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Biomedical subjects

N Vasile

Publications and source records attributed to N Vasile.

At least 73 records · Page 4Linked to original sources

[Value of x-ray computed tomography in evaluating the spread and therapeutic strategy in cancer of the bladder].

Fifty four computed (CT) examinations were performed on patients with bladder carcinoma. A pathological assessment was obtained in 24 cases and the accuracy of CT in local staging was 91%. The accuracy of CT in detecting lymph nodes invasion was also 91%. Moreover, CT is helpful in the follow-up of patients under treatment. As it provides a correct pre-therapeutic evaluation in 83% cases, CT appears as an effective examination to perform in the evaluation of bladder carcinoma.

Aged↗

Primary dissecting aneurysms of the coronary arteries: case report and literature review.

We describe a case of dissecting aneurysm that occurred in a 33-year-old woman suffering from acute myocardial infarction, which was discovered by coronary angiography. Angiographic diagnosis of dissections is rare with only six such cases previously reported. Sixty cases in the literature are reviewed to ascertain the main characteristics of this rare entity. The distinct predominance of this disease among women, particularly post partum, suggests an hormonal influence on its pathogenesis.

Adult↗

Portal vein involvement in hepatocellular carcinoma: dynamic CT features.

The authors conducted a retrospective examination of 62 hepatocellular carcinomas, taking dynamic CT scans of selected sections after an intravenous contrast bolus. The proximal portal vein was involved in 40% of cases and the distal segment in 16%. Angiographic correlation was available in 23 patients. CT signs of main or lobar portal vein involvement included (a) hypodensity and enlargement, (b) periportal arterial hypervascularization surrounding the hypodense intraluminal region, (c) nonvisualization of the lobar portal vein, (d) arterioportal shunting, and (e) differences in lobar attenuation. The characteristic appearance of tumor within the portal vein was noted in many cases; in others, distinction between tumor and bland thrombus could not be made. Peripheral portal vein obstruction was suggested when a small, hypervascular tumor became hypodense during the portal phase of CT. The frequency and significance of these CT signs of portal vein involvement are discussed.

Adolescent↗

CT features of iatrogenic hepatic arterioportal fistulae.

Peripheral arterioportal fistulae are a relatively frequent complication of hepatic biopsies and transhepatic catheterizations. Three cases were revealed by dynamic computed tomography (CT) and confirmed by angiography. The morphologic and densitometric characteristics of these arteriovenous fistulae on CT in most cases indicate the causal mechanism and eliminate consideration of tumor.

Adolescent↗

Hepatic angiosarcoma.

The computed tomographic findings of a case of hepatic angiosarcoma are presented. Although many findings are similar to hemangioma, some features can suggest the diagnosis of angiosarcoma.

Angiography↗

[Hepatic angioscanner in normal subjects and in patients with hepatic tumors. Hemodynamic and morphologic characteristics].

Hepatic angio-CT was performed according to a standardized schedule in 100 healthy subjects and 260 patients with a liver tumor. In normal subjects, it was possible to determine an arterial phase (15 s), a parenchymatous arterial phase (30 s), a parenchymatous portal phase (45 s) followed by a progressive return to liver densities observed before injection. a) Among the 62 cases of hepatocellular carcinoma, 56 were characterized by hypodensity, 3 cases by hyperdensity and 3 cases by isodensity before injection. After injection, slices obtained at the tumor level showed heterogeneous hypervascularisation in 34 cases, and an early homogeneous hypervascularisation (15th-30th s) in 7 small carcinomas (diameter less than 3 cm); a lesion was disclosed in the other hepatic lobe in 12 cases. Slices obtained at the level of the portal vein allowed to assess tumoral involvement in 61 p. 100 of cases. b) Out of 150 cases of hepatic metastases, a hypodense lesion surrounded by hypervascularisation just after injection was the most frequent aspect. c) Out of 40 cases of hemangiomas, lesions were hypodense and well limited in 37 cases; at the 15th s after injection, contrast medium accumulated at the periphery, then diffused to the center of the lesion. d) Adenomas and focal nodular hyperplasias appeared as hypodense lesions with precocious and fugacious hypervascularisation, and were characterized, although inconstantly, by the presence of fat and vessels in the hypodense central zone, respectively. These results provide a rational basis for a better diagnostic approach of liver tumors.

Adenoma↗

[Noninvasive evaluation of aortocoronary bypass graft patency with tomodensitometry and exercise myocardial scintigraphy].

The control of the patency of aortocoronary bypass grafts necessitates further coronary angiography, an invasive investigation which is difficult to perform routinely because over 60 p. cent of operated patients are asymptomatic. Non-invasive methods have been proposed for this task, including computerised axial tomography (CAT) and exercise Thallium 201 myocardial scintigraphy (EMS). The aim of this study was to assess the relative value of CAT and EMS, alone and in association, in comparison with coronary angiography. Thirty six patients (35 men, 1 woman) with a mean age of 54 years were studied. These patients had a total of 59 bypass grafts inserted an average of 23 months before investigation (20 single, 10 double, 5 triple and 1 quadruple bypass grafts). CAT scanning was performed the day before coronary angiography. Sections of the thorax 7 mm thick were recorded after intravenous injection of contrast medium. A patent graft was identified as an opacity increasing after the injection of contrast on one of the aortic walls. During coronary angiography a graft was declared to be patent when it was opacified selectively or during aortography, and when the grafted coronary artery was seen to be revascularised. The quality of the distal coronary bed was also evaluated (implantation of the graft, distal and collateral vessels). Twenty three patients (with a total of 36 grafts) also underwent EMS on the same day as CAT scanning. Normal fixation in the revascularised territory was taken as evidence of a patent graft. --Coronary angiography showed that 44/59 grafts were patent at 24 months. --CAT scanning was unable to evaluate 12/59 grafts. Thoracic metallic clips created stratified artifacts and analysis of the section was impossible (20 p. cent of CAT investigations were non-contributive); of the interpretable investigations, 40/47 grafts were correctly assessed (85 p. cent): 30/32 patent grafts and 10/15 occluded grafts. --The results of EMS were less reliable; 23/36 grafts correctly assessed (64 p. cent), 18/27 patent grafts and 5/9 occluded grafts. However, EMS provides complementary information to that provided by CAT scanning, especially with respect to the distal coronary bed. When the two methods were used together, 15/15 good surgical results (patent grafts with good distal vascularisation) and 6/8 poor results (patent grafts but poor distal vascularisation), were identified. We conclude that these two atraumatic methods, CAT scanning and EMS, which may be performed on out-patients, are valuable for the routine assessment of the patency of coronary bypass grafts. Coronary angiography could therefore be reserved for those patients in whom further surgery is being considered.

Adult↗

Diagnostic value of image processing in myocardial scintigraphy.

The diagnostic value of stress myocardial analog scintigrams, and of five image-processing methods, was assessed by a decisional analysis in 96 patients undergoing coronary arteriography. The methods involved digitalization, nine-point binomial smoothing, background subtraction by linear interpolation, stationary filtering, and a combination of them. The difference between after-test probabilities of having the disease with a positive or a negative examination provided a discriminant index for different prevalences of the disease. Though the processing methods failed to improve the detection of a circumflex stenosis, the stationary filter significantly increased the diagnostic value for the detection of stenosis in a left anterior descending artery for a large range of prevalence, and in a right coronary artery at high prevalence. Thus, the filter seemed to provide a useful tool for enhancing the diagnostic value of myocardial scintigraphy.

Adult↗

Computed tomography and post-laparotomy intra-abdominal abscesses.

Thirty-one patients were prospectively studied and had abdominal computed tomography for post laparotomy sepsis. Computed tomography is of particular interest in seriously ill post-operative patients, 15 of our patients were on ventilators, and it enabled diagnosis and localization of abscesses in 15 patients. Drainage could therefore be achieved via a limited surgical approach, and extensive laparotomy was avoided. Of 16 patients without abscess, the abdominal computed tomogram was negative in 14 cases and there were two false positives. The overall accuracy was 0.94 with a sensitivity of 1 and a specificity of 0.88. The ability to screen the whole abdomen and exactly localize the lesion are the advantages of this non-invasive method.

Abdomen↗

Spinal vacuum phenomenon: CT diagnosis and significance.

Spinal vacuum phenomenon may be encountered in many circumstances, such as degeneration of the intervertebral disk, disk injury, vertebral metastases, ischemic vertebral collapse, Schmorl's nodes, and infectious processes. The high spatial and densitometric resolution of computed tomography (CT) makes it possible to show gas in tissues with high frequency than by conventional radiography. In certain circumstances, the CT findings may be the decisive diagnostic element.

Adult↗

Vertebral osteomyelitis: disk hypodensity on CT.

The importance and role of computed tomography (CT) are discussed on the basis of 36 cases of vertebral osteomyelitis. The bone images themselves, the detection of lumbar disk hypodensity, and the exploration of soft paraspinal regions in the search for an abscess are factors that contribute to the superiority of this method in difficult cases. In cases where the diagnosis is already known, CT offers an excellent method to assess the extent of the lesions. Its accuracy, coupled with its rapidity and noninvasive nature, affects the role of conventional tomography, a method that is incomplete and involves higher radiation doses. CT offers an excellent method for follow-up after treatment of vertebral osteomyelitis.

Abscess↗

[Diagnostic value of computed tomography in blood diseases (author's transl)].

Study of a series of 108 patients with blood disease explored by computer tomography showed that this is a reliable method for investigating retroperitoneal lymph node lesions, and that the cost and irradiation level was equivalent to conventional radiological examination. The scanner can also explore the liver, spleen, and lymph node chains, not revealed by the latter. Computer tomography, which is easily accepted by the patient, can be proposed, therefore, for initial and follow-up examinations of these patients.

Hematologic Diseases↗

[Computed tomography diagnosis of anomalies of aortic arch of the adult (author's transl)].

Seven cases of anomalies of aortic arch investigated by computed tomography are described. The authors emphasized the interest of such an exam in the investigation of these anomalies. It is very interesting to know this pathology in sight to obviate some mistakes in the diagnostic of the tumors of the mediastinum. They describe three specific criterions of CT diagnosis of a right aberrant subclavian artery. The indications of computed tomography in the diagnostic and evaluation of the anomalies of aortic arch are discussed.

Adult↗