A possible parvovirus B19 encephalitis in an immunocompetent adult patient.
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Biomedical subjects
Publications and source records attributed to L Monnier-Cholley.
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We report two cases of acute aortic thrombosis in cancer patients. Aortic thrombosis is rare in the absence of atherosclerosis, dissection, or aneurysm. On the one hand, hypercoagulable state related to cancer is a well-known risk factor for venous thrombosis. On the other hand, arterial thrombosis has been rarely reported in cancer patients. Recognition of aortic thrombosis is important because it is a dangerous condition; furthermore, it exposes at the patient to complications such as peripheral embolism. In addition, anticoagulation can result in resolution of thrombosis.
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Intramural hematoma of the colon is a rare complication of blunt abdominal trauma. We report the case of a 32-year-old man who presented with abdominal pain related to blunt trauma. The initial diagnosis of post-traumatic intramural hematoma of the colon was performed at CT scan and proven at colonoscopy. Although the majority of cases warrant surgery, conservative therapy was proposed in the present case with spontaneous resolution of the hematoma demonstrated by CT scan.
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OBJECTIVE: To evaluate the results of combination of D-Dimer test and simple clinical model for the diagnosis of deep vein thrombosis (DVT). MATERIALS AND METHODS: Inclusion: clinical suspicion of DVT. Non inclusion criteria were Clinical model performed by the referring physician included probability varying from high to low. D-Dimer test was performed by five different rapid techniques. Standard of reference was Doppler ultrasonography (DU) performed by a senior radiologist. RESULTS: Eight hundred and fifty-four DU were performed on a 14 months time period, including 206 suspicion of pulmonary embolism, 109 postoperative time period, 120 non-included or excluded patients, 278 incomplete observations, 141 complete observations. DVT was present in 33 cases and absent in the other 108 cases (prevalence 23%). Sensitivity and negative predictive value of the five tests were between 82 and 97% and 90 et 97%. The most sensitive test had a specificity of 36% and a positive predictive value of 32%. Combination of clinical model and D-Dimer test did not improve the diagnostic accuracy. CONCLUSION: None of the test evaluated in the present study, even when combined with the clinical model results, did allow the exclusion of DVT.
We describe a case of subcutaneous metastasis along the needle track after percutaneous ethanol injection (PEI) for treatment of hepatocellular carcinoma. After surgical resection and extrabeam radiation therapy the patient is alive without evidence of recurrence five years after PEI. One should pay attention to the abdominal wall around the needle track in interpreting CT or MR images of patients with previous PEI.
The purpose of this study was to report 30 cases of missed lung cancers and describe characteristics of each case. Reasons for misdiagnosis were analyzed from the report. Each radiograph was subsequently reviewed by a panel of two experts who quantified several parameters regarding image analysis and film quality. Lesions were not described in 67% of the cases and were misinterpreted as benign processes in 33% of cases. Comparison to previous chest radiographs and clinical information were seldom available on the report. Size of the lesions varied between 1 and 7 cm, location was primarily apical and paramediastinal, normal anatomy was highly or moderately complex in 87%, and distracting lesions were present in 63% of the cases. Image quality was considered perfect in 3 cases only. Among all the factors responsible for missed lung cancer, certain factors can be improved as film quality, comparison with previous radiographs, and better awareness of clinical information.
Filter placement within the inferior vena cava is performed to prevent pulmonary embolism in patients with contraindications or failure of anticoagulant therapy. Several complications of vena cava filters have been described. However, mechanical complications related to IVC filters may not be of any clinical significance. The purpose of this pictorial essay is to present the imaging features of complications related to inferior vena cava filter placement.
OBJECTIVE: The purpose of the present study was to determine the publication rate in Medline-indexed journals of papers originally presented at the Journées Françaises de Radiologie (JFR96). MATERIALS AND METHODS: Proceedings from the JFR 96 were reviewed by two observers in conference. A Medline search encompassing 1997-1999 was performed for the lead author of all abstracts of original papers. Publication year and the journal of publication were recorded. RESULTS: 456 oral presentations were analysed, 39 papers were subsequently published corresponding to a publication rate of 8.5%. 10 papers were published in Radiology, 4 in European Radiology and 4 in the Journal de Radiologie, the other 21 in other journals. Publication rate was significantly higher for two sessions: Research session (publication rate was 22%) and Bone and Joint session (publication rate was 16%). CONCLUSION: Less than 10% of abstracts presented at JFR 96 were subsequently published in Medline-indexed journals. This rate is lower than the publication rate of papers presented at other medical meetings.
A pulmonary artery pseudoaneurysm developed after placement of a Swan-Ganz catheter for liver surgery is described. This observation is unusual for two reasons. Pulmonary artery pseudoaneurysm was discovered on a simple post-operative chest radiograph. Spontaneous thrombosis and radiographic regression were observed.
PURPOSE: To develop and evaluate a scale for assessment of the methodological quality for clinical investigations of radiologic studies. MATERIALS AND METHODS: A scale was developed that included methodological standards compiled from established sources for assessing the methodological quality of study designs in clinical research and characteristics related to biases commonly observed in clinical radiologic research. The scale was composed of 15 standards and was tested with the results of 96 studies on imaging of liver hemangioma. Interrater reliability was measured between two observers by using percentage agreement and kappa statistics. Interrater reliability between two observers for a composite quality index that encompassed the 15 standards was measured with the intraclass correlation coefficient. RESULTS: Agreement between the two observers was almost perfect (kappa value, 0.8-1.0) for 11 standards and substantial (kappa value, 0.74-0.78) for four standards. Agreement between the observers with regard to the composite quality index also was high (intraclass correlation coefficient r, 0.91 [95% CI: 0.87, 0.94]). CONCLUSION: The scale appears to be reliable for the assessment of methodological quality of clinical investigations of radiologic studies.
OBJECTIVE: We retrospectively reviewed five pathologically proven cases of diffuse cavernous hemangioma of the rectosigmoid colon to define the MR imaging features of this entity. CONCLUSION: Diffuse cavernous hemangioma of the rectosigmoid colon is revealed as rectosigmoid wall thickening with high signal intensity on T2-weighted MR images. Such wall thickening is associated with abnormal perirectal fat. The extent of bowel involvement and extrarectal locations are well shown on T2-weighted MR images.
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OBJECTIVE: Our objective was to evaluate the impact of a computer-aided diagnostic scheme on radiologists' interpretations of chest radiographs with interstitial opacities by performing an observer test using receiver operating characteristic (ROC) analysis. MATERIALS AND METHODS: Twenty chest radiographs with normal findings and 20 chest radiographs with abnormal findings were used. Each radiograph was divided into four quadrants. One hundred twenty-nine quadrants (80 normal and 49 abnormal quadrants) were used for testing because we excluded 31 equivocal quadrants. Sixteen independent observers (10 residents and six attending radiologists) participated in this study. The radiologists' performance without and with computer assistance, which indicated cases with normal and abnormal findings by various markers, was evaluated by ROC analysis. RESULTS: The diagnostic accuracy of the observers improved by a statistically significant magnitude when computer-aided diagnosis was used. Thus, the values for the area under the ROC curve obtained with and without the computer-aided diagnostic output were .970 and .948 (p = .0002), respectively, for all observers; .969 and .943 (p = .0006), respectively, for the residents' subgroup; and .972 and .960 (p = .162), respectively, for the attending radiologists' subgroup. The value for the area under the ROC curve for the computerized scheme by itself was .943. CONCLUSION: Our computer-aided diagnostic scheme can assist radiologists in the diagnosis or exclusion of interstitial disease on chest radiographs.
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