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Biomedical subjects

D Vanbeckevoort

Publications and source records attributed to D Vanbeckevoort.

34 records · Page 2Linked to original sources

Pelvic floor descent in females: comparative study of colpocystodefecography and dynamic fast MR imaging.

The purpose of this study was to compare fast dynamic magnetic resonance imaging (MRI) with colpocystodefecography (CCD) in the evaluation of pelvic floor descent in women. Thirty-five women with clinical evidence of pelvic floor descent were studied. A fast single-shot MR sequence was performed in the supine position during pelvic floor relaxation and during maximal pelvic strain. On the same day, a dynamic CCD was performed with the patient seated on a stool-chair. The degree of descent of the bladder, vagina, and anorectal junction was evaluated as the vertical distance between the pubococcygeal line and the bladder base, the vaginal vault, and the anorectal junction, respectively. A bulge of more than 3 cm measured as the distance between the extended line of the anterior border of the anal canal and the tip of the rectocele was interpreted as a rectocele. MRI was compared with CCD during maximal pelvic strain (CCD 1) and during voiding and defecation (CCD II). CCD was considered as the gold standard. Compared with clinical examination, CCD I showed a larger number of involved compartments, except for the middle compartment. CCD II was superior to clinical examination in all cases. In comparison with CCD I and especially CCD II, MRI had a lower sensitivity, especially for the anterior and middle compartment. Even four enteroceles seen on CCD II were not detected by MRI. When CCD I and CCD II were compared, a cystocele, a vaginal vault prolapse, an enterocele, and a rectocele were more readily seen on CCD II than with CCD I. When compared with CCD, supine dynamic MRI is unreliable, especially in the anterior and middle compartment. Even in the detection of enteroceles CCD was superior to MRI. In general, the best results with MRI can be expected for evaluation of the rectum.

Adult↗

Cervical carcinoma: optimized local staging with intravaginal contrast-enhanced MR imaging--preliminary results.

Ten patients suspected of having cervical carcinoma underwent magnetic resonance (MR) imaging before and after opacification of the vagina with a mixture of barium, water, and maltodextrin/calcium lactate. Use of vaginal contrast medium resulted in improved visualization of the vaginal wall, lumen, and fornices in all patients and in a change in local tumor stage in two patients (20%). This technique may contribute to improved noninvasive staging of cervical carcinoma.

Adult↗

Solitary true cyst of the pancreas.

We report a case of a woman diagnosed with a solitary true cyst of the pancreas. CT and especially MRI guided us in the diagnosis of this benign lesion. The cyst has been surgically removed because of secondary bile-duct obstruction causing painless jaundice. Clinical history, laboratory, imaging, and histological findings are reported.

Cholestasis↗

Normal Vaterian sphincter complex: evaluation of morphology and contractility with dynamic single-shot MR cholangiopancreatography.

OBJECTIVE: The objective of this study was to assess the usefulness of dynamic single-shot MR cholangiopancreatography in the evaluation of the morphology and contractility of the normal Vaterian sphincter complex and to assess whether i.v. injection of glucagon can improve visualization. SUBJECTS AND METHODS: Sixty patients without signs of Vaterian sphincter complex dysfunction were studied. A fast single-shot MR imaging sequence was used to obtain 20 consecutive images of the Vaterian sphincter complex during successive episodes of breathholding. In patients of group A (n = 30), 10 images were obtained before and 10 after i.v. administration of a sphincter-relaxing agent (glucagon). In the patients of group B (n = 30), no glucagon was administered. The degree of visualization of the Vaterian sphincter complex was assessed. RESULTS: Overall, the morphology and contractility of the Vaterian sphincter complex was adequately assessed in 57 patients (95%). However, the number of repetitions required to obtain this result varied greatly (mean, seven; range, two to 18). Glucagon had no apparent effect on the visibility of the most distal portion of the common bile duct. CONCLUSION: Nonvisualization of the most distal portion of the common bile duct on MR cholangiopancreatography studies is a normal variant that can simulate disease. Obtaining serial breath-hold images using a single-shot technique is helpful to avoid diagnostic errors.

Adult↗

Imaging of gallbladder and biliary tract before laparoscopic cholecystectomy: comparison of intravenous cholangiography and the combined use of HASTE and single-shot RARE MR imaging.

To compare intravenous cholangiography (i.v.c.) and magnetic resonance imaging (MRI) as preoperative imaging techniques in patients scheduled for laparoscopic cholecystectomy. Twenty patients underwent i.v.c. and MRI, 40 axial 'localizer' images were first obtained with a half-Fourier single-shot turbo spin echo (HASTE) sequence. Next, an extremely high T2-weighted rapid acquisition relaxation enhancement (RARE) acquisition (TE = 1100 msec) was used for MR cholangiography. All images obtained with i.v.c. and MRI were independently analyzed by two observers. The relative visibility of the (normal or abnormal) gallbladder (GB), cystic duct (CD), and bile ducts (BD) on both types of images was scored as follows: 1 = MRI better than i.v.c.; 2 = no difference; 3 = i.v.c. better than MRI. We observed 3 anatomic variants: 1 of the cystic duct and 2 of the intrahepatic bile ducts; 15 patients had gallstones; one had cholecystitis. Magnetic resonance images were considered more informative than i.v.c.-images for visualization of GB in 11 patients (55%), for CD in 9 patients (45%), and in 8 patients (40%) for visualization of the CBD. Intravenous cholangiography outperformed MRI in the evaluation of the CBD and CD in one patient (5%). The combined use of half-Fourier single-shot RARE and high T2-weighted RARE MR imaging is a valuable alternative to i.v.c. in the preoperative evaluation of gallbladder and biliary tract.

Adult↗

The evolution of radioprotection.

In comparison with the first half of this century the frequency of X-ray induced lesions diminished spectacularly both in patients and in radiologists in the second half; this was due to more and more rigorous radioprotection. The present measures of radioprotection may be divided into two groups according to their appliance to the patient or the operator. Prevention of irradiation of an unknown pregnancy is the responsibility of the clinician (application of the 10 days rule) but equally of the radiologist (warning poster in the radiological department, query of possible pregnancy). The sensitivity of the imaging material has been raised by adaptation of film, intensifying screens, grids and the use of image intensifier with TV-chain and photofluorography. The quantity of X-rays to the patient may be directly lowered by reducing the time and dose of fluoroscopy, the number of radiographs, by using a diaphragm, by covering some organs with lead shields and by choosing different examination modalities. Dose reduction to the patient may also be achieved by modifications of the quality of the X-ray beam (filter, KV/MA) and by proper indication of the examination. Patient's dose can be calculated by phantom simulation and by chromosomal blood study. The operator is never allowed to put his unprotected hand in the X-ray beam. The amount of scattering radiation to the operator will be lowered by several of the above mentioned measures reducing the patient's dose and by choosing the most favourable direction of the axis X-ray tube-image intensifier. Direct protection of the operator is achieved by lead-glass screens, lead flaps around the patient, lead gloves, apron and glasses and by raising the distance between the operator and the X-ray tube. Early detection of unusual radiation is possible by systematic dosimetry.

Adult↗

[A case of a limited from of Wegener's granulomatosis].

The history of a man who developed a limited angiitis and granulomatosis of the Wegener type is described. Wegener granulomatosis is a hypersensitivity disease (type III) with an unknown etiology. The typical radiological features, the differential diagnosis and treatment are briefly discussed.

Biopsy↗

Intraarticular osteoid osteoma of the elbow.

The case of a man who developed osteoid osteoma of the elbow is presented. Intraarticular osteoid osteoma of the elbow is a rare lesion presenting both diagnostic and therapeutic problems. The radiologic features of intraarticular osteoid osteoma include osteosclerosis (usually a dominant feature at initial imaging and typically enveloping the nidus), joint effusion and periosteal reaction that can involve the bone in which the osteoid osteoma arises and the adjacent bones. Awareness of these features facilitates correct diagnosis, thereby enabling timely and appropriate treatment.

Adult↗

Delivery related rupture of the gravid uterus: imaging findings.

Rupture of the gravid uterus is a rare, life-threatening obstetric complication. Major symptoms are hypovolemic shock and abdominal pain during late pregnancy or after vaginal delivery. Immediate surgical therapy is required. We report a case of uterine rupture after vaginal delivery diagnosed by means of ultrasonography and computed tomography.

Abdominal Pain↗

Pancreatitis-induced extrahepatic portal vein stenosis treated by percutaneous transhepatic stent placement.

One month after onset of an acute biliary pancreatitis, a 75-year-old man developed refractory ascites. Duplex ultrasound and CT scan revealed a focal stenosis of the extrahepatic portal vein as confirmed by transhepatic direct portography. In the same session, this stenosis, responsible for symptomatic prehepatic portal hypertension, was successfully dilated and stented and afterwards a residual pressure gradient of 1 mmHg over the stented segment was measured. One week after the stenting procedure the patient was free of ascites and control physical and biochemical examination one year later is completely normal.

Acute Disease↗

Struma ovarii: US and CT findings.

We describe the ultrasound and CT findings in a case of struma ovarii. Ultrasound showed a multicystic mass with a well-vascularized solid part. CT demonstrated a multilocular cystic mass with calcifications and solid, enhancing components. To prevent radical surgery, struma ovarii should be included in the differential diagnosis when a mixed, multilocular, teratoma-like tumour of the ovary shows a well-vascularized, enhancing, central solid component.

Adult↗

Mri findings in primary non-Hodgkin's lymphoma of the liver.

Primary lymphoma of the liver is a very rare malignancy. Most often, these lesions consist of diffuse large B-cell non-Hodgkin's lymphoma that occurs mostly in immunodeficient patients. To prove the primary nature of a hepatic lesion, a systemic lymphoproliferative disease should be ruled out. Secondary liver involvement during Hodgkin's and non-Hodgkin's lymphoma is frequent. In advanced cases the incidence varies from 25% to 50%. The present case describes the MRI features of a primary lymphoma of the liver presenting as a solitary nodule. The primary lymphoma presents as a T2-hyperintense homogeneous nodule, with a signal intensity comparable with the signal intensity of the spleen. Signal intensity is comparable on in and out of phase imaging. The nodule is slightly T1-hypointense and doesn't show any arterial contrast uptake. In the late venous phase a slight increase in signal intensity is noted. Two and a half minutes after the administration of contrast agent, the lesion is iso-attenuating with the liver parenchyma. This case is rare because of the concomitant presence of heterozygous sickle cell anaemia and the presence of Gamna-Gandy bodies in the splenic parenchyma. It remains uncertain whether the presence of the Gamna-Gandy bodies is associated with the liver lymphoma or with the underlying sickle cell anaemia, or with a combination of both.

Adult↗

Left ovarian Brenner tumor.

Ovarian Brenner tumors are uncommon neoplasms of the ovary, representing approximately 2% of all ovarian neoplasms. Nowadays there is general agreement that Brenner tumors are derived from the surface epithelium of the ovary or the pelvic mesothelium through transitional cell metaplasia. Association with other surface-derived neoplasms, either in the ipsilateral or contralateral ovary, is reported in 30% of the cases. We report a case of benign ovarian Brenner tumor and discuss the typical features on magnetic resonance imaging (MRI) and computed tomography (CT) scan as well as the differential diagnosis.

Aged↗