In Vivo Measurement of Brain Tumor Elasticity Using Intraoperative Shear Wave Elastography.

Purpose: Objective Shear wave elastography (SWE) enabled living tissue assessment of stiffness. This is routinely used for breast, thyroid and liver diseases, but there is currently no data for the brain. We aim to characterize elasticity of normal brain parenchyma and brain tumors using SWE. Materials and Methods: Patients with scheduled brain tumor removal were included in this study. In addition to standard ultrasonography, intraoperative SWE using an ultrafast ultrasonic device was used to measure the elasticity of each tumor and its surrounding normal brain. Data were collected by an investigator blinded to the diagnosis. Descriptive statistics, box plot analysis as well as intraoperator and interoperator reproducibility analysis were also performed. Results: 63 patients were included and classified into four main types of tumor: meningiomas, low-grade gliomas, high-grade gliomas and metastasis. Young's Modulus measured by SWE has given new insight to differentiate brain tumors: 33.1 ±â€Š5.9 kPa, 23.7 ±â€Š4.9 kPa, 11.4 ±â€Š3.6 kPa and 16.7 ±â€Š2.5 kPa, respectively, for the four subgroups. Normal brain tissue has been characterized by a reproducible mean stiffness of 7.3 ±â€Š2.1 kPa. Moreover, low-grade glioma stiffness is different from high-grade glioma stiffness (p = 0.01) and normal brain stiffness is very different from low-grade gliomas stiffness (p < 0.01). Conclusion: This study demonstrates that there are significant differences in elasticity among the most common types of brain tumors. With intraoperative SWE, neurosurgeons may have innovative information to predict diagnosis and guide their resection.

[Pregnancy and delivery following insemination with frozen donor sperm]. / La grossesse et l'accouchement après insémination avec du sperme congelé de donneur.

A total of 620 pregnancies were followed and only 25 were lost to follow-up (3.8%). The mean age of the women was 30 years. 42% of them had had ovulation induction treatment. There were 538 primiparous women (86.7%). A control series of 130 primiparous women from the same age group was constituted at random. The abortion rate was 15%. 93% of pregnancies did not pose any problems in the 2nd and 3rd trimesters (83% in the control series). 97% of the women delivered at term (the same as in the control series). The mean birth weight was 3,260 g and the sex ratio was 0.97%. There was a high malformation rate of 1.48% and peri-natal mortality was 1.1%. The caesarian rate in the primiparous women was 31.9% compared with 19.2% in the control series and it was 35.5% in the multiparous women. In the Tours series, which is more homogeneous than our control series, the caesarian rate was essentially related to maternal age: 14.7% caesarian sections before the age of 30 and 30.5% over the age of 30. It seems therefore that AID does not constitute a risk factor for the pregnancy.

[Pregnancy and labor after insemination with frozen sperm from a donor]. / La grossesse et l'accouchement après insémination avec du sperme congelé de donneur.

A total of 168 out of 196 pregnancies that were obtained after A.I.D. have been followed up. Six cases were lost for follow-up (3%). The mean age was 30 years and 65% of the women had their ovulation induced. 130 nullipara were delivered. They were compared with a series of nullipara of the same age group and selected from 300 primiparous pregnancies who delivered in the department in the same year. The abortion rate was 12.5%. 79% of the pregnancies were normal in the 2nd and 3rd trimesters as compared with 83% in the control series. 94% delivered at term as compared with 97% in the control series. 21% of the women had Caesarean section as compared with 19.2% in the control series. The sex ratio was 1.08 as compared with 1.06 in the control series. There was no significant difference between the two series. It does seem, however, that the age factor is the most important factor of all in determining how frequent pathological conditions will be and the number of Caesareans that will have to be carried out. 14% were under 30 years of age as compared with 28.5% who were over 30 years of age, which is a significant difference. These results should be followed up in a larger series.