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Biomedical subjects

J P Laissy

Publications and source records attributed to J P Laissy.

At least 19 recordsLinked to original sources

[Sirolimus-associated interstitial pneumonitis in a renal transplant patient].

INTRODUCTION: Sirolimus is a new immunosuppressive drug used in organ transplantation, particularly in renal transplantation. In the future, it could replace calcineurin inhibitors such as cyclosporine. It is currently associated with side effects, such as thrombocytopenia and hyperlipidemia. Several interstitial pneumonitis associated with sirolimus has been previously described in renal transplant recipients associated with marked general symptoms. EXEGESIS: We report on a 65-year-old renal recipient presenting with a non typical case of sirolimus interstitial pneumonitis. He presented with fever and marked general symptoms for several months. CT scan showed a unilateral interstitial pneumonitis. After infectious, inflammatory and tumoral diseases were ruled out, sirolimus associated interstitial pneumonitis was evoked. The patient improved quickly after discontinuation of sirolimus. CONCLUSION: It is important to evoke, after eliminating other aetiologies, sirolimus induced pneumonitis in face of an organ transplant recipient presenting with marked general symptoms even if the pulmonary symptoms are not predominant.

Aged↗

[Section planes for cardiac MRI].

The recent developments of synchronized cardiac MRI are a unique opportunity for the radiology community to integrate cardiac imaging. This educational aticle aims to help radiologists and technicians to obtain cardiac planes comparable to those of cardiac ultrasound and gated SPECT. Of course, cardiac planes described herein for MRI also apply to multi-detector CT.

Aorta, Thoracic↗

[Anomalies of myocardial contractility: CT and MR appearance].

Cardiac output relies on an appropriate contractile function. It is mandatory to recognize kinetic alterations of the myocardium and to precise their extent (i.e. segmental, regional or global), to quantify their consequences on the function of the cardiac pump, and to assess if the underlying disease is reversible or fixed.

Cardiomyopathy, Hypertrophic↗

[Cardiac tumors].

Metastases are the most frequent tumors of the heart even though they seldom are recognized. Most primary cardiac tumors are benign. The main role of imaging is to differentiate a cardiac tumor from thrombus and rare pseudotumors: tuberculoma, hydatid cyst. Echocardiography is the fist line imaging technique to detect cardiac tumors, but CT and MRI are useful for further characterization and differential diagnosis. Myxoma of the left atrium is the most frequent benign cardiac tumor. It usually is pedunculated and sometimes calcified. Sarcoma is the most frequent primary malignant tumor and usually presents as a sessile infiltrative tumor. Lymphoma and metastases are usually recognized by the presence of known tumor elsewhere of by characteristic direct contiguous involvement. Diagnosing primary and secondary pericardial tumors often is difficult. Imaging is valuable for diagnosis, characterization, presurgical evaluation and follow-up.

Adult↗

[Cardiomyopathies].

Cardiomyopathies include a wide variety of cardiac diseases. The value of MR imaging is not only to provide information about cardiac function, but also to detect the underlying cause of the disease.

Cardiomyopathy, Dilated↗

[MR imaging and arrhythmogenic right ventricular dysplasia (ARVD)].

Arrhythmogenic right ventricular dysplasia (ARVD) is a cardiomyopathy of unknown etiology responsible for 20% of cases of sudden death in young adults secondary to arrhythmia. It is characterized histologically by fatty or fibro-fatty infiltration of the right ventricular myocardium. Diagnostic criteria have been proposed for diagnosing ARVD. Imaging, especially MRI, plays an important role. MR imaging must be performed using cardiac gating, and should include both cine-MR sequences for evaluation of segmental and global right ventricular function or any morphological change of the right ventricular shape, and anatomic sequences to detect fatty or fibro-fatty infiltration of the right ventricular myocardium.

Adult↗

[Imaging of the lower limb arteries: when, how and why?].

Noninvasive screening of lower limb arterial disease has long been performed using color Doppler ultrasonography, whereas surgical or endovascular treatment planning relied on conventional angiography. With continued improvements of noninvasive imaging modalities, it is now possible to image the entire lower limb vasculature without arterial catheterization. Multidetector row helical CT angiography has the advantage of visualizing the arterial lumen and arterial wall calcifications, and nephrotoxicity is reduced by decreasing amounts of contrast medium. Three-dimensional MR angiography is a safe procedure, with high contrast sensitivity, and has recently benefited from step table technology that allows a single injection of contrast medium. The literature shows that both helical CT and MR angiography have high levels of accuracy, but outcome studies of their respective role in the setting of acute and chronic lower limb ischemia are lacking. These noninvasive techniques should play a major role in two main situations: first, in critical ischemia where therapeutic planning should ideally be achieved non invasively; second, in the follow-up of treated patients presenting with recurrent ischemia.

Angiography↗

[Complications of myocardial infarction].

Most acute complications of myocardial infarction do not need emergency imaging, since they often result in death prior to hospital admission: ventricular fibrillation and tachycardia, papillary muscle or septal rupture, fissuration and tamponade. Imaging can play a role at distance of the acute phase (papillary muscle dysfunction, false aneurysm, development of a mural thrombus associated to left ventricular apical dyskinesis, with potential embolic complications).

Heart Diseases↗

[Aortic dissection and aberrant right subclavian artery: CT and MR findings].

A case of aortic dissection extending to an aberrant right subclavian artery seen at CT and MRI is reported. The clinical and imaging patterns of this rare disease are described and compared with those of the literature. Multiplanar views are, in this particular case, very useful for a precise assessment of the involved aberrant artery.

Aortic Dissection↗

Effect of contrast dilution on contrast-enhanced MR angiography of the aorta and renal arteries.

The aim of this study was to investigate the effect of gadolinium chelate dilution on vascular enhancement in contrast-enhanced two-dimensional (2D) MR subtraction angiography of aorta and renal arteries. Twenty patients were prospectively included. 2D subtraction MR angiography consisted of successive multisection breathhold GRE acquisitions of 16 s (2D FLASH, TR/TE 72/4, flip angle 60 degrees) obtained in the coronal plane before and after intravenous bolus administration of 0.1 mmol/kg BW gadolinium chelate. Patients underwent both diluted and undiluted gadolinium chelate administration in a random order. The data were studied both qualitatively and quantitatively on source and maximum intensity projection images. The length of renal arteries opacified was found not to differ significantly according to contrast dilution. The contrast enhancement percentage was not significantly modified according to the dilution used, but the time to peak enhancement was observed to be longer with the diluted contrast. Qualitatively, the best MR images were those obtained when undiluted contrast was injected first (chi2, P = 0.01). At a dosage of gadolinium chelate 0.1 mmol/kg BW, undiluted contrast 2D MR subtraction angiography seems to be more appropriate for studying diseases of the aorta and renal arteries than a similar diluted dose.

Adult↗