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Biomedical subjects

P Prassopoulos

Publications and source records attributed to P Prassopoulos.

At least 19 recordsLinked to original sources
PubMed2006

Inferior epigastric artery false aneurysms: review of the literature and case report.

A case report is presented of a IEA false aneurysm successfully embolized in a 50-year old man following a blunt abdominal injury. A literature review revealed another 15 cases. Most cases were iatrogenic (13/16) complicating abdominal wall procedures. Treatment options included open surgery (8 cases), percutaneous coil embolization (6), ultrasound guided thrombin injection or ultrasound guided compression (2). The selected treatment (surgical or non-surgical) was not affected by the size of the aneurysm (p=0.6) and was successful in all patients. However two of the non-surgically removed lesions (25%) remained unchanged in size for a long time causing discomfort. IEA false aneurysms represent an uncommon entity. Open surgery for IEA false aneurysms is easy and cheap. Endovascular approaches can lead to a long delay in resolution of the problem.

Abdominal Injuries↗
PubMed2005

Low-frequency MEG activity and MRI evaluation in Parkinson's disease.

BACKGROUND: Low - frequency activity has been reported in Parkinson disease (PD). We investigated the magnetoencephalographic (MEG) recordings from PD patients and healthy volunteers in the frequency domain. METHODS: The MEG recordings were carried out in a magnetically shielded room with a whole-head 122-channel gradiometer. Nine patients suffering from PD and 9 age and gender matched healthy subjects were included in the study. MRI with T1-w and T2-w images, was available in patients' records. RESULTS: Frequency analysis may be usefully combined in the analysis of data sets, which contain oscillatory components. Prominent low frequencies can be seen in the spectrum obtained from the PD patients whereas in the control group the frequency range was 6Hz in the majority of channels. MRI did not disclose specific findings in any case. CONCLUSIONS: It is suggested that the MEG could be a complementary method in the diagnostic evaluation of PD using spatial distribution of the raw data in the frequency domain.

Aged↗
PubMed2004

Intrahepatic extramedullary hematopoietic tumor mimicking metastatic carcinoma from a colonic primary.

BACKGROUND: Extramedullary hematopoiesis (EMH) is associated with a number of diseases in which the normal function of the bone marrow is disturbed. While organs with hemopoietic capacity like the liver and spleen are most commonly involved, EMH has also occasionally been found in other organs like the adrenal gland, lymph nodes, breast, thymus, small bowel and central nervous system. However, presentation of a myeloproliferative disorder, such as EMH in these organs is a rare event. CASE REPORT: We report clinical and fine-needle aspiration (FNA) findings in a patient who presented with intrahepatic EMH which mimicked metastatic carcinoma from a colonic primary. RESULTS: Ultrasound-guided FNA of the intrahepatic mass revealed megakaryocytes and myelocytes thus establishing the diagnosis of EMH. CONCLUSIONS: EMH is an unusual condition that can mimic other solid masses of the liver. Because radiologic findings are not specific, EMH should be considered in the differential diagnosis, especially in patients with a myeloproliferative disorder. FNA and subsequent cytopathological interpretation of the aspirates enables avoidance of unnecessary potentially hazardous surgery.

Adenocarcinoma↗
PubMed2004

Bilateral metastatic rhabdomyosarcoma to the breast in an adolescent female: touch imprint cytology and implication of MyoD1 nuclear antigen.

BACKGROUND: Rhabdomyosarcoma accounts for approximately 4% of all childhood malignancies. Breast metastases from rhabdomyosarcoma are uncommon with an incidence of 6%. CASE REPORT: We present a patient who developed bilateral mammary metastases from rhabdomyosarcoma arising in the right lower extremity. An 11-year-old female with a 20-month history of rhabdomyosarcoma was referred to our department because of bilateral breast enlargement. A needle core biopsy was performed and touch imprint slides were obtained. Cytology determined the masses to be metastases of rhabdomyosarcoma. MyoD1 immunostain and RT-PCR analysis confirmed the diagnosis. CONCLUSIONS: Cytomorphology with ancillary methods is essential in the diagnosis of metastatic breast deposits in order to avoid unnecessary mastectomy and to employ systemic treatment.

Biomarkers, Tumor↗
PubMed2003

Fine-needle aspiration cytology of a para-aortical solitary plasma-cell tumor.

Extramedullary plasma-cell tumor (EMP) is a very rare disease and mainly arises in the head and neck area. An EMP arising in the paraaortical space was diagnosed by fine needle aspiration cytology and immunocytochemistry, in a 48-year-old male. Smears were cellular and showed dissociated monomorphic plasma cells. Immunocytochemistry demonstrated monoclonal expression of kappa-light immunoglobulin chain and CD38 positivity. Cytomorphology and immunocytochemical profile allowed a definitive diagnosis of plasmacytoma.

Aorta↗
PubMed2002

Development of contrast-enhanced virtual MR cholangioscopy: a feasibility study.

The purpose of this study was to examine the feasibility of contrast-enhanced virtual MR cholangioscopy (CE VMRC). Intraluminal views of the extrahepatic biliary tree were generated in ten patients undergoing abdominal MRI post mangafodipir trisodium administration employing coronal 2.5-mm 3D fast low-angle shot (FLASH) images (TR 6.8 ms, TE 2.3 ms, matrix 195 x 512) with fat saturation and a commercially available software. Contrast-enhanced VMRC was compared with single-shot turbo spin-echo T2-weighted MR cholangiography (T2 MRC) in terms of ductal visualization and artifact presence, utilizing a five-point grading scale. Four anatomic segments were evaluated: the intra- and extra-pancreatic segment of the common bile duct (CBD), and the cystic duct and the area of hepatic duct bifurcation. Both CE VMRC and T2 MRC depicted 38 of 40 segments. There were no significant differences between CE VMRC and T2 MRC in ranking ductal segments visualization ( p=0.27). The high contrast between intraluminal fluid and extraluminal tissues facilitated the generation of endoscopic views. Contrast-enhanced virtual MR cholangioscopy is a feasible technique providing endoscopic views of the CBD. Initial results show correlation of CE VMRC with projectional MR cholangiography.

Bile Ducts↗
PubMed2002

Peripheral primitive neuroectodermal tumour during pregnancy.

The case of a 25-year-old primipara in the second trimester of pregnancy, suffering from a peripheral primitive neuroectodermal tumour (pPNET) diagnosed by bone biopsy, is described. External irradiation was initially performed because of Jacksonian seizures due to a lesion in the right cerebral hemisphere. Appropriate shielding was used to reduce fetal exposure during brain radiotherapy. Caesarian delivery at the 27th week of gestation was performed because of tumour progression. The neonate had no evidence of disease and survived for 1 month. However, the placenta and ovaries showed metastases from the maternal pPNET. The patient died 14 months after initial diagnosis owing to the aggressiveness of the tumour, the rapid and extensive semination (bone marrow, lung, liver, craniospinal axis involvement) and the inability to adequately treat the patient with appropriate doses of chemotherapy.

Adult↗
PubMed2001

Role of conventional radiology in the diagnosis and staging of gastrointestinal tract neoplasms.

Preoperative diagnosis and staging of primary gastrointestinal (GI) neoplasms are challenges for both clinicians and radiologists. Barium studies are very sensitive in disclosing primary malignancies, even at an early stage. Radiologic signs depend on the evolutional stage of the disease and its appearance on gross pathology. A neoplasm may be manifested on barium studies by a wide spectrum of findings, including mucosal abnormalities, mass presence, ulcerative lesions, submucosal infiltration, and lumen stenosis. Advanced disease can be accurately diagnosed, whereas early cancer should be differentiated from other neoplastic or inflammatory disorders by meticulous analysis of radiologic findings. The extent of GI involvement and multiplicity of the lesions can be assessed on barium studies. In the staging of GI neoplasms, barium studies are of little value. Skeletal survey by conventional radiographs and chest plain films can reveal distant metastases in a short time and with low cost, although they are not that sensitive to the detection of early or subtle lesions. The exact role of conventional radiology in the imaging workup of GI malignancies depends on local expertise and availability of other diagnostic techniques and modalities.

Barium↗
PubMed2001

MR enteroclysis protocol optimization: comparison between 3D FLASH with fat saturation after intravenous gadolinium injection and true FISP sequences.

The aim of this study was to introduce the true fast imaging with steady-state precession (FISP) sequence for MR enteroclysis and compare it with the already used T1-weighted fast low-angle shot (FLASH) sequence. Twenty-one patients underwent both MR and conventional enteroclysis. The MR enteroclysis examination was performed after administration of an iso-osmotic water solution through a nasojejunal catheter and the following sequences were included: (a) true FISP; and (b) 3D FLASH with fat saturation after intravenous injection of 20 mg Buscopan or 1 mg glucagon and 0.1 mmol/kg gadolinium chelates. The true FISP sequence provided images with significantly fewer motion artifacts, whereas 3D FLASH was less sensitive to susceptibility and chemical shift artifacts. The homogeneity of endoluminal opacification, wall conspicuity, and distention of the small bowel were very good to excellent and the two sequences presented no statistically significant differences here. True FISP provided significantly better overall image quality than did 3D FLASH. The true FISP sequence can provide good anatomic demonstration of the small bowel on T2-like images and could be combined with T1-weighted FLASH images for an integrated protocol of MR enteroclysis.

Adolescent↗
PubMed2001

An individualized approach for the implantation of a humeral prosthesis with the proper retroversion in fractures.

We applied a new methodology in 7 patients with a fracture of the upper humeral head that required hemiarthroplasty, to implant a humeral prosthesis with an individualized posterior version. Our goal was to determine preoperatively the distance from the posterior edge of the bicipital groove where the lateral fin of the humeral prosthesis should sit, in order to reproduce the individual retroversion during surgery. Using three computed tomography scan sections of the upper humerus and image processing software, we estimated the above-mentioned distance in the sound humerus and implanted the prosthesis in each patient accordingly. The differences in retroversion between the left and right humeral heads permit a better approximation to normal applying this methodology than inserting the prosthesis in a standard retroversion.

Humans↗
PubMed2001

Splenic involvement in lymphomas. Evaluation on serial CT examinations.

PURPOSE: To prospectively evaluate changes in splenic volume (SV) on serial CT of patients with lymphoma and correlate them with other indicators of the disease process. MATERIAL AND METHODS: SV was calculated in 290 abdominal CT examinations of 58 consecutive adults with lymphoma (42 non-Hodgkin's lymphoma, 16 Hodgkin's disease). Each patient had one CT investigation before, 2 during chemotherapy and 2 post-chemotherapy. The changes in SV were correlated with clinical, laboratory and other imaging indicators of the disease process. RESULTS: Three groups of patients were identified. Group A (n=20) presented no changes in SV, showed no splenic parenchymal abnormalities and had normal SV and serum lactic dehydrogenase (S-LDH). Group B (n=25) presented a decrease in SV during treatment suggesting response to therapy. Splenic parenchymal abnormalities (n=5) and other subdiaphragmatic sites of involvement (n=20) underwent remission during treatment. Eighteen patients with high S-LDH at presentation showed normal values during therapy. Group C (n=12) showed an increase in SV post-therapy associated with manifestations of disease recurrence. The S-LDH levels were elevated in 10 patients at the same time. CONCLUSION: Quantitatively assessed splenic size on CT may serve as an indicator of splenic involvement in the course of lymphomas.

Adolescent↗
PubMed2001

Contrast-enhanced magnetic resonance cholangiography versus heavily T2-weighted magnetic resonance cholangiography.

RATIONALE AND OBJECTIVES: To investigate the feasibility of contrast-enhanced magnetic resonance cholangiography (CE-MRC) and compare it with single-shot turbo spin-echo magnetic resonance cholangiography (SSTSE-MRC). METHODS: Fifteen patients with suspected metastatic liver disease (n = 10) or biliary tree abnormalities (n = 5) underwent a magnetic resonance imaging (1.5-T system) examination before and after mangafodipir administration. Contrast-enhanced MRC with a three-dimensional fast low-angle shot sequence after mangafodipir trisodium administration was compared with SSTSE-MRC. Four anatomic segments were evaluated: the intrapancreatic and extrapancreatic common bile duct segments, the cystic duct, and the area of hepatic bifurcation. Contrast-enhanced MRC and SSTSE-MRC were separately analyzed on a 5-point grading scale in terms of ductal segment visualization and lumen narrowing or dilatation. RESULTS: There was no difference (P = 0.375) in segment visualization between CE-MRC and SSTSE-MRC; 56 of the 60 segments were visualized by both techniques. In the evaluation of ductal narrowing or dilatation, nonsignificant differences (P = 0.500) were observed. Contrast-enhanced MRC was not influenced by fluid superimposition and provided additional information from background tissues. CONCLUSIONS: Contract-enhanced MRC is a feasible technique showing anatomic correlation with SSTSE-MRC, and it can in addition provide functional information. Contrast-enhanced MRC may be used in selected patients when traditional SSTSE-MRC is inconclusive.

Bile Ducts↗
PubMed2001

MR enteroclysis imaging of Crohn disease.

Magnetic resonance (MR) enteroclysis imaging is emerging as a technique for evaluation of the small bowel in patients with Crohn disease. Administration of 1.5-2 L of isosmotic water solution through a nasojejunal catheter ensures distention of the bowel and facilitates identification of wall abnormalities. True fast imaging with steady-state precession (FISP), half-Fourier acquisition single-shot turbo spin-echo (HASTE), and postgadolinium T1-weighted three-dimensional fast low-angle shot sequences can be employed in a comprehensive and integrated MR enteroclysis examination protocol to overcome specific disadvantages of each of the sequences involved. Superficial abnormalities that are ideally delineated with conventional enteroclysis are not consistently depicted with MR enteroclysis. The characteristic transmural abnormalities of Crohn disease such as bowel wall thickening, linear ulcers, and cobblestoning are accurately shown with MR enteroclysis imaging, especially with the true FISP sequence. MR enteroclysis is comparable to conventional enteroclysis in the detection of the number and extent of involved small bowel segments and in the disclosure of luminal narrowing or prestenotic intestinal dilatation. The clinical utility of MR enteroclysis in Crohn disease has not been fully established. At present, the method may be used for follow-up studies of known disease, estimation of disease activity, and determination of the extramucosal extent and spread of the disease process.

Artifacts↗
PubMed2001

Image segmentation in treatment planning for prostate cancer using the region growing technique.

The purpose of this study was to evaluate the performance of a region growing technique for segmenting prostate, bladder and rectum in CT images of prostate cancer patients. Prostate, bladder and rectum were segmented in all CT images of 10 patients using the region growing technique and manual tracing. Volumes of the above organs computed with the region growing technique were compared with those from manually traced images on a slice-by-slice basis. Measurement reproducibility of both segmentation techniques was evaluated using the data obtained from four independent observers. The region growing technique was 1.5 times faster than manual tracing. There was no statistical difference between the slice volumes of prostate, bladder and rectum obtained by the two segmentation techniques (p > 0.05, paired Student's t-test). Correlation between slice volumes of all organs of interest provided both by region growing and by manual tracing was very good (prostate r2 = 0.84; bladder r2 = 0.93; rectum r2 = 0.85). An overall reasonable agreement was found between the two segmentation techniques. The intraobserver and interobserver variations for prostate, bladder and rectum volume segmentation were found to be lower with the region growing technique than with manual tracing. The suggested semi-automatic technique allows the possibility of generating accurate and reproducible segmentation of prostate, bladder and rectum from CT data with great saving in labour.

Humans↗