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Biomedical subjects

J Struyven

Publications and source records attributed to J Struyven.

At least 217 records · Page 12Linked to original sources

Magnetic resonance angiography of intravascular endoprostheses: investigation of three devices.

PURPOSE: To assess the value of magnetic resonance angiography (MRA) in the evaluation of vascular patency after intravascular endoprosthesis placement. METHODS: Three different metallic stents (Wallstent, Strecker, Palmaz) were studied in vitro, and in vivo in six patients with spin-echo (SE) and gradient-echo (GRE) MR imaging. Time-of-flight, two-dimensional (2D) gadolinium-enhanced MRA was performed with GRE and flow-compensation technique, and reconstructed with a maximum-intensity projection (MIP) algorithm. MRA was compared to digital angiograms. RESULTS: In vitro studies demonstrated that the signal intensity (SI) within the stent differed according to the device employed, the lowest SI being observed within the Palmaz stent (p = .001). There was no difference in SI or apparent diameter of the stent according to the sequence (SE vs GRE) or length of echo time (TE). In patients, the endoprostheses recorded as a well-defined area of signal void or drop-out (p = 0.004), whereas vessels above and below the stent displayed high signal intensities. CONCLUSION: MRA does not seem as yet to be well suited for evaluating vascular patency after endoprosthesis placement, even if the Strecker and Wallstent endoprostheses provide fewer artifacts than the Palmaz stent.

Arterial Occlusive Diseases↗

Transcatheter embolization of pseudoaneurysms complicating pancreatitis.

PURPOSE: To evaluate the therapeutic role of angiography in patients with pseudoaneurysms complicating pancreatitis. METHODS: Thirteen symptomatic pseudoaneurysms were treated in nine patients with pancreatitis. Eight patients had chronic pancreatitis and pseudocyst and one had acute pancreatitis. Clinical presentation included gastrointestinal bleeding in seven patients and epigastric pain without bleeding in two. All patients underwent transcatheter embolization. RESULTS: Transcatheter embolization resulted in symptomatic resolution in all patients. Rebleeding occurred in two patients, 18 and 28 days after embolization respectively, and was successfully treated by repeated embolization. One patient with severe pancreatitis died from sepsis 28 days after embolization. Follow-up was then available for eight patients with no relapse of bleeding after a mean follow-up of 32 months (range 9-48 months). CONCLUSION: Transcatheter embolization is safe and effective in the management of pseudoaneurysms complicating pancreatitis.

Acute Disease↗

Penetrating atherosclerotic ulcer of the descending thoracic aorta: treatment by endovascular stent-graft.

PURPOSE: To present four cases of penetrating ulcer of the descending thoracic aorta treated by transfemoral insertion of an endoluminal stent-graft. METHODS: Four patients with penetrating aortic ulcers were reviewed. Three cases were complicated by rupture, false aneurysm, or retrograde dissection. All patients were treated by endovascular stent-graft and were followed by helical computed tomography (CT). RESULTS: Endovascular stent-graft deployment was successful in all patients. However, in one case we observed a perigraft leak that spontaneously disappeared within the first month, and two interventions were needed for another patient. Following treatment, one episode of transient spinal ischemia was observed. The 30-day survival rate was 100%, but one patient died from pneumonia with cardiac failure 34 days after the procedure. In one patient, helical CT performed at 3 months showed a false aneurysm independent of the first ulcer. This patient refused any further treatment and suddenly died at home (unknown cause) after a 6-month follow-up period. CONCLUSION: Transluminal placement of endovascular stent-grafts for treatment of penetrating ulcers of the descending thoracic aorta appears to be a possible alternative to classical surgery. After treatment, follow-up by CT is essential to detect possible complications of the disease.

Aged↗

Role of computed tomography and mediastinoscopy in preoperative staging of lung carcinoma.

One hundred fifty-three patients with bronchogenic carcinoma were evaluated prospectively by CT and mediastinoscopy. Nodes larger than 5 mm were considered potentially metastatic. All results were correlated with surgical findings. Computed tomography is more sensitive (89%) in the detection of mediastinal metastases than mediastinoscopy (67%). Computed tomography has a poor predictive value (47%); however, a negative examination is highly accurate (89%). Within a group of 100 node sites, 72% of the nodes involved by tumor were larger than 1 cm in diameter. Squamous cell carcinoma and adenocarcinoma have the highest percentages of sensitivity by CT. The very low incidence of metastatic involvement in nodes under 5 mm allows one to forego mediastinoscopy in the presence of a negative CT.

Adenocarcinoma↗

Delayed enhancement of the bowel wall: a new CT sign of small bowel strangulation.

PURPOSE: To report a new CT sign of small bowel strangulation. MATERIALS AND METHODS: Two cases of small bowel obstruction evaluated by spiral CT with intravenous contrast injection. RESULTS: In both cases we observed an absence of parietal enhancement of the diseased bowel loop, visible on early scans only. This feature was accompanied by signs of bowel obstruction. The two patients had a segment of necrotic ileum resected. CONCLUSION: Delayed enhancement of a bowel loop in cases of small bowel obstruction should suggest the diagnosis of strangulation and lead to rapid surgical treatment.

Acute Disease↗

Splenic parenchymal complications of pancreatitis: CT findings and natural history.

PURPOSE: Splenic parenchymal complications of pancreatitis are unusual and potentially life threatening. They usually require splenectomy in patients in poor condition. The present study describes natural history of splenic parenchymal complications and the role of CT scan in diagnosis and follow-up. METHOD: A retrospective study of 16 consecutive patients with splenic complications diagnosed by CT during staging of pancreatitis was performed. The presence and importance of splenic infarct, abscess, subcapsular collection, and hemoperitoneum were correlated with the patients' symptoms, type of management, and follow-up. RESULTS: No specific symptomatology was observed except in two cases of acute and massive hemoperitoneum. Fourteen infarcts, 11 subcapsular collections, 1 abscess, and 3 hemoperitoneums were observed. Four patients underwent splenectomy including two as an emergency for hemodynamic instability. Twelve patients were conservatively and successfully managed. CONCLUSION: Most splenic parenchymal complications of pancreatitis regress spontaneously and may be managed conservatively. Surgical indication is based mainly on clinical findings. CT is useful for detection and follow-up of these complications.

Abscess↗

Simultaneous neurofibroma and schwannoma of the sciatic nerve.

The authors report a case of simultaneously occurring neurofibroma and schwannoma of the sciatic nerve and discuss the complementary aspects of MR and US. The schwannoma was well-defined and showed distal enhancement on sonographic evaluation, whereas the neurofibroma was ill-defined; both tumors were hypoechoic. T1- and T2-weighted MR images revealed similar signal characteristics of the two tumors, but intense enhancement following administration of gadolinium-DTPA distinguished the schwannoma from the neurofibroma.

Female↗

[Male impotence. Radiologic venous examinations].

A vascular pathology is the most common etiology of male impotence of organic origin and among these vascular problems, the most frequent are represented by the anomalies of the venous drainage. Based on a personal experience of more than 450 radiological examinations, we will describe the techniques of cavernography and cavernometry as well as the effects of intra-cavernous injections of papaverin and we will present the results from the literature.

Erectile Dysfunction↗