PubMed Health⌕ Search

Biomedical subjects

J P Senac

Publications and source records attributed to J P Senac.

At least 19 recordsLinked to original sources
PubMed2001

Reversible amiodarone-induced lung disease: HRCT findings.

The aim of this study was to describe thoracic high-resolution computed tomography (HRCT) findings of reversible amiodarone-induced lung disease (AILD). The thoracic HRCT of 20 symptomatic patients who were considered as having reversible AILD by the medical staff of our institution were retrospectively reviewed. The patient-selection criteria used were the development of new respiratory symptoms while receiving amiodarone, the exclusion of other respiratory and cardiac diseases, and the decrease of both respiratory symptoms and radiological abnormalities after cessation of amiodarone and corticotherapy. The CT data recorded were those usually sought infiltrative lung diseases. The radiological findings using chest film (n=20) and HRCT (n=4) follow-up was noted. All patients had ground-glass opacities, associated with consolidations (n=4), thin intralobular reticulations (n=5), or both (n=11), with a subpleural (n=18) or central (n=2) location. Eight patients had high-density areas and 13 had pleural thickening (n=13). Bronchial abnormalities included dilation (n=16) and wall thickening (n=19). After therapeutic management, the radiological follow-up showed complete (n=17) or incomplete (n=3) improvement. Ground-glass opacities associated with thin intralobular reticulations and/or subpleural consolidations and bronchial abnormalities are common HRCT findings in reversible AILD.

Aged↗
PubMed2000

Acute changes in aortic wall mechanical properties after stent placement in rabbits.

PURPOSE: To evaluate mechanical property changes after endovascular stent placement in small-diameter arteries. MATERIALS AND METHODS: Self-expanding stents (Wallstent) were placed in the infrarenal aorta of five New Zealand White rabbits via a surgical right femoral approach. Blood pressure changes (deltaP) were monitored in the aorta. Blood flow velocity was measured with a 20-MHz, pulsed Doppler probe (n = 4) to calculate the pulsatility index. Aortic diameter (dA) and diameter changes (delta(d)) were measured with a 20-MHz probe in echo-tracking mode. Diameter compliance (Cd) and distensibility coefficient (DC) were calculated as Cd = 2(delta)d/(delta)P and DC = 2delta(d)/delta(P)/dA. RESULTS: Aortic diameter increased from 3.360 +/- 0.4033 mm to 4.020 +/- 0.3033 mm after stent placement at the stent level only. Compliance decreased from 77.644 +/- 24.306 mm kPa(-1) to 31.150 +/-8.245 x 10(-3) mm kPa(-1) at the stent level, and was then significantly lower than upstream (98.500 +/- 53.196 mm kPa(-1)) and down-stream (59.047 +/- 13.833 mm kPa(-1)). There was no significant change in pulsatility index. CONCLUSIONS: Endovascular stent placement produces a significant decrease in arterial wall compliance of the rabbit abdominal aorta.

Acute-Phase Reaction↗
PubMed1999

[Contribution of high-resolution volume computed tomography (HRVCT) for the exploration of diffuse pulmonary infiltrative disorders].

AIM: To assess high-resolution volume computed tomography (HRVCT) for the investigation of diffuse pulmonary infiltrative disorders. PATIENTS AND METHODS: Thirty patients with diffuse interstitial disease (idiopathic fibrosis n = 7, silicosis n = 4, asbestosis n = 5, sarcoidosis n = 7, histiocytosis n = 2, lymphangitis carcinomatosa n = 2, tuberculosis n = 1, bronchiolitis obliterans n = 1) were explored using high-resolution computed tomography (HRCT) and HRVCT. All diagnoses were proven by fiberscopy, bronchoalveolar lavage and respiratory function tests and/or lung biopsy. The HRVCT protocol consisted of spiral tomography using 10 mm slices. Data were processed with a Windows Advantage workstation (GE Milwaukee). Two readers compared multiprojection volume reconstruction (MPVR) using maximal intensity projection (MIP) and minimal intensity projection (MINIP) displays with millimetric HRCT slices acquired at the same volume. RESULTS: Micronodules were detected better with HRVCT than with HRCT. MIP mode enabled better distinction between nodules and vessels. MINIP mode enabled better detection of cysts in the pulmonary parenchyma than HRCT. The honeycomb aspect of pulmonary fibrosis was differentiated better than super-infected central-lobar emphysema. MINIP mode enabled detection of ground glass opacities which were not visible on HRCT. Certain anomalies were however detected only on HRCT. HRVCT was very sensitive to movement effects which altered image quality, particularly in the MINIP mode. CONCLUSION: HRVCT is a new and promising approach for investigating diffuse pulmonary infiltrative disorders.

Adult↗
PubMed1998

Endovascular management of traumatic infrarenal abdominal aortic dissection.

Dissection is a recognized finding after blunt trauma to the abdominal aorta. Immediate and long-term prognosis is poor without surgical treatment especially since most patients present severe associated injuries. On the basis of encouraging results using endovascular techniques to treat experimental dissection of the descending thoracic aorta, we treated three patients with traumatic infrarenal abdominal aortic dissection by percutaneous stent placement. There were two men 34 and 41 years of age and one 89-year-old woman. In all patients, dissection began in the infrarenal portion of the aorta and extended into the iliac arteries. All patients had multiple associated injuries. The main symptoms were acute abdominal pain (two patients) and ischemia of the lower extremities (two patients). Diagnosis was missed in one patient despite exploratory laparotomy for an associated injury. Two patients were treated in the acute phase by placement of a self-expanding endovascular prosthesis at the aortoiliac level. The third patient was treated in the chronic phase by placement of a balloon-expandable endovascular stent. All procedures were performed uneventfully by femoral route. Success of treatment was confirmed by arteriography and computed tomography (CT) scan demonstrating obliteration of the dissection. Upon late follow-up examination, all patients were in satisfactory condition, with normal Doppler ultrasound findings. These findings confirm experimental studies using endovascular treatment for dissection of the descending thoracic aorta and are promising for future clinical management.

Adult↗
PubMed1998

CT-guided percutaneous treatment of inoperable pulmonary aspergillomas: a study of 40 cases.

OBJECTIVE: To treat symptomatic pulmonary aspergilloma in patients who were not considered to be operable. MATERIAL AND METHODS: Forty patients were treated by CT-guided percutaneous injection of amphotericin paste, the aim being to fill the cavity completely and create an anaerobic environment for the aspergillus. The aspergillomas had developed after bacillary infection and pulmonary fibrosis. Surgery was contra-indicated in these patients because of severe respiratory failure. The authors detail the method of preparation of the paste and the technique of percutaneous injection. RESULTS: Hemoptysis ceased in all 40 patients, with a follow-up ranging from 6 to 28 months; six patients were also treated with bronchial embolization. In 26 patients, the aspergilloma disappeared and serum tests for aspergillus became negative. Complete disappearance of both the aspergilloma and the cavity was obtained in three patients. CONCLUSION: This technique appears to be a valuable contribution to non-surgical treatment of inoperable patients with pulmonary aspergilloma, but study should be continued in a larger series to define the exact indications and the interaction with other treatments which have recently been introduced.

Aged↗
PubMed1998

[CT-guided percutaneous treatment of inoperable pulmonary aspergilloma. Apropos of 42 cases].

The authors report 42 cases of symptomatic pulmonary aspergilloma treated by intracavitary percutaneous injections of Amphotericine paste. These patients were not considered as operable. The aspergillomas complicated tuberculosis sequels and pulmonary fibrosis. Surgery was contraindicated in these patients on account of severe respiratory failure. The authors specify the technique for the preparation of the paste and for the type of percutaneous injection under CT guidance; the aim being to obtain complete filling of the cavity and creating an "anaerobic" environment for the aspergillus. The contribution of this technique for the non-surgical treatment of patients appears interesting but should be carried on a larger series to identify the exact indications and the interaction with other treatments (drugs and surgery).

Aged↗
PubMed1997

Diffuse pulmonary calcinosis without calcium metabolism abnormalities in a renal transplant recipient.

Eighteen years after an uneventful renal transplantation, the chest radiograph of an asymptomatic 50 year old man showed diffuse bilateral infiltrations, predominately at the right apex. Computed tomography (CT) scan demonstrated a diffuse alveolar pattern, the alveoli being filled with a very dense material, with some tracheal calcifications. Bronchoalveolar lavage fluid analysis was normal, but bronchial and transbronchial biopsies revealed calcium deposits in the bronchial mucosa and in the alveolar septa. The diagnosis of diffuse pulmonary calcinosis was established, despite normal blood calcium, phosphorus and magnesium levels, based upon computed tomography scan and pathological findings at fibreoptic bronchoscopy, without the need for an open lung biopsy.

Biopsy↗
PubMed1996

Imaging of hyperparathyroidism: US, CT, MRI and MIBI scintigraphy.

Hyperparathyroidism is a rare condition although recently the incidence has increased, particularly the asymptomatic form, as a result of routine serum calcium measurements. A definitive diagnosis can be made using modern bio-assays giving direct measurements of parathormone (PTH). Various methods are currently available for pre-operative localisation of pathological parathyroid glands. Ultrasound is sufficient prior to the initial surgery. However, if primary surgical exploration fails to localise the parathyroid glands then the surgeon faces a more complex problem and requires precise localisation prior to repeat surgery to reduce operating time and risk. No radiological method is available to localise pathological glands in 100% of cases. The surgeon is usually satisfied when two different methods are positive and in concordance. The non-invasive methods such as ultrasound, CT, MRI and scintigraphy are initially performed and if the result remains equivocal then more invasive methods such as arterial or venous sampling are undertaken. Our preliminary results in secondary hyperparathyroidism, before repeat surgery, indicate that associated and complementary tests, morphological and functional, MRI (fat-sat, T1, gadolinium) and MIBI scintigraphy, have greater efficacy.

Adenoma↗
PubMed1996

Interventional chest radiology.

The authors review the various interventional radiology techniques currently used in 1996 by a Medico-Radio-Surgical team. CT guided needle biopsy has an important place in the diagnostic approach to parenchymal as well as mediastinal tumours. But CT guidance allows also routine drainage of thoracic collections and sometimes thoracic sympatholysis. Superior vena cava and tracheobronchial stenting are palliative treatments as the percutaneous aspergilloma treatment. Embolization of bronchial and thoracic systemic arteries are also palliative but effective therapeutic procedures as well as vasoocclusion for arterio-venous fistulae.

Aspergillosis↗
PubMed1996

[Diagnostic percutaneous thoracic punctures. Assessment through a critical study of a compliation of 2406 cases].

The aim of this retrospective study of 2,406 diagnostic percutaneous thoracic needle aspirations under computer tomographic control was to assess the diagnostic value of this method, the technical problems and the complications and finally, to refine the indications. Percutaneous needle aspiration had been carried out after negative fibreoptic bronchoscopy. The authors review their technique and show the value of biopsy material which is only slightly traumatised. Computerised tomography and fine needle aspiration reduce the risk of pneumothorax and haemorrhage in a significant fashion. Personalized collaboration between the radiologist, physician and cytologist is a vital pre-requisite. The indications are discussed notably in cases of solitary pulmonary nodules and of mediastinal masses.

Adolescent↗
PubMed1995

[Pulmonary embolism: contribution of spiral x-ray computed tomography].

PURPOSE: Spiral computed tomography was compared retrospectively with digital subtraction pulmonary angiography (PA) in 45 patients suspected of having acute or chronic pulmonary embolism. MATERIALS AND METHODS: 45 patients in whom the presence of acute or chronic pulmonary embolism was suspected underwent examination by spiral CT and PA. Diagnosis of pulmonary embolism was based on the direct visualization of intraluminal clots. The study of the agreement between the two methods was based on the Kappa test. In 35 cases, pulmonary emboli were proved. Acute pulmonary emboli were present in 28 cases and chronic in 7 cases. RESULTS: Spiral computed tomography represents an excellent way to detect acute pulmonary embolism. In the chronic form, spiral CT is better than PA to detect intraluminal clots. However, Spiral CT can fail to detect small embole in the peripheral arterial bed. In the 10 patients without pulmonary embolism, the spiral CT proved diagnosis pulmonary oedema (n = 3), lymphangitic carcinoma (n = 4), pleural effusion (n = 3). CONCLUSION: This study suggest that the spiral CT examination is accurate for diagnosis of pulmonary embolism specifically in case of suspected important embolism. The advantages of spiral CT are multiple (non invasive, wide diagnosis spectrum). However, may be a limitation to is use is insufficient distal thrombi detection. This eventuality (5 to 10% in the Pioped study) justify the practice of pulmonary angiography. Spiral CT improvements should reduce this insufficiency in the next future.

Acute Disease↗
PubMed1995

[The use of high resolution x-ray computed tomography in the diagnosis of hypersensitivity pneumopathy to gold salts. Apropos of a case].

A hypersensitivity pneumonia is rare during gold therapy. The underlying mechanism is immunological in origin, of Gell and Coombs Type IV. As there are numerous possible pulmonary disorders during the course of inflammatory rheumatism treated with gold, the early detection is vital, in order to prevent progress to fibrosis. In parallel with broncho-alveolar lavage to look for a T8 lymphocytic alveolitis, which is very suggestive, high resolution computed tomography has a place in the early diagnosis, to characterise the lesions, to aid in an aetiological diagnosis, and also to assess progress on treatment. The authors present a case of pneumonitis induced by gold with visible interstitial lesions on computed tomography, accompanied by significant bronchial distortion and bronchiectasis suggestive of fixed lesions. These lesions partially regressed following steroid therapy; the diagnostic and prognostic role for high resolution computer tomography was discussed.

Alveolitis, Extrinsic Allergic↗
PubMed1995

[Palliative percutaneous treatment under x-ray computed tomographic control of inoperable pulmonary aspergilloma. Apropos of 30 cases].

The authors report 30 cases of the percutaneous treatment of symptomatic pulmonary aspergilloma by injection of amphotericine paste in patients who were not considered to be operable. The treated aspergillomas had developed as a sequel to bacilliary infection and pulmonary fibrosis. Surgery was contraindicated in these patients on account of severe respiratory failure. The authors specify the technique for the preparation of the paste and for the type of percutaneous injection, the aim being to obtain complete filling of the cavity and creating an anaerobic environment for the aspergillus. The contribution of this technique for the non-surgical treatment of patients appears interesting but should be carried on a larger series to identify the exact indications and the interaction with other new treatments which have just appeared.

Aged↗