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Biomedical subjects

J Struyven

Publications and source records attributed to J Struyven.

At least 55 records · Page 3Linked to original sources

Atypical and equivocal sonographic features of the spinal cord in neonates.

Thanks to the wider use of sonography to examine the spinal content in the neonate, normal anatomy and anomalies may be detected easily. Yet, unusual sonographic patterns are also observed. These must be differentiated from true pathologies. During a prospective study of 103 neurologically asymptomatic neonates, atypical sonographic patterns were found in 16 patients, corresponding to normal variants in 13. Nine of these 13 patients presented with a widening of the distal part of the central echo complex (one had a dilated ventriculus terminalis). Nerve roots of the cauda equina were disposed asymmetrically in three patients; the spinal cord movements were still present. In two of these babies, this distribution was associated with thin arachnoid pseudocysts. One patient presented with transitorily hyperechoic and narrow subdural spaces, probably related to neonatal dehydration. None of the 13 patients showing normal variants required any treatment. The other 3 patients (of 16) presented with equivocal entities of unknown evolution: sonographic tethered cord, fibrolipoma of the filum terminale and epidural varices. Sonography is highly accurate in evaluating the spinal cord content and aids differentiation of normal and normal variants from equivocal or pathological entities.

Diagnosis, Differential↗

Controversies in vascular imaging and intervention: a panel discussion.

PURPOSE: To express for educational purposes, different and often opposing views on controversial topics of current interest in vascular radiology. And to explore whether or not consensus can be reached on any of these controversial issues. METHOD: Panel discussion among experts in the field. With the help of a moderator, controversial topics were introduced for discussion. For each topic the moderator underscored the principal issue and asked relevant questions. All panelists were asked to express their views on all issues. The following issues were discussed: Atherectomy vs balloon angioplasty; Balloon angioplasty vs stents; Digital vs analog Imaging; TIPS as an emergency procedure; Regional thrombolysis; MRA vs conventional angiography; Laser angioplasty; Carbon dioxide angiography; Lymphangiography vs CT; The training of surgeons in angiography. The panelists were urged to avoid extensive references to the literature but rather to express their own personal opinions based on experience and practice. For each topic an attempt was made to arrive at consensus. RESULTS: Ten issues were presented for debate and discussion. Despite divergent opinions it was possible and relatively painless to reach consensus on seven controversies. On the remaining issues the panelists agreed to disagree. However even when there was disagreement certain trends became apparent. Local considerations and resource availability accounted for varied approaches to the solution of certain controversies. CONCLUSIONS: A panel discussion among experts may be a useful way to address controversies for educational purposes. Despite divergence of opinions consensus may be reached, or in absence of consensus general trends may become apparent.

Angioplasty, Balloon↗

[Cardiac radiology].

From the beginning of the era of X-rays, cardiac radiology has become a target of this new technique. Early pioneers, Ciegem, Rieder, Rosenthal, Williams rapidly accumulated extensive experience with fluoroscopy and radiography and publications on cardiac diseases as soon as 1899 and 1901 and 1902. The next step in cardiac diagnosis was achieved by Forsmann in 1929, with the first attempt at cardiac catheterization and angiocardiography. Many clinicians, Moniz, Reboul, Rousthoi contributed to the development of the technique between 1930 and 1940. A further turning point came in 1941 when Cournand demonstrated that cardiac catheterization was a safe method in man. In the technical field major progress came from Scandinavia were rapid filming was born. The management of ischaemic disease, changed dramatically with the demonstration of coronary anatomy, largely due to Sones, Judkins and Amplatz. A further progress was initiated in 1977 by Gruentzig who invented balloon angioplasty.

Angiocardiography↗

Conventional and high-resolution CT in asymptomatic asbestos-exposed workers.

To compare the value of conventional CT (CCT) and high-resolution CT (HRCT) to detect benign asbestos-related diseases, 159 exposed workers with a normal chest radiography were imaged by both techniques. Pleural plaques were detected in a total of 59 cases (37.1%). Ten cases (16.9%) were detected by CCT only and one case (1.7%) by HRCT only. Pulmonary lesions compatible with parenchymal asbestosis were detected by HRCT in 20 cases, whereas CCT showed abnormalities in 45% of these. Rounded atelectasis was equally recognized by both techniques. The results confirm that in a subject with a normal chest radiography, HRCT is a better diagnostic tool to demonstrate lesions of asbestosis. On the other hand, HRCT is insufficient to exclude the presence of pleural plaques. When HRCT does not reveal pleural abnormalities, CCT should be performed.

Asbestosis↗

Whole lung sections for computed tomographic-pathologic correlations. Modified Gough-Wentworth technique.

RATIONALE AND OBJECTIVES: High-resolution computed tomography of the lung has been advocated in the evaluation of interstitial lung diseases and emphysema. To provide material for correlations with gross pathology and macroscopic quantitation of emphysema, the authors have shortened and simplified the Gough-Wentworth technique. METHODS: The method permits more precise correlation of cross-sectional images and pathologic specimens and is less time-consuming. RESULTS AND CONCLUSIONS: This modified method can be routinely performed in a clinical laboratory of pathology and provides paper-mounted whole lung sections within four days. The sections are protected by a transparency film.

Histological Techniques↗

Fracture of the posterior aspect of the lateral tibial plateau: radiographic sign of anterior cruciate ligament tear.

Plain radiographs obtained in 25 patients with acute anterior cruciate ligament (ACL) tears detected with magnetic resonance imaging were retrospectively evaluated to identify associated bone lesions. Fracture of the posterior part of the lateral tibial plateau (LTP) was seen in 11 patients, impacted fracture of the lateral femoral condyle (LFC) in two, lateral tibial rim fracture (Segond fracture) in three, and avulsion fracture of the tibial attachment of the ACL in two. The latter three fractures have been associated with an ACL tear. Conversely, fractures of the posterior part of the LTP have not been associated with ACL tear and are recognizable on plain radiographs. Impaction of the LFC on the LTP and avulsion of the posterior tibial capsular junction may account for the association of the fracture of the LTP with the acute ACL tear. This type of fracture represents the most frequent indirect sign of ACL tear seen on plain radiographs.

Adolescent↗

Large solitary non-parasitic cyst of the liver.

Non-parasitic solitary liver cysts are rare in children. Yet they should be included in the differential diagnosis of superior abdominal masses. We report one case in a 7-year-old boy that illustrates the difficulties of the diagnosis.

Carcinoma, Hepatocellular↗

Impotence due to corporeal veno-occlusive dysfunction: long-term follow-up of venous surgery.

Corporeal veno-occlusive dysfunction is an important cause of organic impotence and is characterized by increased flow rates to create and to maintain erection during artificial erection produced by intracavernous saline infusion. Sixty-seven patients with this erectile insufficiency underwent penile ligature-resection of deep dorsal vein between 1982 and 1986, and were evaluated by nocturnal plethysmography, pharmacocavernometry as well as a questionnaire about their sexual life for long-term follow-up. The surgical procedure was controlled in the operating room by reduction of the erectile flow rates. Thirty-one patients were potent postoperatively and were able to have satisfactory intercourse. Results after resection were slightly better than after simple ligation of the deep dorsal vein. Four patients had penile glans insensibility resulting from the surgical dissection. There were 7 relapses several months after the procedure due to leakage through other deeper veins. Eight failures were due to additional psychogenic disorders or to neurologic disease not accurately diagnosed before the treatment because they all developed normal papaverine-induced erection after venous surgery while before it they only developed a slight tumescence. Reduction of the erectile flow rates within normal values was impossible during surgery in 3 patients. Eleven failures were due to concomitant arterial disease. Resection of the deep dorsal vein can restore penile erection in patients with cavernovenous leakage in about 50% of well-selected patients.

Erectile Dysfunction↗

Transverse geniculate ligament of the knee: appearance and frequency on plain radiographs.

The aims of the study were to determine the frequency of visualization of the normal transverse geniculate ligament (TGL) of the knee on lateral plain radiographs with magnetic resonance imaging (MRI) as a reference, and to determine features that make this ligament apparent on plain radiographs. 50 consecutive lateral plain radiographs and sagittal T1-weighted images of corresponding knees were evaluated prospectively. A TGL was considered visualized on plain radiographs when an opacity of soft-tissue density was apparent in the posterior part of the Hoffa's fat pad. The TGL was identified in 29 of the 50 (58%) sagittal MR images; a TGL was observed on the lateral plain radiographs of six patients (12%). Correlation with the MR images showed that, when visualized on plain radiographs, the ligament is at least 3 mm thick and completely surrounded by fat. Our study shows that the TGL is a normal variant that can be recognized frequently on lateral plain radiographs of the knee.

Adolescent↗

The ureterovesical junction in children: sonographic findings after surgical or endoscopic treatment.

We retrospectively analyzed pre- and postoperative sonographic and medical records of 335 children who had surgical or endoscopic treatment at the ureterovesical junction, in order to determine normal and atypical sonographic appearances. Normal sonographic findings after ureteral reimplantation include thickening of the posterior bladder wall, pseudodiverticular sacculations, bladder asymmetry, and transitory hydroureteronephrosis. Short-term or persistent (lasting more than 1 month) hydroureteronephrosis, urinoma, hematoma, bladder lithiasis, and diverticula were abnormal findings, occurring in 17% of the patients. After partial ureteronephrectomies, visualization of the residual ureter on sonograms was not possible in cases without complications; in one patient, reflux of fluid dilated the residual ureter and made the ureter visible on sonograms. After endoscopic incisions, the masslike appearance of a collapsed ureterocele was observed. Submucosally injected Teflon always appeared as a curvilinear hyperechoic area with an acoustic shadow. Marked acute or persistent hydroureteronephrosis or ectopic intracavitary Teflon particles were observed in 2% of patients. Granuloma formation was considered likely in 5% of the patients when the area of injected Teflon material was longer than 12 mm on sonograms. Submucosally injected collagen appeared less echogenic than Teflon and showed no acoustic shadowing. The various normal sonographic appearances after treatment must be known in order to distinguish them from significant abnormalities. In patients with anatomic anomalies, such as short-term or persistent hydroureteronephrosis, urinoma, hematoma, and lithiasis, complementary uroradiologic examinations may be necessary to clarify the diagnosis.

Adolescent↗

Gadolinium-DOTA enhanced MR imaging of prostatic lesions. Preliminary results on 14 cases.

Fourteen patients with prostatic carcinoma, benign prostatic hyperplasia, or chronic granulomatous prostatitis underwent gadolinium-DOTA enhanced magnetic resonance imaging of the prostate. Gadolinium-DOTA was administered intravenously in a dosage of 0.1 mmol/kg body weight. All studies were performed on a superconductive 1.5-T system. As compared to noncontrast T1- and T2-weighted images, Gd-DOTA enhanced T1-weighted images were useful in distinguishing malignant tumor from granulomatous prostatitis in one case, but were uncontributive to the differentiation between carcinoma and benign prostatic hyperplasia.

Contrast Media↗

Ultrasound evaluation of soft tissue tumors.

Because of its availability, ultrasound should be the preferred initial modality for the evaluation of palpable superficial masses. Most ultrasound units are equipped with high frequency probes that allow superficial focalization. The differential diagnosis of soft tissue masses and the sonographic features of some benign and malignant soft tissue lesions are reviewed in this article. After an initial ultrasound evaluation confirming the presence of a tumor, the need for and the role of other imaging modalities can be determined. In selected cases ultrasound may obviate the need for further imaging. MRI and CT should be reserved for cases in which sonography fails to establish a specific diagnosis or to demonstrate the limits of the soft tissue mass.

Adult↗