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Biomedical subjects

P Loubeyre

Publications and source records attributed to P Loubeyre.

At least 19 recordsLinked to original sources

Pressure evolution of the high-frequency sound velocity in liquid water.

The high-frequency sound velocity v( infinity ) of liquid water has been determined to densities of 1.37 g/cm(3) by inelastic x-ray scattering. In comparison to the hydrodynamic sound velocity v(0), the increase of v( infinity ) with density is substantially less pronounced, indicating that, at high density, the hydrogen-bond network is decreasingly relevant to the physical properties of liquid water. Furthermore, we observe an anomaly in v( infinity ) at densities around 1.12 g/cm(3), contrasting the smooth density evolution of v(0).

Journal Article↗

Observation of structural transformations in metal oxygen.

X-ray diffraction and Raman measurements have been performed on solid oxygen up to, respectively, 115 and 120 GPa. Metallization at 96 GPa is shown to be associated with a continuous displacive structural transformation. At 110 GPa, a new structure is stabilized. The evolution of the vibron mode reflects also the sequence of phase transitions through the continuity of the vibron frequency at 96 GPa, then the broadening of the vibron peak into the background and finally the reappearance of a sharp vibron at 110 GPa with a -2.5% discontinuity in the frequency. The observation of the vibron peak demonstrates that metallic oxygen is molecular up to at least 120 GPa.

Journal Article↗

Performance of helical computed tomography in unselected outpatients with suspected pulmonary embolism.

BACKGROUND: Helical computed tomography (CT) is commonly used to diagnose pulmonary embolism, although its operating characteristics have been insufficiently evaluated. OBJECTIVE: To assess the sensitivity and specificity of helical CT in suspected pulmonary embolism. DESIGN: Observational study. SETTING: Emergency department of a teaching and community hospital. PATIENTS: 299 patients with clinically suspected pulmonary embolism and a plasma D -dimer level greater than 500 microgram/L. INTERVENTION: Pulmonary embolism was established by using a validated algorithm that included clinical assessment, lower-limb compression ultrasonography, lung scanning, and pulmonary angiography. MEASUREMENTS: Sensitivity, specificity, and likelihood ratios of helical CT and interobserver agreement. Helical CT scans were withheld from clinicians and were read 3 months after acquisition by radiologists blinded to all clinical data. RESULTS: 118 patients (39%) had pulmonary embolism. In 12 patients (4%), 2 of whom had pulmonary embolism, results of helical CT were inconclusive. For patients with conclusive results, sensitivity of helical CT was 70% (95% CI, 62% to 78%) and specificity was 91% (CI, 86% to 95%). Interobserver agreement was high (kappa = 0.823 to 0.902). The false-negative rate was lower for helical CT used after initial negative results on ultrasonography than for helical CT alone (21% vs. 30%). Use of helical CT after normal results on initial ultrasonography and nondiagnostic results on lung scanning had a false-negative rate of only 5% and a false-positive rate of only 7%. CONCLUSION: Helical CT should not be used alone for suspected pulmonary embolism but could replace angiography in combined strategies that include ultrasonography and lung scanning.

Adult↗

[Gross tumor volume and clinical target volume in radiotherapy: lung cancer].

Radiotherapy plays a major role as a curative treatment of various stages non-small cell lung cancers (NSCLC): as an exclusive treatment in curative attempt for patients with unresectable stages I and II; as a preoperative treatment, which is often associated with chemotherapy, for patients with surgically stage IIIA NSCLC in clinical trials; in association with chemotherapy for unresectable stages IIIA and IIIB patients. Currently, three-dimensional conformal radiotherapy allows for some dose escalation, increasing radiation quality. However, the high inherent conformality of this radiotherapy technique requires a rigorous approach and an optimal quality of the preparation throughout the treatment procedure and specifically of the accurate definition of the safety margins (GTV, CTV...). Different questions remain specific to lung cancers: 1) Despite the absence of randomized trials, the irradiated lymph nodes volume should be only, for the majority of the authors, the visible macroscopically involved lymph nodal regions. However, local control remains low and solid arguments suggest the poor local control is due to an insufficient delivered dose. Therefore the goal of radiotherapy, in this particular location, is to improve local control by increasing the dose until the maximum normal tissue tolerance is achieved, which essentially depends on the dose to the organs at risk (OAR) and specifically for the lung, the esophagus and the spinal cord. For this reason, the irradiated volume should be as tiny as possible, leading to not including the macroscopically uninvolved lymph nodes regions in prophylactic view in the target volume; 2) The lung is one of the rare organs with extensive motion within the body, making lung tumors difficult to treat. This particular point is not specifically considered in the GTV and CTV definitions but it is important enough to be noted; 3) When radiation therapy starts after a good response to chemotherapy, the residual tumoral volume should be defined as the target volume in place of the initial tumor volume. These different elements are discussed in this paper.

Carcinoma, Non-Small-Cell Lung↗

Using thoracic helical CT to assess iodine concentration in a small volume of nonionic contrast medium during vascular opacification: a prospective study.

OBJECTIVE: The goal of the study was to assess whether, using thoracic helical CT, diagnostic mediastinal and hilar vascular enhancement can be obtained with a small amount of nonionic contrast material (80 ml) injected at a relatively slow rate (2 ml/sec). SUBJECTS AND METHODS: One hundred twenty patients (60 in their fourth decade of life and 60 in their seventh decade of life) referred for contrast-enhanced thoracic CT for malignancies or infections prospectively entered the study. They were randomly assigned to be given one of three iodine concentrations of a nonionic contrast material: 250 mg/ml (1250), 300 mg/ml (1300), and 350 mg/ml (1350). Two radiologists independently graded perivenous artifacts and arterial enhancement of mediastinal and hilar vessels on a 4-point scale: 1, poor; 2, fair; 3, good; and 4, excellent. Measurements of arterial attenuation values (quantitative assessment) were obtained on the aorta and pulmonary artery. RESULTS: Mean scores were equal to or greater than 3 for all vessels only using 1350. The higher the iodine concentration was, the higher the mean score, but there was a statistically significant difference only between scores obtained with 1350 and those obtained with 1300 or 1250. Mean scores were higher for the patients in their seventh decade of life than those in their fourth decade; however, there was no statistically significant difference between scores of the two decade groups. We found a highly significant statistical relationship between scores and arterial attenuation values. CONCLUSION: During contrast-enhanced helical CT examinations for general thoracic evaluations, good opacification of central vascular structures is obtained with a low volume of high iodine concentration nonionic contrast medium.

Adult↗

Comparison of iron oxide particles (AMI 227) with a gadolinium complex (Gd-DOTA) in dynamic susceptibility contrast MR imagings (FLASH and EPI) for both phantom and rat brain at 1.5 Tesla.

The goal of the study was to compare, in phantom and normally perfused rat brain tissue, a superparamagnetic iron oxide particle-based contrast agent (AMI 227) with a low-molecular-weight gadolinium chelate, gadolinium tetraazacyclododecanetetraacetic acid (Gd-DOTA), in two susceptibility contrast magnetic resonance imaging (MRI) modes [fast low-angle shot sequence (FLASH) and echoplanar imaging (EPI)]. A phantom consisting of dilution series of both contrast agents was manufactured. Dilutions were obtained with isotonic serum from the available agent solutions (0.5 mmol Gd/mL Gd-DOTA; 350 mumol Fe/mL AMI 227). Eighteen rats were studied. Contrast agent (0.1 mL) was bolus injected in each rat, and dynamic MRI was performed (first pass of the contrast agent) in rat brain. The doses of AMI 227 injected were extrapolated from the phantom experiment: 0.2 mmol/kg body weight of Gd-DOTA and 7, 14, and 28 mumol Fe/kg body weight of AMI 227 were injected. For both sequences, signal-to-noise ratios (S/N) were measured on each tube of the phantom and on rat brain from each image of the dynamic imaging. S/N was plotted versus contrast dilution (phantom) and versus time (rats). In the FLASH sequence, a well-shaped curve (S/N decrease, S/N peak decrease, S/N increase) of the first pass of the contrast agent was demonstrated for Gd-DOTA and for AMI 227 (7 mumol Fe/kg body weight). In the EPI sequence, a well-shaped curve was demonstrated for Gd-DOTA, and a plateau effect was noted for both concentrations of AMI 227. With the FLASH technique, dynamic susceptibility contrast imaging of rat brain can be performed with very low concentrations of AMI 227 compared with the Gd-DOTA concentration (0.2 mmol Gd/kg body weight) used in clinical practice. This could be of interest in perfusion imaging, because it may allow for first-pass susceptibility imaging after administration of a small volume in a narrow bolus.

Animals↗

Screening applications for MRI in the detection of upper abdominal disease: comparative study of non-contrast-enhanced single-shot MRI and contrast-enhanced helical CT.

PURPOSE: To compare the value of 'push-button' single-shot non-contrast-enhanced MRI and contrast-enhanced helical CT for detection of upper abdominal disease. METHODS: In 120 patients, images obtained with non contrast-enhanced single-shot MRI (T2: double echo HASTE, and T1: turbo FLASH) and contrast-enhanced helical CT were compared. Lesions or abnormalities were divided in 8 anatomical categories (1: liver; 2: pancreatobiliary; 3: kidney/adrenal gland; 4: retroperitoneum; 5: vascular; 6: spleen; 7: gastrointestinal tract and peritoneum; 8: base of thorax) and classified as follows: 2: seen at MRI only; 1: better seen at MRI; 0: no difference; -1: better seen at CT; -2: seen at CT only. Also recorded were the 'door-to-door' examination times. RESULTS: Of a total of 629 abnormalities, 594 were detected at MRI (94 %) and 536 at CT (85 %). CT offered better results in two categories only: retroperitoneum (mean score: -0.68) and vascular (mean score -0.87). Mean examination times were 19 min for CT and 14.8 min for MRI. CONCLUSION: Unenhanced single-shot MRI is a valuable first step of a comprehensive upper abdominal MR exam and may even be the final step in many patients.

Abdomen↗

[Constrictive bronchiolitis obliterans. Apropos of a case].

INTRODUCTION: Constrictive bronchiolitis obliterans is defined histologically as obliteration of the lumina of bronchioles by inflammatory tissue elements and progressive destruction of bronchioles, eventually replaced by fibrotic tissue. Most of the cases, which are not associated with either solid organ or bone marrow transplantation, occur in the development of rheumatoid arthritis. EXEGESIS: We present the case of a 73-year-old woman who developed severe constrictive bronchiolitis obliterans without readily identifiable cause, rapidly fatal despite corticosteroid therapy. The patient had antinuclear antibodies (titer 1/1024) and antiphospholipid antibodies, but there was no anti-DNA, anti-ENA or anti-beta 2GPI antibodies. Tests for rheumatoid factor were negative. Cryoglobulinemia was present (monoclonal IgM Kappa). CONCLUSION: In this case, constrictive bronchiolitis obliterans was associated with serologic abnormalities and cryoglobulinemia. However, were was no clinical evidence of connective tissue disease.

Aged↗

Assessment of iron oxide particles (AMI 227) and a gadolinium complex (Gd-DOTA) in dynamic susceptibility contrast MR imagings (FLASH and EPI) in a tumor model implanted in rats.

The objective of our study was to assess the feasibility of dynamic susceptibility contrast MR technique after bolus injection of SPIO and Gd-DOTA in a tumor model implanted in rats. Tumors were subcutaneously implanted in 24 rats. A FLASH sequence and EPI were evaluated. Different doses of AMI 227 and Gd-DOTA were assessed. Mean signal intensity vs. time curves were plotted. Well-shaped curves of the first pass of the contrast agent were only obtained with Gd-DOTA. According to these results it appears difficult to assess tumor blood volume with USPIO dynamic susceptibility contrast imaging.

Animals↗

Three-dimensional phase contrast MR cerebral venography with zero filling interpolation in the slice encoding direction.

The purpose of this study was to evaluate the magnetic resonance (MR) cerebral venography findings of a three-dimensional phase contrast MR sequence with zero filling interpolation of the data in the slice encoding direction. Fifty volunteers were enrolled in the study. Images were obtained on a 1.5 MR imaging system with acquisition time of 12 min. MIP images were reconstructed throughout the entire imaging volume. A grading scale system was used to assess dural venous sinuses, major deep veins, cortical, and cortical eponymic veins. Inferior group of dural venous sinuses, inferior sagittal sinus, and cortical eponymic veins were poorly demonstrated. Score of the superior sagittal sinus, the straight sinus, the confluence of the superior sinus group, the right transverse and sigmoid sinuses, the internal veins, and the vein of Galen was excellent. The score of the left transverse and sigmoid sinuses was good. In conclusion, when using zero filling interpolation of the data in a three-dimensional phase contrast MR cerebral venography sequence, the superior group of dural venous sinuses and main major deep veins are demonstrated with good conspicuity.

Adolescent↗

Transplanted renal artery: detection of stenosis with color Doppler US.

PURPOSE: To evaluate the influence of various parameters on peak systolic velocity in the transplanted renal artery and to define the normal range of peak systolic velocity. MATERIAL AND METHODS: Color Doppler ultrasonographic (US) findings in 105 patients were reviewed. There were no clinical or biologic findings suggestive of a stenosis in the transplanted renal artery in these patients. The peak systolic velocity in the transplanted renal and external iliac arteries and the renal resistive index were measured. RESULTS: A large range of peak systolic velocities was noted in the transplanted renal artery. Peak systolic velocity in the renal artery was statistically significantly correlated with that in the external iliac artery when there was no pronounced vessel curvature. There was no relationship between peak systolic velocity and resistive index or time between transplantation and US. High peak systolic velocity was associated with a pronounced vessel curvature. CONCLUSION: The normal range of peak systolic velocity in the transplanted renal artery has considerable variability. Because of the strong correlation, the ratio of velocity in the renal artery to that in the external iliac artery may be useful in detection of stenosis.

Adult↗

Spiral CT artifact that simulates aortic dissection: image reconstruction with use of 180 degrees and 360 degrees linear-interpolation algorithms.

PURPOSE: To evaluate a computed tomographic (CT) artifact that simulates aortic dissection. MATERIALS AND METHODS: Two groups of 65 patients underwent spiral CT of the chest for reasons other than suspected aortic dissection. In each group, two series of images (10-mm sections) were reconstructed with use of a 180 degrees or 360 degrees linear-interpolation algorithm. Series of images were read by two radiologists, and variance between interpretations was statistically measured. RESULTS: Among series of images, artifacts were seen on 21-26 (32%-40%) with use of a 180 degrees algorithm and 41 (63%) and 44 (68%) with use of a 360 degrees algorithm. Concordance between reviewers was fair (kappa = 0.58, 0.59) or good (kappa = 0.65) with use of a 180 degrees algorithm and excellent (kappa = 0.92) with use of a 360 degrees algorithm. In one group, with use of a 180 degrees algorithm, two series of reconstructed images were separated by 5 mm; artifact was observed on seven (11%) CT studies (on both series of images) and was located along the left or left anterior side of the aorta. CONCLUSION: To reduce the frequency of a spiral CT artifact that simulates aortic dissection, two series of segmented images can be reconstructed with a change of image position along the z axis of the aorta and use of a 180 degrees linear-interpolation algorithm.

Adult↗

Early diagnosis of lentivirus-induced infiltrative lung disease in sheep by high resolution computed tomography.

The visna-maedi lentivirus can induce an interstitial pneumonitis in sheep, and provides a convenient example to study natural or experimental lentiviral pathology. We wanted to determine whether high resolution computed tomography (HRCT) is able to detect early morphological changes following lentiviral infection in the lungs. Spontaneously infected adult sheep (n=3) and experimentally infected lambs (n=5) were compared to uninfected controls (n=4). The HRCT scans generally showed abnormal features in infected animals, including: increased parenchymal density; alveolar oedema; thickened interlobular septa; and increased density in peribronchiolar areas. HRCT was more sensitive than chest radiography for the early diagnosis of interstitial pneumonitis, although one sheep with advanced disease and radiographic and histopathological abnormalities had a paradoxically normal scan. One control animal showed minor abnormalities on scanning, which were probably due to the procedure used for anaesthesia. The HRCT observations were confirmed by postmortem histological examination of the lungs. In conclusion, high resolution computed tomography provides a noninvasive means of following the development of lung pathology in a natural ovine model of lentiviral disease.

Animals↗

Transplant renal artery stenosis. Evaluation of diagnosis with magnetic resonance angiography compared with color duplex sonography and arteriography.

The goal of this study was to assess the value of a three-dimensional phase contrast magnetic resonance angiography (3D PC MRA) for diagnosing transplant renal artery stenosis (TRAS). Twelve consecutive patients clinically suspected of having TRAS were prospectively enrolled during a period of 18 months. Delays from transplantation varied from 3 months to 4 years (mean: 18.3 months). Patients first had color Doppler sonography, then MRA-and, on the following day, intraarterial digital subtraction angiography (IADSA). The site of the maximum peak systolic velocity was noted when doing the report of each color Doppler sonogram. On MRA images, any signal cutoff or any vascular narrowing of more than 50% of the diameter of the vessel was considered to be a significant stenosis. Eight patients were considered to have TRAS on MRA, but only two stenoses were noted on IADSA. The six false-positive results of MRA (due to major intravoxel phase dispersion) were observed when elevated peak systolic velocities were noted on doppler sonograms (mean: 214 cm/sec). These elevated peak systolic velocities were noted in the proximal part of the renal artery when there was a tortuous vessel or a sharp angle between the renal artery and the parent vessel. It is our opinion that 3D PC MRA is of limited value for the diagnosis of renal transplant artery stenosis because of a high number of false-positive results.

Adult↗

Carboxymethyl-dextran-gadolinium-DTPA as a blood-pool contrast agent for magnetic resonance angiography. Experimental study in rabbits.

RATIONALE AND OBJECTIVES: The authors evaluate the efficiency of various doses of a paramagnetic macromolecular contrast agent, a gadolinium (Gd)-DTPA-dextran conjugate, as a blood-pool contrast media, in a transverse three-dimensional time-of-flight (TOF) magnetic resonance (MR) angiography sequence of the abdominal aorta in rabbits. METHODS: Imaging experiments were performed on a 1.5-T magnet, using a transverse three-dimensional TOF tilted optimized nonsaturating excitation (TONE) sequence. The macromolecular contrast media used was a carboxymethyl-dextran-Gd-DTPA (CMD-Gd-DTPA). Different concentrations of CMD-Gd-DTPA (0.005, 0.01, 0.03, 0.05 mmol Gd/kg) were evaluated. A comparative study using Gd-DOTA (0.01 and 0.1 mmol/kg) was performed. A visual analysis based on the gain in the visualized length of small arteries (renal arteries), and a quantitative analysis based on the percent contrast enhancement of the aorta plotted against distance in the slab from the top edge of the acquisition volume were obtained. RESULTS: A signal-to-noise ratio enhancement of the distal part of the aorta and an improvement in the visualized length of the renal arteries were noted for concentrations of CMD-Gd-DTPA ranging form 0.01 to 0.05 mmol Gd/kg. Venous enhancement was noted for concentrations greater than 0.01 mmol Gd/kg when using CMD-Gd-DTPA or Gd-DOTA. CONCLUSION: Carboxymethyl-dextran-Gd-DTPA reduced, in part, the saturation effect in a three-dimensional transverse TOF TONE MR angiography in rabbits. To prevent venous enhancement, observed with the higher concentrations used in this study, a decrease in the polydispersity of the polymer should be a goal in the future. Rapid extravasation of the low-molecular weight fraction of the polymer could explain the venous enhancement.

Animals↗

Thin-section CT detection of emphysema associated with bronchiectasis and correlation with pulmonary function tests.

PURPOSE: To evaluate, on thin-section CT scans, the prevalence of emphysema in patients with bronchiectasis and to correlate the results of thin-section CT scans with the results of pulmonary function tests, in order to question whether there was a particular functional test profile in this group of patients. PATIENTS AND METHODS: This is a retrospective study including 90 patients having both thin-section CT scans and pulmonary function tests for bronchiectasis. A CT scoring system was established for assessing the airway disease by the severity and extent of bronchiectasis and by the extent of emphysema. CT scans were reviewed independently by two reviewers and final interpretation was obtained by consensus. Results of thin-section CT scans were correlated with results of pulmonary function tests, including FEV1 and FEV1/FVC to assess air-way obstruction, total lung capacity and residual volume to assess air trapping, and diffusing capacity for carbon monoxide/alveolar volume (DCO/VA). RESULTS: CT evidence of emphysema, which was noted in 45% of the patients (n = 41), was mainly localized in the same bronchopulmonary segments as bronchiectasis. The presence of emphysema was in relation to the extent and to the severity of bronchiectasis. Only eight patients with CT evidence of emphysema had functional evidence of emphysema (20%). When comparing the group of patients with CT evidence of emphysema with the group of patients with no CT evidence of emphysema, the group of patients with CT evidence of emphysema had significantly higher airflow obstruction and air trapping, had significantly lesser value of diffusing capacity, but with no decreased gas transfer (DCO/VA > 80%). CONCLUSION: Our series suggests that there is a high prevalence of emphysema in patients with bronchiectasis. Emphysema that was not suggested using pulmonary function tests in most of the cases could explain in part the higher airway obstruction observed in the group of patients with CT evidence of emphysema. This study could support the suggestive notion that emphysema, which was mainly localized in bronchiectatic lobes, could be due to the inflammatory airway process.

Bronchiectasis↗