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1.
Skeletal Radiol ; 46(3): 367-372, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27966029

RESUMO

Chondroblastoma is a rare benign cartilage neoplasm that arises from the appendicular skeleton in the vast majority of the cases (80%). Chondroblastoma of the spine is an even more rare condition (30 cases reported), and vertebral chondroblastomas, unlike chondroblastomas of the extremities, present with the appearance of an aggressive tumor on CT and MR imaging and occur at least a decade later. Even though vertebral chondroblastomas are very uncommon tumors, they should nonetheless be included in the differential diagnosis when encountered with an aggressive vertebral mass, and a histological confirmation should be performed. We present a case of chondroblastoma of the thoracic spine of a 27-year-old female for which detailed radiologic-pathologic correlation was obtained.


Assuntos
Condroblastoma/diagnóstico por imagem , Vértebras Lombares , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Adulto , Condroblastoma/patologia , Condroblastoma/cirurgia , Meios de Contraste , Feminino , Humanos , Biópsia Guiada por Imagem , Laminectomia , Imageamento por Ressonância Magnética , Neoplasias da Coluna Vertebral/patologia , Neoplasias da Coluna Vertebral/cirurgia , Toracotomia , Tomografia Computadorizada por Raios X
2.
Ann Chir Plast Esthet ; 62(6): 664-668, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28385568

RESUMO

Augmented reality could help the identification of nerve structures in brachial plexus surgery. The goal of this study was to determine which law of mechanical behavior was more adapted by comparing the results of Hooke's isotropic linear elastic law to those of Ogden's isotropic hyperelastic law, applied to a biomechanical model of the brachial plexus. A model of finite elements was created using the ABAQUS® from a 3D model of the brachial plexus acquired by segmentation and meshing of MRI images at 0°, 45° and 135° of shoulder abduction of a healthy subject. The offset between the reconstructed model and the deformed model was evaluated quantitatively by the Hausdorff distance and qualitatively by the identification of 3 anatomical landmarks. In every case the Hausdorff distance was shorter with Ogden's law compared to Hooke's law. On a qualitative aspect, the model deformed by Ogden's law followed the concavity of the reconstructed model whereas the model deformed by Hooke's law remained convex. In conclusion, the results of this study demonstrate that the behavior of Ogden's isotropic hyperelastic mechanical model was more adapted to the modeling of the deformations of the brachial plexus.


Assuntos
Plexo Braquial/diagnóstico por imagem , Elasticidade , Análise de Elementos Finitos , Voluntários Saudáveis , Imageamento por Ressonância Magnética , Simulação por Computador , Humanos , Estresse Mecânico
3.
Skeletal Radiol ; 45(5): 677-88, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26837388

RESUMO

This article reviews and explains the basic physical principles of metal-induced MRI artifacts, describes simple ways to reduce them, and presents specific reduction solutions. Artifacts include signal loss, pile-up artifacts, geometric distortion, and failure of fat suppression. Their nature and origins are reviewed and explained though schematic representations that ease the understanding. Then, optimization of simple acquisition parameters is detailed. Lastly, dedicated sequences and options specifically developed to reduce metal artifacts (VAT, SEMAC, and MAVRIC) are explained.


Assuntos
Aumento da Imagem/métodos , Articulações/diagnóstico por imagem , Articulações/cirurgia , Imageamento por Ressonância Magnética/métodos , Metais , Próteses e Implantes , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
4.
Knee Surg Sports Traumatol Arthrosc ; 22(9): 2007-12, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23392288

RESUMO

PURPOSE: Autologous chondrocyte implantation (ACI) to address isolated condylar lesions is supposed to limit degenerative deterioration in neutrally aligned knees. Here, we report long-term results of the first-generation ACI technique with periosteal flap. METHODS: Twelve patients, 29 years old on average, were included on the basis of pre-operative MRI selection of lesions >2 cm2. Cartilage carrots were harvested arthroscopically, then cultured and finally re-implanted within a mean time interval of 12 weeks. Ten-year MRI results were analysed according to a semi-quantitative scale, along with functional assessment based on International Knee Documentation Committee score, Lysholm et al. score and the Tegner et al. activity scale. RESULTS: One patient secondarily required valgus tibial osteotomy with mosaic plasty. Another incurred graft hypertrophy that necessitated arthroscopic peeling. MRI showed that cartilage repair filled more than 50% of the initial defect in 9 patients. Standard radiographs revealed slight narrowing of the joint line. Overall, functional scores improved durably by 50%, although activity level decreased substantially. CONCLUSION: ACI contained degenerative changes within moderate stages while maintaining durable functional improvement. However, in the absence of controls, it was difficult to differentiate between these findings and the spontaneous evolution of non-treated lesions. LEVEL OF EVIDENCE: Case series, Level IV.


Assuntos
Cartilagem Articular/cirurgia , Condrócitos/transplante , Articulação do Joelho/cirurgia , Imageamento por Ressonância Magnética , Adulto , Cartilagem Articular/lesões , Feminino , Fêmur/lesões , Humanos , Masculino , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
5.
Skeletal Radiol ; 41(1): 33-40, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21308468

RESUMO

OBJECTIVE: The purpose of this study was to assess denervated muscle perfusion using dynamic susceptibility contrast MRI (DSCMRI) and contrast-enhanced ultrasound (CEUS), and to measure denervated muscle apparent diffusion coefficient (ADC) on b1000 diffusion-weighted MRI (DWMRI) at 3 T in order to clarify whether muscle denervation leads to an increase in the extracellular extravascular space, or an increase in blood flow-or both. MATERIALS AND METHODS: Axotomy of the right sciatic nerve of six white rabbits was performed at day 0. At day 9, hind limb muscles MRI and CEUS were performed to assess the consequences of denervation and both semimembranosus muscles of each rabbit were explanted for histological studies. Signal intensity on T2- and T1-weighted MRI, ADC on DWMRI, maximum signal drop (MSD) on DSCMRI and the area under the curve (AUC) on CEUS were measured over circular regions of interest (ROI), in both semimembranosus muscles. Non-parametric Wilcoxon matched-pairs tests were used to assess the mean differences between denervated and normal muscles. RESULTS: T2 fat-saturated (FS) MRI studies showed a strong signal in the right semimembranosus muscles compared with the left side, and gadolinium enhancement was observed on T1 FS MRI. Denervated muscles show a significant increase in ADC on DWMRI (p < 0.01) and a significant signal enhancement on DSCMR imaging (p < 0.05) and on first-pass CEUS (p < 0.05). CONCLUSION: The results of this study--based on perfusion- and diffusion-weighted images--suggest that, after denervation, both increased blood flow through muscle tissue and expansion of the extracellular water volume are present.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Músculo Esquelético/inervação , Músculo Esquelético/fisiopatologia , Imagem de Perfusão/métodos , Nervo Isquiático/fisiologia , Nervo Isquiático/cirurgia , Ultrassonografia/métodos , Animais , Velocidade do Fluxo Sanguíneo/fisiologia , Meios de Contraste , Músculo Esquelético/patologia , Coelhos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
6.
Acta Neurochir (Wien) ; 159(2): 347-348, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27873047
7.
Surg Radiol Anat ; 33(6): 473-80, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21455837

RESUMO

The purpose of our study was to demonstrate and describe the MR and arthro-CT anatomic appearance of the scaphotrapezial ligament and illustrate some of the pathologies involving this structure. This ligament consists of two slips that originate from the radiopalmar aspect of the scaphoid tuberosity and extend distally, forming a V shape. The ulnar fibers, which are just radial to the flexor carpi radialis sheath, inserted along the trapezial ridge. The radial fibers were found to be thinner and inserted at the radial aspect of the trapezium. Twelve fresh cadaver wrists were dissected, with close attention paid to the scaphotrapezio-trapezoidal (STT) joint. An osseoligamentous specimen was dissected with removal of all musculotendinous structures around the STT joint and was performed with high-resolution acquisition in a 128-MDCT scanner. Samples of the wrist area were collected from two fetal specimens. A retrospective study of 55 patients with wrist pain that were submitted to arthrography, arthro-CT, and arthro-MRI imaging was performed (10 patients on a 3-T superconducting magnet and 45 patients on a 1.5-T system). Another ten patients had high-resolution images on a 3-T superconducting magnet without arthrographic injection. MR arthrography and arthro-CT improved visualization and provided detailed information about the anatomy of the scaphotrapezial ligament. Knowledge of the appearance of this normal ligament on MRI allows accurate diagnosis of lesions and will aid when surgery is indicated or may have a role in avoiding unnecessary immobilization.


Assuntos
Ligamentos Articulares/anatomia & histologia , Imageamento por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Articulação do Punho/anatomia & histologia , Articulação do Punho/patologia , Artralgia/diagnóstico , Artrografia/métodos , Cadáver , Dissecação , Feminino , Humanos , Ligamentos Articulares/diagnóstico por imagem , Masculino , Valores de Referência , Estudos Retrospectivos , Osso Escafoide/anatomia & histologia , Osso Escafoide/diagnóstico por imagem , Sensibilidade e Especificidade , Trapézio/anatomia & histologia , Trapézio/diagnóstico por imagem
8.
J Neuroradiol ; 37(2): 116-21, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-19573921

RESUMO

BACKGROUND AND PURPOSE: Middle ear adenomatous tumors (MEAT) are rare tumors which can be begin or malignant and can present a neuroendocrine differentiation. Their radiological aspect is very similar to glomus tympanicum (GT) which are the most common tumoral lesions of the middle ear. We present several radiological and clinical findings that could help radiologists to accurately identify MEAT. MATERIAL AND METHODS: We retrospectively reviewed the radiological and clinical findings of three patients with MEAT and of eight patients with GT. Diagnostic was obtained after surgical resection in all cases. All patients had high resolution CT and MR of the middle ear associated with a subtracted digital carotid angiography. Tumor location, size, extension, signal intensity, and enhancement were analysed. From the medical records of the patients, clinical manifestations (hearing loss, tinnitus), evolution length and recurrences were noted. RESULTS: MEAT and GT appeared as tissular lesion with significant enhancement on CT and MR. A vascular blush was present on angiography in all cases of GT and absent from all cases of MEAT. A close relationship between the tumor and the Jacobson's nerve or its branches was identified in all cases of GT. Pulsatile tinnitus was present in all patients with GT and absent in all patients with MEAT. CONCLUSION: A middle ear tissular lesion clearly separated from the Jacobson nerve or its branches, showing significant enhancement after contrast medium injection but with a normal angiography, should make one suspicious for MEAT.


Assuntos
Tumor Adenomatoide/diagnóstico , Neoplasias da Orelha/diagnóstico , Orelha Média/patologia , Tumor de Glomo Timpânico/diagnóstico , Tumor Adenomatoide/diagnóstico por imagem , Tumor Adenomatoide/patologia , Adulto , Angiografia Digital , Artérias Carótidas/patologia , Diagnóstico Diferencial , Neoplasias da Orelha/diagnóstico por imagem , Neoplasias da Orelha/patologia , Orelha Média/diagnóstico por imagem , Glomo Timpânico/diagnóstico por imagem , Glomo Timpânico/patologia , Tumor de Glomo Timpânico/diagnóstico por imagem , Tumor de Glomo Timpânico/patologia , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Fotomicrografia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
9.
J Radiol ; 91(3 Pt 2): 408-18; quiz 419-20, 2010 Mar.
Artigo em Francês | MEDLINE | ID: mdl-20508575

RESUMO

After being first used for liver imaging, diffusion-weighted imaging of the kidney is in development. The kidney is the only anisotropic organ in the abdomen. It is a complex organ, with different types of flow, that is the subject of multiple research projects. Diffusion-weighted imaging is very sensitive for the detection of tumors, especially small ones. It also facilitates lesion characterization with the help of ADC values. Diffusion restriction indicates hypercellularity, which suggests malignancy. Diffusion-weighted imaging is currently available on clinical scanners. Characterization of different types of collections is possible. The characterization of nephropathies remains investigational.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Nefropatias/diagnóstico , Anisotropia , Humanos , Aumento da Imagem/métodos , Neoplasias Renais/diagnóstico
10.
J Radiol ; 91(9 Pt 1): 841-55, 2010 Sep.
Artigo em Francês | MEDLINE | ID: mdl-20814373

RESUMO

The infrapatellar fat pad or Hoffa's fat pad is a cylindrical extrasynovial collection of fat located in the infrapatellar region. Anatomical, biomechanical and imaging data show that the infrapatellar fat pad constitutes a true crossroads between patella, femur and tibia and helps in understanding if not describing regional pathology. Intrinsic lesions (with abnormal signal on MRI) such as hoffitis, anterolateral impingement, plica syndrome, post-arthroscopic changes, trauma, patellar dislocation and extrasynovial tumors are less frequent. On the other hand, extrinsic lesions are more frequent and may affect the synovium, patellar ligament, vascular structures, and bursae. Mucoid and parameniscal cysts may develop in the infrapatellar fat pad. In this article, the anatomical and imaging features of the infrapatellar fat pad will be summarized and the most common lesions will be illustrated.


Assuntos
Tecido Adiposo/patologia , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Imageamento por Ressonância Magnética , Patela/patologia , Tomografia Computadorizada por Raios X , Ultrassonografia , Artrografia , Artroscopia , Cistos/diagnóstico , Fêmur/patologia , Humanos , Artropatias/diagnóstico , Traumatismos do Joelho/patologia , Articulação do Joelho/patologia , Meniscos Tibiais/patologia , Patela/lesões , Complicações Pós-Operatórias/diagnóstico , Sinovite/diagnóstico , Tíbia/patologia
11.
J Radiol ; 91(3 Pt 1): 271-9, 2010 Mar.
Artigo em Francês | MEDLINE | ID: mdl-20508557

RESUMO

Dedifferentiated chondrosarcomas are highly malignant tumors characterized by conventional low-grade chondrosarcoma with abrupt transition to foci that have dedifferentiated into a higher-grade noncartilaginous more aggressive sarcoma. The dedifferentiated component, an osteosarcoma or fibrosarcoma, determines the prognosis. Its identification is key for management. A diagnosis of dedifferentiated chondrosarcoma should be suggested by the presence of "tumoral dimorphism" with cartilaginous component and aggressive lytic component invading adjacent soft tissues.


Assuntos
Neoplasias Ósseas/diagnóstico , Condrossarcoma/diagnóstico , Idoso , Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Cartilagem/diagnóstico por imagem , Cartilagem/patologia , Desdiferenciação Celular , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Feminino , Fêmur/diagnóstico por imagem , Fêmur/patologia , Fibrossarcoma/diagnóstico , Fibrossarcoma/diagnóstico por imagem , Fibrossarcoma/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Osteólise/diagnóstico , Osteólise/diagnóstico por imagem , Osteólise/patologia , Osteossarcoma/diagnóstico , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/patologia , Prognóstico , Tíbia/diagnóstico por imagem , Tíbia/patologia , Tomografia Computadorizada por Raios X
12.
J Radiol ; 90(7-8 Pt 1): 825-31, 2009.
Artigo em Francês | MEDLINE | ID: mdl-19752788

RESUMO

PURPOSE: The aim of this study was to evaluate ECG-gated whole chest CTA as a routine triage tool for patients with acute chest pain. MATERIAL AND METHODS: Whole chest CTA with retrospective ECG-gating was performed in 30 patients with acute atypical chest pain. The ten main segments of the coronary arteries, the pulmonary arteries, the aorta, and the myocardium (function, morphology) were independently analyzed by a resident and two senior radiologists. The inter-observer agreement between resident and senior radiologists was calculated. A final diagnosis was determined by consensus. RESULTS: Thirty patients were included. The coronary artery segments, myocardium and pulmonary arteries were considered analyzable in 84%, 90% and 97% of cases respectively. A final diagnosis for the cause of pain was retained in 19 patients: significant coronary artery stenosis (5), pulmonary embolus (5), aortic dissection (1), hypokinetic cardiomyopathy (2), lung parenchymal abnormalities (5), and hiatus hernia (1). Inter-observer agreement ranged from 0.76 to 1 between senior radiologists and from 0.76 to 1 between resident and senior radiologists. The average time of image interpretation ranged from 14 to 15 minutes. CONCLUSION: ECG-gated whole chest CT angiography appears as a promising tool for the evaluation of acute chest pain. Combined evaluation of appearance and function of the myocardium can reveal additional interesting information.


Assuntos
Angiografia/métodos , Dor no Peito/diagnóstico por imagem , Eletrocardiografia , Tomografia Computadorizada por Raios X/métodos , Doença Aguda , Idoso , Técnicas de Imagem de Sincronização Cardíaca , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Angiografia Coronária/métodos , Estenose Coronária/complicações , Interpretação Estatística de Dados , Emergências , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Seleção de Pacientes , Estudos Prospectivos , Embolia Pulmonar/complicações
13.
Orthop Traumatol Surg Res ; 104(3): 377-381, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29414721

RESUMO

Cerclage wire is an effective fracture fixation method. However, its mechanical benefits are countered by local ischemia. Its efficacy for treating femoral periprosthetic fractures has been demonstrated since femoral fixation is possible even there is a stem in the diaphysis. It securely holds the proximal femur typically with an additional plate. The development of minimally-invasive surgery with plate fixation has led to the cerclage wire being inserted percutaneously. Here, we report on a case of secondary femoral ischemia following percutaneous cerclage wire of a periprosthetic femoral fracture. This was a Vancouver type B1 fracture. On the 3rd day after admission, minimally-invasive fixation with a femoral locking plate was performed with five cerclage wires added percutaneously. During the immediate postoperative course, the patient developed ischemia of the operated leg that required vascular surgery after confirmation by CT angiography. An arterial stop was visible with deviation of the superior femoral artery, which was not properly surrounded by the cerclage wire. The latter pulled perivascular tissues towards the femur. When combined with reduced arterial elasticity due to severe atherosclerosis, it resulted in arterial plication. The postoperative course was marked by multiple organ failure and death of the patient. Percutaneous surgery is an attractive option but has risks. The presence of severe atherosclerosis is a warning sign for loss of tissue elasticity. This complication can be prevented by preparing the bone surfaces and carefully positioning the patient on the traction table to avoid forced adduction. The surgeon must also be familiar with alternative techniques to cerclage wire such as polyaxial screws and additional plates.


Assuntos
Fios Ortopédicos/efeitos adversos , Fraturas do Fêmur/cirurgia , Fixação Interna de Fraturas/efeitos adversos , Isquemia/etiologia , Extremidade Inferior/irrigação sanguínea , Fraturas Periprotéticas/cirurgia , Idoso de 80 Anos ou mais , Placas Ósseas , Evolução Fatal , Feminino , Fixação Interna de Fraturas/instrumentação , Fixação Interna de Fraturas/métodos , Humanos
14.
J Radiol ; 88(5 Pt 1): 647-55, 2007 May.
Artigo em Francês | MEDLINE | ID: mdl-17541357

RESUMO

Intrarachidian cystic lesions are frequent, with highly varied causes. They can be classified according to their location into intramedullary cystic lesions and extramedullary cystic lesions. In these two categories, they can then be regrouped according to the tissue from which they develop. MRI is the first-choice examination for the study of the intracanal contents and the differential diagnosis between the various lesions.


Assuntos
Cistos do Sistema Nervoso Central/diagnóstico , Cistos/diagnóstico , Imageamento por Ressonância Magnética , Doenças da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/diagnóstico , Adulto , Humanos
15.
Orthop Traumatol Surg Res ; 103(8): 1205-1209, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28965993

RESUMO

INTRODUCTION: Hemophilic arthropathy is painful and disabling. We report a retrospective study of ankle fusion with intra- and peri-operative clotting factor perfusion. The objective was to assess the efficacy of maintaining perioperative clotting factor rates close to 100%, and report long-term results. The study hypothesis was that results would be good, without early hemorrhagic complications. MATERIAL AND METHOD: Between 2000 and 2013, 12 ankle fusions were performed in 9 patients, with a mean age of 39years (range, 19-58years). Anti-hemophilic factor perfusion was controlled by the reference physician of the Regional Hemophilia Treatment Center. Clinical AOFAS and Olerud scores and the Pettersson radiologic score were used for assessment. Mean preoperative AOFAS score was 22 (range, 2-55) and mean Olerud score 7 (range, 5-12). Mean preoperative factor VIII concentration was <1% (range, <1-3%). RESULTS: Mean follow-up was 8years (range, 2-16years). Mean AOFAS score at follow-up was 69 (range, 35-92) and mean Olerud score 70 (range, 30-100). Improvement mainly concerned the Pain dimension. Statistical analysis found a significant difference between pre- and post-operative clinical scores (AOFAS, P=0.004; Olerud, P=0.004). Mean factor VIII concentration at surgery was 90% (range, 24-117%), and 109% (range, 75-152%) the day following surgery. There were no cases of hematoma or surgical site infection. Radiologic fusion was systematic at a mean 3.5 months (range, 3-4months). CONCLUSION: The study hypothesis was confirmed. Ankle fusion in advanced hemophilic arthropathy improved function and quality of life. Perioperative clotting factor perfusion contributed to these good results, providing supplementary prevention of hemorrhagic risk. LEVEL OF EVIDENCE: IV, retrospective study.


Assuntos
Articulação do Tornozelo/fisiopatologia , Articulação do Tornozelo/cirurgia , Artrodese , Hemofilia A/fisiopatologia , Adulto , Artralgia/fisiopatologia , Artralgia/cirurgia , Parafusos Ósseos , Coagulantes/administração & dosagem , Fator VIII/administração & dosagem , Fator VIII/análise , Feminino , Seguimentos , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Osseointegração , Assistência Perioperatória , Qualidade de Vida , Estudos Retrospectivos , Adulto Jovem
16.
J Neuroradiol ; 33(5): 285-91, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17213756

RESUMO

AIMS: To compare unenhanced, gadolinium enhanced, delayed gadolinium enhanced FLAIR images, gadolinium enhanced and delayed gadolinium enhanced T1 images in different types of leptomeningeal diseases, and to determine the most accurate MRI sequence for the diagnosis of leptomeningeal disease. MATERIAL: and methods: Ten patients (6 men, 4 women, age: 52,7+/-16,4) clinically suspected of cerebral leptomeningeal infectious or tumoral disease underwent brain MR examination: Axial FLAIR and T1 SE images were acquired before, immediately after administration of gadobenate dimeglumine (0.1 mmol per kilogram of body weight) (early enhancement), and 20 minutes after injection of contrast media (delayed enhancement). Images were analysed to determine the more appropriate technique for the diagnosis of leptomeningeal disease. RESULTS: Early enhanced FLAIR and delayed enhanced T1 were always more or equally accurate for the diagnosis of leptomeningeal diasease, as compared to, respectively, unenhanced FLAIR and early enhanced T1 images Delayed enhanced FLAIR was always more accurate for the diagnosis of leptomeningeal disease as compared to early enhanced FLAIR images. Delayed enhanced FLAIR was in most of the cases more accurate for the diagnosis of leptomeningeal disease as compared to delayed enhanced T1 images. CONCLUSION: Delayed enhanced FLAIR MR sequence seems to improve the diagnosis of leptomeningeal infectious or tumoral diseases as compared to other MR sequences.


Assuntos
Imageamento por Ressonância Magnética/métodos , Neoplasias Meníngeas/diagnóstico , Meningites Bacterianas/diagnóstico , Meningite Viral/diagnóstico , Adolescente , Idoso , Meios de Contraste , Infecções por Vírus Epstein-Barr/diagnóstico , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Infecções Estreptocócicas/diagnóstico , Streptococcus agalactiae
17.
Diagn Interv Imaging ; 97(7-8): 709-23, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27083752

RESUMO

Pelvic ring fractures when caused by trauma, either violent or in demineralized bone, generally consist of injuries in both the anterior (pubic symphysis and rami) and posterior (iliac wing, sacrum, sacroiliac joint) portions. Injury classifications are based on injury mechanism and pelvic stability, and are used to determine treatment. Acetabular fractures, associated or not to pelvic ring disruption, are classified on the basis of fracture line, into elementary fractures of the acetabular walls, columns and roof, and into complex fractures. Fractures of the proximal end of the femur occur often on demineralized bone following low-energy trauma. The fractures are categorized by anatomic location (neck, trochanter and subtrochanteric region) and degree of displacement. These variables determine the risk of osteonecrosis of the femoral head, which is the main complication of such fractures.


Assuntos
Acetábulo/diagnóstico por imagem , Fraturas Ósseas/diagnóstico por imagem , Fraturas do Quadril/diagnóstico por imagem , Ossos Pélvicos/diagnóstico por imagem , Acetábulo/anatomia & histologia , Acetábulo/lesões , Fraturas Ósseas/classificação , Fraturas do Quadril/classificação , Humanos , Imageamento Tridimensional , Ligamentos/anatomia & histologia , Ligamentos/diagnóstico por imagem , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/diagnóstico por imagem , Ossos Pélvicos/anatomia & histologia , Ossos Pélvicos/lesões
18.
Orthop Traumatol Surg Res ; 102(5): 639-44, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27197681

RESUMO

INTRODUCTION: Villonodular synovitis (VNS) is a rare disease with an incidence of 1.8 per 1,000,000 inhabitants. VNS of the ankle has seldom been described and evaluated given its extreme rarity (2.5% of VNS cases). It presents an 11% recurrence rate. We report a continuous retrospective series with the main objective of clinically and radiologically evaluating these ankles searching for any risk factors of recurrence. At revision the study's main endpoint was the existence of local recurrence (radiological and clinical) and the secondary endpoint was the existence of tibiotalar osteoarthritis. The working hypothesis was that recurrence could be subclinical, warranting systematic imaging studies during follow-up. MATERIAL AND METHODS: The study was retrospective, conducted on seven patients (six males) whose mean age was 42 years treated over a period of 9 years (two diffuse forms and five localized forms). The initial treatment consisted in synovectomy via the conventional approach. Four patients also received adjuvant isotopic synoviorthesis treatment. The revision was clinical (MMTS, AOFAS, and OMAS scores) and radiological (standard and MRI) to evaluate the joint after-effects and search for recurrence. RESULTS: Six patients were seen at a mean 6.5 years of follow-up. One case of early recurrence (4 years) was noted, with a major clinical manifestation because it was associated with joint destruction requiring arthrodesis, and one case of late asymptomatic recurrence (9 years), diagnosed radiologically on the follow-up MRI. The functional results remained good at follow-up (MMTS 77%, AOFAS 71, OMAS 71). Five of the six patients returned to their daily activities. At revision, no sign of osteoarthritis was observed. No risk factor for recurrence was demonstrated. DISCUSSION/CONCLUSION: The hypothesis was confirmed with the existence of asymptomatic recurrence at revision, underscoring the value of systematic MRI at follow-up. Other than major joint destruction, the prognosis remains good even in case of recurrence. The literature emphasizes the existence of an initial diffuse form and partial surgical resection as risk factors of recurrence. None of the reports in the literature has proven that adjuvant treatment, whose modalities do not meet with consensus, reduces this risk. LEVEL OF EVIDENCE: Retrospective series, level IV.


Assuntos
Articulação do Tornozelo/cirurgia , Sinovite Pigmentada Vilonodular/cirurgia , Adulto , Idoso , Articulação do Tornozelo/diagnóstico por imagem , Artrodese , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva , Reoperação , Estudos Retrospectivos , Sinovectomia , Sinovite Pigmentada Vilonodular/diagnóstico por imagem
20.
Semin Ultrasound CT MR ; 26(2): 89-97, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15856810

RESUMO

Radiofrequency current and laser energy can be delivered locally through electrode-needle or optical fiber inserted in the tissue and allows local ablation of tissues, up to a volume of 4 to 5 cm in diameter with one application or vaporizes tissue. Tumor ablation guided with medical imaging proved a high local efficacy over 90% for tumors less than 25 mm in the liver, lung, and kidney. The spinal applications of the thermal energy of RF and laser are reported in this paper. First, the tumor ablation is reviewed with malignant and benign tumors. In malignant tumors, radiofrequency is very efficient in local tumor control and in pain management. The second part of this paper is devoted to disk diseases where laser and RF techniques increase their applications. The technique, indications and results of these techniques are reported and illustrated.


Assuntos
Ablação por Cateter/métodos , Eletrocirurgia/métodos , Disco Intervertebral/cirurgia , Terapia a Laser/métodos , Osteoma Osteoide/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Dor nas Costas/cirurgia , Descompressão Cirúrgica , Fluoroscopia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Ortopédicos/métodos , Radiografia Intervencionista , Tomografia Computadorizada por Raios X
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