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Publications and source records attributed to Y Menu.

At least 109 records · Page 6Linked to original sources

Bronchiectasis: assessment by thin-section CT.

To assess the accuracy of computed tomography (CT) in the evaluation of bronchiectasis, we performed thin-section CT in 36 patients with clinical findings suggestive of this diagnosis. CT was performed with 1.5-mm section thickness and 10-mm intersection spacing. Bilateral (eight patients) and unilateral (28 patients) bronchograms were obtained. CT and bronchographic findings were correlated in 44 lungs. In 15 lungs no bronchiectasis was observed on CT scans and bronchograms. In 25 lungs both examinations accurately indicated the presence and extent of bronchiectasis. In two lungs the extent of disease was underestimated on CT, which failed to indicate bronchiectasis in one segment of the affected lobe. In one case CT findings suggested focal bronchial disease, but the lung was misinterpreted as not bronchiectatic; the bronchogram showed cylindric bronchiectasis. In one case CT disclosed cylindric bronchiectasis in a lobe that was bronchographically normal, but in this case the bronchogram was probably misinterpreted as false negative. In two cases lung findings were better visualized on CT scans than on bronchograms. It is concluded that thin-section CT is an accurate procedure in the recognition of bronchiectasis.

Adolescent↗

[Surgical treatment of hepatocellular carcinoma in cirrhosis. Value of peroperative ultrasonography].

During the past three and half years, 19 patients with hepatocellular carcinoma associated with cirrhosis were operated on. Pain was present in seven patients while 12 were asymptomatic. Alpha foeto-protein was negative in 7 patients. Intraoperative ultrasonography was performed in the last 15 patients. Three right hepatic resections, 5 left hepatic lobectomies and 11 segmentectomies or subsegmentectomies were performed. The operative mortality was 5 p. 100 (one patient). The long term survival in the 3 patients who underwent palliative resection was 6 months. Among the 15 other patients, four died from causes unrelated to their tumor; three patients with tumors larger than 8 cm died from recurrence 12 to 26 months after surgery; and the remaining 7 are still alive without evidence of recurrence 3 to 18 months after surgery. We concluded that in patients with cirrhosis, resection of limited hepatocellular carcinoma is possible, using intraoperative sonography, with low operative mortality. Early detection by repeated ultrasonic examination of the liver in patients with cirrhosis could be the best way to improve the surgical treatment of hepatocellular carcinoma.

Adult↗

[Pancreatic cystadenoma: diagnostic value of ultrasonics and x-ray computed tomography].

We report six cases of pancreatic cystadenoma (three mucinous cysts, three microcystic adenomas). All patients were women. The mean age at the time of diagnosis was 50 years (with a range from 24 to 70 years). The mean age of patients having mucinous cysts (36.6 years) was lower than that of patients having microcystic adenomas (63.3 years). Abdominal pain was the first symptom in five patients. A palpable abdominal mass was found in three cases. The type of the tumor was demonstrated by ultrasonography and computed tomography and was confirmed by laparotomy in five cases. The tumors involved the body and tail of the pancreas. A distal pancreatectomy was performed in five cases, with a splenectomy in four cases. The post-operative course was uneventful. One patient was not operated. The histological examination of the three mucinous cysts showed benign tumors. This study emphasizes the usefulness of ultrasonography and computed tomography for the diagnosis of pancreatic cystadenomas. Surgical therapy is mandatory for mucinous cysts because of their potential malignancy, but a careful follow-up might be proposed for poor-risk patients having a microcyst adenoma, since this tumor is benign.

Adult↗

[Left inferior vena cava. Ultrasonic diagnosis].

A case of left infrarenal vena cava is detected by ultrasonography and confirmed inferior cavography. Embryogenesis of the inferior vena cava aids understanding of this type of congenital anomalies. Ultrasonographic diagnosis is based on the absence of right infrarenal vena cava, the presence of a vascular structure left to the abdominal aorta an a normal hepatic segment of inferior vena cava.

Humans↗

[Magnetic resonance imaging in the study of pulmonary hilar involvement].

A retrospective analysis of results of magnetic resonance imaging (MRI) was conducted in 28 patients with uni- or bilateral pulmonary hilum lesions and findings compared with those of computed tomography (CT). All abnormal hilar masses examined were between 1 and 5 cm in diameter and were easily detected by transverse axial imaging. Contrast of their images was very high in relation to hilar bronchovascular elements in the two types of spin echo sequence with a short TR (0.5-0.7 s) and a long TR (1.5-2 s). Differentiation between tumoral or adenopathies and vessels was simpler than with CT with intravenous contrast. For screening of possible extension of hilar tumors. MRI appears to be superior to CT for providing data on vascular relations of lesions but inferior to CT for determining bronchial relations. Mediastinal extension of hilar tumors is easily defined by the short TR sequence but MRI supplies data of greater value than CT only in a low proportion of cases and then partly as a result of complementary coronal and sagittal imaging.

Adult↗

Budd-Chiari syndrome: US evaluation.

Twelve patients with proved Budd-Chiari syndrome (eight acute and four chronic cases) were examined, using real-time ultrasonography (US). In all acute cases, US study showed at least one hepatic vein with findings suggestive of the syndrome, such as stenosis, dilatation, thick wall echoes, thrombosis, abnormal course, or extrahepatic anastomosis. In chronic cases, hepatic veins were usually not visible. Modifications of liver morphology were present in all patients except those with recent onset of the disease. Caudate lobe hypertrophy was present in only six cases. US study is therefore the procedure of choice for initial diagnosis of acute Budd-Chiari syndrome. Pitfalls were the failure to detect two caval thromboses and one hepatic vein web. Cavography should still be performed systematically, but hepatic phlebography is useful in selected cases only.

Adult↗

Sonographic and computed tomographic evaluation of intrahepatic calculi.

Intrahepatic calculi in non-Asian patients were studied by sonography and computed tomography (CT). Three patients were studied by CT cholangiography also. In two cases, the calculi were consecutive to Caroli disease, and in two others, the biliary stones were formed proximal to a stenosis of a previous surgical anastomosis. Five patients spontaneously developed intrahepatic calculi. All sonograms were abnormal. Image specificity was good, even when bile ducts were not dilated, if appropriate technique allowed identification of a double-arc-shadow pattern. Sonography strongly suggested the diagnosis in eight patients and was nonspecific in only one. On CT, calculi had various densities, and they were not visible in two patients. CT cholangiography was not particularly helpful. Finally, CT added little more information when performed after sonography. Both examinations strongly underestimate the number of stones, and direct cholangiography remains indicated if surgery is planned.

Adult↗

Liver adenomatosis. An entity distinct from liver adenoma?

From 1979 to 1984, we followed the cases of 3 men (aged 13, 31, and 75 yr) and 2 women (aged 38 and 45 yr who had never used oral contraceptives) suffering from liver adenomatosis, an uncommon lesion consisting of numerous benign adenomas in an otherwise normal hepatic parenchyma. During the same period, we observed 20 cases of liver adenoma (one tumor in 18 patients and two tumors in 2 patients). From these cases and the review of previously reported cases of liver adenomatosis and series of liver adenoma, the following distinctive characteristics of these two benign conditions of the liver can be outlined: liver adenomatosis affects men and women, whereas liver adenoma predominantly affects women; liver adenomatosis is unrelated, whereas liver adenoma is closely related, to oral contraceptive use; increases in serum alkaline phosphatase and gamma-glutamyl transpeptidase are common in liver adenomatosis, but are uncommon in liver adenoma.

Adenoma↗

[Value of the sitting position for studying suprahepatic veins by ultrasonography].

Ultrasound imaging of suprahepatic veins was conducted in 50 patients in the sitting and lying down positions and under the same respiratory conditions. Results showed that the sitting down position was frequently useful during exploration of suprahepatic veins, and it should be performed whenever visibility in the lying down position in unsatisfactory.

Hepatic Veins↗

[Evaluation of vascular surgery with digital subtraction angiography. A study of 127 patients].

We have performed digital subtraction angiography (DSA) on 127 patients treated by vascular surgery. This technique was easily and safely performed in outpatients, without any complication. Our experience indicates that DSA is accurate for post operative evaluation in 96% of cases. In digestive arterial surgery, some examinations (3.3%) are insufficient. Distal run off is usually well seen, everywhere, except in kidneys. There is a good correlation between angiographic results and clinical status. However, significant abnormalities were discovered in 5% of cases without any clinical signs. Digital intravenous angiography is a safe and mildly invasive procedure for postoperative evaluation of vascular surgery.

Angiography↗

[Magnetic resonance imaging in the exploration of hepatic masses].

Exploration was conducted by magnetic resonance imaging (MRI) at 0.15 T in 33 patients with hepatic masses, including 18 with malignant tumors, 11 with benign tumors and 4 with non-tumoral masses. All tumors appeared hyperintensive in relation to liver on images acquired by long TR spin echos (SE) and all, except for one fatty tumor, appeared hypointense in relation to liver on images acquired in inversion-recuperation (IR). The study seemed to provide data demonstrating that MRI at 0.15 T enables visualization of hepatic masses with a degree of precision that approaches that of other imaging methods. Tumors of the small size of the order of a centimetre can be detected. Tumor outlines and vascular relations are clearly demonstrated without use of contrast. Characterization of masses is still insufficient since the simple play of contrasts between tumor, parenchyma and vessels does not allow differentiation of malignant from benign tumors, nor the identification of a given histologic type.

Adult↗

[Heterogeneous steatosis. Echographic aspects].

Heterogeneous fatty degeneration of the liver was detected in 8 patients by ultrasound recordings, and confirmed by biopsy and the subsequent course. The etiology was alcoholism in most cases. Elevated transaminases and gamma GT were associated with modifications in hepatic ultrasound images. Foci of liver fatty degeneration were hyperechogenic, usually with clearly defined outlines, and were segmental, polygonal or rounded, and lacking mass effects. This condition requires differentiation from primary or secondary liver tumors, and can be confirmed by a CT scan and biopsy of a hyperechogenic zone found on ultrasonographic images strongly suggestive of the lesions.

Adult↗

Discrepancy between wedged hepatic venous pressure and portal venous pressure after acute propranolol administration in patients with alcoholic cirrhosis.

In patients with alcoholic cirrhosis, wedged hepatic venous pressure closely reflects portal venous pressure. This study was carried out to determine if propranolol-induced reductions in portal venous pressure are accurately evaluated by the measurement of wedged hepatic venous pressure. Hepatic venous cannulation and percutaneous transhepatic catheterization of the portal vein were simultaneously performed in 7 patients with alcoholic cirrhosis. One hour after oral administration of 40 mg of propranolol, wedged hepatic and portal venous pressures significantly decreased from 24.3 +/- 3.5 (mean +/- SD) to 19.0 +/- 3.0 mmHg, and from 24.7 +/- 3.9 to 22.4 +/- 3.6 mmHg, respectively. Although no significant difference was found between baseline wedged hepatic and portal venous pressures, a significant difference was found between these pressures after propranolol administration. We concluded that during acute administration of a drug acting on the splanchnic circulation, the measurement of wedged hepatic venous pressure may not provide a reliable estimation of the magnitude of the changes in portal venous pressure. There is, however, no evidence that the direction of the changes might not be adequately assessed by wedged hepatic venous pressure measurement.

Aged↗

[Modulated filtration for routine standard thoracic films].

A new system is described for the filtration of routine posteroanterior chest films. The apparatus consists of a sliding support and two filters of different thicknesses and slit widths. The whole equipment, filter and sliding support as described is simple in use, and allows correct centering and a choice of two options of modulation as a function of morphology of patients examined.

Humans↗