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Biomedical subjects

G Zeitoun

Publications and source records attributed to G Zeitoun.

27 records · Page 2Linked to original sources

Preoperative assessment of resectability of hepatic metastases from colonic carcinoma: CT portography vs sonography and dynamic CT.

OBJECTIVE: A retrospective study was performed to determine the influence of CT portography vs sonography and dynamic CT on the preoperative assessment of the resectability of hepatic metastases from colorectal cancer. MATERIALS AND METHODS: Results of sonography, bolus dynamic CT, and CT portography in 28 patients who underwent surgical exploration (resection or intraarterial catheter placement) for hepatic metastases from colorectal cancer were retrospectively reviewed by two abdominal radiologists and one hepatic surgeon. For each patient, the resectability and surgical approach were decided on the basis of the results of combined sonography-bolus dynamic CT and compared with the decision made from the CT portographic results alone. The final approach suggested was compared retrospectively with the surgical procedure actually performed. RESULTS: Sixty-nine metastases were identified at surgery and pathologically proved. Combined sonography-bolus dynamic CT and CT portography showed 52 (75%) and 64 (93%) metastases, respectively. Twelve metastases in five patients were seen only with CT portography. In four patients, CT portography depicted additional metastases, which changed the surgical approach that had been chosen on the basis of results of sonography and bolus dynamic CT. In one patient, CT portography showed four additional metastases, precluding hepatic resection. CONCLUSION: Findings from CT portography provide vital data unattainable with sonography and bolus dynamic CT that improve the preoperative assessment of the resectability of liver metastases from colonic carcinoma.

Colorectal Neoplasms↗

[Surgical treatment of portal hypertension].

The surgical treatment, by means of shunts or disconnections, of ruptured oesophageal varices in portal hypertension is always indicated but not always on the forefront. However, it remains the first-line treatment in segmental portal hypertension and in Budd-Chiari syndrome. It is on a par with the non-surgical treatments in case of prehepatic block but ranks second in case of pre- and intrasinusoid blocks. In all the hepatic diseases with threatening hepatocellular deficiency, liver transplantation is the most spectacular of current and future achievements.

Ascitic Fluid↗

[Portal cavernoma].

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Esophageal and Gastric Varices↗

Effects of B16 melanoma transplantation on the respiration of grouped C57Bl female mice.

Two batches of 110 females C57Bl mice were grafted with B 16 melanoma, the first batch at the age of 67 days, the second at 82 days. The animals were divided into groups of 10, and kept under a LD 12 : 12 regimen. The growth of the tumors was more rapid in the second batch. This was accompanied in this batch, by a decrease in body growth, a diminution of heart rate and an increase in QRSII amplitude. Significant decreases in carbon dioxide emission (VCO2) level, mostly during the dark period of time, when the mice had their greatest activity, and decrease in respiratory photic variations at light transitions were obtained when the tumors were well developed. Harmonic analysis of the continuous recording of carbon dioxide shows slight changes in VCO2 ultradian (40 minutes less than tau less than 12 hours) rhythms. The effects on respiration were confirmed by different survival rates and rectal temperatures between tumor grafted and controls submitted to an acute nitrogen normobaric hypoxia.

Animals↗

MRI of Budd-Chiari syndrome.

A retrospective study was undertaken to reassess the various magnetic resonance imaging (MRI) features of Budd-Chiari syndrome (BCS). MRI examinations of 22 patients with pathologically confirmed BCS were studied. Spin-echo (SE) T1- (TR = 300-450 ms/TE = 12-15 ms), and SE T2-weighted (TR = 1600-2000 ms/TE = 30-60/90-120 ms) MRI images were obtained in all patients. Gradient-recalled-echo (GRE) images (TR = 7-60 ms/TE = 3-19 ms, flip angle = 10-40 degrees) were obtained in 14 patients. MRI showed thrombosis of three or two hepatic veins in 19 (86%) and 3 (14%) patients, respectively. Spontaneous intrahepatic anastomoses was depicted in five (23%) patients. Ascites appeared in 15 patients (68%). Thrombosis or external compression of the inferior vena cava (IVC) by an enlarged caudate lobe was depicted in six (27%) and five (23%) patients, respectively. Prominent azygos and hemiazygos veins were demonstrated in seven (32%) patients (six of whom had thrombosis of the IVC). MRI showed hepatomegaly in all patients and enlarged caudate lobe in 18 (82%) patients. SE T1- and SE T2-weighted MRI images revealed inhomogeneous signal intensity of hepatic parenchyma in 14 (64%) patients. SE T1- and SE T2-weighted MRI images showed homogeneous signal intensity of hepatic parenchyma in eight (36%) patients. Our results demonstrate that BCS displays various features on MRI images, and such information is important for diagnosis.

Adult↗

MRI of liver metastases from colorectal cancer vs. CT during arterial portography.

A prospective study was performed to compare, with a lesion-by-lesion analysis, the sensitivities of high field strength MRI and CT during arterial portography (CTAP) in detecting hepatic metastases from colorectal cancer. Twenty-one patients with liver metastases from colorectal cancer were prospectively investigated by high field strength MRI (1.5 or 2 T) and CTAP. High field strength MRI was performed with pre and post gadopentetate dimeglumine enhanced T1-weighted SE sequences and T2-weighted SE sequences. All patients underwent partial hepatectomy and 37 metastases were surgically and pathologically proved. The metastasis detection rate (sensitivity) was 94% (35 of 37) for CTAP and 78% (29 of 37) for high field strength MRI. The 16% (95% confidence interval: 1-31%) difference in sensitivity between CTAP and high field strength MRI was statistically significant (p < 0.05, McNemar test). The use of gadopentetate dimeglumine did not improve the sensitivity of T1-weighted SE sequences. Since our study demonstrated significant difference in sensitivities between high field strength MRI and CTAP in our group of patients, we can conclude that high field strength MRI cannot replace CTAP in the preoperative evaluation of patients with liver metastases from colorectal cancer. Computed tomography during arterial portography must be considered as the preoperative gold standard.

Colonic Neoplasms↗