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S Gryspeerdt

Publications and source records attributed to S Gryspeerdt.

At least 19 recordsLinked to original sources
PubMed2005

CT colonography with fecal tagging after incomplete colonoscopy.

The objective of this study was to evaluate dietary fecal tagging (FT) as a cleansing method prior to CT colonography (CTC) in patients with incomplete conventional colonoscopy (CC). After written informed consent was obtained, 24 patients had standard colonoscopic preparation (ScCl), and 25 patients had FT as cleansing method. Segmental distention, fluid levels, fecal residues, tagged appearance of fluid levels, and residual stool were evaluated. Mann-Whitney U test was used to test for significant differences between FT and ScCl groups. Compared with ScCl, FT improved distention (p=0.001), reduced the amount of fluid (p=0.043), but suffered from residual stool (p=0.046). A clear correlation was found between distention and fluid. No differences were found in stool size between FT and ScCl. FT showed a good labeling of fecal residues, and acceptable labeling of fluid levels. Compared with ScCl, FT reduces fluid, favors distention, but suffers from fecal residues. The tagged nature of these residues, however, allows differentiation from polyps.

Adult↗
PubMed2002

Optimisation of colon cleansing prior to computed tomographic colonography.

Colon preparation technique is a major determinant factor for patient compliance and polyp detection in computed tomographic colonography (CTC). The purpose of this study is to compare three different colon cleansing techniques in terms of patient discomfort, sensitivity and specificity. The following colon cleansing methods were compared in 20 patients each: 1. standard colonoscopy cleansing (ScCl) the day of the examination, based on polyethylene glycol (PEG), 2. a slightly reduced cleansing (RcCI) the day prior to the examination, based on a combination of diet, bisacodyl and a reduced intake of PEG, and 3. a cleansing with dietary fecal tagging (FT) the day prior to the examination, based on a combination of diet, bisacodyl, magnesium citrate and a dedicated barium suspension. ScCl resulted in a clean colon, but produces fluid levels hampering a complete CTC and possibly resulting in false negative diagnosis. RcCl reduced the problem of fluid levels, but was faced with the problem of fecal residues, resulting in false positive diagnosis. FT offered the possibility to obtain a dry colon, with labelled fecal residues, thus reducing false positive findings. Optimisation of the diet and replacement of PEG by magnesium citrate in FT reduced the preparation related discomfort and improved the final opinion. FT is the preferred colon cleansing technique because, compared to ScCl, fluid levels are reduced, and compared to RcCl, differentiation between faecal residues and polyps is improved. Moreover, FT reduces preparation related discomfort, compared to both RcCl and ScCl.

Bisacodyl↗
PubMed2000

Percutaneous treatment of acute multiple limb ischemia.

This study evaluates the use of pulse spray pharmacomechanical thrombolysis (PSPMT) in combination with a low dose urokinase infusion and a possible secondary percutaneous treatment in the management of acute multiple limb ischemia. A retrospective analysis of 185 patients treated with PSPMT revealed eight patients with acute simultaneous ischemia of more than 1 limb. Seven patients presented with acute ischemia of both lower limbs; one patient presented with acute ischemia of the left arm and both lower limbs. All patients were treated using a combination of PSPMT and low dose urokinase infusion. The combination of PSPMT and low dose urokinase infusion was completely successful in 6 cases. In 1 patient with bronchogenic carcinoma PSPMT failed and immediate surgical thrombectomy was performed. In the other patient we obtained clot dissolution with thrombolysis in one leg, residual clots at the popliteal level in the other leg however had to be removed by surgical embolectomy. Embolism was the cause of the occlusion in 6 patients. Atherosclerotic disease appeared to be the underlying cause in the other 2 patients. Atherosclerotic disease was treated with balloon angioplasty and stenting. In the 8 patients with multiple limb ischemia, combination of PSPMT, low dose urokinase infusion, and possibly secondary treatment was useful and constituted a valuable alternative to open surgery. Acute occlusion of the abdominal aorta and acute leg ischemia have a high mortality and amputation rate with variable results in treatment. The use of thrombolysis has reduced the necessity of surgery in arterial occlusive disease and simplifies the treatment of native artery occlusion. Especially in patients with long and multi-level occlusions with poor outflow, thrombolysis seems to be the treatment of choice. In our analysis of 8 cases with acute multiple limb ischemia we review our experience with the combination of pulse spray pharmacomechanical thrombolysis (PSPMT), low dose continuous urokinase infusion and a possible subsequent percutaneous treatment of the obstructing lesion. The final purpose was to investigate if this combination is a successful and safe method in the treatment of acute multiple limb ischemia.

Acute Disease↗
PubMed1999

Diagnosis and treatment of expanding haematoma of the lateral abdominal wall after blunt abdominal trauma.

We report a rare case of an expanding post-traumatic lateral abdominal wall haematoma. A superselective arteriogram of the deep circumflex iliac artery showed extravasation from the ascending branch, urging emergency therapy. Microcoil and Gelfoam embolisation was successfully performed. Haematomas of the abdominal wall can be divided in the common rectus sheath haematomas and the rare haematomas of the lateral abdominal wall. Differentiating both entities is essential, since there is a strong difference in their vascular supply. The typical vascular supply of the lateral abdominal wall is discussed, with emphasis on the ascending branch of the deep circumflex iliac artery.

Abdominal Injuries↗
PubMed1998

Nonalcoholic duct-destructive chronic pancreatitis: imaging findings.

OBJECTIVE: Nonalcoholic duct-destructive chronic pancreatitis is a new entity that should be distinguished from alcoholic chronic pancreatitis. The purpose of this study was to assess the imaging features of nonalcoholic duct-destructive chronic pancreatitis. CONCLUSION: Nonalcoholic duct-destructive chronic pancreatitis has characteristic CT and MR imaging features that include the presence of a focal or more diffuse mass causing either regular or irregular narrowing of the main pancreatic duct, the absence of parenchymal atrophy and significant ductal dilatation proximal to the site of stenosis, and the absence of extrapancreatic spread.

Adolescent↗
PubMed1998

Normal Vaterian sphincter complex: evaluation of morphology and contractility with dynamic single-shot MR cholangiopancreatography.

OBJECTIVE: The objective of this study was to assess the usefulness of dynamic single-shot MR cholangiopancreatography in the evaluation of the morphology and contractility of the normal Vaterian sphincter complex and to assess whether i.v. injection of glucagon can improve visualization. SUBJECTS AND METHODS: Sixty patients without signs of Vaterian sphincter complex dysfunction were studied. A fast single-shot MR imaging sequence was used to obtain 20 consecutive images of the Vaterian sphincter complex during successive episodes of breathholding. In patients of group A (n = 30), 10 images were obtained before and 10 after i.v. administration of a sphincter-relaxing agent (glucagon). In the patients of group B (n = 30), no glucagon was administered. The degree of visualization of the Vaterian sphincter complex was assessed. RESULTS: Overall, the morphology and contractility of the Vaterian sphincter complex was adequately assessed in 57 patients (95%). However, the number of repetitions required to obtain this result varied greatly (mean, seven; range, two to 18). Glucagon had no apparent effect on the visibility of the most distal portion of the common bile duct. CONCLUSION: Nonvisualization of the most distal portion of the common bile duct on MR cholangiopancreatography studies is a normal variant that can simulate disease. Obtaining serial breath-hold images using a single-shot technique is helpful to avoid diagnostic errors.

Adult↗
PubMed1998

T2-weighted MR imaging of the uterus: comparison of optimized fast spin-echo and HASTE sequences with conventional fast spin-echo sequences.

OBJECTIVE: Our objective was to compare the value of a half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence with optimized fast spin-echo and conventional fast spin-echo techniques in evaluation of the uterus. SUBJECTS AND METHODS: Optimized fast spin-echo imaging was compared with fast spin-echo and HASTE imaging, for both image quality and ability to assess the zonal anatomy of the uterus, in 40 volunteers. In optimized fast spin-echo imaging, the imaging time was reduced using partial-Fourier reconstruction, reducing the echo spacing, and increasing the echo train length. RESULTS: HASTE imaging offered the least motion artifact of all techniques. On optimized fast spin-echo imaging, motion artifacts were moderate to severe in 10% of patients. On fast spin-echo imaging, motion artifacts were moderate to severe in 40% of patients. Optimized fast spin-echo imaging was superior to the other two techniques in terms of anatomic sharpness and overall image quality. CONCLUSION: Although HASTE imaging offers the unique feature of providing images free of motion artifacts, optimized fast spin-echo imaging appears to be the preferred technique for T2-weighted imaging of the uterus.

Adolescent↗
PubMed1998

Localized benign fibrous mesothelioma mimicking a malignant tumor of the pleura.

A case of benign fibrous pleural mesothelioma is reported. Imaging studies as well as clinical features suggested malignant pleural mesothelioma. The lesion was judged resectable and no metastases were found. At surgery it was found to be a benign pleural fibrous mesothelioma. Because of the considerable overlap of imaging characteristics between the two entities, the authors conclude that determination of resectability rather than differentiation between benign and malignant mesothelioma should be the primary goal to be achieved by imaging techniques.

Aged↗
PubMed1998

Intraperitoneal contrast material combined with CT for detection of peritoneal metastases of ovarian cancer.

OBJECTIVE: To determine the sensitivity and specificity of CT-peritoneography (CT-P) in detecting peritoneal carcinomatosis in primary or recurrent ovarian cancer. METHODS: Twenty-five patients were submitted to a standard abdominal CT (CT) as well as a computed tomography after intraperitoneal infusion of contrast material (CT-P). Twenty patients had ovarian masses clinically suspected to be malignant. In five patients with ovarian cancer who underwent prior debulking surgery, recurrent disease was suspected. RESULTS: In 21/25 patients an ovarian malignancy was histologically confirmed. During surgery peritoneal spread was found in 13 patients; only in 5 cases CT correctly suggested peritoneal metastases (sensitivity 38%). However, in 10/13 women CT-P indicated peritoneal spread, increasing the overall sensitivity from 38% to 77%. Sensitivity varied substantially according to the different abdominal areas, and was lowest in the left subphrenic space (25%). The sensitivity of CT-P was 71% and 72% in the right paracolic gutter and the pelvis, respectively. Sensitivity of CT-P was not found to be size-dependent, but was mainly related to the morphology of the lesions, with 100% sensitivity in nodular lesions, and only 21% sensitivity for flat peritoneal lesions. CT-P did not improve detection of omental metastases, and was not advantageous when ascites was present. Previous surgery reduced overall specificity from 80% to 57%. CONCLUSION: CT-P greatly improved the sensitivity of CT in the preoperative detection of peritoneal spread of ovarian malignancy. However, the technique failed to detect flat peritoneal metastases, and had a low specificity in patients with a history of prior abdominal surgery.

Contrast Media↗
PubMed1997

Preliminary experience with a new double-echo half-Fourier single-shot turbo spin echo acquisition in the characterization of liver lesions.

A new double-echo half-Fourier single-shot turbo spin echo technique has been implemented in which two images are obtained per excitation pulse, one with an echo time (TE) of 60 ms and another with a TE of 438 ms. The acquisition window per image is 380 ms and is determined by the echo spacing of 4.3 ms and the echo train length of 88 for images with resolution of 160 x 256. No breath holding was performed. The aim of the study was to test whether the additional information of the late TE image improves the characterization of liver lesions. Twenty-eight patients with 39 focal liver lesions (9 cysts, 11 hemangiomas, and 19 solid lesions) were imaged with the new technique, and signal intensity (SI) ratios of lesion and liver were obtained. A t-test analysis showed that in the TE 60 ms image, SI ratios of cysts and hemangiomas were not significantly different, whereas in the TE 438 ms images the two types of lesions can be classified. Signal intensity ratios of solid lesions were in both images clearly lower than those of cysts and hemangiomas. The technique, therefore, seems a promising and straightforward new tool for the characterization of liver lesions.

Cysts↗
PubMed1997

Gastroepiploic artery coronary bypass graft: non-invasive patency evaluation using color and duplex Doppler ultrasonography.

OBJECTIVE: Color and duplex Doppler ultrasound and digital subtraction angiography were compared for the evaluation of graft patency of the gastroepiploic artery (GEA). METHODS: In 77 observations, ultrasound and digital subtraction angiography were compared. The coronary resistance index (cRI) was defined as the maximal systolic flow velocity minus the maximal diastolic flow velocity, divided by the maximal systolic flow velocity. On digital subtraction angiography, the graft was considered patent, occluded, or patent but non-functional. Grafts were defined as non-functional when they had a diameter of less than 5F with the absence of opacification of the native coronary artery. RESULTS: Of the 77 observations, 64 GEAs were patent angiographically, three were occluded and ten grafts were considered as patent but non-functional. Using color and duplex ultrasound, the GEA was identified in 65 out of 77 observations. There were no cases of false positive visualization of the GEA. All sonographically detected non-functional grafts (n = 7) had a cRI of greater than 0.60. When the non-visualized grafts are considered either non-functional or occluded, a cut-off value for a cRI of 0.60 results in a sensitivity and specificity of 100 and 75%, respectively. CONCLUSION: We propose ultrasound as a primary screening tool for evaluating graft patency. While color Doppler is a suitable technique for graft visualization, spectral analysis with the calculation of a cRI is required for functional evaluation.

Adult↗
PubMed1997

Dual-phase helical CT of the liver: value of an early-phase acquisition in the differential diagnosis of noncystic focal lesions.

OBJECTIVE: Contrast-enhanced helical CT images of the liver are usually obtained during the portal vein phase (PVP), during which the parenchyma achieves peak enhancement. The purpose of this study was to determine whether the addition of arterial-phase (AP) scans would lead to improved characterization of focal lesions. MATERIALS AND METHODS: We reviewed the CT appearance of 102 focal lesions with a proven diagnosis. In the first part of the study, we assessed whether the addition of AP scans influenced the diagnostic performance of the three observers. In the second part of the study, we analyzed the morphologic appearance revealed on CT scans of the different types of lesions in the AP and PVP. RESULTS: The addition of AP scans led to a significant increase in the number of correct diagnoses: 71 lesions (70%) were correctly diagnosed with CT scans in both the AP and the PVP, compared with 54 lesions (53%) correctly diagnosed with CT scans in the PVP alone (p < .01). The largest difference was observed in the diagnosis of focal nodular hyperplasia (FNH) and adenoma (16/24 correct diagnoses instead of 6/24) (p < .005). Conversely, AP images did not significantly contribute to the diagnosis of hemangiomas and metastases. The following morphologic features were seen much more often on AP scans than on PVP scans and had a high positive predictive value (PPV): spoke-wheel pattern (FNH; PPV, 100%), central feeding vessel (FNH; PPV, 100%), and heterogeneous appearance with hyperdense components (hepatocellular carcinoma; PPV, 75%). CONCLUSION: Our data show that the radiologists' evaluation of CT scans in both the AP and the PVP improves the differentiation of hepatocellular carcinoma and FNH from other types of hepatic neoplasms.

Adenoma, Liver Cell↗
PubMed1996

Assessment of accuracy of renal artery stenosis grading in helical CT angiography using maximum intensity projections.

The purpose of the study was to investigate whether visual inspection of maximum intensity projection (MIP) images is a reliable method for assessment of the severity of renal artery stenoses (RAS). Therefore, 20 RAS were investigated with helical CT. Native axial images and MIP images were analysed separately or in combination ("two-step method"). A phantom study was performed to investigate the influence of window setting on apparent stenosis severity. Accuracy for diagnosis of 50-69% and 70-99% RAS and the mean inter-observer agreement were 82.5%, 77.5% and 82.5% respectively, using study of MIP images alone, and 100%, 97.5% and 95% using the "two-step method". The phantom study showed that the apparent severity of vascular stenoses on MIP images depends on the selected window centre values. It is concluded that combined evaluation of both MIP images and native axial images is more reliable than study of MIP images alone for assessing the severity of RAS.

Aged↗
PubMed1996

Spiral CT of intracranial aneurysms: correlation with digital subtraction and magnetic resonance angiography.

Spiral CT and magnetic resonance angiography (MRA) were performed in ten patients with 14 intracranial aneurysms known from conventional angiography. All lesions, the smallest 3 mm in diameter, were visible on spiral CT and MRA. The neck of the aneurysm and its anatomical relations could very accurately be determined in all cases. Advantages of spiral CT over MRA are: a short acquisition time with reduction of motion artefacts, no dependence on flow rate or cardiac output, and excellent visualisation of calcification, thrombus and bony landmarks. Disadvantages are the necessity for iodinated contrast medium, long postprocessing and reconstruction time and the possibility of overlap of bone and venous blood.

Aged↗