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J Giron

Publications and source records attributed to J Giron.

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

Kinematic MR imaging of the shoulder: normal patterns.

OBJECTIVE: We performed this study to define the normal patterns of the glenohumeral joint with kinematic MR imaging in healthy volunteers. SUBJECTS AND METHODS: Twenty healthy volunteers (39 shoulders) were studied with a 1.5-T imager. Successive fast low-angle shot images (75/11 [TR/TE], 15 degrees flip angle) were obtained in the axial plane from full internal to full external rotation at the superior, middle, and inferior glenoid levels. RESULTS: The free margin of the anterior labrum was seen to be slightly mobile and its base was always fixed. The anterior labrum showed changes in shape and signal intensity during internal rotation (54%). The posterior labrum remained motionless in 97% of patients and no shape or signal-intensity changes were noted during internal rotation. The anterior joint capsule was taut during external and internal rotation, exhibited a slack pattern in 51% of patients, and a folded pattern in 14% of patients. CONCLUSION: Kinematic MR imaging, which permits dynamic evaluation of the various anatomic components that may be involved in shoulder instability, also provides information on the labrocapsular ligamentous complex.

Adult↗
PubMed1996

[Cine-MRI of the shoulder. Normal aspects].

PURPOSE: To define the normal patterns of gleno-humeral joint, with kinematic MR imaging in asymptomatic volunteers. MATERIAL AND METHOD: Twenty asymptomatic volunteers (39 shoulders) were studied with a 1.5 Tesla imager. Successive acquisitions Flash (99, 18, 15 degrees) were obtained in the axial plane, from full internal to full external rotation, at the superior, mid and inferior glenoid level. RESULTS: Free edge of the anterior labrum was noted slightly mobile, its base was always immobile. The anterior labrum exhibited modification of shape and increased signal intensity in internal rotation (54%). The posterior labrum remained motionless in 97% and neither shape or signal intensity changes were noted in internal rotation. Inferior labro-capsular ligamentous complex was visualised in all cases. The anterior capsular joint was taut in external rotation and exhibited a slack (51%) or folded (13.5%) pattern during internal rotation. CONCLUSION: Kinematic MR imaging allows a dynamic assessment of the different anatomic components which may be implicated in shoulder instability. It provides information about the labro-capsular ligamentous complex.

Adult↗
PubMed1996

[Ischemic cerebrovascular complications in Rendu-Osler disease: a case].

Rendu-Osler disease is a familial disorder transmitted as an autosomal dominant trait of high penetrance. It is characterized by telengiectasias of the skin, mucous membranes and viscera, associated with recurrent bleedings. Neurological complications (brain abcesses and hemorrhagic manifestations) occur in 10% of the patients. Neurological symptoms are often associated with arteriovenous fistula of the lung (50%). Ischaemic strokes occuring in such patients with an hemorrhagic disease while unfrequent, have been described. The pathophysiology of stroke in that case remains unclear. Polycythemia causing hyperviscosity, air embolism following hemoptysis, paradoxical embolism through right-to-left shunt have been proposed. We report a new case of ischaemic strokes occuring in a caucasian forty-year-old woman, with Rendu-Osler disease (familial history, epistaxis, telengiectasias) and with an arteriovenous malformation of the right lung. She presented two strokes and one transient ischaemic attack. Her pulmonary malformation was occluded by embolization. The role of arteriovenous malformation in the pathophysiology of strokes is discussed.

Adult↗
PubMed1996

[X-ray computed tomographic and radiographic aspects of thoracic actinomycosis].

UNLABELLED: The aim of this study was to evaluate chest radiographs and computed tomography (CT) in patients with thoracic actinomycosis. MATERIAL AND METHOD: Chest radiographs and CT scans of 9 patients with proved thoracic actinomycosis were reviewed. CT scans were performed after intravenous contrast administration. RESULTS: Airspace consolidation was present in the upper lobes in 6 patients and in the lower lobes in 3. Cavitations not apparent on the radiographs were seen on CT s in 2 cases. Mediastinal lymphadenopathies were seen on CT s in 2 cases, in one the infection extended through the mediastinal pleura into the mediastinum. Pleural thickening adjacent to the airspace consolidation was identified in 6 cases. Chest wall invasion occurred in 4 cases with a wavy periostal reaction involving ribs adjacent to the site of parenchymal involvement in 3 cases. Extension into the abdomen through the diaphragm was seen in one case. DISCUSSION: In humans, actinomycosis involves the thorax in 15% of the cases. Thoracic and pulmonary parenchymal involvement is usually secondary to aspiration of colonized material from the oropharynx in patients with poor oral hygiene. There is a basilar predominance of the disease, but some studies have reported apical predominance. The pulmonary infection leads to an airspace consolidation mainly in the lung periphery. The infection may extend across fissures and through the pleura. Chest wall and bone invasion are not uncommon. A wavy periosteal reaction involving ribs is said to be highly suggestive of pulmonary actinomycosis. CONCLUSION: Thoracic actinomycosis is characterized by airspace consolidation with adjacent pleural thickening. Chest wall invasion with a wavy periosteal reaction is highly suggestive.

Actinomycosis↗
PubMed1996

[Nocardia respiratory infection in patients with chronic obstructive lung disease].

Pulmonary nocardiosis is a respiratory infection which is usually described in the immunocompromised. We report three cases in patients suffering from chronic airflow obstruction. In two cases there was a parenchymal disorder and in one case bronchial suppuration without involvement of the alveolar region. The diagnosis was made in all cases by bacteriological examination from specimens obtained at fiberoptic bronchoscopy. The outcome was favourable in all three cases after appropriate treatment. These observations underline the diversity of the clinical forms of respiratory nocardiosis. Furthermore, it demonstrates their possible occurrence in non-immunocompromised patients and the need to look for this germ specifically in long drawn infections. A bacteriological diagnosis is vital to start early and appropriate antibiotic therapy which should be prolonged because of the risk of recurrence and disseminated infection.

Aged↗
PubMed1996

[Unusual spinal and pulmonary metastases].

We present the clinical and imaging findings of a 72 year old man with lytic dorsal bone lesions and a pulmonary spread of nodules (miliary) that were mistakenly attributed to a cancerous disease.

Aged↗
PubMed1996

[Diagnostic percutaneous thoracic punctures. Assessment through a critical study of a compliation of 2406 cases].

The aim of this retrospective study of 2,406 diagnostic percutaneous thoracic needle aspirations under computer tomographic control was to assess the diagnostic value of this method, the technical problems and the complications and finally, to refine the indications. Percutaneous needle aspiration had been carried out after negative fibreoptic bronchoscopy. The authors review their technique and show the value of biopsy material which is only slightly traumatised. Computerised tomography and fine needle aspiration reduce the risk of pneumothorax and haemorrhage in a significant fashion. Personalized collaboration between the radiologist, physician and cytologist is a vital pre-requisite. The indications are discussed notably in cases of solitary pulmonary nodules and of mediastinal masses.

Adolescent↗
PubMed1995

Radiologic findings in two AIDS patients with Rhodococcus equi pneumonia.

Rhodococcus equi (R. equi) has been reported as an occasional cause of pulmonary infection in severely immunocompromised hosts, including AIDS patients. Our purpose is to describe the radiologic findings in two AIDS patients with R. equi pneumonia. Chest radiographs showed right-upper-lobe consolidation and cavitation in both patients. Chest CT confirmed upper mediastinal involvement and precarinal lymphadenopathy in both cases. Multiple lung nodules related to the bronchi were also identified in one patient. In an AIDS patient from a rural area or with exposure to horses, the possibility of R. equi infection should be considered when cavitary pneumonia is present, even if there is mediastinal involvement and/or lymphadenopathy, or if multiple lung nodules are also present.

AIDS-Related Opportunistic Infections↗
PubMed1995

[Pulmonary embolism: contribution of spiral x-ray computed tomography].

PURPOSE: Spiral computed tomography was compared retrospectively with digital subtraction pulmonary angiography (PA) in 45 patients suspected of having acute or chronic pulmonary embolism. MATERIALS AND METHODS: 45 patients in whom the presence of acute or chronic pulmonary embolism was suspected underwent examination by spiral CT and PA. Diagnosis of pulmonary embolism was based on the direct visualization of intraluminal clots. The study of the agreement between the two methods was based on the Kappa test. In 35 cases, pulmonary emboli were proved. Acute pulmonary emboli were present in 28 cases and chronic in 7 cases. RESULTS: Spiral computed tomography represents an excellent way to detect acute pulmonary embolism. In the chronic form, spiral CT is better than PA to detect intraluminal clots. However, Spiral CT can fail to detect small embole in the peripheral arterial bed. In the 10 patients without pulmonary embolism, the spiral CT proved diagnosis pulmonary oedema (n = 3), lymphangitic carcinoma (n = 4), pleural effusion (n = 3). CONCLUSION: This study suggest that the spiral CT examination is accurate for diagnosis of pulmonary embolism specifically in case of suspected important embolism. The advantages of spiral CT are multiple (non invasive, wide diagnosis spectrum). However, may be a limitation to is use is insufficient distal thrombi detection. This eventuality (5 to 10% in the Pioped study) justify the practice of pulmonary angiography. Spiral CT improvements should reduce this insufficiency in the next future.

Acute Disease↗
PubMed1995

[The double band sign: pleural tuberculosis in x-ray computed tomography].

We described on computed tomography, two cases of pleural tuberculosis with parietal pleural enhancement and thickening associated with another external high density line. We called this parietal pleural and extra pleural change, the "double band sign". After study of the regional anatomy, we think that this external line is the endothoracic fascia.

Humans↗
PubMed1995

[Multiple bronchial artery aneurysms in a patient with silicosis].

We report a case of haemoptysis in a long-standing silicotic in whom arteriography revealed saccular aneurysms of the bronchial arteries. Embolisation was satisfactory in excluding the aneurysms and leading to a favourable outcome. The mechanism of the formation of these aneurysms which is extremely rare was discussed with reference to the few reports and literature.

Aged↗
PubMed1995

[The use of high resolution x-ray computed tomography in the diagnosis of hypersensitivity pneumopathy to gold salts. Apropos of a case].

A hypersensitivity pneumonia is rare during gold therapy. The underlying mechanism is immunological in origin, of Gell and Coombs Type IV. As there are numerous possible pulmonary disorders during the course of inflammatory rheumatism treated with gold, the early detection is vital, in order to prevent progress to fibrosis. In parallel with broncho-alveolar lavage to look for a T8 lymphocytic alveolitis, which is very suggestive, high resolution computed tomography has a place in the early diagnosis, to characterise the lesions, to aid in an aetiological diagnosis, and also to assess progress on treatment. The authors present a case of pneumonitis induced by gold with visible interstitial lesions on computed tomography, accompanied by significant bronchial distortion and bronchiectasis suggestive of fixed lesions. These lesions partially regressed following steroid therapy; the diagnostic and prognostic role for high resolution computer tomography was discussed.

Alveolitis, Extrinsic Allergic↗
PubMed1995

[Palliative percutaneous treatment under x-ray computed tomographic control of inoperable pulmonary aspergilloma. Apropos of 30 cases].

The authors report 30 cases of the percutaneous treatment of symptomatic pulmonary aspergilloma by injection of amphotericine paste in patients who were not considered to be operable. The treated aspergillomas had developed as a sequel to bacilliary infection and pulmonary fibrosis. Surgery was contraindicated in these patients on account of severe respiratory failure. The authors specify the technique for the preparation of the paste and for the type of percutaneous injection, the aim being to obtain complete filling of the cavity and creating an anaerobic environment for the aspergillus. The contribution of this technique for the non-surgical treatment of patients appears interesting but should be carried on a larger series to identify the exact indications and the interaction with other new treatments which have just appeared.

Aged↗
PubMed1994

Osteoid osteoma: MR imaging versus CT.

PURPOSE: To compare the performance of computed tomography (CT) and magnetic resonance (MR) imaging in diagnosis of osteoid osteoma. MATERIALS AND METHODS: Nineteen patients with histologically proved osteoid osteoma underwent CT and MR imaging before excision of the lesion. CT and MR images were compared regarding lesion conspicuity and detection of marrow, soft-tissue, and/or synovial changes adjacent to the primary lesion. RESULTS: CT was more accurate than MR imaging in detection of the osteoid osteoma nidus in 63% of cases. MR imaging was better than CT in showing intramedullary and soft-tissue changes in all cases. This may produce a misleading aggressive appearance on MR images. There was a statistically significant correlation between presence or absence of marrow or soft-tissue changes and treatment with antiinflammatory medications (P < .05). CONCLUSION: CT remains the best imaging modality for diagnosis of osteoid osteoma. MR images should not be interpreted without reference to plain radiographs and CT scans if serious errors in diagnosis are to be avoided.

Adolescent↗