Biomedical subjects

P G Taourel

Publications and source records attributed to P G Taourel.

4 recordsLinked to original sources

PubMed1996

Acute mesenteric ischemia: diagnosis with contrast-enhanced CT.

PURPOSE: To evaluate the accuracy of dynamic, contrast material-enhanced computed tomography (CT) in the diagnosis of acute mesenteric ischemia. MATERIALS AND METHODS: Reviewers blinded to patient diagnoses retrospectively compared the CT scans in a study group with those in a control group. The study group comprised 39 consecutive patients (23 men, 16 women; aged 55-88 years) with surgically proved acute mesenteric ischemia. The control group comprised 24 patients (13 men, 11 women; aged 50-82 years) with suspected acute mesenteric ischemia that was disproved at surgery. RESULTS: For the diagnosis of acute mesenteric ischemia, each of the following findings had a specificity of more than 95% and a sensitivity of less than 30%: arterial or venous thrombosis, intramural gas, portal venous gas, focal lack of bowel-wall enhancement, and liver or splenic infarcts. When CT was used in the diagnosis of suspected acute mesenteric ischemia, the detection of at least one of these signs resulted in a sensitivity of 64% (25 of 39; confidence interval, 0.49, 0.79), a specificity of 92% (22 of 24; confidence interval, 0.81, 1.00), and an accuracy of 75% (47 of 63; confidence interval, 0.64, 0.86). CONCLUSION: Dynamic, contrast-enhanced CT is a valuable tool in the diagnosis of and determination of prognosis in acute mesenteric ischemia.

Acute Disease↗

PubMed1995

Small hepatocellular carcinoma in patients undergoing liver transplantation: detection with CT after injection of iodized oil.

PURPOSE: To assess computed tomography (CT) with iodized oil for depiction of small hepatocellular carcinoma (HCC) before liver transplantation. MATERIALS AND METHODS: Thirty-five consecutive cirrhotic patients underwent CT with iodized oil to determine the presence, number, size, and location of possible nodules. All patients underwent liver transplantation within 4 months after CT. Explanted livers were cut in 8-mm slices that corresponded to axial CT scan planes. Comparison between CT staging and pathologic findings was made. RESULTS: Pathologic studies showed 17 HCC nodules (diameter, 0.9-4.0 cm) in nine of the 35 livers. CT depicted nine of these 17 nodules. Lesion-by-lesion analysis revealed a sensitivity of 53%; CT falsely depicted three additional nodules not confirmed with pathologic findings. Patient-by-patient analysis revealed an 89% sensitivity and an 88% specificity. CONCLUSION: CT with iodized oil, when assessed lesion by lesion, has a low sensitivity. These results must be considered when liver resection is proposed for HCC.

Carcinoma, Hepatocellular↗

PubMed1995

Value of CT in the diagnosis and management of patients with suspected acute small-bowel obstruction.

OBJECTIVE: The purpose of this prospective study was to evaluate the role of CT in the diagnosis of patients with suspected acute small-bowel obstruction in whom clinical and plain radiographic findings were inconclusive. SUBJECTS AND METHODS: Fifty-seven nonconsecutive patients with suspected acute small-bowel obstruction were referred for CT to differentiate small-bowel obstruction from ileus (33 patients) or to establish the cause of obstruction (24 patients). The final diagnosis was established either by surgery (42 patients) or by the clinical evolution (15 patients). The change in the prescan diagnosis as to the presence, cause, and severity (strangulation) of small-bowel obstruction made on the basis of the CT findings was noted. Finally, the changes in therapy resulting from the CT information were recorded. RESULTS: CT correctly distinguished between small-bowel obstruction and ileus in all cases except one. CT enabled us to modify an erroneous clinical diagnosis correctly in 12 (21%) of 57 cases, including eight cases for which pre-CT diagnosis was ileus and four cases for which pre-CT diagnosis was small-bowel obstruction. CT allowed us to predict the cause of obstruction correctly in 33 (85%) of 39 patients with confirmed small-bowel obstruction but it failed to differentiate adhesions from internal hernias and radiation enteritis. The pre-CT diagnosis of the cause of obstruction was correctly changed because of CT findings in 17 (44%) of 39 patients with subsequently proved small-bowel obstruction. CT was able to identify strangulation in nine of the 12 patients with proved strangulation, which altered the pre-CT diagnosis in three patients. CT findings correctly modified the management in 12 (21%) of 57 patients, by changing either a conservative management to an operative one in 10 (18%), or an operative to a conservative one by differentiating ileus from obstruction in two patients. CONCLUSION: Our findings show that CT is a valuable diagnostic procedure in patients with suspected acute small-bowel obstruction. CT not only is useful in distinguishing obstruction from paralytic ileus, but it frequently establishes the cause of the obstruction and the presence of strangulation. CT findings lead to decisions to treat patients surgically in a significant number of patients.

Acute Disease↗

PubMedDate not supplied

The query corner.

Explore the source record for details and available documents.

Acute Disease↗