European radiology
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The purpose of this study was to assess the therapeutic efficacy and immediate and long-term safety of expanded-tetrafluoroethylene covered stent-grafts for transjugular intrahepatic portosystemic shunts in patients with portal hypertension-related complications. A cohort of 56 patients suffering from severe portal hypertension-related complications underwent implantation of an expanded-polytetrafluoroethylene-covered stent-graft. All patients suffered from severe liver cirrhosis graded Child-Pugh A (n=8; 16%), B (n=13; 21%) or C (n=35; 63%). ⋯ Three of these four patients died within the 1st month after TIPS placement. A very high primary patency rate of TIPS can be obtained long-term after implantation of an e-PTFE-covered stent-graft, leading to a definitive resolution of portal hypertension-related complications. The incidence of TIPS-induced hepatic encephalopathy is acceptable.
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It has been reported that 3D-FLAIR can reduce the flow artifact resulting from cerebrospinal fluid (CSF) at 1.5 T compared to 2D-FLAIR. Flow-related artifacts tend to be worse at 3 T than at 1.5 T. The purpose of this study was to compare the CSF flow artifacts of 2D-FLAIR and 3D-FLAIR sequences at 3 T in eight healthy volunteers. ⋯ The CSF in-flow artifact scores were significantly higher on axial 2D-FLAIR than on axial 3D-FLAIR MPR images in all areas except the bilateral sylvian fissures, and higher on sagittal 2D-FLAIR than on sagittal 3D-FLAIR MPR images in perimedullary, bilateral CP angle and suprasellar cisterns. The CSF-related flow artifacts were significantly reduced by 3D-FLAIR, while structures in the cistern were depicted more clearly, even at 3 T. Further study is necessary to compare the clinical efficacy between 2D-FLAIR and 3D-FLAIR in depicting subtle abnormalities.
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The aim of this retrospective study was to emphasize the performances of spiral CT (HCT) and multidetector-row CT (MDCT) as very effective imaging modalities for the diagnosis of intestinal perforations caused by calcified alimentary foreign bodies. Eight sites of perforations of the ileum by ingested foreign bodies were found in seven patients--one patient presenting with two separate sites of perforation. The diagnosis was successfully made by HCT in four patients and MDCT in the remaining three. ⋯ In each patient, this identification was only possible thanks to the scrupulous analysis of very thin overlapping reconstructions obtained not only in the perforation sites (6/8 sites), but also through the entire abdomen (2/8 sites). Our report emphasizes the high performances of CTA and MDCT in identifying intestinal perforation caused by calcified alimentary foreign bodies. Moreover, the high specificity of the CT diagnosis made it possible to avoid surgerical exploration in three patients.
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When attempting a literature review on contrast-enhanced ultrasound (CEUS) in trauma, very few articles are found. There are a large number of papers dealing with FAST (focused assessment with sonography in trauma) which, in practice, is the definition for detection of free fluid in the abdomen, but there are papers covering assessment of parenchymal damage with non-enhanced ultrasound. This review focuses on direct assessment of parenchymal damage in blunt abdominal trauma, and includes papers on non-enhanced ultrasound to give a historical background to scientific approaches to ultrasound diagnosis of parenchymal injury. A report on our local experience of CEUS in trauma has also been included.
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The objective of this study was to develop a technique which would permit access to the entire contents of long bones using a minimally invasive approach. Vascular catheterization techniques were used to allow access to the entire marrow cavity through a minimal percutaneous approach. A new device was also developed to reach the epiphysis of the long bone. ⋯ A percutaneous approach was made through the bone shaft from a remote entry site using principles from endoscopy in an ex vivo experiment. This method may become an alternative technique when a direct approach to lesional sites in long bones is dangerous or impossible. For example, it could be used in cases of preventive cement injections in weakened bones.