PubMed | Service dimagerie pediatrique et prenatale, Service de radiologie adultes et neuroradiologie, BiosTIC and Service de radiologie et imagerie medicale
Type: Journal Article | Journal: Diagnostic and interventional imaging | Year: 2016
The goals of this study were to develop and evaluate a joint theoretical/practical training course for radiology residents and technicians and to start a collaborative practice agreement enabling radiology technicians to perform PICC placement under the responsibility of an interventional radiologist.A joint training session based on literature evidences and international recommendations was designed. Participants were assessed before and after training, and were also asked to evaluate the program one month after completion of the training course. Practical post-training mentoring guidelines were laid down for radiologists supervising technicians.From January to April 2014, 6 radiology residents and 12 radiology technicians from the two interventional radiology departments of the University hospitals in Marseille took part in the training program. For both residents and technicians, significant improvement was observed between pretraining and post-training assessment. The majority of participants were satisfied with the program.Our experience suggests that combined theoretical and practical training in PICC placement allows improving technical skill and yields high degrees of satisfaction for both radiology residents and technicians. A collaborative practice agreement is now formally established to enable radiologists to delegate PICC placement procedures to radiology technicians.
Da Ines D.,Service de Radiologie et Imagerie Medicale |
Petitcolin V.,Service de Radiologie et Imagerie Medicale |
Joubert-Zakeyh J.,Service dAnatomopathologie |
Demeocq F.,Service de Pediatrie Generale et Multidisciplinaire |
Garcier J.-M.,Service de Radiologie et Imagerie Medicale
Pediatric Radiology | Year: 2010
Epithelioid hemangioendothelioma of the liver is a very rare vascular tumour in children with intermediate malignant potential. We present a case in which the typical imaging appearances of coalescent peripheral hepatic masses with capsular retraction contributed to the diagnosis. A positron emission tomography-CT (PET-CT) procedure was performed in staging the disease with a strong suspicion of coeliac nodal involvement confirmed after laparotomy and histological analysis. Our case is unique because of the rarity of the disease, the young age of the child, and proven nodal metastases at initial diagnosis. The use of PET-CT allows better staging at initial diagnosis and thus better management with improved follow-up in these patients. © 2010 Springer-Verlag.
PubMed | Service durologie, Institute Paoli Calmettes, Service danatomie pathologique, Service de radiologie et imagerie medicale and 2 more.
Type: | Journal: Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie | Year: 2016
To report oncological outcomes of patients with prostate cancer undergoing active surveillance according to SURACAP criteria.This multicentric study included patients who were initially treated with active surveillance for localized prostate cancer according to the SURACAP criteria. The duration of active surveillance as well as the causes of discontinuing the protocol and the definitive pathological results of patients who further underwent radical prostatectomy were retrospectively evaluated. The predictors of discontinuing active surveillance were assessed using a univariable Cox Model. In addition, the predictive value of initial MRI was assessed for patients who performed such imagery.Between 2007 and 2013, 80 patients were included, with a median age of 64 years [47-74]. Median follow-up was 52.9 months [24-108]. At 5 years follow-up, 43.4% patients were still under surveillance. Among patients that underwent surgery, 17.8% had an extra-capsular extension. The risk of discontinuing was not significantly greater for patients with tumor size of 2 or 3mm versus 1mm (HR=0.9 [0.46-1.75], P=0.763), 2 positives cores versus 1 (HR=0.98 [0.48-2.02], P=0.967), T2a vs. T1c stage (HR=2.18 [0.77-6.18], P=0.133), increased PSA level (HR=1 [0.96-1.15], P=0.975) or the patients age (HR=1 [0.93-1.16], P=0.966). Among the 50 patients who performed initial MRI, the results of such imagery was not significantly associated to the risk of discontinuing active surveillance MRI (HR=1.49 [0.63-3.52], P=0.36).Although this study reveals a high rate of release from active surveillance at 5 years, the rate of extra-capsular tumors reported in the group of patients that underwent surgery is among the lowest in literature.4.
Eyssartier E.,Service de Chirurgie Pediatrique Viscerale |
Ang P.,Unite de Specialites Pediatriques |
Bonnemaison E.,Unite de Specialites Pediatriques |
Gibertini I.,Unite de Specialites Pediatriques |
And 9 more authors.
Pediatric Pulmonology | Year: 2014
Primary endobronchial tumors are rare in children and they include a broad spectrum of lesions. The aim of this study was to determine the characteristic features, treatments and outcomes of these tumors. We report a retrospective analysis of all patients treated for endobronchial tumor in nine French hospitals between 1990 and 2010 and a comparison of the results with those reported in the medical literature. Twelve tumors were reported: five low grade muco epidermoid carcinomas, two inflammatory myofibroblastic tumors, two hemangiomas, one anaplastic large cell lymphoma, one carcinoid tumor, and one juvenile xanthogranuloma. The mean age of the patients was 7.5 ± 3.5 years. The most common sign revealing the disease was persistent atelectasis or recurrent pneumonia (eight cases). The other revealing signs were a persistent bronchospasm (three cases) and hemoptysis (one case). The clinical presentation, biology, serum tumor markers, and chest X-ray abnormalities were not specific to a particular histological diagnosis. Chest CT scan revealed the presence of an endobronchial tumor in 11 cases. Nine tumors could be diagnosed from a biopsy obtained by video endoscopy. Complete surgical resection was performed in seven patients. Bronchoscopic removal was performed in five cases and was successful in three. There were no deaths. Endobronchial tumors are rare in childhood and their histology is diverse. Chest CT scan and per-endoscopic endobronchial biopsies are required for diagnosis, when possible. Surgical or endoscopic treatment should be discussed by a multidisciplinary team. Despite the multiple etiologies, the prognosis of these tumors is good if diagnosis is early and if resection is complete. Long-term recurrences have been described, so long-term follow-up of these children is recommended. © 2014 Wiley Periodicals, Inc.
Preoperative angiographic CT-scan imaging for perforator flaps transfer. Clinical applications in an emergency unit of reconstructive surgery: Case report [Intérêt de l'angio-TDM dans la chirurgie des lambeaux perforants. Applications dans une unité de chirurgie plastique et reconstructrice. À propos de quatre cas cliniques]
Bosc R.,Service de chirurgie plastique |
Hivelin M.,Service de chirurgie plastique |
Benjoar M.-D.,Service de chirurgie plastique |
Pigneur F.,Service de radiologie et imagerie medicale |
Lantieri L.,Service de chirurgie plastique
Annales de Chirurgie Plastique et Esthetique | Year: 2010
Our experience of the deep inferior epigastric artery perforator flap has led us to perform systematically an abdominal CT-scan for the pretherapeutic checking. This exam gives us a precise vascular mapping of musculocutaneous and septocutaneous perforators artery of the flap, may enable a better orientation in the dissection and reduce the surgery time. We have enlarged the indication of this exam to the members flaps who needs the dissection of a musculocutaneous or a septocutaneous perforators vessels: Nakajima's et al. classification . The mapping of perforating vessels on 3D reconstruction pictures helps us to planify the vascular cutaneous autologous grafts. © 2009 Elsevier Masson SAS.
Eyssartier E.,Service de Chirurgie Pediatrique Viscerale |
Villemagne T.,Service de Chirurgie Pediatrique Viscerale |
Maurin L.,Service de Radiologie et Imagerie Medicale |
Machet M.C.,Service dAnatomie et de Cytologie Pathologiques |
Lardy H.,Service de Chirurgie Pediatrique Viscerale
Journal of Pediatric Urology | Year: 2013
Lipoblastomas are rare benign mesenchymal tumors of fetal white fat tissue appearing most commonly in children under 3 years of age, and usually affecting the extremities. Only nine cases of intrascrotal lipoblastoma have been reported to our knowledge, and although they are benign, in one case an orchidectomy was performed. We describe two new cases of intrascrotal lipoblastoma, and review the literature.
Coutton C.,Laboratoire Of Genetique Chromosomique |
Coutton C.,Joseph Fourier University |
Poreau B.,Service de Genetique Clinique |
Devillard F.,Laboratoire Of Genetique Chromosomique |
And 8 more authors.
Molecular Syndromology | Year: 2014
Holoprosencephaly (HPE) is the most common forebrain defect in humans. It results from incomplete midline cleavage of the prosencephalon and can be caused by environmental and genetic factors. HPE is usually described as a continuum of brain malformations from the most severe alobar HPE to the middle interhemispheric fusion variant or syntelencephaly. A microform of HPE is limited to craniofacial features such as congenital nasal pyriform aperture stenosis and single central maxillary incisor, without brain malformation. Among the heterogeneous causes of HPE, point mutations and deletions in the SHH gene at 7q36 have been identified as well as extremely rare chromosomal rearrangements in the long-range enhancers of this gene. Here, we report a boy with an HPE microform associated with a Currarino syndrome. Array CGH detected a de novo 2.7-Mb deletion in the 7q36.3 region including the MNX1 gene, usually responsible for the Currarino triad but excluding SHH, which is just outside the deletion. This new case provides further evidence of the importance of the SHH long-range enhancers in the HPE spectrum. © 2013 S. Karger AG, Basel.
PubMed | Grenoble University Hospital Center, Service de Genetique Clinique, Laboratoire Of Genetique Chromosomique, Joseph Fourier University and Service de Radiologie et Imagerie Medicale
Type: Journal Article | Journal: Molecular syndromology | Year: 2014
Holoprosencephaly (HPE) is the most common forebrain defect in humans. It results from incomplete midline cleavage of the prosencephalon and can be caused by environmental and genetic factors. HPE is usually described as a continuum of brain malformations from the most severe alobar HPE to the middle interhemispheric fusion variant or syntelencephaly. A microform of HPE is limited to craniofacial features such as congenital nasal pyriform aperture stenosis and single central maxillary incisor, without brain malformation. Among the heterogeneous causes of HPE, point mutations and deletions in the SHH gene at 7q36 have been identified as well as extremely rare chromosomal rearrangements in the long-range enhancers of this gene. Here, we report a boy with an HPE microform associated with a Currarino syndrome. Array CGH detected a de novo 2.7-Mb deletion in the 7q36.3 region including the MNX1 gene, usually responsible for the Currarino triad but excluding SHH, which is just outside the deletion. This new case provides further evidence of the importance of the SHH long-range enhancers in the HPE spectrum.
PubMed | Service de Chirurgie Generale, Service de Medecine Interne and Service de Radiologie et Imagerie Medicale
Type: | Journal: The Pan African medical journal | Year: 2016
Wandering or migrating spleen is a rare anomaly which is usually described in children. Complications, which include pedicle torsion, are common and can be life-threatening. We report the case of a 17 year-old patient with a long past medical history of epigastric pain suffering from wandering spleen with chronic torsion of the pedicle. The clinical picture was marked by spontaneously painful epigastric mass, evolved over the past 48 hours. Abdominal ultrasound objectified heterogeneous hypertrophied ectopic spleen in epigastric position and a subcapsular hematoma. Doppler showed a torsion of splenic pedicle which was untwisted 2 turns and a small blood stream on the splenic artery. Abdominal CT scan with contrast injection showed a lack of parenchymal enhancement of large epigastric ectopic spleen and a subcapsular hematoma. The diagnosis of wandering spleen with chronic torsion of the pedicle complicated by necrosis and subcapsular hematoma was confirmed. The patient underwent splenectomy. The postoperative course was uneventful. We here discuss the contribution of ultrasound and CT scan in the diagnosis of wandering spleen with chronic torsion of the pedicle.
PubMed | Service de radiologie et imagerie medicale
Type: Case Reports | Journal: Diagnostic and interventional imaging | Year: 2012
One per cent of cases of mechanical occlusion of the small intestine are caused by internal hernias, the rarest type being an internal hernia through the broad ligament of the uterus, and representing approximately 5% of cases. While conventional treatment of mechanical occlusions of the small intestine is based on laparotomy, a laparoscopic approach is feasible in nearly half of cases, with an acceptable rate of morbidity. Preoperative diagnosis has for a long time been difficult but the usefulness has recently been emphasized of computed tomography. We report the cases of two patients who presented an internal hernia of the right broad ligament diagnosed with CT who afterwards underwent laparoscopic surgery.