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Garabedian C, Verpillat P, Czerkiewicz I, Langlois C, Muller F, Avni F, Bigot J, Sfeir R, Vaast P, Coulon C, Subtil D, Houfflin-Debarge V. Does a combination of ultrasound, MRI, and biochemical amniotic fluid analysis improve prenatal diagnosis of esophageal atresia? Prenat Diagn 2014; 34:839-42. [DOI: 10.1002/pd.4376] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 03/31/2014] [Accepted: 03/31/2014] [Indexed: 11/10/2022]
Affiliation(s)
- C. Garabedian
- Department of Obstetrics; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - P. Verpillat
- Department of Pediatric Radiology; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - I. Czerkiewicz
- Biochemistry-Hormonology Department, Robert Debré Hospital, AP-HP; University Paris Ile de France Ouest; Paris France
| | - C. Langlois
- Department of Biostatistics, EA2694, UDSL; University of Lille Nord de France, CHRU de Lille; Lille France
| | - F. Muller
- Biochemistry-Hormonology Department, Robert Debré Hospital, AP-HP; University Paris Ile de France Ouest; Paris France
| | - F. Avni
- Department of Pediatric Radiology; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - J. Bigot
- Department of Pediatric Radiology; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - R. Sfeir
- Reference Center for Congenital Esophageal Abnormalities (CRACMO); Lille France
| | - P. Vaast
- Department of Obstetrics; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - C. Coulon
- Department of Obstetrics; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - D. Subtil
- Department of Obstetrics; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
- University of Lille Nord de France; Lille France
| | - V. Houfflin-Debarge
- Department of Obstetrics; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
- University of Lille Nord de France; Lille France
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Morel B, Avni F, Ducou Le Pointe H, Gorincour G. Prenatal and paediatric imaging needs you! Diagn Interv Imaging 2012; 93:559-60. [DOI: 10.1016/j.diii.2012.07.006] [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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Liu Y, Aeby A, Balériaux D, David P, Absil J, De Maertelaer V, Van Bogaert P, Avni F, Metens T. White matter abnormalities are related to microstructural changes in preterm neonates at term-equivalent age: a diffusion tensor imaging and probabilistic tractography study. AJNR Am J Neuroradiol 2012; 33:839-45. [PMID: 22241389 DOI: 10.3174/ajnr.a2872] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Preterm infants have a high risk of brain injury and neurodevelopmental impairment, often associated with WMA on conventional MR imaging. DTI can provide insight into white matter microstructure. The aim of this study was to investigate the association between WMA on conventional MR imaging and DTI parameters in specific fibers in preterm neonates at term-equivalent age. MATERIALS AND METHODS Seventy preterm neonates (39 boys and 31 girls) were included in the study. WMA were classified as no, mild, moderate, or severe. Probabilistic tractography provided tract volumes, FA, MD, λ(//), and λ(⊥) in the CST, SLF, TRs, and corpus callosum. Data were compared by using MANOVA, and adjustment for multiple comparisons was performed. RESULTS Important associations were found between WMA and microstructural changes. Compared with neonates with no WMA (n = 41), those with mild WMA (n = 27) had significantly increased λ(⊥) and MD in the left ATR, the left sensory STR, the bilateral motor STR, and for λ(⊥) also in the right CST; FA decreased significantly in the left sensory STR. Diminished tract volumes and altered diffusion indices were also observed in the 2 neonates with moderate WMA. CONCLUSIONS Altered DTI indices in specific tracts, with λ(⊥) as most prominent, are associated with mild WMA in preterm neonates at term-equivalent age.
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Affiliation(s)
- Y Liu
- Departments of Radiology, ULB-Hôpital Erasme, Brussels, Belgium.
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Liu Y, Metens T, Absil J, De Maertelaer V, Balériaux D, David P, Denolin V, Van Overmeire B, Avni F, Van Bogaert P, Aeby A. Gender differences in language and motor-related fibers in a population of healthy preterm neonates at term-equivalent age: a diffusion tensor and probabilistic tractography study. AJNR Am J Neuroradiol 2011; 32:2011-6. [PMID: 21940804 DOI: 10.3174/ajnr.a2690] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE Sex differences in white matter structure are controversial. In this MR imaging study, we aimed to investigate possible sex differences in language and motor-related tracts in healthy preterm neonates by using DTI and probabilistic tractography. MATERIALS AND METHODS Thirty-eight preterm neonates (19 boys and 19 girls, age-matched), healthy at term-equivalent age and at 12 months were included. TBV was measured individually. Probabilistic tractography provided tract volumes, relative tract volumes (volume normalized to TBV), FA, MD, and λ(⊥) in the SLF, in the TRs, and in the CSTs. Data were compared by using independent t tests, and Bonferroni corrections were performed to adjust for multiple comparisons. RESULTS We showed that healthy preterm boys had larger TBV than girls. However, girls had statistically significantly larger relative tract volumes than boys bilaterally in the parieto-temporal SLF, and in the left CST. Moreover, in the left parieto-temporal SLF, a trend toward lower MD and λ(⊥) was observed in females. CONCLUSIONS Structural sex differences were found in preterm neonates at term-equivalent age in both sides of the parieto-temporal SLF and in the left CST. Further studies are necessary to investigate whether these structural differences are related to later sex differences in language skills and handedness or to the effect of prematurity.
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Affiliation(s)
- Y Liu
- Department of Radiology, ULB-Hopital Erasme, Brussels, Belgium.
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5
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Damaj L, Bruneau B, Ferry M, Moutard ML, Garel C, Odent S, Adamsbaum C, Avni F, Tréguier C, Lazaro L. Pediatric outcome of children with the prenatal diagnosis of isolated septal agenesis. Prenat Diagn 2011; 30:1143-50. [PMID: 20936603 DOI: 10.1002/pd.2628] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Isolated Septal Agenesis (SA) is a rare disease with clinical outcomes (especially neurological outcomes) that are unknown. The purpose of this study was to evaluate the clinical outcome of these children. METHODS We conducted a retrospective multicenter study of 17 children with an isolated SA or SA combined with a moderate ventricular dilatation (VD) that was diagnosed antenatally and confirmed by a magnetic resonance imaging (MRI) performed in the antenatal period. RESULTS Of the 17 children, 14 had normal neurological examinations, 2 had language development delay and visuo-spatial dyspraxia, and 3 of the 17 children had behavioral problems. Eight children had neuropsychological evaluations, and the results were normal in six cases. There were 3 cases of septo-optic dysplasia (SOD) diagnosed postnatally, which highlighted the difficulties in assessing the optic tract and hypothalamic-pituitary region in antenatal imaging. Language delay and behavioral disorders were the main abnormalities at follow-up. CONCLUSION The discovery of an isolated SA reveals the difficulties of prenatal diagnosis to correlate the neurological and functional prognosis to morphological findings. The prognosis seemed to be good. It appears necessary to improve the diagnostic performance of fetal brain imaging and to follow-up these children prospectively to assess their long-term cognitive-behavioral outcomes.
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Affiliation(s)
- L Damaj
- Department of Pediatrics, Teaching Hospital of Rennes, Rennes, France.
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Borens-Fefer B, Lingier P, Cassart M, Zalcman M, D'Haene N, Avni F. Synovial sarcoma of the duodenum in adolescent. JBR-BTR 2009; 92:142-143. [PMID: 19670569] [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: 05/28/2023]
Affiliation(s)
- B Borens-Fefer
- Department of Medical Imaging, ULB, Erasme University Hospital, Brussels, Belgium
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Cassart M, Bosson N, Garel C, Eurin D, Avni F. Fetal intracranial tumors: a review of 27 cases. Eur Radiol 2008; 18:2060-6. [PMID: 18458906 DOI: 10.1007/s00330-008-0999-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Accepted: 03/30/2008] [Indexed: 01/18/2023]
Abstract
Fetal intracranial tumors are rare. The diagnosis is generally made on histology after birth. The aim of this study was to analyze clinical and imaging data in a series of fetal intracranial tumors and emphasize the findings that may help approach the diagnosis antenatally. We retrospectively analyzed imaging and clinical findings in 27 cases of fetal intracranial tumors assessed by ultrasound (27/27) and MR imaging (24/27). A histological diagnosis was always obtained. Main diagnoses included 15 germinal tumors (13 teratomas), 4 glial tumors, 2 craniopharyngiomas and 3 hamartomas. Average gestational age at diagnosis was 27 weeks for teratomas, 21 weeks for hamartomas and 34 weeks for glial tumors. All tumors but one were supra tentorial, and the lesion extended in the posterior fossa in two teratomas. A heterogeneous pattern, which was more frequently seen in teratomas, was better visualized by MR than US imaging. In addition, in two cases of teratomas, MR imaging better assessed the extension of the tumor. Teratomas and gliomas are the most frequent brain tumors in the fetus. US and MR imagings appear complementary in the prenatal assessment of these lesions.
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Affiliation(s)
- M Cassart
- Department of Medical Imaging, Erasme University Hospital, 808 Route de Lennik, 1070 Brussels, Belgium.
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Cassart M, Massez A, Cos T, Tecco L, Thomas D, Van Regemorter N, Avni F. Contribution of three-dimensional computed tomography in the assessment of fetal skeletal dysplasia. Ultrasound Obstet Gynecol 2007; 29:537-43. [PMID: 17444568 DOI: 10.1002/uog.4001] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To compare the diagnostic accuracy of two-dimensional (2D) ultrasound and three-dimensional (3D) computed tomography (CT) for the diagnosis of fetal skeletal anomalies. METHODS Eleven pregnant women underwent 2D ultrasound and 3D-CT. Ten fetuses presented skeletal anomalies on 2D ultrasound and one fetus had a normal ultrasound exam but a familial history of osteopetrosis. We compared retrospectively the diagnoses established on 2D ultrasound and 3D-CT with the neonatal and/or postmortem work-up, which were used as the gold standard. RESULTS 2D ultrasound provided the correct diagnosis in only two of the 11 cases. CT yielded the correct diagnosis in eight; in six of these, 2D ultrasound had been inconclusive. 3D-CT was more accurate than was 2D ultrasound in visualizing vertebral anomalies (abnormal shape of the vertebral bodies, abnormal interpedicular distance), pelvic bone malformations (delayed ossification of the pubic bones, abnormal acetabular shape) and enlarged metaphysis or synostoses in long bones. In three cases, neither 2D ultrasound nor CT provided the correct diagnosis. CONCLUSION In this series, which included a variety of skeletal dysplasias, 3D-CT had a better diagnostic yield than did 2D ultrasound. Both imaging techniques are useful in the management of fetal dysplasia; 2D ultrasound is a useful screening test and 3D-CT is a valuable complementary diagnostic tool.
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Affiliation(s)
- M Cassart
- Department of Medical Imaging, Erasme University Clinics, and Department of Fetal Medicine, Brugmann Hospital, Brussels, Belgium.
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9
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Staebler M, Donner C, Van Regemorter N, Duprez L, De Maertelaer V, Devreker F, Avni F. Should determination of the karyotype be systematic for all malformations detected by obstetrical ultrasound? Prenat Diagn 2005; 25:567-73. [PMID: 16032766 DOI: 10.1002/pd.1187] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether karyotyping should be performed for every fetal malformation detected in low risk populations. METHODS A karyotype was obtained from 428 fetuses examined over a 10-year period after fetal malformation was diagnosed using obstetrical ultrasound. These fetuses were separated into two groups, one with isolated malformations and the other with multiple malformations. The association between each type of malformation and the result of karyotype was evaluated. RESULTS Forty-eight chromosomal abnormalities were encountered in 428 fetuses (11.2%). The karyotype was abnormal in 32/343 (9.3%) fetuses with isolated malformations and 16/85 (18.8%) fetuses with multiple malformations (p=0.022). The probability of an abnormal karyotype among the group of isolated malformation depended on the anatomical system involved (p<0.001). Our study demonstrated several isolated malformations without chromosomal abnormality (hydronephrosis with high obstruction, unilateral multicystic dysplastic kidney, gastroschisis, intestinal dilatation, meconium peritonitis, cystic adenomatoid malformation, pulmonary sequestration, tumor, vertebral anomaly). CONCLUSION Each fetus with multiple malformations needs a chromosomal analysis. Within the group of isolated malformations, our study emphasizes that medical maternal history and the type of malformation need to be taken into account before performing a fetal karyotype.
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Affiliation(s)
- M Staebler
- Department of Medical Imaging, Children's University Hospital Queen Fabiola, Université Libre de Bruxelles, Belgium
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10
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Gorincour G, Bouvenot J, Mourot MG, Sonigo P, Chaumoitre K, Garel C, Guibaud L, Rypens F, Avni F, Cassart M, Maugey-Laulom B, Bourlière-Najean B, Brunelle F, Durand C, Eurin D. Prenatal prognosis of congenital diaphragmatic hernia using magnetic resonance imaging measurement of fetal lung volume. Ultrasound Obstet Gynecol 2005; 26:738-44. [PMID: 16273597 DOI: 10.1002/uog.2618] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To investigate the correlation between fetal lung volume (FLV), measured with magnetic resonance imaging (MRI), and postnatal mortality in newborns with prenatally diagnosed isolated congenital diaphragmatic hernia (CDH). METHODS In a 4-year prospective multicenter study, 77 fetuses with isolated CDH diagnosed between 20 and 33 weeks' gestation underwent fast spin-echo T2-weighted lung MRI. These MRI-FLV measurements were compared with a previously published normative curve obtained in 215 fetuses without thoracoabdominal malformations and with normal ultrasound biometric findings. FLV measurements were correlated with postnatal survival. The mean gestational age at MRI was 31.3 weeks. RESULTS The measured/expected FLV ratio was significantly lower in the newborns with CDH who died compared with those who survived (23.6 +/- 12.2 vs. 36.1 +/- 13.0, P < 0.001). When the ratio was below 25%, there was a significant decrease in postnatal survival (19% vs. 40.3%, P = 0.008). Survival was significantly lower for neonates when one lung could not be seen by fetal MRI compared with those fetuses with two visible lungs on MRI (17.9% vs. 62.1%, P < 0.001). CONCLUSION In isolated CDH, FLV measurement by MRI is a good predictor of postnatal mortality due to pulmonary hypoplasia.
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Affiliation(s)
- G Gorincour
- Department of Pediatric Radiology, La Timone Children's Hospital, Marseilles, France.
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Fernández-Aguilar S, Noël JC, Donner C, Avni F. Congenital pulmonary airway malformation and congenital varicella infection-a possible association. Ultrasound Obstet Gynecol 2005; 26:680-2. [PMID: 16211646 DOI: 10.1002/uog.2588] [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: 05/04/2023]
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Cassart M, Massez A, Denolin V, Pardou A, Chambrier D, Avni F. [The thoraco-abdominal applications of MRI in the fetus]. JBR-BTR 2005; 88:253-4. [PMID: 16302340] [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: 05/05/2023]
Affiliation(s)
- M Cassart
- ULB-Hôpital Erasme, Bruxelles, Belgium.
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Damry N, Anaye A, Tran E, Avni F, Christophe C. [Acute myocardial infarction and MRI: a comparison of infarct size by MRI and peak creatine kinase after a first episode]. Ann Cardiol Angeiol (Paris) 2005; 54:250-6. [PMID: 16237914 DOI: 10.1016/j.ancard.2005.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
AIM To compare the assessment of infarct size using MRI and peak CK value. POPULATION AND METHODS 16 patients presenting with a first MI and seriall measurement of CK underwent gadolinium-enhanced MRI. RESULTS A significant correlation was observed between both estimates of infarct size (r=0.56, p=0.0025). In addition, an inverse correlation was found between residual viability and peak CK (r=-0.51; p=0.043). CONCLUSION After a first episode of MI, infarct size estimate by MRI correlates with that determined by peak CK measurement.
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Affiliation(s)
- N Damry
- Service de radiologie, CHU Brugmann, 4, place Van-Gehuchten, 1020 Bruxelles, Belgique.
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Christophe C, Johanson A, Massez A, Ziereisen F, Avni F. [Importance of echocardiography and MRI in periventricular leukomalacia]. Rev Med Brux 2003; 24:154-61. [PMID: 12891882] [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: 03/04/2023]
Abstract
Periventricular leukomalacia (PVL) consists of focal coagulation necrosis and of more diffuse and mild white matter involvement as gliosis and lesions of immature oligodendrocytes. PVL affects essentially the premature newborn and has become the dominant form of perinatal neurological insults. Its diagnosis remains difficult to assess as neurological examination is poorly contributive. Diagnostic imaging plays an important role as it completes clinical, biological and electrophysiological data in depicting the cerebral lesions. Cerebral ultrasound remains the first imaging modality to perform in order to investigate and follow ill neonates. However ultrasound has a low sensitivity and specificity in depicting non cavitated PVL. Magnetic resonance imaging (MRI), in the acute stage, provides additional information about the extension and the depiction of hemorrhagic component of the lesions. Furthermore, diffusion-weighted MRI appears useful for the early identification of the diffuse component of PVL. MRI in the chronic stage is the only imaging method to study the progress of myelination and precise the extension of sequellar lesions.
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Affiliation(s)
- C Christophe
- H.U.D.E.R.F. Service d'Imagerie Médicale Avenue J.J. Crocq 15 1020 Bruxelles
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15
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Struyven J, Avni F, Balériaux D, Cassart M, David P, Gevenois PA, Golzarian J, Laureys M, Madani A, Matos C, Metens T, Scillia P, Sadeghi N, Stallenberg B, Van Gansbeke D, Zalcman M. [The medical imaging and radiology department]. Rev Med Brux 2003; 23 Suppl 2:79-84. [PMID: 12584918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Technological developments arising from research have affected the whole wide spectrum of medical endeavor and have made a very significant impact on clinical practice and especially on imaging sciences. Ultrasonography brought spectacular advances, but CT and MRI became important landmark techniques. A further important development, which greatly increased the involvement of radiologists in direct patient management, was the growth of interventional and therapeutic techniques, called interventional radiology. Some statistics: approximately 155,000 patients per year including 19,000 CT Scans, 10,000 MRI exams, 21,000 ultrasound examinations and 1,000 therapeutic procedures. Some research activities: CT quantification of pulmonary emphysema, respiratory mechanics, MR and CT angiography, antenatal diagnosis of congenital and genetic diseases of the fetus, quantification of portal haemodynamics, MR imaging of bile and pancreatic ducts, morphologic and functional imaging of the brain, radiology of bone trauma, MR characterization in hepatic lesions.
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Damry N, Hall M, Avni F. Ectopic vaginal insertion of a duplicated ureter: demonstration by magnetic resonance imaging (MRI). JBR-BTR 2002; 84:270. [PMID: 11817480] [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: 02/23/2023]
Affiliation(s)
- N Damry
- Department of Radiology, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium
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Courtens W, Johansson AB, Dachy B, Avni F, Telerman-Toppet N, Scheffer H. Infantile spinal muscular atrophy variant with congenital fractures in a female neonate: evidence for autosomal recessive inheritance. J Med Genet 2002; 39:74-7. [PMID: 11826032 PMCID: PMC1734957 DOI: 10.1136/jmg.39.1.74] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Robert Y, Mestdagh P, Ziereisen F, Launey S, Avni F. [Clinical case: questions--answers. Imaging of the female pelvis in adolescence]. J Radiol 2001; 82:1781-2. [PMID: 11917647] [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: 02/24/2023]
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20
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Robert Y, Mestdagh P, Ziereisen F, Launay S, Avni F. [Imaging of the female pelvis in adolescence]. J Radiol 2001; 82:1765-80. [PMID: 11917646] [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: 02/24/2023]
Abstract
The aim of this chapter is to familiarize the radiologists with the evolutive morphological features of the female genital apparatus, as it can be seen during the puberty, and to view the pathologies panel which may occur in ths period of life. This chapter is going to illustrate the morphological sonographic modifications from the childhood to the adolescence, emphasing the signs of pubertal maturation (uterus and ovaries shape, size and vascularization). Through clinical signs (delayed sexual maturation, primary or secondary amenorrhea, menstrual dysfunction, acute, cyclic, chronic pelvic pain and pelvic mass) the different pathologies are viewed, illustrating the important role of ultrasonography, but not an exclusive role.
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Affiliation(s)
- Y Robert
- Service de Radiologie et Imagerie Médicale, Hôpital Jeanne de Flandre, 2 avenue Oscar Lambret, 59037 Lille.
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Brisse H, Servois V, Bouche B, Avni F, Petit P, Thibault F, Zucker JM, Devalck C, Neuenschwander S. Hepatic regenerating nodules: a mimic of recurrent cancer in children. Pediatr Radiol 2000; 30:386-93. [PMID: 10876822 DOI: 10.1007/s002470050768] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pseudometastatic lesions of the liver may be discovered incidentally in children previously treated for malignant tumour. OBJECTIVE To describe the radiological pattern of these lesions and to analyse their pathogenesis. MATERIALS AND METHODS Nine children, 2-12 years' old at the time of diagnosis, are described in this retrospective multicentre report. The primary tumours were: nephroblastoma (n = 2), neuroblastoma (n = 2), Ewing's tumour/PNET (n = 2), non-Hodgkin's lymphoma (n = 1), and osteosarcoma (n = 2), treated by surgery (8/9), chemotherapy (9/9), intensive chemotherapy and bone-marrow transplantation (5/9), and radiotherapy (7/9). Three children suffered veno-occlusive disease (VOD) during treatment. The hepatic assessment was performed by sonography (8/9), Doppler (7/9), multiphase spiral CT (8/9) and MRI (7/9). RESULTS Lesions were discovered 15 months to 16 years after completing treatment. CT was the most sensitive modality for diagnosis. Lesions were multiple in eight cases, measured 2-50 mm, and appeared hypervascular on the arterial phase of CT and/or MRI in every case. Metastases were excluded on the basis of histological verification (n = 2) and clinical and radiological follow-up. CONCLUSION Pseudometastatic hypervascular hepatic nodules can appear after treatment of a malignant tumour in children. The hypothesis of benign regenerative lesions secondary to treatment and/or VOD is considered.
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Affiliation(s)
- H Brisse
- Department of Radiology, Institut Curie, Paris, France
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Abstract
We report unusual findings in two patients with Langerhans' cell histiocytosis (LCH), namely a cervical mass lesion with extensive destruction of the posterior elements of a cervical vertebra and gastrointestinal lesions as part of multisystem involvement. The aim of our report is threefold. Firstly, LCH can be responsible for osteolysis of the vertebral posterior arches, with or without involvement of the vertebral body, and should be included in the differential diagnoses of cervical mass lesions. Secondly, in a patient with confirmed LCH and additional protein-losing enteropathy, gastrointestinal involvement should be considered as a possibility since it is an important factor for establishing prognosis. Thirdly, LCH lesions can be very extensive and yet have a good response to therapy, whereas less spectacular lesions may not respond or respond only partially to therapy. Thus, an important factor in establishing prognosis is the presence of multisystem involvement at diagnosis, regardless of the extent of a lesion at a particular site.
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Affiliation(s)
- N Damry
- Department of Radiology, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium
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Dacher JN, Avni F, François A, Rypens F, Monroc M, Eurin D, Le Dosseur P. Renal sinus hyperechogenicity in acute pyelonephritis: description and pathological correlation. Pediatr Radiol 1999; 29:179-82. [PMID: 10201035 DOI: 10.1007/s002470050566] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This paper reports on the association between renal sinus hyperechogenicity and acute pyelonephritis. The medical records and imaging studies of 18 children displaying this pattern were retrospectively studied. Thickening of the renal pelvis and renal enlargement were the most frequent associated sonographic abnormalities. Further subtle findings can be found on sonography and colour/power Doppler. Their identification can help in the diagnostic approach to acute pyelonephritis and may obviate the need for other imaging modalities such as enhanced CT or 99mTc-DMSA scintigraphy. Renal sinus hyperechogenicity was also identified in a parallel study performed in female rabbits with experimental pyelonephritis and was shown, histologically, to be related to exudates of fibrin and polymorphonuclear leukocytes, interstitial oedema and micro-abscesses.
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Affiliation(s)
- J N Dacher
- Department of Pediatric Radiology, Hôpital Charles Nicolle, Rouen, France
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24
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Versteegh C, Avni F, Cuvelier P, Ferster A. [Persistence of pulmonary lesions in a 6-year-old boy with type I Gaucher's disease treated by alglucerase since the age of 20 months]. Arch Pediatr 1998; 5:1341-3. [PMID: 9885741 DOI: 10.1016/s0929-693x(99)80053-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Gaucher's disease is a serious disorder which becomes curable by bone marrow transplantation. Enzyme replacement therapy has permitted improvement in quality of life and has been shown to decrease the disease's progression. OBSERVATION A 6-year-old boy was treated by alglucerase (Ceredase) since the age of 20 months. He presented at that time a failure to thrive, pancytopenia, hepatosplenomegaly and bone involvement. The lung X-rays revealed a diffuse reticulonodular pattern. After 4 years and 5 months, there was an improvement of growth and hepatosplenomegaly, associated with hematological parameters and bone changes normalization. However, an important interstitial syndrome without clinical signs persisted. CONCLUSION In our patient it is impossible to note the difference between pulmonary disease from fibrotic origin and pulmonary involvement by Gaucher's cells accumulation.
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Affiliation(s)
- C Versteegh
- Service d'hématologie, hôpital universitaire des enfants Reine-Fabiola, ULB, Belgique
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25
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Avni F. Two comments on Dr. Ebel's review on congenital obstruction of the urinary tract. Pediatr Radiol 1998; 28:902. [PMID: 9874621] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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27
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Tannouri F, Rypens F, Peny MO, Noël JC, Donner C, Struyven J, Avni F. Fetal endocardial fibroelastosis: ultrasonographic findings in two cases. J Ultrasound Med 1998; 17:63-66. [PMID: 9440110 DOI: 10.7863/jum.1998.17.1.63] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
EFE is a rare cardiac disorder with poor prognosis and uncertain cause. Primary and secondary forms have been described. Most authors consider that all EFE is secondary--a reactive process set off in the endocardium by stress on the myocardium. We report two cases representing the primary dilated form and the secondary contracted form. The dilated form was associated with intracavitary thrombus of the left ventricle. In both cases, an unusual presence of subendocardial calcifications was noted. The ultrasonographic findings are discussed.
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Affiliation(s)
- F Tannouri
- Department of Radiology, Hospital Erasme, Brussels, Belgium
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Abstract
This paper presents 12 infants (9 boys, 3 girls) in whom the diagnosis of a suprarenal mass (10 left, 2 bilateral) was made on antenatal sonography. All were otherwise healthy neonates who were born at term after a normal pregnancy, labor and delivery. The masses ranged from 1 to 3.5 cm in diameter on initial scans at gestational ages of 19-35 weeks. Eleven masses were hyperechoic and 4 of these contained small, well-defined cysts. The 12th was hypoechoic. Follow-up sonography showed complete disappearance of the mass antenatally in 1 case and postnatally by 4-6 months in 5 cases; there was marked diminution in the size of the mass by 2 months of age in 4 infants, by 4 months in 1 case and by 15 months in 1 case. Eleven were managed nonoperatively. Laparotomy (after disappearance of the mass) in the 12th case revealed only some fibrous tissue. The 11 echogenic masses resemble previously reported imaging findings in infants with histologically proven intra-abdominal sequestrated lung. Conservative management with careful sonographic follow-up should, therefore, be considered in otherwise healthy fetuses or neonates with these imaging findings. We are less certain what the hypoechoic mass represented.
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Affiliation(s)
- A Daneman
- Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada
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Donner C, Rypens F, Paquet V, Cohen E, Delneste D, van Regemorter N, Vamos E, Avni F, Rodesch F. Cordocentesis for rapid karyotype: 421 consecutive cases. Fetal Diagn Ther 1995; 10:192-9. [PMID: 7639943 DOI: 10.1159/000264235] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Between October 1985 and December 1993, 421 patients underwent fetal blood sampling for rapid karyotyping (426 samplings, 5 twin pregnancies). The aim of the study was to evaluate cordocentesis in terms of results, complications and additional information in this specific indication especially in case of abnormal pregnancy sonogram. The fetal loss rate possibly related to fetal blood sampling was 1.9%. Abnormal sonograms represented 91% of rapid karyotype indications. Chromosomal abnormalities were found in 9.5% of abnormal sonograms and in 16.9% of fetal structural anomalies (37 cases). The commonest chromosomal abnormality was trisomy 21 (11 cases). In conclusion, cordocentesis is a safe and reliable method for rapid karyotyping although it is associated with more risks than in other indications (congenital infections). The high rate of chromosomal abnormalities pleaded for ultrasonographic screening in a population usually not investigated by cytogenetic studies.
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Affiliation(s)
- C Donner
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Belgium
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Donner C, Noel JC, Rypens F, van Kerkem J, Avni F, Rodesch F. Twin-twin transfusion syndrome--possible roles for Doppler ultrasound and amniocentesis. Prenat Diagn 1995; 15:60-3. [PMID: 7739999 DOI: 10.1002/pd.1970150112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A 29-year-old woman was referred for suspicion of twin-twin transfusion syndrome (TTTS). Several ultrasonographic and neonatal criteria of TTTS were encountered in this twin pregnancy. The peculiar observations in this case were, firstly, the demonstration of superficial anastomosis by Doppler ultrasound and, secondly, that one single therapeutic amniocentesis could have been sufficient to partially correct the progression of the syndrome, as after amniocentesis it was no longer possible to demonstrate the vascular communication. This observation suggests that superficial anastomoses could also have a role in the genesis of TTTS. Their effect could be monitored by Doppler ultrasound and could be more easily corrected by therapeutic amniocentesis.
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Affiliation(s)
- C Donner
- Department of Obstetrics and Gynecology, Free University of Brussels, Belgium
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Donner C, Simon P, Karioun A, Avni F, Rodesch F. Experience of a single team of operators in 891 diagnostic funipunctures. Obstet Gynecol 1994; 84:827-31. [PMID: 7936521] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To assess the efficacy and safety of diagnostic funipuncture. METHODS Between October 1985 and November 1993, fetal circulation was accessed 891 times in 828 pregnancies. The technique was similar to that described in earlier studies. We did not make more than two attempts at the procedure in any session. Each procedure was recorded prospectively in a computerized data base. Data included information about indications, laboratory indices, gestational age, number of successful and failed punctures, duration of fetal bradycardia, duration of bleeding, ultrasonographic findings, follow-up of pregnancies, and perinatal outcome. RESULTS The most frequent indication was rapid karyotyping (48.9%), followed by risk of congenital infection (38.6%). The success rate of the method was high (98.6%). Most samples (97%) were pure fetal blood, undiluted by amniotic fluid. Transient bleeding was observed from the cord puncture site in 9.8% of the procedures. Sixty-three percent of prolonged bradycardia occurred in growth-retarded or congenitally malformed fetuses. Seven fetal and neonatal deaths (five pregnancies) occurred within 1 week after the funipuncture; the funipuncture indication was rapid karyotyping in four of these cases. CONCLUSION Funipuncture performed by operators trained in ultrasonic needle guidance is a safe and reliable procedure.
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Affiliation(s)
- C Donner
- Department of Obstetrics and Gynecology, Hôpital Erasme, Free University of Brussels, Belgium
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Rypens F, Avni F, Braude P, Matos C, Rodesch F, Pardou A, Struyven J. Calcified inferior vena cava thrombus in a fetus: perinatal imaging. J Ultrasound Med 1993; 12:55-58. [PMID: 8455222 DOI: 10.7863/jum.1993.12.1.55] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- F Rypens
- Department of Radiology, Hospital Erasme, Brussels, Belgium
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Donner C, Simon P, Gosselin F, Vermeylen D, Avni F, Liesnard C, Vamos E, Cochaux P, Vassart G, Rodesch F. [Cordocentesis: experience in 391 initial samples]. Rev Med Brux 1990; 11:217-22. [PMID: 2371468] [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: 12/31/2022]
Abstract
The first diagnostic cordocentesis was performed in our unit in october 1985. Our 4-year experience is reported: 391 cordocentesis were performed in 360 patients during gestational weeks 14 to 42. The first attempt was successful in 90% of the procedures, 4 samplings failed, there were 4 fetal deaths within one week after diagnostic cordocentesis, one of them appears to be directly linked to the punction. A transient fetal bradycardia was observed in 9.9% of the cases, bleeding occurred in 19% of the cases. The indications for cordocentesis were: risk of fetal infection, karyotyping, hemopathy, search for paternity, assessment of fetal acid-base status, biochemical dosage. Our data confirm that cordocentesis is a safe and reliable diagnostic procedure providing guidelines for management of the pregnancy.
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Affiliation(s)
- C Donner
- Laboratoire de Cytogénétique, Hôpital Universitaire Brugmann
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Vamos E, Elmer C, Lévi S, el Khazen N, Donner C, Avni F, Rodesch F. [The value of prenatal chromosomal diagnosis in cases of fetal abnormalities: results obtained in 468 pathological pregnancies]. Rev Med Brux 1990; 11:231-5. [PMID: 2371470] [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: 12/31/2022]
Abstract
The authors report the results of 468 foetal karyotypes performed on amniotic fluid or foetal blood samples after ultrasound discovery of foetal anomalies. A total of 46 chromosomal aberrations (10%) were detected. The rates of anomalies vary considerably according to the alarm sign; very high (greater than 30%) in cases of multiple malformations, foetal hydrops or foetal death, low (less than or equal to 2%) in cases of poly- or oligohydramnios and foetal growth retardation without detectable malformation. In addition to these chromosomal diagnoses, further investigations enabled in 9 cases the diagnosis of genetic autosomal recessive disorders. Our results which are comparable with those reported in the literature, demonstrate the importance of prenatal diagnosis in cases of pathological pregnancies, with regard to obstetrical and perinatal management as well as to genetic counseling.
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Affiliation(s)
- E Vamos
- Laboratoire de cytogénétique, Hôpital Brugmann, Bruxelles
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Abstract
The first diagnostic cordocentesis was performed in our unit in October 1985, our 2-year experience is reported. 144 samplings were performed in 137 patients (139 fetuses - 2 patients had twin pregnancies) during gestational weeks 14 to 42. The first attempt was successful in 80% of the procedures, 4 samplings failed. There were no fetal deaths within 3 days after diagnostic cordocentesis, a transient fetal bradycardia was observed in 12.2% of the cases, bleeding occurred in 13.6% of the cases. The indications for cordocentesis were: risk of fetal infection, karyotyping, hemophilia A, alloimmunisation, search for paternity, assessment of fetal acid-base status. Our data confirm that cordocentesis is a safe and reliable diagnostic procedure providing guidelines for management of the pregnancy.
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Affiliation(s)
- C Donner
- Department of Obstetrics & Gynecology, Hopital Erasme, Free University of Brussels, Belgium
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Lemaitre L, Marconi V, Avni F, Remy J. The sonographic evaluation of normal thymus in infants and children. Eur J Radiol 1987; 7:130-6. [PMID: 3297700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Sonography has been used to evaluate 50 "asymptomatic" infants (aged from birth up to two years) with typical appearing thymus on chest X-ray. The ultrasonic features of the normal gland are described. Moreover, the contribution of ultrasound is illustrated by five cases of partially ectopic thymus and by one case of prominent gland in a teenager. Ultrasound may help in differentiating normal gland from mediastinal masses by defining echogenicity, location and extension.
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Van Regemorter N, Vamos E, Defleur V, el Khazen N, Jeanty P, Levi S, Avni F, Foulon W, Liebaers I, Rodesch F. Pathological pregnancies. Results of amniotic fluid studies and fetal outcome. Acta Obstet Gynecol Scand 1986; 65:27-32. [PMID: 3521186 DOI: 10.3109/00016348609158225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Late amniocenteses (greater than 20 weeks' gestation) were performed in 114 pregnancies with no a priori genetic risk, but referred because of abnormal clinical and/or ultrasound findings suggesting fetal malformations. Reasons for referral included polyhydramnios (51 cases), oligohydramnios (15 cases), fetal growth retardation (FGR) (16 cases) and abnormal fetal ultrasound findings excluding anencephaly (32 cases). In 42 of these cases, referral was motivated by a combination of the above abnormal findings. When polyhydramnios was the sole anomaly (25 cases), 5 fetuses were malformed (20%), abnormal fetal karyotype and/or elevated amniotic fluid alphafetoprotein (AFP) were demonstrated in 2 cases. Oligohydramnios was the sole anomaly in one case; the infant died of prematurity. Fetal growth retardation was the sole anomaly in 14 cases, 11 otherwise normal newborns were small for date, 2 died at birth and 1 was malformed (1/14, 7%). In this group all fetal karyotypes were normal and in 2 cases amniotic fluid AFP were increased. In the 32 pregnancies without abnormal amniotic fluid volume and/or FGR and with fetal malformation(s) suggested by ultrasound, all malformations except one (ovarian cyst possibly ruptured during birth) were confirmed at birth, amniotic fluid AFP was elevated, and/or karyotype was abnormal in 6 cases. In 42 pregnancies where more than one alarm sign was present, abnormal karyotype and/or elevated amniotic fluid AFP level were recorded in 21 of the 39 cases where amniocentesis was performed, 33 fetuses were malformed (79%) and 13 died in the perinatal period (31%). The high incidence of abnormal results of amniocentesis found in this survey of pathological pregnancies, particularly in those with multiple alarm signs, emphasizes the need for amniocentesis in these situations.
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Avni F, Kalifa G, Sauvegrain J. Gastric and duodenal duplications in infants and children. Ann Radiol (Paris) 1980; 23:195-202. [PMID: 7369684] [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: 01/24/2023]
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