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Biomedical subjects

A Geoffray

Publications and source records attributed to A Geoffray.

At least 19 recordsLinked to original sources
PubMed1997

[Chronic recurrent multifocal osteomyelitis. A diagnosis to be called to mind].

Chronic recurrent multifocal osteomyelitis is a rare disorder that affects children and teenagers. Clinically, it is characterized by insidious onset of local swelling and pain in several metaphyses. A symmetric, recurrent and multifocal pattern is usual. Spinal involvement is possible. Inconstant association with a cutaneous affection (palmoplantar pustulosis, acne fulminans, psoriasis), or less frequently with an inflammatory chronic gut disorder is described. Pathogenesis usually recognized is an enthesopathy. Enthesitis may progress to the osseous part of the enthese and produce an aseptic chronic osteomyelitis. Biopsy specimen with culture is certainly necessary to rule out bacterial osteomyelitis and bone tumor. It is particularly true when the bone lesion is isolated. Disease course is benign and self-limited. The clinical course is characterized by recurrences and remission occurring for 6 to 10 years. Treatment based on non steroid antiinflammatory drugs is usually effective.

Adolescent↗
PubMed1996

Ultrasound contribution in the analysis of the newborn and infant normal and clubfoot: a preliminary study.

The aim of this study was to evaluate the potential use of ultrasound in the preoperative assessment of clubfoot and follow-up growth. We first studied 50 normal newborns and infants (aged 1 day to 1 year). The normal values established were reliable, dynamic and reproducible measurements allowing the assessment of osteo-articular relationships and cartilage morphology. Ultrasound appears to be more useful than radiography because it allows delineation of cartilaginous structures (which are not visible on conventional radiographs) and dynamic study of foot positions, and has no danger from radiation. A future paper will contain preliminary results of cases of clubfoot studied by ultrasound.

Clubfoot↗
PubMed1991

Ultrasonographic posttreatment follow-up of breast cancer patients.

Clinical, radiographic (mammograms), and ultrasonographic data were compared retrospectively for 171 patients to evaluate the utility of ultrasound for the follow-up of breast cancer patients treated medically or by conservative surgery. When used to follow patients treated medically by induction or exclusive chemotherapy, ultrasonography accurately quantified tumor and nodal regression. After conservative surgery, sonograms are ideal to diagnose (and sometimes to treat) early complications such as hematoma, lymphocele, and abscess. Ultrasonography was more sensitive than mammography for the detection of late complications and benign lesions, but was insufficient for the detection of recurrent disease (95.5% sensitivity for radiography vs 90% for ultrasonography). After radical surgery and breast reconstruction, ultrasonography is the only procedure required for follow-up of patients with breast implants because it can determine the size and penetration of cutaneous recurrences. The fact that 30% of patients treated by lumpectomy and irradiation ultimately develop malignant or benign abnormalities justifies systematic ultrasonography for the follow-up of treated breast cancers. All sonographically demonstrable abnormalities warrant ultrasound-guided puncture biopsy.

Breast↗
PubMed1991

[Value of mammography in the diagnosis of breast masses in adolescents].

Breast masses in teenagers are uncommon; in most cases, the palpation of a mass by the patient herself leads to physical and radiological examination. According to the age of the patient, radiographic exams should be limited, and mammography in particular, should not necessarily be performed. Ultrasonography using a high frequency transducer is very useful when associated with physical examination, and gives an accurate diagnosis in most cases. A large isolated mass detected in a healthy young girl is usually benign (adenofibroma). Multiple small masses suggest a malignancy (metastases or hemopathy), especially if the subject has been previously treated for such a disease. Primary breast carcinoma is exceptional.

Adolescent↗
PubMed1991

[Ultrasonographic surveillance of treated breast cancer].

Clinical, radiographic (mammograms) and ultrasonographic data were compared retrospectively for 171 patients to evaluate the utility of ultrasound for the follow-up of breast cancer patients treated medically or by conservative surgery. When used to follow-up patients treated medically by induction or exclusive chemotherapy, ultrasonography accurately quantified tumor and nodal regression. After conservative surgery, sonograms are an ideal means to diagnose (and sometimes to treat) early complications (hematoma, lymphocele, abscess). Ultrasonography was more sensitive than mammography for the detection of recurrent disease (95.5% sensitivity for radiography versus 90% for ultrasonography). After radical surgery and breast reconstruction, ultrasonography is the only procedure required to follow-up of patients with breast implants, because it can determine the size and penetration of cutaneous recurrences. The fact that 30% of patients treated by lumpectomy and irradiation ultimately develop malignant or benign abnormalities justifies systematic ultrasonography for the follow-up of treated breast cancers. All sonographically demonstrable abnormalities warrant ultrasound-guided puncture biopsy.

Breast Neoplasms↗
PubMed1990

[Venous relations in cervical adenopathy. Review of a series of 300 cases].

Three hundred cases of cervical adenopathies were reviewed in connection with head and neck cancers (205 patients) and lymphoma (95 patients). Overall, physical examination failed to detect such adenopathies in 83 cases. The echostructure of the cervical node was less echoic than that of the muscles in 111 cases (58 cases of lymphoma, 53 cases of metastasis), more echoic than the muscles in 185 cases (35 cases of lymphoma, 150 cases of metastasis), and nucrotic in 4 cases (2 cases of lymphoma and 2 cases of metastasis). Jugular vein thrombosis was noted in 78 cases (75 cases of metastasis, 3 cases of lymphoma); jugular vein compression without thrombosis was observed in 65 cases (35 cases of metastasis, 30 cases of lymphoma). Before histologic proof is obtained, jugular thrombosis suggests a diagnosis of metastasis, regardless of node size. The presence of nodular intraparotid lesions (12 cases) suggests lymphoma. By contrast, neither node size nor echostructure suggest the etiology of cervical adenopathies.

Head and Neck Neoplasms↗
PubMed1990

[Imaging of malignant lymphoma of muscular sites].

Seventeen cases of muscular lymphoma are reported (5 primary non-Hodgkin lymphoma, 11 secondary NHL, 1 secondary Hodgkin's disease). The psoas or gluteus muscle was involved in 10 cases, and the lower limb was affected in the remaining 7 cases. Nine cases of muscular extension of bone NHL are also reported. On sonograms these lesions were always large and less echogenic than adjacent structures, with no signs of necrosis before treatment. US and CT patterns were comparable for both primary and secondary lesions, regardless of the type of lymphoma or whether or not there was any previous bone lesion. Associated lymphomatous lesions were observed in 14 cases. On angiograms, muscular lymphomatous involvement presented a hypovascular pattern. While ultrasonography is an excellent monitoring technique for soft tissue lymphomas (specially for the lower limbs), a major contribution of CT is the detection and the follow-up of deep or thoracic wall lesions.

Adolescent↗
PubMed1990

[Tomodensitometric aspects of brain lymphomas: apropos of 19 cases. Brain lymphoma].

The authors present the results of CT studies for 19 patients with cerebral lymphoma (including 12 primary tumors). CT appearances varied considerably, because 5 of the 12 primary lymphomas presented as multifocal lesions, and lesion sites included the corpus callosum (3 cases), the central caudate nucleus (4 cases), the posterior fossa (3 cases), and the cerebral hemispheres (6 cases). These findings are in agreement with literature data. Although a solitary, hyperdense and homogeneous lesion in the corpus callosum or the central caudate nucleus is indicative of cerebral lymphoma, numerous other aspects are possible and owing to the increasing frequency of this pathology should suggest this diagnosis. There is no specific appearance for secondary lymphomas, but diagnosis is often facilitated by concomitant systemic involvement.

Adult↗
PubMed1990

[Echography and computed tomography in the evaluation and follow-up of uterine cancers].

In this review of 139 cancers of the cervix uteri and 43 cancers of the corpus uteri, the authors compare clinical, sonographic and CT data. For the 58 patients with cervical cancer who presented infiltration of the parametrium at physical examination under general anesthesia, sonography gave 11 false negative errors while CT gave 8 false positives. By contrast, for the 47 tumors staged IIb after examination under general anesthesia, sonography disclosed additional abnormalities in 20 cases and CT in 22 cases. A series of 52 disease recurrences in patients who had received curative treatment for uterine cancer was also reviewed; overall, an association of physical examination and ultrasonography had the same value as CT. In light of these results, the authors propose an algorithm for the exploration of uterine cancers in which the results of physical examination condition examination by ultrasonography or CT.

False Negative Reactions↗
PubMed1990

[Hepatic x-ray computed tomography. Value of delayed (6 hours) scanning in patients with normal biliary function].

Delayed hepatic CT (DH-CT) was studied in 250 patients without any major bile duct pathology. One hundred thirty-five of these patients had liver metastases. All patients were administrated 76 grams of iodine. Tolerance of the examination was good. Six hours after injection, average contrast enhancement in the normal liver was 24 HU (greater than 1.3 g/kg iodine), 22 HU (1 to 1.3 g/kg) and 14 HU (1 g/kg). Comparison of scans taken before, immediately after, and 6 hours post-injection revealed the frequent superiority of postinjection scans for diagnosis of liver metastases. Focal steatosis is the only benign pathology to benefit from DH-CT, because of the parallelism in the difference in density between the normal and steatotic tissue regardless of the time of scanning. Aside from isolated tumors requiring exploration by conventional CT (pre- and post-contrast studies), the workup of liver metastases can be optimized by postcontrast and DH-CT scans.

Evaluation Studies as Topic↗
PubMed1989

[The isolated pulmonary nodule. Biopsy guided by x-ray computed tomography].

Transparietal CT-guided biopsy location can be successfully performed for isolate pulmonary nodules, defined as lesions with a maximal diameter of 3 cm, without any other parenchymal or mediastinal abnormality. A 21 G needle has been used according to an identical protocole in 64 cases (10 benign, 54 malignant). The biopsy was successful in 77.7% of the malignant cases. In relation to the diameter of the nodules, biopsy was successful in 66.7% of the nodules smaller than 2 cm and in 76% of the nodules ranging from 2 to 3 cm. The complications observed were rare (1 case of pneumothorax requiring drainage, 9 cases of pneumothorax without clinical signs and simply followed up, 4 cases of minor hemoptysis requiring no treatment and 5 cases of hematomas smaller than 5 cm on CT).

Adult↗
PubMed1988

[Magnetic resonance imaging for bone marrow metastases of neuroblastoma].

From March 1985 to February 1987, 41 patients (pts) presenting with a neuroblastoma underwent 52 MRI to detect bone marrow metastases. Mean age was 4 years (R: 6 m, 13 y). Acquisitions were done with a 1.5 t unit. Images were obtained in coronal (legs and pelvis) and sagittal (dorso-lumbar spine) sections. Nine out of 52 examinations were excluded because of artifacts or technical failure. In 13 cases, MRI was performed for initial staging, in 30 during follow-up. Out of 24 anatomically proven medullary involvement (18 pts), MRI showed focal abnormal signals in 23 (17 pts): foci of hypersignal in T2 weighted images, compared to the normal value of bone marrow and fat tissue, were more often detected in lower limbs than dorso-lumbar vertebral body or iliac bone. In our series, the sensitivity of MRI to detect BM metastases is 84% and the specificity is 88%. In comparison to the medullograms and bone marrow biopsy, MRI explores distinct sites, especially lower limbs which are often involved.

Bone Marrow↗
PubMed1988

Bone marrow metastases in children's neuroblastoma studied by magnetic resonance imaging.

Forty-one patients (pts) presenting with a neuroblastoma underwent 52 MRI to detect bone marrow metastases. Mean age was 4 years. Acquisitions were done with a 1.5 tesla unit. T1 and T2 weighted images were obtained in coronal (legs and pelvis) and sagittal (dorso-lumbar spine) sections. In 13 cases MRI was performed for initial staging, in 30 during the follow-up. 43/52 examinations were evaluable. Out of 24 anatomically proven medullary involvement (19 pts), MRI showed focal abnormal signals in 23 (18 pts): foci hypersignal in T2 weighted images and hyposignal in T1 weighted images compared to the normal bone marrow (BM) and fat tissue. The lesions were more often detected in lower limbs than dorso-lumbar vertebral body or iliac bone. Nineteen examinations were performed in 15 pts with cytologically and histologically normal BM. MRI raised suspicion of BM metastases in 5 pts (7 MRI). Out of those 5 pts, 1 (2 MRI) had BM relapse 9 months later; 1 (2 MRI) had intra cranial relapse 6 months later; 1 (1 MRI) is disease free 1 1/2 year later; the follow-up is too short for 2 remaining pts (2 MRI). MRI's specificity was 88.9% and sensitivity 84.4%.

Adolescent↗
PubMed1987

Ultrasonography and computed tomography for diagnosis and follow-up of biliary duct rhabdomyosarcomas in children.

The authors report eight cases of biliary duct rhabdomyosarcoma in children, examined by US and CT. There were five boys and three girls, aged 2 to 17 years. At presentation, US demonstrates the tumor mass within the liver or the hepatic hilum; it allows measurement of it and defines the relationship with portal vessels, biliary tract and other important structures. CT complements the US evaluation and determines operability. As US and CT cannot assess the histological origin of the tumor, a biopsy is mandatory before treatment. If complete surgical excision does not seem possible, percutaneous biopsy is preferable to incomplete excision and its possible complications. During the follow-up period, US can be repeated to measure tumor regression under chemotherapy. After surgery, CT seems preferable because of gas interposition. Both US and CT proved to be valuable for the early detection of local recurrence. The prognosis of these tumors remains bad. However, with more aggressive and hopefully more efficient chemotherapy a precise evaluation of the tumor extension by US and CT is very important. Surgery will then be performed only on localized tumors or on residual masses after chemotherapy.

Adolescent↗
PubMed1987

Ultrasonography and computed tomography for diagnosis and follow-up of pelvic rhabdomyosarcomas in children.

The authors report 18 cases of pelvic rhabdomyosarcomas in children examined at presentation and followed on US and CT. There were 11 boys, 7 girls; tumor location was bladder, prostate or uterus in 12, perineum in 4, buttock in 2. US is good to define tumoral extension within the bladder CT is better to delineate the extension outside the bladder and regional spread to iliac nodes. CT is the only useful examination for perineal tumors. During chemotherapy US can be frequently repeated to appreciate tumoral regression and to give measurement of the mass. Preoperative CT should be performed when tumoral regression seems sufficient to permit complete tumoral excision without pelvic exenteration. Correlation between US and CT and surgical findings proved to be good. US and CT are also very useful in the follow-up when the child has finished treatment as it can demonstrate a local recurrence before clinical symptoms appear. However, post-surgical and post-radiation changes may be difficult to recognize. These aspects are discussed.

Adolescent↗