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Biomedical subjects

J N Bruneton

Publications and source records attributed to J N Bruneton.

At least 37 records · Page 2Linked to original sources
PubMed1996

Primary tumour staging of gastric and colorectal cancer.

Almost 15 years after its introduction, endosonography or endoscopic ultrasonography is an important technique in a wide range of gastrointestinal diseases. Other imaging techniques are CT, MRI and barium examination. There is a general consensus that the most important prognostic factor in gastric and colorectal carcinoma is the presence or absence of lymph node invasion, but malignant fixation of tumour through direct invasion of adjacent tissues also appears to be very important. Non-invasive preoperative assessment of tumour stage based on one or a combination of the above imaging modalities should allow appropriate treatment to be planned in each case.

Barium Sulfate↗
PubMed1996

Benign fibrous mesothelioma of the pleura: MR study and pathologic correlation.

Benign fibrous mesothelioma of the pleura is a rare tumor of mesodermal origin. We describe the MR findings in three pathologically proven cases. All three tumors were imaged by MR as well-circumscribed lesions with smooth margins in contact with the pleura, but without chest wall invasion. Their low signal intensity on T1- and T2-weighted sequences reflect their fibrous nature. In one case a pedicle connecting the tumor to the chest wall was visualized on a sagittal MR scan. In two cases gadolinium-enhanced T1-weighted gradient echo sequences revealed intense contrast uptake by the tumor correlated with the intratumoral hypervascularization noted by histologic examination. Although the number of cases presented is small, MR seems to be the most accurate imaging modality in the assessment of the diagnosis.

Aged↗
PubMed1996

Sonographic diagnosis of solitary solid liver nodules in cancer patients.

The purpose of this study was to analyse the sonographic patterns of solitary solid liver lesions in cancer patients and to evaluate the diagnostic accuracy of ultrasound alone and in combination with other techniques (liver function tests, histology). A total of 422 solitary solid liver lesions (SSLL) were diagnosed by ultrasound in cancer patients; 197 lesions were benign and 225 malignant. The predominant aetiology for hypoechoic SSLL (128 cases) was metastasis (112 cases), whereas most hyperechoic SSLL (265 cases) were haemangiomas (155 cases) rather than a metastasis (86 cases). The 29 isoechoic SSLL included 27 metastases and 2 benign lesions. A halo was found to be highly predictive of malignancy (97%-100%). The positive predictive value for malignancy of an SSLL was very high when the results of liver function tests were abnormal (97%-100%). In our experience, histological proof is unnecessary in the majority of liver lesions in cancer patients.

Alkaline Phosphatase↗
PubMed1996

Indications for hepatic ultrasonography in breast cancer staging and follow-up.

Retrospective analysis of the medical records of 6649 breast cancer patients seen over an 11-year period found 438 patients (6.6%) with liver metastases (LM) and 432 patients (6.5%) with benign liver lesions (BLL). Liver ultrasonography (LUS) and liver function tests had been performed for all patients. LM were the first manifestation of metastatic spread in 20.1% of the 438 patients; median survival was related to the presence (6.7 mo.) or absence (12.2 mo.) of extrahepatic metastases (EHM). Liver function tests were normal in 20.5% of the patients in whom LM were first diagnosed by LUS. Most LM were hypoechoic (70.9%) BLL corresponded to cysts, hemangiomas, calcifications, and focal fatty infiltration. LUS appears indicated for (i) pretherapy disease staging, and in particular for detection of BLL, and (ii) follow-up of patients without EHM for early diagnosis of LM.

Breast Neoplasms↗
PubMed1996

Tolerability and utility of mangafodipir trisodium injection (MnDPDP) at the dose of 5 mumol/kg body weight in detecting focal liver tumors: results of a phase III trial using an infusion technique.

PURPOSE: To evaluate the tolerability of mangafodipir trisodium (MnDPDP) and its utility for enhancing the ability of magnetic resonance (MR) imaging to detect focal hepatic lesions compared with non-enhanced MR and contrast-enhanced computed tomography (CT). MATERIALS AND METHODS: 119 patients with focal hepatic lesions were examined by MR and by contrast-enhanced CT. MR was performed before and after the infusion of 5 mumol/kg MnDPDP, at a concentration of 10 mumol/ml. Histologic confirmation was obtained in 79 patients. RESULTS: There were no severe adverse events. Five patients reported mild adverse events related to the infusion. MnDPDP-enhanced SE T1 and GE T1 sequences revealed more focal lesions than the same sequences before contrast infusion in, respectively 22.6 and 36.1% of the cases, and fewer focal lesions in, respectively 5.9 and 1.7% of the cases. Contrast-enhanced MR demonstrated more focal lesions than the SE T2 sequence in 29.4% of cases and fewer lesions in 5.9% of cases. MnDPDP-enhanced MR revealed more nodules than CT in 31.1% of cases and fewer nodules in 13.4% of cases. The additional information provided by MnDPDP enhancement led to modification of management for 12 patients (10.1%). CONCLUSION: MnDPDP is a well-tolerated contrast agent allowing better MR detection of focal hepatic lesions than non-enhanced MR or contrast-enhanced CT.

Carcinoma, Hepatocellular↗
PubMed1996

[Ultrasonography of the parotid venous plane].

The venous plane of the parotid gland is a good marker of the intraparotid facial nerve that no imaging method can display precisely. In our study, we performed conventional B-mode imaging, color Doppler and power Doppler to detect the venous plane of the parotid. Some healthy patients (one hundred forty-two) without head or neck disease were examined with color Doppler and Power Doppler sonography using a 10 Mhz transducer. Sonography detected the venous plane of the parotid gland in more than two thirds of the examined patients whatever the sonographic method we used. Color Doppler and Power Doppler actually increased the sensitivity and quality of the examination.

Female↗
PubMed1995

CT of small-bowel neoplasms.

The diagnosis of neoplasms of the small intestine remains a difficult challenge owing to their nonspecific clinical presentation. CT is an efficient and contributive tool in their diagnosis and preoperative staging. Enabled by CT, the evaluation of the intramural and extramural portions of such tumors complements the mucosal analysis allowed by barium examination. Strict technical rules should be applied to minimize pitfalls mainly resulting from insufficient bowel opacification. Although characteristic appearances are rare, typical CT findings may suggest a specific diagnosis where lipomas and carcinoid tumors are concerned.

Adenocarcinoma↗
PubMed1995

[Comparative studies of the tolerability of gadodiamide, dimeglumine gadopentetate and meglumine gadoterate in MRI tests of the central nervous system].

The development of new non-ionic magnetic resonance (MR) contrast media as gadodiamide injection increased the choice of paramagnetic contrast agents available in MR of the central nervous system (CNS). The purpose of our paper was to compare at the dose of 0.1 mmol/kg b.w. the safety of gadodiamide (Gd-DTPA-BMA) to gadopentetate dimeglumine (Gd-DTPA) and to gadoterate meglumine (Gd-DOTA) in two multicentric double-blind studies. A total of 551 patients were enrolled with 143 patients in the Gd-DTPA group, 132 patients in the Gd-DOTA group and 276 patients in the Gd-DTPA-BMA group. Safety was assessed by recording the adverse events up to 24 hours after the injection. One or more adverse events were recorded in 14% of the Gd-DTPA patients, in 15.1% of the Gd-DOTA patients and in 11.6% of the Gd-DTPA-BMA patients. These reactions were related to the contrast media in 9.1%, 13.6% and 8.7% of the cases respectively. Their intensity was defined as mild in 8.4% of the patients in the Gd-DTPA group, in 13.6% of the patients in the Gd-DOTA group and in 8.3% of the patients in the Gd-DTPA-BMA group. No severe reaction or death were recorded. An injection-site reaction (heat, coldness, pain) has been observed in 43% of the cases although an adverse event other than local reactions (headache, dizziness, nausea) has been noticed in 57% of the cases. No significant statistical difference was observed between the groups. Gadodiamide is a safe and effective contrast agent in MRI of the CNS in comparison with Gd-DTPA and Gd-DOTA currently in routine use.

Adult↗
PubMed1995

[Compression of the subscapular nerve in the spino-glenoid tract by a synovial cyst].

We observed a case of synovial cyst in the shoulder joint leading to spino-glenoid symptomatology in a weight-lifter. Explorations included standard radiography, echography and magnetic resonance imaging. Differentiation between a true cyst and a pseudo-cyst was basedose presence of a synovial membrane. Mechanical contraints appear to be the most frequently suspected aetiology of spinoglenoid cysts. Echography cannot always confirm the liquid nature of the formation due to the close bone. Magnetic resonance imaging gives good tissue characterization and good topographic analysis. Gadolinium injection appears to be important for differential diagnosis with neurogenic tumours.

Humans↗
PubMed1995

[MRI of uterine leiomyosarcoma. Apropos of 2 cases].

Prognosis is poor for uterine leiomyosarcomas. Diagnosis is often an unexpected pathology discovery after hysterectomy for fibroma. Prognosis depends on the degree of locoregional extension and thus on early diagnosis. Echography and computed tomography scan are note very specific. There is little literature on imagining studies, and particularly on MRI in this pathology. Yet MRI, especially the T2 weighted sequences, is quite interesting for evaluating tumour extension in the uterus. It can be used whenever an abnormal increase in size is observed during the per- or postmenopausal period in a women with a fibroma. We report two cases of uterine leiomyosarcoma explored by MRI and review the literature.

Aged↗
PubMed1995

[Giant bronchopyocele. General and radiological characteristics. Apropos of a case].

A case of giant bronchocele is reported. This lesion is due to a mucus and pus filled dilatation of the bronchial tree proximal to a stenosis. The latter can be either congenital or acquired, or in the context of a diffuse bronchopathy, which can be responsible for a functional stenosis. Both plain radiography and computed tomography findings are diagnostic. The etiology of the abnormality however represents an important problem to be solved. Further, a thoractomy is often necessary, except in those case arising in the context of a diffuse bronchopathy, which usually resolve either spontaneously or following medical treatment.

Bronchi↗
PubMed1995

[Comparative study of power Doppler and color Doppler in breast diseases].

In order to evaluate the interest of power doppler in breast studies, we studied 27 breast lesions in 22 patients. This series includes 8 malignant lesions, 11 benign lesions, and 8 enlarged lymph nodes. We used a Esaote Biomedica ultrasound machine with a 7 MHz transducer. We compared power doppler and pulsed doppler for every lesion. Power doppler was more sensitive in 3 out of 8 malignant tumors, 8 out of 11 benign lesions, and 5 out of 8 lymph nodes involvement. This study shows the value of power doppler in breast studies. The increased sensitivity, however, is balanced by a decreased specificity.

Breast Diseases↗
PubMed1994

Magnetic resonance imaging of von Meyenburg complexes: report of a pathologically documented case.

Von Meyenburg complexes (VMC) are rare malformations of the bile ducts. They are usually associated with adult dominant polycystic disease (ADPCD). Although generally benign, they may give rise to cholangiocarcinomas. Herein, we report the third MR documented case of VMC. The comparative diagnostic value of ultrasound (US), computed tomography (CT), and magnetic resonance (MR) examinations is discussed.

Aged↗
PubMed1994

Perflubron as an oral contrast agent for MR imaging: results of a phase III clinical trial.

PURPOSE: To assess perflubron for magnetic resonance (MR) imaging in the abdomen and pelvis in a multicenter trial. MATERIALS AND METHODS: MR images were obtained in 127 subjects before and after ingestion of perflubron with T1-, proton-density-, and T2-weighted sequences at 0.38, 1.0, or 1.5 T. Postcontrast images were compared with baseline images, and percentage of additional bowel darkened, distinction of bowel from adjacent tissue, and change in image artifact were graded. RESULTS: Perflubron increased the bowel darkening in over 92% of subjects with all sequences and field strengths. It improved definition of the left lobe of the liver and body and tail of the pancreas in 67%, 29%, and 42% of subjects, respectively, and of the uterus and bladder in 80% and 76%. Abnormal tissue was more conspicuous in 69% of subjects. Highest scores were achieved when the upper abdomen was imaged 5-30 minutes and the pelvis 10-40 minutes after ingestion. No image artifacts or side effects were attributed to perflubron. CONCLUSION: Perflubron is safe, and its efficacy was unaffected by pulse sequences, magnetic field strength, or time delay.

Abdomen↗
PubMed1994

Novel injectable fluorinated contrast agents with enhanced radiopacity.

Novel emulsions containing iodinated fluorinated radiopaque (IFR) molecules were prepared and evaluated as injectable contrast agents with prolonged intravascular persistence. Various stable IFR/egg yolk phospholipid emulsions were produced, heat-sterilized, and tested as to their radiopacity, shelf-stability and in vivo tolerance. No significant change in mean particle sizes was observed over a 3-month storage period at 40 degrees C. Intravenous injection of an emulsion of a 0.39 g/kg bw dose of a typical IFR, C6F13CH = CIC6H13 (F6H6IE) in rabbits led to high contrast in the liver and spleen. The same radiopacity of the liver was achieved with 7 times less IFR than perfluorooctyl bromide. Histological examination after 24 h, and blood analysis after 24, 48 h and 7 days, demonstrated normal functioning of the liver, even when high concentrations of IFR were present. The neat IFR was tolerated i.p. in mice at a 45 g/kg bw dose. Emulsified IFR was tolerated in rats and mice i.v. at a 8 g/kg bw dose. The iodinated fluorinated molecule tested appears promising for the formulation of new contrast agents for diagnosis.

Animals↗
PubMed1994

Very high frequency (13 MHz) ultrasonographic examination of the normal neck: detection of normal lymph nodes and thyroid nodules.

Very high frequency (13 MHz) ultrasonographic examination of the neck successfully visualized one or more normal lymph nodes (weakly echoic oval structures with an echoic central hilum) in 67.6% of 1000 healthy volunteers. Efficacy was not related to recent ear, nose, and throat infection, sex, or age. The longitudinal-transverse diameter ratio was greater than or equal to 2 in 86.2% of cases. No signal was detected with color Doppler imaging. One or more thyroid nodules were also identified in 34.7% of the subjects: the frequency was 44% in women and 42% in subjects over 50 years of age.

Age Factors↗
PubMed1994

[1,5 Tesla MRI in focal nodular hyperplasia. Review of the literature apropos of 7 cases].

Six patients with 7 focal nodular hyperplasia lesions were investigated with 1.5 Tesla magnetic resonance imagery (MRI). Surgical specimens were obtained in all cases and histological examination confirmed the diagnosis of focal nodular hyperplasia. In all cases, the tumour was isointense on the T1 weighted sequences. On the T2 weighted sequences in six cases, the tumour gave a hypersignal compared with the surrounding healthy liver tissue. Central scar tissue was found in all the lesions. On the T2 weighted images, the center gave a hypersignal 4 times and a hyposignal 3 times. Gadolinium injection on the echo gradient sequences (GRASS) showed product uptake suggestive of vessels within the central scar in one case. The report in the literature confirm the variability of focal nodular hyperplasia depending on the magnetic field used. In 1.5 Tesla MRI an isointense signal on at least one sequence would appear to be sufficient for the diagnosis of focal nodular dysplasia if the tumour is homogeneous and if the central scar is hyperintense in T2 sequences.

Adolescent↗