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Biomedical subjects

K Tlili-Graiess

Publications and source records attributed to K Tlili-Graiess.

14 recordsLinked to original sources

[Imaging of acute cerebellitis in children. Report of 4 cases].

Acute cerebellitis is one of the main causes of acute cerebellar dysfunction in children. It is either infectious, usually viral, post-infectious or post vaccinal in etiology. Diagnosing acute cerebellitis may be difficult in patients with only subtle cerebellar signs and when cerebro-spinal fluid examination is normal. MRI is the most adequate imaging technique to demonstrate cerebellar involvement. The authors report the clinical and neuro-imaging findings in 4 paediatric cases. Patient's age varied from 2 to 7 years and predominant clinical symptoms were fever, headache and vomiting; ataxia was noted only in 2 cases. Viral serologic tests were negative in 3 cases and demonstrated Epstein-Barr virus in 1. Initial MRI examination (2 cases) demonstrated increased intensity on T2W and Flair sequences of the cerebellar gray matter with pial enhancement. Clinical outcome was good with complete resolution of symptoms in 3 cases and persistent mild right upper limb paresis in one. The resolution of the signal abnormality was well demonstrated on MRI in one case, suggesting an inflammatory etiology with moderate residual cerebellar atrophy.

Acute Disease↗

[Cerebral hydatid disease: imaging features].

Cerebral hytatid cysts (HC) are extremely rare, forming 2% of all intra cranial space occupying lesions even in counties where the disease is endemic. HC diagnosis is usually based on a pathognomonic computed tomography (CT) pattern. In order to assess the value of MR we reviewed the CT (n=25) and magnetic resonance (MR, n=4 including diffusion and proton magnetic resonance spectroscopy in 1) imaging of 25 patients with pathologically confirmed cerebral hydatid disease. 19 HC were seen in children under 16 years. All were supra tentorial with 22 in the middle cerebral artery territory. HC was solitary in 18 cases, unilocular in 23 and multi-vesicular in 2 with heavily calcified pericyst in 1. 2 cysts were intra ventricular and 1 intra aqueducal. The most typical features were well defined, smooth thin walled spherical or oval cystic lesions of CSF density and/or signal with considerable mass effect (20/25). Surrounding oedema with complete or incomplete rim enhancement was seen in 3 cases which were labelled as complicated and/or infected cysts. Although CT is diagnostic of hydatid disease in almost all cases (22/25), MRI including diffusion and spectroscopy precisely demonstrate location, number, cyst capsule, type of signal and enhancement and allows diagnosis of atypical or complicated HC and appears more helpful in surgical planning.

Adolescent↗

[Magnetic resonance imaging features of desmoplastic cerebral ganglioglioma of infancy: report of 1 case].

Desmoplastic infantile ganglioglioma is a rare intracranial tumor of infancy, characterized by solid and cystic component, voluminous size and supratentorial location. These tumors are diagnosed usually below the age of 2 years. We report 1 case of desmoplastic ganglioglioma in 13-year-old male. Computed tomography and magnetic resonance imaging diagnosed supratentorial mixed cystic and solid tumor, which presented as a large cystic component with intense contrast enhancement of a mural nodule. The tumor was surgically removed, and histology revealed desmoplastic ganglioglioma. The patient had a good follow up. This observation emphasizes the possibility of desmoplastic ganglioglioma in older infants. It mustn't be considered as a specific entity of very young age infant and must be recognized in older infant because it may be misdiagnosed as malignant glioma. Despite the pseudo malignant appearance, these tumors have a good prognosis after surgery and when excision is complete they don't led to recurrences.

Adolescent↗

[MRI findings in the diagnosis of pseudotumoral humeral hydatid].

Hydatidosis of bone is rare. Vertebral localizations predominate. Standard imaging may be misleading, suggestive of a malignant tumor or infection. We present the case of a patient with a humeral hydatid. This localization is very rare and presents an unusual radiographic aspect. Computed tomography produces an image suggestive of a tumor. The correct diagnosis can be established with MRI, particularly with the STIR sequence. In our patient, MRI enabled us to establish the diagnosis preoperatively and evaluate extension. MRI has been found to be highly contributive to the diagnosis of hydatidosis of bone and for assessment of intra- and peri-osseous extension.

Adult↗

[Magnetic resonance imaging features of cystic meningiomas. Report of four cases].

Four cases of cystic meningioma are reported, and the imaging features and diagnostic pitfalls of cystic meningiomas are reviewed. Cystic meningiomas are infrequent tumors and remain difficult to diagnose in spite of advanced imaging techniques. Our patients were between 15 and 58 years of age, and underwent CT and MR imaging. In all the four cases, the meningiomas were supratentorial and included Nauta type I, type II and type III tumors.

Adolescent↗

[Esophageal mucocele: report of 2 pediatric cases].

Two cases of esophageal mucocele in pediatric patients are reported: two children of 5 and 9 years respectively underwent surgical isolation of the esophagus and esophagocoloplasty for caustic stenosis related to accidental ingestion of caustic soda. Clinical pattern of mediastinal compression was proved with cervical fistulous tract in one case. In both cases, thoracic computed tomography was a sensitive imaging method to demonstrate the mucocele and its extension. Esophageal mucocele is rarely described in children, especially following esophageal corrosive stricture.

Burns, Chemical↗

[Abdominal actinomycosis. Report of 4 clinical cases studied with radiography].

We report 4 cases of pathologically proven abdominal actinomycosis. US and CT demonstrated an infiltrative abdominal mass with ill-defined margins and heterogeneous enhancement after IV contrast. The ileo-cecal region was involved in one case; the mass appeared following cholecystectomy and recurred 3 years after surgical resection in one case; and no predisposing factor was identified in the 2 other cases. In one of these, recurrence was observed 12 years after the first episode. Actinomycosis must be included in the differential diagnosis of invasive abdominal lesions with "malignant" appearance.

Abdomen↗

[Acute pyelonephritis and subcapsular hematoma revealing nephroblastoma at the age of 15 years].

BACKGROUND: Nephroblastoma' the most common renal tumor in children between 1 and 5 years, occurs rarely in the oldest child. CASE REPORT: A 16-year-old teenager suffered from acute pyelonephritis caused by Klebsiella pneumoniae. Renal ultrasonography showed a left subcapsular hematoma; the CT scan confirmed the finding and also showed renal scarring. However, a second CT scan showed pulmonary nodules suggestive of metastasis, a diagnosis that was confirmed by needle biopsy of pulmonary lesions. Recovery was obtained after chemotherapy and nephrectomy with a 3-year-follow-up. CONCLUSION: This nephroblastoma was particular because its development in an adolescent, its association with acute pyelonephritis and subcapsular hemorrhage.

Adolescent↗

[Value of imaging in the assessment of malignant fibrous histiocytoma of the soft tissues].

Malignant fibrous histiocytoma (MFH) is a rare and potentially highly malignant sarcoma. The authors report 6 cases of MFH in various sites: two in the chest wall, one in the pelvis, two in the gluteal zones and one on the scalp. Ultrasonography and computed tomography were the main imaging methods used in the assessment of the structure and extension of the tumor. A poor prognosis was noted in four cases: death within a few months in the two thoracic sites, recurrence in the pelvic and scalp lesions, radical surgery allowed recovery in two cases. A review of the literature showed that MRI and CT are complementary in the initial staging and follow-up of these patients.

Adult↗

[Ultrasonographic aspects of kidney pelvis tumors associated with infectious hydronephrosis of lithiasic origin].

The ultrasonographic findings of 4 patients with surgically confirmed urothelial tumors associated with calculic pyonephrosis are presented. All the involved were markedly enlarged and hydronephrotic with obstructive calculi, stigmata of pyonephrosis and, an echoic pelvic mass, extending in calyceas in 2 cases. The sonographic appearance correlated well with the gross pathological findings. The histological types were 2 squamous cell carcinomas, 1 adeno-squamous cell carcinoma and 1 transitional carcinoma. The chronic calculic irritation was proved to induce squamous and glandular metaplasia. The subsequent squamous carcinoma and adenocarcinoma were documented in the literature. The preoperative diagnosis of the associated tumor was rarely done. The sonographic features reported are highly suggestive of urothelial tumor and may lead to an accurate preoperative diagnosis.

Adenocarcinoma↗

[Emphysematous pyelonephritis. Apropos of a case diagnosed by ultrasonography].

Emphysematous pyelonephritis is a severe infection of the Kidney observed mainly in diabetic patients. The disease is characterized by the production of intra-renal and occasionally perirenal gas. Because of the high mortality associated with this fulminant septic infection, it is imperative to establish a prompt diagnosis and start an appropriate therapy early in the course of the disease. We report a case of emphysematous pyelonephritis diagnosed by sonography: sonographic features consist of multiple high amplitude echoes within the renal parenchyma, renal sinus and perirenal space associated with distal shadows containing low level echoes. We discuss the value of the radiologic imaging methods.

Diabetic Nephropathies↗

[Cavitary tumor lesions of the small intestine. Radio-ultrasonic diagnosis. Apropos of 4 cases].

Excavated lesions of small intestine are rare and generally of a malignant nature, the must frequent cause being metastases. In Tunisia these lesions are usually the aneurysmal type of lymphoma. The etiology in a series of four cases of excavated lesion of small intestine was not always lymphomatous. Radiologic and ultrasound semeiology are outlined and etiologies discussed. Scan images are not available since whole-body scanners are not in use in Tunisia.

Adolescent↗

[Adrenal tumors in Beckwith-Wiedemann syndrome. Apropos of a case].

A case of a neonate with Beckwith-Wiedemann syndrome is presented. Antenatal sonography detected a right adrenal cystic mass confirmed in post-natal which resolved spontaneously within 1 month. The child developed an adrenal adenoma detected by abdominal sonography at six months of surveillance. The authors review the different adrenal lesions possibly associated with Beckwith-Wiedemann syndrome and specially the pseudo-tumorous lesions. The value of abdominal sonography in the neonatal periods and in the surveillance of children with Beckwith-Wiedemann syndrome is emphasized.

Adenoma↗