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Biomedical subjects

V Vilgrain

Publications and source records attributed to V Vilgrain.

At least 109 records · Page 6Linked to original sources
PubMed1990

Staging of esophageal carcinoma: comparison of results with endoscopic sonography and CT.

We compared the results of endoscopic sonography and CT in the preoperative staging of 46 patients with esophageal carcinoma studied prospectively. All patients had surgery and 44 had pathologic examination of the mediastinal and celiac lymph nodes. The results of CT and endoscopic sonography were compared with surgical and pathologic findings. A total of 51 tumors were found in 46 patients. Sonographic estimation of tumor extension through the different layers of the esophagus was correct in 37 (73%) of all 51 tumors and in 22 (85%) of the 26 tumors in which the examination was complete. The echoendoscope (13-mm diameter) could not pass through the tumor in 23 cases (50%). Infiltration to adjacent organs was found in 15 cases at surgery. In four of these 15, the extension was detected by CT; in seven of the 15 cases, it was detected by sonography. False-negative determination of tumor extension occurred with endoscopic sonography in patients with stenotic tumor. There were no false-positive results with either CT or endoscopic sonography. For detection of mediastinal lymph-node involvement, the sensitivity of CT was 48%. The sensitivity of sonography was 50% if metastatic nodes unexplored by sonography were included, or 84% if only cases in which stenosis was passed were considered. Statistical comparison revealed that sonography was superior to CT for the detection of metastases to lymph nodes. CT and endoscopic sonography provide complementary information. When the echoendoscope can be maneuvered past the tumor, sonography can be used accurately to define extension through the layers of the esophagus, extension to the adjacent organs, and involvement of the lymph nodes. When the tumor cannot be passed by the echoendoscope, CT is superior to sonography for detection of mediastinal extension.

Adult↗
PubMed1990

[Endoscopic ultrasonic diagnosis and cancer of the esophagus. Results of a prospective comparative study with x-ray computed tomography in 51 surgically treated patients].

To investigate whether endoscopic ultrasonography could improve the preoperative staging of esophageal carcinoma we prospectively studied 56 tumors in 51 patients between March 1987 an March 1988. The results for assessing local and regional extension and preoperative staging were compared with those of computed tomography, surgery, and pathological findings. When the procedure was complete (n = 25) the accuracy of parietal spread assessment was 85.7 percent; sensitivity for nodal involvement was 83.3 percent versus 50 percent for computed tomography with an accuracy of 97.6 percent versus 96.4 percent; the discrimination between superficial and advanced cancer was 100 percent; the accuracy for preoperative staging using the Japanese classification was 84 percent. When the procedure was not complete (stenosis), endoscopic ultrasonography was complementary to computed tomography: local invasion of anatomical structures (n = 16) was better assessed by combined endoscopic ultrasonography and computed tomography (n = 11) than by endoscopic ultrasonography (n = 8) or computed tomography (n = 6) alone. We conclude that endoscopic ultrasonography is the best procedure for staging esophageal carcinoma without stenosis; further miniaturization of the transducer is necessary to improve results in the case of narrow stenosis.

Adenocarcinoma↗
PubMed1989

Endosonography: promising method for diagnosis of extrahepatic cholestasis.

Endosonography, ultrasonography, and computed tomography (CT) were carried out prospectively in 52 patients with extrahepatic cholestasis. 35 patients had extrahepatic biliary obstructions (21 tumorous, 14 non-tumorous) and 17, with recent gallstone migration within the bile duct, had no extrahepatic obstruction at the time of investigation. The definitive diagnosis was established by surgery (in 39 patients), by transendoscopic sphincterotomy (11 patients), or by retrograde biliary opacification (2 patients). Endosonography was significantly more sensitive than ultrasonography or CT (100% vs 80% and 83%, respectively) in making a positive diagnosis of obstruction. Endosonography was also significantly more accurate than ultrasonography or CT (97% vs 49% and 66%) in diagnosing the cause of the obstruction and more effective in the assessment of the locoregional spread of tumorous obstructions (75% vs 38% and 62%). Thus, endosonography was superior to ultrasonography and CT in the diagnosis and staging of biliary obstructions.

Adult↗
PubMed1989

[High-resolution x-ray computed tomography in lymphoid interstitial pneumonia].

Three patients with lymphoid interstitial pneumonia (two HIV 1+ patients with chronic lymphadenopathic syndromes and one with a not-characterized autoimmune disease) have been studied with high-resolution computed tomography (HR-CT). This technique reveals septal lines, small reticulonodular opacities, polyhedral micronodular opacities, "ground-glass" opacities and a dense, subpleural, curved broken line in one patient. The lesions dominate in the bases of the lungs. They are not characteristic for lymphoid interstitial pneumonia. If a patient present with a chronic lymphadenopathic syndrome, the diagnosis of an opportunistic infection should not be automatically made, since the syndrome can be caused by lymphoid interstitial pneumonia.

Adult↗
PubMed1989

[Value of a score using clinical and biological variables for determining the benignity or malignancy of a hepatic mass].

The purpose of this study was to show that clinical and biological data can help in the diagnosis of benignity and malignancy in liver tumors seen on ultrasound. Three hundred and ninety-four patients with liver masses detected by ultrasound (270 malignant, 124 benign) were prospectively studied. Clinical and biological data were tested by univariate and multivariate analysis. The most important variables were gamma-glutamyl-transferase, sedimentation rate, known primary cancer, proven cirrhosis, abnormal abdominal palpation, ascites and weight loss. A regression model was used and a score was defined with these variables. Using this score, 94.8 p. 100 of the liver masses were accurately classified as benign and malignant tumors.

Diagnosis, Differential↗
PubMed1989

[Ultrasonographic and x-ray computed tomographic aspects of Mirizzi's syndrome].

The Mirizzi syndrome is due to common hepatic duct obstruction secondary to the impaction of a large gallstone in the neck of the gallbladder or the cystic duct. The sonographic and computed tomography features in 3 cases of Mirizzi syndrome are described and compared with percutaneous transhepatic cholangiography or endoscopic retrograde cholangiography findings. The Mirizzi syndrome was diagnosed preoperatively on sonography in 2 out of 3 cases and on plain computed tomography scans in all 3 cases. However pre or intraoperative visualization of the biliary tract is mandatory in suspected Mirizzi syndrome to detect the presence or absence of cholecystobiliary fistula, in order to adapt the operative strategy.

Adult↗
PubMed1987

[Value of cytopuncture associated with microbiopsy in solid masses in the pancreas. Preliminary study].

Efficacy of fine needle puncture and microbiopsy technics was compared in 19 patients with a solid pancreatic mass. Results showed sensitivity and global accuracy of 71 and 72% respectively for cytology, 92 and 82% for microbiopsy and 100 and 94% for their combined use. Global accuracy and negative predictive values reached 100% when repeat samples were collected because of insufficient material. No false positives were noted and no complications in this preliminary series.

Adenocarcinoma↗
PubMed1987

[90 fine-needle punctures for diagnosis of the upper abdomen under ultrasonic guidance. Contribution of cyto- and histologic analysis].

Fine needle puncture was performed of upper abdomen in 19 cases. The method is rapid, reliable, of low cost and only weakly traumatic. The recent possibility of coupling histologic and cytologic analysis with fine needles provides improved results by increasing diagnostic precision and identification of malignant tumors and benign tumors of difficult cytologic diagnosis.

Abdomen↗
PubMedDate not supplied

Correlation of MR changes with Doppler US measurements of blood flow in exercising normal muscle.

Muscle data from phosphorus-31 magnetic resonance (MR) spectroscopy and hydrogen-1 MR imaging and popliteal artery data from duplex Doppler ultrasound were compared during an exercise test of the anterior compartment of the leg, in nine healthy volunteers. Significant variations (mean +/- standard deviation) were observed at the end of exercise versus rest in intracellular pH (pHi) (6.32 +/- 0.02 vs 7.02 +/- 0.04, P < .001), T2 (38.2 msec +/- 2.3 vs 29.5 msec +/- 1.1, P < .001), and popliteal output (652 mL/min +/- 232 vs 149 mL/min +/- 65, P < .001). These variables showed the following significant correlations at the end of exercise: T2 and pHi (r = -.784, P < .01), T2 and popliteal output (r = .737, P < .03), and pHi and popliteal output (r = -.902, P < .001). However, during recovery, the T2 curve was significantly different from those of pHi and popliteal output. This suggests that even if circulatory conditions play a role in the maximum T2 variation during exercise, they do not directly explain T2 changes. Furthermore, the correlations involving pHi suggest the role of the metabolism of exercising muscle in transcapillary fluid movement.

Adult↗
PubMedDate not supplied

Association of multiple liver cell adenomas with spontaneous intrahepatic portohepatic shunt.

The association of multiple liver cell adenomas containing foci of focal nodular hyperplasia with a spontaneous intrahepatic portohepatic venous shunt is reported in a 13-year-old male patient. At least eight nodules less than 10 cm in diameter were recognized and proved by means of surgical resection or surgical biopsies. These lesions were heterogeneous and hypodense on precontrast computed tomographic (CT) scans, and were slightly enhanced after injection of contrast medium. At magnetic resonance (MR) imaging, the signal intensity of these nodules varied. It was either hyperintense or hypointense on T1-weighted SE images. Sonography and angiography demonstrated a portohepatic venous shunt and hepatic arterialization was observed. These findings emphasize the hypothesis that hepatic arterialization may cause the development of liver cell adenomas. Moreover, it is suggested that liver cell adenoma and focal nodular hyperplasia have a common pathogenesis.

Adenoma, Liver Cell↗
PubMedDate not supplied

Radiologic features of papillary adenoma and papillomatosis of the biliary tract.

BACKGROUND: The purpose of this study was to describe the imaging findings of papillary adenoma of the bile ducts. METHODS: Imaging modalities including sonography, computed tomography, cholangiography, and endoscopic sonography obtained in five patients with papillary adenoma of the bile duct were retrospectively reviewed and correlated with pathologic findings. RESULTS: In four cases, imaging findings were a dilatation of the bile ducts due to a protruding mass within the lumen of the common bile duct. In one case, the biliary tract obstruction was not due to the mass but to mucus secretion that was detected at sonography, endoscopic sonography, and cholangiography. Multiple lesions were observed in two cases at pathology and not detected preoperatively. All the lesions contained foci of in situ carcinoma or mild dysplasia. CONCLUSION: Imaging is useful in detecting bile duct tumors. Hypersecretion of mucus is rare but highly characteristic of bile duct adenoma.

Adenoma↗
PubMedDate not supplied

Disappearance of liver cell adenoma: CT and MR imaging.

We report the disappearance of liver cell adenoma, documented by computed tomography (CT) and magnetic resonance (MR) imaging. A 42-year-old woman with a diagnosis of hepatic adenoma was followed up by CT and MR imaging after cessation of oral contraceptive use. At the time of diagnosis, the adenoma was 4 cm in diameter and appeared hypervascular on CT. At MR imaging, the lesion was hypointense on T1-weighted sequences, and hyperintense on T2-weighted sequences. The lesion disappeared 4 years after cessation of oral contraceptive use. We conclude that in nonoperated patients CT scans and MR imaging are useful for following the evolution, and documenting the regression, of liver cell adenomas.

Adenoma, Liver Cell↗
PubMedDate not supplied

[Radiofrequency ablation of hepatic tumors].

This article aims to review the state of the art in ablation techniques for hepatic lesions. In addition to discussing the indications, outcomes, and potential complications of the technique, we illustrate the spectrum of imaging findings after treatment. Recent years have seen the development of a wide variety of minimally invasive techniques to treat liver cancer. These include ethanol injection, and thermal ablation using radiofrequency, laser, microwaves, or cryosurgery. Percutaneous radiofrequency ablation is one of the most promising non-surgical treatments for hepatic neoplasms. The results of several studies show that radiofrequency ablation enables adequate local control of tumors with few complications, achieving acceptable survival rates. Radiofrequency ablation can be performed using any imaging technique, although it is most commonly performed under ultrasound guidance. CT and MRI show the degree of tumor necrosis better and are more frequently employed in follow up. This article reviews the indications and contraindications for the procedure, potential complications, long-term outcome, and imaging findings for percutaneous radiofrequency ablation of hepatic tumors.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

[Abdominal imaging].

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Bile Duct Diseases↗