Biomedical subjects

H Trillaud

Publications and source records attributed to H Trillaud.

8 recordsLinked to original sources

PubMed1996

Cystic smooth-muscle tumor of the liver and spleen associated with Epstein-Barr virus after renal transplantation.

Immunosuppression is known to favor the development of various types of tumors. After organ transplantation, the risk of lymphoproliferative disease, whether clonal or not, is particularly increased and clearly associated with Epstein-Barr virus infection. We report a case of an unusual large cystic tumor of the liver with satellite hepatic and splenic nodules occurring 4 years after renal transplantation. Radiologic examination showed a rich vascularization of the tumor. Light and electron microscopy of a surgical liver biopsy, completed by an immunohistochemical study, demonstrated a well-differentiated tumor of smooth-muscle origin. Using in situ hybridization, we showed large amounts of Epstein-Barr virus messenger RNAs within the tumor cells. In addition, Southern blot analysis revealed that viral DNA was present in the form of a single monoclonal episome within the tumor. The polymerase chain reaction analysis of the genomic DNA of tumoral cells also indicated a monoclonal pattern. At last, the tumor was shown to be of host origin. Six months later, and despite three courses of chemotherapy, the tumoral lesions were unchanged. This case underlines the role of Epstein-Barr virus infection in the development of unusual and clonal smooth-muscle tumors after organ transplantation. The evolution of these rare tumors is uncertain.

Female↗

PubMed1996

Diagnosis of renovascular hypertension: feasibility of captopril-sensitized dynamic MR imaging and comparison with captopril scintigraphy.

OBJECTIVE: Angiotensin-converting enzyme inhibitors may decrease glomerular filtration rate when a significant renal artery stenosis is present. The purpose of this preliminary study is to evaluate the feasibility of captopril-sensitized, dynamic MR imaging of the kidney in a series of patients with a high suspicion of renovascular hypertension and to compare the results with those of captopril scintigraphy. SUBJECTS AND METHODS: Fifteen hypertensive patients with renal artery stenosis shown by angiography were studied with sequential gadolinium-enhanced MR imaging after oral administration of 50 mg of captopril, an inhibitor of angiotensin-converting enzyme. Symmetry of onset and evolution of tubular phases between the two kidneys were analyzed, and medullary signal intensity time curves were drawn for each kidney. When asymmetry between kidneys was noted, the same dynamic study was repeated 24 hr later, without captopril sensitization. All patients also underwent renal scintigraphy after administration of captopril to compare captopril-induced changes in both techniques. Three-dimensional time-of-flight MR angiography was also performed on all patients. RESULTS: MR imaging with normal and symmetric tubular phases showed that 11 patients had no impairment of glomerular filtration after administration of captopril. MR imaging showed that four had impairment of glomerular filtration: studies without captopril were symmetric (n = 2) or slightly asymmetric (n = 2), but administration of captopril induced severe functional impairment on the side of stenosis--that is, a delayed tubular phase with late corticomedullary decrease of signal intensity in the first two patients and absence of tubular phase in the other two. The results of scintigraphy were concordant in all but one case, in which the segmental distribution of filtration impairment, shown by MR imaging, was not shown by scintigraphy. The renal artery stenosis was shown by MR angiography in 10 of 15 patients (67%). CONCLUSION: Captopril-sensitized dynamic MR imaging of the kidney is feasible in patients with renovascular hypertension. However, captopril-induced changes are not present in all patients proven to have the disease. Scintigraphy provides similar results but may ignore segmental functional involvement.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed1995

High resolution renal diffusion imaging using a modified steady-state free precession sequence.

A modified steady-state free precession (SSFP) diffusion sequence is proposed for high resolution renal imaging. A pair of bipolar diffusion gradients was used to minimize the errors in measured apparent diffusion coefficient (ADC) caused by variations in T1, T2, and RF flip angle that have been observed with previously employed SSFP diffusion sequences. Motion sensitivity was reduced by the use of compensated gradients, frame-by-frame averaging, and a repetition time of 22 ms, which for a single-acquisition 128 x 128 image requires only 3 s. High resolution was achieved by signal averaging. The modified sequence was applied to in vivo diffusion measurements. In six normal rat kidneys the ADCs (mean +/- SD; x 10(-3) mm2/s) of the cortex, outer medulla, and inner medulla were 2.28 +/- 0.05, 2.38 +/- 0.10, and 2.95 +/- 0.05, respectively. The technique requires relatively large gradients to achieve adequate diffusion weighting.

1-Propanol↗

PubMed1995

USPIO-enhanced MR imaging of glycerol-induced acute renal failure in the rabbit.

Enhanced-MR imaging in combination with ultrasmall superparamagnetic iron oxide (USPIO) was used in the glycerol-induced model of acute renal failure (ARF) in the rabbit to detect renal perfusion abnormalities. A control group (n = 5) and an ARF group (n = 5) were studied after intramuscular injection of glycerol (10 ml/kg) with T2-weighted spin-echo sequence at 1.5 T and a 27 mumol/kg IV dose of iron. The signal intensity (SI) was quantified in the cortex, the outer medulla (OM), and the inner medulla (IM). In control rabbits, the maximum SI decrease after USPIO injection was in the OM (76% +/- 3.6), as this is the region of maximal vascular density, then in the IM (73.4% +/- 2.9). In the glycerol group, SI loss in the OM (61% +/- 12.6) and the IM (45.2% +/- 16.24) was significant less than in the control group (p < .05). Pathology results showed fibrinous thrombus in the efferent arterioles and congestive aspect of the vasa recta in the medulla. We argue that a reduced medullary concentration of USPIO in the renal failure group is indicative of medullary hypoperfusion.

Acute Kidney Injury↗

PubMed1995

[Exploration of renal arteries by angio-MRI].

Major clinical challenges are involved in applications of MR-angiography for the study of renal arteries, mostly for the diagnosis of renovascular hypertension. This technique now competes with color Doppler flow sonography and spiral CT. MR angiography of the renal arteries can be performed with 2D or 3D, flight-time or phase contrast sequences. Main and co-dominant arteries are usual by visualized on all sequences, but small accessory arteries are often missed. The diagnosis of stenosis is based on the presence of an area of signal extinction. The degree of extinction depends on the degree of turbulence, the type of technique, the length of TE and spatial resolution parameters, which is why scoring of stenoses is difficult and frequently overestimated. The diagnostic performance for stenosis is between 50 and 100% for sensitivity and between 80 and 97% for specificity. Detection of distal stenoses is poor because of respiratory artifacts. Multiphase acquisitions make it possible to measure the renal blood flow on each renal artery, adding hemodynamic criteria to this diagnosis.

Humans↗

PubMed1994

Evaluation of intrarenal distribution of ultrasmall superparamagnetic iron oxide particles by magnetic resonance imaging and modification by furosemide and water restriction.

RATIONALE AND OBJECTIVES: The steady-state intrarenal distribution of ultrasmall superparamagnetic iron oxide (USPIO) particles in the cortex, the outer medulla (OM), and the inner medulla (IM) was investigated using magnetic resonance imaging in the normal rabbit kidney and in situations that modify the corticopapillary osmotic gradient. METHODS: Experiments were performed on rabbit kidneys with T2-weighed spin-echo sequence and T2-weighted gradient-recalled-echo sequence. The intravenous dose was 27 mumole/kg of iron in all rabbits. Three groups were studied: normally hydrated rabbits (n = 5), after water restriction (n = 5) to increase the osmotic gradient, and after furosemide injection (n = 5) to decrease the osmotic gradient. The signal intensity (SI) was quantified by region of interest placed on the cortex, the OM and the IM. RESULTS: In normally hydrated rabbits, a maximal decrease of the SI after USPIO was noted in the medulla, without significant difference between the OM and the IM on spin-echo sequences. The decrease of the SI was maximal in the IM on gradient-recalled echo sequences. In dehydrated animals, the maximum SI loss was in the OM. The furosemide-induced transient enhancement of the IM lasted a few minutes. CONCLUSIONS: The observed SI changes due to the distribution of the USPIO between OM and IM were not based on modifications of the osmotic gradient. The authors suggest that these SI changes were mostly dependent on the vascular density.

Animals↗

PubMedDate not supplied

First-pass evaluation of renal perfusion with TurboFLASH MR imaging and superparamagnetic iron oxide particles.

First-pass intrarenal hemodynamics were studied with superparamagnetic iron oxide particles and a T2-weighted TurboFLASH (fast low-angle shot) magnetic resonance (MR) imaging sequence. Four groups of five rabbits each were imaged after bolus injection of 40, 100, 140, and 200 mumol/kg iron, respectively. Images were acquired every 1.2 seconds, with an acquisition time of 700 msec. The signal intensity was measured in the cortex, outer medulla, inner medulla, and globally. In preliminary pathologic applications, two rabbits were imaged after ligation of the lumbar ureter and two after embolization of the renal artery. The reproducibility of the normal dynamics was evaluated with a cross-correlation test. On the images, the intravascular progression of the iron particles could be visualized within the cortex and the two compartments of the medulla in all cases. The maximal reduction in signal intensity in the cortex and medulla increased with the dose. The relationship between signal intensity decrease and dose was not linear, and the reproducibility of the signal intensity versus time plots was acceptable only at the 140 and 200 mumol/kg doses. The decrease in signal intensity was reduced and delayed in the embolized and hydronephrotic kidneys.

Animals↗

PubMedDate not supplied

Gd-DOTA tubular transit asymmetry induced by angiotensin-converting enzyme inhibitor in experimental renovascular hypertension.

In stenosis of a renal artery, angiotensin-converting enzyme inhibitor (ACEI) can induce a decrease in ipsilateral glomerular filtration. Dynamic MR imaging with gadolinium chelate enhancement was tested to detect this glomerular filtration reduction in experimental renovascular hypertension in the rat. Thirteen rats, with surgically induced left renal artery stenosis, developed hypertension and were studied before and after intravenous injection of ACEI with sequential Gd-DOTA-enhanced MR imaging. The time to onset of the tubular phase, the time of the maximal drop of signal, and the medullary signal-time curves of both kidneys were compared. Before ACEI, tubular phases were symmetric in 11 rats and slightly asymmetric in 2. Twelve rats showed ACEI-induced changes (positive test): absence of tubular phase on the left side (n = 8) or delay (n = 4) with significant differences (P < .01). Tubular phases remained symmetric in one (negative test). Dynamic MR imaging can identify ACEI-induced Gd-DOTA tubular transit asymmetry, indicative of functionally significant renal artery stenoses, in rats.

Angiotensin-Converting Enzyme Inhibitors↗