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P Germain

Publications and source records attributed to P Germain.

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

Magnetic resonance imaging in congenital heart disease of newborns: preliminary results in 23 patients.

Until now little attention has been paid to the potential of MR imaging in congenital heart disease of the newborn. ECG-gated MRI was therefore performed at 0.5 tesla in 23 newborns (mean age 7.5 days) with suspected congenital heart disease. Two newborns were controlled after surgery (switch, Blalock-Taussig procedure). All had undergone prior evaluation by two-dimensional Doppler echocardiography (2-D DE). MR imaging was of a satisfying quality in all but one newborn. The aim of this study was to assess complementary information provided by MRI in comparison to 2-D DE. Pre-operatively MRI missed some abnormalities shown by 2-D DE: one coartaction, one ductus arteriosus and one pulmonary atresia. MRI demonstrated lesions that echocardiography had either failed to visualize or found inconclusive, including double aortic arch (one patient), muscular ventricular septum defect (two patients) and severe ductus arteriosus (one patient). In one of the two patients with a ventricular septum defect, angiography was avoided and in the other patient it merely confirmed the MRI results. Post-operatively, MRI demonstrated information complementary to that obtained from to 2-D DE: (1) clearly visualizing the reinsertion of the coronary arteries in the 'switched' transposition of the great vessels, (2) appreciating the diameter and patency of the palliative shunt in the Blalock-Taussig procedure.

Angiography↗
PubMedDate not supplied

Spin echo MRI in the evaluation of pericardial disease.

As in other pathological processes of the heart, the contribution of MRI is not limited to optimal anatomical evaluation but also offers functional or etiological information (approach of tissue characterization). In this work we report on our experience in evaluating normal and pathological pericardium with MRI spin echo sequences. The results with 41 patients, including pericardial effusion, thickening, and mass are discussed and confronted with previously reported data. Contrary to classical echocardiographic notions, pericardial effusions are more frequently in the anterior than posterior location (26/30 vs. 19/30 p less than 0.03). Not only does MRI provide a precise and positive diagnosis, but also a rather clear distinction appears in spin echo sequences between hemopericardium with high signal intensity and other effusions with lower signal (high intensity found in 6/6 patients with hemopericardium versus only 8/24 in the remaining group; p less than 0.01). When constriction signs are present, MRI solves the difficult differential diagnosis between pericardial thickening and restrictive cardiomyopathy. In paracardiac primary or metastatic tumors pericardial involvement is clearly demonstrated. Distinction between paracardiac, respectively pericardial cyst or false aneurysm is possible. We conclude that MRI is a new imaging method, complementary to echocardiography and/or computed tomography in the evaluation of pericardial pathology especially when hemopericardium, constrictive pericarditis, or tumoral etiologies are suspected. Important technological improvements are needed to solve the problem of long acquisition time and to improve the possibilities of tissue discrimination.

Aged↗
PubMedDate not supplied

Detection and quantification of recent myocardial infarction: diagnostic value of multiecho multislice spin echo imaging.

Thirty-four patients with documented transmural MI were studied with gated three echo, multislice MR imaging. In 12 patients MRI MI size was compared with CK release measurement, Tl-201 SPECT defect, and with Tc-99m LVEF. Infarct was visualised in 29/34 patients on 3rd echo images (18/34 on 2nd and 6/34 on 1st echo images). Mean MR infarct size (planimetered from 3rd echo images): 33.1 +/- 9% overestimated the SPECT defect (mean value of 23.8 +/- 15%). However, the overall correlation between MRI and Tl-201 sizing was significant: r = 0.82; p less than 0.001; SEE = 5.5%. The correlation with LVEF also appeared significant: r = -0.61; p less than 0.038.

Adult↗
PubMedDate not supplied

Fetal shoulder measurements with MRI.

OBJECTIVE: We studied the ability of MRI to predict fetal shoulder width (FSW). MATERIALS AND METHODS: In 30 patients referred for MR pelvimetry, measurement of FSW was performed and compared with caliper measurements at term. We report here the feasibility of a method using axial and coronal MR images oriented to the fetal body axes. RESULTS: Shoulder width by MRI (mean = 12.76 +/- 1.42 cm) correlated significantly with postnatal orthopedic caliper measurements (mean = 12.99 +/- 1.37 cm; r = 0.955, SEE = 4.29 mm, p = 0.00001) and with birth weight (r = 0.63, p = 0.0005). Mean paired differences showed a statistically significant 2.3 +/- 4.2 mm underestimation of FSW by MRI (p = 0.01). This reasonably quick nonionizing technique seems to have the potential for evaluating shoulder dystocia and deserves further evaluation.

Female↗
PubMedDate not supplied

[Perforation of rectal with peritonitis during a barium enema administration. Report of a case (author's transl)].

The authors report one case of perforation of rectal with peritonitis during a barium enema administration in a patient suffering from an adeno-carcinome of colon, and died after 48 hours with collapsus. After a brief review of the literature, the authors expose pathogeny and clinical signs of this relatively rare accidients. The conclusions repose on watchful precautions according to indications and technical way of barium enema examination in patients specially exposed to perforation accidents.

Adenocarcinoma↗
PubMedDate not supplied

[Value of global ejection fractions based on the presence or absence of left ventricular dyskinesia. A comparison between contrast angiography and angioscintigraphy].

The total ejection fraction of the left ventricle is studied in 37 patients, most of them with coronary disease, according to two methods: contrast angiography in a single plane and angioscintigraphy (first passage and balanced), in order to compare the results according to the presence or the absence of dyskinesias. The two methods are performed in succession according to the usual views. The population is divided in two sub-groups according to the presence (17 patients) or the absence (20 patients) of segmental abnormalities. Segmental abnormalities are divided into 11 antero-apical aneurysms and 6 infero-posterior aneurysms. The correlations of the ejection fractions calculated according to the two methods and the two views, are usually satisfactory in the two sub-groups and especially as the parietal kinetics is homogeneous. In case of segmental abnormalities of the contraction, there are variations in the total ejection fractions depending on the technique and the views that are used, but the differences are not significant.

Arrhythmias, Cardiac↗
PubMedDate not supplied

[Diagnostic elements of a right papyraceous ventricle. The value of nuclear magnetic resonance].

We are reporting the case of a young man presenting repeated syncopes linked to episodes of ventricular tachycardia. The rhythm disorders were due to the existence of a papyraceous right ventricle with concomitant involvement of the left ventricle disclosed during the etiological work-up. We are reporting, at this time, the usual diagnostic elements of this disease, but mostly original data provided by the nuclear magnetic resonance, as the clinical examination and the EKG are often less revealing except for late potentials always found in the arrhythmic form. The right, ventricular dysplasia and the papyraceous right ventricle represent two very close entities. Particular characteristics enable to differentiate them and also the differential diagnosis with other diseases are discussed by stressing the advantage of magnetic resonance imaging, a new method, non invasive, which lends itself well to the analysis of cardiac morphology.

Adult↗