[Pyloric stenosis in an adult with eosinophilic gastroenteritis].
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Adult↗
Biomedical subjects
M Tassart
Publications and source records attributed to M Tassart.
[Imaging of salivary lithiasis].
Lithiasis is the most common disease of salivary glands after mumps. The purpose of this review is to analyze the respective role of the different available imaging techniques for the diagnosis of lithiasis and related complications since the treatment of salivary lithiasis has evolved with the emergence of minimally invasive and non surgical techniques. In spite of its limitations, US represents an excellent first line imaging technique because it is non-invasive and widely available. Non contrast helical CT with multiplanar reconstructions seems to be the gold standard for the diagnosis of lithiasis, especially when small and poorly calcified since these may not be visible on standard radiographs. CT allows accurate characterization of the number and position of lithiasis. MR Sialography is increasingly replacing the more invasive conventional sialography for the non invasive visualization of the ductal system of major salivary glands even though conventional sialography has a higher spatial resolution.
Diagnostic Imaging↗
[Endovascular stent grafting for chronic proximal thoracic aortic pseudoaneurysm].
Chronic descending aortic pseudoaneurysm generally result from traumatic and can spontaneously progress to rupture. We report the case of a 70-year-old patient presenting a chronic pseudoaneurysm of the thoracic aorta treated by endovascular stent-grafting. The patient underwent imaging evaluation for endoluminal repair: thoracic aorta was evaluated by contrast-enhanced CT scan and supra-aortic and iliac vessels were evaluated by MRI-imaging. Stent-graft was deployed under fluoroscopic guidance across the aneurysmal defect. The left sub-clavian artery was covered, but no ischemic symptoms appeared and transposition of the left sub-clavian artery was not necessary. Clinical and radiological follow-up at 6 and 30 months showed total exclusion and thrombosis of the pseudoaneurysm. Chronic pseudoaneurysm of the thoracic aorta do benefit from endoluminal repair, which is adapted to patients with high surgical risk.
Aged↗
[MR Sialography].
Indications for sialography have became rare and radiologists are less and less experienced for salivary gland cannulation. MR Sialography allows opacification of salivary ducts without any cannulation and could replace residual indications for sialography. The purpose of this paper is to review the principle of the technique, the normal and pathologic aspects of MR Sialography and to emphasize advantages and limitations compared to other techniques.
Cost-Benefit Analysis↗
Upper extremity digital subtraction venography with gadoterate meglumine before fistula creation for hemodialysis.
BACKGROUND: The purpose of this study was to evaluate the feasibility, safety, and potential role of gadoterate meglumine (Gd-DOTA) as a contrast agent for upper extremity venography before the creation of an arteriovenous fistula (AVF) for nondialyzed renal insufficiency patients. METHODS: Over a 16-month period, 50 venographies were performed on end-stage renal insufficiency patients, using Gd-DOTA as a contrast agent on a high-resolution digital subtraction angiography system. Three sequences were performed on forearm, arm, and chest at 3 mL/sec for a total of 35 mL of Gd-DOTA. Examinations were reviewed by two radiologists for diagnostic and opacification quality. Tolerance was evaluated on the evolution of serum creatinine levels and occurrence of pain during injection. RESULTS: Good interobserver correlation was obtained in evaluating the feasibility of AVF creation by vein segment (0.64 < kappa < 0.88) and in relationship to opacification quality (0.62 to 0.87). No deterioration in renal function (creatinine level before and after) or pain was observed. Twenty-six patients underwent surgical creation of brachiobasilic (N = 8), brachiocephalic (N = 8), radiocephalic (N = 8), and cubitocephalic (N = 1) fistulas or insertion of a polytetrafluoroethylene (PTFE) graft (N = 1). Seventeen were awaiting AVF or were on peritoneal dialysis. Two died before surgery for reasons unconnected with the venography. CONCLUSIONS: Venography with Gd-DOTA is an effective and safe technique in planning AVFs for renal insufficiency patients.
Adult↗
Is selective embolization of uterine arteries a safe alternative to hysterectomy in patients with postpartum hemorrhage?
OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of selective arterial embolization to control severe postpartum hemorrhage. MATERIALS AND METHODS: Twenty-five women with intractable postpartum hemorrhage underwent uterine embolization in our institution during a 6-year period. RESULTS: Angiography revealed arterial extravasation in 13 patients (52%). Sixty-nine arteries were embolized. External bleeding resolved immediately or was markedly decreased in 24 women. In one patient, embolization failed to control the bleeding, and surgical treatment was required. No major complication of embolization therapy was observed. Ten women were followed up for an average of 2 years. Menstruation resumed in all patients, and one woman became pregnant. CONCLUSION: Embolization of acute postpartum hemorrhage is a safe and effective alternative to hysterectomy.
Adult↗
[Investigation of peripheral vascular bed in critical lower limb ischemia: comparative study between arteriography and magnetic resonance angiography].
OBJECTIVES: To determine the precise role of arteriography and contrast-enhanced magnetic resonance angiography (MRA) to evaluate the peripheral vascular bed in critical ischemia of the lower limbs in candidates for distal vascularization. MATERIAL AND METHODS: Fifteen patients (mean age 66 +/- 18 years) underwent MRA and arteriography. In all, 23 lower limbs were studied by non-selective arteriography with aortic injection (n=12) or selective arteriography with iliofemoral injection (n=11). RESULTS: The strength of agreement between MRA and selective arteriography was good (k=0.75) for analysis of leg arteries. MRA was better than non-selective arteriography (p<0.035) to evaluate artery patency. In our study, only MRA improved the treatment decision. CONCLUSION: In patients requiring an assessment of the peripheral vascular bed before distal revascularization, contrast-enhanced MRA can be the first exam. In case of an inadequate MRA, only selective arteriography needs to be performed.
Adult↗
[Calcific retropharyngeal tendinitis: unusual diagnosis].
Acute calcific retropharyngeal tendinitis is a rare entity that often is initially misdiagnosed a retropharyngeal abscess and treated with IV administration of antibiotics. In our 2 cases, imaging enabled a correct diagnosis to be made. Two patients were admitted to the hospital with dysphagia, severe neck discomfort and fever. Lateral radiographs of the cervical spine and CT were obtained in both cases, while MRI was obtained in one case. Calcification of the prevertebral muscles was demonstrated by CT in both cases, and detected on lateral radiographs in only one case. Soft tissue swelling was noted at CT and MRI. A clinical diagnosis of calcific retropharyngeal tendinitis may be difficult to achieve and a definitive diagnosis can be confirmed at imaging studies.
Adult↗
Pulmonary arteriovenous malformations.
OBJECTIVE: Helical CT scan (HCT), a noninvasive method, can detect pulmonary arteriovenous malformations (PAVMs). Its sensitivity is superior to that of global digitalized angiography, but patients receive a significant dose of radiation during diagnostic HCT. We compared HCT to contrast-enhanced pulmonary magnetic resonance angiography (CEMRA), a new noninvasive radiation-free method, in the diagnosis of PAVMs. PATIENTS AND METHODS: Five consecutive patients with PAVMs underwent HCT, CEMRA, and pulmonary artery digital subtraction angiography (PADSA). CEMRA was performed during the pulmonary arterial phase of an IV bolus of gadolinium. PADSA was performed during the embolization procedure. All images were examined for PAVMs. The site and size of aneurysms were specified, as well as the diameter of the vascular pedicles. RESULTS: Thirty PAVMs were detected by CEMRA and 38 by HCT. All 20 PAVMs at least 5 mm in diameter and 10 of the 18 PAVMs < 5 mm in diameter identified on HCT were also identified by CEMRA. Whatever the site, all PAVMs with a feeding artery diameter of at least 3 mm (ie, PAVMs with clinical consequences) were detected by CEMRA. No false-positive results were obtained with CEMRA. CEMRA therefore had a sensitivity of 78% and a specificity of 100%. CONCLUSIONS: CEMRA, a nonionizing and noninvasive procedure, has high sensitivity and specificity for the diagnosis of clinically relevant PAVMs.
Adult↗
[Cannabis and tobacco: cofactors favoring juvenile obliterative arteriopathy].
The causal effect of cannabis, associated or not with smoking, in juvenile thromboangiitis disorders such as Leo Buerger disease, has been suggested. We describe here a case of a 30-year-old woman who smoked cannabis and developed intermittent claudication of the lower limbs. Female sex and proximal localization of the lesions (external iliac artery) are not usually described in "cannabis arteritis". Cannabis would be involved not only in the pathogenesis of juvenile obstructive arteriopathy, but also in the development of atheromatous lesions in the young subject.
Adult↗
[Cirrhosis following hepatitis C, schistosomiasis and pulmonary artery hypertension. Trial with a interferon alpha treatment].
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Adult↗
Utility of CT scan for the diagnosis of chest wall tuberculosis.
The objective of this study was to determine the utility of CT scan findings for the diagnosis of chest wall tuberculosis, excluding the spine. We reviewed 15 patients (13 Africans and 2 Indians) with chest wall tuberculosis, retrospectively. The radiologic examination consisted of a plain X-ray and a CT scan of the chest for each patient. The site of disease was the rib in 13 patients or the body of the sternum in 2 patients. One rib was involved in 11 patients, 2 contiguous ribs (one site) in 2 patients, and bilateral disease (two sites) was observed in the remaining patient. The 14 rib sites involved the posterior arc or costovertebral joint in 11 cases, the anterior arc in 2 cases, and the anterior and middle arc in 1 case. The CT scan findings were an abscess (n = 14) or a soft tissue mass (n = 2), osteolytic lesions (n = 13), periosteal reaction (n = 10), and sequestrum (n = 14). Bone sclerosis was observed only in 3 cases of rib involvement. The association of a soft tissue abscess, an osteolytic lesion, and sequestrum, especially in immigrants to France, suggests chest wall tuberculosis on CT scan.
Adult↗
Primary pulmonary AIDS-related lymphoma: radiographic and CT findings.
STUDY OBJECTIVES: To describe the radiographic and CT findings of primary AIDS-related lymphoma (ARL) of the lung (ARLL), and to evaluate percutaneous transthoracic needle biopsy (PTNB) in the diagnosis of primary ARLL. MATERIALS AND METHODS: Seven chest radiographs and seven CT scans of HIV-infected patients with histologically proved primary pulmonary non-Hodgkin's lymphoma (PPL) were reviewed at our institution. All of the patients had fibroscopy with BAL. The diagnosis of PPL was established histologically by means of PTNB (n = 4), open-lung biopsy (n = 2), or autopsy (n = 1). RESULTS: All but one patient had multiple peripheral well-defined nodules of various sizes on the chest X-ray film and CT scan. One patient had a subpleural parenchymal infiltrate and another had a main peripheral mass with spontaneous cavitation. Hilar/mediastinal adenopathies and pericardial/pleural effusion were never associated with the parenchymal abnormalities. Fibroscopy with BAL was always negative. PTNB, done in six cases, was diagnostic in four cases and suggested primary ARLL in two cases. No complications occurred during these procedures. CONCLUSION: After excluding infectious causes, multiple peripheral nodules and/or masses without hilar or mediastinal adenopathies and without pleural effusion are suggestive of primary pulmonary ARL. A specific diagnosis can be obtained by means of PTNB.
AIDS-Related Opportunistic Infections↗
[Magnetic resonance angiography (MRA) of the abdominal aorta and its branches].
Technical aspects of 3D contrast-enhanced magnetic resonance angiography are exposed, detailing more particularly the pulse sequence used and the mode of injection of contrast agent. Then, various vascular territories are analyzed, and illustrated using various examples of main pathologies observed in routine clinical practice: abdominal aorta, renal arteries, pelvic and mesenteric vessels, and peripheral arteries.
Aneurysm↗
[Thoracic radiology in pregnant women].
Radiological explorations of the thorax raise a certain number of risks for the mother and infant which should be well recognized by the pneumologist. Irradiation is the major risk and can be evaluated in comparison with other risks of radiation. We recall the dosimetric system based on the effective dose expressed in Sievert (Sv). The risks of irradiation are described. The dangers related to contrast agents are discussed. Each type of thoracic imaging is then considered from the standpoint of the technique, risks involved and means of radioprotection. Precise indications for each technique are given in detail for pregnant women. We review rapidly the physiological and pathological signs and symptoms observed during pregnancy and propose a practical attitude for ordering radiographic explorations.
Female↗
[Use of Gadolinium as a contrast agent in the course of renal arterial angioplasty].
For a 72-year-old patient with chronic renal failure, and a renal artery stenosis, we used gadolinium as a contrast agent to perform a digital subtraction arteriography and subsequent arterial angioplasty. Ten ml of gadolinium were used for the arteriography, and during a second procedure 40 ml for the angioplasty, giving high quality images. Renal function remained stable after the procedure, while blood pressure was easier to control.
Aged↗
[Muscular myxoma. A case of myxoma of the psoas].
Report about one case of rare tumor of the muscles (myxoma of the psoas muscles). Ultrasonographic, tomographic and arteriographic appearance.
Aged↗
[A study of gamma-glutamyl-transpeptidase and of the ratio of IgA to transferrin in the pregnant woman (and when using oral contraception) and in the newborn (author's transl)].
The authors confirm the absence of a marked variation in levels of gamma-glutamyl-transpeptidase in women under the influence of oestrogens, but a considerable rise in this enzyme in the newborn, particularly after delivery following vaginal obstetrical manoeuvre. They base these findings on 242 samples taken from pregnant women in the 3 trimesters of normal pregnancies and after delivery, and in the cord blood of newborn infants as well as in patients taking oral contraception. There is a slight rise in the levels of immunoglobulins A in the 3rd trimester of pregnancy. The overall rise in the blood levels of transferrin under the effect of oestrogens is confirmed. Norms were obtained for the levels of the IgA/T ratio which drops progressively as pregnancy progresses and with oral contraception. It has been found that in the last two trimesters the upper limit of the normal is 1 for the IgA/T ratio as compared with 1.9 in the general population. The study of these constants is of value when screening for maternal alcoholism and as a consequence for the prevention of the fetal alcohol syndrome.
Contraceptives, Oral↗