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Biomedical subjects

F Diard

Publications and source records attributed to F Diard.

At least 19 recordsLinked to original sources
PubMed1999

Localised proton magnetic resonance spectroscopy of the brain after perinatal hypoxia: a preliminary report.

OBJECTIVES: Perinatal hypoxic ischaemic injury is a significant cause of neurodevelopmental impairment. The aim of this study was to evaluate localised proton magnetic resonance spectroscopy (1H-MRS) after birth asphyxia. MATERIALS AND METHODS: Thirty newborn infants suspected of having perinatal asphyxia (Apgar score < 3) were studied. The mean gestational age was 37 weeks, mean age at the MR examination was 18 days and mean weight was 2.9 kg. A 1.5-T unit was used for imaging and spectroscopy. None of the babies had mechanically assisted ventilation. No sedation was used. Axial T1-weighted and T2-weighted images were obtained. 1H-MRS was recorded in a single voxel, localised in white matter, using a STEAM sequence. RESULTS: Image quality was good in 25 of 30 babies. 1H-MRS was performed in 19 of 30 subjects, with adequate quality in 16. Choline, creatine/phosphocreatine and N-acetylaspartate peaks and peak-area ratios were analysed. Lactate was detected in four infants. The N-acetylaspartate/choline ratio was lower in infants with an impaired neurological outcome, but the difference was not statistically significant. CONCLUSIONS: This study suggests that 1H-MRS may be useful for assessing cerebral metabolism in the neonate. A raised lactate level and decreased N-acetylaspartate/choline ratio may be predictive of a poor outcome. However, in our experience this method is limited by the difficulty in performing the examination during the first hours after birth in critically ill babies, the problems related to use of a monovoxel sequence, the dispersion of the ratios and the lack of determination of the absolute concentration of the metabolites.

Aspartic Acid↗
PubMed1999

Abdominal ultrasound findings in children with hemophagocytic lymphohistiocytosis.

Hemophagocytic lymphohistiocytosis, a variant of histiocytosis, is characterized by an uncontrolled activation of the cellular immune system, including hepatic mononuclear phagocytic cells. Abdominal ultrasound findings in children are evaluated in this disease. We present six pediatric cases, two with familial and four with sporadic hemophagocytic lymphohistiocytosis, examined by abdominal sonography. Three signs were frequently observed: thickening of the gallbladder wall (all cases), increased periportal echogenicity (four cases), and enlarged lymph nodes in the porta hepatis (four cases). Hepatomegaly, splenomegaly, and ascitic fluid may also be found. These imaging findings are not specific and may be seen in viral hepatitis. However, once hepatitis is excluded, they may suggest the diagnosis of hemophagocytic lymphohistiocytosis in a critically ill child. A bone smear must be done to establish the diagnosis.

Abdomen↗
PubMed1999

Anterolateral compartment of the ankle in the lateral impingement syndrome: appearance on CT arthrography.

OBJECTIVE: This article describes the appearance of the anterolateral recess of the posttraumatic ankle on CT arthrography and clearly shows the benefit of this technique in the diagnosis of soft-tissue impingement. MATERIALS AND METHODS: The study was carried out on 44 patients examined by CT arthrography and arthroscopy for chronic, posttraumatic ankle pain. The analysis principally concerned the lateral compartment--in particular, the synovial regularity and the cartilage of the talar dome. RESULTS: Four CT patterns were identified: type 0, uniform filling of the recess with clear limits; type I, intraarticular linear structure outlined by contrast agent; type II, nodular formation in the lateral groove; and type III, irregular appearance of the edges of the lateral groove. Ninety-one percent (10/11) of type II patterns were characterized as meniscoid lesions by arthroscopic examination, 100% (14/14) of type III patterns corresponded to an abundant fibrous reaction, and arthroscopic findings were normal for 100% (2/2) of type 0 patterns and 88% (15/17) of type I patterns. The latter was thus considered as a normal variant outlining the accessory anterior inferior tibiofibular ligament. Type II and III lesions were statistically associated (p = .001) with a chondropathy when time from initial trauma was greater than 22 months. CONCLUSION: CT arthrography provides evidence of anterolateral soft-tissue impingement--in particular, in type II or III patterns. These lesions are statistically associated with a chondropathy.

Adult↗
PubMed1999

Brain stem infiltration by mixed Langerhans cell histiocytosis and Chester-Erdheim disease: more than just an isolated case?

Langerhans cell histiocytosis is classically considered as totally different from Chester-Erdheim's disease which consists in the infiltration of various parenchymas by macrophagic CD68-positive histiocytes. We report the case of a 46-year-old woman with a long history of diabetes insipidus who presented typical lesions of Langerhans cell histiocytosis on vulvar and skin biopsies as well as bony cellular infiltrates characteristic of Chester-Erdheim's disease. A few months later she presented cerebellar disorders and died after an 18-month course. At autopsy the pons was enlarged, due to numerous cellular infiltrates which were also scattered in the middle cerebellar pedoncles, dentate nuclei, midbrain and hypothalamus. There were S100-protein positive Langerhans cells intermingled with numerous ovoid CD68-positive histiocytes. There are a few reported cases of Chester-Erdheim's disease presenting foci of Langerhans cells histiocytosis in other parenchymas. In addition, there are 10 reported cases with diabetes insipidus and bilateral infiltration of the brain stem and cerebellum, considered as presenting either one type of histiocytosis or the other. Our case demonstrates that both histiocytoses may coexist in the brain and thus correspond in fact to the same pathology in certain particular cases.

Biopsy↗
PubMed1998

Breast metastases in adolescent girls: US findings.

We report five adolescent girls with secondary breast tumours. All were imaged by US and the imaging findings have been analysed. Four girls had rhabdomyosarcoma as the primary malignant disease and one had leukaemia. US features were variable, but most of the cases showed heterogeneous nodules which were quite different from the usual benign lesions (fibroadenoma, abscess, cyst) encountered at this age. The metastases produced a variety of echo characteristics: masses with well-defined margins, hyperechoic foci and sonolucent or hypoechoic nodules with posterior attenuation or lacking posterior enhancement. One lesion was round and heterogeneous with a hyperechoic centre. These US findings in an adolescent girl suggest the need for fine-needle aspiration. Mammograms, when performed, never revealed microcalcifications and were quite difficult to analyse at this age, due to the dense glandular breast tissue.

Adolescent↗
PubMed1998

Granulomatous hepatitis in pasteurella multocida infection.

Numerous diseases can lead to multilocular lesions of the liver. The authors report a rare pediatric case of hepatic granulomas due to Pasteurella multocida: a 7-year-old girl with chronic fever was investigated by sonography and CT scan, demonstrating mesenteric lymph node enlargement and numerous small hepatic lesions. After surgical biopsy, histopathology of the liver specimens showed pyogenic granuloma, with serologic testing positive for Pasteurella multocida. Treatment with a tetracycline and corticosteroids was successful. Pasteurella multocida infection, despite its habitual benign course, should be suspected among differential diagnoses of lymphogranulomatous affections with hepatic involvement. No case of liver and lymph node foci in a child has been previously described.

Anti-Bacterial Agents↗
PubMed1998

[Diagnostic prenatal ultrasonography of malformations of the fetal anterior abdominal wall].

Abdominal wall defects include a broad spectrum of structural malformations with variable severity and prognosis. The purpose of prenatal ultrasound examination is to correctly diagnose and classify these malformations according to their localization (particularly their relation to the umbilical cord insertion), their contents, their size and associated malformations or karyotypic abnormalities. Based on this examination, two groups can be distinguished: gastroschisis or omphalocele (when the latter is isolated, in particular without karyotypic abnormalities) which can be surgically corrected at birth, and for which predictive criteria of outcome must be evaluated (vitality of herniated bowel, size and contents of omphalocele); severe malformations (ectopia cordis, cloacal exstrophy, Beckwith-Wiedemann syndrome, short umbilical cord, amniotic band syndrome) for which pregnancy termination could be proposed.

Abdominal Muscles↗
PubMed1997

Cranial aneurysmal bone cysts presenting with raised intracranial pressure: report of two cases.

Aneurysmal bone cysts in the skull vault are reported in two patients 7 and 9 years old, who presented with vomiting and headaches caused by raised intracranial pressure. CT showed the cystic lesion in the diploë, with predominantly inward expansion. Fluid-fluid levels were seen on both CT and MRI; the latter also showed bleeding within the cyst. MR angiography showed compression of the superior sagittal sinus in the second case.

Bone Cysts, Aneurysmal↗
PubMed1996

[Acute torsion of an accessory spleen].

A case of acute torsion of an accessory spleen is reported. In a 15-year-old girl was admitted to hospital with acute abdominal pain. Ultrasonography showed a round, hypoechoic, solid mass. Computed tomography demonstrated a low-density mass with peripheral enhancement after intravenous contrast medium. These findings suggest the presence of a capsule. At laparotomy, the patient was found to have torsion and infarction of an accessory spleen. Sonographic and computed tomographic findings are discussed.

Acute Disease↗
PubMed1996

[Imaging of Erdheim-Chester disease].

Erdheim-Chester disease is a form of Histiocytosis which involves the adults and is distinct from Histiocytosis X. It is characterized by a constant diaphyseal and metaphyseal bone involvement predominating in the lower links. The diagnosis can readily be envisaged when the typical radiological findings are present. Bone involvement may be isolated and well tolerated, or can be associated with systemic involvement and a severe prognosis. We describe three cases of women aged 46, 50 and 73 years. One patient presented with isolated bone lesions, while the two others had a multiorgan localization. From the three cases and from an extensive review of the literature, we describe the spectrum of bone and visceral lesions that can be seen by imaging. The emphasis is put on lesions of the skeletal system, the retroperitoneum, the nervous system, and the pericardium. Furthermore, the relationships between Erdheim-Chester disease and Histiocytosis X are discussed.

Aged↗
PubMed1995

Infantile myofibromatosis.

An unusual case of infantile myofibromatosis with foci of calcifications was presented, with atypical age of onset and location. The radiological features of this tumor are not always evocative, and histological examination is necessary for diagnosis.

Actins↗
PubMed1994

[Agyria-pachygyria and pachygyria in children. Contribution of imaging].

BACKGROUND: Lissencephaly (agyria-pachygyria) is a defect in migration of cerebral neurons resulting in failure of cortical gyri to develop. Progress in imaging techniques improves its diagnosis. POPULATION AND METHODS: The files of 17 patients (ten boys and seven girls), aged 7 months to 16 years, were retrospectively studied. The clinical picture consisted of mental retardation (17 patients), seizures (eight patients), facial dysmorphia (seven patients), axial hypotonia (four patients). CT scan was performed in 16 cases and MRI with T1 and T2 weighted images in all 17. RESULTS: The CT scan identified pachygyria in 12 cases. Cerebral calcifications were seen in four cases. MRI detected typical changes in all 17 cases: thickened cortex and gyri, loss of cortical white matter interdigitations, lack of operculisation of the sylvian fissure. Pachygyria was generalized (six patients) or localized (11 patients). Associated abnormalities were dysgenesis of corpus callosum in three patients, cerebellar hypoplasia in one, deep grey matter heterotopia in one; hypersignal of the white matter was identified on T2 weighted images in five patients. CONCLUSION: MR imaging permits precise analysis of abnormalities secondary to a defect in neuronal migration.

Adolescent↗
PubMed1993

[Imaging of scoliosis].

The majority of scoliosis (80%) and especially the idiopathic scoliosis are simply investigated by plain films of the entire spine with erect frontal and lateral views, and supine frontal view at the initial examination. Repeated erect frontal views are sufficient for the follow-up. The important radiation dose (average of 1.2 mG for the frontal view and 2.2 mG for the lateral views) imposes to reduce the frequency of these radiographs. This radiological study allows: to separate non structural and structural curves; the identification and the measurement of a structural curve, discussion for its etiology, appraisal of its progressiveness, discussion of the operative or non operative treatment, and radiological follow-up. Modern imaging (C.T, C.T myelography, MRI) is indicated only in very particular cases: idiopathic scoliosis with neurological symptoms, congenital scoliosis with structural vertebral abnormalities, especially these with posterior arch abnormalities, and progressive scoliosis in spinal dysplasiae. Painful scoliosis are unusual. If pain is present consideration should be given for diagnosis of an underlying lesion. In this case a relevant strategy using modern imaging becomes useful and will be discussed.

Humans↗
PubMed1992

[Ectasia of the umbilical recess during the antenatal period. 3 case reports].

Having found three cases of ectasia of the umbilical recess in the antenatal period we decided to review the embryology and the ultrasound of the anatomy of the portal system. We consider that this is a normal anatomic variant of the portal system because the lesion is asymptomatic and regresses spontaneously.

Congenital Abnormalities↗