Biomedical subjects
R F Dondelinger
Publications and source records attributed to R F Dondelinger.
[Breast implants. Evaluation of breast implants using magnetic resonance imaging (MRI)].
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Neurosarcoma of the face: MRI.
Neurosarcoma is a rare tumour originating from the sheath of peripheral nerves. Facial lesions have been reported in about 20 patients. We describe the MRI appearances of neurosarcoma with histological correlation in three patients. The lesions lay in the submandibular region, the left parapharyngeal space and the right orbit. MRI showed a well-defined mass with mixed components. The lesions were moderately heterogeneous on T1-weighted images in two cases and on T2-weighted images in all cases. Gadolinium enhancement occurred in all cases to variable degrees. In two cases, small high signal foci were seen on T2-weighted sequences. MRI appearances of neurosarcoma are not specific.
Multiple pulmonary artery pseudoaneurysms: intrasaccular embolization.
We report the case of a 32-year-old female presenting with two pulmonary artery false aneurysms of mycotic origin. Considering the natural history and potential complications, we treated the patient by intrasaccular embolization with steel coils. No complication occurred.
Safety and efficacy of contrast-enhanced MRI in the brain, head and neck: gadodiamide injection versus gadopentate dimeglumine.
The objective of the present study was to evaluate the safety and efficacy of gadodiamide injection, a non ionic MRI contrast medium in comparison with the ionic agent gadopentate dimeglumine. Two groups of 50 patients with known or suspected lesions of the brain or head and neck were enrolled in a double -blind, randomised trial. In the gadopentate dimeglumine group three patients reported four adverse events, and in the gadodiamide injection group, four patients reported four side effects. All events were minor. Two radiologists analyzed pre and post-contrast MR images. The parameters evaluated were the number of lesions, delineation of the lesion, gain of diagnostic information, and final diagnosis. Both contrast media gave identical diagnostic information.
Comparison of radiography, magnetic resonance imaging, and surgical findings in dogs with elbow dysplasia.
OBJECTIVE: To describe the magnetic resonance imaging (MRI) appearance of medial coronoid process and humeral condyle lesions in dysplastic cubital joints and to compare survey radiography and MRI for evaluation of fragmented medial coronoid process (FMCP) and lesions of the medial aspect of the humeral condyle (MAHC). ANIMALS: 18 dogs with elbow dysplasia. PROCEDURE: Radiography of 22 cubital joints was performed. The 22 joints then underwent MRI. The scans were evaluated with regard to the shape and signal of the coronoid process; articular cartilage change, subchondral bone disruption of the MAHC. Surgical findings were used as the standard to calculate accuracy, sensitivity, specificity, and positive- and negative-predictive values for specific diagnosis of FMCP (free fragment) and lesions of the MAHC. RESULTS: At surgery, 31.8% of the joints had FMCP (free), 36.4% had nondisplaced unmineralized coronoid process, and 27.2% had nondisplaced mineralized coronoid process. Eleven joints had lesions of the MAHC, and wear lesions were observed in 41% of the joints. On radiography, FMCP (free) was visualized in 9% of the joints and lesions of the MAHC were observed in 23%. MRI had the highest accuracy (95.5%), sensitivity (100%), and negative-predictive value (100%) for detection of FMCP (free), and had accuracy (91%), sensitivity (87.5%), specificity (92.5%), and positive (87.5%)- and negative (92.5%)-predictive values for detection of nondisplaced unmineralized coronoid process. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with radiography, MRI was useful for detection of nondisplaced unmineralized coronoid process; images consistently correlated with surgical findings. The technique is accurate and especially useful when radiographic findings are inconclusive.
Evaluation of colour images printed by a thermal dye diffusion process.
Dry printing of medical images, without photochemicals, may be based on the principle of thermal dye diffusion. The Drystar (Agfa Gevaert, Mortsel, Belgium) system was evaluated in colour-coded Doppler examinations of the carotid arteries. A total of 25 consecutive patients were examined for the colour test and 37 patients for the black-and-white test. Colour and black-and-white data were available on the same view. The performances of the Drystar were tested against against laser films, matrix films and two types of glossy paper using the following criteria: grey scale, colour scale, quality of reproduction of vascular colouring, registration, endothelial layer, intraluminal echogenicity, spectral resolution, and artefacts. The overall handiness of the document was graded. A significant difference (p = 0.00005) was noted in favour of the Drystar concerning registration, grey scale, spectral resolution and vascular colouring. The global score for handiness of the colour film was 96%. Radiologists preferred the colour hard copy as compared with glossy paper prints. As in the black-and-white test, blue-base and clear-base films obtained with the Drystar were rated inferior to laser films, a double line print mode was included in the printer, giving a density of 2.3 OD.
Computed tomography of thoracic aortic trauma.
During a 63-month period, 28 consecutive patients suspicious for injury of the thoracic aorta were examined by computed tomography (CT). Twelve aortic ruptures were evidenced; pseudoaneurysm and mediastinal haematoma in close contact with the aorta were present in 12 patients, marginal lucency in 9, marginal irregularity in 8 and intimal flap in 6. CT was falsely negative in 1 patient with injury of the left subclavian artery. Angiography and surgery confirmed the diagnosis in 7 patients, and surgery alone in 5 patients. CT had a sensitivity of 92% and a specificity of 100%. The need for angiography was obviated in 67% of patients. A radiologist with experience in trauma management, CT and angiography should perform both examinations.
Vertebra plana: benign or malignant lesion?
The case of a 9-year-old boy presenting with a vertebra plana at T7 is reported. The initial diagnosis, as suggested by clinical presentation, conventional radiographs and CT scans, was eosinophilic granuloma. Positive radionuclide bone scan led to biopsy of the posterior arch, which suggested giant cell tumour. MRI showed extraspinal tumour involvement. Vertebrectomy revealed osteosarcoma.
A combined CT and angiography suite with a pivoting table.
In a suite with fully interactive computed tomography (CT) and C-arm fluoroscopy units, emergency and elective interventional procedures were performed successfully in 41 patients (overall time range, 40-180 minutes [mean, 80 minutes]). The table can be manually pivoted from the fixed CT position to the free-floating angiography position, in an overall working space of about 40 m(2), with room for anesthesiology and monitoring equipment and personnel.
Percutaneous management of enterocutaneous fistulas.
OBJECTIVE: Our objective was to evaluate retrospectively the results of percutaneous catheter management of enterocutaneous fistulas. SUBJECTS AND METHODS: From 1983 to 1995, 147 patients with enterocutaneous fistulas were referred to our department after at least 1 month of unsuccessful medical treatment. One hundred eleven of these patients (76%) had developed fistulas after surgery. Ninety-three of 147 patients (63%) had high-output fistulas, and 54 (37%) had low-output fistulas. Patients underwent fluoroscopically guided catheterization of the fistulous tracts and cannulation of the enteric segments. Abscesses were drained either through the cutaneous orifice or under CT or sonographic control when no communication with the fistulous tract existed. RESULTS: We defined success as closure of the fistulous tract and the cutaneous orifice and definitive healing of abscesses. The overall closure rate was 81%. The respective clinical success rates for high-output fistulas and low-output fistulas were 90% with a mean duration of 32 days and 65% with a mean duration of 45 days. CONCLUSION: Percutaneous management of enterocutaneous fistulas is a valuable therapeutic approach in patients not responding to medical treatment, particularly patients with high-output fistulas.
Lipomembranous polycystic osteodysplasia.
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Treatment of patent ductus arteriosus by placement of intravascular coils in a pup.
A 3-month-old female mixed-breed pup was referred for evaluation and treatment of patent ductus arteriosus (PDA). Selective angiography was performed to confirm the diagnosis. A cone-shaped PDA with a large aortic base was outlined. A second selective angiographic procedure was performed to functionally close the PDA by use of thrombotic coils; complete obstruction was obtained. Twenty-four hours after the procedure, the murmur disappeared. One month later, the dog was reexamined and found to be clinically normal.
A short history of non-vascular interventional radiology.
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Musculoskeletal hemangioma.
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[Spiral tomodensitometry applied to interventional radiology].
Spiral CT can be applied to many interventional procedures. Rapid scanning time reduces the duration of percutaneous CT guided biopsy and examination time of polytrauma patients. 3D reconstructions are applied to the planning and follow-up of vascular interventional procedures such as embolization of aneurysms or arteriovenous fistulae, stent grafting of aortic aneurysms or dissection, percutaneous transluminal angioplasty of the renal arteries, supra-aortic or iliac arteries. TIPS, percutaneous biliary procedures and percutaneous treatment of liver tumors do largely benefit from 3D reconstructions as a planning method.