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Biomedical subjects

M Levesque

Publications and source records attributed to M Levesque.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

MRI of Budd-Chiari syndrome.

A retrospective study was undertaken to reassess the various magnetic resonance imaging (MRI) features of Budd-Chiari syndrome (BCS). MRI examinations of 22 patients with pathologically confirmed BCS were studied. Spin-echo (SE) T1- (TR = 300-450 ms/TE = 12-15 ms), and SE T2-weighted (TR = 1600-2000 ms/TE = 30-60/90-120 ms) MRI images were obtained in all patients. Gradient-recalled-echo (GRE) images (TR = 7-60 ms/TE = 3-19 ms, flip angle = 10-40 degrees) were obtained in 14 patients. MRI showed thrombosis of three or two hepatic veins in 19 (86%) and 3 (14%) patients, respectively. Spontaneous intrahepatic anastomoses was depicted in five (23%) patients. Ascites appeared in 15 patients (68%). Thrombosis or external compression of the inferior vena cava (IVC) by an enlarged caudate lobe was depicted in six (27%) and five (23%) patients, respectively. Prominent azygos and hemiazygos veins were demonstrated in seven (32%) patients (six of whom had thrombosis of the IVC). MRI showed hepatomegaly in all patients and enlarged caudate lobe in 18 (82%) patients. SE T1- and SE T2-weighted MRI images revealed inhomogeneous signal intensity of hepatic parenchyma in 14 (64%) patients. SE T1- and SE T2-weighted MRI images showed homogeneous signal intensity of hepatic parenchyma in eight (36%) patients. Our results demonstrate that BCS displays various features on MRI images, and such information is important for diagnosis.

Adult↗
PubMedDate not supplied

Involvement of superior mesenteric vessels and portal vein in pancreatic adenocarcinoma: detection with CT during arterial portography.

A prospective study was designed to determine the utility of computed tomography (CT) during arterial portography (CTAP) in the detection of superior mesenteric vessels and portal vein involvement in patients with pancreatic adenocarcinoma. Eighteen patients with adenocarcinoma of the head of the pancreas and eight patients with benign pancreatic disease were investigated with CTAP, dynamic contrast-enhanced CT, and angiography. Appropriate review was made to determine presence or absence of superior mesenteric vessels and portal vein involvement. Final diagnosis was obtained in all cases by surgical explorations. The overall accuracy rate for detecting or excluding superior mesenteric vessels and portal vein involvement was 96% (25 of 26 patients) with CTAP, 88% (23 of 26 patients) with dynamic contrast-enhanced CT, and 85% (22 of 26 patients) with angiography. No statistically significant difference in accuracy was found among the three techniques. Our results suggest that the use of CTAP is not indicated in the preoperative detection of superior mesenteric vessels and portal vein involvement in patients with pancreatic adenocarcinoma.

Adult↗
PubMedDate not supplied

CT of fibrolamellar hepatocellular carcinoma.

We retrospectively evaluated 10 patients with pathologically proven fibrolamellar hepatocellular carcinoma (FLHCC) to assess the utility of CT (n = 9), ultrasound (n = 10), angiography (n = 9), and MR (n = 3). The tumors were solitary in 6 of 10 patients, well delineated in 7 of 10, and hypervascular in 8 of 10. With use of multimodality imaging techniques, a central scar was demonstrated in 3 of 10 patients, calcifications in 4 of 10, dilated intrahepatic ducts in 2 of 10, thrombosis of a segmental portal branch in 2 of 10, and lymph node involvement in 3 of 10. Computed tomography was the most accurate technique for diagnosis and staging. Magnetic resonance imaging helped establish the correct diagnosis in one patient. This report emphasizes the wide variability of imaging features of FLHCC and the predominant role of CT for suggesting the diagnosis.

Adolescent↗
PubMedDate not supplied

MRI of liver metastases from colorectal cancer vs. CT during arterial portography.

A prospective study was performed to compare, with a lesion-by-lesion analysis, the sensitivities of high field strength MRI and CT during arterial portography (CTAP) in detecting hepatic metastases from colorectal cancer. Twenty-one patients with liver metastases from colorectal cancer were prospectively investigated by high field strength MRI (1.5 or 2 T) and CTAP. High field strength MRI was performed with pre and post gadopentetate dimeglumine enhanced T1-weighted SE sequences and T2-weighted SE sequences. All patients underwent partial hepatectomy and 37 metastases were surgically and pathologically proved. The metastasis detection rate (sensitivity) was 94% (35 of 37) for CTAP and 78% (29 of 37) for high field strength MRI. The 16% (95% confidence interval: 1-31%) difference in sensitivity between CTAP and high field strength MRI was statistically significant (p < 0.05, McNemar test). The use of gadopentetate dimeglumine did not improve the sensitivity of T1-weighted SE sequences. Since our study demonstrated significant difference in sensitivities between high field strength MRI and CTAP in our group of patients, we can conclude that high field strength MRI cannot replace CTAP in the preoperative evaluation of patients with liver metastases from colorectal cancer. Computed tomography during arterial portography must be considered as the preoperative gold standard.

Colonic Neoplasms↗
PubMedDate not supplied

MRI of adenomatous hyperplastic nodules of the liver in Budd-Chiari syndrome.

We present two cases of adenomatous hyperplastic nodules (AHN) occurring in patients with chronic Budd-Chiari syndrome who were investigated with MRI. In one case the foci of AHN were isointense to the liver on spin echo (SE) T1-weighted MRI and were hyperintense on both SE proton density and SE T2-weighted MRI. In the other case the nodules were hyper-intense on SE T1-weighted MRI. They were isointense on SE proton density-weighted MRI and became slightly hyperintense on SE T2-weighted MRI. Furthermore, in both cases one nodule displayed hyperintensity with hypointense rims on SE T2-weighted MRI.

Adult↗
PubMedDate not supplied

Cystic tumors of the pancreas: dynamic CT studies.

OBJECTIVE: Our retrospective study was performed to reassess the common dynamic CT manifestations of cystic tumors of the pancreas and to determine whether they might allow the differentiation between benign and malignant tumors. MATERIALS AND METHODS: Dynamic CT examinations of 19 patients with 20 cystic tumors of the pancreas, including 7 serous cystadenomas, 3 benign mucinous cystadenomas, 5 mucinous cystadenocarcinomas, 3 mucin-producing duct ectasias, and 2 papillary cystic epithelial neoplasms, were retrospectively reviewed. The examinations were obtained with 4 to 5 mm collimation with intravenous injection of 120-130 ml of contrast agent. RESULTS: Calcifications were found only in benign tumors (seven serous cyst-adenomas). Internal septations were found in benign and malignant tumors (seven serous cystadenomas, three benign mucinous cystadenomas, three mucinous cystadenocarcinomas). Solid excrescences within cystic cavities were found only in malignant tumors (two mucinous cystadenocarcinomas, two mucin-producing duct ectasias). Dynamic CT features allowed the distinguishing of serous cystadenomas from other cystic tumors and mucin-producing duct ectasias from other mucinous tumors. Dynamic CT features did not permit differentiation between benign mucinous cystadenomas, mucinous cystadenocarcinomas, and papillary cystic epithelial neoplasms. CONCLUSION: The review suggests that dynamic CT findings are useful to differentiate (a) serous cystadenomas and mucin-producing duct ectasias from other cystic tumors of the pancreas and (b) benign from malignant tumors. Such differentiation has impact on patient management.

Aged↗
PubMedDate not supplied

[Evaluation of the role of echography in the positive diagnosis of renal colic secondary to kidney stone].

To evaluate sensitivity and specificity of ultrasound in detecting urinary calculus in renal colic, a prospective study of 31 patients examined by both ultrasound and intravenous urography (IVU) was undertaken. Of the 27 cases of renal colic proved by IVU and/or recovery of a calculus, ultrasound correctly diagnosed urinary calculus in 26 cases with a sensitivity of 96.3%. In the 4 cases in which the sonographic examination demonstrated neither calculi nor unilateral obstruction, further evaluation confirmed the absence of calculi. Specificity of ultrasound was 100%. The results of this study support the use of ultrasound in detecting renal calculus and point out the important place of ultrasound in initial evaluation of renal colic.

Adult↗
PubMedDate not supplied

[Weber-Christian syndrome and pancreatic involvement. Apropos of a case with review of the literature].

The Weber-Christian syndrome associates generalized nodular inflammatory panniculitis with osteoarticular manifestations. Pathogenesis of this rare affection is still obscure but a pancreatic origin has been reported in the literature. A case is presented having the particular features of being revealed by a subacute episode of chronic pancreatitis, and by the intensity of radiologic bony manifestations.

Adult↗
PubMedDate not supplied

[Case of the day].

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Adult↗