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Biomedical subjects

F Cattin

Publications and source records attributed to F Cattin.

At least 19 recordsLinked to original sources

Diagnostic efficacy of SonoVue, a second generation contrast agent, in the assessment of extracranial carotid or peripheral arteries using colour and spectral Doppler ultrasound: a multicentre study.

The purpose of this study was to demonstrate the improvement in diagnostic quality and diagnostic accuracy of SonoVue microbubble contrast-enhanced ultrasound (CE-US) versus unenhanced ultrasound imaging during the investigation of extracranial carotid or peripheral arteries. 82 patients with suspected extracranial carotid or peripheral arterial disease received four SonoVue doses (0.3 ml, 0.6 ml, 1.2 ml and 2.4 ml) with Doppler ultrasound performed before and following each dose. Diagnostic quality of the CE-US examinations was evaluated off-site for duration of clinically useful contrast enhancement, artefact effects and percentage of examinations converted from non-diagnostic to diagnostic. Accuracy, sensitivity and specificity were assessed as agreement of CE-US diagnosis evaluated by an independent panel of experts with reference standard modality. The median duration of clinically useful signal enhancement significantly increased with increasing SonoVue doses (p< or =0.002). At the dose of 2.4 ml of SonoVue, diagnostic quality evaluated as number of inconclusive examinations significantly improved, falling from 40.7% at baseline down to 5.1%. Furthermore, SonoVue significantly (p<0.01) increased the accuracy, sensitivity and specificity of assessment of disease compared with baseline ultrasound. SonoVue increases the diagnostic quality of Doppler images and improves the accuracy of both spectral and colour Doppler examinations of extracranial carotid or peripheral arterial disease.

Adult↗

[MRI of the pituitary gland: indications and results in gynaecology and in obstetrics].

MRI is the sole radiological examination to be obtained if abnormal menses, galactorrhea or anovulation evokes the diagnosis of prolactinoma. Nevertheless, iatrogenic hyperprolactinemia or presence of big prolactin has to be ruled out before MRI is asked for. MRI of the pituitary gland must be technically optimal; analysis of the images has to be directed by clinical and biological data.

Amenorrhea↗

[Imaging of the extracranial carotid arteries: when, how and why?].

The indications for treating carotid artery stenosis are related to the symptomatic nature of the lesion and the degree of stenosis. Duplex sonography is adequate for screening. While some groups believe that Duplex US alone or in combination with transcranial Doppler imaging may be sufficient for presurgical evaluation, it often is recommended to complete the evaluation with either MRA or CTA. Both techniques are advantageous since they allow evaluation of the cervical and intracranial arteries as well as cerebral parenchyma hence providing valuable information prior to definitive management. Catheter angiography remains indicated in patients with multi-vessel disease and ischemic cardiomyopathy, when results at non-invasive evaluation are discordant or in an emergency setting. Duplex US is used for routine follow-up of non-surgical lesions and after endarterectomy. Transcranial Doppler as well as advances in MRA and CTA techniques will be reviewed. Even though the treatment of atherosclerotic carotid artery stenoses remains primarily surgical, specific considerations related to angioplasty will be reviewed. Finally, diseases of the intracranial carotid artery and non-atherosclerotic diseases (dissection...) will also be discussed.

Angiography↗

Intracerebral alveolar echinococcosis.

There are two species of the genus Echinococcus, Echinococcus multilocularis (also called alveolar hydatid) and Echinococcus granulosus, characterized by distinct growth features in humans. The main endemic regions for human alveolar echinococcosis (AE) caused by E. multilocularis are Central Europe, Russia, Turkey, Japan, China, eastern France and North America. Human echinococcosis is usually caused by an intrahepatic growth of parasitic larvae. Cerebral occurrence of E. multilocularis disease is rare, accounting for only 1% of cases, and is generally considered to be fatal. This report presents two cases of intracerebral E. multilocularis disease which occurred in two infected patients with AE pulmonary metastases. The anatomical and clinical features are discussed. Our retrospective survey would indicate that surgical treatment should be envisaged whenever possible.

Adult↗

[Rathke's cleft cyst].

Rathke's cleft cyst (RCC) are frequent benign cystic sellar lesions. Most RCC are small, intrasellar and asymptomatic. Larger cysts may compress adjacent structures and rarely become symptomatic. Diagnosis is strongly suggested at MRI by the presence of a midline non-enhancing lesion located exactly between the anterior and posterior lobes of the pituitary gland. Even if its signal is variable and related to intracystic protein concentration, it must be homogeneous with no fluid-fluid level. Once a diagnosis of RCC made, routine MR and clinical follow-up is sufficient for incidental asymptomatic cysts whereas the rare symptomatic lesions are neurosurgically resected.

Central Nervous System Cysts↗

[Follow-up MRI after trans-sphenoidal surgery].

The authors report their 10 year experience on postsurgical MRI of the sphenoidal region. All patients underwent MRI examination 4 days after surgery, then between 2 and 3 months and one year or more after surgery. The reproducibility of pulse sequences is mandatory to make a diagnosis of recurrent adenoma as early as possible.

Adenoma↗

[Pituitary gland imaging in Cushing's disease].

Specific MR techniques are required for optimal detection of adenocorticotropic hormone secreting adenomas responsible for Cushing's disease. Adequate MR sequences, high resolution coronal T1 and T2 - weighted images, dynamic MR imaging, post-gadolinium delayed images, dose of gadolinium adjusted for each sequence can routinely demonstrate pituitary adenomas less than 3 mm in Cushing's disease.

Adenoma↗

Hypervascular intracisternal acoustic neuroma.

The diagnosis of acoustic neuroma is usually evoked in a patient presenting with a long history of hearing disturbance in whom an enhancing lesion within the internal auditory canal and/or the cerebellopontine angle is found on MRI. Hypervascularity with arteriovenous shunting and early filling of enlarged veins is a common feature of malignancy and has been reported very rarely in benign acoustic neuroma. We present the case of a patient without hearing disturbance, who showed a highly vascular lesion with no component in the internal auditory canal, making the preoperative diagnosis of acoustic neuroma very challenging. We discuss here the intracisternal site of origin and hypervascularity of acoustic neuroma, and also the differential diagnoses and management of such tumors.

Adult↗

[Symptomatic venous congestion of the brain stem after embolization for dural fistula of the cavernous sinus].

We report the case of a 60-year old woman presenting, 3 days after arterial embolization of a dural arteriovenous fistula, with diplopia and gait disturbance in relation with right oculomotor nerve palsy and cerebellar dysfunction. On T2 weighted MR images, several hyperintense areas appeared in the pons and the midbrain. After one month, clinical symptoms and diffuse hyperintense areas resolved spontaneously, as the patient was treated by anti-vitamin K. This complication probably corresponds to reversible pontine venous congestion caused by poor venous drainage of the dural arteriovenous fistula.

Brain Edema↗

[Gadolinium in arteriography and interventional radiology: 39 patients].

OBJECTIVE: To report the experience of using various Gadolinium chelates as contrast media in digital subtraction angiography in patients with relative or absolute contraindications for iodinated contrast agents. MATERIAL: and Methods. Forty-two arteriograms were performed in 39 consecutive patients using Gadolinium chelates (gadoteridol, gadodiamide, and gadopentetate dimeglumine). The vasculature of the brain, of the upper and lower limbs and the renal arteries were examined. Among these 39 patients, 17 were treated by various endovascular procedures. RESULTS: In 40 examinations out of 42, the angiographic result was satisfactory, allowing either a diagnostic evaluation or an endovascular therapeutic procedure. Clinical tolerance was excellent. In one case of renal failure that was reported after angiography, the patient had received both iodine and gadolinum-based contrast agents. CONCLUSION: Gadolinium appears to be an interesting alternative for arteriography in patients with absolute or relative contraindication to iodinated contrast agents, and also seems to demonstrate efficacy during endovascular therapeutic procedures.

Aged↗

[Increased T1 signal of the residual normal anterior pituitary gland following medical treatment of pituitary prolactinoma].

PURPOSE: To illustrate that residual normal pituitary gland may show hyperintense signal on T1-weighted image after medical treatment of pituitary prolactinoma. MATERIAL: and methods. Three patients treated with bromocriptine for a prolactinoma and showing hyperintense signal of the residual normal pituitary tissue on T1-weighted images were studied. In all patients, measurements of the anterior pituitary gland signal (APGS) and the temporal lobe white matter signal (TLWMS) were obtained by a "region of interest" (ROI) on coronal T1-weighted images. The APGS/TLWMS ratios were calculated and compared to those of a control group of 30 normal subjects. RESULTS: In the three patients, the measurements obtained by ROI confirmed the visual impression of high signal of the residual normal pituitary tissue. Ratios were ranging from 1.15 to 1.21, while they were ranging, in the control group from 0.92 to 1.09. CONCLUSION: In patients with prolactin-secreting adenoma seen after medical treatment, high signal of the residual normal pituitary tissue can be observed, probably due to cellular hyperactivity as it can be noticed during some physiological states. This pattern has to be differentiated from other pituitary abnormalities demonstrating T1 hyperintensity such as hemorrhagic changes of a prolactinoma.

Adult↗

Dural enhancement in pituitary macroadenomas.

We describe the normal dural enhancement patterns of the sellar region and determine whether the duramater is affected by pituitary macroadenomas. Dural enhancement appeared to be usually abnormal in 20 patients with pituitary macroadenoma compared with 20 control patients, mainly at the planum sphenoidale and carotid sulcus. However dural changes are subtle and their recognition requires knowledge of the normal enhancement patterns. Dural changes, reported in a variety of inflammatory and infectious dural diseases and after surgery, are not specific and may be also seen in pituitary macroadenomas.

Adenoma↗