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P Peretti-Viton

Publications and source records attributed to P Peretti-Viton.

14 recordsLinked to original sources

Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty.

A pulmonary embolus of acrylic cement was present in a 41-year-old woman with Langerhans' cell vertebral histiocytosis (LCH) after percutaneous vertebroplasty. Chest radiograph and CT confirmed pulmonary infarction and the presence of cement in the pulmonary arteries. She was treated with anticoagulants, and responded favorably. This rare complication occurred because perivertebral venous migration was not recognized during vertebroplasty. Adequate preparation of cement and biplane fluoroscopy are recommended for vertebroplasty.

Adult

Short-term assessment of periradicular corticosteroid injections in lumbar radiculopathy associated with disc pathology.

We evaluated periradicular injection of corticosteroids performed by neuroradiologists under fluoroscopic guidance in the treatment of lumbosacral nerve root pain in 40 patients (average age 48 years) presenting with lumbosciatica or radiculopathy not responding to conservative treatment. Patients with root pain due to infectious, neoplastic or inflammatory diseases were excluded, as were patients who needed immediate surgery. Pain was evaluated using a visual analogue scale (VAS) 10 and 90 days after the injection. After 10 days a substantial decrease in root pain was observed, with a statistically significant decrease in mean VAS. This decrease was observed in 90% of patients, and it persisted after 90 days in 85%. Side effects were rare, mild and disappeared spontaneously. They were related to the drug injected (corticosteroids).

Adrenal Cortex Hormones

Contrast-enhanced magnetisation transfer MRI in metastatic lesions of the brain.

Our purpose was to compare prospectively the sensitivity of contrast-enhanced magnetisation transfer (MT) MRI and gradient-echo (GE) T1-weighted images in metastatic disease of the brain. We studied 52 patients with brain metastases, using conventional T1-weighted GE and MT spin-echo (SE) images after the same standard dose of gadolinium. Axial 5-mm reconstructions of GE data were compared with 5-mm MT images in the same plane. Metastases were counted independently by two neuroradiologists. In 12 patients (23%) MT imaging showed more metastases than GE images (P = 0.03). We detected 68 more metastases with the former technique.

Adult

Short-term evaluation of periradicular corticosteroid injections in the treatment of lumbar radiculopathy associated with disc disease.

OBJECTIVES: The purpose of this study was to evaluate the feasibility and efficacy of periradicular corticosteroid injections performed under fluoroscopic guidance in the treatment of pain originating in the lumbosacral nerve roots. METHOD: Forty patients presenting with lumbosciatica or femoral neuralgia unresponsive to conventional conservative treatment were admitted to the study. Patients with nerve root pain due to infectious, tumorous or inflammatory diseases were excluded, as were patients who needed immediate surgery. Pain was evaluated using a visual analog scale on the day of the injection and ten (D10) and ninety (D90) days later. RESULTS: All patients were evaluated as scheduled on D10 and D90. The mean visual analog scale score decreased from 53.3 mm at baseline to 30.1 mm on D10 and to 21.8 mm on D90. Ninety per cent of patients had a visual analog pain score decrease on D10 and 85% on D90. Reported side effects were two cases of mild spontaneously regressive acne and one case of radicular pain exacerbation of less than one day's duration. CONCLUSION: Periradicular injections of corticosteroids done under fluoroscopic guidance as an outpatient procedure was effective and safe in our study and may deserve to be used as part of the conservative management of lumbar nerve root pain before resorting to more invasive methods.

Acne Vulgaris

MRI of intracranial chordomas. Extent of tumour and contrast enhancement: criteria for differential diagnosis.

We present six proven cases of chordoma of the clivus studied by CT and MRI, with special attention to the extent of the tumour and to the signal intensity after intravenous gadolinium. MRI is the best technique for assessing the extent of the tumour but CT is important for showing osteolysis. Our aim was to determine differential diagnostic neuroradiological criteria. Reliable signs of chordoma of the skull base are: posterior extension to the pontine cistern; a lobulated, "honeycomb" appearance after gadolinium: the swollen appearance of the bone in the early stages; bone erosion on CT and frequent extension to critical structures such as the circle of Willis, cavernous sinuses and brain stem.

Adult

Theoretical situation of brain white matter tracts evaluated by three-dimensional MRI.

An accurate knowledge of cerebral anatomy is important in order to evaluate the precise location of a cerebral lesion. Cortical structures are identified by knowledge of the adjacent gyri and sulci; however, white matter tracts are difficult to differentiate from one another due to the lack of clear anatomic landmarks. Therefore, even if MRI shows obvious white matter abnormalities, in some cases it is difficult accurately to localize the lesion. The purpose of this study is to evaluate the location of the main white matter tracts by using three-dimensional MR imaging. MRI study was performed by 1.5 Tesla (Signa: General Electric). Computer assisted analysis with Voxtool software (General Electric) was used to generate both surface brain and tomographic images. The exact anatomic basis of white matter signal abnormalities is important when analyzing patients with disconnective syndromes or neuropsychological deficits such as conduction aphasia, visuospatial deficit etc. This preliminary attempt at constructing a three-dimensional MRI white matter atlas of the brain may be helpful for evaluating the anatomico-clinical correlations in these patients, and also as teaching materials for the clinical (neurologic, neurosurgical), anatomic and radiographic disciplines.

Adult

Location of hand function in the sensorimotor cortex: MR and functional correlation.

PURPOSE: To determine the location of hand function in the sensorimotor cortex using MR and positron emission tomography imaging studies. METHODS: Anatomic and physiological methods were used for this study. Anatomic study was based on the MR analysis of 22 subjects. The length of the sensorimotor cortex was measured in the axial and sagittal planes. Physiologic study was based on the positron emission tomography studies of 4 subjects. Each of the studies was correlated with MR. RESULTS: We found that the superior genu of the central sulcus corresponds to hand function in the sensorimotor cortex. This level may prove useful for any clinical correlations or for surgery. CONCLUSIONS: From this study, the hand function area in the sensorimotor cortex is easily understood with its characteristic shape in axial MR scan. The comparison of MR and positron emission tomography data clearly show anatomic correlations. This may be applied to the functional mapping of the pathologic studies in the sensorimotor cortex regions.

Adult

Astrocytic tumours.

Astrocytic tumours are frequent, accounting for nearly 50% of all brain tumours. They are divided into three groups: benign astrocytomas, anaplastic astrocytomas and malignant glioblastomas. The usual clinical manifestations of benign astrocytic tumours are epileptic seizures, whereas those of glioblastomas are rapidly progressing neurological deficits. These lesions show fairly characteristic neuroradiological features which have been largely studied. Injections of iodine-based or paramagnetic contrast media are important since they help in tumour grading: low-grade tumours are not enhanced, while glioblastomas are almost invariably enhanced. MRI seems to be indispensable for the study of astrocytic tumours: it provides an excellent anatomical analysis of the lesion during preoperative or pretherapeutic evaluation, and it is the only available method to confirm low-grade lesions that have passed unnoticed or have merely been suspected at CT. To avoid missing these tumours, every adult presenting with recent onset epileptic seizures should be explored by MRI using T2-weighted spin-echo sequences.

Adult

Oligodendrogliomas.

Oligodendrogliomas are tumours developed from oligodendrocytes. They may be pure or associated with astrocyte proliferation. They are usually benign, but their malignancy grade is varied. These tumours affect middle-aged adults and are characterized by their slow growth and their fairly suggestive neuroradiological features which are those of a large, calcified, poorly enhanced, peripheral frontal lesion. Computerized tomography and magnetic resonance imaging are suitable complementary methods to characterize the tumour and evaluate its extension.

Adult

Brain metastases.

Brain metastases are frequent, accounting for 20% of all brain tumours. The most common primary tumours responsible for brain metastases are lung cancer in man and breast cancer in women. Most metastases are located at the grey matter-white matter junction, in junctional vascular territories and in the rolandic region. Although non-specific, MRI is the most sensitive neuroradiological method for the lesions, especially when accompanied by gadolinium injection. MRI must absolutely be performed before surgical treatment, as gadolinium might detect other metastatic lesions or show metastatic tumours so small that they were not visible at computerized tomography (CT).

Aged

Primary and secondary lymphomas of the brain: an MRI study.

Three types of lymphoma of the central nervous system are known: primary non-Hodgkin's malignant lymphoma (NHML), secondary NHML and neurological lesions of Hodgkin's disease. NHML's are rare tumours, often associated with immunodeficiency and presenting predominantly as neuropsychological disorders. In this study 8 patients were explored by CT and MRI, with pathological confirmation. None of our patients had AIDS. The most typical neuroradiological image of this type of tumour is that of a large and intensely contrast-enhanced tumoral mass which is often multifocal and periventricular with infiltration of the subarachnoidal spaces and leptomeninges. Mass effect and perifocal oedema are less pronounced than expected with tumours of that size. NHML's may totally regress under corticosteroid therapy. This tumour of obscure aetiology must be recognized as it is now increasingly frequent.

Aged

Magnetic resonance imaging in gangliogliomas and gangliocytomas of the nervous system.

Gangliogliomas and gangliocytomas are rare and benign neuronal tumors which affect young subjects. This study concerns 3 cases of ganglioglioma and 3 cases of gangliocytoma explored by CT and MRI and confirmed by pathological examination. The most typical CT image was that of an often calcified contrast-enhanced cystic tumor. At MRI, each tumor emitted a low-intensity signal on T1-weighted sequences and a high-intensity signal on T2-weighted sequences. Contrast enhancement after gadolinium injection was frequent. Neuroradiology is not specific, and these tumors are usually diagnosed at pathology. However, the diagnosis may be considered in young patients with a history of old, drug-resistant partial epilepsy and having a contrast-enhanced, calcified cystic lesion in the temporal lobe or the cerebellum.

Adolescent

Supratentorial ependymomas. Neuroradiological study.

Ependymoma is a rare tumour developed from ependymal cells and belonging to the group of neuroglial tumours. It may be located in any part of the central nervous system, but shows a preference for the ventricular cavities. Neuroradiology is not specific. CT shows a frequently large, calcified and cystic lesion of varied density and strongly contrast-enhanced. The signal emitted at MRI is often heterogeneous. Treatment consists of surgery combined with radiotherapy. Prognosis is poor owing to the difficulty of surgical excision and to the possibility of CSF grafts.

Adult