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P Devred

Publications and source records attributed to P Devred.

At least 19 recordsLinked to original sources
PubMed2006

[Kidney trauma in children: state of the art medical imaging].

Traumatic renal lesions have some particularities in the pediatric age group, especially for anatomic reasons. Imaging is very important for diagnosis and staging. Ultrasonography with Doppler is the first line examination performed in children and frequently allows initial diagnosis. From the Doppler-ultrasonographic results and the type of trauma, renal Computed Tomography (CT) is complementary performed. The association of these imaging techniques allows comprehensive work-up of traumatic renal lesions, and also of associated or pre-existing lesions. Conservative management is the rule in most cases. Interventional imaging techniques are sometimes used for therapeutic care of renal pedicular vascular lesions or lesions of the collecting system. Far from the traumatic event, imaging allows to follow up the morphologic and functional evolution of major renal lesions, in particular lesions of excretory renal ducts.

Algorithms↗
PubMed2006

[Systemic learning planification for residents during the 6-month pediatric radiology training].

Diagnostic Radiology and Medical Imaging residents of French University Hospitals benefit from a wide array of learning tools. However, the professors' clinical workload, lack of sufficient proper formal training, lack of practical applicability of existing standards, and absence of rigorous assessment during the specialized training, reduce their very good quality formation to the level of accidental learning. This study originates from the need to apply a systemic planification of learning activities to the French residents' formal training curriculum, such as the one originally designed and applied within the Quebec educational system. This presentation also benefits from the recent introduction of the CanMEDS 2000 objectives by the Royal College of Physicians and Surgeons of Canada, in order to design an adapted version for the professional and academic activities of French radiologists. Needless to say this work will respect the outlined systematic planning of any learning activity: learning requirements, definition of learning objectives, selection of learning methods, assessment of the participants' achievement of these objectives, and evaluation of the learning activity itself.

Canada↗
PubMed2005

[Cystic intrathoracic hemolymphangioma: a rare differential diagnosis of acute bronchiolitis in an infant].

Hemolymphangioma is a benign malformation of the lymphatic vessels. Cervical localisation is the most frequent. Mediastinal localisation is rare, but may be life-threatening because of airway compression. We report on a four-month-old boy who presented, in a context of epidemics, with clinical signs of acute bronchiolitis requiring mechanical ventilation for several days. Chest X-rays showed an important mediastinal mass with airways compression. Diagnosis was evoked on CT-scan aspects and confirmed by histology. Surgery allowed complete resolution, but dysphonia and oropharyngeal disorders persisted for several months. This rare congenital malformation is reviewed.

Acute Disease↗
PubMed2005

[Immature hemangiomas in infants: MR and Doppler-US imaging features].

PURPOSE: To determine the MR imaging features of immature hemangiomas. To discuss the value of MR imaging compared to Doppler ultrasonography (US). MATERIALS AND METHODS: We performed a retrospective study of clinical, Doppler US and MRI data of 12 immature hemangiomas in 11 children. The mean age was 2 months and 21 days. The mean clinical follow up was 22 months and 7 days. RESULTS: MRI was performed for non-diagnosed lesions (4 cases) or to further define lesion extension (8 cases). The lesions either involved the head and neck (8 cases) or the extremities (4 cases). At MR imaging, all immature hemangiomas corresponded to well defined homogeneous T2W hyperintense masses. On T1-weighted images, 11 immature hemangiomas were isointense with intense homogeneous enhancement. Eleven tumors contained linear low signal intensity flow voids. Ten lesions had superficial cutaneous and/or subcutaneous extension whereas 2 lesions had intra-muscular extension. At Doppler US, immature hemangiomas were highly vascularized masses, with well defined margins, often compressibles, homogeneous isoechoic or heterogeneous with nodular hypoechoic foci, relative to subcutaneous fat. A diagnosis of immature hemangioma was confirmed either by pathology (2 cases) or clinical follow up (10 cases). CONCLUSION: In our study, the MR imaging features of immature hemangiomas were reproducible and similar to reports from the literature. MRI is a useful tool to better define the extent of immature hemangiomas, which can be difficult to assess at US. The sensitivity and specificity of MR imaging for this pathology remain to be defined.

Age Factors↗
PubMed2005

[Non-traumatic abdominal emergencies in paediatric practice].

Do advances in MR imaging and Computed Tomography have encroached upon the private territory of Ultrasound-Doppler imaging on paediatric practice? Do the enthusiasm promoted by the use of CT on non traumatic acute abdomen in adult has contaminated the indomitable village of paediatric radiologist? Undoubtfully, Ultrasound-Doppler stayed the first imaging modality to perform. However, the habits are less crystallised than a few years ago. The goal of this article is to describe the ultrasound findings and the potential indications for MRI or CT in the major non traumatic abdominal paediatric emergencies.

Abdomen, Acute↗
PubMed2005

[Imaging of the pediatric pancreas: state of the art].

The use of high frequency (7-12 MHz) transducers on state of the art US units equipped with Doppler imaging provides excellent evaluation of the pediatric pancreas that compares to other cross-sectional imaging techniques. The availability of multidetector CT imaging reduces the need for sedation but requires additional review of the indications and protocols to avoid unnecessary radiation exposure. Evaluation of pancreatitis and tumors remains the main indication. Advances in MR imaging and MRCP has lead to very good results in children. Storage diseases of the pancreas can be diagnosed at MRI. The length of the examinations, the need for sedation and the limited spatial resolution remain the main pitfalls of MR imaging of the pancreas in pediatric patients.

Child↗
PubMed2003

[Activities of radiologists in teaching hospitals].

AIM: To determine if teaching hospital imaging units are adequately staffed: how are the medical activities of radiologists distributed in such units? MATERIALS AND METHODS: A questionnaire was sent to all teaching hospital radiologists in June 2001. The questionnaire covered 7 areas RESULTS: Urgent cases represent, on average, 22% of patients. Imaging procedures are becoming more frequent (increase of 2 to 8% per year). The mean working week (excluding periods on duty and on call) is 48 hours per FTE radiologist. The mean time spent on teaching, expertise and organization is 10 hours per week. The mean working time per FTE radiologist is thus 58 h/week. The medical activity per FTE radiologist represents 530.240e. CONCLUSION: The workload of radiologists in teaching hospitals is extremely high, whatever the indicator used (time or activity), indicating major under-staffing.

Diagnostic Imaging↗
PubMed2002

Value of fetal skeletal radiographs in the diagnosis of fetal death.

The aim of this study was to assess the value of fetal skeletal radiographs in determining the etiology of fetal death. A total of 1193 post-mortem fetal skeletal radiographs were analysed. Fetuses were classified into one of three groups (group I: abnormality diagnosed during pregnancy; group II: maternal pathology; group III: spontaneous abortion of pregnancy, IIIa before 26 weeks of gestation (WG), IIIb after 26 weeks of gestation). Face, supine and lateral skeletal views were performed. Skeletal abnormalities were detected in 33.9% of the fetuses, including 22.7% with minor abnormalities (abnormal rib number, no nasal bone ossification, amesophalangia or P2 hypoplasia of the fifth digit) and 14.5% with major abnormalities (other skeletal abnormalities). Among the fetuses with major abnormalities, 98.8% came from group I, 2.9% came from group II, 2.3% came from group IIIa and none came from group IIIb. Fetal skeletal radiographs are not useful in fetuses arising from spontaneous abortion of pregnancy without abnormality on ultrasound screening, abnormality clinical examination or in fetuses with prenatal diagnosis of chromosomal abnormality. This practice is valuable only if there is a multidisciplinary team, with all the participants (pathologists, radiologists, geneticists) knowledgeable about fetal pathology. In the absence of this multidisciplinary approach, it is easier to X-ray all fetuses to avoid misdiagnosis and the important consequences for genetic counselling.

Bone Diseases↗
PubMed2001

Rate of abnormal osteoarticular radiographic findings in pediatric patients.

OBJECTIVE: The objective of our study was to assess the rate of abnormal radiographic findings in the most frequent osteoarticular locations of traumatic injury in a pediatric population. SUBJECTS AND METHODS: During two periods of 12 weeks each, all patients admitted to the pediatric emergency department for osteoarticular trauma who underwent radiography were prospectively included in this study. A connection was drawn between the rate of abnormal radiographic findings for the seven most frequently radiographed locations and the clinical findings. RESULTS: Of 3128 locations of trauma in 2470 children, only 22% of the radiographic examinations were considered to reveal abnormal findings. In decreasing order, the hand and fingers, the ankle, the wrist, the knee, the elbow, the foot and toes, and the forearm were the most frequently examined locations. The rate of abnormal findings was 25.7% for the hand and fingers, 9.0% for the ankle, 42.5% for the wrist, 9.5% for the knee, 33.3% for the elbow, 18.3% for the foot, and 43.2% for the forearm. When only the direct sign of fracture was taken into account, these rates decreased for the ankle and knee to 2.6% and 1.9%, respectively. There was always a significant link between the degree of clinical suspicion and the rate of abnormal radiographic findings. However, fewer than 50% of the cases with high clinical suspicion of fracture were radiographically confirmed. CONCLUSION: It appears necessary, especially in cases of lower limb trauma, to evaluate clinical tests, including the implementation of the Ottawa ankle rules, to reduce the number of unnecessary radiographic examinations. This reduction will improve some parameters of children's quality of life and will significantly decrease the cost of emergency care.

Adolescent↗
PubMed2001

[Echography of the hip and other imaging techniques in pediatrics].

OBJECTIVES: To standardize the ultrasound evaluation in congenital hip dysplasia according to the consensus meeting of 1991 in Paris. Detection of congenital anomalies is a daily pediatric challenge. The coronal plane at US of the hip is considered as the gold standard: its technique, its morphologic and dynamic results either normal or pathological, have been described. A standardized report and a simple terminology are proposed. 2. To explain the role of ultrasound, when performed in close collaboration with a pediatric orthopedic surgeon, for initial diagnosis and follow-up of anatomical anomalies. The role of arthrography and MR imaging will be discussed. 3. To describe the benefit of the ultrasound in cases of painful hip in children, including osteoarthritis, acute synovitis, osteochondritis. . . In these cases, the assessment of the hip is also done with radiographs, computer tomography, MR imaging and bone scan.

Age Factors↗
PubMed2000

[Atypical sonographic findings of bacterial colitis].

We report three pediatric cases of infectious colitis that were misinterpreted on US examination as Crohn's disease. These colitis were limited to the left colon and presented with transmural hypoechoic thickening of the wall and homogenous hyperechoic appearance of the surrounding fat.

Abdominal Pain↗
PubMed2000

[Legionella pneumophila: unusual lung and hepatic manifestations].

We report an uncommon presentation of Legionella pneumophila infection following a placentalblood transplantation in an immunodeficient child. The patient presented with lung nodules and liver abscesses. We discuss how a digestive contamination can be suspected.

Autopsy↗
PubMed1999

Pulmonary anthracosis in children.

We report two cases of children with malignancies and subpleural nodules found on computed tomography (CT) scan. In both cases the diagnosis was anthracosis. This pathologic condition has never been reported in children. Causes of anthracosis include a smoking environment, living in urban areas and air pollution.

Air Pollutants↗
PubMed1999

[Is ultrasonographic evaluation the the length of the kidney possible in children? Apropos of a prospective study in Madagascar children less than 1 year of age].

Renal US was prospectively performed in 124 madagascan children less than 1 year of age. Patients were examined in the prone position and maximum kidney length was measured in the longitudinal plane. These measurements and the height and weight of our patient population were compared to published tables. Kidney length and height and weight of our patient population were inferior to the previously published reference data and the growth curve of kidneys steeper than normative standards (p < 0.001). Because of the important variability in US measurement of kidney length it is not possible to definitely conclude that length and growth curve of kidneys in madagascan children are statistically different from those of the published normative standards.

Age Factors↗