Showing papers by "Hervé Deramond published in 2008"

3T MR imaging of postoperative recurrent middle ear cholesteatomas: value of periodically rotated overlapping parallel lines with enhanced reconstruction diffusion-weighted MR imaging.

Abstract: BACKGROUND AND PURPOSE: MR diagnostic of postoperative recurrent cholesteatomas is difficult. Our purpose was to compare multishot fast spin-echo periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) diffusion-weighted MR imaging (DWI) with array spatial sensitivity encoding technique (ASSET) single-shot echo-planar DWI and late postgadolinium T1-weighted MR imaging for the detection of postoperative recurrent middle ear cholesteatomas with a 3T imaging unit. MATERIALS AND METHODS: Thirty-five patients with suggested postoperative recurrent middle ear cholesteatoma underwent 3T MR imaging with PROPELLER DWI, ASSET echo-planar DWI, and late postgadolinium T1-weighted MR imaging. Three radiologists (2 seniors, 1 fellow) analyzed unlabeled images for visualization of recurrence. Interobserver and intraobserver agreement was assessed by using the Cohen κ statistic test. Sensitivity, specificity, and predictive value were assessed for the 3 observers. RESULTS: Nineteen recurrent cholesteatomas were diagnosed. PROPELLER interobserver agreement was very good (1, 0.89, 0.89) among the 3 observers. Intraobserver agreement between PROPELLER and T1-weighted imaging was very good to moderate (0.88, 0.57, 0.58). PROPELLER DWI provided less interobserver variability than other sequences, and the best sensitivity, specificity, and predictive value. CONCLUSIONS: On a 3T imaging unit, multishot fast spin-echo PROPELLER DWI allows an easier detection of postoperative recurrent middle ear cholesteatoma than T1-weighted imaging by reducing artifacts and by its better contrast. DWI with PROPELLER is diagnostically robust and accurate.

Cavités sinusiennes de la face : aspect scanographique des variantes anatomiques et leur risque chirurgical

Abstract: Sinonasal cavities: CT imaging features of anatomical variants and surgical risk Anatomical variants of the sinonasal cavities are common About 15 major variants are described (nasal septal deviation is present in up to 62% of the population) Because the may lead to complications at the time of endovascular procedures or endoscopic sinonasal surgery (vascular, nervous, or osseous injury), there detection has medicolegal implications Knowledge of anatomical variants by radiologists and ENT surgeons is thus required We will describe these variants, their imaging features, frequency, implications and associated risk of potential complication

Do TIAs require investigation by thin-slice high-resolution diffusion MRI with a 3T MR unit?

Abstract: A 34-year-old, right-handed man with no past medical history presented with sudden onset of paresis of the left hand and paresthesias of the left side of the body with no other neurological signs. Symptoms resolved in <1 h. Blood pressure was 140/89 mmHg and body mass index was 23. Cardiological examination was normal. Electrocardiogram, 24-h ECG monitoring, transthoracic and transoesophageal echocardiography and duplex Doppler ultrasound were all normal. Standard blood tests were normal (blood glucose: 4.14 mM, LDL-cholesterol: 1 g/l, screening tests for autoimmune diseases and infectious causes were negative, absence of acquired or inherited thrombophilia). The 3T MR imaging (General Electric Medical System; HDX, Milwaukee, WI, USA) was performed 10 h after onset of the symptoms (Fig. 1). The examination protocol included classical Axial Diffusion (5-mm slice, 1-mm gap, 1 NEX, matrix 128*128, TR/TE 8000/85.8, b = 0.1000 s/mm, FOV 24*24, direction 6, duration 1:12, 24 slices), Axial thin-slice high-resolution diffusion (3-mm slice, 0.5-mm gap, 2NEX, matrix 192*160, TR/ TE 10000/86.4, b = 0.1000 s/mm, FOV 24*24, direction 6, duration 2:40, 39 slices). Voxel volumes obtained were 17.6 mm for classical diffusion and 5.6 mm for TSHRDWI. Classical diffusion was scanned first and time elapsed between the two sequences was 5 min. Images analysis was performed on Advantage Windows. Classical diffusion MRI was normal, thin-slice high-resolution diffusion (TSHRDWI) revealed a 2 mm hypersignal (lesion volume: 12 mm) on the right frontal cortical motor area with a 30% decrease of apparent coefficient diffusion. The site of this image matched clinical symptoms, leading to the conclusion of ischaemic stroke in a distal territory of the middle cerebral artery of unknown origin with a rapidly favourable outcome. The patient received 160 mg aspirin daily.

An uncommon imaging aspect of recurrent cholesteatoma: the donut.

Abstract: The syringe can then be fixed to the outflow end of the spacer as the diameter of the barrel is a compatible size to this with a snug fit (see Fig. 1). The irrigation end of the syringe will fit securely onto a paediatric tracheostomy tube. Increased compliance with inhaled bronchodilator therapy and a reduction in the need for nebulised steroid and bronchodilator was seen in our patient using this device. Conclusion