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Biomedical subjects

M Bazot

Publications and source records attributed to M Bazot.

At least 19 recordsLinked to original sources
PubMed2006

Uro-retroperitoneum after ultrasound-guided transvaginal follicle puncture in an oocyte donor: a case report.

Ultrasound-guided transvaginal follicle aspiration is the standard technique for oocyte retrieval prior to IVF. Complications are rare, but some are potentially serious. We report a case of ureteral injury with acute-onset uro-retroperitoneum in a volunteer oocyte donor. The patient recovered rapidly after ureteral stenting. This case underlines the need for all candidate oocyte donors to receive proper information on serious procedure-related complications.

Adult↗
PubMed2006

[Uterine embolization for submucous fibroid: a bad alternative to surgery?].

A case of septic expulsion of a leiomyoma is reported 18 weeks after uterine artery embolisation (UAE). The patient underwent UAE for a symptomatic sub-mucous leiomyoma (type 2) of 5 cm. She was feverish and presented pelvic pain and purulent vaginal discharges. Vaginal examination revealed a necrotic mass prolapsed through the cervix that was carefully twisted out. Histopathologic examination showed extensive necrosis of the myomatous tissue. Microbiologic cultures showed heavy growth of Escherichia coli. Such findings challenge the interest and the safety of UAE for sub-mucous fibroids. Our case report stresses that uterine artery embolisation for submucous fibroids does not constitute, because of its risks, an alternative to conventional surgical treatment represented mainly by hysteroscopic resection.

Embolization, Therapeutic↗
PubMed2005

[Accuracy of MR imaging combined with sonography for the diagnosis of persistent adnexal masses during pregnancy: about nine cases].

OBJECTIVE: To evaluate the accuracy of MR imaging combined with sonography for the diagnosis of persistent adnexal masses during pregnancy. PATIENTS AND METHODS: From January 1999 to November 2003, nine patients with a persistent adnexal masse were included in this retrospective study. All patients underwent both transvaginal and transabdominal sonography combined with MR imaging. Accuracy of imaging techniques was evaluated by comparison with histology. RESULTS: Adnexal masse was detected by systematic sonography in six women whereas three patients were symptomatic. Mean gestational age at the diagnosis was 17 weeks of amenorrhea (range 5-36). Mean tumor size was 96 mm (range 2-15). Two patients underwent a surgery during pregnancy; one for acute abdominal pain related to an adnexal torsion and the second for suspicion of malignancy. One patient underwent a caesarean delivery for obstetrical reasons. In all patients, benign ovarian tumours were found. For eight patients the diagnosis suspected by imaging techniques was confirmed by histology. DISCUSSION AND CONCLUSION: The combination of sonography and MR imaging allows diagnosing accurately adnexal masses during pregnancy.

Adnexal Diseases↗
PubMed2005

[Value of sonography and MR imaging for the evaluation of deep pelvic endometriosis].

Deep pelvic endometriosis may involve the uterosacral ligaments, cul-de-sac of Douglas, vagina, rectum, and occasionally the bladder. Evaluation by physical examination is difficult, and imaging techniques are needed to evaluate the location and extent of endometriosis. In this review, we review the transvaginal and transrectal sonographic and MR imaging features suggestive of deep pelvic endometriosis and their diagnostic value.

Adnexal Diseases↗
PubMed2004

Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis.

OBJECTIVE: To determine the accuracy of transvaginal sonography (TVS) for the diagnosis of deep pelvic endometriosis. METHODS: In a prospective study, 142 women with clinical signs of endometriosis underwent TVS followed by surgical and histopathological investigations. The presence and extent of endometriosis involving the uterosacral ligaments, vagina, rectovaginal septum, intestines, bladder and ovaries shown by TVS were compared with surgical and histological findings. The sensitivity, specificity, predictive values and accuracy of TVS for predicting deep pelvic endometriosis were assessed. RESULTS: Ovarian and deep pelvic endometriosis were found by surgery and histology in respectively 83 (58.5%) and 79 (55.6%) of the 142 patients. The sensitivity, specificity, and positive and negative predictive values of TVS for the diagnosis of deep pelvic endometriosis were 78.5%, 95.2%, 95.4% and 77.9%, respectively. The sensitivity and specificity of TVS for endometriotic involvement of the uterosacral ligaments, vagina, rectovaginal septum and intestines were 70.6% and 95.9%, 29.4% and 100%, 28.6% and 99.3%, and 87.2% and 96.8%, respectively. The sensitivity and specificity of TVS for bladder involvement were 71.4% and 100%, respectively. CONCLUSION: TVS accurately diagnoses intestinal and bladder endometriosis, but is less accurate for uterosacral, vaginal and rectovaginal septum involvement.

Adult↗
PubMed2004

[Laparoscopic colorectal resection for endometriosis: preliminary results].

OBJECTIVE: Colorectal endometriosis is source of chronic pelvic pain greatly affecting quality-of-life. Colorectal resection is indicated after failure of medical treatment. Few data are available on complications and functional results after laparoscopic colorectal resection for endometriosis. Therefore, the aims of this prospective study were to evaluate the feasibility, peri-operative complications and functional results of laparoscopic colorectal resection for endometriosis. MATERIALS AND METHODS: From March 2001 to March 2003, 32 consecutive women with clinically-suspected colorectal endometriosis confirmed by MR imaging and rectal endoscopic sonography were included in this prospective study. RESULTS: Conversion to open surgery was required for four of the 32 women (12.5%). Mean operating time was 6 hours (range 4 to 13). Associated surgical procedures were: adhesiolysis (n=24), ureteral lysis (n=19), ovarian cystectomy (n=11), and hysterectomy (n=4). Mean blood loss was 2.4 g/dl (range: 0 to 8.6). Blood transfusion was required in 6 women including two who underwent laparoconversion. Two rectovaginal fistulae (6.3%) occurred requiring a colostomy. Urinary retention was noted in 6 women (15.6%). CONCLUSION: Laparoscopic colorectal resection for endometriosis is feasible and is associated with a significant improvement of symptoms. However, the benefit of this procedure has to be weighed against the high morbidity.

Adult↗
PubMed2002

[Imaging of myomas: is preoperative MRI usefull?].

Leiomyomas are the most common uterine neoplasms. Leiomyomas classified as intramural, submucosal, or subserosal are usually associated with various types of degeneration. The diagnosis and the treatment of leiomyomas vary among these subtypes of leiomyomas. Magnetic resonance imaging is the most accurate imaging technique for detection, localization, and characterization of myomas. The differential diagnosis at MR imaging includes adenomyosis and solid adnexal masses. Despite its relatively high cost, MR imaging is a very useful procedure which can assist preoperative planning.

Female↗
PubMed2002

Limitations of transvaginal sonography for the diagnosis of adenomyosis, with histopathological correlation.

OBJECTIVES: To evaluate the accuracy of transabdominal sonography (TAS) and transvaginal sonography (TVS) for the diagnosis of adenomyosis, and to determine the diagnostic relevance of various sonographic criteria. SUBJECTS AND METHODS: A total of 129 women scheduled for hysterectomy were enrolled into this prospective study. Group 1 (n = 23) consisted of patients with menometrorrhagia who were free of myoma and endometrial disorders on TAS. Group 2 consisted of all the other patients (n = 106). TAS and TVS findings were compared to histopathological results. RESULTS: The prevalence of adenomyosis in Groups 1 and 2 was 91.3% and 24.5%, respectively. TAS had limited value for the diagnosis of adenomyosis in both groups. The sensitivity, specificity, and positive and negative predictive values of TVS in Groups 1 and 2 were 80.9% and 38.4%, 100% and 97.5%, 100% and 83.3%, and 40% and 82.9%, respectively. The accuracy of combined TAS and TVS in Groups 1 and 2 was 91.3% and 83%, respectively. The presence of myometrial cysts was the most specific ultrasound diagnostic criterion for adenomyosis. Hypoechoic linear myometrial striations related to the presence of myometrial hypertrophy correlated to hormonal status with a sensitivity of 66.6% and a specificity of 100% in Group 1. CONCLUSIONS: Our results show that TAS has a limited diagnostic capacity for adenomyosis but also that TVS alone was poor in patients with an enlarged uterus. In these cases a combination of TVS and TAS should be used.

Adult↗
PubMed2002

[Retrotracheal cystic mass in the mediastinum].

We describe a case of retro-tracheal mass of the visceral compartment of the mediastinun in a 79-year-old woman revealed by signs of tracheal compression. Visualization of a vascular image coming from the cervical zone on reconstructed injected CT, and biological demonstration of a primary hyperparathyroidism led to the diagnosis of ectopic parathyroid adenoma, in spite of the cystic aspect of that tissular mass. Surgery by cervical approach was able to remove this mass without any problem. Pathological examination confirmed that it was a parathyroid adenoma with necrotic modifications. Follow up show a clinical and a biological improvement.

Adenoma↗
PubMed2001

Assessment of Fallopian tube patency by HyCoSy: comparison of a positive contrast agent with saline solution.

OBJECTIVE: To compare the efficiency of air-filled albumin microspheres (Infoson) with saline solution in determining Fallopian tube patency during hysterosalpingo contrast sonography (HyCoSy). METHODS: This was a prospective randomized multicenter study with a sequential design. Over a 10-month period, 23 patients (mean age, 33 years) referred for infertility were examined by HyCoSy (saline or Infoson) before conventional hysterosalpingography (Iopamiron 370), performed during the same session. Contrast agents were administered through a 5-F Ackrad balloon catheter inserted transcervically into the uterine cavity. HyCoSy was performed with a 7-MHz transvaginal probe using both B-mode and color Doppler, and tubal patency was demonstrated by the appearance of contrast agent in the peritoneal cavity near the ovaries. Data were registered for each patient during the examination and the results were monitored by sequential analysis. RESULTS: Mean volumes of contrast injections were 35.3 mL of saline, 14.4 mL of Infoson, and 13.8 mL of Iopamiron 370. Infoson-enhanced HyCoSy provided a significantly larger (P = 0.006) number of correct diagnoses (20/22 Fallopian tubes) than did saline HyCoSy (12/24 Fallopian tubes), and the same number as that achieved by hysterosalpingography. CONCLUSION: A positive ultrasound contrast agent appears to be more efficient than saline solution at determining Fallopian tube patency in infertile women by means of HyCoSy, and as efficient as an iodinated contrast agent in the same population explored by HSG. HyCoSy could be used to screen infertile women, thereby avoiding the use of iodinated contrast medium and exposure to ionizing radiation during conventional HSG in patients with patent Fallopian tubes.

Adult↗
PubMed2001

Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology.

BACKGROUND: The objective of this study was to compare the accuracy of transabdominal (TAUS) and transvaginal sonography (TVUS) and magnetic resonance imaging (MRI) for the diagnosis of adenomyosis, and to correlate imaging with histological findings. METHODS: In a prospective study, 120 consecutive patients referred for hysterectomy underwent TAUS, TVUS and MRI. Results of these examinations were interpreted blindly to histopathological findings. RESULTS: Histological prevalence of adenomyosis and leiomyomas was 33.0 and 47.5% respectively. Adenomyotic uteri were accompanied by additional pelvic disorders in 82.5% of cases. Sensitivity, specificity, and positive and negative predictive values of TAUS and TVUS were 32.5 and 65.0%, 95.0 and 97.5%, 76.4 and 92.8%, and 73.8 and 88.8% respectively. Myometrial cyst was the most sensitive and specific TVUS criterion. In MRI, the presence of a high-signal-intensity myometrial spot was as specific but less sensitive than a maximal junctional zone thickness (JZ(max)) >12 mm and a JZ(max) to myometrial thickness ratio >40%. Sensitivity, specificity, and positive and negative predictive values of MRI were 77.5, 92.5, 83.8 and 89.2% respectively. No difference in accuracy was found between TVUS and MRI, but sensitivity was lower with sonography in women with associated myomas. CONCLUSIONS: TVUS is as efficient as MRI for the diagnosis of adenomyosis in women without myoma, while MRI could be recommended for women with associated leiomyoma.

Adult↗
PubMed2001

Is selective embolization of uterine arteries a safe alternative to hysterectomy in patients with postpartum hemorrhage?

OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of selective arterial embolization to control severe postpartum hemorrhage. MATERIALS AND METHODS: Twenty-five women with intractable postpartum hemorrhage underwent uterine embolization in our institution during a 6-year period. RESULTS: Angiography revealed arterial extravasation in 13 patients (52%). Sixty-nine arteries were embolized. External bleeding resolved immediately or was markedly decreased in 24 women. In one patient, embolization failed to control the bleeding, and surgical treatment was required. No major complication of embolization therapy was observed. Ten women were followed up for an average of 2 years. Menstruation resumed in all patients, and one woman became pregnant. CONCLUSION: Embolization of acute postpartum hemorrhage is a safe and effective alternative to hysterectomy.

Adult↗
PubMed2001

[Investigation of peripheral vascular bed in critical lower limb ischemia: comparative study between arteriography and magnetic resonance angiography].

OBJECTIVES: To determine the precise role of arteriography and contrast-enhanced magnetic resonance angiography (MRA) to evaluate the peripheral vascular bed in critical ischemia of the lower limbs in candidates for distal vascularization. MATERIAL AND METHODS: Fifteen patients (mean age 66 +/- 18 years) underwent MRA and arteriography. In all, 23 lower limbs were studied by non-selective arteriography with aortic injection (n=12) or selective arteriography with iliofemoral injection (n=11). RESULTS: The strength of agreement between MRA and selective arteriography was good (k=0.75) for analysis of leg arteries. MRA was better than non-selective arteriography (p<0.035) to evaluate artery patency. In our study, only MRA improved the treatment decision. CONCLUSION: In patients requiring an assessment of the peripheral vascular bed before distal revascularization, contrast-enhanced MRA can be the first exam. In case of an inadequate MRA, only selective arteriography needs to be performed.

Adult↗
PubMed2001

[Calcific retropharyngeal tendinitis: unusual diagnosis].

Acute calcific retropharyngeal tendinitis is a rare entity that often is initially misdiagnosed a retropharyngeal abscess and treated with IV administration of antibiotics. In our 2 cases, imaging enabled a correct diagnosis to be made. Two patients were admitted to the hospital with dysphagia, severe neck discomfort and fever. Lateral radiographs of the cervical spine and CT were obtained in both cases, while MRI was obtained in one case. Calcification of the prevertebral muscles was demonstrated by CT in both cases, and detected on lateral radiographs in only one case. Soft tissue swelling was noted at CT and MRI. A clinical diagnosis of calcific retropharyngeal tendinitis may be difficult to achieve and a definitive diagnosis can be confirmed at imaging studies.

Adult↗
PubMed2001

[Imaging of the endometrium].

During genital activity, physiological and pathological modifications can be observed; Pre- and postmenopausal menometror-rhagia are the principle clinical signs of various endometrial pathologies: benign (polyp, atrophy or endometrial hypertrophy), malignant (cervical or endometrial carcinoma) or neighboring pathologies (myometrium or ovary). The value and methods of various imaging techniques (B-mode and Doppler abdominal and endovaginal ultrasonography, hysterosonography, computed tomography, MR imaging and hysteroscopy) are described together with symptomatological features permitting identification of the endometrial pathology.

Endometrium↗