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Biomedical subjects

M Ghossain

Publications and source records attributed to M Ghossain.

24 records · Page 2Linked to original sources

[Contribution of MRI in the staging of cancer of the bladder. Apropos of 40 cases].

56 patients with bladder carcinoma were examined by magnetic resonance in the pre-operative staging. In 40 patients where total cystectomy with enterocystoplasty and pelvic node dissection were performed, a good correlation with surgical and pathologic findings was obtained. MR examination using T1 (TR 400 ms, TE 28 ms) and T2 (TR 1,200-1,600 ms, TE 40 80 120 ms) weighted images in different planes where performed after biopsy of the bladder tumor through endoscopy and within 1 or 2 weeks before surgery. Neoplasms were characterized by site, size and growth pattern. Extension through the deep muscle of the bladder wall was correctly identified in 95% with a sensitivity of 95% and a specificity of 95%. Extension through perivesical fat was assessed accurately in 85% with a sensitivity of 66% and a specificity of 100%. Accuracy in evaluating invasion of adjacent organs was 85%, sensitivity 44%, specificity 96%. Lymphadenopathy has been accurately assessed in 97.5% with a sensitivity of 83% and a specificity of 100%. MR correctly staged the tumor according to TNM classification in 24/40 (60%) patients, overestimated the extension in 3/40 (7.5%) and underestimated the extension in 13/40 (32.5%).

Adult↗

[X-ray computed tomography of endometrioid cancers of the ovary. Apropos of 4 cases].

The preoperative CT scan of 4 patients who had surgery for endometrioid adenocarcinoma of the ovaries were studied retrospectively and the results correlated to operative and pathological findings. 1) All tumors were bilateral. 2) Uterine involvement was diagnosed in 1 out of 3 cases. 3) Fallopian tubes involvement was present in 3 cases but was never seen on CT scan. 4) Ascites and peritoneal metastasis were correctly diagnosed in 2 out of 3 cases.

Adenocarcinoma↗

[Compression of the common peroneal nerve by a synovial cyst].

The authors report a successfully treated case of compression of the peroneal nerve by a simple (extraneural) ganglion. A brief review of the pathogenesis of intraneural and extraneural ganglions is exposed. The authors emphasize on considering this diagnosis in every patient who is complaining of pain or paralysis in the territory of the peroneal nerve. The treatment is always surgical. Prognosis depends on early diagnosis, non mutilating surgery for the nerve and ligation of an eventual stalk joining the ganglion to the articulation.

Adult↗

Preoperative assessment of the extension of rectal carcinoma: correlation of MR, surgical, and histopathologic findings.

Nineteen patients with rectal carcinoma were evaluated prospectively. The extent of tumor and the relationship of the tumor to the levator ani muscle were studied as this determines the choice of the surgical procedure (abdominoperineal resection versus low anterior resection). Peroperative assessment and detailed evaluation of the pathologic specimens were correlated with magnetic resonance (MR) features. Magnetic resonance staging and surgical findings were at variance in four of 15 cases (27%). Magnetic resonance had sensitivities and specificities of 75 and 100% in the detection of perirectal growth. Magnetic resonance demonstrated invasion of adjacent pelvic side wall and sacrum in two of two cases. The comparison with TNM classification demonstrated that MR correctly staged 15 of 19 cases (79%). This study shows that MR is a good examination to evaluate the involvement of perirectal fatty tissues and adjacent structures. The low prevalence of involved lymph nodes in our cases prevents significant positive predictive values. Nevertheless, MR can help to select patients for local excision or for preoperative radiotherapy.

Adenocarcinoma↗

[Indications for arteriography in penetrating wounds of the lower limbs].

One hundred arteriographies were performed in emergency in 87 patients with penetrating trauma of the lower limbs caused by high- or medium-velocity projectiles (bullet or shell fragment). Thirteen patients had bilateral wounds. In 79 cases, the arteriogram was abnormal and led to surgical exploration. In 76 cases, an arterial lesion was found and treated (positive predictive value = 76/79 = 96%). In three cases, no arterial lesion was detected (3 false-positive findings). Among the 21 patients with normal arteriograms, 10 had surgical exploration because of clinical suspicion. An arterial lesion was found in 2 cases (2 false-negative findings). In the other 11 cases, the clinical and Doppler sonographic observations were normal (negative predictive value = 19/21 = 90%). The sensitivity rate was 97%, specificity 86% and accuracy 95%. In 8 cases, arteriography led to modifying the surgical procedure. These results show that preoperative arteriography, performed as an emergent examination in hemodynamically stable patients, allows avoiding surgery in some cases, and modifying the procedure in others.

Adolescent↗

[Pulmonary embolism. The role of computed tomography angiography].

NONINVASIVE PROCEDURE: Helical CT angiography is a noninvasive procedure whose only relative contraindications are renal insufficiency and iodine allergy. MASSIVE PULMONARY EMBOLISM: If a massive pulmonary embolism is suspected, helical CT angiography is the examination of choice because of its high accuracy in detecting proximal thrombi and its safety profile. NON-MASSIVE PULMONARY EMBOLISM: If a non massive pulmonary embolism is suspected, helical CT angiography, because of its high specificity, can be the first examination instead of scintigraphy. If a thrombus is depicted by CT, the diagnosis of pulmonary embolism is confirmed and treatment is started. If no thrombus is visualized by CT, pulmonary embolism can be ruled out in most cases. In case of doubt, another noninvasive procedure should be performed. Angiography should be the exception and seldom is needed.

Angiography↗