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Biomedical subjects

C Manelfe

Publications and source records attributed to C Manelfe.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Cerebral lesions in AIDS: what can be expected from scintigraphy? Cerebral tomographic scintigraphy using thallium-201: a contribution to the differential diagnosis of lymphomas and infectious lesions].

CT and MRI are not consistently able to differentiate central nervous system (CNS) lymphoma from focal cerebral infection such as toxoplasmosis in the human immunodeficiency virus (HIV) involvement. In this study thallium 201 (and/or technetium-MIBI) SPECT was performed in 6 patients suffering from AIDS and CNS lesions. An index based on the ratio of thallium uptake in the lesion vs the contralateral scalp was calculated. In 4 out of 5 patients with lymphoma (3 confirmed by biopsy, 2 highly suspected on CT and resistance to antitoxoplasmosis treatment) focal lesions showed high uptake of thallium. On the other hand one markedly necrotic lymphoma and all infectious lesions did not take up thallium. This suggests a role for thallium 201 brain SPECT in the workup of focal CNS lesions in AIDS.

AIDS-Related Opportunistic Infections↗
PubMed1995

[Results of magnetic resonance imaging in the acute phase of cerebral infarction].

Brain ischemia is now possible to trace through the multiple facets of MRI, morphological as well as functional. Experimental studies have been conducted for many years and clinical feasibility is reached. Although the initial decrease in blood flow does not influence morphological imaging, this early phase is shown with functional MRI, either with diffusion imaging or with cerebral blood volume imaging. The later is achieved either with the calculation of the integral of the first passage of a bolus of a diffusible paramagnetic agent or with the circulation of positive or negative blood pool contrast agents. This may serve to confirm an early diagnosis before inclusion in therapeutic trials. Immediate metabolic changes are reflected on phosphorus and proton spectroscopy achievable during the same session as imaging. This type of information may at this stage serve as a reference. It allows observation of the turnover of lactate over time in the lesion and the neuronal loss shown by decreased N-acetyl-aspartate. Edema, as a reaction to ischemia, builds up over time and has already been described for long as it modifies T1- and T2- weighted sequences. Similarly the breakdown of the blood-brain barrier is well known on conventional sequences because it produces contrast enhancement.

Acute Disease↗
PubMed1994

Histiocytosis X of the petrous bone in the adult: MRI.

Two cases of histiocytosis X in young adults with involvement of only the petrous bone are reported. In the first symptoms and signs consisted of a seventh nerve palsy of gradual onset over 3 years, and in the second, of pulsatile tinnitus associated with otorrhoea of clear fluid and impaired vestibular function. CT revealed large lytic lesions of the petrous bone. T1-weighted MRI before and after gadolinium confirmed the presence of a mixed tumour of the petrous bone with marked uptake of contrast medium. Spin echo images demonstrated the absence of extradural extension, and the patency of the arterial and venous network, therefore enabling differential diagnosis from extensive glomus jugulare tumours.

Adolescent↗
PubMed1994

Randomised double blind trial of the safety and efficacy of two gadolinium complexes (Gd-DTPA and Gd-DOTA).

The main difference between macrocyclic Gd-DOTA and linear Gd-DTPA complexes is the greater stability of the former which theoretically might reduce biological interactions in man. To evaluate the clinical relevance of this property, 300 unselected neurological patients were included in a randomised double-blind comparison involving five European centres, focused mainly on the tolerance of these two contrast media. Clinical tolerance was assessed immediately after the procedure and 24 h later. Adverse events were found with a similar frequency in the two groups (17.3% for Gd-DOTA and 19.3% for Gd-DTPA). Minor neurological symptoms were the most frequent (48.6%) headache being the most common (29.2% of adverse events). No difference in efficacy was found.

Adult↗
PubMed1994

[Complications of the intravascular treatment of intracranial aneurysms using metal microcoils. Embolization using coils in intracranial aneurysms].

Embolization of intracranial aneurysms with coils. The authors present the results and complications of microcoils embolization of intracranial aneurysms in 28 patients. Fibers platinum microcoils were used (Target Therapeutic) 28 patients (males: 6, females: 22; mean age: 51 years) were treated, 27 suffered from sub-arachnoid hemorrhage (SAH) and one presented with a pseudotumoral syndrome (giant aneurysm). All patients were evaluated on the day of treatment, according to the World Federation of Neuro-Surgeon classification (W.F.N.S.) of SAH and after 4 months of follow-up. At a mean follow-up period of 4 months, according to Glasgow Outcome Scale (G.O.S.) there were 13 cases of good results, 5 cases of "moderate disability", 2 cases of "severe disability", 2 cases of "vegetative state" and 6 deaths. Complications were observed in 11/28 cases. Coils migration and malposition in the parent artery were linked to the procedure (mechanical detachable coil) and resulted in severe deficit (one case), transient disability (one case) or went unnoticed (4 cases). Primary or secondary complete occlusion was achieved in 8/28 patients (32%). A majority of cases (11 cases) ended with stable residual aneurysmal sac lumen while rebleeding occurred in 3 patients and was responsible for 2 deaths. In the third case a favourable outcome was obtained after balloon occlusion of the parent artery.

Adult↗
PubMed1993

[Transmission of neurosurgical medical records through computers. Simple reality, considerable progress].

Tests on the transmission of view data processing images were undertaken for 5 months from two experimental micro-processing sites specialized in medical imagery and linked to the R.N.I.S. network. The aim of the research was to validate the equipment and the software, and to find a way of working with regard problems related to long-distance diagnosis. Using an everyday equipment like Apple Macintosh II fx, 75 files were transferred corresponding in 375 images (1% conventional X-ray, 5% digital angiography, 31% scanner and 63% M.R.I.). It has been found that the transfer of medical data is reliable (the images do not deteriorate), easy (less than 3 hours to be familiar with the program) and above all fast (actual transfer time: 8.72 Ko per second). Neurosurgeon and neuroradiologist writers talk about their experience in this field.

Computer Communication Networks↗
PubMed1993

[Percutaneous treatment of lumber disk herniation. Radiological criteria of therapeutic decision].

Invasive diagnostic imaging methods such as discography, discomanometry, C.T.-discography are generally not required to accurately depict herniated lumbar disks. On the contrary they should be implemented in specific clinical situations in order to confirm the choice of a percutaneous treatment: nucleolysis or nucleotomy. The major role is devoted to discography. Discomanometry and C.T.-discography are second order methods that will help in difficult cases in choosing therapeutic strategy.

Adult↗
PubMed1993

[Foraminal and latero-foraminal hernia. Mid-term results of percutaneous techniques nucleolysis-nucleotomy].

Forty cases of foraminal (28) and lateroforaminal (12) herniated discs treated either by nucleolysis (N.L.) or percutaneous automated nucleotomy (P.A.N.) were investigated over a period of 12 months or more. The group of patients treated with P.A.N. (15 males, 5 females) with a mean age of 41.8 years, had severe radicular pain in 25% of cases, caused by foraminal (15 cases) and lateroforaminal (5 cases) herniated discs which were predominantly located at the L4-L5 level (12 cases). The group of patients treated with N.L. (13 M, 7 F) with a mean age of 50.3 years complained of severe radicular pain in 65% of cases, caused by foraminal (13 cases) and lateroforaminal (7 cases) disc herniations evenly distributed over the last three mobile segments. The overall results obtained with N.L and P.A.N. showed a 67.5% success rate. The best results were obtained in cases of cruralgia with severe radicular pain caused by foraminal herniated disc at the L3-L4 or L4-L5 levels. A significantly better result was obtained in the group of patients treated by N.L. (80% success rate) than in the group of patients treated by P.A.N. (p < 0.04).

Adult↗
PubMed1993

[Histiocytosis X of the petrous pyramid in adults. X-ray computed tomographic and MRI aspects].

Two cases are reported of histiocytosis X in young adults, both confined to the petrous bone. In one case the clinical signs were those of a progressive facial palsy, developing over 3 years; the other case had pulsatile tinnitus with clear otorrhoea and symptoms of vestibular deficiency. Computed tomography showed extensive bone destruction by a soft-tissue density process which enhanced strongly after iodinated contrast injection. Magnetic resonance imaging (T1 weighted sequences before and after intravenous gadolinium injection) confirmed the presence of a mass lesion in the petrous bone with contrast medium uptake which showed cystic areas within it: it also showed the absence of extension through the dura mater by the intracranial component which remained extradural. It confirmed the patency of arteries and veins, so enabling a differentiation to be made between histiocytosis X and advanced glomus tumours.

Adolescent↗
PubMed1993

Magnetic resonance imaging evaluation of lower limb muscles during bed rest--a microgravity simulation model.

Head-down (-6 degrees) bed rest, a microgravity simulation model in humans, leads to muscular atrophy of the lower limbs. Magnetic Resonance Imaging (MRI) at 0.5 tesla was performed at 1 year intervals on the same six volunteers (except one) before and after 1 month bed rest. Three of the six subjects were daily exposed in a lying position to LBNP (lower body negative pressure), a countermeasure to cardiovascular deconditioning (LBNP group). The groups were exchanged the second year. After bed rest, the quadriceps of the thigh lost uniformly 11% of its cross section area (CSA) and the triceps of the leg 10.5%, with 12.8% lost from the deeper soleus versus 8.5% from the gastrocnemius (p < 0.05). LBNP produced no effect on these changes. The MRI signal intensity of muscles exhibited a trend toward higher values after bed rest although without statistical significance. MRI allowing for noninvasive and reliable quantification of muscle fibers of the lower limbs is an excellent procedure for the assessment of muscle disuse and countermeasures.

Adult↗
PubMed1992

Experimental focal cerebral ischaemia assessed with IVIM*-MRI in the acute phase at 0.5 tesla.

Intravoxel incoherent motion (IVIM*)-MRI has been performed on a clinical system at 0.5 tesla with a b gradient factor of 100 s/mm2, in a feline focal model of cerebral ischaemia. Images were obtained in 26 cats from less than 1 hour and up to 7-12 hours after stroke. The apparent diffusion coefficient (ADC) was decreased at the site of injury when compared to the contralateral normal side, by 30% in the first, 33% in 1-2 h and 27% in 2-4 h; it increased at 7-12 h, when vasogenic oedema occurred. IVIM*-MRI demonstrated early changes, due to cytotoxic oedema, during the acute phase of cerebral ischaemia to which conventional T2-weighted spin-echo imaging was not sensitive.

Animals↗
PubMed1992

[Neuro-imaging studies in migraine].

Neuroimaging studies in migraine patients are useful for three important reasons. 1) Brain imaging techniques and primarily CT-scan should be used in every patient with atypical or complicated migraine to rule out a vascular malformation or brain tumor; 2) angiography, which was extensively used in the 1960's and 1970's, discloses a number of arterial anomalies including spasm or occlusion, of unclear pathogenic significance; 3) T2-weighted magnetic resonance images in migraine often show increased signals generated by the white matter; this finding is as yet poorly understood but is undoubtedly related to factors very different from those seen in elderly patients or patients with vascular risk factors.

Adult↗
PubMed1992

[Dissection of the sylvian artery with resulting aneurysm in a 6 years old child].

BACKGROUND: Dissection of the walls of the cervical and cerebral arteries is rare in childhood. CASE REPORT: A 6 year-old girl suddenly suffered a loss of consciousness followed by a generalized tonic-clonic seizure 90 min after a non-traumatic fall. At admission, she had a massive right hemiplegia with aphasia. The CSF was not hemorrhagic. A CT-scan performed at H3 without infusion of radiopaque contrast material was normal, but a second CT-scan on day 4 showed a low density in the low area of the middle cerebral artery. An arteriogram taken on day 6 showed that the wall of the proximal part of this artery was irregular, with a discrete additive imaging. The child was treated with IV heparin for 3 weeks, then with aspirin. All investigations for the possible cause of thrombosis (protein C and S, antithrombin III, homocystinuria, etc...) were negative. Two further arteriograms, the last after a follow-up of 16 months, showed progressive disappearance of the wall irregularities and replacement of the additive imaging by a large aneurysm, suggesting a dissection. The hemiplegia persists under prolonged aspirin therapy. CONCLUSION: This case shows that dissection may occur in childhood without any apparent cause. It can result in the development of an aneurysm, a complication which is more frequent following dissection of the cervical rather the cerebral arteries.

Aortic Dissection↗
PubMed1992

Imaging of degenerative processes of the spine.

Because MR imaging provides accurate, clear, and noninvasive imaging for diseases of the spine and spinal cord, it has become the primary imaging modality in patients with spinal pathology. Degenerative processes of the spine are frequent, including disk degeneration and herniations, spondylosis, spinal canal stenoses, calcifications, and ossifications of the spinal ligaments. Several papers have been published recently on MR imaging in degenerative processes of the spine.

Humans↗
PubMed1991

[New imaging methods by nuclear magnetic resonance in multiple sclerosis].

Magnetic resonance imaging (MRI) has rapidly attained a major position among the examinations used in the diagnostic approach of multiple sclerosis because it is highly sensitive in demonstrating lesions. However, these lesional images may have several meanings, and there is the problem of distinguishing between oedema, which is said to reflect recent lesions, and gliosis which is thought to betray old lesions. The intrinsic MRI parameters studied (i.e. relaxation times) are unable to make this distinction, whereas it is provided by paramagnetic contrast media such as gadolinium. There is no correlation between the changes observed at MRI and the severity of the disease. Another problem is the accuracy of lesion localization, since visualization is predominantly macroscopic. This raises several questions about the demonstration of correlations between clinical signs and site of the lesion(s). At the moment, several teams of neuroradiologists are trying to find the most reliable method to determine the size of the lesion. The possible prognostic value of this size and its changes as time goes by are other parameters to be considered once the basic diagnosis has been made.

Brain↗
PubMed1991

Doppler ultrasound study of the anterior cerebral artery in neonates.

In neonates doppler ultrasound of the anterior cerebral artery (ACA) enables cerebral haemodynamics to be studied in a non-invasive manner at the patient's bedside. The signal of the pericallosal artery is recorded through the fontanelle with a 7.5 mHz real-time probe. Two parameters are monitored: Pourcelot's resistance index and mean velocity which reflects blood flow rate. Having established normal values according to the gestational and post-natal ages, the authors describe the changes in cerebral circulation observed in such pathological situations as intraventricular haemorrhage, apnoea, patent ductus arteriosus, hydrocephalus and post-asphyxia syndrome.

Apnea↗
PubMed1991

Imaging of the spine and spinal cord.

Recent technologic advances in MR imaging of the spine and spinal cord have been aimed at shortening examination time and suppressing artifacts. Gradient-recalled fast T2-weighted imaging is advocated for evaluating cervical radiculopathy. Better signal-to-noise ratios are achieved with three-dimensional Fourier transform gradient-recalled T2-weighted imaging and with decreased bandwidth acquisition. Obtaining high-contrast images of the spine is often complicated by the appearance of truncation artifacts. In outpatient radiculography, both iopamidol and iohexol appear safe, but iohexol seems better tolerated. In trauma, MR imaging is definitive, and signal abnormalities can help in evaluating neurologic recovery. Intraoperative spinal sonography may be helpful in evaluating acute injury. Enhancement with gadolinium diethylenetriamine penta-acetic acid is useful in the evaluation of disk space infections, osteomyelitis, and epidural abscess and in the study of spinal cord sarcoidosis. In patients with the acquired immunodeficiency syndrome, MR imaging may show hyperintense spine on T2-weighted images. MR imaging with gadolinium diethylenetriamine penta-acetic acid or gadolinium tetra-azacyclododecane tetra-acetic acid enhancement can be useful in evaluating intramedullary and intradural extramedullary tumors and for determining the extent of spinal leptomeningeal metastases. MR imaging can also be used to differentiate benign from pathologic fractures.

Humans↗