subjects

E de Kerviler

Publications and source records attributed to E de Kerviler.

At least 37 records · Page 2Linked to original sources
PubMed1999

Imaging findings in patients with myelofibrosis.

The purpose of this review is to illustrate the wide range of radiological abnormalities in myelofibrosis. Myelofibrosis, also called myeloid metaplasia, is a myeloproliferative disorder of unknown etiology. The common imaging findings in patients with myelofibrosis are osteosclerosis, hepatosplenomegaly, and lymphadenopathies. In addition, extramedullary hematopoiesis may develop in multiple sites such as chest, abdomen, pelvis, and central nervous system, simulating malignant disease. Selected plain-film, CT, and MR images in patients with myelofibrosis are shown as pictorial essay to allow ready recognition of the most common imaging abnormalities of the disease.

Bone and Bones↗
PubMed1999

Subacute and chronic benign superior vena cava obstructions: endovascular treatment with self-expanding metallic stents.

OBJECTIVE: Our purpose is to report our clinical experience with patients who underwent endovascular treatment with Wallstents for subacute or chronic benign obstruction of the superior vena cava (SVC). SUBJECTS AND METHODS: Twelve patients who were an average of 54 +/- 12 years old were referred for treatment of severe SVC syndrome related to implanted central venous catheters (n = 8), postradiation fibrosis (n = 2), a permanent pacemaker (n = 1), or a benign tumor (n = 1). Symptoms were present for an average of 16 weeks (range, 4-48 weeks) before treatment. Diagnosis of SVC obstruction was confirmed with helical CT and pretherapeutic phlebography. Four patients had Stanford's type II stenosis; two, type III; and six, type IV. The mean clinical and radiologic follow-up intervals were 11 months (range, 1-36 months) and 7 months (range, 1 week to 32 months), respectively. RESULTS: Recanalization was successful in all patients. Fifteen stents were implanted in the 12 patients. Stents were placed after percutaneous balloon angioplasty in nine patients, and primary stent placement was attempted in three patients. We immediately achieved a satisfactory SVC diameter in all patients, whose symptoms were relieved completely within 1 week of stent placement. No technical or clinical complications occurred. SVC syndrome recurred in one patient 2 months after stent placement and was treated by placing a second stent. CONCLUSION: Endovascular treatment with stent placement should be considered relevant and safe for refractory benign SVC syndrome. However, a larger series and a longer follow-up period are needed to define the role of stent placement for this syndrome.

Adult↗
PubMed1999

[Scanner-guided biopsy technic with abdominal compression].

The aim of this study was to present a CT-guided biopsy technique using an abdominal compression device. With this system, the digestive structures (mainly the colon and the small bowel) can be displaced away from the needle track and the distance between the skin and the target lesion can be reduced by approximately one-third. The technique has been used in 29 patients and was successful in 28, allowing node biopsies in the mesenteric, retroperitoneal or pelvic areas. The compression system is easily mounted and used standard sterilizable material. The procedure is well tolerated by patients and complication rate is not raised compared with conventional biopsy techniques.

Abdomen↗
PubMed1999

[Fast imaging sequences].

Although conventional spin echo and gradient echo sequences are still in general use, the need to improve the temporal resolution of MRI and to study organ function has prompted to develop fast imaging techniques. These techniques are based on different approaches, but present common underlying principles which allow optimize k space fitting. As a result, both contrast and spatial resolution may be improved aside from the capability to reduce scan time. The selection of the most appropriate fast imaging technique will depend on the needed temporal resolution, spatial resolution and contrast. The aim of this paper is to review and explain the basic principles of fast imaging techniques, with emphasis on their advantages, limitations, and clinical applications.

Computer Systems↗
PubMed1998

Contrast agents in magnetic resonance imaging of the liver: present and future.

New contrast agents are being developed by drug companies to better image the liver magnetic resonance imaging (MRI). They can be divided into hepatobiliary agents (Gd-EOB-DTPA, Gd-BOPTA, Mangafodipir) and nanoparticulate agents directed to the reticulo-endothelial system (ferumoxides, SHU 555A). After intravenous injection, all these agents concentrate in the liver and induce profound signal changes. Particulate agents induce predominantly a darkening of the liver parenchyma, while hepatobiliary agents induce a brightening. In both cases, liver-lesion conspicuity is enhanced, leading to a better visualization of the lesion. After a description of the principal pharmacokinetic characteristics of the compounds, this review paper summarizes the utility of the agents in the detection and characterization of focal liver diseases.

Contrast Media↗
PubMed1998

Computed radiography.

In several medical centers computed radiography has almost completely replaced the use of conventional screen-film systems for general radiography. The aim of this paper is to explain the basic principles of the four most frequently numerical detectors used in the world, with emphasis on the phosphor plates, which are the most frequently used both in hospitals and by practitioners. The other two systems are based on a receptor with selenium. The fourth uses charged coupled device (CCD) detectors. The most important principles of digital processing are then described with concentration on unsharp mask filtering. In the future computed radiography will replace standard radiology and will create a system in medicine using the power of computers to archive--with more efficiency and less space--patient medical data. The transmission of data to workstations and the processing of this data is the topic of a new field in medicine.

Humans↗
PubMed1998

Fat suppression techniques in MRI: an update.

Due to short relaxation times, fat has a high signal on magnetic resonance images (MRI). This high signal, easily recognized on MRI, may be useful to characterize a lesion. However, small amounts of lipids are more difficult to detect on conventional MRI. In addition, the high signal due to fat may be responsible for artifacts such as ghosting and chemical shift. Lastly, a contrast enhancing tumor may be hidden by the surrounding fat. These problems have prompted development of fat suppression techniques in MRI. Fat may be suppressed on the basis of its difference in resonance frequency with water by means of frequency selective pulses or phase contrast techniques, or on the basis of its short T1 relaxation time by means of inversion recovery sequences. Lastly, hybrid techniques combining several of these fat suppression techniques are also possible. The aim of this paper is to review the basic principles of all these fat suppression techniques and to exemplify their clinical use.

Adipose Tissue↗
PubMed1998

Surgical endoscopic techniques in the diagnosis and follow-up of patients with lymphoma.

BACKGROUND: In patients with lymphoma, tissue for histology can be obtained through image-guided techniques or by surgery. The aim of this study was to assess the efficacy of surgical endoscopic techniques in obtaining adequate tissue specimens. METHODS: Ninety-two patients with suspected or confirmed lymphoma were referred for a surgical biopsy of a deeply located intrathoracic or intra-abdominal mass or lymph node. The 86 patients who had surgery using a surgical endoscopic technique were included in this study. There were 54 men and 32 women, of mean age 34 (range 15-78) years. Most were selected directly for surgery while five previously had a failed computed tomography-guided biopsy. A total of 89 procedures were performed in 86 patients: laparoscopy (15 patients), thoracoscopy (61) and mediastinoscopy (13). RESULTS: No patient died. One intraoperative complication occurred during thoracoscopy (1 per cent). Two postoperative complications were noted (2 per cent). Three patients required conversion to open surgery (3 per cent). Adequate tissue for histology was obtained by surgical endoscopic procedures in 87 per cent. Twelve of 13 mediastinoscopies were successful. After thoracoscopy, the success rate was 92 per cent but only nine of 15 laparoscopies were considered successful. CONCLUSION: In patients with lymphoma, surgical endoscopic techniques have a high diagnostic yield and a low morbidity rate. Barring exceptional circumstances these should be favoured rather than conventional open surgery.

Adolescent↗
PubMed1998

Evaluation of abdominal fat distribution in noninsulin-dependent diabetes mellitus: relationship to insulin resistance.

Accumulation of visceral adipose tissue is associated with metabolic complications such as noninsulin-dependent diabetes mellitus. The aim of this study was to evaluate the effect of abdominal adipose tissue on insulin sensitivity in subjects with noninsulin-dependent diabetes mellitus (NIDDM). Areas of abdominal fat were calculated from axial magnetic resonance images obtained at the level of the umbilicus in 21 men with NIDDM [age, 45.6 +/- 8.3 (+/-SD) yr; body mass index, 29.3 +/- 4.5 kg/m(-2); total body fat (skinfold thickness), 26.8 +/- 5.4%; waist to hip ratio, 0.97 +/- 0.07; duration of diabetes, 59 +/- 47 months; hemoglobin A1c, 8.1 +/- 1.5%]. Insulin sensitivity was evaluated by an insulin tolerance test. The areas of deep abdominal fat and sc abdominal fat were, respectively, 135.3 +/- 55.1 and 211.8 +/- 99.1 cm2. The blood glucose disappearance rate was 2.11 +/- 0.87%/min and was negatively related to deep abdominal fat (r = 0.72; P = 0.0025). In contrast, areas of sc abdominal fat, total body fat, body mass index, and waist to hip ratio were not related to the blood glucose disappearance rate. Plasma triglyceride concentrations averaged 1.8 +/- 0.8 mmol/L and were positively related to deep abdominal fat (r = 0.69; P = 0.0018). We conclude that insulin sensitivity is strongly related to visceral adipose tissue accumulation in NIDDM.

Abdomen↗
PubMed1998

[What is bright on T1 MRI scans?].

The list of entities associated with a high signal intensity on T1-weighted images is extensive and classically includes fat, proteins, hemorrhage, melanin and gadolinium. However, additional entities may be responsible for abnormally high signal intensity on T1-weighted images. These include ion deposition in metabolic disorders, free radicals, increased proton density, flow phenomena, some artifacts, and new contrast agents. The aim of this article is to display both the common and uncommon causes for a high T1 signal intensity and to discuss the underlying mechanisms or attributable pathophysiology for this phenomenon.

Artifacts↗
PubMed1997

Radiologic anatomy of the inferior lung margins as demonstrated on computed radiography with enhancement of low frequencies.

The aim of this work was to describe the radiologic anatomy of the inferior lung margins (ILMs). The method was to enhance the low frequencies of 50 normal chest computed radiographs. On each side, the anterior and posterior ILMs were divided into two halves. The frequency of visibility of each half of each ILM was calculated as their shape, lateral and medial continuities, depth, and vertebral level. The differences were compared by a paired Student t-test. The right posterior ILM was always visible and usually concave upward (94%). Its height was 8.7 +/- 1.6 cm. Its most inferior part faced L1 or L2 in 92% of cases. It was continuous medially inside with the azygo-esophageal recess in 96% of cases. The left posterior ILM was not visible laterally in 34% of cases and medially in 60% of cases. It was most often concave upward (82% of cases). Its height was 6.9 +/- 1.5 cm. Its most inferior part was at the level of L1 or L2. It was continuous medially with either the left paraspinal line or the paraaortic line. The right anterior ILM was visible in 76% of cases. It was most often oblique upward and medially (46%) or concave upward (33%) and often notched (38%). The left anterior ILM was visible in 64% of cases and more often oblique inward and upward (58%). It was continuous medially with the left inferior precardiac recess. The anterior ILMs were more variable than the posterior. The posterior ILMs were very similar in shape and inferior level and differed in depth only by the difference of height of the diaphragmatic cupolas.

Adult↗
PubMed1997

Sternal abscess due to Bartonella (Rochalimaea) henselae in a renal transplant patient.

Bartonella henselae, previously called Rochalimaea henselae, is the causative agent of cat scratch disease (CSD) in immunocompetent subjects and bacillary angiomatosis in immunocompromised ones. Bone lesions are common in bacillary angiomatosis, but not in CSD. We present the case of a patient with a renal transplant treated by immunosuppressive therapy who developed a sternal abscess with a histological pattern of CSD. The CT pattern was that of a lytic bone lesion with adjacent fluid collection. The diagnosis was made on the basis of a polymerase chain reaction amplification performed on bone material. Bartonella henselae is a newly described bacteria that causes CSD in a normal host and bacillary angiomatosis in immunocompromised patients. We report a case of an osteolytic lesions of the sternum with adjacent fluid collection related to CSD, which occurred in a patient with a renal transplant.

Abscess↗
PubMed1997

Combined effects of caloric restriction and branched-chain amino acid supplementation on body composition and exercise performance in elite wrestlers.

Twenty-five competitive wrestlers restricted their caloric intake (28 kcal.kg-1.day-1) for 19 days, using a hypocaloric control (hC, n = 6), hypocaloric high-protein (hHP, n = 7), hypocaloric high-branched-chain amino acid (hBCAA, n = 6), hypocaloric low-protein (hLP, n = 6) diet to determine the effects of caloric restriction on body composition and performances versus control diet (C, n = 6). Anthropometric parameters (weight, percent body fat) and adipose tissue (AT) distribution measured by magnetic resonance imaging (MRI) obtained before and after diet, were compared. A significant highest body weight loss (-4 kg, p < 0.05) and decrease in the percent of body fat (-17.3%, p < 0.05) were observed for subjects of the hBCAA group. Subjects of the hBCAA group exhibited a significant reduction (-34.4%, p < 0.05) in abdominal visceral adipose tissue (VAT). There was no change in aerobic (VO2max) (p > 0.75) and anaerobic capacities (Wingate test) (p > 0.81), and in muscular strength (p > 0.82). We conclude that under our experimental conditions, the combination of moderate energy restriction and BCAA supplementation induced significant and preferential losses of VAT, and allowed maintainance of a high level of performance.

Amino Acids, Branched-Chain↗
PubMed1997

[Digital radiography of the thorax].

Digital radiography of the thorax can, now be substituted to conventional chest radiography. Computed radiography with phosphor plates and the new selenium detector are emphasized. The major image processing are explained. Successively the main other methods of digital radiography are described: scanning equalization radiography, laser-digitized radiography and multiwire proportional chambers. Then the advantages and the drawbacks of chest computed radiography are extensively reviewed.

Humans↗
PubMed1997

[Thoracoscopic approach in pulmonary nodules: a prospective evaluation of a series of 120 patients].

UNLABELLED: More and more pulmonary nodules are currently approached via thoracoscopy. We have evaluated the results and the morbidity of a consecutive series of 120 patients operated on by a single surgeon. PATIENTS AND METHODS: Hundred twenty-two nodules have been approached thoracoscopically in 120 patients. The average size of these nodules was 16 mm (3-30 mm). A pre-operative localisation technique has been used in 61 patients (50%). The procedures were as follows: biopsy (6 cases), wedge-resection (110 cases). A video-assisted lobectomy has been performed in 26 cases. RESULTS: The mortality rate was 0.08% (One case of ARDS in the post-operative course of a video-assisted lobectomy). Intra-operative morbidity rate was 1.6% (2 cases of haemorrhage requiring a thoracotomy and the post-operative morbidity rate was 5%. Six procedures were converted to thoracotomy 55%). The nodules have been localised in all cases but 2 (1.6%). The mean post-operative stay was 4.6 days in the whole series and 3.2 days in the series of patients with a simple biopsy or wedge-resection. COMMENT: The morbidity rate of thoracoscopic resection of lung nodules is very low and decreases with surgeon's experience. Experience allows one not to use a localisation technique in many cases, but the later remains helpful in small size nodules. It allows for a safe, rapid and accurate procedure to be performed. The need for a mini-thoracotomy is very rare. Mastering the techniques of radiological localisation techniques, thoracoscopic biopsy and wedge resection as wall as video-assisted lobectomies should make it possible for thoracoscopic resection of lung nodules to fulfil the criteria of a minimally invasive operation.

Adolescent↗
PubMed1996

[Spinal tuberculous arachnoiditis].

Tuberculous arachnoiditis of the spine is a rare complication of tuberculous meningitis and can occur despite correct treatment. We report two cases of arachnoiditis in patients with tuberculous meningitis. In both cases, clinical signs included flaccid paraparesia and sphincter dystonia. Evidence for diagnosis was obtained with magnetic resonance imaging of the lombosacral spine after a 3 or 11 week course. Adding corticosteroids to the anti-tuberculosis therapy provided spectacular clinical improvement within 8 days in both cases. The diagnosis of tuberculous arachnoiditis of the spine is often made late but can be confirmed easily with magnetic resonance imaging. Our cases emphasize the importance of oral corticosteroid therapy to avoid severe sequellae.

Adult↗