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P Taourel

Publications and source records attributed to P Taourel.

At least 73 records · Page 4Linked to original sources
PubMed1994

Current CT/MRI examination of the upper intestinal tract.

When properly performed, CT of the abdomen can provide valuable information about mural diseases of the alimentary tract. It can demonstrate the digestive origin of an abdominal mass, categorize a given lesion on the basis of its specific CT appearance and any associated CT findings, assess the extramural spread of gastrointestinal lesion, guide various interventional procedures (biopsy, drainage) and follow a patient's response to therapy.

Crohn Disease↗
PubMed1994

Hemodynamic changes after transcatheter arterial embolization of hepatocellular carcinomas.

PURPOSE: To evaluate the serial hemodynamic changes that occur after transcatheter arterial embolization (TAE) of hepatocellular carcinomas (HCCs). MATERIALS AND METHODS: Twenty patients with HCCs treated with TAE were evaluated with color and duplex Doppler sonography before, immediately after, and 2 days after TAE. The changes in hepatic artery and portal vein velocity and flow were evaluated. RESULTS: The portal venous velocity and flow did not change significantly after TAE. The peak systolic velocity in the proximal hepatic artery decreased significantly (P < .01) immediately after TAE then returned to baseline values 2 days after TAE; the resistance index of the proximal hepatic artery increased significantly (P < .01) immediately after embolization, then returned to baseline values 2 days after TAE. Arterial signal in the distal hepatic artery, generally absent immediately after TAE, could be recorded 2 days after. CONCLUSION: There is a rapidly reversible decrease in hepatic arterial flow induced by embolization, without any change in portal venous flow.

Adult↗
PubMed1993

[Failure factors of guided puncture of hepatic masses].

This study was carried out to assess the failure factors of guided hepatic mass puncture in 320 biopsies. Results of the puncture, follow-up or surgery allowed us to divide 320 biopsies into true positives or false negatives. Compared with the group of true positive diagnosis, the group of false negative diagnosis revealed a significantly higher percentage either of lesions less than 2 cm (52.5% versus 34%), of benign tumors (19% versus 5%), or of pseudotumors (24% versus 1.5%). Compared with the group with cytology and histology diagnosis, the group in which only histology established the diagnosis revealed a significantly higher percentage of hepatocellular carcinoma (52.5% versus 34%) and of benign tumors (21% versus 0%). A diameter less than 2 cm, a histology of benign tumors or pseudotumors, are failure factors of guided biopsy. The use of histology is useful for the diagnosis of benign tumors and increases the accuracy of diagnosis for hepatocellular carcinoma.

Biopsy, Needle↗
PubMed1992

Acute abdomen of unknown origin: impact of CT on diagnosis and management.

A prospective study was performed including 40 patients with an acute abdominal syndrome presenting difficulties in defining the etiology. All patients underwent an emergency computed tomographic (CT) scan. The CT scan made the syndrome's diagnosis in 95% of cases and it permitted the detection of a lesion in 57.5% of cases. The diagnostic impact of CT scan was significant (p less than 0.01). The value and the specific contribution of CT in various diseases were analyzed. CT allowed appropriate therapeutic decisions in 95% of cases where clinical examination performance was positive in only 60% of cases. We had two negative CT results leading to an inappropriate therapeutic decision; it consisted of two cases of undiagnosed appendicitis. CT modified the primary therapeutic strategy in 30% of cases and avoided seven laparotomies.

Abdomen, Acute↗
PubMed1992

[Evaluation of the effects of molsidomine and propranolol-molsidomine combination on portal hemodynamics by pulsed Doppler ultrasound].

Molsidomine, a long acting vasodilator with antianginal properties, has been shown to decrease porto-hepatic pressure gradient in patients with cirrhosis. The present study aimed at assessing the effects of molsidomine, propranolol and of the association of these two drugs on portal vein blood flow as measured using Doppler and B-mode sonography. In 10 patients without liver disease (group 1), portal flow time average mean velocity (TAV) and portal vein blood flow (PVBF) were measured under basal conditions, 1 hour then 2 hours after ingestion of 4 mg of molsidomine. The same measurements were performed in 15 patients with cirrhosis (group 2) under basal conditions, 1 then 2 hours after double-blind administration of either molsidomine (10 patients) or placebo (5 patients). Fifteen further patients with cirrhosis (group 3) were studied after the double blind administration of 80 mg of propranolol and two hours later of 4 mg of molsidomine (10 patients) or placebo (5 patients); TAV and PVBF were measured under basal conditions, two hours after propranolol ingestion or placebo, then one and two hours after molsidomine or placebo ingestion. TAV and PVBF remained unchanged in patients treated with placebo. Molsidomine reduced TAV by 23.8 +/- 19.5% in group 1 (P < 0.01) and by 25.6 +/- 21.4% in group 2 (P < 0.01). In group 3, a 10% decrease was observed after propranolol (NS). When molsidomine was added, TAV was further decreased (-17.6 +/- 13.3% vs baseline, P < 0.01). PVBF remained unchanged in the three groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Doppler study of fasting and postprandial resistance indices in the superior mesenteric artery in healthy subjects and patients with cirrhosis.

PURPOSE: We assessed the resistance index (RI) in the superior mesenteric artery under fasting and postprandial conditions in healthy subjects and in patients with cirrhosis to determine whether the amount of change in the RI reflects the presence or severity of liver dysfunction. METHODS: Fifteen subjects with normal livers and 27 patients with cirrhosis underwent Doppler sonography of the superior mesenteric artery before and after ingesting a standard meal. The RI at baseline (fasting state) and the postprandial RI were compared between the 2 groups. The fasting RIs and post postprandial RIs changes in cirrhotic patients were correlated with the severity of disease. RESULTS: No difference was found between the baseline RIs in healthy (RI = 0.85) and cirrhotic subjects (RI = 0.84), nor was there a difference in baseline RIs between subgroups of cirrhotic patients according to the severity of liver disease. The RI decreased significantly (p < 0.05) after the meal in both the healthy (13%) and cirrhotic (8%) subjects, but the postprandial decrease was significantly less pronounced (p < 0.05) in cirrhotic patients than in healthy subjects. Among cirrhotic patients, there was no correlation between the postprandial decrease of the RI and severity of liver disease. CONCLUSIONS: The marked decrease in the postprandial RI in the SMA in healthy subjects is generally not seen in patients with cirrhosis, and changes in the postprandial RI do not reliably predict the severity of liver dysfunction.

Adult↗
PubMedDate not supplied

Changes in renal artery resistance after meal-induced splanchnic vasodilatation in cirrhotic patients.

PURPOSE: A relationship between vasomotor tone changes in mesenteric and renal vessels in cirrhotic patients has been suspected but remains controversial. The aim of this study was to assess by duplex Doppler sonography the changes in the circulatory resistance of the renal arteries and superior mesenteric artery (SMA) following meal-induced splanchnic vasodilatation. METHODS: Twenty-seven cirrhotic patients and 15 healthy volunteers with no hepatic or renal dysfunction were prospectively included in the study. The resistance index (RI) of the SMA and of the right and left renal arteries was measured by duplex Doppler sonography before and 30 minutes after ingestion of a standard 400-kcal balanced liquid meal. Values in controls and patients and values before and after the meal were compared, and correlations between RIs, Child-Pugh class (liver function), and creatinine clearance were assessed in cirrhotic patients. RESULTS: The fasting renal artery RI was greater in cirrhotic patients than in controls (p < 0.0001), but there was no difference in fasting SMA RIs. After the meal, there was a significant decrease in the SMA RI in controls (0.85 +/- 0.04 before versus 0.74 +/- 0.03 after meal, p = 0.0001) and in cirrhotic patients (0.85 +/- 0.04 before versus 0.77 +/- 0.04 after, p = 0.0001) and a significant increase in the renal artery RI (0.57 +/- 0.06 before versus 0.62 +/- 0.05 after in controls, p = 0.001; 0.68 +/- 0.07 before versus 0.70 +/- 0.07 after in cirrhotic patients, p = 0.001). No correlation was found in cirrhotic patients between the changes in renal artery RI and the postprandial SMA RI decrease, the Child-Pugh class, or the creatinine clearance. CONCLUSIONS: Meal-induced SMA vasodilatation (RI decrease) is associated with a marked increase in the renal artery RI, worsening the renal vasoconstriction in cirrhotic patients.

Adult↗
PubMedDate not supplied

Sonographic assessment of the normal and abnormal bowel wall in nondiverticular ileitis and colitis.

BACKGROUND: To assess the value of high resolution sonography (HRS) in identifying normal and inflammatory bowel wall in nondiverticular ileitis and colitis by using a segment-by-segment analysis. METHODS: Thirty-five HRS were performed in patients with nondiverticular inflammatory bowel disease, without knowledge of clinical, endoscopic, and radiologic data. HRS evaluated separately five intestinal segments (terminal ileum, cecum/ascending colon, transverse, descending colon, and sigmoid colon) and was considered positive for inflammation when wall thickness during compression exceeded 3 mm. We compared HRS findings with results of endoscopy or enteroclysis performed within 8 days of HRS; endoscopic and radiologic results were classified into two subgroups: mild inflammatory lesions and frank inflammatory lesions. RESULTS: Segment-by-segment analysis resulted in an accuracy of 81%, a sensitivity of 70%, and a specificity of 93%. Sensitivity was significantly lower for mild lesions (52%) than for frank lesions (87%, p < .001). Of the 32 patients having an inflammatory bowel condition, 29 (91%) had at least one segment correctly identified as inflammatory by HRS. CONCLUSION: Even if relatively insensitive for minor lesions, HRS is a promising, minimally invasive method for assessing normal and inflammatory bowel wall in nondiverticular ileitis and colitis.

Adolescent↗
PubMedDate not supplied

Enhancement patterns of renal masses during multiphase helical CT acquisitions.

BACKGROUND: To describe the appearance of renal masses during multiphase helical computed tomography (CT) acquisition and evaluate the impact of a cortical nephrographic phase on diagnosis. METHODS: The CT examinations of 33 patients with 37 lesions [18 renal cell carcinomas (RCC), nine solid tumors, 10 cystic lesions] were reviewed to characterize renal masses during four phases of CT scanning: plain, cortical nephrographic, tubular nephrographic, and pyelographic. Two reviewers analyzed all lesions on the complete data set, and a third reviewer analyzed three combinations of images separately: (1) plain and tubular nephrographic phases, (2) plain and cortical nephrographic phases, and (3) three phases combined. Receiver operating characteristics (ROC) curves were generated to determine the respective value of each combination in lesion characterization. RESULTS: During the cortical nephrographic phase, hyperdensity of solid renal masses was 100% specific and 22% sensitive for RCC, whereas combining hyperdense and isoattenuating heterogeneous masses was 91% specific and 56% sensitive. ROC curves demonstrated a sensitivity of 85%, 90%, 100% for the three combinations, respectively, with a constant specificity of 88% for diagnosing RCC. CONCLUSION: The cortical nephrographic phase is useful to characterize renal masses and should be included in the routine helical CT protocol.

Abscess↗
PubMedDate not supplied

Hydatid cyst of the liver: comparison of CT and MRI.

Twenty-seven cases of proven liver hydatid cysts were examined by MR and CT. On MR the cyst wall showed a rim of low signal intensity on both T2- and T1-weighted imaging. This capsule was more easily identified by MR than by CT. Specific signs of daughter hydatid cysts and detachment of the membrane were also evident by CT and MR examinations. Magnetic resonance was more effective than CT in detecting complications of the cyst; the first echo of T2-weighted imaging showed a very high signal of the hydatid content in cysts that communicated with the biliary tree or in superinfected cysts. However, MR did not help characterize solid or pseudotumoral forms of hydatid disease.

Calcinosis↗