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Loffroy R, Favelier S, Pottecher P, Estivalet L, Genson P, Gehin S, Cercueil J, Krausé D. Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes. Diagn Interv Imaging 2015; 96:731-44. [DOI: 10.1016/j.diii.2015.05.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 05/06/2015] [Indexed: 02/08/2023]
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Loffroy R, Favelier S, Pottecher P, Estivalet L, Genson PY, Gehin S, Krausé D, Cercueil JP. Transjugular intrahepatic portosystemic shunt for acute variceal gastrointestinal bleeding: Indications, techniques and outcomes. Diagn Interv Imaging 2015; 96:745-55. [PMID: 26094039 DOI: 10.1016/j.diii.2015.05.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [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: 05/13/2015] [Accepted: 05/19/2015] [Indexed: 12/19/2022]
Abstract
Acute variceal bleeding is a life-threatening condition that requires a multidisciplinary approach for effective therapy. The transjugular intrahepatic portosystemic shunt (TIPS) procedure is a minimally invasive image-guided intervention used for secondary prevention of bleeding and as salvage therapy in acute bleeding. Emergency TIPS should be considered early in patients with refractory variceal bleeding once medical treatment and endoscopic sclerotherapy fail, before the clinical condition worsens. Furthermore, admission to specialized centers is mandatory in such a setting and regional protocols are essential to be organized effectively. This procedure involves establishment of a direct pathway between the hepatic veins and the portal veins to decompress the portal venous hypertension that is the source of the patient's bleeding. The procedure is technically challenging, especially in critically ill patients, and has a mortality of 30%-50% in the emergency setting, but has an effectiveness greater than 90% in controlling bleeding from gastro-esophageal varices. This review focuses on the role of TIPS in the setting of variceal bleeding, with emphasis on current indications and techniques for TIPS creation, TIPS clinical outcomes, and the role of adjuvant embolization of varices.
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Affiliation(s)
- R Loffroy
- Department of vascular, oncologic and interventional radiology, Le2i UMR CNRS 6306, University of Dijon School of Medicine, Bocage Teaching Hospital, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France.
| | - S Favelier
- Department of vascular, oncologic and interventional radiology, Le2i UMR CNRS 6306, University of Dijon School of Medicine, Bocage Teaching Hospital, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - P Pottecher
- Department of vascular, oncologic and interventional radiology, Le2i UMR CNRS 6306, University of Dijon School of Medicine, Bocage Teaching Hospital, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - L Estivalet
- Department of vascular, oncologic and interventional radiology, Le2i UMR CNRS 6306, University of Dijon School of Medicine, Bocage Teaching Hospital, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - P Y Genson
- Department of vascular, oncologic and interventional radiology, Le2i UMR CNRS 6306, University of Dijon School of Medicine, Bocage Teaching Hospital, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - S Gehin
- Department of vascular, oncologic and interventional radiology, Le2i UMR CNRS 6306, University of Dijon School of Medicine, Bocage Teaching Hospital, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - D Krausé
- Department of vascular, oncologic and interventional radiology, Le2i UMR CNRS 6306, University of Dijon School of Medicine, Bocage Teaching Hospital, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - J-P Cercueil
- Department of vascular, oncologic and interventional radiology, Le2i UMR CNRS 6306, University of Dijon School of Medicine, Bocage Teaching Hospital, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
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Loffroy R, Pottecher P, Cherblanc V, Favelier S, Estivalet L, Koutlidis N, Moulin M, Cercueil J, Cormier L, Krausé D. Current role of transcatheter arterial embolization for bladder and prostate hemorrhage. Diagn Interv Imaging 2014; 95:1027-34. [DOI: 10.1016/j.diii.2014.03.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
The availability of intra-arterial hepatic therapies (radio and/or chemo-embolisation, intra-arterial hepatic chemotherapy) has convinced radiologists to perfect their knowledge of the anatomy of the liver arteries. These sometimes, complex procedures most often require selective arterial catheterization. Knowledge of the different arteries in the liver and the peripheral organs is therefore essential to optimize the procedure and avoid eventual complications. This paper aims to describe the anatomy of the liver arteries and the variants, applying it to angiography images, and to understand the implications of such variations in interventional radiological procedures.
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Affiliation(s)
- S Favelier
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France.
| | - T Germain
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - P-Y Genson
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - J-P Cercueil
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France; Unité Inserm U866, faculté de médecine, Dijon, France
| | - A Denys
- Département de radiologie interventionnelle, CHU Vaudois, Lausanne, Switzerland
| | - D Krausé
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - B Guiu
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France; Unité Inserm U866, faculté de médecine, Dijon, France; Département de radiologie interventionnelle, CHU Vaudois, Lausanne, Switzerland
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Abstract
The liver segmentation system, described by Couinaud, is based on the identification of the three hepatic veins and the plane passing by the portal vein bifurcation. Nowadays, Couinaud's description is the most widely used classification since it is better suited for surgery and more accurate for the localisation and monitoring of intra-parenchymal lesions. Knowledge of the anatomy of the portal and venous system is therefore essential, as is knowledge of the variants resulting from changes occurring during the embryological development of the vitelline and umbilical veins. In this paper, the authors propose a straightforward systematisation of the liver in six steps using several additional anatomical points of reference. These points of reference are simple and quickly identifiable in any radiological examination with section imaging, in order to avoid any mistakes in daily practice. In fact, accurate description impacts on many diagnostic and therapeutic applications in interventional radiology and surgery. This description will allow better preparation for biopsy, portal vein embolisation, transjugular intrahepatic portosystemic shunt, tumour resection or partial hepatectomy for transplantation. Such advance planning will reduce intra- and postoperative difficulties and complications.
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Affiliation(s)
- T Germain
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France.
| | - S Favelier
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - J-P Cercueil
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France; Unité Inserm U866, faculté de médecine, Dijon, France
| | - A Denys
- Département de radiologie interventionnelle, CHU Vaudois, Lausanne, Switzerland
| | - D Krausé
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - B Guiu
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France; Unité Inserm U866, faculté de médecine, Dijon, France; Département de radiologie interventionnelle, CHU Vaudois, Lausanne, Switzerland
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Benhamiche H, Sottier D, Funes De La Vega M, Cuisenier B, Mejean N, Krausé D. Peritoneal hydatidosis and hepatic hydatid cyst perforation. Diagn Interv Imaging 2013; 94:1157-60. [DOI: 10.1016/j.diii.2013.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Affiliation(s)
- D Krausé
- Service de radiologie et imagerie médicale diagnostique et thérapeutique, 2, boulevard Mal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon cedex, France
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Sottier D, Petit JM, Guiu S, Hamza S, Benhamiche H, Hillon P, Cercueil JP, Krausé D, Guiu B. Quantification of the visceral and subcutaneous fat by computed tomography: Interobserver correlation of a single slice technique. Diagn Interv Imaging 2013; 94:879-84. [DOI: 10.1016/j.diii.2013.04.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Loffroy R, Kretz B, Guiu B, Bouchot O, Cercueil J, Brenot R, Krausé D, Steinmetz E. [Transabdominal percutaneous embolization of a type 2B endoleak in a patient with covered abdominal aortic endoprosthesis]. J Radiol 2010; 91:901-904. [PMID: 20814378 DOI: 10.1016/s0221-0363(10)70132-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Lambert A, Loffroy R, Guiu B, Mejean N, Lerais J, Cercueil J, Krausé D. Rotator cuff tears: value of 3.0 T MRI. Clin Imaging 2009. [DOI: 10.1016/j.clinimag.2009.08.013] [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: 10/20/2022]
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Loffroy R, Abualsaud B, Delgal A, Guiu B, Kermarrec I, Michel F, Cormier L, Mousson C, Majbri N, Rebibou JM, Cercueil JP, Krausé D. [Role of percutaneous arterial embolization in renal pathology]. Prog Urol 2009; 20:161-71. [PMID: 20230936 DOI: 10.1016/j.purol.2009.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Revised: 07/02/2009] [Accepted: 07/07/2009] [Indexed: 11/28/2022]
Abstract
Therapeutic embolization in renal pathology is used for various conditions in cancerology, traumatology, urology, nephrology and for iatrogenic complications of percutaneous manoeuvers. Any department of vascular radiology may be requested to use this technique, especially in emergent traumatology or palliative cancerology. The authors study the various conditions that may benefit from these procedures and give the highlights of the main indications and the main types of embolic agents used. Complications, side effects and the major precautions are also reviewed.
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Affiliation(s)
- R Loffroy
- Département de radiologie diagnostique et thérapeutique, CHU Le Bocage, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon cedex, France.
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Guiu B, Petit JM, Walker PM, Loffroy R, Hillon P, Brunotte F, Krausé D, Cercueil JP. [Magnetic resonance spectroscopy: a new standard for quantification of liver steatosis?]. ACTA ACUST UNITED AC 2009; 33:967-70. [PMID: 19646833 DOI: 10.1016/j.gcb.2009.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2008] [Revised: 04/04/2009] [Accepted: 05/18/2009] [Indexed: 11/29/2022]
Affiliation(s)
- B Guiu
- Département d'imagerie médicale diagnostique et thérapeutique, CHU Le Bocage, boulevard Maréchal-de-Lattre-de-Tassigny, 21000 Dijon, France.
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Meder JF, Krausé D, Pruvo JP. [Imaging in a University Medical Center: from concern to hope]. J Radiol 2009; 90:667-668. [PMID: 19623118 DOI: 10.1016/s0221-0363(09)74720-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Tixier H, Loffroy R, Filipuzzi L, Grevoul J, Mutamba W, Cercueil J, Krausé D, Douvier S, Sagot P. [Uterine artery embolization with resorbable material prior to myomectomy]. ACTA ACUST UNITED AC 2009; 89:1925-9. [PMID: 19106850 DOI: 10.1016/s0221-0363(08)74788-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE Fibroids are a frequent cause of gynecology referral. Myomectomy is a conservative treatment alternative. The main risk from this procedure is hemorrhage. The main objective of this study was to demonstrate the efficacy of preoperative uterine artery embolization with resorbable agents to reduce blood losses and facilitate myomectomy. Secondary objectives were to evaluate morbidity and subsequent fertility. PATIENTS AND METHODS Retrospective study of 21 patients with preoperative uterine artery embolization prior to myomectomy at the University Medical Center of Dijon over a 3 year period. RESULTS Myomectomy after uterine artery embolization with resorbable agents was associated with only minimal blood loss. Mean preoperative and postoperative hemoglobin levels were comparable (p<0.0001). Uterine suturing was technically simpler. The number of resected fibroids (p=0.2824) and the presence of preoperative anemia (p=0.474) had no statistically significant impact on the duration of hospital stay. Uterine synechiae occurred in three patients after the procedure, and were easily treated. Two patients had normal subsequent pregnancies. CONCLUSION Preoperative uterine artery embolization with resorbable agents was effective in reducing surgical blood losses. This technique reduces the number of hysterectomies and hemorrhagic complications (hematoma, infection, weaker scar tissue). It should be considered in patients wishing uterine preservation when the hemorrhagic risk is high. Its use in patients seeking subsequent pregnancy should be further assessed with larger series.
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Affiliation(s)
- H Tixier
- Service de Gynécologie-Obstétrique, Médecine Foetale et Stérilité Conjugale, BP 77908, 21079 Dijon Cedex, France.
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16
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Régis A, Ben Salem D, Lambert A, Couaillier JF, Casasnovas O, Piard F, Krausé D. [Concomitant pulmonary Langerhans cell histiocytosis and malignant lymphoma: report of two cases]. ACTA ACUST UNITED AC 2009; 90:66-8. [PMID: 19182717 DOI: 10.1016/s0221-0363(09)70081-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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Loffroy R, Guiu B, Delgal A, Lambert A, Cercueil J, Krausé D. Abstract No. 323: Management of Intractable Bladder and Prostate Hemorrhage with Selective Arterial Embolization: Short- and Long-Term Outcomes. J Vasc Interv Radiol 2009. [DOI: 10.1016/j.jvir.2008.12.318] [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: 12/01/2022] Open
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Loffroy R, Guiu B, Lambert A, Mezzetta L, Cercueil J, Krausé D. Abstract No. 176: Arterial Embolotherapy for Endoscopically Unmanageable Acute Hemorrhage from Gastroduodenal Ulcers: Predictors of Early Bleeding Recurrence. J Vasc Interv Radiol 2009. [DOI: 10.1016/j.jvir.2008.12.164] [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: 11/29/2022] Open
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Guiu B, Loffroy R, Cercueil J, Lambert A, Lerais J, Krausé D. Abstract No. 324: Foraminal Corticosteroids Infiltrations in Cervical Neuralgias Under CT Guidance: A Long Term Analysis of Clinical Results (300 Patients). J Vasc Interv Radiol 2009. [DOI: 10.1016/j.jvir.2008.12.319] [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] Open
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Guiu B, Loffroy R, Ben salem D, Masson D, Hervé G, Petit J, Krausé D, Cercueil J. Liver steatosis and in- and out-of-phase MR imaging: theory and clinical applications of 3T. Clin Imaging 2008. [DOI: 10.1016/j.clinimag.2008.04.027] [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: 11/28/2022]
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Loffroy R, Guiu B, Lambert A, Mousson C, Tanter Y, Martin L, Cercueil JP, Krausé D. Management of post-biopsy renal allograft arteriovenous fistulas with selective arterial embolization: immediate and long-term outcomes. Clin Radiol 2008; 63:657-65. [DOI: 10.1016/j.crad.2007.11.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Revised: 11/06/2007] [Accepted: 11/11/2007] [Indexed: 12/11/2022]
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Loffroy R, Varbédian O, Guiu B, Delgal A, Michel F, Cercueil JP, Krausé D. [Xanthogranulomatous pyelonephritis: main imaging features]. Prog Urol 2008; 18:266-74. [PMID: 18538270 DOI: 10.1016/j.purol.2008.03.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Accepted: 03/11/2008] [Indexed: 11/29/2022]
Abstract
Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis, which frequently has a pseudotumoral appearance, as a result of which differential diagnosis with malignant renal neoplasia is difficult, especially as there are no specific signs of this lesion. The aim of this article is to notice the various histological, clinical and radiological characteristics, and the different modalities of diagnostic and treatment of this affection.
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Affiliation(s)
- R Loffroy
- Département de radiologie et d'imagerie médicale diagnostique et thérapeutique, CHU Le Bocage, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, B.P. 77908, 21079 Dijon cedex, France.
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Guiu B, Loffroy R, Ben Salem D, Masson D, Hervé G, Petit J, Krausé D, Cercueil J. Stéatose hépatique et séquence phase- opposition de phase : aspects théoriques et applications pratiques à 3T. ACTA ACUST UNITED AC 2007; 88:1845-53. [DOI: 10.1016/s0221-0363(07)78362-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Meder JF, Dacher JN, Krausé D. [Is an evaluation required at the third cycle?]. J Radiol 2007; 88:927-8. [PMID: 17878847 DOI: 10.1016/s0221-0363(07)89897-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
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Loffroy R, Guiu B, Watfa J, Michel F, Cercueil JP, Krausé D. Xanthogranulomatous pyelonephritis in adults: clinical and radiological findings in diffuse and focal forms. Clin Radiol 2007; 62:884-90. [PMID: 17662737 DOI: 10.1016/j.crad.2007.04.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Revised: 03/25/2007] [Accepted: 04/19/2007] [Indexed: 12/30/2022]
Abstract
AIM To describe the clinical and radiological features of focal and diffuse xanthogranulomatous pyelonephritis (XGP) in adults. MATERIALS AND METHODS A retrospective review of the clinical data, laboratory findings, imaging features, and surgical treatment of 13 cases of histologically proven XGP diagnosed between January 1993 and December 2005 was undertaken. There were 10 women and three men with a mean age of 55.2 years (range 30-87 years). All patients underwent both sonography and computed tomography (CT) of the kidneys. Magnetic resonance imaging (MRI) was performed in two patients. RESULTS XGP was diffuse in 11 patients and focal in two patients. Fever, anorexia and weight loss, urinary symptoms, and flank pain were the most common manifestations. Urinary tract infection was found in eight patients. Sonography and CT showed diffuse kidney enlargement in seven cases and atrophy in five cases; a solitary solid mass was found in two patients. Hydronephrosis was noted in nine cases, staghorn calculus in six, and extensive pararenal disease in six. MRI failed to provide the preoperative diagnosis in the two patients with focal XGP. Total or partial nephrectomy was performed without postoperative complications. CONCLUSION Although rare, XGP is the main differential diagnosis of malignant renal neoplasia. The definitive diagnosis depends on histological examination of the operative specimen. Preoperatively, the diagnosis can often be suspected based on imaging studies, primarily CT.
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Affiliation(s)
- R Loffroy
- Department of Radiology, Bocage Hospital, University Hospital Center, Dijon, France.
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Loffroy R, Guiu B, Varbédian O, Michel F, Sagot P, Cercueil JP, Krausé D. Diffuse xanthogranulomatous pyelonephritis with psoas abscess in a pregnant woman. Can J Urol 2007; 14:3507-9. [PMID: 17466157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We report the first case, to our knowledge, of xanthogranulomatous pyelonephritis (XGP) with psoas abscess occurring during pregnancy. A 37-year-old woman in the third trimester of pregnancy presented with low back pain and a fever. From sonographic features, a multidisciplinary team decided to perform computed tomography of the abdomen with contrast agent injection, which strongly suggested diffuse XGP of the left kidney with a psoas abscess. Cesarean section at 32 weeks was followed by extended nephrectomy. Pathological examination of the operative specimen confirmed the diagnosis. Outcomes were favorable in the mother and baby. The diagnosis and treatment of XGP during pregnancy are discussed.
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Affiliation(s)
- R Loffroy
- Service de Radiologie et Imagerie Médicale Diagnostique et Thérapeutique, CHU Le Bocage, Dijon cedex, France
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Krausé D. [Publishing in the Journal de Radiologie: an absolute necessity!]. J Radiol 2006; 87:599. [PMID: 16788533 DOI: 10.1016/s0221-0363(06)74052-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Abstract
The main goal of urgent imaging evaluation of patients with suspected CNS infection is to differentiate infectious from tumoral or vascular lesions in order to provide appropriate management. MR imaging, including diffusion weighted imaging and spectroscopy, is superior to CT imaging to characterize lesion location and etiology. The CT and MRI features of the more frequent bacterial, viral and parasitic CNS infections will be described.
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Affiliation(s)
- D Ben Salem
- Service de Neuroradiologie et de Radiologie des Urgences, Hôpital général, CHU Dijon, 3 rue du Fg. Raines, 21033 Dijon Cedex, France.
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Ben Salem D, Sauvage PJ, Pellerin O, Krausé D, Ricolfi F. [Therapeutic management of lumbar synovial cysts. Comments on the article by Ph. Métellus et al]. Neurochirurgie 2003; 49:616-7. [PMID: 14735008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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Cognet F, Dranssart M, Cercueil JP, Peyrou F, Krausé D. [Sinusoidal abnormalities of the liver: MR imaging features]. J Radiol 2002; 83:611-8. [PMID: 12063423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
This article reviews the different MR features found in sinusoidal lesions of the liver parenchyma. The diagnosis of these abnormalities is mainly based on the pathologic examination. These diagnoses relate to numerous diseases including veno-occlusive disease, Budd-Chiari disease, peliosis, hepato-portal sclerosis, and portal intra-sinusoidal thrombosis. The use of fast multi-slice acquisitions associated with dynamic enhancement of the liver leads to an efficient examination and allows analysis of both the parenchymal and vascular components of the liver.
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Affiliation(s)
- F Cognet
- Service d'Imagerie Diagnostique et Thérapeutique, Le Bocage, 21034 Dijon, France.
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Cercueil JP, Krausé D, Reynaud M, Lamazière I, Charmasson L, Lerais JM, Aho S. [Comparison between iopamidol and ioxaglate in digital arteriography of the lower limbs]. J Radiol 1996; 77:643-7. [PMID: 8944120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This prospective study concerning 100 subtraction angiographies of the lower limbs compared two iodine concentrations of iopamidol (300 and 370 mg l/l) and ioxaglate (320 and 350 mg l/l). More pain and movements disturbed the subtraction with iopamidol 370 in comparison with ionic contrast media (p < 0.005). The quality of the contrast was better with ioxaglate 350 (p = 0.05) than with the others. This one appears to be a good compromise for this type of examination.
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Affiliation(s)
- J P Cercueil
- Service de Radiologie, Hôpital Le Bocage, CHRU, Dijon, France
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Cercueil JP, Krausé D, Thibaud JC, Fontalirand C, Vezina J. [Immobilization and filtration for arteriography of the lower limbs]. J Radiol 1995; 76:295-6. [PMID: 7783046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- J P Cercueil
- Service de Radiologie, Hôpital le Bocage, CHRU Dijon
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Drapé JL, Krausé D, Kempf JF. [Exploration of menisci of the knee by MRI. Value of the acquisition 3D]. Rev Prat 1992; 42:2059-62. [PMID: 1485112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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