[Complete ureteric duplications and urinary infection in adults: a report on 27 cases (author's transl)].
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Adult↗
Biomedical subjects
Y Menu
Publications and source records attributed to Y Menu.
Two-dimensional time-of-flight magnetic resonance angiography of renal arteries without maximum intensity projection: a prospective comparison with angiography in 21 patients screened for renovascular hypertension.
PURPOSE: We compared magnetic resonance angiography (MRA) with conventional angiography to establish its value as a screening test in the workup for renal hypertension. METHODS: Twenty-one patients underwent MRA and angiography within a three-day interval. Fifteen patients were suspected of having renovascular hypertension on the basis of clinical findings; the remaining six had multivessel atherosclerosis with renal insufficiency. MRA was performed on a 1 Tesla magnet in three planes: axial, coronal and perpendicular to the axis of each renal artery, by means of several contiguous or overlapping individual slice acquisitions. The two examinations were read by the same two independent observers, before and after an interval of 3 months. RESULTS: Conventional angiography showed 48 renal arteries. All main and three of six accessory renal arteries were correctly identified by MRA, as well as 11 of 14 significant stenoses or thromboses. Overreading of stenoses by MRA was observed in 4 cases. There were two false negatives for the two readers. The sensitivity and specificity of MRA for the detection of stenoses of the main renal arteries were found to be 70 and 78% respectively, for the first reading and 85 and 86% for the second reading. CONCLUSION: MRA is considered a useful noninvasive method to determine the need for conventional angiography in patients in whom renal artery stenosis is suspected.
Adult↗
Bile duct involvement in hepatocellular carcinoma: MR demonstration.
BACKGROUND: To determine the magnetic resonance (MR) features of hepatocellular carcinoma (HCC) with associated bile duct involvement. METHODS: MR examinations of six patients (mean age, 62 years) demonstrating bile duct involvement due to HCC were retrospectively reviewed and compared to surgical and pathologic findings. RESULTS: Three of the tumors were solitary, and three were multifocal. In two patients, MR showed direct biliary duct invasion by tumor. On T1-weighted MR images, four tumors were hypointense compared to the liver and two were isointense. On T2-weighted MR images, four tumors were hyperintense, and two were isointense. The two tumors studied with dynamic T1-weighted MR images obtained after intravenous administration of a gadolinium chelate, displayed enhancement similar to that of the liver. There was no evidence of a tumor capsule on either unenhanced or enhanced MR images. Intrahepatic bile duct dilatation was seen in five patients. The extrahepatic bile duct was normal in all cases. CONCLUSION: Although rare, HCC should be included when considering the etiology of intrahepatic bile duct obstruction. Imaging features suggestive of the diagnosis by MR include intrabiliary tumor or bile duct obstruction with an associated hepatic mass.
Aged↗
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↗
Dynamic gadolinium-DOTA-enhanced MR imaging at 1.0 T. Value in the differentiation of hepatic tumors.
A prospective study was performed to determine the value of dynamic gadolinium-tetraazacyclododecane-tetraacetic acid (Gd-DOTA)-enhanced magnetic resonance (MR) imaging at 1.0 T, using a gradient-echo (GRE) technique, in the differentiation of hepatic tumors. Fifty patients with hemangiomas (n = 14), focal nodular hyperplasia (n = 4), and malignant tumors of the liver (n = 32) underwent GRE MR imaging at 1.0 T before and repeatedly for 4 minutes after intravenous bolus administration of Gd-DOTA. The diagnoses were proved by histology or follow-up examination. On unenhanced GRE images, hemangiomas had a significantly lower tumor-to-liver contrast-to-noise (C/N) ratio (-14.74 +/- 4.49) than did the other tumors (-6.96 +/- 5.49) (p < 0.02), and benign tumors had a significantly lower C/N ratio (-12.43 +/- 5.99) than did malignant tumors (-7.29 +/- 5.71) (p < 0.05). On contrast-enhanced images, hemangiomas had a significantly lower C/N ratio (-17.60 +/- 6.90) than did the other tumors (-5.07 +/- 12.12) (p < 0.05) in the early phase. During the delayed phase, hemangiomas had a significantly higher C/N ratio (3.90 +/- 3.81) than did the other tumors (-4.85 +/- 6.51) (p < 0.01), and benign tumors had a significantly higher C/N ratio (3.21 +/- 3.65) than did malignant tumors (-5.56 +/- 6.56) (p < 0.001). Our data suggest that dynamic Gd-DOTA-enhanced MR imaging at 1.0 T provides useful information to differentiate between benign and malignant hepatic tumors, and to distinguish hemangiomas from the other tumors.
Adult↗
Primary leiomyosarcoma of the liver MR findings.
The magnetic resonance (MR) features of a 67-year-old woman with a surgically and pathologically proved primary leiomyosarcoma of the liver studied at 1.0 T, using T1- (TR/TE = 450/15), and T2- weighted (TR/TE = 2200/45 to 90) spin-echo (SE) images, are described. On T1-weighted SE images, the tumor was well defined, was slightly heterogeneous, and displayed hypointensity to the adjacent hepatic parenchyma, with an area displaying hyperintensity. On T2-weighted SE images, the tumor was encapsulated, was heterogeneous, and displayed marked hyperintensity.
Aged↗
Epithelioid hemangioendothelioma of the liver: MR and CT findings.
The MR imaging features in five patients with hepatic epithelioid hemangioendothelioma (EHE) were correlated with CT and pathologic findings. Two hemangioendotheliomas appeared as multiple nodular lesions with a predominantly peripheral location in the liver. In three more extensive cases, the tumors formed confluent peripheral lesions with macroscopic invasion of portal or hepatic veins (n = 3), signs of portal hypertension (n = 3), and nodular hypertrophy of uninvolved liver (n = 2). These findings, suggestive of EHE, were well demonstrated by MR imaging and CT. The internal architecture of the tumors was clearly depicted on T2-weighted MR images. Viable tumor peripheries appeared moderately hyperintense relative to liver. The center of the tumors consisted of one or several concentric zones. Hyperintense central zones were composed of loose, edematous connective tissue. Hypointense zones contained mainly coagulation necrosis, calcifications, and scattered hemorrhages. Except for the presence of calcifications, the internal architecture of EHE was better defined by MR imaging than by CT.
Adolescent↗
Contrast-enhanced fast MRI in differentiating brain toxoplasmosis and lymphoma in AIDS patients.
OBJECTIVE: Dynamic contrast-enhanced MRI was used to investigate space-occupying lesions of the brain in 22 AIDS patients without prior neurologic disease. Final diagnoses were toxoplasmosis in 13 patients (19 lesions), primary lymphoma in 7 patients (9 lesions), and both diseases in two (2 lesions, respectively). MATERIALS AND METHODS: Dynamic contrast-enhanced MRI was done by using a heavily T1-weighted GE sequence (TR/TE 100/5, 80 degrees flip angle) performed before and repeatedly for a period of 15 min after intravenous bolus injection of Gd-DOTA (0.1 mmol/kg). Signal enhancement of the lesions and normal brain was measured as the difference of signal intensity before and after intravenous administration of contrast medium. RESULTS: Lymphomas displayed significantly greater enhancement (mean 67%; SD 18%) than toxoplasmosis did (mean 34%; SD 16%; p < 0.001) on FLASH images. The enhancement ratios of the two lesions were significantly (p < 0.01) different between 30 and 600 s after injection. The difference between toxoplasmosis (mean 49%; SD 17%) and lymphoma (mean 69%; SD 26%) enhancement ratios on delayed SE images was less significant (p = 0.04). CONCLUSION: Preliminary evidence suggests that dynamic sequences increase the specificity of MR in distinguishing between toxoplasmosis and lymphoma, and this has important clinical implications.
AIDS-Related Opportunistic Infections↗
Intrahepatic cholangiocarcinoma: MRI and pathologic correlation in 14 patients.
PURPOSE: Our goal was to determine the MR features of intrahepatic cholangiocarcinoma and to correlate them with pathologic findings in a surgical series. METHOD: MRI in 14 patients with intrahepatic cholangiocarcinoma who had undergone resection was reviewed. All patients had T1- and T2-weighted SE sequences. Contrast-material-enhanced MRI was performed in 12 cases. Comparison between findings at MRI and pathologic examination was made. RESULTS: MRI depicted all the lesions but one satellite nodule of 2 cm diameter. All lesions were hypointense relative to the liver on T1-weighted images. On T2-weighted images, the tumors were predominantly isointense or slightly hyperintense relative to liver parenchyma in nine cases (64%) and were strongly hyperintense in five cases (36%). Central hypointense areas or bands were seen in eight cases. No capsule was detected. On contrast-enhanced MR studies, all lesions had progressive and concentric filling with contrast material. Associated findings such as vascular encasement, focal liver atrophy, or dilatation of intrahepatic bile ducts were observed in 10 cases (71%). Comparison with pathologic examination revealed that lesion signal intensity on T2-weighted MR images was due mostly to the amount of fibrosis, necrosis, and mucous secretion within the lesion. The nine isointense or slightly hyperintense lesions contained abundant fibrosis and had a low content of mucous secretion or necrosis, whereas the five hyperintense lesions contained low or moderate fibrosis and prominent mucous secretion and/or necrosis. CONCLUSION: Our study suggests that the MR features of intrahepatic cholangiocarcinoma are well correlated with pathologic findings, but are nonspecific. Associated findings may strengthen the diagnosis of intrahepatic cholangiocarcinoma at MRI.
Adult↗
Cystic dystrophy of the duodenal wall in the heterotopic pancreas: radiopathological correlations.
PURPOSE: The purpose of this work was to correlate the CT features of cystic dystrophy in heterotopic pancreas (CDHP) with pathological features. METHODS: Patients were selected from 190 patients who underwent pancreatico-duodenectomy over a 10 year period in our institution. CT findings were retrospectively analyzed in 20 cases and correlated with pathological findings. RESULTS: Lesions were found to be located in the inner part of the second portion of the duodenum in all except one case. In all cases, the duodenal wall was thickened, both at CT and at histopathological examination, and moderate to strong contrast enhancement of the duodenal wall was noted at CT in all cases but one. Cysts were multiple in all cases. No heterotopic pancreas was identified with CT. Inflammatory changes with or without enlarged nodes were detected on CT in 15 of 20 cases. Chronic pancreatitis was present in 10 cases at pathology, including 5 cases with calcifications. The radiopathological correlation was excellent for all criteria but two: the size of the cysts and the extent of pyloric involvement. CONCLUSION: In patients with CDHP, CT features correlate well with pathological results. Multiple cysts located in an enlarged duodenal wall with postcontrast enhancement and inflammatory changes are strongly suggestive of CDHP.
Adult↗
Imaging of atypical hemangiomas of the liver with pathologic correlation.
Compared with the imaging features of typical hepatic hemangiomas, the imaging features of atypical hepatic hemangiomas have not been well studied or well described. Knowledge of the entire spectrum of atypical hepatic hemangiomas is important and can help one avoid most diagnostic errors. A frequent type of atypical hepatic hemangioma is a lesion with an echoic border at ultrasonography. Less frequent types are large, heterogeneous hemangiomas; rapidly filling hemangiomas; calcified hemangiomas; hyalinized hemangiomas; cystic or multilocular hemangiomas; hemangiomas with fluid-fluid levels; and pedunculated hemangiomas. Adjacent abnormalities consist of arterial-portal venous shunt, capsular retraction, and surrounding nodular hyperplasia; hemangiomas can also develop in cases of fatty liver infiltration. Associated lesions include multiple hemangiomas, hemangiomatosis, focal nodular hyperplasia, and angiosarcoma. Types of atypical evolution are hemangiomas enlarging over time and hemangiomas appearing during pregnancy. Complications consist of inflammation, Kasabach-Merritt syndrome, intratumoral hemorrhage, hemoperitoneum, volvulus, and compression of adjacent structures. In some cases, such as large heterogeneous hemangiomas, calcified hemangiomas, pedunculated hemangiomas, or hemangiomas developing in diffuse fatty liver, a specific diagnosis can be established with imaging, especially magnetic resonance imaging. However, in other atypical cases, the diagnosis will remain uncertain at imaging, and these cases will require histopathologic examination.
Arteriovenous Malformations↗
[Guided biopsy of tumors of the liver: a consensus should be hoped?].
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Biopsy, Needle↗
[Pancreatic cystadenomas. Pitfalls and limitations of radiologic diagnosis].
Pancreatic cystadenoma (CA) are rare tumors. According to the classification described by Compagno and Oertel, microcystic and macrocystic CA are differentiated. The former is a benign tumor with slow growth, but the latter has a malignant potential. According to the literature, these tumors may be differentiated on the basis of US and CT findings in a high percentage of cases. We report a series of 11 cases (5 microcystic CA, 4 mucinous CA, 1 leiomyoblastoma and 1 adrenal cyst) representing all cases of radiologically suspected CA and all cases of histologically proved CA. A correct diagnosis of microcystic CA was possible in 2 out of 5 cases, and in 3 out of 4 cases of mucinous CA. The 2 extra-pancreatic tumors were misinterpreted as mucinous CA. No patient had a false positive diagnosis of microcystic CA. The diagnosis of mucinous CA was made in 7 cases, but only 3 were true positives. There was 1 false negative of mucinous CA. In other cases, laparotomy and resection are mandatory as sonography and CT cannot accurately detect malignancy or differentiate pancreatic CA from adjacent sites tumors.
Adult↗
[Heterogenous hepatic steatosis: ultrasonic anomalies may be persistent].
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Adult↗
[Peroperative echotomography in the surgery of liver tumors].
Intra-operative ultrasonography was performed in 10 patients with apparently single malignant tumours of the liver without invasion of the portal or hepatic veins. Five patients had hepatocellular carcinoma associated with cirrhosis and 5 had a secondary liver cancer. At laparotomy other tumoral lesions in 3 cases, portal vein thrombosis in 2 cases and invasion of the left hepatic vein in 1 case were detected by ultrasonography. In 2 patients deep intra-hepatic tumours less than 2 cm in diameter, which were neither visible nor palpable, were also detected by this method. As a result of the examination, subsegmental resection was carried out in 3 cases and hepatic lobectomy in 2 cases. Intra-operative ultrasonography therefore is a useful method to locate invisible tumours and vascular structures, thus preventing vascular injuries during the operation, facilitating limited tumoral resections and generally improving prognosis in patients operated upon for malignant hepatic tumours.
Adult↗
[Osteosclerotic myeloma. Report on three cases and review of the literature (author's transl)].
Three cases of osteosclerotic myeloma are reported. Clues for diagnosis are agarose gel electrophoresis and sclerotic bone biopsy. Review of 50 cases of literature points out frequency of peripheral neuropathy and Ig A type Immunoglobulin. Iliac crest biopsy shows thickening of bone structures and plasmocytosis in medullary spaces. Main X-Ray signs are mentioned and pathogenesis is discussed.
Aged↗
[Pitfalls of the dorsal decubitus in aortography].
The use of the prone position in aortography improves the visualization of the anterior wall of the aorta. This is supported by observation of an obstructed aortobifemoral by-pass and seems interesting in the study of aneurysms. More often, it is useful in case of decreased blood flow or increased local turbulence.
Aortography↗
[Is the barium enema preparation a good preparation for echography?].
A comparative study of 50 patients without previous preparation and 50 who were prepared by a barium enema and low residue diet demonstrated that this method of preparing for ultrasonography improved visibility of the pancreas and the overall quality of the examination. However, the difference in patients with or without previous preparation was not sufficient to justify its routine use.
Anthraquinones↗