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Biomedical subjects

V Hazebroucq

Publications and source records attributed to V Hazebroucq.

At least 19 recordsLinked to original sources
PubMed2000

[Medico-legal aspects of thoracic imaging in 2000].

The radiologist's responsibility for the radiographic procedure concerns control of the indication and patient information and consent, as well as the examination procedure itself, including safety measures, interpretation, report delivery, and patient follow-up until referral to a colleague. Details on five specific medico-legal points are examined here: 1) patient information and consent, a problem recently brought to the forefront by the recent French Supreme Court decision, 2) lung cancer unrecognized on a radiography, 3) implications of complementary examinations related to the discovery of a suspect lesion, 4) fortuitous discovery of a malignant lesion in a patient undergoing exploration for another reason, 5) questions of a legal and ethical nature raised by the development of telemedicine.

Diagnostic Errors↗
PubMed1999

Swallowing disorders in paralysis of the lower cranial nerves: a functional analysis.

Deficits of the lower cranial nerves (nerves IX, X, XI, and XII) occurring after treatment of skull base tumors may cause disabling swallowing disorders. To assess the mechanisms of swallowing disorders involved in such cases, we performed functional examinations: a videoendoscopic swallowing study and simultaneous manometry and videofluoroscopy in 7 patients. This study shows that the main mechanism of the swallowing disorders was a disturbance of the pharyngeal stage, including a decrease of pharyngeal propulsion, reduced laryngeal closure, and cricopharyngeal dysfunction, which led to aspiration. Decreased pharyngeal propulsion was found in 6 patients, with a very high correlation between fiberoscopy and simultaneous manometry-fluoroscopy. The responsibility of the upper esophageal sphincter in swallowing disorders was more difficult to assess. The role of the upper esophageal sphincter and pharyngeal propulsion in the onset of the problem is discussed in regard to the cricopharyngeal myotomy.

Adult↗
PubMed1999

[Exposure and good practice in helical computed tomography].

Helical CT is the imaging modality that delivers the highest exposure to patients. For each acquisition, the average radiation dose is between 20 and 30 mGy. This dose can potentially be reduced by decreasing the intensity or voltage and by increasing the pitch. Helical data can be reformatted to obtain images with smaller increment or multiplanar reconstructions, hence reducing the need for additional acquisitions. Hardware and software devices designed for dose reduction must be systematically used. Operators of CT units should be aware of the radiation dose delivered with helical CT and must carefully assess the need of each additional acquisition. Obsolete protocols such as angulation of the gantry for lumbar CT, which increases patient exposure, should no longer be used. Rational use of helical CT decreases radiation exposure and is faster, whereas improper use increases radiation exposure without added benefit.

Filtration↗
PubMed1999

[Proper technics and the reduction of radiation in helical computed tomography].

Helical computed tomography is the main source of ionizing radiation delivery in diagnostic radiology. For each series, average radiation dose is between 20 and 30 mGy. This dose can potentially be reduced by decreasing intensity or voltage and by increasing pitch. Helical acquisition allows reformating of images with smaller increment or different obliquity, and avoids additional irradiation. Hardware and software devices designed for dose reduction must be systematically used. Users of CT systems should be aware of radiation dose delivered with CT and must carefully assess the need of each additional acquisition. Obsolete habits, as gantry tilting for lumbar CT, which increases patient exposure, must be given up. Rational use of helical CT decreases radiation exposure and gains time, whereas thoughtless use increases radiation exposure without real benefit.

Computer Systems↗
PubMed1998

Role of videoendoscopy in assessment of pharyngeal function in oropharyngeal dysphagia: comparison with videofluoroscopy and manometry.

OBJECTIVE: The purpose of the current report is to evaluate the ability of videoendoscopic swallowing study in assessing pharyngeal propulsion and aspiration episodes when compared with videofluoroscopy and manometry. STUDY DESIGN: Prospective study. METHODS: Thirty-four patients with oropharyngeal dysphagia underwent videoendoscopy of swallowing to assess pharyngeal propulsion as pathologic or nonpathologic, and aspiration. These features were compared with those found on manometry and videofluoroscopy, which were considered as the reference examinations. Sensitivity, specificity, and positive and negative predictive values of videoendoscopy were estimated, with their 95% confidence intervals. RESULTS: A total agreement between videoendoscopy and videofluoroscopy was found in 76.4% of cases for pharyngeal propulsion and in 82.3% for aspiration. This rate for pharyngeal propulsion reached 82.3% between videoendoscopy and manometry. Moreover, in 24 cases (70.5%) in which videofluoroscopy and manometry agreed for pharyngeal propulsion, 22 were assessed similarly through fiberoscopy. When using fluoroscopy and manometry as reference examinations, videoendoscopy detected nearly 90% (95% confidence interval [CI] = 0.80, 1.0) of impaired pharyngeal propulsion. Concerning aspiration, 70% (95% CI = 0.54, 0.85) of events detected by videoendoscopy were also observed on videofluoroscopy. Sensitivity, specificity, and positive and negative predictive values of videoendoscopy reached a higher rate (90% to 92.8%) when agreement was found between fluoroscopy and manometry. CONCLUSIONS: Videoendoscopy is an examination that can be used to detect inexpensively pharyngeal propulsion disorders and aspiration episodes.

Adult↗
PubMed1998

[Value of high-frequency (20 MHz)in the diagnosis of cutaneous tumors].

The purpose of the present study is to asses the value of high frequency ultrasonography (20 MHz), a new noninvasive imaging technique, in cutaneous tumors. Cutaneous tumors are clinically varied and their diagnosis is still based on histopathological analysis. 140 cutaneous tumors have been examined with US and imaging findings have been compared to the results of clinical and histological examinations. This study shows that high frequency ultrasonography, even though it cannot replace pathological analysis, may help the dermatologist in the positive diagnosis of some cutaneous tumors and in accessing the location and the in depth-extension of the lesions in the different layers of the skin.

Adolescent↗
PubMed1998

[Imaging of adrenal incidentalomas].

Imaging plays an important role in evaluating fortuitously discovered adrenal masses. These unanticipated masses (incidentalomas) are usually discovered at CT examinations. Although most incidentally discovered adrenal tumors are non-hyperfunctioning adenomas, they must be distinguished from primary or secondary malignant lesions. Recent studies have established that both unenhanced CT scans and chemical shift MR imaging can accurately differentiate benign adenomas from nonadenomatous masses by features that reflect the large amount of lipid found in most adenomas and absent in most nonadenomas. We review here the current imaging issues concerning adrenal incidentalomas including diagnostic approaches and management.

Adenoma↗
PubMed1997

Technetium-99m sestamibi scintigraphy, magnetic resonance imaging and venous blood sampling in persistent and recurrent hyperparathyroidism.

Surgical treatment for primary hyperparathyroidism (HPT) is effective in 90% of cases. Recurrent or persistent HPT occurs in 10% of cases. Parathyroid imaging is indicated to confirm and locate an abnormal gland before reoperation. The aim of this study was to evaluate whether the combination of 99Tcm sestamibi scintigraphy, MRI and venous blood sampling (VBS) improved the overall sensitivity for abnormal parathyroid gland detection. 18 patients with recurrent or persistent HPT underwent sestamibi scintigraphy (n = 18), MRI (T1 weighted and STIR sequences) (n = 18) and venous blood sampling (n = 12) at different sites (internal jugular veins, innominate veins, and superior vena cava). All patients underwent surgical exploration. MRI yielded positive results in 15 cases (sensitivity 88%), sestamibi scintigraphy in 14 cases (83%) and VBS in 10 cases out of 12 (83%). Combined results of MRI, sestamibi and VBS yielded positive results in 16 cases (94%). The combination of MRI, sestamibi scintigraphy and VBS improved accuracy in detecting abnormal parathyroid glands before reoperation.

Adenoma↗
PubMed1997

[Internal supporting mammary lamina. Results of the detection of breast lesions].

In order to stabilize the curves of a surgically remodelled breast, Bustos associated to a periareolar mammaplasty a synthetic internal supporting lamina. At the beginning, in 1985, a smooth perforated silicone sheet was used. Since then, other materials were proposed (radioopaque ou radiotransparent, resorbable or not). Because of their superficial situation, in front of the mammary gland, it was essential to study the consequences of the presence of such a material on the mammographic follow-up. We radiographied all the different types of sheet in vitro, and also in vivo, 3 to 19 months after surgery. At the same time we studied the modifications in the breast tissue, in 117 patients after surgical treatment for ptosis or mammary hypertrophy, using different kinds of incisions (periareolar or anchor-shaped, J or L shaped, inferolateral oblique or lower vertical incisions). We also studied the effects of mammary implants covered with Dacron, since some internal mammary supporting lamina are made with this material. The silicone sheet gives some artifacts and may calcify. The resorbable sheet has no effects on the mammography. The radiotransparent non resorbable ones causes no problems on short terms, but we are not sure whether some calcifications appear on long term or not.

Adult↗
PubMed1995

Hepatic artery thrombosis after liver transplantation: diagnosis with spiral CT.

OBJECTIVE: The purpose of this study was to prospectively evaluate spiral CT with maximum-intensity projection in the diagnosis of hepatic artery thrombosis in patients with liver transplants. SUBJECTS AND METHODS: Thirty liver transplant recipients (19 men, 11 women; mean age, 49 years) underwent Doppler sonography and spiral CT with maximum-intensity projection to evaluate both hepatic parenchyma and hepatic vessels. In five cases, these examinations were followed by angiography for suspected hepatic artery thrombosis. RESULTS: Among the 30 patients, results of both Doppler sonography and spiral CT were abnormal in five patients. In all five patients, Doppler sonography revealed an absence of intrahepatic arterial signal (sensitivity, 100%). Spiral CT showed the hepatic artery to be patent from its origin to the anastomosis and then occluded distally in four patients and showed occlusion of the entire hepatic artery in one patient (sensitivity, 100%). Aortography and/or selective arteriography of the celiac axis confirmed the diagnosis of hepatic artery thrombosis in all five cases. The other 25 patients had a normal clinical outcome, 24 with normal findings on Doppler sonograms (specificity, 96%), and 23 with normal findings on spiral CT. Two patients had false-positive CT studies because of technical failures (specificity, 92%). CONCLUSION: Spiral CT with maximum-intensity projection is highly accurate in identifying hepatic artery thrombosis after liver transplantation.

Adult↗
PubMed1993

Pyrimethamine plus azithromycin for treatment of acute toxoplasmic encephalitis in patients with AIDS.

A prospective study was conducted to evaluate azithromycin in combination with pyrimethamine for treatment of acute Toxoplasma encephalitis in patients with AIDS. Of the 14 patients given 75 mg pyrimethamine and 500 mg azithromycin daily for four weeks, eight were evaluable for clinical response. Five responded favorably, one had an intermediate response and two an unfavorable response. Of the nine patients evaluable for radiological response, six responded favorably, and three had an intermediate response. Eleven adverse events occurred in nine patients: rash (n = 5), abnormal liver function (n = 2), vomiting (n = 3) and hypoacousia (n = 1). This pilot study suggests that the combination of pyrimethamine and azithromycin may be further investigated and that the optimal dosage of azithromycin has yet to be determined.

AIDS-Related Opportunistic Infections↗
PubMed1993

[Radiology in the medicolegal identification of cadavers. A new technique of radiography of the maxilla].

After removal, the maxilla and the mandible are placed on a standard radiologic cassette and a X-ray is performed with a low energy beam. Different views can be obtained if required. These radiographic images provide a complete, permanent and detailed record of dental anatomy and restorations, for comparison with antemortem radiographies. Two examples are provided. Moreover, this technique enables the determination of the dental age of children.

Cadaver↗
PubMed1993

[Prognostic value of x-ray computed tomography in acute pancreatitis. Value of a new classification].

CT plays an important role in the screening of complications of acute hemorrhagic pancreatitis. There are three classifications at present, one based on a bioclinical score (Ranson) and the other two consisting of gradual stages of severity and resorting to CT imaging (Balthazar and Hill). The authors report about a study on 34 cases of acute pancreatitis, including 10 that became complicated, to which they applied a new classification including the existence of glandular necrosis, the number of extrapancreatic streaks, related to Ranson's bioclinical score. This classification makes it possible to classify acute pancreatitis into three stages: a mild stage with a favorable outcome, a medium stage requiring close surveillance, and stage 3 involving a high (75%) risk of severe complications.

Acute Disease↗