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Biomedical subjects

M T Farrés

Publications and source records attributed to M T Farrés.

At least 19 recordsLinked to original sources
PubMed1996

Stenoses of the first segment of the vertebral artery: difficulties in angiographic diagnosis.

Pathology at the origin of the vertebral artery may be the cause of incapacitating vertebrobasilar insufficiency (VBI). Preoperative diagnosis is made primarily on angiographic criteria. We compared intraoperative and angiographic findings in 30 patients and found important diagnostic discrepancies in patients with a caudal, ventral or dorsal origin of the vertebral artery. In their angiograms, vessel superimposition led us to over look 3 ostial stenoses and 10 stenoses due to kinking. Angiographic assessment of patients with VBI can be difficult. Adequate visualisation of the origin of the vertebral artery is mandatory for accurate diagnosis.

Aged↗
PubMed1996

[CT-assisted definition of puncture site and penetration angle for percutaneous lumbar diskectomy].

In 20 consecutive patients submitted to CT evaluation of a suspected disk protrusion at level L4-5, CT measurements to define entry point and penetration angle for percutaneous diskectomy were performed. It was shown that in order to reach the disk center, the entry point had to be more lateral than recommended by most authors. Body height, weight and body surface area were not significantly correlated to entry point position or penetration angle. In particular, the extension of the intervertebral facet joint determined the route of the probe to the disk center. Therefore, CT-assisted planning of the instrument route prior to percutaneous lumbar diskectomy is helpful in defining the proper entry point and penetration angle for safe and effective instrument positioning.

Adult↗
PubMed1996

Spiral CT angiography: study of stenoses and calcification at the origin of the vertebral artery.

The origin of the vertebral artery may be difficult to show on sonography or conventional angiography. Our aim was to evaluate the accuracy of CT angiography (CTA) in detecting arteriosclerotic changes in the first segment (V1) of the vertebral artery. We performed CTA and intra-arterial digital subtraction angiography (DSA) on 24 patients with vertebrobasilar insufficiency. The ostium and the V1 segment were examined. Stenosis was assessed on a three-grade scale, and calcification and the degree of kinking were recorded. DSA and CTA results were compared. The ostium of the artery was seen in all cases on CTA and in 33 of 47 cases with DSA. All ostial stenoses diagnosed on DSA were seen with CTA. CTA revealed 4 stenoses in cases in which angiography proved inadequate, 11 zones of calcification and 5 cases of luminal reduction due to calcified plaques undetected on DSA. In the V1 segment DSA and CTA showed 3 stenoses, 9 cases of kinking, 1 of coiling and 4 stenoses due to kinking. CTA also demonstrated 4 additional stenoses, 2 cases of kinking and 3 stenoses due to kinking.

Aged↗
PubMed1993

[Ultrasound-guided needle biopsies of thoracic space-occupying lesions].

This study is concerned with the results and experience gained from performing ultrasound-guided needle biopsies of thoracic masses in 56 patients. The accuracy of the biopsy results were related to the certainty of the method, the visibility of the biopsy needle on real time images, the effect of biopsy needle thickness and tumour size. Correct diagnosis was achieved in 84.6%. Inability to see the biopsy needle resulted in only 5.4% of cases and only when using a low frequency transducer (3 MHz). The thickness of the biopsy needle affected the accuracy of the biopsy, since all false negative or inconclusive biopsies resulted from the use of fine calibre needles. There was no significant correlation between tumour size and the accuracy of the biopsy results.

Adult↗
PubMed1993

[The radiologic clinical picture of primary bone lymphoma].

Primary lymphoma of bone is a rare form of non-Hodgkin lymphoma which involves a single bone and has a relatively good prognosis following radiation therapy. We observed 17 histologically verified cases and found 97 cases in the literature. This rare tumour may occur at any time in adults and usually affects the metaphyses of long bones. It produces osteolytic changes and usually only mild periosteal reactions. Radiologically as well as histologically, differentiation from other highly malignant bone tumours is extremely difficult and sometimes impossible. A correct diagnosis can only be made from an accurate knowledge of the radiological appearances, localisation of the tumour and age of the patient.

Adolescent↗
PubMed1992

["Pseudo-dissection" in an abdominal aortic aneurysm].

Sonography of 52 patients with aneurysms of the abdominal aorta revealed in 7 cases hypoechoic crescent-like zone between parietal thrombus and the aortic wall which simulated aortic dissection. Duplex-sonography was performed in all cases and no flow could be detected in this area. In two patients intraoperatively several milliliters of a serous fluid could be aspirated from this zone which confirmed the suggestion of seroma within the parietal thrombus. This observation may be found rather frequently and should not be a reason for immediate surgery.

Aortic Dissection↗
PubMed1991

[The value of mammography in patients up to the age of 35].

The use of mammography in young women is under debate. In this prospective study of 220 women aged up to 35 years, the indications for mammography were compared with the final diagnosis. In this way, an attempt was made to define the signs and symptoms that justify mammography in this age group. The results show that mammography is indicated only in the presence of palpable lumps. All other signs or symptoms should not be investigated by means of ionising radiation in this particular age bracket.

Adolescent↗
PubMed1991

Tumor vascularization: assessment with duplex sonography.

In this prospective study, the authors examined 123 patients with benign or malignant neoplasms (breast cancer, n = 44; liver neoplasms, n = 43; and tumors affecting other organs, n = 36) to establish general criteria for evaluation of neoplastic lesions by means of duplex sonography. The frequency shifts determined by means of different Doppler frequencies (2.31 or 3.75 MHz) were converted into flow velocities. Only the highest systolic peak flow velocity obtained from a lesion was used for statistical evaluation. Receiver operating characteristic curves showed that a flow velocity of 0.4 m/sec is the optimal threshold value with which to differentiate benign from malignant tumors. The data obtained in all lesions indicated that only positive findings are potentially reliable. It is concluded that negative results of sonography should not be used to diagnose the presence of a benign lesion. The resistive index of the tumors was of negligible importance.

Blood Flow Velocity↗
PubMed1990

[The value of intravenous digital subtraction angiography in Leriche's syndrome].

The value of intravenous digital subtraction angiography was examined in 20 patients with Leriche's syndrome. The method is highly accurate for localising the level of the aortic occlusion (100%), the demonstration of distal patency (95%) and the collateral circulation (90%). An important advantage of this method compared with transaxillary, transbrachial or translumbar aortography is its low invasiveness.

Adult↗
PubMed1989

[Diagnosis of liver trauma: ultrasound versus computed tomography].

This study used 14 of our own patients and a review of the literature in order to determine the value of CT and sonography for investigating injuries to the liver. It appears that CT, with a sensitivity of 0.93, has a somewhat higher accuracy than sonography, which has a sensitivity of 0.83. We were also able to observe typical changes in the appearances, depending on the interval since the injury. Fresh injuries appeared as isodense or mildly hypodense areas, together with variable hyperdense portions on CT. Subsequently these areas become increasingly hypodense and may evolve into cystic lesions. Sonographically, recent injuries of the liver show echo-rich, non-homogeneous lesions which may contain smaller echo-free portions. Older lesions become increasingly devoid of echoes and become increasingly demarcated from normal liver parenchyma.

Evaluation Studies as Topic↗
PubMed1989

[Diagnosis of pelvic fractures: synoptic views of the pelvis versus CT].

An attempt has been made, using 21 patients with pelvic fractures, to determine the circumstances in which plain films provide adequate information and when additional information can be obtained by CT. It was found that in all cases of acetabular fractures the diagnosis could be suspected on plain films, but that it proved impossible to demonstrate accurately the position of fragments, the degree of dislocation or the presence of intra-articular bone fragments. These problems could be solved by using CT. In patients with injury to the sacro-iliac joints or of the sacrum, the extent of the injury and the degree of pelvic instability was better shown by CT. All other bony lesions, such as fractures of the ilium, pubis, ischium or the symphysis could be diagnosed adequately by simple radiographs.

Fractures, Bone↗
PubMed1989

[Intrathoracic splenosis].

Intrathoracic splenosis is an unusual event after diaphragmatic and splenic rupture, which causes intrathoracic mass lesions. It results from spontaneous autotransplantation of splenic tissue to serous surfaces. On chest X-rays, three different radiological appearances were distinguished: pulmonary mass lesions, pleural lesions and mediastinal tumors. Since the radiological appearance is nonspecific, a diagnosis may only be suspected together with the characteristic anamnesis. In those case scintigraphy should be performed because this method may verify the diagnosis. Here we report the radiological and clinical appearances of this entity by one of our own and 13 well-documented cases in the literature.

Adult↗
PubMed1989

[Perforation of the right ventricle during pulmonary angiography: possible causes and their prevention].

This is a report on a perforation of the myocardium during pulmonary angiography. The choice of the catheter is very important for the occurrence of such complications. We used a Cook 7 French polyethylene multipurpose catheter, which did not guarantee sufficient stabilisation due to its small number of side holes during injection of contrast medium. On the other hand the straight top of the catheter promoted its penetration into the myocardium. To avoid such often lethal complications, catheters with pigtail configuration should be used.

Angiography↗
PubMed1988

[Sternocostoclavicular hyperostosis: a space-occupying lesion of the superior thoracic aperture].

Sternocostoclavicular hyperostosis is a rare disease characterized by soft-tissue ossifications and hyperostosis of the clavicles, anterior segments of the upper ribs and sternum. These changes may imitate other disorders and thus may be misinterpreted. We present the radiologic appearances of this entity and discuss the diagnostic value of computerized tomography, magnetic resonance imaging and scintigraphy.

Female↗
PubMedDate not supplied

Spiral computed tomographic angiography of the renal arteries: a prospective comparison with intravenous and intraarterial digital subtraction angiography.

PURPOSE: To assess the accuracy of computed tomographic angiography (CTA) in the evaluation of the renal arteries in comparison with intravenous (IVDSA) and intraarterial digital subtraction angiography (IADSA). METHODS: In 18 patients, 35 CTAs and DSAs (27 IADSA, 8 IVDSA) of the renal arteries were performed. CTA was done with 2-3 mm collimation,2-4 mm/sec table speed, after intravenous injection of 80 ml of contrast medium at 4 ml/sec with a scanning delay time of 14-21 sec. No previous circulation time curve was performed. CTA data were reconstructed with maximum intensity projection (MIP) and shaded surface display (SSD). The presence of stenosis was assessed on a three-point rating scale (grade 1-3). The quality of the examinations; visualization of the ostium, the main artery, and its branches; vessel sharpness, linearity, and intraluminal contrast filling were evaluated. We compared CTA with DSA. RESULTS: CTA had 96% sensitivity, 77% specificity, and 89% accuracy in the detection of stenoses > 50%. Due to technical errors two stenoses were erroneously diagnosed as positive but there were no false negative diagnoses. The quality of CTA was good in 56% and moderate in 34% of cases. Visualization of the ostium and main artery was graded as 1.74 (out of 2) points and of the renal branches as 1.02 (out of 2) points and of the renal branches as 1.02 (out of 2) points. The quality of CTA images was worse than that of IADSA in 52%, equal in 41%, and better in 7% of cases. CTA was equal to IVDSA in 25% and better in 75% of the cases. CONCLUSION: CTA is an accurate noninvasive method for the evaluation of renal arteries. Examination quality is essential for the diagnosis. CTA is limited in its ability to visualize the branches of the renal artery and accessory arteries. CTA seems to be superior to IVDSA.

Adult↗
PubMedDate not supplied

Gastric wall dissection as a complication of percutaneous gastrostomy.

A percutaneous gastrostomy (PG) was complicated by gastric wall dissection and partial tube malposition. It occurred after tangential puncture along the greater curvature of the stomach which was performed in order to avoid an enlarged left lobe of the liver. To prevent this complication we recommend not using hydrophilic guidewires during PG.

Aged↗
PubMedDate not supplied

Percutaneous mitoxantrone injection for primary and secondary liver tumors: preliminary results.

PURPOSE: To determine the effects of percutaneous intratumoral chemotherapy with mitoxantrone (PIM) in the palliative treatment of malignant liver lesions. METHODS: We treated 15 progressive lesions in nine patients in whom either previous therapy failed or serious complications developed as a result. Seven lesions were metastatic and eight were due to foci of hepatocellular carcinoma. Under computed tomography (CT) guidance, we percutaneously injected 10-20 mg of mitoxantrone mixed with 0.5 ml of contrast medium into the tumor, performing one to three treatments at intervals of 1 month. RESULTS: There were no complications. The morphologic responses of the tumors after treatment were: minor response in one case, no change in 11 cases, progressive disease in three cases. Mitoxantrone induced tumor necrosis with no viable cancer tissue in eight of 11 biopsies. Recurrence was observed in nine of the treated lesions 2-9 months after treatment. New lesions were observed in five of nine patients 1-9 months after treatment. CONCLUSION: In patients with malignant liver lesions with no other therapeutic possibilities, minimally invasive intratumoral mitoxantrone injection was carried out safely with good tumor delivery of chemotherapy, and tumor necrosis was demonstrated at biopsy. We feel this approach warrants further investigation.

Adult↗