Biomedical subjects
Publications and source records attributed to A Maubon.
Adenomyomatosis of the gall bladder is a classical but seldom recognized cause of gallbladder wall thickening. The authors review the imaging features of this disease and emphasize the value of ultrasound and MRI. Although considered a benign disease, some recently described cases of neoplastic transformation may warrant surgery.
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RATIONAL AND OBJECTIVES: The feasibility of tubal occlusion by selective salpingography was tested in an animal model; three novel occluding materials also were tested for this application. METHODS: Unilateral selective salpingography was performed in three groups of six rabbits; fallopian tubes were embolized with ethanol (group 1), a hydrogel (group 2), or an occluding emulsion (Ethibloc, Laboratoire Princeps, Neuilly sur Seine, France) (group 3). Animals were killed 2 days or 30 days after the procedure, according to randomization; tubal patency and histologic modifications were evaluated. RESULTS: Selective tubal catheterization was obtained in 100% of the cases. In group 1, no satisfactory occlusion was obtained; in group 2, 65% of the tubes were occluded with little histologic damage; in group 3, 80% of the tubes were occluded, but significant inflammation and tissue necrosis were noted. CONCLUSION: Selective salpingography proved a suitable method for gaining access to the fallopian tube and allowed selective injection of occluding materials. More research is needed to determine a suitable occluding material, focusing on biocompatibility and on long-term efficacy.
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Case report of a cystic dystrophia appearing in an ectopic pancreas. The clinical diagnosis was preoperatively suspected by the findings of CT scan revealing a tumor located in the wall of the duodenum and by the data of MRI indicating its cystic and fibrotic structure. A focus of reacting pancreatitis was found in the vicinity of the cystic dystrophia while the remaining pancreas was normal. The surgical treatment was a duodenopancreatectomy, justified by the potential risks of complications.
From a series of 110 trans-uterine venographies, the authors present the normal radiological anatomy of the uterine venous vascularization and of its efferent venous drainage. They also present the most frequent variations from normal and examples of the pathologies encountered.
Selective salpingography was used in a total of 64 patients, engaged in evaluation for infertility and in whom standard hysterograms showed no tubal passage of contrast medium. Fallopian tube catheterization was successful in 92% of the cases; a peritoneal spill of contrast medium was obtained in 74% of the cases by manual injection. Recanalization of an obstructed oviduct was successful in 61% of the cases. Thus, after the procedure, 82% of the patients had at least one patent tube. We conclude that selective tubal catheterization, and recanalization when needed, should be included in the therapeutic procedures for tubal infertility, prior to in-vitro fertilization or tubal microsurgery.
The authors report a pancreatic metastasis of sinusal squamous cell carcinoma in a 69 year-old man, 18 years after the first excision of the primary neoplasm. The metastases appearing in a patients having previously presented several tumors, was detected by a rising CA 19-9 level and a pancreas head enlargement at the CT. The diagnosis was identified at laparotomy by tumor biopsy. The vascular involvement of the tumor obliged to perform double bypass. 103 cases of pancreatic metastases, published in the literature from 1983 to 1991, are reviewed. Generally the pancreatic mass is visualized by CT but the diagnosis is only carried out on microscopy. Treatment depends on anatomical and pathological characteristics of primary and secondary tumours. Solitary metastasis of renal carcinoma origin have the best prognosis after radical surgery. In other cases palliative procedures are widely used. First case of pancreatic metastasis originated from recurrent sinusal squamous cell carcinoma with poly-tumoral clinical presentation.
Seven cases of pelvic endometriosis of the urinary or digestive tracts are reported: 4 cases of vesical endometriosis, 1 case of ureteral involvement, 1 rectal case and 1 sigmoid location. The authors point out the difficulty of the clinical preoperative diagnosis--in despite of cyclic troubles--and underline the interest of complementary explorations performed at the time of periods: ultrasound, cystoscopy, rectosigmoïdoscopy and coelioscopy. The MR imaging, showing high intensity a T1-weighted images and prominent high intensity on T2-weighted images, is very suggestive of an endometrial lesions. A joint medical and surgical treatment is required. Endoscopic excision, endoprothetic tube, excision-suture, resection-anastomosis and a complementary medical treatment using Danazol, Decapeptyl or progestational agents have to be proposed. Per-operative microscopy is advised as routine procedure in order to avoid excessive surgery.
The study involved 70 patients considered to be sterile and in whom hysterosalpingography showed no tubal passage. Selective catheterisation enabled opacification under pressure in more than 80 p. cent of cases, with perfect visualisation of the entire tubes and significant peritoneal passage. In the presence of obstructive stenosis, disobstruction-reacanalisation using a soft probe was attempted with success in more than one case out of two. Future perspectives of selective salpingography appear to be very large. This technique seems to have a large number of indications apart from transport problems: recanalisation, sterilisation, and tubal antibiotic sensitivity studies.
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Results of CT scan and ultrasound exploration were discordant in a patient with the pseudotumoral form of hepatic tuberculosis. Although rare, this localization should not be unrecognized because of the curable nature of the affection. Tissular characterization of lesion was not possible by medical imaging alone and liver puncture-biopsy examination was necessary.
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A case is reported of calcifying metastases of colon origin localized to psoas muscle. Emphasis is placed on the effectiveness of CT scan and MR imaging and the rarity of this localization. The presence of intra-lesional calcifications as described in hepatic metastases raises the question of the etiopathogenic mechanism and the predictive value of the detection of a calcified mass during the course of colon adenocarcinoma.
Magnetic resonance imaging is a novel noninvasive imaging modality for the assessment of pelvic floor dysfunction. It relies on static sequences with a high spatial resolution to study muscle morphology (levator ani) and fast imaging dynamic sequences during contraction, rest, and straining. Prolapse of the various pelvic compartments is detected with respect to organ position relative to the pubococcygeal line during dynamic phases. Compared with clinical examination, its input appears to be especially invaluable in the posterior compartments (peritoneal and digestive) and to assess complex prolapses involving more than one pelvic compartment. It is also useful for understanding postsurgical recurrences.
The objective of this study was to investigate sexual intercourse with magnetic resonance imaging (MRI). A volunteer couple (30 year-old male, 27-year-old female) with a normal sex life, had face-to-face sexual intercourse (reversed missionary position) under MRI. Static and dynamic T2-weighted sagittal sequencies were acquired on the midline before and during vaginal penetration. In this position, before penetration, the vagina was parallel to the pubococcygeal line and had normal anterior convexity. After penetration, accentuation of the vaginal convexity was observed, produced by the penile gland reaching the anterior cul-de-sac and contact with the anterior vaginal wall. The posterior bladder wall was pushed forward and upward, the uterus upward and backward. In this initial experience, we observed a preferential contact of the penis in erection with the anterior vaginal wall and the anterior cul-de-sac in the face-to-face sexual position. MRI allows a noninvasive assessment of sexual intercourse.
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Interventional radiology now finds a wide range of applications in the gynecologic area. They can be divided in general procedures applied to gynecology and procedures specific to gynecology.