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M Coulomb

Publications and source records attributed to M Coulomb.

At least 55 records · Page 3Linked to original sources
PubMed1996

False aneurysm of the pulmonary artery induced by a Swan-Ganz catheter: clinical presentation and radiologic management.

OBJECTIVE: This study evaluates retrospectively the clinical presentation, radiographic findings, and angiographic management of false aneurysm of the pulmonary artery resulting from Swan-Ganz catheter placement. MATERIALS AND METHODS: Over a 4-year period, seven false aneurysms of the pulmonary artery were diagnosed in five patients (four women, one man) who were 67-81 years old. All five patients underwent Swan-Ganz catheter placement to monitor cardiac surgery--coronary artery bypass grafting in four and mitral valve replacement in one. All patients were anticoagulated. For five patients, we reviewed the medical records and the results of chest radiography, digital subtraction pulmonary angiography, and pulmonary artery embolization. For two patients, we reviewed the results of CT scanning. RESULTS: Non-life-threatening hemoptysis was noted in all cases and occurred in three patients after the Swan-Ganz catheter had been removed (elapsed time of 1-19 days). Chest radiographs revealed a pulmonary infiltrate in one patient and a pulmonary mass in two patients. The results were unremarkable in the other two patients. CT depicted two false aneurysms of the pulmonary artery as round masses with eccentrically enhanced lumina circumscribed by thrombosis. Pulmonary angiography revealed a single false aneurysm in three patients and two false aneurysms in two patients. All false aneurysms were localized in segmental or subsegmental branches of the right middle pulmonary artery (n = 4) or the right lower pulmonary artery (n = 3). All patients were successfully treated with transcatheter steel-coil embolization. CONCLUSION: Even when the chest radiograph appears unremarkable, patients clinically suspected of developing a false aneurysm of the pulmonary artery after Swan-Ganz catheter placement require enhanced CT or pulmonary angiography to establish the diagnosis. False aneurysms of the pulmonary artery can be treated at the time of pulmonary angiography by steel-coil embolization.

Aged↗
PubMed1995

Benign noninflammatory bronchial stenosis: treatment with balloon dilation.

PURPOSE: To assess the efficacy of balloon dilation in the treatment of acquired, noninflammatory bronchial stenosis of benign origin. MATERIALS AND METHODS: Balloon bronchoplasty was performed with fluoroscopic guidance 36 times in 19 bronchial stenoses in 16 consecutive patients, with use of a local anesthetic. RESULTS: Initial technical success was attained in all cases; clinical success was achieved in 13 (68%) of 19 bronchial stenoses. Six of the 19 stenoses were dilated unsuccessfully because they were caused by localized bronchomalacias. Of these initial successes, seven stenoses recurred but were redilated with success in four cases. At a mean follow-up of 21.6 months (range, 7-60 months), improvement in both fiberoptic bronchoscopy and respiratory status was seen in nine (69%) of 13 patients with fibrous stenoses. CONCLUSION: Balloon bronchial dilation can be proposed as the primary treatment in acquired, noninflammatory bronchial stenoses of various benign origins including stenoses after lung transplantation.

Adolescent↗
PubMed1995

[Left ventricular insertion of a permanent pacemaker (radiographic aspect)].

We report a case of inadvertent transarterial permanent pacing of the left ventricule that was not diagnosed on routine chest radiography or ECG. The malposition was diagnosed because of the rupture of the mitral valve cordage 2 months after pacemaker implantation. We emphasize the radiographic appearance of this rare malposition.

Cardiac Pacing, Artificial↗
PubMed1995

[Progress in tomodensitometry. Applications in cancerology].

Since 1992, spiral CT scanners replace conventional CT units in radiology departments. In the first part of this paper, we present some technical considerations concerning spiral CT (continuous rotation and emission of the source-detector; continuous translation of the patient at a constant rate through the gantry), as well as advantages and limitations of volumic acquisition. The main advantages can be summerized as: reduction of the acquisition time, optimization of contrast enhancement with intravenous opacification, and post processing allowing retrospective creation of overlapping images, multiplanar reconstructions, and 3-D reconstructions. Spiral CT improves lesions detection and characterization. Disadvantages are due to contrast media injection and radiation exposure. Then we describe clinical applications in the carcinologic field concerning pharyngo-laryngeal tumors, bronchogenic carcinoma, mediastinal tumors, pulmonary nodules, sub-diaphragmatic tumors. However, tumors of brain, spine, bone, and soft tissue are better explorated with MRI. Authors conclude on the future improvements of spiral CT.

Adult↗
PubMed1994

The "horseshoe" lung: six new cases.

Six cases of horseshoe lung have been found in a group of 147 scimitar syndrome cases collected in a cooperative multicenter study. These cases were associated either with the severe infantile or with the benign adult form of the scimitar syndrome. The aim of this paper is to describe the clinical and imaging signs as well as the prognosis of 6 new cases of horseshoe lung in association with scimitar syndrome. The authors conclude (1) that the diagnosis of horseshoe lung may be strongly suspected on standard chest radiographs and confirmed by thoracic CT scan; (2) that the prognosis of scimitar syndrome does not seem to be worse when associated with horseshoe lung.

Adolescent↗
PubMed1994

[Diagnosis of broncholithiasis. Role of high resolution tomodensitometry].

PURPOSE: to evaluate high resolution computed tomography (HRCT) in the diagnosis of broncholithiasis. PATIENTS AND METHODS: 10 patients with broncholithiasis underwent chest X ray, fiberoptic bronchoscopy (FOB), CT and HRCT. RESULTS: in 9 cases, chest X rays were abnormal but the diagnosis of broncholithiasis can't never be affirmed. In 9 cases, FOB was abnormal: broncholith were identified in only 2 cases; the other diagnosis were tumor like stenosis (n = 3), inflammatory stenosis (n = 3), extrinsic compression (n = 1). On conventional CT scan, broncholithiasis was suspected in 8 patients but because of volume averaging the relationship between calcified lymph nodes and bronchial tree was difficult to determine exactly. Only HRCT sections, sometimes tilted in the axis of the middle lobar bronchus, can affirm the endobronchial or peribronchial location of calcified lymph nodes in all patients. CONCLUSION: conventional CT scan can suggest the presence of broncholithiasis but HRCT sections are need to affirm the diagnosis.

Adult↗
PubMed1993

[Intrathoracic hydatid cyst. Contribution of tomodensitometry. Apropos of 25 cases].

Twenty-five cases of thoracic hydatic disease, studied by CT since 1982, are reviewed. Fifteen patients were Maghrebin, 10 were native. The lungs were interested 22 times, the mediastinum 3 times and the heart only once. Complications of hydatic disease were present 8 times. We compare contribution of CT to the other diagnosis criterious. Our results show the accuracy of CT for the diagnosis of non complicated cyst and the lack of specificity for complicated cysts.

Echinococcosis↗
PubMed1992

Somnofluoroscopy, computed tomography, and cephalometry in the assessment of the airway in obstructive sleep apnoea.

BACKGROUND: Assessments of the upper airways in patients with the obstructive sleep apnoea syndrome are usually carried out on awake patients who are upright. The dynamics of the airway in a patient who is asleep and lying down may be different. METHODS: Somnofluoroscopy, computed tomography of the upper airway, and cephalometry were carried out in 11 patients with the obstructive sleep apnoea syndrome (10 male; mean (SD) age 53 (10) years) to examine the airway while they were awake and asleep. RESULTS: At somnofluoroscopy 10 patients were in stage 2 sleep and only one in REM sleep. At least five obstructive events were visualised by lateral fluoroscopy in each patient. Imaging allowed observation of the dynamics of airway collapse, which began in the oropharynx in all cases, progressing to the hypopharynx in 10 cases and to the laryngopharynx in five. At fluoroscopy the soft palate was seen to hook up during airway occlusion in 10 patients, thereby increasing its cross sectional area. It was then sucked down into the hypopharynx. Somnofluoroscopic and cephalometric findings agreed, eight of the 10 patients with hypopharyngeal collapse shown by somnofluoroscopy having an inferiorly placed hyoid bone according to cephalometry (distance from the mandibular plane to the hyoid bone (MP-H distance) increased); the one patient with no hypopharyngeal collapse had a normal MP-H. By contrast, six of the 11 patients had a normal or supranormal hypopharyngeal cross sectional area of the airway on the computed tomogram. CONCLUSIONS: Somnofluoroscopy allows examination of the dynamics of airway closure in this disorder and shows the important role of the soft palate in acting as a plug in the oropharynx. Dynamic studies are required to determine the pattern of pharyngeal obstruction in obstructive sleep apnoea.

Adult↗
PubMed1992

[How can the extension of lung cancer to the osteo-muscular wall of the diaphragm, the pleura and the apex be assessed radiologically?].

The merits of evaluating the parietal extension of lung cancers is emphasized by the new TNM classification. CT and MRI have added to the conventional radiological techniques. The authors successively analyze the contribution of these techniques to the assessment of extension of lung cancers to the wall, including the costal and phrenic compartments, to the pleura and to the apex. Lung radiographs show obvious lesions, such as extensive costal lysis and major pleural extensions. Computed tomography has better sensitivity and specificity than lung radiographs to establish pleuroparietal involvement; it is best performed in the inclined plane of the ribs and in the high-resolution mode. The presence of costal lysis means parietal involvement, while the integrity of the pleura can be established if the lesion remains at a distance from the wall. The persistence of an extrapleural fatty rim between the tumor and the wall allows ruling out parietal extension. MRI provides accurate details in case of doubtful CT findings for the extension to the costovertebral groove, to the intervertebral foramina, to the peridural space and to the diaphragm. Its major asset is to assess the vertebral, vascular and nervous extension of cancers of the apex pulmonis.

Carcinoma, Non-Small-Cell Lung↗
PubMed1992

[Diffuse infiltrative lung diseases: histological support of elementary lesions observed on tomodensitometry].

High resolution computed tomography (TDM-HR) is now the technique of choice in the diagnosis and management of diffuse infiltrative lung disease (PID). After a brief review of the technique the authors describe the normal appearance; anatomical observations and the in vivo findings have shown that TDM-HR allow for the exploration of details of structure down to the second pulmonary lobule. Thus, through the alterations that are transmitted in the lobular area, and from its contents and its limits, PID has led to the elaboration of a new semeiology. The authors review the basic computed tomographic images and correlate these in each case with the histological evidence. The spatial distribution and the time sequence of the elementary images are the two other terms in the diagnostic equation of PID. The spatial distribution of several elementary images presents in TDM-HR a superior aetiological pointer to that which is furnished by thoracic radiographs; and the time sequence may furnish a useful indication as to the progress of the treated disease. Sarcoidosis, histiocytosis X, idiopathic interstitial fibrosis and lymphangitis carcinomatosis would serve as examples. Nevertheless, the authors point out that it would be dangerous during the period of evaluation to prematurely extend to all cases of PID conclusions which are only possible to make at present in a restricted number of disorders.

Histiocytosis, Langerhans-Cell↗
PubMed1992

[Value of high resolution tomodensitometry in pulmonary histiocytosis X. Radiological, clinical and functional correlations].

Histiocytosis is a rare cause of diffuse interstitial pneumonia. Its aetiology is not known and the outcome is often unsatisfactory. In 10 subjects in whom the diagnosis of histiocytosis X was established at CHU in Grenoble, 7 could be followed up. We report the clinical, functional, radiological and high resolution tomographic data on these 7 subjects suffering from histiocytosis X and followed up for a period between 3 and 13 years (8 +/- 3 years). All the subjects were symptomatic at the time of diagnosis. The clinical outcome amongst the 10 subjects included 2 patients who died, 2 who stabilised, 1 worsened and there were 4 clinical cures, 1 patient was lost to follow up. The respiratory function tests of the 7 subjects who were followed up was characterised by the appearance of airflow obstruction and a significant fall in the DLCO/VA (KCO) of 68 +/- 17% of the predicted value to 43 +/- 13%. An analysis comparing the initial pulmonary radiography to the current films showed that the reticular nodular lesions tended to progress to a diminution in size, while there was an increase in the reticulation. The high resolution computed tomography was confirmed as better technique than pulmonary radiography in detailing the cystic and nodular lesions. This was the only examination which correlated with DLCO/VA (R: 0.8; p: 0.018). A progressive model for computed tomographic lesions is proposed. Computed tomography appears to be the key examination, orientating the diagnosis based on the association of the nodules and cysts and enabling a better appreciation of the severity of the pulmonary disease taking account of its excellent correlation with diffusion.

Adult↗
PubMed1991

[The role of new medical imaging technics (TDM and MRI) in the diagnostic strategies of superior vena cava syndrome].

Superior vena caval syndrome (VCS), is easily recognised in the advanced case, however in the early case without clinical signs its detection is much less easy. New techniques of medical imagery such as IRM and above all computer tomography (TDM) have shown an increasing place in the daily clinical practice of the respiratory physician; these enable an early diagnosis to be made and a work up of the aetiology of the syndrome of VCS. With TDM the obstruction of the VCS appears the sign of direct obstruction (thrombosis or extrinsic compression) and of a collateral venous circulation deriving some anastomoses from the brachio-cephalic venous trunk (TVBC) and the azygos system, the VCS and the inferior vena cava (VCI), the two TVBC at the junction of the median line principally by the suprasternal network and finally these portal systemics, by the veins from the anterior wall of the trunk and the accessory portal veins of the round ligament. IRM introduced more recently enables a direct vision of the causal lesion endo or extra luminally, enabling an early detection of the syndrome by showing signs of a slow down of the venous flow. But the detection of a collateral circulation seems more difficult to demonstrate by this method.

Humans↗
PubMed1990

Pulmonary histiocytosis X with mediastinal lymph node involvement.

In this report, we describe a patient with the classic histology of pulmonary histiocytosis X, who had bilateral reticulonodular densities and mediastinal lymph node involvement. The diagnosis was confirmed by the use of electron microscopy and immunohistochemical markers (PS100, HLA-DR, and CD1), which allowed us to recognize the lymph node infiltration of X histiocytes. An association of mediastinal lymph node enlargement with pulmonary histiocytosis X has been reported but it has never been histologically documented.

Adult↗