An unusual case of unilateral periureteral retroperitoneal fibrosis.
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Aged↗
Biomedical subjects
G Villeirs
Publications and source records attributed to G Villeirs.
Leakage assessment in adjustable laparoscopic gastric banding: radiography versus (99m)Tc-pertechnetate scintigraphy.
The least invasive of all surgical weight-lowering procedures is the adjustable laparoscopic gastric banding (ALGB) technique. A rare complication (0.9%-1.8% of patients) but one that may require surgical revision is leakage of the gastric banding device. This paper reports on the usefulness of technetium-99m scintigraphy for the assessment of gastric band leaks as compared with radiography. Between March 1997 and October 2001, 23 obese patients (20 women and 3 men; mean age 35 years; range 23-60 years; mean body mass index before gastric banding procedure, 39.2 kg/m(2); range 29.3-52.1 kg/m(2)) were referred for exclusion of gastric banding leakage by means of radiography and (99m)Tc-pertechnetate scintigraphy. Both procedures were performed on the same day in all patients. Two patients underwent both procedures, respectively two and three times. A total of 27 radiographic and scintigraphic examinations were performed. Radiographs were judged positive for leakage when escape of contrast agent through a defect in the gastric banding device was visualised or when indirect criteria, e.g. smooth passage of barium suspension through the stoma after injection of contrast agent, were present. Scintigraphic images were judged positive when tracer disappearance out of the banding device and uptake in the thyroid gland as well as enhancement of the gastric mucosa were observed 30 min and/or 3 h post injection. Overall sensitivity, specificity and accuracy for radiography and (99m)Tc scintigraphy were 81.8% vs 81.8%, 75% vs 100% and 77.7% vs 92.6%. Leakage from the reservoir or the connecting tube is a late complication of ALGB. The presented data suggest that (99m)Tc-pertechnetate scintigraphy is more efficient than radiography in determining the presence of such leaks.
Adult↗
Heparin-induced thrombocytopenia and fat necrosis of the breast.
Fat necrosis of the breast is a well-known complication following trauma, surgery, or radiotherapy. The present paper describes a rare case of fat necrosis after heparin-induced thrombocytopenia. The mammographic, sonographic, and MR evaluation and pathologic correlation after a 1-year follow-up period are reported.
Aged↗
Lesion detection in breast carcinoma.
Early detection and identification of infraclinic breast lesions are a challenge for the radiologist. Diagnostic accuracy relies on careful analysis of some important mammographic clues, which are discussed in this paper. In particular, asymmetric breast tissue, focal asymmetric density, nonpalpable solid masses, stellate lesions and calcifications are reviewed.
Breast↗
Initial experience with the use of preoperative transarterial chemoembolization in the treatment of liver metastasis.
We retrospectively evaluated the influence of preoperative Transarterial Chemoembolization (TAE) on technique and complications, tumour histology, and disease-free survival after surgery for hepatic metastasis. In a 2-year period, a total of 23 patients were treated. In a first group of 14 patients, preoperative TAE was performed; in a second group of 9 patients only surgical resection was done. Extensive tumour necrosis was seen in the majority of patients treated with TAE; in tumours with an important fibrotic component, embolization was less effective. No significant effect was seen on operating time, transfusion requirement or perioperative complication rate. In the group of patients who underwent TAE, survival rate was 93% after a mean follow-up period of 15.5 months (SD: 12.5); recurrence was seen in only 8% of the survivors. In the second group, however, mortality was 33% after a median follow-up of 17.5 months (SD: 10), and recurrence was present in 66.7% of the survivors. These results indicate that preoperative TAE reduces the recurrence rate in the first postoperative year. Thereby survival may be improved in patients with resectable metastatic liver cancer.
Antineoplastic Agents↗
[Breast calcifications].
Calcifications are found in many women undergoing mammography. The majority of these calcifications are benign. Calcifications suggestive for malignancy prove to be cancer in about 30% of cases after biopsy. Study and personal experience should result in ready recognition of characteristically benign calcifications. Calcifications suggestive for malignancy should be biopsied and the ratio of malignant over benign biopsies should be as high as possible. The purpose of this paper is to present a practical approach to the evaluation of breast calcification, by means of a survey of the pattern of calcifications in breast pathology. We describe six types of typically benign calcifications and six criteria that entail an increased risk of malignancy.
Breast Diseases↗
[Legal liability of the radiologist in missed breast cancer diagnosis].
There have been few lawsuits alleging missed breast cancer diagnosis in Belgium so far. However, since the introduction of the Flemish organised breast cancer screening program in June 2001, one might expect an increase in the years to come. In the present paper, we focus on risk management pointers that minimize the risk of incurring a malpractice lawsuit.
Belgium↗