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J Remy

Publications and source records attributed to J Remy.

At least 19 recordsLinked to original sources
PubMed1995

[Scimitar syndrome with anatomical or functional absence of the right pulmonary artery. Apropos of 4 cases].

BACKGROUND: Scimitar syndrome is characterized by an anomalous pulmonary vein draining into the inferior vena cava and visible roentgenographically as a crescentic shadow of vascular density along the right border of the cardiac silhouette. The aim of this study is to report four cases associated with anatomical or functional absence of the right pulmonary artery. CASE REPORTS: Diagnosis of scimitar syndrome had been made in 4 patients aged 3, 10, 23 and 33 years. Pulmonary scintigraphy and/or CT scan detected the scimitar syndrome and the type of pulmonary and systemic vascularization. In all cases, the vascularization of the right lung did not originate from the pulmonary artery trunk but was supplied by systemic vessels arising from the abdominal aorta. The right pulmonary artery was vascularized a retro, against the stream, by the systemic vessels (two cases); alternatively, circulation into the right pulmonary artery resulted directly from the systemic vessels, this pulmonary artery being anatomically absent (two cases). Pulmonary arterial pressures were normal in all four cases and functional tolerance was good in three cases; repeated and severe hemoptysis required right pneumonectomy in the last patient. CONCLUSIONS: These four cases are compared to six other similar cases in the literature. Elegant and non invasive methods are now disposable to detect such a syndrome and to assess the type of pulmonary vascularization.

Child↗
PubMed1995

Hilar lymph nodes: identification with spiral CT and histologic correlation.

PURPOSE: To determine the appearance of normal hilar lymph nodes and associated soft tissue at spiral computed tomography (CT). MATERIALS AND METHODS: At spiral CT in 50 healthy patients, peribronchovascular hypoattenuated areas of 42 right and 45 left hila were systematically evaluated. Histologic results were correlated in five additional cases. RESULTS: Hilar lymph nodes were depicted (a) in the right hilum (lateral to A2 [n = 33 (79%)], medial [n = 29 (69%)] or lateral [n = 11 (26%)] to the interlobar pulmonary artery, and medial to the lower-lobe pulmonary artery [n = 30 (71%)], A7 [n = 9 (21%)], and A8-10 [n = 8 (19%)]; and (b) in the left hilum (lateral to A2 [n = 22 (49%)], medial to the interlobar pulmonary artery [n = 45 (100%)], and the lower-lobe pulmonary artery [n = 27 (60%)], and in the angles of bifurcation of A7 + 8 and A9 + 10 [n = 18 (40%)]). Hilar lymph nodes were seen to be triangular or linear and to be less than 3 mm wide except around the left-lower-lobe pulmonary artery. CONCLUSION: Spiral CT accurately depicts normal hilar lymph nodes and their major anatomic relationships.

Contrast Media↗
PubMed1995

Diagnosis of central pulmonary embolism with helical CT: role of two-dimensional multiplanar reformations.

OBJECTIVE: The purpose of this study was to evaluate the role of multiplanar two-dimensional (2D) reformations in the diagnosis of central pulmonary embolism with helical CT. SUBJECTS AND METHODS: Thirty-five patients with suspected pulmonary embolism underwent contrast-enhanced helical CT of the pulmonary arterial tree. Two sets of images were analyzed: overlapped transverse sections and 2D reformatted images of 10 obliquely oriented arteries (intralobar pulmonary artery, A2, A4+5, A6, and A10 [A = artery]) selected on three-dimensional shaded surface displays of each pulmonary arterial tree. RESULTS: Among the 20 patients with unequivocal central pulmonary emboli on transverse sections (group 1), 2D reformations enabled a more precise analysis of the extent of thromboembolic disease in 13 cases. These patients underwent no further diagnostic procedure. In six patients (group 2), transverse sections alone excluded central pulmonary embolism with angiographic (n = 2) or scintigraphic (n = 4) confirmation. No additional information was provided with the 2D reformations. In nine patients with an uncertain diagnosis of pulmonary embolism on transverse sections (group 3), 2D reformations enabled us to exclude central emboli in all the cases, with angiographic (n = 4) or scintigraphic (n = 5) confirmation. In groups 1 and 3, 2D reformations provided adequate visualization of obliquely oriented arteries (n = 30) and enabled assessment (n = 2) or exclusion (n = 28) of endovascular changes, a clear distinction between endoluminal and perivascular abnormalities (n = 7), or a precise evaluation of extensive mural thrombi (n = 6). CONCLUSION: Our results show that 2D reformations enable confident exclusion of pulmonary embolism on inconclusive helical CT examinations and improve analysis of the extent of thromboembolic disease.

Adult↗
PubMed1995

[Erdheim-Chester disease. Clinico-pathologic study of two cases].

Erdheim-Chester disease is a rare visceral xanthogranulomatosis characterized by bilateral, symmetrical sclerosis of the metaphyseal regions of long bones and infiltration of foamy, lipid-laden histiocytes. Clinically, it ranges from an asymptomatic, focal process to a fatal, systemic disease. We report two new cases, different in their presentation and extension.

Female↗
PubMed1994

Pulmonary parenchymal abnormalities of vascular origin: high-resolution CT findings.

High-resolution computed tomography (HRCT) is a proved imaging modality for use in assessment of infiltrative lung disease. Findings suggestive of infiltrative lung disease on HRCT scans include ground-glass attenuation, consolidation, nodules, and interlobular septal thickening. Similar patterns, however, may be caused by various vascular abnormalities including regional or diffuse increase in blood flow, pulmonary edema, pulmonary hypertension, and thromboembolism. A correct diagnosis can usually be made by careful analysis of the pulmonary vasculature. Parenchymal abnormalities of vascular origin are associated with increased or decreased vessel diameter, vascular compression, or intraluminal filling defect.

Humans↗
PubMed1994

Angioarchitecture of pulmonary arteriovenous malformations: clinical utility of three-dimensional helical CT.

PURPOSE: To determine the clinical utility of three-dimensional (3D) helical computed tomography (CT) in pretherapy evaluation of the angioarchitecture of pulmonary arteriovenous malformations (PAVMs). MATERIALS AND METHODS: Thirty-seven PAVMs were prospectively evaluated with both helical CT and pulmonary angiography. Single-threshold shaded-surface displays were obtained with 2- or 5-mm section thickness, a pitch of 1, and a 360 degrees linear interpolation algorithm but without injection of contrast medium. RESULTS: A reliable analysis of the angioarchitecture of 28 PAVMs (76%)--25 simple and three complex--was provided by 3D reconstructions; combined interpretation of 3D images and transverse sections led to accurate evaluation of 35 PAVMs (95%). Positioning of the target anatomy in the reconstructed volume, threshold value, number of stacked sections, and section thickness influenced the diagnostic information. CONCLUSION: Unenhanced 3D helical CT appears to be a reliable noninvasive tool for pretherapy evaluation of PAVMs.

Adolescent↗
PubMed1994

Pulmonary sarcoidosis: role of CT in the evaluation of disease activity and functional impairment and in prognosis assessment.

PURPOSE: To investigate the role of computed tomography (CT) in determining disease activity and functional impairment and in predicting the prognosis of lung involvement in patients with sarcoidosis. MATERIALS AND METHODS: Two groups of patients underwent CT, pulmonary function tests, and bronchoalveolar lavage. Disease activity was based on serum angiotensin converting enzyme activity and/or lymphocytosis at bronchoalveolar lavage. CT findings in group 1 were correlated with indexes of disease activity and functional parameters at diagnosis. In group 2, evaluation initially and at follow-up led to investigation of correlations between initial CT findings and evolution of disease activity and functional impairment. RESULTS: CT abnormalities in group 1 were nodules, air-space consolidation, lung distortion, septal and nonseptal linear areas of high attenuation, ground-glass attenuation, and honeycombing. Profusion of septal lines was the only CT finding that correlated with disease activity. Statistically significant (P < .05) but low correlation (r < .48) was observed between the extent of abnormalities at CT and impairment of lung function, except for nodules. CONCLUSION: Profusion of lung changes reflects functional impairment but not disease activity. CT findings cannot help predict the evolution of lung changes over time.

Adult↗
PubMed1994

Lung changes in rheumatoid arthritis: CT findings.

PURPOSE: To evaluate lung changes in rheumatoid arthritis (RA). MATERIALS AND METHODS: The authors reviewed the computed tomographic (CT) scans from 84 patients with RA with a mean articular disease duration (+/- standard deviation) of 12 years +/- 8 (range, 0.3-45 years). Fifteen patients underwent sequential CT evaluation during 5-65-month follow-up (mean, 18 months). RESULTS: Thirty-eight patients (49%) had abnormal CT scans showing the following abnormalities: (a) bronchiectasis and/or bronchiolectasis (n = 23, 30%), (b) pulmonary nodules (n = 17, 22%), (c) subpleural micronodules and/or pseudoplaques (n = 13, 17%), (d) nonseptal linear attenuation (n = 14, 18%), (e) areas of ground-glass attenuation (n = 11, 14%), and (f) honeycombing (n = 8, 10%). Abnormal CT examinations were recorded in 11 of 38 asymptomatic patients (29%) and 27 of 39 symptomatic patients (69%). The following CT abnormalities were found with a significantly higher frequency among patients with respiratory symptoms: (a) bronchiectasis and/or bronchiolectasis, (b) rounded areas of attenuation, (c) areas of ground-glass attenuation, and (d) honeycombing. CONCLUSION: CT may be a useful noninvasive tool for recognition of RA-associated lung disease with special emphasis on bronchial and bronchiolar changes.

Adult↗
PubMed1993

Computed tomography assessment of ground-glass opacity: semiology and significance.

Among the computed tomography (CT) signs of parenchymal lung disease, the ground-glass pattern is the one most difficult to diagnose and most influenced by CT technique. Ground-glass opacity may result from changes in the airspaces or interstitial tissues in acute or chronic infiltrative lung disease. It may also be seen as a consequence of increased capillary blood volume in redistribution of blood flow due to airway disease, emphysema, or pulmonary thromboembolism. Definition of this sign on high-resolution CT (HRCT) images, its various HRCT patterns, and potential pitfalls in its recognition are described with special attention to optimal HRCT technique.

Humans↗
PubMed1993

Morphologic effects of cigarette smoking on airways and pulmonary parenchyma in healthy adult volunteers: CT evaluation and correlation with pulmonary function tests.

A prospective computed tomographic (CT) study was performed to determine the prevalence of lung changes in smokers. The study group comprised 175 healthy adult volunteers (current smokers, n = 98; ex-smokers, n = 26; nonsmokers, n = 51). The subjects underwent clinical examination, pulmonary function tests, chest radiography, and conventional and high-resolution CT (HRCT). Significant differences between current smokers, ex-smokers, and nonsmokers were observed with HRCT in the identification of subpleural (P = .11) and parenchymal (P < .001) micronodules, emphysema (P < .001), and areas of ground-glass attenuation (P = .0001). All subjects had normal pulmonary function. Parenchymal micronodules, areas of ground-glass attenuation, and emphysema were observed with a significant predominance in the upper lung zones (P < .01). Presence of emphysema and abnormal bronchial wall thickening were the only HRCT signs associated with significantly lower values of functional parameters. These data support the concept that parenchymal abnormalities can be detected in healthy smokers with normal findings at chest radiography and pulmonary function tests.

Adult↗
PubMed1993

Lung parenchymal changes secondary to cigarette smoking: pathologic-CT correlations.

To determine the histopathologic basis for computed tomographic (CT) interpretation of smokers' lung and the accuracy of CT in the detection of alterations related to cigarette smoking, parenchymal lung lesions were studied from 41 heavy smokers who underwent thoracotomy for removal of a solitary pulmonary nodule. CT scanning of the resected lungs, corresponding exactly to the sections seen on preoperative CT scans, resulted in the following pathologic-CT correlations. Areas of ground-glass attenuation seen on preoperative CT scans (n = 11 [27%]) were related to three main histologic features: (a) accumulation of pigmented macrophages and mucus in the alveolar spaces, associated with mild interstitial inflammation and/or fibrosis (n = 7); (b) thickening of the alveolar walls with inflammatory cells with normal alveolar spaces (n = 3); and (c) presence of organizing alveolitis (n = 1). Parenchymal micronodules depicted presurgically (n = 4 [10%]) corresponded to bronchiolectases with peribronchiolar fibrosis (n = 4) associated with obliterative bronchiolitis in one patient. When emphysema was detected presurgically (n = 21 [51%]), it was always present at pathologic study to a higher extent than initially suspected.

Bronchitis↗
PubMed1993

Pulmonary nodules: detection with thick-section spiral CT versus conventional CT.

Spiral volumetric computed tomography (CT) with single breath-hold technique was compared with conventional sequential CT in 39 patients. The spiral CT protocol consisted of a 10 mm/sec table feed during a 24-second breath hold at 145 mA, with reconstruction of images at 10-mm intervals; one (n = 21) or two (n = 18) sequences were necessary to screen the complete lung. Conventional CT was performed with a 1-second scan time, 145 mA, and contiguous 10-mm-thick sections. In the 39 patients studied with each technique, no lung nodule was detected in three, two had a single nodule, and 29 had multiple nodules. Two patients with normal findings at chest radiography and three with a solitary pulmonary nodule at conventional CT had multiple nodules at spiral CT. Mean number of nodules per patient was significantly higher with spiral versus conventional CT (18 +/- 4.5 vs 12.6 +/- 3.2 [mean +/- standard error of the mean], P = .01) as were the number of nodules less than 5 mm in diameter per patient (12.7 +/- 3.7 vs 8.4 +/- 2.3, P < .05) and 5-10 mm in diameter (2.9 +/- 0.9 vs 2.4 +/- 0.8, P < .05). Respiratory motion artifacts were never observed with spiral CT although they were present on four conventional CT scans.

Adolescent↗
PubMed1993

Pulmonary involvement in progressive systemic sclerosis: sequential evaluation with CT, pulmonary function tests, and bronchoalveolar lavage.

Computed tomographic (CT) findings obtained in 53 patients with progressive systemic sclerosis were correlated with functional parameters and bronchoalveolar lavage (BAL) results, and lung changes over time were assessed in 17 patients. CT findings were normal in 21 patients (group 1) with otherwise normal lung function, except for subclinical alveolitis in seven patients. CT depicted pleural and parenchymal abnormalities in 32 patients, grouped according to the absence (group 2) or presence (group 3) of honeycombing. In group 2 (n = 13), mean values of functional parameters were normal, and BAL showed a significant increase in neutrophils compared to group 1 (P < .05). Among patients in group 3 (n = 19) with limited extent of honeycombing (n = 12), the mean diffusing capacity value was lower in patients with a moderate ground-glass profusion score (n = 4) than in those with a mild score (n = 8) (68% +/- 4 [standard error of the mean] vs 80% +/- 3). CT is the method of choice for evaluating parenchymal destruction, and profusion and extent of ground-glass opacities can help in predicting the severity of lung damage in areas devoid of destructive changes.

Adolescent↗
PubMed1993

Subacute and chronic bird breeder hypersensitivity pneumonitis: sequential evaluation with CT and correlation with lung function tests and bronchoalveolar lavage.

PURPOSE: To evaluate lung involvement in the subacute (group 1) and chronic (group 2) stages of bird breeder hypersensitivity pneumonitis. MATERIALS AND METHODS: Computed tomographic (CT) findings in 45 patients were correlated with pulmonary function testing and bronchoalveolar lavage. Twenty-seven patients underwent sequential CT examination 0.3-4 years apart, with functional evaluation in 20 of them. RESULTS: In group 1, CT showed diffuse micronodules, ground-glass attenuation, focal air trapping or emphysema, and mild fibrotic changes, with normal lung volumes but impaired diffusing capacity and a predominant lymphocyte alveolitis. In group 2, two categories of chronic forms were identified at CT on the basis of presence or absence of honeycombing. After cessation of exposure, CT showed a return to normal or dramatic improvement in group 1 and considerable reduction in ground-glass attenuation and micronodules in group 2. CT depicted no fibrotic or emphysematous changes during follow-up. CONCLUSION: Subacute bird breeder hypersensitivity pneumonitis may share CT features with other types of hypersensitivity pneumonitis. CT may help in identification of emphysematous and fibrotic forms of chronic disease.

Acute Disease↗
PubMed1993

Importance of ground-glass attenuation in chronic diffuse infiltrative lung disease: pathologic-CT correlation.

PURPOSE: To correlate areas of ground-glass attenuation at computed tomography (CT) with findings at open lung biopsy in chronic diffuse lung disease. MATERIALS AND METHODS: The cases of 26 patients were included on the basis of (a) extensive areas of ground-glass attenuation as the predominant (n = 17) or exclusive (n = 9) abnormality at CT in the absence of honeycombing and (b) histologic evaluation at open lung biopsy. Severity of ground-glass attenuation was scored in the lobe sampled at biopsy, with separate analysis of associated lung changes. RESULTS: Correlation of CT with histologic findings at the 37 biopsy sites demonstrated that ground-glass attenuation corresponded to inflammation in 24 (65%) cases and to fibrosis in 13 (54%) cases. Eleven of the 13 patients (85%) with fibrosis had traction bronchiectasis or bronchiolectasis. These findings were not present in any of the patients with inflammation. CONCLUSION: In patients with chronic diffuse infiltrative lung disease, areas of ground-glass attenuation not associated with traction bronchiectasis or bronchiolectasis are a reliable indicator of inflammation.

Biopsy↗
PubMed1992

Pulmonary arteriovenous malformations: evaluation with CT of the chest before and after treatment.

A total of 109 single or multiple pulmonary arteriovenous malformations (PAVMs) were evaluated with computed tomography (CT) of the chest in 40 patients separated into three groups to study the usefulness of CT (a) in the diagnosis and pretherapeutic management of PAVMs by comparison with selective pulmonary angiography of each lung (group 1: 20 patients), (b) in the follow-up of patients who received treatment (group 2: 27 patients), and (c) as an isolated diagnostic procedure in elderly patients (n = 3) or family members with Osler-Weber-Rendu disease (n = 8) (group 3: 11 patients). Follow-up ranged from several weeks to 10 years (mean follow-up, 4 years). In group 1, conventional and dynamic CT enabled identification of 107 PAVMs (98.2%) (vs 65 PAVMs [59.6%] identified with angiography), with confident segmental location in 56 of 65 PAVMs (86%) and reliable analysis of angioarchitecture in 17 PAVMs (26%) (vs 39 PAVMs [60%] analyzed with angiography). In group 2, progressive aneurysmal retraction was associated with successful occlusion. In group 3, CT enabled noninvasive evaluation of patients unable to undergo treatment and detection of PAVMS in family members.

Adult↗
PubMed1992

Chronic hypersensitivity pneumonitis: high-resolution CT and radiographic features in 16 patients.

To evaluate the manifestations of chronic hypersensitivity pneumonitis at radiography and high-resolution computed tomography (HRCT), findings in 16 patients with this disease were reviewed. To ensure objectivity, 50 patients with other chronic infiltrative lung diseases (fibrosing alveolitis [n = 29], sarcoidosis [n = 16], and miscellaneous conditions [n = 5]) were included. All patients had chronic disease with evidence of fibrosis at HRCT, as indicated by irregular linear areas and architectural distortion. Radiographs and HRCT scans were reviewed separately, in random order, and without knowledge of diagnosis. On radiographs and HRCT scans, the fibrosis in cases of hypersensitivity pneumonitis was situated predominantly in the middle lung zones or showed no zonal predominance. Lung apices and bases were relatively spared in all cases. The distribution of fibrosis in the transverse plane was random in seven cases, subpleural in six, and peri-bronchovascular in three. The distribution of fibrosis can allow distinction of chronic hypersensitivity pneumonitis from other causes of fibrosis in many cases.

Adolescent↗