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Biomedical subjects

E Mousseaux

Publications and source records attributed to E Mousseaux.

At least 55 records · Page 3Linked to original sources
PubMed1996

Evaluation by electron beam computed tomography of intracardiac masses suspected by transoesophageal echocardiography.

OBJECTIVES: To assess the suitability of electron beam computed tomography (EBT) in evaluating and subsequently managing cardiac masses suspected as a result of examination by transthoracic and transoesophageal cross sectional echocardiography. DESIGN AND PATIENTS: In 76 consecutive patients with suspected cardiac masses, the impact of the EBT examination was analysed by reviewing whether EBT examination altered management by confirming or excluding a mass, whether EBT imaging substantially contributed to decision-making, and lastly whether EBT influenced the decision to operate on the patient. RESULTS: EBT modified the diagnosis or confirmed results which had been questionable with cross sectional echocardiography in 53 cases (70%): these cases included those with anatomical features such as dense calcifications or fatty structures (n = 20), lipomatous lesions (n = 5), equivocal thrombi (n = 5), pericardial masses (n = 5), or hydatid cysts (n = 2). EBT gave information over and above cross sectional echocardiography in all patients with malignant tumours (n = 16) by providing a better delineation of the relation between intracavity masses and normal structures, including the mural site of tumour attachment and tumour extension to the great vessels and the adjacent extracardiac mediastinal structures. EBT provided no additional information over cross sectional echocardiography in the remaining patients (n = 23), particularly in those with myxomas (n = 11) or small valvar lesions (n = 6). EBT only confirmed that the lesion was well demarcated, limited in extent, or not associated with a mass. CONCLUSIONS: EBT has considerable potential for clinical management and surgical planning and may help clinicians to decide against surgery, particularly in patients with unresectable tumours.

Adolescent↗
PubMed1996

Endomyocardial fibrosis: electron-beam CT features.

PURPOSE: To present morphologic and functional electron-beam computed tomographic (CT) features of endomyocardial fibrosis. MATERIALS AND METHODS: Twelve patients with histologic evidence of endomyocardial fibrosis and/or definitive echocardiographic and angiocardiographic findings were examined with electron-beam CT. RESULTS: Endomyocardial fibrosis was depicted as linear calcifications and/or a thin tissue band of low attenuation within the endomyocardium. In right ventricular involvement, CT depicted obliteration of the apex associated with extension along the free wall and/or papillary muscles of the tricuspid valve. In left ventricular involvement, a large amount of endocardial tissue led to severe obliteration within the inflow tract and/or of the apex. At ventricular volume analysis, restrictive patterns of the disease were determined. CONCLUSION: Electron-beam CT allows direct visualization of endomyocardial fibrosis and the resulting volumetric changes and enables distinction of the disease from constrictive pericarditis.

Adolescent↗
PubMed1996

[Right retroauricular hematoma of late manifestation. Contribution of cardiac imaging].

Right intrapericardial retroatrial haematomas are usually discovered in an acute context of tamponade, following cardiac surgery. The original feature of this case was the asymptomatic nature of a right retroatrial haematoma, after surgical closure of an ostium secundum atrial septal defect, with a free interval of more than 20 years between the surgical procedure and the first relatively minor symptoms, consisting of supraventricular arrhythmias. It can be difficult to determine the intra- or extra-atrial topography of a right-sided mass by transthoracic echocardiography. On the other hand, transoesophageal echocardiography and ultrafast CT can provide a precise topographic diagnosis and appear to be complementary to assess the nature of pericardial masses.

Adult↗
PubMed1995

[Value and limitations of methods for measuring left ventricular mass].

M-mode echocardiographic measurement of the left ventricular mass is inaccurate when the hypertrophy is asymmetric and the ventricule very deformed. The routine calculation of the mass is based on several hypotheses, verified in normal and hypertensive subjects: the standard error (SEE) is 30-40 g, 10-15% (r > 0.9). The standard deviation of inter-examination differences (> 25 +/- 30 g with a variation coefficient c = 10-15%) makes it difficult to appreciate variations of mass in a given patient. Two-dimensional echocardiographic measurement of left ventricular mass requires the use of geometric formulae which have not been validated in the cardiomyopathies. The absence of a consensus on the models used has favorized the use of MRI and of ultrafast computed tomography. MRI measurement of mass has been validated in normal and ischaemic hearts (r > 0.97, SEE < 8 g, c = 15%) but the times of acquisition are long. Using ultrafast CT, not universally available, this measurement has been validated in vivo and in vitro, including in cardiomyopathy for which the SEE is low (6%) and reproducibility excellent (c = 4-8%), comparable with results in normal subjects.

Angiocardiography↗
PubMed1995

[MRI in cardiology: clinical applications and perspectives].

MRI is an effective tool in the evaluation of cardiovascular diseases. With continued improvements in MR angiography, velocity mapping, myocardial tagging, imaging speed and display, it is anticipated that MRI will play an ever-increasing role in the morphological evaluation of many cardiovascular anomalies. The need for quantification in cardiology has led to the development of a variety of techniques to assess cardiac size and function. In attempting to answer these clinical questions, MRI provides major advantages several: extraordinary flexibility, powerful contrast mechanisms, sensitivity to flow and motion, and freedom from ionizing radiation, contrast agent and acoustic windows. Because of accurate initial results in quantifying cardiac chamber size, global and segmental function, it is likely that MRI methods will play an increasing role in the evaluation of cardiac structure and function. Recently, MRI has emerged as an important tool in the evaluation of great vessel disease, particularly in the evaluation of both congenital and acquired abnormalities of the aorta. Early evidence suggests that magnetic resonance may help in distinguishing constrictive pericarditis from restrictive cardiomyopathy (e.g., amyloid heart disease). Cardiac-MRI lends itself to assessment of intracardiac masses. Spin-echo imaging alone is often sufficient for diagnosis. Cine-MRI has important additive value, however, when a mass lesion shows dynamic motion, or when abnormal flow patterns in conjunction with a mass lesion require evaluation.

Echocardiography↗
PubMed1995

[Morphological and functional study of pulmonary arteries by MRI].

This article presents an exhaustive review of MRI in the assessment of the pulmonary arteries (sequences, normal results, clinical signs of the main diseases). Its current preferential indications are: the study of the main pulmonary artery trunks (primary tumours, proximal embolism, caliber abnormalities, anatomical relations with central tumours), the assessment and post-treatment follow-up of pulmonary arterial malformations. Angio-MRI is currently being developed and, in the near future, should allow the reliable diagnosis of pulmonary embolism and will therefore be indicated alongside spiral computed tomography. MRI also allows functional assessment of the right circulation (measurements of circulatory velocity and flow rates). It should rapidly become an examination of choice in the haemodynamic follow-up of patient with pulmonary hypertension and transplant recipients and as an evaluation tool for new drugs.

Humans↗
PubMed1995

[Corynebacterium diphtheriae endocarditis complicated by septic arthritis and cerebral abscess].

The authors report a rare case of the mitis type Corynebacterium diphteriae endocarditis on a prosthetic valve complicated by septic arthritis and cerebral abscess. The authors underline the importance of regular transoesophageal echocardiographic control and underline the diagnostic value of ultrafast computed tomography for the diagnosis of aortic annular and interventricular septal abscesses in patients with mechanical prosthetic valves.

Arthritis, Infectious↗
PubMed1995

[New imaging techniques in pulmonary embolism].

Acute pulmonary embolism is a medical emergency and diagnostic certitude must be obtained as early as possible. In clinically serious situations, spiral CT is a reliable diagnostic tool. It provides direct signs of embolism with visualisation of thrombi in the pulmonary arteries as far as the segmental branches and its diagnostic value does not change in cases of pulmonary parenchymal involvement. In emergencies, spiral CT should replace pulmonary angiography, which is more costly and associated with greater morbidity and mortality. Other methods, in particular MRI, which is totally innocuous, could play an important role in the diagnostic strategy of acute pulmonary embolism in the near future.

Diagnostic Imaging↗
PubMed1994

Determination of left ventricular mass with electron beam computed tomography in deformed, hypertrophic human hearts.

This study firstly determined the accuracy of left ventricular mass (LVM) determination by electron beam CT in normal and distorted human cadaver hearts, and secondly the in vivo reproducibility of these measurements, in normal subjects and patients with various cardiac diseases, over a wide range of LVM (104-631 g). In cadaver hearts, there was a close correlation between electron beam CT and autopsy LVM values: r = 0.97, SEE = 16 g. Intra-observer variability: results of LVM measurements obtained in cadaver hearts by observer 1 and in in vivo studies by observer 2 were y = 1.001 x -1.34, r = 0.99, SEB = 6 g and y = 0.99 x +3.78, r = 0.99, SEE = 19 g, respectively. Inter-observer variability: results in cadaver and in vivo studies were y = 1.05 x -5.94, r = 0.98, SEE = 14 g and y = 1.13 x -23, r = 0.99, SEE = 28 g, respectively. Thus, these results over a wide LVM range provide extensive validation of electron beam CT measurements in hearts with marked left ventricular distortion. This method should play a valuable role, within the scope of clinical research, in assessing left ventricular remodelling in various conditions in which echocardiographic data are inaccurate.

Adult↗
PubMed1994

Cardiac lymphoma presenting as atrial flutter in an AIDS patient.

An increasing number of patients with the acquired immunodeficiency syndrome (AIDS) and cardiac lymphoma have been documented. Antemortem diagnosis of cardiac non-Hodgkin lymphoma in AIDS is difficult because of the non-specificity of the clinical findings. Rapid progression of cardiac dysfunction is common after symptoms appear. We report the case of a patient with AIDS and cardiac lymphoma revealed by an atrial flutter.

Atrial Flutter↗
PubMed1994

Quantification of hemodynamics in primary pulmonary hypertension with magnetic resonance imaging.

The aims of this study were first to analyze pulmonary flow differences between patients with primary pulmonary hypertension (PPH) and volunteers, and second to determine whether magnetic resonance (MR) 3D Fourier encoding velocity imaging is capable of assessing hemodynamics in PPH. Pulmonary and aortic flows were quantified with MR imaging in 13 patients with PPH confirmed by right heart catheterization (RHC) within the same week and in 10 volunteers. MR pulmonary antegrade velocities, acceleration time (defined as the time from the onset of flow to the peak velocity), and arterial distensibility (maximal surface-minimal surface/minimal surface) were significantly different in patients (p < 0.05). MR pulmonary and aortic flow volumes correlated well with each other in the two populations (r = 0.98). Agreement between MR and RHC data was low: for the right cardiac output (mean difference) the 95% confidence interval was -0.88 to -0.22 L/min and for the right stroke volume 2.83 to 9.71 ml. However, the high coefficient correlations found between the two techniques showed that MR data could be used as indicators of right hemodynamics. 3D Fourier encoding-velocity sequence is a reliable noninvasive flow measurement method for the quantification of right hemodynamics in patients with PPH.

Adolescent↗
PubMed1994

[Dynamic cardiovascular studies with electron beam computed tomography].

Electron Beam CT (EBCT) is still emerging as a new functional imaging procedure in providing high morphological studies and dynamic quantitative functional data. Morphological EBCT studies have previously proven their usefulness in pathologic conditions of the thoracic aorta, in congenital diseases, in cardiac masses or tumors... Functional studies achieved using cine mode and/or flow mode are used to assess both mobility and perfusion of structures. Such dynamic analysis have confirmed that their applications will have a major impact on the knowledge of cardiac physiology, the understanding of cardiovascular diseases, if not in daily patient care. For instance, in studies on ventricular function, among the imaging modalities in current use, EBCT is probably most accurate for the evaluation of systolic regional or global function. EBCT is a cross-sectional imaging methods which overcome an important limitation shared by most other imaging modalities, namely the superimposition of overlapping cardiac and thoracic structures. Since in the method high spatial, contrast, and temporal resolution tomography displays the myocardial wall itself, an accurate delineating of endocardial and epicardial contours in contiguous levels can be obtained. Further developments in computer-automated analysis from dynamic EBCT studies have to be carried out to gain clinical acceptance and to facilitate the routine.

Cardiovascular Diseases↗
PubMed1994

[Electron canon computed tomography. Technique and clinical applications in cardiac imaging].

Electron Beam CT (EBCT) was initially devoted to both dynamic and morphological cardiac studies. ECG gated slices acquired in 100 milliseconds produce cardiac images without motion artefacts. Intracavitary tumors and thrombus are clearly detected and EBCT contributes to the stagging and follow-up of masses. Exploration of congenital abnormalities such as pulmonary atresia can be performed even in newborns. EBCT allows the diagnosis of tiny modifications of coronary arteries, endocardium or pericardium. EBCT offers a new modality of cardiac imaging which gives complementary informations to other modalities.

Coronary Disease↗
PubMed1994

[Contribution of the electron beam scanner (Imatron) in aortic pathology].

Electron Beam CT (SFE, Imatron) uses electron beam to generate X rays. This allows the shortest acquisition time today available (50-100 ms). It is the best CT examination for moving structures. In vascular disease arterial wall study is the most important end point, especially in aortic pathology. EBCT is effective in aortic aneurysm, dissection and aortitis diagnosis. It allows a pre-surgical mapping of the lesion and follow-up. We believe that EBCT is superior to other diagnostic mean in the assessment of the ascending aorta and of small arterial lesions.

Aortic Dissection↗
PubMed1993

High-precision MR velocity mapping by 3D-Fourier phase encoding with a small number of encoding steps.

The final result of Fourier velocity mapping is a set of images, each representing the spatial distribution of spins at a given velocity. To acquire data in a short time, the number of encoding gradient steps must be as small as possible, but this can mean sacrificing velocity resolution. We used interpolation methods to obtain high velocity resolution with a small number of encoding steps involving linear interpolation from 16 encoding steps or more and zero-filling interpolation from two to eight encoding steps. Velocity measured by interpolated Fourier-flow encoding agreed well with values obtained using a calibrated phantom. A simulation of noise on the images of the phantom showed that, for a given acquisition time, increasing number of encoding steps in the Fourier flow encoding gave better precision for velocity measurement than did averaging identical signals in phase-mapping methods.

Algorithms↗