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Biomedical subjects

F Astinet

Publications and source records attributed to F Astinet.

At least 19 recordsLinked to original sources
PubMed1995

Budd-Chiari syndrome: technical, hemodynamic, and clinical results of treatment with transjugular intrahepatic portosystemic shunt.

PURPOSE: To evaluate use of the transjugular intrahepatic portosystemic shunt (TIPS) as a nonsurgical approach for the management of Budd-Chiari syndrome (BCS). MATERIALS AND METHODS: Twelve patients with fulminant (n = 2), subacute (n = 5), or chronic (n = 5) BCS underwent TIPS placement. Hepatic venous obstruction was demonstrated at computed tomography and color duplex sonography. BCS was confirmed histologically in all patients. Hemodynamic parameters and clinical characteristics were assessed. RESULTS: TIPS creation was successful in all patients. Treatment reduced the portal venous pressure gradient by 75% and resulted in a mean shunt flow of 2,300 mL/min +/- 650 (standard deviation). No serious procedure-related complications were observed. The two patients with fulminant BCS died of septicemia or progressive liver failure despite intervention. The other 10 patients showed clinical improvement with reduction or disappearance of ascites. During follow-up, shunt dysfunction occurred in five of 10 patients with recurrence of ascites requiring repeat intervention. CONCLUSION: TIPS placement is safe and effective in patients with portal hypertension caused by subacute or chronic BCS.

Acute Disease↗
PubMed1993

Femoral head perfusion in patients with femoral neck fracture and femoral head necrosis.

Femoral head perfusion in adults was studied by superselective i.a. DSA in 35 normal subjects, in 9 patients with medial femoral neck fracture preoperatively, and in 36 patients with femoral head necrosis before bone grafting, and as therapeutic control after grafting. All patients with femoral neck fracture showed an interruption of the proximal nutrient branches. In 93% of the cases with femoral head necrosis, these branches were rarefied or the medial circumflex femoral artery was interrupted. Postoperative DSA after pedicled pelvic bone graft revealed a regularly perfused graft in 82%. Superselective i.a. DSA is a valuable procedure for the therapeutic decision in selected patients with femoral neck fracture as well as before pedicled pelvic bone grafting and as therapeutic control after grafting.

Adult↗
PubMed1992

[The HR computed tomography of interstitial lung diseases].

In 50 patients with pulmonary disease of varying aetiology and involvement of the pulmonary interstitium, high resolution CT with 1 mm sections have been performed. Various morphological changes within the secondary lobule could be demonstrated which helped in reducing the differential diagnosis. Compared with conventional CT with 10 mm cuts it was also possible to improve the demonstration of pleural lesions by changing window levels.

Asbestosis↗
PubMed1991

[Superselective intra-arterial DSA in femur head necrosis and femoral neck fractures].

The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA--after pedicled pelvic bone graft--revealed a regular arterial graft perfusion in 82%.

Adult↗
PubMed1991

[The place of angiography and radiologic intervention before and after liver transplantation].

The study demonstrates the value of angiography and radiological interventions before and after liver transplantation. From September 1988 till February 1991 84% out of 124 hepatic transplant recipients underwent pretransplant angiography evaluation for the exact demonstration of arterial and portal venous blood supply of the liver. Posttransplant angiography was performed in cases with suspected vascular complications, chronic rejection, and spleno-hepatic steal syndrome. Radiological interventions were performed for bacteriological examination and percutaneous drainage of encapsulated fluid collections.

Angiography↗
PubMed1991

[Three-dimensional computerized tomography of fractures].

In 32 patients with fractures of different localisation the transverse CT layers were compared with three-dimensional reconstructions. Evaluation showed that three-dimensional CT can better visualize complicated anatomical conditions especially if there are dislocated fragments in the facial part of the skull and in the trunk of the body. Hence, 3-D CT is a valuable complement to axial CT which, however, remains the basis of the findings. Misinterpretations are possible of the reconstructions are used alone because of the lack if visualization of the lesions of the soft parts that accompany fractures and because there may be pseudoforamina at thin osseous lamellae.

Adolescent↗
PubMed1990

[Improved inner ear diagnosis by controlled use of computerized tomography].

Problems in the examination of the inner ear using conventional CT are described. Intraoperative findings often differ from CT findings. A new development HR-CT is introduced. Findings of middle and inner ear malformations and otosclerosis are demonstrated. It is shown that HR-CT imaging using a new 1024 matrix, enables better spatial resolution. This new CT technique improves inner ear examination, especially in the preparation for cochlear implantation.

Child, Preschool↗
PubMed1990

[High-resolution computerized tomography of the petrous bone with two-dimensional and three-dimensional reconstruction].

Fifty patients with various diseases of the petrous bone were examined by HR-CT with a 1024 x 1024 matrix. It is demonstrated that the improved spacial resolution results in a better discrimination of subtle anatomical structures and therefore leads to an expansion of the diagnostic possibilities in diseases of the auditory and vestibular organs. Evaluation of the two-dimensional reconstructed images shows that best quality is obtained with contiguous 1 mm, sections in the primary scans. In most cases these reconstructed images are diagnostically sufficient. In addition they help to reduce patient strain (no problem with patient positioning, no further x-ray exposure, time-saving). Three-dimensional reconstructions from the base of the skull allow a good visualization of complex and extensive osseous destructions of the temporal bone. The disadvantage of this method is on the one hand the lacking representation of soft tissue and the poor spacial resolution (no 3-D imaging of the ossicular chain), and on the other hand the smoothing of contours because of arithmetical filters. Thus tumor expansion and finer osseous erosions may not be distinguishable. Consequently, 2D primary or reconstructed images must continue to be the basis of diagnosis.

Adult↗
PubMed1990

[Dynamic CT and angio-CT following liver transplantation].

This is a prospective study of the value of dynamic CT with a rapid scan frequency for the control of liver transplants. In 28 patients dynamic CT was performed with table movement and angio-CT without table movement, using a standard contrast bolus. In 97% of cases the central portions of the portal and hepatic veins could be delineated. The peripheral vessels were better demonstrated by angio-CT (79%) than by dynamic studies with table movement (47%). Parenchymal lesions, such as infarcts, and changes round the liver, such as lymphoedema or haematomas, were adequately demonstrated by either method. In addition, angio-CT provided information on abnormalities of perfusion within the transplant.

Adult↗
PubMed1990

[Differentiation of malignant liver tumors using rapid dynamic CT].

In this prospective study 39 patients with malignant liver tumours were examined by rapid CT. CT was performed before contrast, as dynamic CT, with and without table movement and, in some patients, images were obtained four hours after contrast injection. Time/density curves of hepato-cellular carcinomas (nine cases) showed more rapid and more intense enhancement of the tumour than of the liver parenchyma, whereas tumours of biliary origin (ten cases) showed a slower and less marked enhancement than surrounding tissue. In addition, it was possible to differentiate hypovascular metastases (18 cases) and hypervascular lesions by means of the time-density curve. Best diagnostic information was obtained by dynamic bolus CT. This method without table movement is best for differentiating focal lesions, whereas dynamic CT with table movement shows the extent and number of tumour lesions.

Adenoma, Bile Duct↗
PubMed1990

[The value of 3D-CT in maxillary surgical diagnosis and therapy planning].

In 25 patients in whom oral surgery was required, we examined what additional information can be obtained via three-dimensional CT compared with conventional transverse CT scans. We showed that D-3 CT facilitated the spatial orientation by complex osseous destructions. Better therapy planning and postoperative control was therefore feasible. However, CT diagnosis continued to be based on transverse scans.

Aged↗
PubMed1990

[The Berlin Radiology Communication Project. The initial clinical experiences].

As part of a radiological communication project (RADKOM), two PACS systems of the radiological clinic in the Rudolf Virchow University Clinic in Charlottenburg and Wedding were connected via the BERKOM network of the German post office. Within the radiology departments, all CT and MRT systems were joined through a local network. The first results have shown that the PACS stations are of value for providing uniformity of diagnosis and for radiological conferences. It is evident, however, that the speed of transfer and the architecture within the PACS system would be of crucial importance for their practicability for radiological conferences.

Berlin↗