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J Struyven

Publications and source records attributed to J Struyven.

At least 37 records · Page 2Linked to original sources

Choledochal cysts: comparison of findings at MR cholangiopancreatography and endoscopic retrograde cholangiopancreatography in eight patients.

PURPOSE: To compare prospectively the data provided with endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance (MR) cholangiopancreatography (MRCP) in eight patients with symptomatic choledochal cysts. MATERIALS AND METHODS: Eight patients (three children, five adults) with choledochal cyst and abdominal pain underwent sequential single-shot turbo spin-echo T2-weighted MRCP and ERCP. Seven of the eight patients had relapsing pancreatitis. In three patients, a dynamic MR examination was performed after secretin stimulation of exocrine pancreatic function. RESULTS: A complete correlation was observed between ERCP and MRCP for defining the anatomic characteristics of the cyst (seven type I cysts, one type IV cyst) and the presence of an abnormal pancreaticobiliary junction (PBJ) (six patients) with a long common channel. Of the seven patients with acute pancreatitis, six had an abnormal PBJ and one had common bile duct (CBD) stones with a normal ductal union evidenced with both techniques. In two patients, dynamic MRCP demonstrated preferential filling of the gallbladder and the CBD after secretin injection, whereas normal duodenal filling was observed in another patient without a junctional abnormality. CONCLUSION: MRCP provides information equivalent to that provided with ERCP, without potential complications, for the preoperative assessment of choledochal cysts. Dynamic secretin-stimulated MRCP studies might help better understand the pathophysiologic characteristics of this entity.

Adolescent↗

Acinar filling during secretin-stimulated MR pancreatography.

OBJECTIVE: The purpose of this study is to report a new sign, "acinar filling," observed on dynamic MR pancreatography after secretin stimulation in patients with suspected early chronic pancreatitis. CONCLUSION: Acinar filling might reflect tissue hypertension or loss of pancreatic parenchyma compliance or both. This finding is probably an insensitive but specific sign of early chronic pancreatitis.

Aged↗

Helical CT of aorta after endoluminal stent-graft therapy: value of biphasic acquisition.

OBJECTIVE: We report our prospective study evaluating biphasic helical CT of the aorta after endoluminal stent-graft placement. SUBJECTS AND METHODS: Biphasic helical CT scans in 95 patients with abdominal and thoracic aortic aneurysms who had undergone endoluminal stent-graft placement were reviewed. After a test bolus injection of 15 ml of contrast media at a rate of 3.5 ml/sec for the measurement of the optimal start delay, the aorta was scanned using the following parameters: collimation of 5 mm, table speed of 7 mm per rotation, tube rotation time of 0.75 sec, 120 kV, and 295 mA. A delayed helical CT scan was obtained 15 sec after the initial acquisition using the same parameters. RESULTS: Biphasic helical CT scans showed perigraft leakage in 45 (47%) of 95 patients. Leakage was shown only on arterial phase CT in eight patients and only on the delayed scans in three patients. In two patients, leakage shown on the delayed acquisition was retrospectively seen on the first scan. Leakage and outflow vessels were most visible on the arterial phase acquisition in 17 patients and on the second acquisition in six patients. Overall, biphasic acquisition was superior to arterial phase acquisition alone in 15 (16%) of 95 patients. CONCLUSION: The diagnostic value of biphasic helical CT is superior to arterial phase acquisition alone for the evaluation of the aorta after endoluminal stent-graft therapy.

Aged↗

Fetal endocardial fibroelastosis: ultrasonographic findings in two cases.

EFE is a rare cardiac disorder with poor prognosis and uncertain cause. Primary and secondary forms have been described. Most authors consider that all EFE is secondary--a reactive process set off in the endocardium by stress on the myocardium. We report two cases representing the primary dilated form and the secondary contracted form. The dilated form was associated with intracavitary thrombus of the left ventricle. In both cases, an unusual presence of subendocardial calcifications was noted. The ultrasonographic findings are discussed.

Adult↗

[Mucosecretory and papillary intraductal tumors of the pancreas: clinicopathological considerations and radiological aspects including computed tomography symptomatology].

Intraductal papillary-mucinous tumor of the pancreas (IPMT) is an uncommon entity, defined as an intraductal papillary proliferation of mucin-producing epithelial cells. Since the original description of the disease by Ohhashi in 1982, the definition and the classification of the disease has remained confused until the recently published classification of the World Health Organisation (WHO). The purpose of this article is therefore to report the clinico-pathological features of IPMT according to the WHO classification, to illustrate the radiological features especially the computed tomographic signs and to discute of the treatment.

Cholangiography↗

Endovascular aortic stent-grafts: transcatheter embolization of persistent perigraft leaks.

PURPOSE: To assess efficacy of transcatheter embolization of peri prosthetic leaks from aortic stent-grafts MATERIALS AND METHODS: Eight patients with a long-standing (3-13 months) perigraft leak after stent-graft implantation underwent transcatheter embolization. Leakage was demonstrated at helical computed tomography (CT). Angiography was performed for evaluation of outflow vessels and transcatheter embolization. All patients underwent helical CT follow-up after the procedure and every 3 months. RESULTS: Embolization was successful in seven patients and resulted in aneurysmal sac thrombosis. A second procedure was necessary in one patient to complete occlusion of the aneurysm. No further aneurysmal growth was detected during 4-9 months follow-up. Right leg paresis was observed in one patient immediately after the procedure, but symptoms disappeared completely after 8 days. Another patient had a minor sensory deficit in the region of the right crural nerve. CONCLUSION: Transcatheter embolization of perigraft leaks appears to be an effective technique to achieve aneurysmal thrombosis.

Aged↗

Pancreatic duct: morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation.

PURPOSE: To assess the utility of dynamic MR pancreatography in the evaluation of the behavior of the pancreatic duct after secretin stimulation and to estimate pancreatic exocrine reserve in patients suspected of having acute recurrent or chronic pancreatitis. MATERIALS AND METHODS: Ten healthy volunteers and 13 patients suspected of having pancreatic disease and no obvious markers of chronic pancreatitis were studied. Single-shot turbo spin-echo T2-weighted dynamic MR pancreatograms were obtained before and every 30 seconds during the 10 minutes after secretin administration. Morphologic features and diameter of the pancreatic duct were monitored before and during secretin stimulation. Duodenal filling volume was graded. Results were compared with those of endoscopic retrograde cholangiopancreatography and secretin stimulation testing with collection of pancreatic fluid. RESULTS: Secretin improved the delineation of ductal morphologic features in both groups. Persistent dilatation of the pancreatic duct after stimulation (five patients) was a significant finding (P = .0015) in the diagnosis of papillary stenosis. The mean duodenal filling score was significantly lower in patients with reduced exocrine function (six patients) than that in the volunteers (P < .0001). CONCLUSION: The use of dynamic MR pancreatography with secretin stimulation may be useful for diagnosing pancreatic papillary stenosis or dysfunction and for detecting reduced pancreatic exocrine reserve.

Adult↗

Case report: Renal pseudotumours mimicking tumour recurrence after partial nephrectomy.

Partial nephrectomy and tumour enucleation are increasingly accepted as an organ sparing approach for small renal cell carcinomas. Repeated computed tomography or sonography for the early detection of tumour recurrence are mandatory during the follow-up. We report two cases of renal pseudotumour mimicking a tumour recurrence: one case is related to the pseudotumoral appearance on sonography of a tumour defect filled by a fatty flap, and the other to the relative migration of an accessory spleen into the site of the cuneiform nephrectomy. The recognition of renal pseudotumours following partial nephrectomy prevents confusion with tumour recurrence on follow-up examinations.

Adult↗

[Abdominal complications of ventriculoperitoneal shunts].

Three cases of abdominal complications of ventriculo-peritoneal shunts are reported. Abdominal pseudocysts were identified in 2 patients (surinfection was proven in one of them). Malposition of the shunt was demonstrated for the third patient. Ultrasound was the most helpful imaging technique for the detection of these abdominal complications. Abdominal computed tomography confirmed the sonographic findings before the patients were reoperated.

Abdomen↗

Primary biliary cirrhosis and bone changes.

Two cases of primary biliary cirrhosis with bone lesions are reported. In one case radiographic findings in the hands and right shoulder are found to be characteristic of primary biliary cirrhosis rather than other concomitant diseases present in the patient which are also susceptible to produce bone lesions. The second case is an example of less specific bone changes which may be attributed to primary biliary cirrhosis or other rheumatoid disease.

Aged↗

[Imaging of acquired pathologies of the thoracic aorta].

For many years, imaging of thoracic aorta has been dominated by angiography. Development of new imaging modalities has modified the diagnostic approach to thoracic aortic pathology. The knowledge of the advantages and limitations of each technique enables a better choice for patient evaluation, in particular under emergency conditions. This study is based on a review of the literature and reports the authors' experience.

Aortic Dissection↗

[Emergency treatment of hemobilia using embolization].

Embolotherapy has gained widespread acceptance as the modality of choice for the management of hemobilia because of its safety profile. Our case reports a successful transcatheter embolization of the right hepatic artery aneurysm causing hemobilia in a patient in hemodynamic instability.

Aged↗

[Placing of a Nitiol Memotherm prosthesis: personal experience].

The authors report their experience in the placement of a new Nitinol stent. Thirty eight stents were placed in 28 iliac arteries, 3 superficial femoral arteries, 1 popliteal artery, 2 subclavian arteries, and 2 veins of hemodialysis fistulae. The primary success rate was 100%, but several angioplasty balloons have been ruptured due to the specific configuration of the stent. The mean follow-up period was 6 months. Memotherm placement is an easy procedure, but the specific structure of the device makes the manipulation of the angioplasty balloons delicate, especially in tortuous vessels.

Aged↗