Search PubMed⌕ Search

Biomedical subjects

D Balériaux

Publications and source records attributed to D Balériaux.

At least 19 recordsLinked to original sources
PubMed2006

Endovascular treatment of intracranial aneurysms with a branch arising from the sac.

BACKGROUND AND PURPOSE: The endovascular treatment (EVT) of intracranial aneurysms is no more limited by the presence of a branch at the neck or by the neck width. Saccular aneurysms with a branch arising from the sac, however, are mostly candidates for surgery rather than embolization. We prospectively evaluated the feasibility and safety of the EVT in such cases. METHODS: Between May and November 2004, 9 consecutive patients with a saccular aneurysm that presents a branch arising from the sac were treated by embolization. There were 7 women and 2 men (mean age, 58 years). Six patients presented with a subarachnoid hemorrhage (SAH), and 3 were asymptomatic. All patients were treated by selective coiling with (n = 6) or without (n = 3) the remodeling technique. Clinical outcome was assessed with a modified Glasgow Outcome Scale at 3 months. RESULTS: EVT was successfully performed in all patients and resulted in 7 excellent outcomes and 2 deaths related to SAH complications. The arterial branch could be preserved in 7 cases and intentionally occluded in 2. Neither embolic nor ischemic complication occurred in the vascular territory of the involved branch. Angiographic results showed 5 neck remnants, 2 incomplete occlusions, and 2 complete occlusions. No rebleeding occurred. CONCLUSION: Our study, though limited by its small patient population, suggests that saccular intracranial aneurysms with a branch arising from the sac may be treated by endovascular approach with excellent clinical results; however, larger series with long-term follow-up are mandatory to confirm these preliminary results mostly in terms of anatomic stability.

Adult↗
PubMed2006

Cystic extramedullary ependymoma.

Intradural extramedullary location of ependymoma is rare. To the best of our knowledge, only 9 cases have been described in the literature. We report a case of a histologically confirmed ependymoma (WHO grade II) presented in the MR imaging as a cystic, nonenhancing thoracic intradural extramedullary lesion compressing the spinal cord. The cystic appearance mimicking an arachnoid cyst at diagnosis and the leptomeningeal dissemination developed later were peculiarities that have never been previously described in relation to these rare tumors.

Aged↗
PubMed2006

Do cerebral blood volume and contrast transfer coefficient predict prognosis in human glioma?

INTRODUCTION: Noninvasive measurements of cerebral blood volume (CBV) and contrast transfer coefficient (K(trans)) have potential benefits in the diagnosis and therapeutic management of adult glioma. This study examines the relationship between CBV, K(trans), and overall survival. METHODS AND MATERIALS: Twenty-seven adult patients with glioma underwent T1-weighted dynamic contrast-enhanced MR imaging, and parametric maps of CBV and K(trans) were calculated. The relationship of histologic grade, CBV, K(trans), age, sex, surgical resection, and use of adjuvant therapy to survival were analyzed by using the logrank method and Cox regression analysis. The Kaplan-Meier method for displaying survival curves was used. The relationship of factors such as comorbidity, elevated intracranial pressure, size of nonenhancing tumor, and peritumoral edema were not considered. RESULTS: Both CBV (P < .01) and K(trans) (P < .01) show a significant relationship to histologic grade. CBV (P = .004), K(trans) (P = .008), and histologic grade (P < .001) all demonstrate a significant association with patient survival when analyzed individually. Cox regression analysis identified only histologic grade (P < .01) and K(trans) (P < .05) as independent significant prognostic indicators. Examination of survival data from high-grade (III and IV) tumors demonstrated a linear relationship between K(trans) and patient survival (P < .01). CONCLUSION: This study suggests a direct relationship between K(trans) and length of survival in high-grade gliomas, which could be of clinical importance. CBV relates directly to histologic grade but provides no independent prognostic information over and above that provided by grade. Further large prospective studies should be planned to test whether this observation holds true.

Adult↗
PubMed2005

Functional MRI activation of somatosensory and motor cortices in a hand-grafted patient with early clinical sensorimotor recovery.

The aim of this study was to investigate somatosensory and motor cortical activity with functional MRI (fMRI) in a hand-grafted patient with early clinical recovery. The patient had motor fMRI examinations before transplantation, and motor and passive tactile stimulations after surgery. His normal hand and a normal group were studied for comparison. A patient with complete brachial plexus palsy was studied to assess the lack of a fMRI signal in somatosensory areas in the case of total axonal disconnection. Stimulating the grafted hand revealed significant activation in the contralateral somatosensory cortical areas in all fMRI examinations. The activation was seen as early as 10 days after surgery; this effect cannot be explained by the known physiological mechanisms of nerve regeneration. Although an imagination effect cannot be excluded, the objective clinical recovery of sensory function led us to formulate the hypothesis that a connection to the somatosensory cortex was rapidly established. Additional cases and fundamental studies are needed to assess this hypothesis, but several observations were compatible with this explanation. Before surgery, imaginary motion of the amputated hand produced less intense responses than executed movements of the intact hand, whereas the normal activation pattern for right-handed subjects was found after surgery, in agreement with the good clinical motor recovery.

Adult↗
PubMed2005

[Transsphenoidal approach with low field MRI for pituitary adenoma].

INTRODUCTION: Appropriate evaluation of resection remains one of the major difficulties of surgical treatment of pituitary adenoma. The transsphenoidal approach does not allow direct visual control. Endoscopy provides useful information but may no distinguish well residual adenoma from the pituitary gland. Intraoperative MRI offers new perspectives for assessing the quality of resection. We report our experience with low field intraoperative MRI in surgical treatment of pituitary adenoma. POPULATION: Intraoperative MRI (Polestar N10, 30 patients and Polestar N20, 17 patients) was performed in 45 consecutive patients undergoing surgery for pituitary adenoma. Thirty-seven patients had a macroadenoma. Patients were in the prone position with the head fixed with a three-pin MRI-compatible headholder. METHOD: Coronal T1 MRI scans with enhancement were acquired pre and per operatively. We compared scans and surgical filling (complete removal). If there was a difference, a surgical control was undertaken. RESULTS: Intraoperative images were unavailable for two patients due to small size of the neck and the pituitary glands which were not in the middle in the field of view. For the others, the pituitary glands were in the field of view and the intraoperative scans could be used for comparison. For four patients, there was a discrepancy between surgeon filling and the intraoperative MRI. A control showed no residual adenoma but hemostatic tissue. CONCLUSION: Low field intraoperative MRI is an excellent technique for controlling the size of pituitary adenoma resection.

Adenoma↗
PubMed2005

Apparent diffusion coefficient (ADC) and magnetization transfer ratio (MTR) in pediatric hypoxic-ischemic brain injury.

BACKGROUND AND PURPOSE: a review of the literature reveals the increasing interest in using Diffusion magnetic resonance imaging, with diffusion weighted images (DWI) and ADC (Apparent Diffusion Coefficient) quantitation, in pediatric hypoxic-ischemic brain injury. However, ADC and MTR (Magnetization Transfer Ratio) as quantitative tools have not been investigated together in these pathological conditions in young pediatric patients. The aim of this study was to apply a quantitative method by using ADC and MTR calculation in order to propose a reproducible quantitation of brain parenchymal lesions. METHODS: we conducted a prospective study including all children presenting with suspected cerebral hypoxic-ischemic injury. 15 children were included, among them 10 males and 5 females aged from 36 weeks of gestation to 17 months with a median age of 10,5 months. All MR examinations were performed at 1.5 Tesla unit including conventional MR (T1, T2 and Inversion-recovery sequences) and DWI with ADC map. ADC and MTR ROI (region of interest) measurements were made, in the frontal subcortical and periventricular white matter (WM) as well as in the gray matter (GM=basal ganglia), and in focal lesions. RESULTS: ADC and MTR values were abnormal in focal lesions and in diffuse injury with no evidence of lesion on conventional MRI and DWI. We observed a strong inverse correlation between these ADC and MTR (R=0,66 in WM; R=0,61 in GM). CONCLUSION: ADC and MTR calculation may be helpful as a reproductive method to quantify the lesions and detect diffuse lesions in hypoxic-ischemic pediatric brain injury.

Diffusion Magnetic Resonance Imaging↗
PubMed2003

[Role of new MRI techniques in neuroradiologic practice].

Magnetic Resonance Imaging (MRI) has been introduced in clinical practice in the mid-eighties. However, MRI is an ever evolving imaging technique with constant new developments allowing broadening of clinical applications. In particular, angio-MRI involves many different acquisition techniques that will guide their clinical use. On the other hand, clinical applications of the following techniques are briefly discussed: diffusion, perfusion, tractography and diffusion tensor imaging, spectroscopy and functional imaging.

Brain Diseases↗
PubMed2002

Unusual CT features of dermoid cyst in the posterior fossa.

A dermoid cyst of the posterior fossa in a 73-year-old man is reported. The presentation of the cyst was unusual because of the age of the patient, the spontaneously hyperdense aspect of the mass on CT, the partial rim enhancement of the lesion, and the presence of perilesional edema. On pathologic examination, the cyst contained small amount of fat, hairs, necrosis, and small areas of hemorrhage. The amount of hemorrhage found could not explain the spontaneous hyperdensity of the lesion found on CT. The hyperdensity may be related to high protein content of the lesion.

Aged↗
PubMed2002

Magnetic resonance imaging of metastatic disease to the brain with gadobenate dimeglumine.

Seventy-four patients with one to eight proven intraaxial brain metastases received a total cumulative dose of 0.2 mmol/kg bodyweight gadobenate dimeglumine, administered as sequential injections of 0.05, 0.05 and 0.1 m mol/kg over a 20-min period. MR imaging was performed before the first administration (T2- and T1-weighted sequences) and after each injection of contrast agent (T1-weighted sequences only). Quantitative assessment of images revealed significant (P <0.01) dose-related increases in lesion-to-brain (L/B) ratio and percent enhancement of lesion signal intensity. Qualitative assessment by two independent, blinded assessors revealed additional lesions in 22%, 25% and 38% (assessor 1) and 29%, 32% and 34% (assessor 2) of patients after each cumulative dose when compared with combined T1- and T2-weighted pre-contrast images. Significantly more lesions (P < 0.01) were noted by both assessors after the first injection and by one assessor after each subsequent injection. For patients with just one lesion observed on unenhanced T1- and T2-weighted images, additional lesions were noted in 12%, 16% and 28% of patients by assessor 1 following each dose and in 24%, 27% and 30% of patients by assessor 2. Contemporaneously, diagnostic confidence was increased and lesion conspicuity improved over unenhanced MRI. For patients with one lesion observed after an initial dose of 0.05 mmol/kg, additional lesions were noted by assessors 1 and 2 in 9.1% and 11.8% of patients, respectively, after a cumulative dose of 0.1 mmol/kg and in a further 9.1% and 5.9% of patients, respectively, after a cumulative dose of 0.2 mmol/kg. No safety concerns were apparent.

Brain Neoplasms↗
PubMed2002

[The medical imaging and radiology department].

Technological developments arising from research have affected the whole wide spectrum of medical endeavor and have made a very significant impact on clinical practice and especially on imaging sciences. Ultrasonography brought spectacular advances, but CT and MRI became important landmark techniques. A further important development, which greatly increased the involvement of radiologists in direct patient management, was the growth of interventional and therapeutic techniques, called interventional radiology. Some statistics: approximately 155,000 patients per year including 19,000 CT Scans, 10,000 MRI exams, 21,000 ultrasound examinations and 1,000 therapeutic procedures. Some research activities: CT quantification of pulmonary emphysema, respiratory mechanics, MR and CT angiography, antenatal diagnosis of congenital and genetic diseases of the fetus, quantification of portal haemodynamics, MR imaging of bile and pancreatic ducts, morphologic and functional imaging of the brain, radiology of bone trauma, MR characterization in hepatic lesions.

Belgium↗
PubMed2001

Cavernous haemangioma in the cavernous sinus: case report and review of the literature.

We report a cavernous haemangioma in the left cavernous sinus. This lesions very rarely occurs in this site and is difficult to diagnose correctly preoperatively. CT, angiography and MRI permit differentiation of the cavernous haemangioma from other tumours in this region and thereby contribute to a better surgical approach. The radiological features of cavernous haemangioma reported in the literature are summarised.

Aged↗
PubMed2001

Intracranial meningiomas revealed by non-traumatic subdural haematomas: a series of four cases.

OBJECTIVE: A review of the literature shows 33 cases of ipsilateral subdural haematomas (SDH) associated with meningiomas. We suggest that physiopathological mechanisms could be primary haemorrhages from abnormal vessels in the tumours and the opening of the intratumoral haematomas into the subdural space. Our working hypothesis relies on a series of 300 meningiomas operated upon in our department since 1990; of these, 4 were revealed by SDH. CLINICAL PRESENTATION: The four patients surgically treated in our department had developed a progressive impairment of consciousness. There was no history of trauma, blood dyscrasia or anticoagulant therapy. After diagnosis, the SDH was drained, and the meningeal tumour was totally resected once it had been discovered. In one case, the presence of a tumour was demonstrated by magnetic resonance imaging (MRI) performed only after the evacuation of a recurrent SDH. INTERVENTION: In each case, an acute SDH showing signs of recent bleeding was evacuated. The meningeal tumour discovered proved to be the source of the haemorrhage because of the numerous fresh blood clots both around and inside it. HISTOLOGY: In the four cases histology showed fresh intratumoral haemorrhages (ITH), large blood vessels with thin endothelial linings and haemosiderin deposits. In this review, SDH is associated with other haemorrhage sites in 24 of 37 cases (33+our 4 cases). ITH was present in 14 cases (40%). CONCLUSION: The treatment should consist of the extirpation of the meningioma at the same time as the evacuation of the haematoma. If primary ITH from abnormal vessels is the source of SDH, complete meningioma resection should prevent the recurrence of SDH. Subdural membranes and haematomas should therefore be inspected for their intrinsic pathology, especially when there is no history of trauma.

Aged↗
PubMed2000

Intracranial aneurysms: detection with gadolinium-enhanced dynamic three-dimensional MR angiography-initial results.

PURPOSE: To assess the clinical utility and accuracy of contrast material-enhanced dynamic three-dimensional (3D) T1-weighted magnetic resonance (MR) angiography in the detection of unruptured intracranial aneurysms. MATERIALS AND METHODS: A prospective blinded comparison of 3D contrast-enhanced T1-weighted MR angiography with 3D inflow magnetization transfer and tilted optimized nonsaturating excitation (MT TONE) imaging, phase-contrast MR angiography, and conventional digital subtraction angiography (DSA) was performed in 32 consecutive patients. The first dynamic 3D contrast-enhanced T1-weighted acquisition was individually timed after injection of a bolus of gadolinium-based contrast agent to obtain an arterial phase image followed by two sequential venous phase images (three 18-second acquisitions). Two readers independently interpreted and graded the MR images for diagnostic confidence and depiction of aneurysms and subsequently compared them with DSA images. RESULTS: Three-dimensional contrast-enhanced T1-weighted MR angiograms depicted all 23 aneurysms detected in 17 patients at DSA (mean size, 6 mm; range, 2-21 mm) with one false-positive result by one reader (sensitivity, 100%; specificity, 94%). MT TONE and phase-contrast images failed to depict one and seven aneurysms, respectively (MT TONE sensitivity of 96% and specificity of 100%, phase-contrast sensitivity of 70% and specificity of 100%). Aneurysm depiction at 3D contrast-enhanced T1-weighted MR angiography was significantly better than that at MT TONE imaging (P <.012), and that with both was significantly superior to that of phase-contrast imaging (P <. 001). Differences in diagnostic confidence in the presence of an aneurysm were not significant between 3D contrast-enhanced T1-weighted and MT TONE imaging (P =.076). CONCLUSION: Dynamic 3D contrast-enhanced T1-weighted MR angiography is a fast, efficient, and minimally invasive imaging method with which to diagnose intracranial aneurysms.

Adult↗
PubMed1999

[Periventricular leukomalacia in premature infants: prognostic role of ultrasonography and MRI].

PURPOSE: To evaluate the role of cranial US and MRI to establish the neurological prognosis of premature infants with periventricular leukomalacia (PVL). PATIENTS AND METHODS: Follow-up results of cranial US and early MRI evaluation (before 25 weeks*) of 28 premature infants were retrospectively reviewed and compared to the neurological outcome at 18 months* (*corrected age). RESULTS: Follow-up by cranial US was more sensitive (8/28) than early MRI to detect cystic PVL lesions because of the transient nature of these cysts. This has prognostic implications since all patients (8/8) with cystic PVL lesions had neurological sequelae. MRI was useful, as a complement to cranial US, for the evaluation of non-cystic PVL lesions. Indeed, patients with evidence of hemorrhage or paucity of white matter at MRI had a higher risk of neurological sequelae (9/11) than infants with echogenic periventricular white matter at US without evidence of white matter abnormality at MRI (p < 0.013). CONCLUSION: MRI was useful, as a complement to cranial US, to evaluate the prognosis of infants with non-cystic PVL lesions.

Developmental Disabilities↗
PubMed1997

An atypical infectious complication of anterior cervical surgery.

We report a 44-year-old woman who developed an atypical retro-oesophageal abscess 4 years after anterior cervical surgery with fusion (ACSF). She presented with dysphagia but no fever or definite laboratory signs of inflammation. Delayed or chronic dysphagia following Cloward's operation is usually related to graft displacement. Infection may also, more rarely, be encountered in conjunction with dysphagia, but is typically associated with a classical clinical presentation and laboratory results. We recommend that in cases of delayed dysphagia without evidence of graft migration, the possibility of retropharyngeal infection should be considered, even in the absence of clinical signs or supporting laboratory evidence. MRI in this rare delayed complication is nonspecific but suggestive, and hence represents the imaging modality of choice in such situations.

Adult↗
PubMed1997

Facet joints diseases.

A review of the normal anatomy, developmental abnormalities, traumas and disorders affecting the facet joints is provided, with a recall of the major imaging modalities.

Arthrography↗
PubMed1997

[Multiple and de novo aneurysms in Ehlers-Danlos syndrome].

BACKGROUND AND PURPOSE: In 1964, the first case of "de novo" aneurysm has been reported by Graf and Hamby. The risk of late formation of aneurysm is unknown. Some factors could influence risk: history of hypertension, oral contraceptives, cigarette smoking. We report a rare case of "de novo" aneurysm associated with Ehlers-Danlos syndrome. RESULTS: A 35-year-old female developed a subarachnoid hemorrhage (SAH). Angiography demonstrated 4 aneurysms. Five years before, she presented a SAH. At that time, four vessels angiography demonstrated only one PICA aneurysm. A Ehlers-Danlos syndrome was suspected, which was demonstrated on skin biopsies. CONCLUSION: At our knowledge, this is the first case of "de novo" aneurysm associated with a Ehlers-Danlos syndrome.

Adult↗