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1.
Prog Urol ; 32(2): 115-120, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34148768

RESUMO

PURPOSE: To report our preliminary experience with water vapor thermal therapy with the Rezum™ System and Prostate Artery Embolization (PAE) for treatment of medically refractory, complete urinary retention to achieve successful cessation of catheter dependency in frail-patients. PATIENTS AND METHODS: A multi-institutional study was conducted including all patients who underwent Rezum™ procedure and PAE between October 2017 and June 2020. The included population focused on frail-patients unsuitable for conventional surgery with complete urinary retention. Rezum™ patients were identified and matched (1:1) with patients who underwent PAE. The matching criteria were age, Charlson score, prostate volume and duration of follow-up. The primary outcome was catheter-free survival, defined as spontaneous voiding and release from catheter dependence. RESULTS: Eleven patients from the Rezum™ group were matched to 11 embolized patients. PAE and Rezum™ patients were comparable in age (median: 77 vs. 75 years), Charlson score (median: 6 vs. 6) and prostate volume (74 vs. 60 cc). Procedures were significantly longer in the PAE group compared to the Rezum™ procedures (median: 148 vs. 8min, P<0.001). After a median follow-up of 12 months, spontaneous voiding was conserved in all cases (100%) after the Rezum™ procedure and in 5 cases (45.4%) after PAE (P=0.01). In catheter-free patients, the rate of benign prostatic hyperplasia medication use after procedure was 40% for PAE and 18.2% for Rezum™ patients (P=0.54). CONCLUSIONS: Our preliminary experience for treatment of complete urinary retention in frail-patients shows the feasibility of PAE and Rezum™ to restore spontaneous urination without being associated with the occurrence of major complications. Early data suggests that Rezum™ may provide superior results in terms of cessation of catheter dependence. Future studies are needed to definitively assess which treatment would be best suited for each patient. LEVEL OF EVIDENCE: 3.


Assuntos
Embolização Terapêutica , Sintomas do Trato Urinário Inferior , Hiperplasia Prostática , Artérias , Cateteres de Demora , Humanos , Sintomas do Trato Urinário Inferior/terapia , Masculino , Próstata , Hiperplasia Prostática/complicações , Hiperplasia Prostática/terapia , Vapor , Resultado do Tratamento , Cateterismo Urinário , Cateteres Urinários
2.
Prog Urol ; 31(5): 249-265, 2021 Apr.
Artigo em Francês | MEDLINE | ID: mdl-33478868

RESUMO

OBJECTIVE: The aim of the Male Lower Urinary Tract Symptoms Committee (CTMH) of the French Urology Association was to propose an update of the guidelines for surgical and interventional management of benign prostatic obstruction (BPO). METHODS: All available data published on PubMed® between 2018 and 2020 were systematically searched and reviewed. All papers assessing surgical and interventional management of adult patients with benign prostatic obstruction (BPO) were included for analysis. After studies critical analysis, conclusions with level of evidence and French guidelines were elaborated in order to answer the predefined clinical questions. RESULTS/GUIDELINES: Offer a trans-uretral incision of the prostate to treat patients with moderate to severe lower urinary tract symptoms (LUTS) with a prostate volume<30cm3, without a middle lobe. TUIP increases the chances of preserving ejaculation. Propose mono- or bipolar trans-urethral resection of the prostate (TURP) to treat patients with moderate to severe LUTS with a prostate volume between 30 and 80cm3. Vaporization by Greenlight™ or by bipolar energy can be offered as an alternative to TURP. Offer a Greenlight™ laser vaporization to patients at risk of bleeding. Offer endoscopic prostate enucleation to surgically treat patients with moderate to severe LUTS as an alternative to TURP and open prostatectomy (OP). Minimally invasive prostatectomy is an alternative to OP in centers without access to adequate endoscopic procedures. Embolization of the prostatic arteries may be offered in the event of a contraindication or refusal of surgery for prostates with a volume>80cm3. Prostatic uretral lift is an alternative in patients interested in preserving their ejaculatory function and with a prostate volume<70cm3 without a middle lobe. Aquablation and Rezum™ are under evaluation and should be offered in research protocols. CONCLUSION: Major changes in surgical management of BPO have occurred and aim at reducing morbidity and improving quality of life of patients.


Assuntos
Hiperplasia Prostática/cirurgia , Obstrução Uretral/cirurgia , Humanos , Masculino , Prostatectomia/métodos , Prostatectomia/normas , Hiperplasia Prostática/complicações , Obstrução Uretral/etiologia
3.
Prog Urol ; 31(5): 266-274, 2021 Apr.
Artigo em Francês | MEDLINE | ID: mdl-33358720

RESUMO

INTRODUCTION: New surgical techniques for the treatment of benign prostatic obstruction (BPO) have emerged in recent years. We sought to give an overview on each of these technologies. MATERIAL: A comprehensive review of the literature between 2013 and 2020 was carried out by a panel of national experts already practicing these interventions. All the data were then discussed among all the co-authors in order to obtain a consensus with regard to the selected articles and their analysis. Finally, an inventory was drawn to provide an overview of these technological advances and their availability in France. RESULTS: The treatment benign prostatic obstruction has diversified greatly over the past 5 years. 5 new technologies have emerged, allowing today a transurethral non-ablative treatment (UROLIFT®, ITIND®), a transurethral ablative treatment (REZUM®), a transurethral ablative treatment with robotic assistance (AQUABEAM®) or an endovascular management by embolization of the prostatic arteries. Only UROLIFT® is considered an established technology in the latest EAU-Guidelines. The other four are under evaluation and recommendations have only been issued for two of them, AQUABEAM® and the embolization of the prostatic arteries. CONCLUSION: These new minimally invasive techniques aim to increase the therapeutic options for the management of BPO in order to offer a management more suited to the wishes of the patient. Some are positioned as an alternative to surgical or medical treatment, others between medical and surgical treatment. These technologies are not all at the same level of development, evaluation and level of proof, but have in common a limited distribution in France, in particular given their cost. Validated studies will allow them to position their subsequent use more precisely.


Assuntos
Hiperplasia Prostática/cirurgia , Obstrução Uretral/cirurgia , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos , Prostatectomia/métodos , Hiperplasia Prostática/complicações , Obstrução Uretral/etiologia
4.
Prog Urol ; 30(12): 624-631, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32826195

RESUMO

PURPOSE: To report the results of convective radiofrequency (RF) water vapor thermal therapy in men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) with one-year follow-up evaluation. MATERIAL AND METHOD: The study was conducted in 2 French hospitals, for men with moderate to severe LUTS secondary to BPH, as an alternative to classical surgery treatment. The pre- and postoperative evaluation of urinary symptomatology was based on the International Prostate Symptom Score (IPSS) questionnaire, measures of peak urinary flow rate (Qmax) and post-void residual volume (PVR). Erectile and ejaculatory functions were evaluated via the IIEF5 and MSHQ-ejd questionnaires. Rates of retreatment and complications were also reported. RESULTS: Sixty-two outpatients including 8 with urinary retention were treated. The median preoperative prostate volume was 47 (27-200) mL. At 6months postoperative, the IPSS had decreased significantly by 13.9 points (68.1%, P<0.001) and, at one year, by 12 points (61.5%, P<0.001). The quality of life (QoL) score at one year had decreased by 3.2 points (P<0.001) and the Qmax had improved by 6mL/s (P<0.001). All patients with urinary retention were weaned from bladder catheterization. No serious side effects (>Clavien II) were observed. No cases of de novo erectile dysfunction and an anejaculation rate of 10.8% was reported. The surgical retreatment rate at one year was 2.1%. CONCLUSION: The short-term results are encouraging, with significant efficacy on urinary symptoms and respect of sexual function. Nevertheless, it will be necessary to pursue the follow-up of this cohort to evaluate the mid-term and long-term evolution. LEVEL OF EVIDENCE: 3.


Assuntos
Sintomas do Trato Urinário Inferior , Hiperplasia Prostática , Humanos , Hiperplasia , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Próstata , Hiperplasia Prostática/complicações , Hiperplasia Prostática/cirurgia , Qualidade de Vida , Vapor , Resultado do Tratamento
5.
Eur J Obstet Gynecol Reprod Biol ; 248: 227-232, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32248048

RESUMO

OBJECTIVE: The benefits of restaging surgery for patients with a borderline ovarian tumor (BOT) discovered on initial surgery are debatable. We performed a meta-analysis to evaluate the role of restaging surgery on recurrence in patients with BOTs. STUDY DESIGN: We systematically reviewed published studies comparing restaging surgery and incomplete surgery in BOT patients from January 1985 to December 2017. Endpoints were recurrence and mortality rates. Study design features that possibly affected participant selection, reporting of recurrence and death, and manuscript publication were assessed. For pooled estimates of the effect of restaging surgery on recurrence, fixed-effect meta-analytical models were used. RESULTS: Of the 577 articles initially selected, four retrospective observational studies (Restaging group: 166 patients; Non-Restaging group: 394 patients) met our research criteria. No significant differences in terms of recurrence between the two groups were observed (pooled Peto Odds Ratio [OR] = 0.88; 95 % confidence interval [CI]: 0.41-1.92). The number of deaths was insufficient for statistical analysis. CONCLUSIONS: This meta-analysis based on retrospective studies, suggests that restaging surgery does not significantly reduce recurrence in patients with BOT.


Assuntos
Carcinoma Epitelial do Ovário/cirurgia , Neoplasias Ovarianas/cirurgia , Adulto , Carcinoma Epitelial do Ovário/mortalidade , Feminino , Humanos , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Estudos Observacionais como Assunto , Neoplasias Ovarianas/mortalidade , Reoperação/efeitos adversos , Reoperação/métodos , Estudos Retrospectivos
6.
Prog Urol ; 29(7): 371-377, 2019 Jul.
Artigo em Francês | MEDLINE | ID: mdl-31027871

RESUMO

OBJECTIVE OF THE STUDY: To analyze the medium-term results and complications of the artificial urinary sphincter (AUS) AMS 800 implanted using laparoscopic robot surgery in women with stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD). DESIGN, SETTING, AND PARTICIPANTS: We conducted a prospective cohort study, which included all procedures done in the CHU of Nîmes from July 2015 to January 2017. Patients with SUI by ISD needing an AUS or patients with a malfunctioning AUS needing to be changed were included. We collected data on intraoperative complications, length of hospitalization, postoperative complications, continence rate at twelve months and satisfaction of patients. RESULTS: Nineteen patients were included, 10 for primo-implantation and 9 for AUS revision. There were 4 postoperative bladder injuries, of which 2 led to laparoconversions. The mean length of hospitalization was 4.1days. Three patients had postoperative complications, which needed an intervention without AUS removal. One patient with persisting SUI due to bladder weakness preferred AUS ablation rather than having a cuff change. There was a median follow-up of 22months (12 to 33months). Sixteen patients out of 19 were completely continent and were satisfied of their intervention and the improvement of their quality of life. CONCLUSION: The laparoscopic robot surgery for AUS implantation is safe and reproducible with good medium-term results. LEVEL OF EVIDENCE: 4.


Assuntos
Laparoscopia , Procedimentos Cirúrgicos Robóticos , Incontinência Urinária por Estresse/cirurgia , Esfíncter Urinário Artificial , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Complicações Intraoperatórias/epidemiologia , Tempo de Internação , Pessoa de Meia-Idade , Satisfação do Paciente , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Implantação de Prótese/métodos , Fatores de Tempo , Resultado do Tratamento , Esfíncter Urinário Artificial/efeitos adversos , Procedimentos Cirúrgicos Urológicos/métodos
8.
Prog Urol ; 27(6): 351-361, 2017 May.
Artigo em Francês | MEDLINE | ID: mdl-28483482

RESUMO

INTRODUCTION: Complications of prostate cancer treatments are responsible of a lower quality of life. We evaluated the prevalence and the perceptions of sexual consequences of prostate cancer treatments. MATERIALS AND METHODS: A retrospective self-administered questionnaire was sent to all the members of the Association Nationale des Malades du Cancer de la Prostate (ANAMACAP). All the answers were analyzed. RESULTS: 226 questionnaires were analyzed, the average age was 67.3 years old, the average follow-up was 58.1 months. 110 patients had surgery only, 29 had hormone therapy plus radiotherapy, 28 had radiation therapy only and 49 had combined treatments. After the treatment of the prostate cancer, an erectile dysfunction was reported by 75.2% of the patients; an orgasmic dysfunction by 69%; a climacturia by 21%; a reduced penile length by 70% of them and a less sensitive glans by 59%. They were responsible of a lower quality of life for 75% to 90% of the patients depending on the symptom. A PDE5-inhibitor treatment was effective for only 25.6% of them when taken daily and for 39% on demand. CONCLUSION: Functional consequences of prostate cancer treatments are common, diverse and directly involved in the sexual life. It is necessary to improve therapeutical education and onco-sexology with the help of patients' associations, to build a new balance in the couples. LEVEL OF EVIDENCE: 3.


Assuntos
Neoplasias da Próstata/terapia , Disfunções Sexuais Fisiológicas/etiologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Autorrelato , Grupos de Autoajuda
10.
Prog Urol ; 27(4): 238-243, 2017 Mar.
Artigo em Francês | MEDLINE | ID: mdl-28043779

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of the adjustable suburethral sling Remeex® in the treatment of male stress urinary incontinence (SUI). PATIENTS AND METHODS: Single-center prospective study of patients treated for SUI after radical prostatectomy or transurethral resection of prostate. The severity of incontinence was evaluated by the number of pads used per day. Success rate, complications and number of adjustments were studied. RESULTS: From February 2011 to May 2015, Remeex® was implanted in 25 patients. The average preoperative number of pads used per day was 3,8 (±1,8). Sling tension has been adjusted the day after surgery in all patients. Mean follow-up was 31 months (±15). During follow-up, 6 patients did not need any readjustment (24%) and 15 patients (60%) had to be readjusted. One Remeex system had to be completely removed because of a sub-occlusive syndrome. Three patients had early infection requiring partial system removal (Varitensor). At the end of follow-up, 9 patients were cured (36%), 9 patients (36%) were significantly improved and 7 patients (28%) were not improved. Five patients are waiting for a new readjustment. CONCLUSION: In this short series of patients who had prostatic surgery, at mid-term follow-up, the placement of a BSUA-R was associated with an improvement or cure of urinary incontinence symptoms in two-thirds of cases. LEVEL OF EVIDENCE: 4.


Assuntos
Slings Suburetrais , Incontinência Urinária por Estresse/cirurgia , Idoso , Seguimentos , Humanos , Masculino , Satisfação do Paciente , Complicações Pós-Operatórias , Estudos Prospectivos , Prostatectomia/efeitos adversos , Índice de Gravidade de Doença , Ressecção Transuretral da Próstata/efeitos adversos
11.
Prog Urol ; 26(10): 566-72, 2016 Sep.
Artigo em Francês | MEDLINE | ID: mdl-27473788

RESUMO

OBJECTIVES: The main goal of our phantom study was to compare the precision of adjustable periurethral balloons positioning depending whether the guidance was obtained by retrovision or rigid cystoscopy. MATERIAL AND METHODS: A navigation guidance system was used to localize the introduction mandrel which was equipped with tracking targets. Two ideal sites of implantation were predefined and recorded into the navigation system. The two points were placed symmetrically to the phantom reproducing the urethra. Four different users were asked to position the tip of the introduction mandrel as close as possible to the ideal site of implantation with the help of each method of guidance. For each attempt, the distance (mm) between the tip of the introduction mandrel and the ideal position was recorded by the navigation system. RESULTS: For each method of guidance, a total of 20 attempts on each side were made by direct puncture on one side and a symmetrical contralateral puncture. For direct puncture, the median distances were 5.20 (±3.96) and 4.38 (±1.55) mm with rigid cystoscopy and retrovision respectively (P=0.29). For symmetrical contralateral puncture, the median distance were 7,19 (±3,78) and 6,86 (±2,76) mm with rigid cystoscopy and retrovision respectively (P=0,32) CONCLUSION: This study could not demonstrate any significant difference between the two guidance systems. Nevertheless, it showed that navigation guidance system could be used to compare the precision of surgical interventions. LEVEL OF EVIDENCE: 4.


Assuntos
Cistoscopia/métodos , Imagens de Fantasmas , Uretra , Cistoscópios
12.
Prog Urol ; 26(10): 558-65, 2016 Sep.
Artigo em Francês | MEDLINE | ID: mdl-27052819

RESUMO

OBJECTIVES: To evaluate the impact of laparoscopic sacrocolpopexy on symptoms, health-related quality of life and sexuality after a 36 month-follow-up. We also reported anatomical outcomes and reoperation rate. PATIENTS AND METHODS: A prospective monocentric study was carried out including 82 women with symptomatic Pelvic Organ Prolapse (POP) stage≥2 according to Pelvic Organ Prolapse Quantification classification. Symptoms were evaluated using the Pelvic Floor Distress Inventory (PFDI-20) and health-related quality of life by the Pelvic Floor Impact Questionnaire (PFIQ-7). Sexual function was evaluated using the Pelvic Incontinence Sexual Questionnaire (PISQ-12). Measurements were recorded at the preoperative examination, then at 3, 12 and 36 months after surgery. RESULTS: PFDI-20 scores were significantly improved at 3 months (91.9 vs. 31.8, P<0.05) and PFIQ-7 scores also (60.8 vs. 16, P<0.05). This scores improvement remained significant at 12 months. There was no significant difference between results obtained at 12 and 36 months for PFDI-20 (36.8 vs. 42.2, P>0.05) and for PFIQ-7 (18.4 vs. 24.7, P>0.05). PISQ-12 score remained significantly improved at 3, 12 and 36 months compared to baseline (34.8, 35.3, 38.5 and 38.5, respectively). Ten patients (12.8%) had anatomical recurrence at 36 months for posterior compartment, 4 (5.1%) for anterior compartment and 1 (1.2%) for medium compartment. Four patients (4.9%) required reintervention. CONCLUSION: Laparoscopic sacrocolpopexy improved early functional outcome that remained significant after at least a 36 months follow up. LEVEL OF EVIDENCE: 4.


Assuntos
Laparoscopia , Prolapso de Órgão Pélvico/cirurgia , Qualidade de Vida , Autorrelato , Sexualidade/fisiologia , Colo do Útero , Feminino , Seguimentos , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Sacro , Avaliação de Sintomas , Fatores de Tempo , Vagina
13.
Prog Urol ; 26(5): 295-303, 2016 Apr.
Artigo em Francês | MEDLINE | ID: mdl-26971674

RESUMO

INTRODUCTION: Robot-assisted partial nephrectomy rapidly took on among urologists, even though studies showing its superiority over other techniques are still scarce and its costs hard to evaluate, especially in the French medical system. OBJECTIVE: To evaluate the cost overrun of robot-assisted partial nephrectomy compared to that of open partial nephrectomy. EQUIPMENT AND METHODS: From January 2010 to December 2013, 77 patients underwent a partial nephrectomy, 46 of which by robot-assisted laparoscopy and the remaining 31 by lombotomy. The two groups were similar in composition. Economic data regarding the staff, the consumables and the premises involved have been analyzed. RESULTS: Costs are significantly higher in the NPR group (9253.21 euros vs. 7448.42 euros) due to higher consumable expenses as well as the costs pertaining to the amortization and maintenance of the robot. Yet, that difference tends to diminish as the duration of the experiment increases. No significant difference was found in warm ischemia times, operation duration and renal function a month after the operation. On the other hand, patients from the NPR group spent a significantly smaller amount of time in recovery room (159 minutes vs. 205 minutes, P=0.004), presented fewer complications and were discharged faster (6.1 days vs. 8.1 days, P=0.04). CONCLUSIONS: To be profitable for the hospital in the French GHS system, robot-assisted partial nephrectomy must take place in a complex where at least 300 robot-assisted interventions are performed annually, in the framework of a hospitalization lasting four days or less, the use of a single needle holder and no systematic use of a haemostatic agent. LEVEL OF EVIDENCE: 4.


Assuntos
Neoplasias Renais/cirurgia , Laparoscopia , Nefrectomia , Procedimentos Cirúrgicos Robóticos , Índice de Massa Corporal , Feminino , França , Humanos , Laparoscopia/economia , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Nefrectomia/economia , Nefrectomia/métodos , Obesidade/complicações , Estudos Retrospectivos , Fatores de Risco , Procedimentos Cirúrgicos Robóticos/economia , Procedimentos Cirúrgicos Robóticos/métodos , Resultado do Tratamento
14.
J Gynecol Obstet Biol Reprod (Paris) ; 45(4): 372-9, 2016 Apr.
Artigo em Francês | MEDLINE | ID: mdl-26002988

RESUMO

OBJECTIVE: To describe severe complications during pregnancy requiring surgery in patients with a history of obesity surgery. MATERIEL AND METHODS: A retrospective study in a hospital with tertiary care perinatology and an obesity reference center, on all pregnancies following bariatric surgery over a 10-year period, analyzing all cases of surgical complications. RESULTS: There were 8 major complications related to the procedure in 141 pregnancies with bariatric surgery. The 2 complications in women with gastric banding were band slippage resulting in severe dysphagia, one of which leading to intractable vomiting and serious hydrolectric disorders. Among the 6 complications after bypass surgery, 4 were occlusions: 3 on internal hernias of which 2 with volvulus and 1 associated with intestinal invagination, as well as one with intestinal invagination only. One patient had a laparotomy for a suspected invagination which was not confirmed. The other surgical complications after gastric bypass were a hernia and an exploratory laparotomy for suspected intussusception which was overturned. There was no case of maternal or perinatal death. CONCLUSION: Pregnancies in patients with a history of bariatric surgery are at high risk, in particular for complications related to the surgery and thus require careful interdisciplinary surveillance, and determination of predictive factors.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Complicações na Gravidez/etiologia , Adulto , Cirurgia Bariátrica/estatística & dados numéricos , Feminino , França/epidemiologia , Hospitais Especializados/estatística & dados numéricos , Humanos , Perinatologia/estatística & dados numéricos , Gravidez , Complicações na Gravidez/epidemiologia , Estudos Retrospectivos
16.
J Gynecol Obstet Biol Reprod (Paris) ; 44(8): 787-91, 2015 Oct.
Artigo em Francês | MEDLINE | ID: mdl-25818112

RESUMO

Female sexual mutilations result in an important physical and mental suffering. A large number of women have been affected and require a global management, including surgical clitoral transposition. This surgical technique is allowing a rapid improvement of clinical symptoms. In this article, we will describe the indications and operative technique of the clitoral transposition.


Assuntos
Circuncisão Feminina/efeitos adversos , Clitóris/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Feminino , Humanos
18.
J Ultrasound ; 15(1): 7-15, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23396264

RESUMO

The supraspinatus tendon is composed of 5 different layers consisting of intertwining bundles. On a front portion of the tendon, the layers become coated bundles which insert on the trochanter. At the insertion, the superficial or bursal surface of the tendon corresponding to the tendon fibers in contact with the subacromial bursa can be distinguished from the deep surface corresponding to the fibers in contact with the glenohumeral joint. A tendon tear may involve partial or total disruption of the tendon fibers and is called full-thickness tear if it affects the entire tendon, and partial-thickness tear if it involves only part of the tendon. Partial-thickness tears of the supraspinatus tendon include lesions of the superficial, deep and central surface or tendon delamination.A contrast enhanced examination requires injection of contrast agent into the joint (arthrography followed by computed tomography (CT) or magnetic resonance imaging (MRI)) to study the deep surface, and injection into the subacromial bursa (bursography followed by CT) to study the superficial surface. MRI and ultrasound (US) examination allow the study of these different tendon layers without the use of contrast agent (which is not possible at CT).

19.
J Radiol ; 91(9 Pt 2): 1057-67, 2010 Sep.
Artigo em Francês | MEDLINE | ID: mdl-20814396

RESUMO

The new diagnostic criteria for ankylosing spondylitis include MRI. MRI frequently allows early diagnosis of inflammatory lesions in patients with normal plain films. In addition, MRI is useful for the detection and quantification of inflammatory and structural lesions, and to assess disease activity.


Assuntos
Aumento da Imagem , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Espondilite Anquilosante/diagnóstico , Adolescente , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Vértebras Lombares/patologia , Masculino , Pessoa de Meia-Idade , Articulação Sacroilíaca/patologia , Sacro/patologia , Espondilite Anquilosante/etiologia , Vértebras Torácicas/patologia , Adulto Jovem
20.
J Radiol ; 91(3 Pt 1): 271-9, 2010 Mar.
Artigo em Francês | MEDLINE | ID: mdl-20508557

RESUMO

Dedifferentiated chondrosarcomas are highly malignant tumors characterized by conventional low-grade chondrosarcoma with abrupt transition to foci that have dedifferentiated into a higher-grade noncartilaginous more aggressive sarcoma. The dedifferentiated component, an osteosarcoma or fibrosarcoma, determines the prognosis. Its identification is key for management. A diagnosis of dedifferentiated chondrosarcoma should be suggested by the presence of "tumoral dimorphism" with cartilaginous component and aggressive lytic component invading adjacent soft tissues.


Assuntos
Neoplasias Ósseas/diagnóstico , Condrossarcoma/diagnóstico , Idoso , Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Cartilagem/diagnóstico por imagem , Cartilagem/patologia , Desdiferenciação Celular , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Feminino , Fêmur/diagnóstico por imagem , Fêmur/patologia , Fibrossarcoma/diagnóstico , Fibrossarcoma/diagnóstico por imagem , Fibrossarcoma/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Osteólise/diagnóstico , Osteólise/diagnóstico por imagem , Osteólise/patologia , Osteossarcoma/diagnóstico , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/patologia , Prognóstico , Tíbia/diagnóstico por imagem , Tíbia/patologia , Tomografia Computadorizada por Raios X
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