Percutaneous CT-Guided Treatment of Osteochondritis Dissecans of the Sacroiliac Joint

Osteochondritis dissecans (OCD) is a joint disorder that affects the articular cartilage and subchondral bone, most commonly at the knee. OCD of the sacroiliac joint is extremely rare. Management of OCD remains controversial, and surgery is often needed, especially when conservative treatment fails. We present a rare case of OCD involving the left sacroiliac joint successfully treated by percutaneous computed tomography—guided retrograde drilling and debridemen

Pneumoscrotum, pneumomediastinum, pneumothorax, and pneumorrhachis following colon surgery

AbstractWe report the case of an 80-year-old man who developed a colocutaneous fistula as a complication of anastomotic leakage following segmental colonic resection. The patient presented with an abscess of the abdominal wall, subcutaneous emphysema, pneumomediastinum, pneumothorax, pneumorrhachis, and pneumoscrotum. We discuss the possible mechanisms for these unusual clinical presentations of extraperitoneal air following anastomotic leak

Infarctus du myocarde et IRM: Étude de la masse né crosée par rapport au pic de créatine kinase après un premier infarctus

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. © 2005 Elsevier SAS. Tous droits réservé s.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Urothelial Carcinoma Recurrence in an Ileal Neobladder Nine Years after Primary Surgery with Muir-Torre Syndrome

We report a patient who presented with a urothelial carcinoma recurrence developed nine years after radical cystoprostatectomy, related to Muir-Torre syndrome

Successful preoperative localization of a small pancreatic insulinoma by diffusion-weighted MRI

Context: Insulinoma is the most common functioning endocrine tumor of the pancreas responsible for fasting hypoglycemia resulting from autonomous insulin hypersecretion. Most insulinomas are small and difficult to localize with conventional imaging. We successfully localized a small insulinoma in our patient using diffusion-weighted magnetic resonance imaging before surgery. Case report: We report the case of a female patient with a clinical suspicion of insulinoma. A preoperative MR with diffusion-weighted imaging was performed and localized a small nodule in the pancreatic tail. Treatment consisted of surgical enucleation. Histologic examination identified a neuroendocrine tumor compatible with an insulinoma. Conclusion: Diffusion-weighted imaging can be useful in detecting and localizing small insulinomas, especially for those with no hypervascular pattern.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Differentiation of focal liver lesions: usefulness of parametric imaging with contrast-enhanced US.

Purpose: To evaluate whether parametric imaging with contrast material-enhanced ultrasonography (US) is superior to visual assessment for the differential diagnosis of focal liver lesions (FLLs). Materials and Methods: This study had institutional review board approval, and verbal patient informed consent was obtained. Between August 2005 and October 2008, 146 FLLs in 145 patients (63 women, 82 men; mean age, 62.5 years; age range, 22-89 years) were imaged with real-time low-mechanical-index contrast-enhanced US after a bolus injection of 2.4 mL of a second-generation contrast agent. Clips showing contrast agent uptake kinetics (including arterial, portal, and late phases) were recorded and subsequently analyzed off-line with dedicated image processing software. Analysis of the dynamic vascular patterns (DVPs) of lesions with respect to adjacent parenchyma allowed mapping DVP signatures on a single parametric image. Cine loops of contrast-enhanced US and results from parametric imaging of DVP were assessed separately by three independent off-site readers who classified each lesion as benign, malignant, or indeterminate. Sensitivity, specificity, accuracy, and positive and negative predictive values were calculated for both techniques. Interobserver agreement (κ statistics) was determined. Results: Sensitivities for visual interpretation of cine loops for the three readers were 85.0%, 77.9%, and 87.6%, which improved significantly to 96.5%, 97.3%, and 96.5% for parametric imaging, respectively (P < .05, McNemar test), while retaining high specificity (90.9% for all three readers). Accuracy scores of parametric imaging were higher than those of conventional contrast-enhanced US for all three readers (P < .001, McNemar test). Interobserver agreement increased with DVP parametric imaging compared with conventional contrast-enhanced US (change of κ from 0.54 to 0.99). Conclusion: Parametric imaging of DVP improves diagnostic performance of contrast-enhanced US in the differentiation between malignant and benign FLLs; it also provides excellent interobserver agreement

Percutaneous CT-guided treatment of osteochondritis dissecans of the sacroiliac joint.

Osteochondritis dissecans (OCD) is a joint disorder that affects the articular cartilage and subchondral bone, most commonly at the knee. OCD of the sacroiliac joint is extremely rare. Management of OCD remains controversial, and surgery is often needed, especially when conservative treatment fails. We present a rare case of OCD involving the left sacroiliac joint successfully treated by percutaneous computed tomography-guided retrograde drilling and debridement