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Biomedical subjects

S Gryspeerdt

Publications and source records attributed to S Gryspeerdt.

36 records · Page 2Linked to original sources

Supra- and juxtarenal aneurysms of the abdominal aorta: preoperative assessment with thin-section spiral CT.

PURPOSE: To assess the contribution of thin-section spiral computed tomography (CT) to the preoperative radiologic evaluation of juxta- and suprarenal abdominal aortic aneurysms. MATERIALS AND METHODS: Thirty-eight patients (26 men, 12 women; age range, 60-81 years) with infrarenal (n = 23), juxtarenal (n = 8), and suprarenal (n = 7) aneurysms underwent digital subtraction angiography (DSA) and 2-mm-collimation spiral CT. Cine-interactive display of overlapping axial, reformatted, and maximum intensity projection images were used for CT image analysis. CT findings were compared with angiographic and surgical findings. RESULTS: The proximal extent of the juxta- and suprarenal aneurysms (n = 15) could be correctly predicted in 12 cases (80%) with DSA and was exactly determined in 14 (93%) with CT. All renal arteries except three accessory renal arteries were correctly depicted with spiral CT (83 of 86 [96%]). With DSA as the standard of reference, renal artery stenoses of at least 70% were accurately assessed in 95% of cases. CONCLUSION: Thin-section spiral CT can provide additional information in the preoperative diagnosis of juxta- and suprarenal aneurysms.

Aged↗

Extramedullary hematopoiesis encasing the pelvicalyceal system: CT findings.

A rare case of symmetric renal extramedullary hematopoiesis is hypothesized in a patient with long-standing Vaquez' disease and myelofibrosis. At CT, soft tissue densities were found in the renal hilar area encasing the pelvicalyceal system. Although there is nothing specific about the CT findings, the diagnosis can be suggested in the proper clinical setting. The association with generalized osteosclerosis is another diagnostic clue.

Diagnosis, Differential↗

Case report: pseudotumoral pelvic retroperitoneal fibrosis associated with orbital fibrosis.

We report the case of a man with bilateral orbital fibrous pseudotumours and a large pelvic mass which was initially thought to be malignant. Sonographically guided transrectal core biopsies showed it to be a fibrotic retroperitoneal pseudotumour. The mass decreased after steroid therapy. The computed tomography and magnetic resonance imaging features of this unusual form of pelvic fibrosis as well as the association with heterotopic fibrosis are discussed.

Fibrosis↗

Helical CT for the preoperative localization of islet cell tumors of the pancreas: value of arterial and parenchymal phase images.

OBJECTIVE: In two-phase helical CT, organs are scanned in both the arterial and the parenchymal phase after IV injection of contrast material. The purpose of our study was to evaluate the usefulness of two-phase helical CT for the preoperative localization of pancreatic islet cell tumors. MATERIALS AND METHODS: Ten patients with 11 surgically proven islet cell tumors were included in the study. Helical CT scans of the pancreas were obtained with 5-mm collimation and overlapping image reconstruction. Images were obtained in the arterial and parenchymal phases after contrast material injection. A test bolus was used for tailored bolus timing. Images were analyzed by two observers. If a tumor was detected, its density relative to the surrounding parenchyma was scored by consensus, using a five-point scale. RESULTS: Nine of 11 tumors could be located using two-phase helical CT (sensitivity, 82%), including one 4-mm gastrinoma. Two lesions smaller than 5 mm could not be visualized. Two tumors were easier to detect (n = 1) or could only be detected on parenchymal-phase images (n = 1). Tumor conspicuity was better on arterial-phase images in two patients. CONCLUSION: Our results show that obtaining CT scans in both the arterial and the parenchymal phase leads to improved detection of pancreatic islet cell tumors.

Adenoma, Islet Cell↗

Abdominal pain in the postpartum: role of imaging.

The post-delivery evaluation of the obstetric patient presenting with severe abdominal pain can be a challenge to the obstetrician, the internist, and the radiologist. Besides non-pregnancy-related causes of abdominal pain, several pregnancy-related complications should be included in the list of differential diagnoses. Based on pathogenesis, these conditions can be divided in four categories: thromboembolic disease, infectious complications, mechanical complications, and complications of preeclampsia. Most disease processes can be adequately visualized with sonography. CT can be indicated for the evaluation of the extent of ovarian vein thrombosis and for depiction of deep abdominal collections in obese patients or in cases of abundant overlying abdominal gas. MRI can be useful to provide the specific diagnosis of hemorrhagic liver infarction in the clinical setting of a HELLP syndrome.

Abdominal Pain↗

[Spiral CT in parenchymatous disorders of the kidney].

Spiral-CT enables accurate diagnosis of renal parenchymal diseases and tumors, and when necessary, staging. Important prerequisites are optimal timing after injection of contrast medium and problem-tailored reformatting. In the optimal setting, this allows to reduce the examination time, the radiation dose, and the dose of contrast medium. Moreover, many other so-called complementary examinations as MRI, angiography, cavography, and diagnostic puncture can be avoided.

Adenocarcinoma↗

[Spiral CT of the renal blood vessels].

Spiral CT angiography has been successfully applied to the detection and grading of renal artery stenoses. In this manuscript the technique, the diagnostic accuracy and the advantages and limitations of this new method are discussed.

Angiography↗

[Spiral CT angiography].

Spiral CT angiography (CTA) is a promising technique for the evaluation of vascular lesions. We review some important technical aspects in CTA such as longitudinal resolution, determination of injection scan interval and limitations of three-dimensional rendering techniques. Several current and potential applications are discussed.

Angiography↗

[Spiral CT of cerebral aneurysms].

Spiral CT was performed in 9 patients with 13 cerebral aneurysms known from angiography. All lesions were detected by spiral CT, the smallest lesion measuring 3 mm in diameter. The neck of the aneurysm and the anatomical relations could be determined very accurately in all cases. Advantages of spiral CT over magnetic resonance angiography include: the short examination time, the independence of flow rate and cardiac output, and the excellent visualisation of calcification, thrombus and the bony landmarks. Disadvantages are the necessity of iodinated contrast media, the long postprocessing and reconstruction time and the possibility of overlap from bone and venous blood.

Cerebral Angiography↗

[Spiral CT of the liver: detection of focal liver lesions].

The advantages of spiral CT mainly reside in the possibility to scan the entire liver volume in a single period of about 20 to 30 seconds, while the patient holds his breath. This high acquisition speed allows to selectively evaluate the entire liver during the arterial and/or portal venous phase. In addition, spiral CT is a true volumetric technique that allows a posteriori calculation of perfectly contiguous or even overlapping slices. These two specifications, high acquisition speed and the absence of data gaps improves the detection of focal liver lesions.

Humans↗

[Spiral CT of the pancreas].

Spiral CT allows rapid acquisition of axial images during a single breath-hold. This results in optimal vascular and parenchymal opacification and eliminates respiratory misregistration. These factors also contribute to high quality multiplanar displays. Double phase spiral CT allows repeated scanning in the vascular (arterial) phase and in the parenchymal phase after contrast injection, resulting in optimal detection of parenchymal as well as vascular lesions. The advantages and applications of spiral scanning for imaging the pancreas are discussed.

Acute Disease↗

The history of uroradiology.

In the first period (1896-1910), investigation was made through plain abdominal film with description and differential diagnosis of the different calcifications in the right hypochondrium. Second period (1911-1924): indirect signs of liver and gallbladder pathology were described. Via pneumoperitoneum and gastro-intestinal opacification the pathology in the right hypochondrium was delineated and interpreted. Third period (1924 until now): due to the development of contrast agents for the gallbladder and biliary tree, these organs could be directly visualized either by intravenous injection, or by peroral administration; sometimes direct injection of contrast in the bile ducts was used.

History, 19th Century↗

Determination of scan delay time in spiral CT-angiography: utility of a test bolus injection.

OBJECTIVE: The usefulness of a test bolus of contrast medium for predicting the optimal scan delay time in spiral CT-angiography (CTA) was determined. MATERIALS AND METHODS: Two axial single level CT studies were performed at the level of the pancreas in 20 patients, first after injection of a 12 ml "test" bolus, second after administration of a 90 ml bolus. The time interval between the start of the test bolus injection and peak aortic enhancement (T-peak) was measured and compared with the time required to reach a 50, 100, and 150 HU level of aortic enhancement after 90 ml bolus injection. RESULTS: The time required to reach 50, 100, and 150 HU enhancement during the 90 ml bolus was largely variable (mean SD 4.9 s). The T-peak varied between 11 and 32 s (mean 20, SD 6.1 s). There was a strong correlation between the T-peak and the time to the different levels of enhancement during the 90 ml bolus (R2 > or = 0.83). The mean time to 50, 100, and 150 HU enhancement was T-peak -3.3 s (SD 2.5 s), T-peak -1.2 s (SD 2.4 s), and T-peak + 1.3 s (SD 2.4 s). CONCLUSION: The injection of a test bolus improves the timing of a spiral CTA acquisition.

Adult↗

Evaluation of hepatic perfusion disorders with double-phase spiral CT.

Double-phase (dual-phase) spiral computed tomography (CT) represents a technologic advance that allows two evaluations of hepatic blood flow during a single 19-29-second breath hold: once during the hepatic arterial phase (HAP) and again during the portal venous phase (PVP). Perfusion disorders of the hepatic parenchyma are more readily observed at double-phase spiral CT. The various hepatic perfusion disorders are related to (a) portal venous inflow obstruction, (b) hepatic venous outflow obstruction (e.g., Budd-Chiari syndrome, cardiac failure, mediastinal fibrosis), (c) mediastinal or thoracic venous inlet obstruction, (d) focal liver lesions, (e) inflammatory processes, (f) normal anatomic variants in the hepatic blood supply, (g) altered hemodynamics after the placement of a transjugular intrahepatic portosystemic shunt, and (h) uncertain causes. In general, the area of involvement appears hyperattenuating on HAP images and of normal or near-normal attenuation on PVP images. Familiarity with the spiral CT appearances of different types of perfusion disorders allows the radiologist to separate clinically insignificant flow phenomena from perfusion disorders caused by underlying parenchymal or vascular disease.

Adult↗

Small bowel obstruction due to a persistent omphalomesenteric duct.

We report a case of a Meckel diverticulum connected with the umbilicus through a fibrotic cord causing small bowel obstruction. On admission, the patient presented with an acute abdomen. A plain upright radiography of the abdomen, an ultrasonography of the abdomen, and an enema with gastrografin were performed, showing a small bowel obstruction at the level of the pre-terminal ileum, without revealing the cause. Urgent surgery followed, showing a persistent omphalomesenteric duct connected to the abdominal wall through a fibrotic cord, with a secondary volvulus of the small bowel. The remnant was resected and the volvulus reduced. The post-operative course was uneventful. Because of the serious complications and even possible mortality due to ischemic disease of the affected small bowel the possibility of a complicated persistent omphalomesenteric duct should be kept in mind, even if the preoperative work-up does not reveal a Meckel diverticulum.

Abdomen, Acute↗

Fibrolamellar hepatocellular carcinoma in a 65-year-old woman: CT features.

A 65-year old woman with recurrent deep vein thrombosis underwent a CT scan of the upper abdomen for detection of underlying malignancy. A fibrolamellar hepatocellular carcinoma with extrahepatic subdiaphragmatic satellite lesion was found. This uncommon tumor has distinct clinical, pathological, radiological and prognostic features and therefore it is important to distinguish it from benign liver tumors, especially FNH, and from other malignant liver tumors such as conventional HCC. Though the tumor characteristically occurs in younger patients, our case proves that older patients can also be affected.

Aged↗

Jaw fixation as the key to diagnosis of fibrodysplasia ossificans progressiva.

Fibrodysplasia ossificans progressiva is a very rare and disabling hereditary disorder of connective tissue characterised by symmetric congenital anomalies of the great toes and thumbs and by progressive heterotopic ossification of tendons, ligaments, fasciae and striated muscles. In this case we report a 17-year-old boy who presented with a painful swelling of the right mandibula with trismus. Multiple heterotopic soft tissue calcifications, severe scoliosis and typical anomalies of toes and thumbs on the radiographs were pathognomonic for fibrodysplasia ossificans progressiva.

Adolescent↗