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Bertholdt C, Morel O, Hossu G, Cherifi A, Beaumont M, Eszto ML. Evaluation of utero-placental vascularization using contrast-enhanced ultrasound: Early first trimester maternal perfusion of the intervillous space is confirmed. Placenta 2024; 148:53-58. [PMID: 38401206 DOI: 10.1016/j.placenta.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/17/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION The objective was to confirm and semiquantify the maternal perfusion of the intervillous space between 8 and 13 + 6 gestational weeks (GW). METHODS We conducted a prospective, multicenter, and nonrandomized open study. Women undergoing voluntary termination of pregnancy at three different gestational ages (Group 8 GW: 8 to 8 + 6 GW, Group 11GW: 11 to 11 + 6 GW and Group 13GW: 13 to 13 + 6 GW) were included, with 14 subjects per group. Women presenting with a personal risk of preeclampsia and/or intrauterine growth restriction were excluded. Contrast-enhanced ultrasound (CEUS) was performed with an intravenous bolus administration of 2.4 mL of microbubbles. The region of interest (ROI) was the entire placenta. The perfusion curves and kinetic parameters, including wash-in perfusion index, peak enhancement and mean transit time, were calculated. RESULTS Of the 42 women initially included, interpretable perfusion curves could be obtained for 33. Regardless of the gestational age, contrast was observed in the entire placenta. No significant difference in perfusion parameters was observed between groups. There was an association between signal intensity and both maternal heart frequency and placental location. Signal intensity was decreased when the heart frequency increased (p < 0.05) and when the placenta was in a nonanterior position (p > 0.005). DISCUSSION We confirmed the presence of maternal perfusion of the intervillous space as early as 8 GW. No significant increase in perfusion parameters was observed between 8 and 13 + 6 GW. Our observations, in accordance with the previous experiment published by Roberts et al.1, strongly challenge the classic trophoblastic plug theory.
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Affiliation(s)
- C Bertholdt
- Université de Lorraine, CHRU-NANCY, Pôle de la Femme, F-54000, Nancy, France; Université de Lorraine, Inserm, IADI, F-54000, Nancy, France.
| | - O Morel
- Université de Lorraine, CHRU-NANCY, Pôle de la Femme, F-54000, Nancy, France; Université de Lorraine, Inserm, IADI, F-54000, Nancy, France
| | - G Hossu
- Université de Lorraine, Inserm, IADI, F-54000, Nancy, France; CHRU-NANCY, Inserm, Université de Lorraine, CIC, Innovation Technologique, F-54000, Nancy, France
| | - A Cherifi
- CHRU-NANCY, Inserm, Université de Lorraine, CIC, Innovation Technologique, F-54000, Nancy, France
| | - M Beaumont
- Université de Lorraine, Inserm, IADI, F-54000, Nancy, France; CHRU-NANCY, Inserm, Université de Lorraine, CIC, Innovation Technologique, F-54000, Nancy, France
| | - M L Eszto
- Obstetric Department, Metz-Thionville Regional Hospital Center, Mercy Hospital, 1 Allée du Château, 57085, Metz, Cedex 03, France
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Mazeaud C, Salazar BH, Braun M, Hossu G, Khavari R. Functional MRI in neuro-urology: A narrative review. Prog Urol 2023:S1166-7087(23)00082-9. [PMID: 37062631 DOI: 10.1016/j.purol.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/26/2023] [Indexed: 04/18/2023]
Abstract
Neuro-imaging has given urologists a new tool to investigate the neural control of the lower urinary tract. Using functional magnetic resonance imaging (fMRI), it is now possible to understand which areas of the brain contribute to the proper function of the storage and voiding of the lower urinary tract. This field of research has evolved from simple anatomical descriptions to elucidating the complex micturition network. A keyword search of the Medline database was conducted by two reviewers for relevant studies from January 1, 2010, to August 2022. Of 2047 peer-reviewed articles, 49 are included in this review. In the last decade, a detailed understanding of the brain-bladder network has been described, elucidating a dedicated network, as well as activated areas in the brainstem, cerebellum, and cortex that share reproducible connectivity patterns. Research has shown that various urological diseases can lead to specific changes in this network and that therapies used by urologists to treat lower urinary tract symptoms (LUTS) are also able to modify neuronal activity. This represents a set of potential new therapeutic targets for the management of the lower urinary tract symptoms (LUTS). fMRI technology has made it possible to identify subgroups of responders to various treatments (biofeedback, anticholinergic, neuromodulation) and predict favourable outcomes. Lastly, this breakthrough understanding of neural control over bladder function has led to treatments that directly target brain regions of interest to improve LUTS. One such example is the use of non-invasive transcranial neuromodulation to improve voiding symptoms in individuals with multiple sclerosis.
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Affiliation(s)
- C Mazeaud
- Department of Urology, Houston Methodist Hospital, Houston, TX, United States of America; Department of Urology, Nancy University Hospital, Nancy, France; Université de Lorraine, Inserm, IADI U1254, 54000 Nancy, France
| | - B H Salazar
- Department of Urology, Houston Methodist Hospital, Houston, TX, United States of America
| | - M Braun
- Université de Lorraine, Inserm, IADI U1254, 54000 Nancy, France; Department of Diagnostic and Interventional Neuroradiology, Nancy University Hospital, Nancy, France
| | - G Hossu
- Université de Lorraine, Inserm, IADI U1254, 54000 Nancy, France
| | - R Khavari
- Department of Urology, Houston Methodist Hospital, Houston, TX, United States of America.
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Dupont A, Hossu G, Cherifi A, Beaumont M, Mandry D, Poussel M. From training to overtraining: The necessity of an integrated approach. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Grandjean GA, Bertholdt C, Zuily S, Fauvel M, Hossu G, Berveiller P, Morel O. Fetal biometry in ultrasound: A new approach to assess the long-term impact of simulation on learning patterns. J Gynecol Obstet Hum Reprod 2021; 50:102135. [PMID: 33798748 DOI: 10.1016/j.jogoh.2021.102135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/18/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
CONTEXT Simulation-based education (SBE) has demonstrated its acceptability and effectiveness in improving ultrasound training. Because of the high cost of its implementation (investment in equipment and supervision), a pragmatic assessment of the transfer of skills learned in SBE to clinical practice and the identification of its optimal scheduling conditions have been requested to optimize its input. OBJECTIVES To quantify the long-term impact of simulation-based education (SBE) on the adequate performance of ultrasound fetal biometry measurements (I). The secondary objective was to identify the temporal patterns that enhanced SBE input in learning (II). METHODS Trainees were arbitrarily assigned to a 6-month course in obstetric ultrasound with or without an SBE workshop. In the SBE group, the workshop was implemented 'before' or at an 'early' or a 'late-stage' of the course. Those who did not receive SBE were the control group. The ultrasound skills of all trainees were prospectively collected, evaluated by calculating the delta between OSAUS (Objective Structured Assessment of Ultrasound Skills) scores before and after the course (I). Concomitantly, the accuracy of trainees' measurements was assessed throughout the course by verifying their correlation with the corresponding measurements by their supervisors. The percentage of trainees able to perform five consecutive sets of correct measurements in the control group and in each SBE subgroup were compared (II). RESULTS The study included 61 trainees (39 SBE and 22 controls). Comparisons between groups showed no significant difference in the quantitative assessment of skill enhancement (difference in the pre- and post-internship OSAUS score: 1.09 ± 0.87 in the SBE group and 0.72 ± 0.98 in the control group) (I). Conversely, the predefined acceptable skill level was reached by a significantly higher proportion of trainees in the 'early' SBE subgroup (74%, compared with 30% in the control group, P<0.01)(II). CONCLUSIONS The quantitative assessment does not support the existence of long-term benefits from SBE training, although the qualitative assessment confirmed SBE helped to raise the minimal level within a group when embedded in an 'early' stage of a practical course.
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Affiliation(s)
- G Ambroise Grandjean
- Université de Lorraine, IADI - INSERM, F-54000 Nancy, France; Department of Obstetrics and Gynecology, CHRU Nancy, F-54000 Nancy, France; Midwifery Department, Université de Lorraine, Nancy F-54000, France.
| | - C Bertholdt
- Université de Lorraine, IADI - INSERM, F-54000 Nancy, France; Department of Obstetrics and Gynecology, CHRU Nancy, F-54000 Nancy, France
| | - S Zuily
- Université de Lorraine, Hôpital virtuel de Lorraine, Nancy F-54000, France
| | - M Fauvel
- CHRU Nancy, Université de Lorraine, CIC-IT, F-54000 Nancy, France
| | - G Hossu
- CHRU Nancy, Université de Lorraine, CIC-IT, F-54000 Nancy, France
| | - P Berveiller
- Department of Obstetrics and Gynecology, CHI Poissy Saint-Germain-en-Laye, F-78300 Poissy, France; Université Versailles Saint-Quentin, EA 7404 - GIG, F-78180 Montigny le Bretonneux, France
| | - O Morel
- Université de Lorraine, IADI - INSERM, F-54000 Nancy, France; Department of Obstetrics and Gynecology, CHRU Nancy, F-54000 Nancy, France
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Ambroise Grandjean G, Berveiller P, Hossu G, Bertholdt C, Judlin P, Morel O. [Skills assessment for the practice of fetal ultrasound biometry: Prospective validation of the OSAUS METHOD score]. ACTA ACUST UNITED AC 2021; 49:275-281. [PMID: 33453459 DOI: 10.1016/j.gofs.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To develop and validate a customized variant for fetal biometry of the generic OSAUS score (Objective Structured Assessment of Ultrasound Skills) METHODS: The 5-points OSAUS METHOD grid was elaborated by defining five target skills specific to fetal biometry for each thematic item of the generic score. The level of skills of 43 trainees was prospectively assessed during an ultrasound examination by using this grid. The results of the "novice" level group (experience<10 ultrasounds) were compared to those of the "intermediate" level group (experience≥10 ultrasounds) (I). The reached/non-reached skills ratio within the different items composing the score allowed the identification of priority areas of improvement (II). Previously published distribution and actual distribution of ratings according to the generic pass/fail score were compared (III). RESULTS Median scores of "novices" (n=29) and "intermediates" (n=14) groups were statistically different, 1.87 (±0.75) and 3.31 (±0.83) (P=1.85-5), respectively and corresponded to the pre-existing experience (I). A lower ratio of reached skill allowed the identification of "documentation of the examination" item as a priority area of improvement for both groups (II). The relevance of the pass/fail score is consolidated, even if an overlap was observed between novices and intermediates groups (III). CONCLUSIONS The relevancy and feasibility of using OSAUS scoring method for fetal biometry are supported. In addition, the possibility of comparisons with generic OSAUS remains.
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Affiliation(s)
- G Ambroise Grandjean
- Département d'Obstétrique, CHRU de Nancy, 54000 Nancy, France; Inserm, Université de Lorraine, IADI, rue du Morvan, 54000 Vandoeuvre-les-Nancy, France; Département universitaire de Maïeutique, université de Lorraine, 54000 Nancy, France.
| | - P Berveiller
- Département d'Obstétrique, CHI de Poissy Saint-Germain-en-Laye, 78300 Poissy, France; Université Versailles Saint-Quentin, 78180 Montigny-le-Bretonneux, France
| | - G Hossu
- Inserm, CHRU de Nancy, université de Lorraine, CIC, 54000 Nancy, France
| | - C Bertholdt
- Département d'Obstétrique, CHRU de Nancy, 54000 Nancy, France; Inserm, Université de Lorraine, IADI, rue du Morvan, 54000 Vandoeuvre-les-Nancy, France
| | - P Judlin
- Département d'Obstétrique, CHRU de Nancy, 54000 Nancy, France
| | - O Morel
- Département d'Obstétrique, CHRU de Nancy, 54000 Nancy, France; Inserm, Université de Lorraine, IADI, rue du Morvan, 54000 Vandoeuvre-les-Nancy, France
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Varoquier M, Rumeau C, Vuissoz PA, Perez M, Hossu G, Jankowski R. Do the upper lateral nasal cartilages exist? The concept of septolateral cartilages. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:77-81. [PMID: 33144032 DOI: 10.1016/j.anorl.2020.06.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In the cartilaginous nose, classical surgical anatomy describes 2 triangular upper lateral cartilages (ULCs) framing the lateral sides of the mid-third of the nasal pyramid, which articulate with to the superior edge of the quadrangular cartilage (QC) of the nasal septum. This anatomic arrangement in 3 distinct cartilage parts is, however, controversial. OBJECTIVE The present study aimed to describe the articulation between the ULCs and the QC, avoiding dissection artefacts. MATERIALS AND METHODS Six nasal pyramids were taken in monobloc from fresh cadavers and imaged on micro-MRI with 0.4mm slice thickness. Images were interpreted jointly by 2 head and neck surgeons and a radiologist. RESULTS The cartilage skeleton supporting the mid-third of the nasal dorsum in all specimens presented as 2 septal plates backing onto the midline and curving on either side to form a continuous dome under the inferior aspect of the piriform aperture. CONCLUSION Like the alar cartilages framing the tip of the nose, there are two continuous septolateral cartilages (SLCs) framing the mid-third of the nasal pyramid, likewise showing 2 cruras, medial and lateral, joined in a dome. The SLCs (also known as triangular cartilages) thus cannot be separated as 2 individual anatomic structures. These findings are in line with the shared embryological origin of all the elements composing the fibrocartilaginous nose in evo-devo theory.
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Affiliation(s)
- M Varoquier
- CHRU-Nancy, ORL et Chirurgie Cervico-Faciale, Hôpitaux de Brabois, Bâtiment Louis Mathieu, Allée du Morvan, 54600 Vandoeuvre les Nancy, France
| | - C Rumeau
- CHRU-Nancy, ORL et Chirurgie Cervico-Faciale, Hôpitaux de Brabois, Bâtiment Louis Mathieu, Allée du Morvan, 54600 Vandoeuvre les Nancy, France
| | - P A Vuissoz
- Université de Lorraine, Inserm, IADI, U 1254, 54000 Nancy, France
| | - M Perez
- Université de Lorraine, Faculté de Médecine, Laboratoire d'Anatomie, 54000 Nancy, France; Université de Lorraine, Inserm, IADI, U 1254, 54000 Nancy, France
| | - G Hossu
- Université de Lorraine, Inserm, IADI, U 1254, 54000 Nancy, France; CHRU-Nancy, Inserm, Université de Lorraine, CIC, Innovation Technologique, 54000 Nancy, France
| | - R Jankowski
- CHRU-Nancy, ORL et Chirurgie Cervico-Faciale, Hôpitaux de Brabois, Bâtiment Louis Mathieu, Allée du Morvan, 54600 Vandoeuvre les Nancy, France.
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Riou-Comte N, Guillemin F, Gory B, Lapergue B, Zhu F, Soudant M, Piotin M, Humbertjean L, Mione G, Lacour JC, Anxionnat R, Hossu G, Bracard S, Richard S. Predictive factors of functional independence after optimal reperfusion in anterior circulation ischaemic stroke with indication for intravenous thrombolysis plus mechanical thrombectomy. Eur J Neurol 2020; 28:141-151. [PMID: 32916042 DOI: 10.1111/ene.14509] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/26/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Intravenous thrombolysis plus mechanical thrombectomy (IVT + MT) is the best current management of acute stroke due to large-vessel occlusion and results in optimal reperfusion for most patients. Nevertheless, some of these patients do not subsequently achieve functional independence. The aim was to identify baseline factors associated with 3-month independence after optimal reperfusion and to validate a prediction model. METHODS All consecutive patients with intracranial anterior large-vessel occlusion, with indication for IVT + MT and achieving optimal reperfusion (defined as modified Treatment in Cerebral Ischaemia score 2b-3), from the THRACE trial and the ETIS registry, were included in order to identify a prediction model. The primary outcome was 3-month independence [modified Rankin Scale (mRS) score ≤ 2]. Multivariate inferences invoked forward logistic regression, multiple imputation and bootstrap resampling. Predictive performance was assessed by c-statistic. Model validation was conducted on patients from the ASTER trial. RESULTS Amongst 139 patients (mean age 65.5 years; 54.3% female), predictors of 3-month mRS ≤ 2 (n = 82) were younger age [odds ratio 0.62 per 10-year increase; 95% confidence interval (CI) 0.53-0.72] and higher Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (odds ratio 1.65 per 1-point increase; 95% CI 1.47-1.86) with c-statistic 0.77. Model validation (n = 104/181 patients with 3-month mRS ≤ 2) demonstrated a moderate discrimination (c-statistic 0.74; 95% CI 0.66-0.81) combining age and ASPECTS. The validation model was improved by the adjunction of three candidate variables that were found to be predictors. Addition of baseline National Institutes of Health Stroke Scale (NIHSS) score, history of vascular risk factor and onset-to-reperfusion time significantly improved discrimination (c-statistic 0.85; 95% CI 0.83-0.87). CONCLUSIONS After optimal reperfusion, younger age, higher ASPECTS, lower NIHSS score, shorter onset-to-reperfusion time and absence of vascular risk factor were predictive of independence and could help to guide patient management.
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Affiliation(s)
| | - F Guillemin
- Clinical Investigation Centre 1433, INSERM, University Hospital, Université de Lorraine, Nancy, France
| | - B Gory
- Neuroradiology, INSERM U1254, IADI, University Hospital, Nancy, France
| | - B Lapergue
- Stroke Center, Foch Hospital, Suresnes, France
| | - F Zhu
- Neuroradiology, INSERM U1254, IADI, University Hospital, Nancy, France
| | - M Soudant
- Clinical Investigation Centre 1433, INSERM, University Hospital, Université de Lorraine, Nancy, France
| | - M Piotin
- Neuroradiology, Fondation Ophtalmologique Rothschild, Paris, France
| | | | - G Mione
- Stroke Unit, University Hospital, Nancy, France
| | - J-C Lacour
- Stroke Unit, University Hospital, Nancy, France
| | - R Anxionnat
- Neuroradiology, INSERM U1254, IADI, University Hospital, Nancy, France
| | - G Hossu
- Clinical Investigation Centre 1433, INSERM, University Hospital, Université de Lorraine, Nancy, France.,Neuroradiology, INSERM U1254, IADI, University Hospital, Nancy, France
| | - S Bracard
- Neuroradiology, INSERM U1254, IADI, University Hospital, Nancy, France
| | - S Richard
- Stroke Unit, University Hospital, Nancy, France
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Ambroise Grandjean G, Gabriel P, Hossu G, Zuily S, Morel O, Berveiller P. [Training in fetal ultrasound biometry: Prospective assesment of Objective Structured Assessment of Ultrasound Skills (OSAUS) efficiency]. ACTA ACUST UNITED AC 2020; 48:800-805. [PMID: 32461028 DOI: 10.1016/j.gofs.2020.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Fetal biometry quality directly influences obstetrical care relevance. However, obstetrician proficiencies are heterogeneous in particular during initial training. OBJECTIVES To assess the predictive value of OSAUS scale to identify operators with enough command to perform a valid estimation of fetal weight (EFW) (I). This study also assesses OSAUS intra-operator inter-exams variability (II) and pass/fail score relevancy (III). METHODS Lecturers in Nancy University Hospital assessed trainees' proficiency for EWF systematically and prospectively through OSAUS scale. The trainee assessment was performed right after the one of the senior operator (reference EFW) on three consecutive patients during standard care ultrasounds. To ensure variability in proficiency within the sample, previous practice was taken into account during enrollment ("novices" and "intermediates" for<20 and 20 past exams, respectively). Correlation between mean OSAUS and validity of EFW (a valid EFW was defined by a difference with the reference EWF<0.8 Z-score) and variability between consecutive assessments were assessed. RESULTS The study population was constituted of 8 "novice" and 8 "intermediate" trainees. Association between OSAUS and EFW validity was significant (P<0.03) (I). Intra-operator inter-exams variability was majored in the "novice" group (coefficients of variation were 25% vs. 10% in "novice" and "intermediate" group respectively) (II). Within the sample, specificity and positive predictive value of a pass/fail score OSAUS>3.5 to predict EFW validity were 77% and 71%, respectively (III). CONCLUSION A 3.5 OSAUS pass/fail score could provide a relevant threshold to estimate operator proficiency in assessing fetal biometry in an autonomous and secure way.
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Affiliation(s)
- G Ambroise Grandjean
- Département d'obstétrique, CHRU de Nancy, 54000 Nancy, France; Inserm, IADI, université de Lorraine, 54000 Nancy, France; Département universitaire de maïeutique, université de Lorraine, 54000 Nancy, France.
| | - P Gabriel
- Inserm, IADI, université de Lorraine, 54000 Nancy, France
| | - G Hossu
- Inserm, CIC, CHRU de Nancy, université de Lorraine, 54000 Nancy, France
| | - S Zuily
- Hôpital Virtuel, université de Lorraine, 54000 Nancy, France
| | - O Morel
- Département d'obstétrique, CHRU de Nancy, 54000 Nancy, France; Inserm, IADI, université de Lorraine, 54000 Nancy, France
| | - P Berveiller
- Département d'obstétrique, CHI Poissy Saint-Germain-en-Laye, 78300 Poissy, France; Université Versailles Saint-Quentin, 78180 Montigny-le-Bretonneux, France
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Ambroise Grandjean G, Berveiller P, Hossu G, Noble P, Chamagne M, Morel O. Prospective assessment of reproducibility of three-dimensional ultrasound for fetal biometry. Diagn Interv Imaging 2020; 101:481-487. [PMID: 32241702 DOI: 10.1016/j.diii.2020.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/18/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare fetal ultrasound measurements performed by two observers with different levels of experience and evaluate the potential contribution of the use of three-dimensional (3D) ultrasound on repeatability, reproducibility and agreement of two-dimensional (2D) and 3D-derived measurements. MATERIALS AND METHODS Two observers (one senior and one junior) measured head circumference (HC), abdominal circumference (AC) and femur length (FL) in 33 fetuses (20 to 40 weeks of gestation). Each observer performed two series of 2D measurements and two series of 3D measurements (i.e., measurements derived from triplane volume processing). Measurements were converted into Z-scores according to gestational age. Variability between the different series of measurements was studied using Bland-Altmann plots and intra-class correlation coefficients (ICC). RESULTS Agreement with the 2D measurements of the senior observer was higher in 3D than in 2D for the junior observer (systematic differences of -0.4, -0.2 and -0.8 Z-score vs. -0.1, -0.1 and -0.6 for HC, AC and FL on 2D and 3D datasets, respectively). The use of 3D ultrasound improved junior observer repeatability (ICC=0.94, 0.88, 0.90 vs. 0.94, 0.94 and 0.96 for HC, AC and FL in 2D and 3D, respectively). The reproducibility was greater using the junior observer 3D datasets (ICC=0.75, 0.60 and 0.45 vs. 0.79, 0.89 and 0.63 for HC, AC and FL, respectively). CONCLUSION The use of 3D ultrasound improves the consistency of the measurements performed by a junior observer and increases the overall repeatability and reproducibility of measurements performed by observers with different levels of experience.
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Affiliation(s)
- G Ambroise Grandjean
- Inserm, IADI, Université de Lorraine, 54000 Nancy, France; Department of Obstetrics and Gynecology, Centre hospitalier regional universitaire de Nancy, 54000 Nancy, France; Midwifery Department, Université de Lorraine, 54000 Nancy, France.
| | - P Berveiller
- Department of Obstetrics and Gynecology, Centre hospitalier intercommunal de Poissy Saint-Germain-en-Laye, 78300 Poissy, France; Université Versailles-Saint-Quentin, 78180 Montigny-le-Bretonneux, France
| | - G Hossu
- CIC-IT, Centre hospitalier regional universitaire de Nancy, 54000 Nancy, France
| | - P Noble
- Department of Obstetrics and Gynecology, Port-Royal, hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France
| | - M Chamagne
- Department of Obstetrics and Gynecology, Centre hospitalier regional universitaire de Nancy, 54000 Nancy, France
| | - O Morel
- Inserm, IADI, Université de Lorraine, 54000 Nancy, France; Department of Obstetrics and Gynecology, Centre hospitalier regional universitaire de Nancy, 54000 Nancy, France
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Douis N, Formery A, Hossu G, Martrille L, Kolopp M, Gondim Teixeira P, Blum A. Metal artifact reduction for intracranial projectiles on post mortem computed tomography. Diagn Interv Imaging 2020; 101:177-185. [DOI: 10.1016/j.diii.2019.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/07/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
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Riou-Comte N, Guillemin F, Gory B, Zhu F, Soudant M, Hossu G, Bracard S, Richard S. Facteurs prédictifs d’une indépendance fonctionnelle après infarctus cérébral sur occlusion artérielle proximale. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2019.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Gondim Teixeira PA, Biouichi H, Abou Arab W, Rios M, Sirveaux F, Hossu G, Blum A. Evidence-based MR imaging follow-up strategy for desmoid-type fibromatosis. Eur Radiol 2019; 30:895-902. [PMID: 31468156 DOI: 10.1007/s00330-019-06404-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/04/2019] [Accepted: 07/29/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To propose a follow-up strategy for desmoid-type fibromatosis (DF) based on tumor growth behavior and the signal on T2-weighted MRI. METHODS We retrospectively reviewed 296 MRI studies of 34 patients with histologically proven DF. In each study, tumor volume and T2 signal relatively normal striated muscle were assessed. Volume variation and monthly growth rates were analyzed to determine lesion growth behavior (progressing versus stable/regressing lesions). Growth behavior was correlated with T2 signal, tumor location, β-catenin status, treatment strategy, and follow-up duration. Interobserver variability of volume measurements and interobserver measurement variation ratio were assessed. RESULTS There were 25 women and 9 men with a mean age of 39.9 ± 19 (4-73) years. Mean follow-up time in the patients included was 55 ± 41 (12-148) months. In progressing lesions, the mean average monthly growth ratio was 10.9 ± 9.2 (1.1-42.5) %. Interobserver variability of volume measurements was excellent (ICC = 0.96). Mean interobserver measurement variation ratio was 20.4 ± 23.6%. The only factor correlated with tumor growth behavior was T2 signal ratio (p < 0.0001). Seventeen out of 34 (50%) patients presented a signal change over the threshold of 1 during follow-up. There were five occurrences of secondary growth after a period of stability with a mean delay until growth of 38.2 ± 44.2 (17-116) months. CONCLUSION DF growth rate was quantitatively assessed. A threshold for volume variation detection was established. DF growth behavior was significantly related to T2 signal. An evidence-based follow-up strategy is proposed. KEY POINTS • In progressing desmoid fibromatosis, the mean average monthly growth ratio was 10.9 ± 9.2%. • Lesions with muscle/tumor T2 signal ratios lower than 1 tended to be stable or regress over time. • Given the interobserver measurement variability and MRI in-plane spatial resolution, a variation higher than 42.6% in tumor volume is required to confirm punctual progression.
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Affiliation(s)
- P A Gondim Teixeira
- Guilloz Imaging Department, Central Hospital, Regional University Hospital Center of Nancy (CHRU-Nancy), 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy, France.
| | - H Biouichi
- Guilloz Imaging Department, Central Hospital, Regional University Hospital Center of Nancy (CHRU-Nancy), 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy, France
| | - W Abou Arab
- Guilloz Imaging Department, Central Hospital, Regional University Hospital Center of Nancy (CHRU-Nancy), 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy, France
| | - M Rios
- Lorraine Cancer Institute, Vandoeuvre-lès-Nancy, France
| | - F Sirveaux
- Emile Gallé Surgical Center, Regional University Hospital Center of Nancy, Nancy, France
| | - G Hossu
- Inserm, IADI, Université de Lorraine, Nancy, France
| | - A Blum
- Guilloz Imaging Department, Central Hospital, Regional University Hospital Center of Nancy (CHRU-Nancy), 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy, France
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Gondim Teixeira P, Chanson A, Verhaeghe JL, Lecocq S, Louis M, Hossu G, Blum A. Correlation between tumor growth and hormonal therapy with MR signal characteristics of desmoid-type fibromatosis: A preliminary study. Diagn Interv Imaging 2019; 100:47-55. [DOI: 10.1016/j.diii.2018.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/09/2018] [Accepted: 06/27/2018] [Indexed: 12/28/2022]
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Ambroise Grandjean G, Hossu G, Bertholdt C, Noble P, Morel O, Grangé G. Artificial intelligence assistance for fetal head biometry: Assessment of automated measurement software. Diagn Interv Imaging 2018; 99:709-716. [DOI: 10.1016/j.diii.2018.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/04/2018] [Accepted: 08/06/2018] [Indexed: 12/31/2022]
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Gondim Teixeira PA, Bravetti M, Hossu G, Lecocq S, Petit D, Loeuille D, Blum A. Protocol optimization of sacroiliac joint MR Imaging at 3 Tesla: Impact of coil design and motion resistant sequences on image quality. Diagn Interv Imaging 2017; 98:865-871. [PMID: 28739431 DOI: 10.1016/j.diii.2017.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/15/2017] [Accepted: 06/21/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the impact of coil design and motion-resistant sequences on the quality of sacroiliac magnetic resonance imaging (MRI) examination in patients with spondyloarthropathy. PATIENTS AND METHODS One hundred and twenty-one patients with suspected sacroiliitis and referred for MRI of the sacroiliac joints were retrospectively evaluated with MRI at 3-Tesla. There were 78 women and 43 men with a mean age of 36.7±11.5 (SD) years (range: 15.8-78.4 years). Conventional and motion-resistant fat-saturated fast-spin echo T2-weighted sequences were performed with two different coils. Image quality was subjectively evaluated by two independent readers (R1 and R2) using a four-point scale. Confidence in the identification of bone marrow edema pattern (BMEP) was also evaluated subjectively using a three-point scale. RESULTS Phased array body coil yielded improved image quality compared to surface coil (14.1 to 30.4% for R1 and 14.6 to 25.7% for R2; P<0.0001). The impact of the sequence type on quality was also statistically significant (P=0.0046). BMEP was identified in 40 patients and best inter-reader agreement was obtained using the combination of phased-array body coil with motion-resistant T2-weighted sequence (kappa 0.990). The smallest number of indeterminate BMEP zones was seen on MRI set acquired with the phased-array body coil and motion-resistant T2-weighted sequence. CONCLUSION Phased array body coil and motion-resistant T2-weighted sequences perform better than surface coil and conventional T2-weighted sequences for the evaluation of sacroiliac joints, increasing confidence in the identification of BMEP.
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Affiliation(s)
- P A Gondim Teixeira
- Department of Radiology Guilloz, hôpital Central, CHRU de Nancy, 29, avenue Marechal-Lattre-de-Tassigny, 54035 Nancy, France.
| | - M Bravetti
- Department of Radiology Guilloz, hôpital Central, CHRU de Nancy, 29, avenue Marechal-Lattre-de-Tassigny, 54035 Nancy, France.
| | - G Hossu
- Université de Lorraine, IADI, U947, 54505 Vandœuvre-Lès-Nancy, France.
| | - S Lecocq
- Department of Radiology Guilloz, hôpital Central, CHRU de Nancy, 29, avenue Marechal-Lattre-de-Tassigny, 54035 Nancy, France.
| | - D Petit
- Department of Radiology Guilloz, hôpital Central, CHRU de Nancy, 29, avenue Marechal-Lattre-de-Tassigny, 54035 Nancy, France.
| | - D Loeuille
- Department of Rhumatology, CHRU de Nancy, Brabois adultes, rue du Morvan, 54500 Vandœuvre-Lès-Nancy, France.
| | - A Blum
- Department of Radiology Guilloz, hôpital Central, CHRU de Nancy, 29, avenue Marechal-Lattre-de-Tassigny, 54035 Nancy, France.
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Lafitte M, Laurent V, Soyer P, Ayav A, Balaj C, Petit I, Hossu G. MDCT features of hepatocellular carcinoma (HCC) in non-cirrhotic liver. Diagn Interv Imaging 2015; 97:355-60. [PMID: 26546291 DOI: 10.1016/j.diii.2015.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 09/20/2015] [Accepted: 09/22/2015] [Indexed: 12/28/2022]
Abstract
PURPOSE To describe the multidetector row computed tomography (MDCT) imaging features of HCC that develops in patients who are free from underlying liver cirrhosis and to determine if the MDCT presentation of this specific tumor differs from that of the more common HCC that develops in patients with liver cirrhosis using a retrospective case-control study. PATIENTS AND METHODS The MDCT examinations of 38 patients with HCC in non-cirrhotic liver (group 1) were quantitatively and qualitatively analyzed and compared to those obtained in 38 patients with HCC in cirrhotic liver (group 2) matched for age and gender. Quantitative and qualitative characteristics of HCC of both groups were compared using univariate analysis. RESULTS HCCs were significantly larger in group 1 (81.5mm±55.5) than in group 2 (44.5mm±39.1 SD; P=0.0015). In group 1, HCCs were more frequently single tumors (87%) than in group 2 (37%) (P<0.0001), encapsulated (92% vs. 47% respectively; P<0.0001), had more frequently fatty component (24% vs. 8%, respectively; P=0.0279) and internal hemorrhage (29% vs. 3%, respectively; P=0.0033). No significant differences were found between the two groups for location, hyperenhancement of HCC during the arterial phase, washout during the portal phase, endoluminal portal involvement by HCC, endoportal cruoric thrombus, invasion of adjacent organs and underlying liver steatosis. CONCLUSION HCC in non-cirrhotic liver are larger than those observed in cirrhotic liver and more frequently present as a single encapsulated tumor. They have the same patterns of enhancement than HCC that develops in cirrhotic liver.
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Affiliation(s)
- M Lafitte
- Service de radiologie, hôpital Brabois, allée du Morvan, 54511 Vandœuvre-lès-Nancy, France.
| | - V Laurent
- Service de radiologie, hôpital Brabois, allée du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - P Soyer
- Université Sorbonne Paris-Cité-Diderot Paris 7, 10, avenue de Verdun, 75010 Paris, France
| | - A Ayav
- Service de radiologie, hôpital Brabois, allée du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - C Balaj
- Service de radiologie, hôpital Brabois, allée du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - I Petit
- Service de radiologie, hôpital Brabois, allée du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - G Hossu
- Service de radiologie, hôpital Brabois, allée du Morvan, 54511 Vandœuvre-lès-Nancy, France
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Sewonu A, Hossu G, Carbillet F, Anxionnat R. Design and set-up of an automatic quality control procedure in magnetic resonance imaging. Phys Med 2014. [DOI: 10.1016/j.ejmp.2014.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Joly L, Mandry D, Marie P, Benetos A, Hossu G, Kourtiche K, Diallo M, Karcher G. P159: New method of assessment of reflected waves with MRI during aging. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70334-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Joly L, Verger A, Marie P, Benetos A, van der Gucht A, Guedj E, Hossu G, Morel O, Mandry D, Fay R. P077: Central pulse pressure is a determinant of heart and brain remodeling in the older people: MRI and PET imaging study. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70252-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Watfa G, Heck O, Micard E, Lamiral Z, Hossu G, Felblinger J, Rossignol P, Benetos A, Zannad F, Bracard S. P076: Analysis of MRI-DTI diffusion values as an alternative to the Fazekas score. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70251-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Weiner K, Maillard L, Jonas J, Hossu G, Brissart H, Jacques C, Loftus D, Grill-Spector K, Rossion B. Removing the right inferior occipital gyrus does not disrupt face-selective responses in human ventral temporal cortex: Evidence against a strict hierarchical model of face perception. J Vis 2014. [DOI: 10.1167/14.10.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sewonu A, Hossu G, Felblinger J, Anxionnat R, Pasquier C. An automatic MRI quality control procedure: Multisite reports for slice thickness and geometric accuracy. Ing Rech Biomed 2013. [DOI: 10.1016/j.irbm.2013.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Braun M, Lasanne G, Hossu G, Anxionnat R, Bracard S. Anatomie morphologique et fonctionnelle de la moelle épinière. Rev Neurol (Paris) 2012. [DOI: 10.1016/j.neurol.2012.01.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Constans JM, Collet S, Kauffmann F, Hossu G, Dou W, Ruan S, Rioult F, Derlon JM, Lechapt-Zalcmann E, Chapon F, Valable S, Théron J, Guillamo JS, Courthéoux P. Five-Year Longitudinal MRI Follow-up and (1)H Single Voxel MRS in 14 patients with Gliomatosis Treated with Temodal, Radiotherapy and Antiangiogenic Therapy. Neuroradiol J 2011; 24:401-14. [PMID: 24059663 DOI: 10.1177/197140091102400309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 01/03/2011] [Indexed: 11/15/2022] Open
Abstract
Gliomatosis cerebri (GC) is a challenging tumor, considered to have a poor prognosis and poor response to treatments. The purpose of this study is to better understand glial tumor metabolism and post chemotherapy, radiotherapy and antiangiogenic variations in a longitudinal study to determine cerebral variation in MRS area, amplitude, and ratios of metabolites and spectral profiles during a five year longitudinal follow-up in 14 patients with gliomatosis without initial hyperperfusion and treated with chemotherapy (Temozolomide (Temodal(®))), radiotherapy and subsequent antiangiogenic therapy. The study also aimed to detect changes in infiltration, proliferation, lipids or glycolytic metabolism, as these changes could be monitored longitudinally in humans with glial brain tumors (low and high grade) after therapy, using conventional magnetic resonance imaging (MRI), spectroscopy (MRS) and MR perfusion. Most patients had first initial clinical and MRS improvement and stable MRI. After 12 to 24 chemotherapy treatment cycles MRS usually showed an increase in the Cho/Cr ratio (proliferation) and sometimes contrast enhancements. Later, the patients showed clinical deterioration and radiotherapy was started. There was an improvement with radiotherapy that lasted nine to 18 months. This was followed by a worsening that led to try antiangiogenic therapy. Later in the evolution for three patients with hyperperfusion this symptom disappeared, but proliferation, infiltration and glycolytic metabolism remained at a high level. Spectroscopic and metabolic changes often occur well before clinical deterioration and sometimes before improvement. Therefore, MRS could be more sensitive and could detect changes earlier than MRI and is sometimes predictive. Despite the difficulty, the variability and unknown factors, these repeated measurements give us a better insight into the nature of the different processes, tumor progression and could lead to better understanding of therapeutic response.
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Affiliation(s)
- J M Constans
- CHU Caen; Caen, France - Cervoxy, UMR 6232 CI-NAPS, CNRS, CEA Basse Normandie Caen University, Centre CYCERON; Caen, France -
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Constans J, Kauffmann F, Hossu G, Guillamo JS, Dou W, Sesboué A, Rioult F, Lechapt-Zalcmann E, Derlon JM, Courthéoux P. Suivi longitudinal de trois ans IRM et SRM 1H simple volume de 20 patients atteints de tumeur oligodendrogliale ou de gliomatose traités par Témodal. J Neuroradiol 2008. [DOI: 10.1016/j.neurad.2008.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Constans JM, Kauffmann F, Bansard JY, Hossu G, Rioult F, Delcroix N, Fohlen A, Cremilleux B, de Certaines JD, Courtheoux P. SRM proton cérébrale monovoxel courte: étude de reproductibilité, individuelle et en fonction de la région anatomique chez le sujet sain. J Neuroradiol 2007. [DOI: 10.1016/j.neurad.2007.01.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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