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Biomedical subjects

A Ramée

Publications and source records attributed to A Ramée.

At least 19 recordsLinked to original sources
PubMed1999

[Comparison of accreditation procedures, ISO 9000 certification procedures and total quality management. Personal experiences and application of quality assurance in a department of radiology and medical imaging].

Management of quality assurance protocols in a radiology department can be done by using several tools or models. Some are specific like accreditation manuals issued by some organizations, others like the ISO 9000 certification and the Total Quality management are more general and already well known by manufacturers. In order to implement a process of quality improvement, we have reviewed three models of quality assurance: evaluation in total quality based on the European model "EFQM", accreditation based on booklets from French cancer centers and Canadian radiology centers and, finally, accreditation based on the ISO 9002 certification model. Based on results of our comparative study, these three tools of quality management are not contradictory and may be complementary. However, they can be compared in terms of constraints they impose, of their historical background, of the criteria evaluated as well as the role of different teams. In conclusion, we suggest that directors of radiology department interested in implementing a quality assurance program first evaluate their department using the Canadian accreditation model issued in 1993 which is useful to become familiar with this new concept of quality. In a second step, a self assessment using the EFQM has to be done in collaboration with all members of the administration board in order to integrate all parameters and to share this protocol with all decision makers. The last step is to consolidate the organization of the quality assurance protocols by means of the ISO 9002 certification.

Accreditation↗
PubMed1999

[From accreditation to certification. Quality management in a radiology department].

The leaders of a radiology department started a quality process based on ISO 9001 certification and the total quality management program. The purpose of this work is to match the conformity of this quality system to ANAES recommendations. If the concordance is obvious, the advantages of using quality insurance to get an accreditation are important. In conclusion, a quality process is proposed, it includes a quality insurance manual of ISO 9001 norm, the total quality management in the first point of the norm and the ANAES recommendations spread over the 20 points of the norm.

Accreditation↗
PubMed1999

[Optimization of a teleradiology system between two geriatric hospitals and a radiology department of a CHU].

The routine use of a 64 kb/sec Numeris network requires that a compromise be reached between image quality and time required for image transfer. Our goal was to present our experience and describe our choices when reporting examinations for two geriatric hospitals located at a short distance from our radiology department. Different digitization parameters were tested (resolution, compression) for 10 plain films corresponding to the usual clinical situations: abdominal X ray, chest X ray, wrist, spine and pelvis X rays. A subjective analysis of the global quality and of the quality of a region of interest enlarged twelve times has been performed. After result analysis, our choices were: digitization using 75 or 150 DPI and systematic use of a reversible compression format. This system proved satisfactory for both clinicians and radiologists; since its implementation, 1,800 files have been reviewed.

Computer Communication Networks↗
PubMed1998

[Radiologic analysis of known-interval cancers after 2 years of organized mass screening for breast cancer in Ille-et-Vilaine].

The first thirty-two known interval breast cancers (appearing within the first or second year after a negative screen) occurring during a two-year breast screening round were reviewed and the radiograms analyzed. Five classes were established: true interval cancers (13/32 cases), radiologically occult cancers (2/32), cancers with no specific sign (7/32), false negative cancers (5/32) and unclassifiable cancers (5/32). In more than 50% of the cases, there was no abnormality on the initial radiographic test, although the literature reports that the rate of false-negatives in interval cancers is less than 20%. Standard classification (by at least 3 readers) is very important to provide a possible explanation of cancer development. Action should be initiated to reduce their number.

Adult↗
PubMed1996

[Preliminary evaluation of the performance of 3D morphometer and spiral scanner in carotid stenoses].

Carotid stenosis evaluation is now possible with 3D Imaging. We prospectively compared the diagnostic value of Spiral CT and 3D Morphometer with conventional intraarterial DSA considered as the gold standard. We studied 19 bifurcations in 10 patients. We evaluated the stenosis following the NASCET guidelines on the DSA, with common carotid injection, on the 3D databases of 3D morphometer and of spiral CT (using MIP display). There was a good correlation between the degree of stenosis calculated with the 3D morphometer and angiography even if severe stenoses were slightly overestimated with the former. For the spiral CT databases, accurate diameters were impossible to obtain in case of huge calcifications. There was no benefit of measuring the surfaces on reoriented axial views in comparison with native axial views and MIP images. With the 3D morphometer, post processing selective visualization of the carotid bifurcations is possible without selective injection. The 3D acquisition with 3D morphometer could be an additional acquisition of a standard DSA. It should replace selective injections and should reduce the side effects of angiography.

Angiography↗
PubMed1995

[Glossary of terms used by radiologists in image processing].

We give the definition of 166 words used in image processing. Adaptivity, aliazing, analog-digital converter, analysis, approximation, arc, artifact, artificial intelligence, attribute, autocorrelation, bandwidth, boundary, brightness, calibration, class, classification, classify, centre, cluster, coding, color, compression, contrast, connectivity, convolution, correlation, data base, decision, decomposition, deconvolution, deduction, descriptor, detection, digitization, dilation, discontinuity, discretization, discrimination, disparity, display, distance, distorsion, distribution dynamic, edge, energy, enhancement, entropy, erosion, estimation, event, extrapolation, feature, file, filter, filter floaters, fitting, Fourier transform, frequency, fusion, fuzzy, Gaussian, gradient, graph, gray level, group, growing, histogram, Hough transform, Houndsfield, image, impulse response, inertia, intensity, interpolation, interpretation, invariance, isotropy, iterative, JPEG, knowledge base, label, laplacian, learning, least squares, likelihood, matching, Markov field, mask, matching, mathematical morphology, merge (to), MIP, median, minimization, model, moiré, moment, MPEG, neural network, neuron, node, noise, norm, normal, operator, optical system, optimization, orthogonal, parametric, pattern recognition, periodicity, photometry, pixel, polygon, polynomial, prediction, pulsation, pyramidal, quantization, raster, reconstruction, recursive, region, rendering, representation space, resolution, restoration, robustness, ROC, thinning, transform, sampling, saturation, scene analysis, segmentation, separable function, sequential, smoothing, spline, split (to), shape, threshold, tree, signal, speckle, spectrum, spline, stationarity, statistical, stochastic, structuring element, support, syntaxic, synthesis, texture, truncation, variance, vision, voxel, windowing.

Diagnostic Imaging↗
PubMed1993

Short-term follow-up of inferior vena caval filters: comparison of imaging techniques.

OBJECTIVE: The aim of this prospective study was to assess the advantages and limitations of various imaging techniques in identifying problems associated with percutaneous placement of filters in the inferior vena cava. SUBJECTS AND METHODS: One hundred four vena caval filters (65 Filcard, 39 Cardial) were placed in 100 patients (four patients received two filters). Venacavograms, duplex sonograms of the abdomen, abdominal radiographs, perfusion scans of the lung, and impedance plethysmograms were obtained in all patients within 1-2 days and 3 months after filter placement. CT scans of the filter were obtained in 55 patients. RESULTS: In five patients, thrombosis of the inferior vena cava, with retraction of the filter struts in four patients, was noted on venacavograms, CT scans, duplex sonograms, and impedance plethysmograms. Perforation of the inferior vena cava was noted in 36 patients after comparison of findings on venacavograms and CT scans, with an increase in the filter span in 29 patients (apparent on duplex sonograms in only two patients). Four filter tiltings (> 30 degrees) and 25 migrations (> 5 mm) were noted on abdominal radiographs. Trapped thrombi in the filter were shown on venacavograms in nine cases, but on duplex sonograms and unenhanced CT scans in only two cases. CONCLUSION: Our study shows that the major complications of inferior vena caval filters can be detected by noninvasive examinations. Only venacavograms consistently show small trapped thrombi that do not extend above the filter, but the importance of such thrombi is unknown.

Adult↗
PubMed1989

Recurrent postoperative sciatica: evaluation with MR imaging and enhanced CT.

Magnetic resonance (MR) imaging and computed tomography enhanced with intravenous iodine injection (ECT) were prospectively compared in 80 patients in the diagnosis of recurrent postoperative sciatica. Diagnostic accuracy was determined with surgical verification. Isolated fibrosis was considered a contraindication to surgery. A decision to operate was made in 56 of the 80 patients on the basis of MR imaging findings; in 21 of the 56, the decision was also made on the basis of ECT findings. Of the 80 patients, 45 underwent surgery, In all but one of these patients, the diagnosis made on the basis of MR imaging findings was confirmed with surgical analysis. The only surgical finding that did not agree with MR imaging findings was a calcification of the common posterior ligament. The 21 diagnoses of disk herniation based on ECT findings were confirmed surgically, but among the 24 diagnoses of fibrosis made with the help of ECT, there were actually 19 recurrent herniations, four herniations with fibrosis, and one herniation at the level above the previously resected disk. MR imaging seems to be the investigation of choice in diagnosing the cause of recurrent postoperative sciatica.

Adult↗
PubMed1988

Hepatic artery injection of I-131-labeled lipiodol. Part I. Biodistribution study results in patients with hepatocellular carcinoma and liver metastases.

Biodistribution of iodine-131-labeled Lipiodol Ultra-Fluide (I-131 LUF) injected into the hepatic artery was studied scintigraphically in 47 patients with hepatocellular carcinoma (n = 23), hepatic metastases (n = 14), or normal livers (n = 10). The investigation was extremely well tolerated. I-131 LUF concentrated mainly in the liver (L) and the lungs (l), with L/L + l activity ratios greater than 75% for all three groups of patients. I-131 LUF distribution was homogeneous in normal livers and heterogeneous in cirrhotic livers. I-131 LUF concentrated in the tumor with a tumorous (T) to nontumorous (NT) activity ratio (T/NT) of 4.3 +/- 3.6 for hepatocellular carcinoma and 2.4 +/- 0.7 for hepatic metastases. The effective half-life of I-131 LUF is more than 4.5 days for the three groups. It was eliminated mainly through the urine. Clearance from tumor is slower than from normal liver, as shown by the increase in T/NT at day 18. Biodistribution did not change in patients who had a second injection, which indicates that there is no saturation phenomenon. The results of this study suggest that LUF may be considered as a potential carrier vehicle for therapeutic agents.

Carcinoma, Hepatocellular↗
PubMed1988

Hepatic artery injection of I-131-labeled lipiodol. Part II. Preliminary results of therapeutic use in patients with hepatocellular carcinoma and liver metastases.

Internal radiation therapy with transarterial injection of iodine-131-labeled iodized oil (Lipiodol Ultra-Fluide [LUF]) was evaluated in 15 patients with hepatocellular carcinoma and eight with hepatic metastases. Five patients with hepatocellular carcinoma received more than one injection. Treatment tolerance was excellent, as assessed clinically and by means of liver function tests. An analgesic effect was noted in the two patients with painful hepatocellular carcinomas. Serum alpha 1-fetoprotein levels dropped rapidly in 11 of the 12 patients with elevated basal values. An average reduction in tumor size of 50% was observed in the nine cases followed up with computed tomography. After 5-12 months of follow-up, six of the 15 patients with hepatocellular carcinoma were alive. Two of them had undergone liver transplantation. Histologic examination of one of the livers, removed 3 months after a third injection, revealed microscopic features highly suggestive of radiation effect in LUF-containing areas. In the group with widespread hepatic metastases, no objective response was noted, except for an analgesic effect in three cases.

Adult↗
PubMed1988

[Comparison of MRI and scanning coupled with myelography in the diagnosis of cervicobrachial neuralgia].

A prospective study was undertaken to compare the accuracy of surface coil magnetic resonance imaging (MRI) and computed tomography with myelography (CTM) in the determination of cervical radiculopathy with or without myelopathy. Twenty five patients underwent both imaging studies. The separately imaging diagnosis and the surgical findings were the basis of this study. The based-MRI and based-CTM predictions were not significant. MRI predicted two disc herniations that CTM did not predict. CTM predicted a combination of disk herniation and stenosis and one more lateral stenosis that MRI did not predict. Among the fourteen patients who underwent surgery, one underwent surgery only on based-MRI prediction, it was a disc herniation; one patient was operated on only on based-CTM prediction, it was a stenosis. In these operated patients, the predictive value of the both imaging modalities was not significant. In this report the diagnostic assessment of MRI and CTM was overall the same. The major advantages of MRI were its ability to display all the cervical spine, to study the disk pathology and to delineate a signal alteration within cord substance but the disadvantage was the difficulty to characterize the osteophytes made of cortical bone which did not give signal.

Adult↗
PubMed1987

[Value of magnetic resonance imaging in the diagnosis of recurrent postoperative lumbosciatica].

Twelve patients who had a subsequent lumbar sciatica after surgery were evaluated with computerized tomography (C.T.) and magnetic resonance imaging (M.R.I.). The M.R.I. was performed with a 0.35 T whole body superconducting unit using spin echo technique. Two pulse sequences were realized varying the repetition time (TR) from 500 to 2,000 ms and the echo time (TE) from 28 to 60 ms. For the longer pulse, the twice echo were interpreted. The slide obtained with a surface-coil were performed in sagittal plane for the twice pulse sequences and in transaxial plane for the shorter pulse sequence. In seven cases, the results obtained with C.T. and M.R.I. were correlated. In two cases, the C.T. showed a scar formation, the M.R.I. showed a recurrent disk herniation. In three times, C.T. was unable to differentiate clearly between recurrent disk herniation and scar formation, the M.R.I. showed unequivocally on one case a scar formation and on two cases a recurrent disk herniation.

Adult↗
PubMed1987

[A new diagnostic method of spondylodiscitis. Magnetic resonance imaging].

Twenty four patients who were hospitalized for a suspicion of spondylodiscitis were prospectively evaluated with magnetic resonance imaging (MRI), radiology and radionuclide studies. Fifteen patients had an infectious spondylodiscitis, four had a vertebral degenerative disease, four had a rheumaticus spondylodiscitis, one had a chemical spondylodiscitis. The microbiological examinations and the clinical development bore the diagnosis out. Seven patients underwent Indium 111 scanning. The results of this scanning were correlated with MRI results. The MRI was performed with a 0.35 T whole body superconducting unit using spin echo technique. All patients were studied in the sagittal plane with two pulse sequences and more often with a surface-coil: TR 500 msec./TE 28 msec. and TR 2,000 msec./TE 60 msec. In all cases of true infectious spondylodiscitis the MRI results finding were characteristics. On the image obtained with the TR 500 msec./TE 28 msec., there was a confluent decreased signal intensity from the vertebral bodies and the intervertebral disk space. On the image obtained with TR 2,000 msec./TE 60 msec. there was an increased signal intensity from the vertebral bodies and the intervertebral disk space. The other spondylodiscitis have given a different MRI imaging, it was a confluent decreased signal intensity from the vertebral bodies and the intervertebral disk space on the twice pulse sequences. different images were obtained during the evolution of the infectious: first we observed a modification of the vertebral signal then the typical image that we described then a normal signal of the vertebral bodies with a pathological signal from the intervertebral disk space at last a degenerative intervertebral disk.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Angioplasty in primary Budd-Chiari syndrome. Apropos of 3 cases].

Three patients with the primary Budd-Chiari syndrome were treated by percutaneous transluminal angioplasty. Results showed an apparent poor response to angioplasty of irregular stenoses of the suprahepatic vessels and a good response when stenosis was due to membrane, but recurrence of the latter lesion after several months. The transient efficacy of this procedure in cases with a suprahepatic or caval membrane suggests that it be used pre-operatively for this indication.

Adult↗