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Biomedical subjects

J R Michel

Publications and source records attributed to J R Michel.

At least 19 recordsLinked to original sources
PubMed1991

[Spontaneous urine extravasation during intravenous urography. Apropos of 21 cases. Review of the literature].

Twenty one cases of spontaneous urine extravasation during an intravenous urography have been analysed in order to determinate the radiological signs and the causes of this rare phenomenon. Related to the increased pressure of the excretory tract, these extravasations usually disappear without complications. No specific treatment is required except the treatment of the obstacle due generally to calculi. No infection nor development of retroperitoneal fibrosis nor sinusal lipomatosis were observed in the patients we studied.

Adult↗
PubMed1991

[Spontaneous urine extravasation during intravenous urography. Apropos of 21 cases. Review of the literature].

Twenty one cases of spontaneous urine extravasation during an intravenous urography have been analysed in order to determinate the radiological signs and the causes of this rare phenomenon. Related to the increased pressure of the excretory tract, these extravasations usually disappear without complications. No specific treatment is required except the treatment of the obstacle due generally to calculi. No infection nor development of retroperitoneal fibrosis nor sinusal lipomatosis were observed in the patients we studied.

Adult↗
PubMed1990

[Cancer of the kidney: venous staging using magnetic resonance imaging].

Venous tumor invasion in 42 renal cell carcinomas was evaluated by MRI. A correct diagnosis of renal vein and inferior vena cava (IVC) involvement was made in 14 of 17 tumors: 1 false negative diagnosis of right renal vein invasion was due to a double renal vein in which the inferior vein (identified by MRI) was not involved; 2 cases of IVC involvement were understaged (1 case of suprahepatic extension) or not identified (the false negative of renal vein invasion previously described). One false positive (among 31 tumors without venous invasion) was reported in a case of a large tumor in which the compressed but free right renal vein was overevaluated by MRI.

Carcinoma, Renal Cell↗
PubMed1990

[Extracorporeal lithotripsy of urinary calculi. Results and radiologic criteria of effectiveness. Apropos of 700 cases].

The results of extracorporeal shock wave lithotrity (Dornier lithotriptor) for 700 cases of urinary calculi have been reviewed and correlated with the radiological features of the calculi in order to define some predictive radiological criteria of effectiveness. The calculi were broken up in 74.5% of all cases, complete destruction (no residual fragment) was achieved in 34.5% and partial destruction in 40% of cases. The rate of failure (failure to break up or scatter the calculus) is 8.9%. Complications were observed in 2.6% of all cases, a second session of lithotrity or a surgical operation was required in 4.8% of cases (evolution lost to follow-up: 9.2%). The comparison of these results with the radiological data obtained before lithotrity allows distinguishing 2 categories of calculi: 1) Calculi with a favorable prognosis: single, smaller than 1 cm, pyelic, not very opaque and heterogeneous, located in normal-sized cavities; 2) calculi with a poor prognosis: multiple, larger than 2 cm, lower calyceal or ureteral, very opaque and homogeneous, located within dilated cavities.

Adolescent↗
PubMed1989

[Echography in pyelocaliceal tumors].

In a study of over 32 pyelocaliceal tumors greater than 1 cm in diameter, the authors review retrospectively the reports of the pyelographic and sonographic documents obtained in these patients before the definitive diagnosis was confirmed by the pathological examination. They observed that pyelography has a much greater diagnostic accuracy than does sonography: 31 confirmed (27) or suspected (4) tumors whereas only one tumor was overlooked (silent kidney) on pyelography and 12 diagnosed tumors, 15 overlooked and 5 diagnostic errors on ultrasonography. However, it should be noted that the results of ultrasonography are much better when the results of the intravenous pyelogram are known than when the latter is performed first. These results are supported by triple-blind re-reading of ultrasonographic documents of tumors of the excretory tract grouped with documents of normal kidneys presenting another disease of the sinus. The authors conclude that ultrasonography must be performed first whenever a tumor of the excretory tract is suspected (especially in case of hematuria) and that in this field, there are essentially two indications for ultrasonography: --To remove a stone (hyperechogenic with a cone of shadow) if there is a pyelocaliceal lacuna of unknown cause. --To establish that obstruction is due to a tumor, in the presence of a silent kidney.

Hematuria↗
PubMed1988

[Calcified masses of the kidney. Apropos of 58 cases].

Case reports were analyzed of patients with calcified renal masses observed in the department since 1968. Of the 65 radiologic reports reviewed, 7 were rejected since the course since diagnosis was unknown. Of the 58 case reports studied, 34 were of masses of certain diagnosis, 12 undetermined, 7 of masses in polycystic kidneys, 3 in tuberculous kidneys and 3 probably calcified hematomas. Analysis involved only those masses of proven diagnosis. Results confirmed the absence of specificity in favor of the cyst of peripheral character of calcifications: 33% of these masses were cancers. The existence of tissue calcification is synonymous of a solid mass, nearly always malignant (92% of cases). For peripherally calcified masses, arteriography was not sufficient to affirm benign nature of lesions, most of these masses having a particularly poorly vascularized or even avascular appearance. In these cases angiotensin was of special interest. Ultrasound imaging proved to be a reliable and perfectly sensitive examination. The presence of calcifications rarely interfered with study of tumoral contents. CT scan imaging and puncture biopsy were also perfectly sensitive and reliable examinations. Because of the high frequency of cancers in masses with peripheral calcification, all these masses should be surgically explored or at least punctured. Although a "benign" CT scan image appears sufficient to affirm the benign nature, this still requires more ample confirmation.

Adult↗
PubMed1988

[Aberrant papillae. Apropos of 47 personal cases. Review of the literature].

Based on a personal series of 47 cases of aberrant papillae and a review of the literature, the authors stress the relative frequency of this anomaly and the almost constant possibility of making the diagnosis by means of intravenous pyelography on the basis of the following signs: regular, round or oval filling defect, surrounded by a fine opaque halo which separates it from the surrounding urine; or a notch with a regular arc-shaped border prolonged towards the exterior at its two extremities by a small spur. This spur, like the halo on the frontal view, corresponds to the presence of a small fornix at the insertion of the wall into the papilla. In doubtful cases, the persistence and stability of the image on repeated films constitutes a valuable diagnostic element. Haematuria is not more frequent in cases of aberrant papillae than in the overall population seen in a urological radiology department; in most cases, it is unrelated to this papilla. Only exceptional cases presenting with bleeding from the papilla may raise diagnostic problems due to the irregular contours of this papilla as a result of the vascular dysplasia responsible or the presence of clots. However, the finding of an opaque halo at the periphery of the filling defect or a spur at the extremities of the notch should draw attention, suggest the diagnosis and prohibit any aggressive management.

Female↗
PubMed1988

[Ultrasonographic concept of the central prostate. Value of the endorectal approach].

In view of the difficulties involved in tissue characterisation of prostatic lesions by suprapubic and transrectal ultrasonography, the authors propose the concept of the central prostate in order to improve the possibility of histological diagnosis based on a topographical approach to ultrasound modifications. When the lesions are selectively situated in the central prostate, with clear distinction between the central prostate and the peripheral prostate, there is a low probability of a neoplastic lesion. However, the histological diagnosis must be extremely cautious and when a suspicious lesion is detected on ultrasonography, ultrasound guided aspiration biopsy may be required.

Adenoma↗
PubMed1986

[Radiological studies in the preoperative diagnosis of cystic cystadenoma of the kidney].

Investigations in 7 patients with cystadenoma (5 cases) or cystadenocarcinoma (2 cases) of kidney included intravenous urography, ultrasonography, arteriography and in 4 cases, computed tomography imaging. All these examinations, and particularly ultrasound imaging, provided strongly suggestive evidence of the diagnosis, as seen on images as a single parenchymatous mass constituted of "cystic" formations separated by partitions of variable thickness. Possible differential diagnosis includes necrotic cancer, hydatid or blood-containing cysts. Unfortunately, these different imaging techniques fail to distinguish between thick wall cystadenoma and cystadenocarcinoma, positive diagnosis requiring histology. Preoperative recognition of cystadenoma allows initial conservative surgery to be performed, followed by secondary operation if histology reserves an unpleasant surprise.

Adult↗
PubMed1983

[Lymphography and lymph node excision in bladder cancer. Apropos of a series].

The authors reviewed a series of 100 consecutive total cystectomies for carcinoma of the bladder, 78 with bilateral pelvic lymph node dissection and 43 with preoperative lymphography, attempting to determine the reliability of lymphography, to quantify the risk of lymphadenectomy and to assess the usefulness of lymphadenectomy when the nodes are involved. Routine reading of lymphography was associated with a level of accuracy of 68.7% an error rate of 10.8% and a level of uncertainty of 20.5%. Evaluating the results by number of patients rather than by the number of sides opacified by lymphography, the score was even lower: accuracy 60.5%, error 13.2%, doubt 26.3%. Strictly reviewing those cases where all necessary information was present in the record, initial routine reading of lymphographies gave 58% accuracy, 14% error, and 28% doubtful. Retrospective reading by one radiologist only gave much better results, but these did not correspond with the results obtained in everyday routine work. The number of complications related to lymphadenectomy appeared slight: amongst 78 operations, one lymphocoele, two cases of prolonged lymphatic discharge and three cases of oedema of the lower limbs. Of 14 patients with involved nodes, only three are living without recurrence and with follow-up periods which are as yet too short. All patients with involvement extending above the common iliac bifurcation died within a short time, as did all those with prostatic involvement. Comparing the data from their own series and the literature, the authors came to the following conclusions.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1982

[Ultrasonographic appearance of renal cancer. Correlation with arteriographic and histopathologic findings in 45 cases (author's transl)].

Ultrasonographic, arteriographic, and histopathological findings were compared in 45 patients with histologically-confirmed renal cancer. Ultrasound images clearly demonstrate the presence of a mass possessing similar echographic characteristics to those of the renal parenchyma (isoechogenic forms). Images are rarely homogeneous and are usually of a heterogeneous nature, either diffuse or including anechogenic zones (heterogenic lacunar forms). This latter appearance is almost specific for tumor necrosis, but a diffuse heterogenic image may be observed with or without the presence of necrosis. Necrotic cancers, with limited peripheral vascularization, present few diagnostic difficulties during ultrasonographic examination: the appearance is that of a solid mass, isoechogenic in the present series, heterogeneous, and with or without anechogenic zones. No correlation exists between the degree of echographic image alterations and the importance of vascularization, poorly vascularized cancers, of particular histological types, demonstrating hypo or hyper-echogenic changes more frequently than typical adenocarcinomas.

Adult↗
PubMed1982

[The echographic assessment of the size of normal pyelo-calyceal cavities. Accuracy and limits (author's transl)].

The authors studied using two echographies 90 kidneys in 53 patients free of known urinary tract pathology and not suffering from renal colic, the first immediately before intravenous urography (at a stage of relative fluid restriction) and the second before micturition (at a stage of higher urine output and filling of the bladder). Findings were as follows: - normal excretory cavities may be seen by echotomography, this being in contrast to a widely held view; - changes in the echographic appearance of the pyelocalyceal cavities may occur in the absence of any pathology merely as a result of changes in urine output. They draw attention to the possible errors inherent in echotomography performed alone. They emphasise the need, at least in the absence of renal insufficiency, to preceed any echography by intravenous urography.

Adolescent↗