Biomedical subjects
Publications and source records attributed to R Palau.
Renal angiomyolipomas are renal hamartomas. They are usually found incidentally, presenting as well-defined echogenic masses on sonography and fat containing tumors on CT and MRI. We report a case of angiomyolipoma with sonographic and CT evidence of extension to the renal vein and inferior vena cava.
Fatty tumors of the uterus are rare. Most reported cases have been of the mixed type, consisting of smooth muscle and mature adipose tissue. We present the first case of a pure lipoma with pathologic correlation in which a preoperative diagnosis was made by magnetic resonance imaging.
X-ray exposure during radiologically guided interventional procedures may have some deleterious effects. The aim of our study was to analyse the factors affecting patient dose during percutaneous coronary angioplasty (PTCA). We evaluated radiation dose during coronary angiography followed by one-vessel PTCA in 402 consecutive patients who were treated by three experienced physicians using both femoral and radial techniques. Fluoroscopy time (t) and patient dose measured by a dose-area product (DAP) meter were recorded. A good correlation was observed between t and the DAP (r=0.78, p<0.001). To assess the factors affecting radiation exposure, we studied the differences between operators, arterial catheterization access and stenting strategy. Median (25th to 75th percentiles) values for t were 19 (13 to 26) min and for DAP were 191 (145 to 256) Gy cm(2) for operator 3 compared with t=12 (9 to 18) min and DAP=137 (91 to 208) Gy cm(2) for operator 2 (p<0.005 versus operator 3) and t=13 (9 to 17) min, and DAP=134 (93 to 190) Gy cm(2) for operator 1 (p<0.001 versus operator 3). Differences between the radial and the femoral techniques were: t=17 (13 to 24) min versus 12 (8 to 17) min, (p<0.001) and DAP=175 (128 to 246) Gy cm(2) versus 138 (93 to 197) Gy cm(2), (p<0.001). In comparison with stenting without pre-dilation, direct stenting significantly reduced t and DAP [t=12 (9 to 16) min versus 16 (11 to 22) min, (p<0.001) and DAP=130 (95 to 186) Gy cm(2) versus 163 (119 to 230) Gy cm(2), respectively, (p<0.01)]. Radiation exposure to patients and staff are strongly dependent on operators, stenting strategy and the arterial access chosen for ad hoc one-vessel PTCA.
Multidetector CT and MRI are the most efficient non invasive techniques in the assessment of pancreatic diseases. As with MRI, multidetector CT has now become an all in one examination using 2 D and 3 D multiplanar reformations with the ability to perform with high accuracy: a) vascular assessment using MIP reconstruction and b) biliary and pancreatic ducts assessment using minIP reconstruction. This review compares and illustrates the respective advantages of MRI and multidetector CT in the assessment of pancreatic diseases.
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US and CT have both become major tools in imaging of the anterior abdominal wall. The goal of this pictorial review is to illustrate the respective roles of US and CT in the evaluation of normal and abnormal anterior abdominal wall.
Two cases of recurrent macroscopic hematuria in which the diagnosis of left renal vein varices has suggested on CT are described. Bloody efflux was seen from the left ureteric orifice. On CT scans, tubulated contrast-enhanced densities in left perineal fat were seen. Selective renal angiography was normal. Selective left renal phlebography demonstrated intra and perirenal varices. In the two cases, embolization with metallic coli was successfully performed during left renal phlebography, to stop renal varices flux. Diagnostic and therapeutic modalities of renal varices are discussed with predominant place for CT and phlebography.
We report a case of cavo-mesenterico-portal shunt in vena cava obstruction. The main role and frequency of this preferential pathway are reviewed and analyzed.
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The diagnosis of intestinal obstruction still rests on radiography of the abdomen without preparation. Three X-ray films must systematically be taken: a general film and a film centred on the diaphragmatic domes with the subject standing; another general film with the subject lying on his back. It is relatively easy to identify the obstructed segment, but the cause of obstruction remains difficult to determine. For small bowel obstruction, emergency surgery is often necessary. If the patient's condition permits, it may be useful to opacify the dilated segment in order to study the nature of the obstacle. Colonic obstruction is opacified through the anus, this route being more informative. There are two types of acute obstruction: by occlusion and by strangulation. The various causes are considered, but there are also incomplete obstructions and dilatations without obstruction.
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The first part of the article deals with the relevance of the various radiological incidences and the CT examination technique in the acetabular fractures. Then, the study of the total hip arthroplasties radiological follow-up is covered, with the pertinence of doing arthrography during complications (loosening, sepsis).
A retrospective, morphological and immunochemical study was performed on 60 bone marrow biopsies (BOM) and 12 tumor specimens surgically excised, from 9 patients with neuroblastoma (NB). Immunochemistry concerned "neuron-specific enolase" (NSE), chromogranin A (CGA) and synaptophysin (SP). The results of immunochemical stains and the study of reticulin network on the argentic stain were compared to the results of morphological evaluation on the routine stain. NSE, CGA and SP staining of tumor cells (part or all of them) was obtained from all surgical specimens. 17/75 BOM (20%) were discarded because of poor material. NB cells were observed in 24 BOM from 3 patients. Tumor cells formed large strands (1 patient) or nests (2 patients) associated with segregated cells. Diagnosis of metastatic BM involvement was negative or doubtful for 6 BOM (3 obtained at the same time, 2 patients), in which NB cells were clearly demonstrated by immunochemical staining of NSE and/or CGA. Reticulin and/or collagen myelofibrosis was present in 32/35 BOM from the 3 patients metastatic in bone marrow (BM+) even if NB cells could not be demonstrated in these samples.
The purpose of this prospective study was to assess the usefulness of intravenous cholangiograms before elective cholecystectomy for lithiasis. The accuracy of preoperative intravenous cholangiography to detect choledocolithiasis was compared with that of routine operative cholangiography. All patients had preoperative intravenous cholangiography provided that they did not have known common bile duct gallstones or a previous history of adverse reaction to iodine. As well, patients presenting with cholestasis, cholecystitis or cholangitis were excluded. A choledocotomy was performed when the operative cholangiography disclosed choledocolithiasis; the preoperative intravenous cholangiograms were shown to the surgeon only after the operation. One hundred patients were selected among 206 consecutive operations for biliary lithiasis. A choledocolithiasis was detected in 3 preoperative and in 9 operative cholangiographies. Twelve choledocotomies were performed: one or more stones (1 to 12) were found in 9 patients; operative cholangiography was accurate in all these cases whereas preoperative cholangiography was accurate in only 2 (sensitivity = 22 percent). We conclude that preoperative cholangiography is useless before elective cholecystectomy for lithiasis and is unreliable to select patients in which operative cholangiography could be omitted.
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Ultrasound anatomy of the right hypocondrium as it appears on control scans is described and illustrated. Such views are often self-speaking and are readily understood by the clinicians, because they are similar to the classified radiological anatomy. Moreover, coronal studies of the right hypocondrium proves to be very suitable in a wide variety of pathological situations and in some peculiar patients such as the stout ones.
Cholangiographic and histological examinations after partial hepatectomy in rats have demonstrated the presence of biliary as well as hepatocyte regeneration. Commencing very soon after hepatectomy, biliary degeneration is confirmed by radiological investigation, showing hypertrophy of the intra-hepatic biliary canals, and corroborated histologically by evidence of mitoses in the biliary epithelium. This suggests that intravenous cholangiography can be a simple means of evaluating hepatic regeneration after partial hepatectomy in humans.