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Biomedical subjects

J Boisvert

Publications and source records attributed to J Boisvert.

At least 19 recordsLinked to original sources
PubMed1992

Intussusception in children: reliability of US in diagnosis--a prospective study.

To assess the diagnostic value of ultrasound (US) in clinically suspected acute intestinal intussusception in children, the authors prospectively compared US and enema studies in 83 episodes. None of the cases negative at US proved to be intussusception at enema study (negative predictive value = 100%). The sensitivity of US was 100%, and the specificity was 88%. Most of the sonograms were initially obtained and examined by residents. Several unsuspected abnormalities were also found with US. The authors conclude that a few months of training in US appears to be sufficient for high-accuracy investigation of clinically suspected intussusception, enabling selection of those patients in need of an enema.

Barium Sulfate↗
PubMed1992

Development of the fetal brain in the second trimester: an anatomic and ultrasonographic demonstration.

The authors provide an anatomic and ultrasonographic description of the fetal brain from the 16th to the 27th week of development. During the second trimester the primitive brain is smooth and homogeneous and has few sulci and relatively large lateral ventricles. The cerebral hemispheres consist largely of cells migrating from the periventricular germinal matrix to the primitive cortex. The "featureless" hemispheres yield homogeneous ultrasonographic images very different from the more complex and familiar cerebral anatomy of fetuses and premature babies in the third trimester.

Brain↗
PubMed1991

Prenatal diagnosis of fetal anomalies during the second trimester of pregnancy: their characterization and delineation of defects in pregnancies at risk.

During a follow-up study of 19,790 pregnancies at risk for a genetic disease, from 1968 to 1989, 1083 fetuses were found to have an anomaly during the second trimester, leading to 977 terminations of pregnancy. Neural tube defects (31.4 per cent), chromosomal disorders (27.1 per cent), and Mendelian or multifactorial diseases (10.6 per cent) were the main causes of fetal anomaly. More than half (52.9 per cent) of the fetal anomalies were detected by routine ultrasound examination. Forty-two per cent of cystic hygromas were secondary to a chromosomal defect. We stress the importance of a comprehensive fetal and newborn examination to ensure an accurate diagnosis so that subsequently accurate counselling can be provided.

Abdominal Muscles↗
PubMed1991

In utero sonographic diagnosis of diaphragmatic hernia with hepatic protrusion into the pericardium mimicking an intrapericardial tumour.

A case of right-sided congenital diaphragmatic hernia was detected at 33 weeks of gestation. Fetal echocardiography revealed the presence of an intrapericardial mass (3.5 x 3 cm) localized at the right of the heart and surrounded by a massive pericardial effusion. This mass had the same echogenicity as the liver, with which it shared vascular channels. The diagnosis of right diaphragmatic hernia with protrusion of hepatic tissue into the pericardial sac and secondary pericardial effusion was made and confirmed after birth. In utero diagnosis of this anomaly enabled correct assessment of perinatal risk, and optimal fetal and infant management.

Adult↗
PubMed1991

Antenatal diagnosis of ovarian cysts: natural history and therapeutic implications.

A retrospective study from 1980 to 1990 shows 29 ovarian cysts in 27 patients diagnosed by prenatal ultrasound performed between 28 and 38 weeks of gestation. Ten patients underwent surgery, 17 patients were observed with serial ultrasound. Delayed good quality sonograms after spontaneous resolution of the cyst in a selected group of 7 patients showed restoration of a normal ovarian anatomy. The size of the cyst and/or its sonographic characteristics are the 2 main factors for deciding a conservative or a surgical management.

Female↗
PubMed1990

Normal portal venous diameter in children.

A study was conducted on 156 children, in whom the portal veins were measured using standard real time ultrasonography. Knowledge of the normal dimension may be important in patients with liver disease.

Adolescent↗
PubMed1990

Fetal lobation. An anatomo-ultrasonographic correlation.

Remnants of the fusion of fetal renunculi have been mistaken for renal scars or tumors. We compared anatomic cuts of 24 cadaveric kidneys with fetal lobation (ages ranged from 16 weeks gestation to 49 years) to identical ultrasonographic sections performed in a water bath and to sonograms of healthy persons of similar ages as the cadavers. Fetal lobation was characterized as follows: there were fine, linear demarcations indenting the renal surface, separating normal lobes, consisting of a central pyramid and surrounding cortex. Separate renunculi seen in early fetal life progressively fuse throughout gestation, leaving interlobar grooves. During the third trimester, the renal surface becomes smoother and the interlobar grooves become invisible. One prominent indentation of the renal surface, the interrenuncular junction, incorporates perirenal fat and invaginates the anterior surface of the upper third of the kidney to the hilum and is the most easily visible remnant of fetal lobation. The sharply defined linear remnants of interlobar grooves should not be mistaken for scars, which are wider, less well defined and always associated with loss of renal cortex.

Adolescent↗
PubMed1987

Investigation of childhood blunt abdominal trauma: a practical approach using ultrasound as the initial diagnostic modality.

During a 5.5-year retrospective study (1979-84) 170 children with blunt abdominal trauma were investigated with intravenous urography (IVU), ultrasound (US) and scintigraphy. For the investigation of the last 71 children (after 1982) a 4th generation CT scanner was available in the same department. The results of radiologic investigations were compared with clinical outcome in 157 and results at laparotomy in 13 children. During the study period, real time US became the first line screening tool, and was combined with IVU in suspected renal trauma. In spite of permanent accessibility of CT since November 1982, the latter was used only in complex diagnostic problems or in children with multiple injuries (8% of the series). There were no deaths resulting from abdominal trauma. During the study, the incidence of splenectomy and exploratory laparotomy decreased, and no diagnostic peritoneal lavage were performed after 1980.

Abdominal Injuries↗
PubMed1987

Management of thyroid nodules in children: a 20-year experience.

The medical records and surgical slides of 58 patients with the diagnosis of thyroid nodules (solitary nodule in 50 patients) are reviewed. The most common cause of thyroid nodules in this series is follicular adenoma (27 patients or 46%). A nuclear scan (technetium or radioactive iodine) was performed in 55 patients, of which 40 showed a cold nodule. Twelve of the 40 cold nodules were malignant (30%). However, for solitary nodules the incidence of cancer is 27%. This last figure is significantly greater than the one recently reported by Hung et al (18.5%). Available diagnostic methods are reviewed and the clinical management as derived from our experience is presented.

Adolescent↗
PubMed1986

Multicystic dysplastic kidneys: spontaneous regression demonstrated with US.

In nine neonates, spontaneous regression of a multicystic dysplastic kidney (MCDK) was witnessed by means of repeated ultrasound (US) examinations. In three of these patients, the diagnosis was made in utero. Follow-up examinations at the ages of 3, 5, and 32 weeks post-partum showed what would have been called unilateral agenesis of the affected side if no fetal US study had been done. In the remaining neonates, the diagnosis was made postnatally, and marked reduction in size or complete disappearance of the MCDK was observed on serial US examinations. Three neonates underwent surgical exploration. No trace of a kidney, renal artery, or ureter was found in two. A small MCDK was removed in the third patient. US reveals new features of the natural history of MCDKs. Because malignant transformation of an MCDK is rare and because US provides a means of serial assessment, the authors believe a more conservative, nonsurgical approach is appropriate and recommend an observation time of 1 year before deciding on surgical intervention, unless other problems necessitate surgical removal of the MCDK.

Female↗
PubMed1985

Lesser omental thickness in normal children: baseline for detection of portal hypertension.

The lesser omentum between the left lobe of the liver and the aorta at the level of the celiac axis harbors the left gastric vein and artery, lymphatics, nerves, and some fatty tissue. In one study, it was found to be thickened in most of 50 children with portal hypertension, but normal values were not established. Lesser omental thickness was measured in 150 children without systemic, liver, or renal disease, and it was found that it did not exceed 1.7 times the diameter of the aorta at the same level. Increased measurements were obtained in children with portal hypertension, obesity, or systemic steroid therapy (by fatty infiltration), preaortic lymphadenopathy, or with transient interposition of the gastric antrum or pancreas between the liver and aorta. In the absence of obesity or lymphadenopathy, a lesser omentum measuring more than 1.7 times the aortic diameter should raise the possibility of portal hypertension.

Adolescent↗
PubMed1985

A pseudo-choledocal cyst.

A four-year-old boy presented with a history of intermittent obstructive jaundice. Investigation and surgical exploration revealed an abnormal configuration of the biliary tree which, to our knowledge, has never been otherwise reported.

Bile Ducts↗
PubMed1984

Urinary tract infection in children. A reappraisal of its radiologic investigation.

In a prospective study, 100 children with either an acute or a previous history of urinary tract infection were investigated by intravenous urography, micturition cystourethrography, and ultrasonography. The results from the three diagnostic modalities were compared: The urinary tracts in 59 patients were normal, and revealed some abnormality in 41. Ultrasonography proved to be superior to intravenous urography in outlining renal contours and in detecting subtle cortical changes secondary to urinary tract infection (such as slight increases in cortical thickness and edema or cortical scarring). The mucosa of the renal pelvis and bladder was more easily assessed by ultrasound than by intravenous urography. Both modalities were "equally" accurate in detecting important congenital malformations of the urinary tract. Ultrasound failed to detect 24 of 28 ureters demonstrating reflux on voiding cystourethrography. We propose that carefully performed abdominal ultrasonography can replace intravenous urography in the initial investigation of urinary tract infection in children. It should be done in association with a radiographic or radionuclide voiding cystogram. Intravenous urography would then become a complementary examination for abnormal or problematic patients.

Adolescent↗
PubMed1984

[Echography of pyloric stenosis].

In order to assess the accuracy of ultrasonographic (US) criteria for the diagnosis of pyloric stenosis (PS), the record of 78 infants admitted to Hôpital Sainte-Justine with the clinical diagnosis of PS during the past year was reviewed. Fifty-eight patients had PS at laparatomy. Thirty-four of these had US with 30 true positives and four "doubtful" findings. Twenty-two had normal US. Two of these had PS, nine gastroesophageal reflux and five normal barium studies of the upper gastrointestinal tract (the last six were followed clinically and remained well). The following were criteria for US diagnosis of PS: pyloric anteroposterior diameter greater than or equal to 1.5 cm, length greater than or equal to 2 cm or a muscle thickness greater than or equal to 4 mm. This series contains no false positive US studies and two false negatives, for a positive predictive accuracy of 94% and a negative predictive accuracy of 100% when we measure the length greater than or equal to 2 cm or combine a length of less than or equal to 2 cm with a muscle thickness greater than or equal to 4 mm.

Female↗
PubMed1984

[The role of echography in splenic injuries in children].

We have reviewed 39 cases of ruptured spleen in children from 1979 to march 1983 at Ste-Justine Hospital in Montreal. We were mainly interested in the role of ultrasonography, its value and limitations. The practical management is exposed. To the best of our knowledge, it is the first report of this kind in pediatrics.

Child↗