Biomedical subjects
Publications and source records attributed to D Vadrot.
An original case of a gas-containing pyelic calculus is described. This phenomenon in a radiolucent calculus spontaneously visible by computed tomography is attributed to the fissuration of a crystallin calculus. The hypothesis is emitted that, like gallstones, the apparition of gas is a fissuration that may precede the spontaneous disappearance of the calculus.
Remotely controlled tables are still largely employed as diagnostic tools, but they have not evolved during the recent past when compared with computed tomography or ultrasonography. The most recent attempts at improvement have been the introduction of complex stands capable of numerous integrated movements, but very heavy and costly, and integrated development systems for the films. Current technological possibilities should permit very much greater progress. New high definition wide field amplifiers associated with high performance TV could suppress the directly exposed film and thus the selector. As with other systems employing a video image, a multi-image camera could be used. Acquisition of data in this way, combined with the use of visual treatment of this data, should considerably reduce patient irradiation. The introduction of the microcomputer and the lightening of stands (absence of the selector...) should simplify the obtaining of complex movements. These "revolutions" in the conception of remotely controlled tables are now possible, and all that remains is to evaluate possible improvements in diagnostic value and to assess the various economic implications.
Seven cases of anomalies of aortic arch investigated by computed tomography are described. The authors emphasized the interest of such an exam in the investigation of these anomalies. It is very interesting to know this pathology in sight to obviate some mistakes in the diagnostic of the tumors of the mediastinum. They describe three specific criterions of CT diagnosis of a right aberrant subclavian artery. The indications of computed tomography in the diagnostic and evaluation of the anomalies of aortic arch are discussed.
An original case of a gas-containing pyelic calculus is described. This phenomenon in a radiolucent calculus spontaneously visible by computed tomography is attributed to the fissuration of a crystallin calculus. The hypothesis is emitted that, like gallstones, the apparition of gas is a fissuration that may precede the spontaneous disappearance of the calculus.
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By using rigourous examination techniques and interpretive criteria, ultrasonography of the pancreas can, in many cases, confirm the etiological diagnosis of solid pancreatic masses. Factors influencing diagnosis are the volume and shape of the pancreas, the ultrasound structure, the attenuation of ultrasounds, the outline of the pancreas, and the effect on neighbouring structures. The association of signs is often characteristic and can differentiate benign from malignant masses.
A new case of this unusual entity is reported. The patient, male aged 43 has an hypertrophy of the first and second left fingers. Radiographic examination shows bony overgrowth and marked soft tissue thickening. Arteriography did not show any evidence of angioma or arteriovenous fistula. Histologic examination shows deposits of fat in soft tissue thickening. Macrodystrophia lipomatosa is a rare disease, usually confined to one or two digits of the hand, and sometimes of the foot. A dysembryoplasic aetiology could be sustained, and this entity is very close from others bone or soft-tissue hamartomas.
Presentation of a polyethylene catheter formed by the end-to-end apposition of two tubes of different calibre, the proximal being of a wide calibre and thus easy to manipulate, and the distal being of fine calibre and very useful for hyperselective catheterisation.
Embolization of the aeso-cardiotuberositary varices, by selective catheterization of the coronary vein of the stomach and the posterior gastrics, seems to be valuable palliative treatment in portal hypertension, owing to its relative innocuousness, inspite of a certain number of failures. It is carried out by transhepatic puncture of the portal system or catheterization of the umbilical vein.
A case of hyperreactio luteinalis in an otherwise normal pregnancy is reported. Ascites was present, but no peritoneal implants or adenopathy were seen. Findings that would have suggested the correct diagnosis are the symmetrical and bilateral pattern of the mass, as well as the rather uniform size of the loculi, which were 1 to 3 cm in diameter.
Nineteen patients with rectal carcinoma were evaluated prospectively. The extent of tumor and the relationship of the tumor to the levator ani muscle were studied as this determines the choice of the surgical procedure (abdominoperineal resection versus low anterior resection). Peroperative assessment and detailed evaluation of the pathologic specimens were correlated with magnetic resonance (MR) features. Magnetic resonance staging and surgical findings were at variance in four of 15 cases (27%). Magnetic resonance had sensitivities and specificities of 75 and 100% in the detection of perirectal growth. Magnetic resonance demonstrated invasion of adjacent pelvic side wall and sacrum in two of two cases. The comparison with TNM classification demonstrated that MR correctly staged 15 of 19 cases (79%). This study shows that MR is a good examination to evaluate the involvement of perirectal fatty tissues and adjacent structures. The low prevalence of involved lymph nodes in our cases prevents significant positive predictive values. Nevertheless, MR can help to select patients for local excision or for preoperative radiotherapy.
OBJECTIVE: Fibrothecomas of the ovary are mesenchymal tumors representing 4-5% of all ovarian neoplasms. The purpose of this study is to describe a large series of CT findings in this type of tumor. MATERIALS AND METHODS: We reviewed retrospectively the CT examinations in 25 unilateral cases confirmed by surgery and pathology. Unenhanced and enhanced CT scans were performed in all cases and dynamic CT scans were performed in nine cases. These findings were compared to ultrasound in all cases. RESULTS: Computed tomography detected all but two small ovarian tumors (< 2 cm). Eighteen of 23 fibrothecomas were solid, with significant (> 10 HU) enhancement between precontrast and delayed CT scans. In all eight uncomplicated cases, nonincremental dynamic CT scan did not visualize arterial vessels; in seven of nine cases examined dynamically, early uptake of contrast material was visualized. Three of 23 fibrothecomas were partly cystic, partly solid. Two cases with torsion were mainly cystic with thickening and hemorrhage of the tube. CONCLUSION: In conclusion, 79% of ovarian fibrothecomas appeared as solid masses with delayed accumulation of contrast medium. On dynamic CT, the absence of arterial vessels and absence or slight early uptake of contrast enhancement could be useful findings for preoperative diagnosis. When partly or mainly cystic (21% of cases), ovarian fibrothecomas could not be easily differentiated from other ovarian masses.
OBJECTIVE: Our goal was to determine the CT and US aspects of the fallopian tube in adnexal torsion. MATERIALS AND METHODS: The CT scans and US studies of 10 patients with surgically proven unilateral torsion of the adnexa were reviewed. RESULTS: On CT the fallopian tube on the involved side was identified in eight cases as an almost tubular or comma-shaped structure extending from the uterine cornua and covering partially the adnexal mass. This tube was significantly thickened and measured 20-40 mm. Hemorrhage (density > or = 50 HU on precontrast CT scans) was present in the tube in six patients. A heterogeneous contrast agent uptake was detected in the tube in five patients. An adnexal mass was visualized on the involved side in all patients, with hemorrhage in the mass in four patients. Peritoneal fluid and/or ileus were present in six patients. On US an echogenic structure that corresponded to the enlarged tube visualized on CT was detected in three cases and an adnexal mass in all cases. CONCLUSION: Thickening of the fallopian tube with hemorrhage could be detected by CT and is suggestive of torsion especially if associated with an adnexal mass.
Spiral CT angiography was performed in a patient suspected of having pulmonary embolism. The right pulmonary system was normal. The left arterial system was small but patent. The left upper lobe was small and hyperlucent. The left lower lobe was collapsed and contained bronchiectasis. The bronchi were patent. High resolution CT in inspiration and expiration confirmed air trapping in the left upper lobe. A diagnosis of Swyer-James syndrome of the left upper lobe was made.
Two rare muscular diseases, macrophagic myofasciitis and fibromuscular dysplasia, are associated in the patient reported here. Their respective etiologies are unknown. The possible link has to be discussed.
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