Suspected invasive placenta: evaluation with magnetic resonance imaging.

Purpose: To determine the utility of magnetic resonance imaging (MRI) in diagnosing invasive placenta (IP).

Materials And Methods: MRI findings in 32 women with suspected IP were evaluated independently by four readers. Interobserver agreement was calculated with kappa (κ) statistics.

Three-dimensional MDCT angiography of splanchnic arteries: pearls and pitfalls.

Fast scanning along with high resolution of multidetector computed tomography (MDCT) have expanded the role of non-invasive imaging of splanchnic arteries. Advancements in both MDCT scanner technology and three-dimensional (3D) imaging software provide a unique opportunity for non-invasive investigation of splanchnic arteries. Although standard axial computed tomography (CT) images allow identification of splanchnic arteries, visualization of small or distal branches is often limited.

Postpartum hemorrhage resulting from pelvic pseudoaneurysm: a retrospective analysis of 588 consecutive cases treated by arterial embolization.

Objective: This study was designed to determine the incidence of arterial pseudoaneurysm in patients presenting with postpartum hemorrhage (PPH), to analyze the angiographic characteristics of pseudoaneurysms that cause PPH, and to evaluate the effectiveness of pelvic arterial embolization for the treatment of this condition.

Study Design: Eighteen women with pelvic arterial pseudoaneurysm were retrieved from a series of 588 consecutive patients with PPH treated by arterial embolization. Clinical files, angiographic examinations, and procedure details were reviewed.

[Post-partum haemorrhage associated with genital tract lacerations: series of 44 cases].

Objectives: Genital tract lacerations are responsible for potentially serious postpartum hemorrhage (PPH), and are often underestimated. The objective of this study was to analyze the characteristics of genital tract lacerations associated with severe PPH in a reference center.

Patients And Methods: All women transferred for treatment of PPH due to genital tract lacerations between January 2008 and April 2011 were included in this observational study.

Placental vascularity and resorption delay after conservative management of invasive placenta: MR imaging evaluation.

Objectives: To assess the potential of magnetic resonance (MR) imaging in evaluating placental vascularity and predicting placental resorption delay after conservative management of invasive placenta.

Methods: MR examinations of 23 women with conservative management of invasive placenta were reviewed. Twelve women had pelvic embolisation because of postpartum haemorrhage (Group 1) and 11 had no embolisation (Group 2).

Impact of 64-slice coronary CT on the management of patients presenting with acute chest pain: results of a prospective two-centre study.

Objective: Our two-centre prospective study evaluates the usefulness of 64-slice coronary computed tomography (CCT) to rule out significant coronary artery stenosis in patients admitted in emergency departments (ED) for acute coronary syndromes (ACS) with low-to-intermediate risk score.

Methods: Patients (175) admitted for acute chest pain (ACP), unmodified electrocardiogram and first troponin measurement within normal ranges were included. A second troponin measurement and a 64-slice CCT within 24 h were performed.

[Transfers for postpartum haemorrhage in a Reference center (Lariboisière hospital): our experience during two years (2008 and 2009)].

Objectives: The postpartum haemorrhage (PPH) is the main cause of maternal mortality and is responsible in France every year of a quarter of the maternal deaths. We realized a study on the transfers for postpartum haemorrhage in 2008 and 2009 in a Reference center (Lariboisière Hospital).

Patients And Methods: It is a descriptive retrospective study over a period of two years, including all the patients cared for a postpartum haemorrhage.

Predictive factors of advanced interventional procedures in a multicentre severe postpartum haemorrhage study.

Purpose: Severe postpartum haemorrhage (SPPH) is the leading cause of peripartum hysterectomy and maternal death. There are no easily measurable parameters that indicate the failure of medical therapy and the need for an advanced interventional procedure (AIP) to stop genital tract bleeding. The aim of the study was to define factors predictive of the need for an AIP in the management of emergent PPH.

Conservative two-step procedure including uterine artery embolization with embosphere and surgical myomectomy for the treatment of multiple fibroids: preliminary experience.

Objective: To evaluate the feasibility and safety of combined uterine artery embolization (UAE) using embosphere and surgical myomectomy as an alternative to radical hysterectomy in premenopausal women with multiple fibroids.

Materials And Methods: Mid-term clinical outcome (mean, 25 months) of 12 premenopausal women (mean age, 38 years) with multiple and large symptomatic fibroids who desired to retain their uterus and who were treated using combined UAE and surgical myomectomy were retrospectively analyzed. In all women, UAE alone was contraindicated because of large (>10 cm) or subserosal or submucosal fibroids and myomectomy alone was contraindicated because of too many (>10) fibroids.

Differentiation between cavernous hemangiomas and untreated malignant neoplasms of the liver with free-breathing diffusion-weighted MR imaging: comparison with T2-weighted fast spin-echo MR imaging.

Objective: To test interobserver variability of ADC measurements and compare the diagnostic performances of free-breathing diffusion-weighted (FBDW) with that of T2-weighted FSE (T2WFSE) MR imaging for differentiating between cavernous hemangiomas and untreated malignant hepatic neoplasms.

Materials And Methods: Thirty-five patients with cavernous hemangiomas and 35 with untreated hepatic malignant neoplasms had FBDW and T2WFSE MR imaging. Hepatic lesions were characterized with ADC measurement and visual evaluation.

Value of pelvic embolization in the management of severe postpartum hemorrhage due to placenta accreta, increta or percreta.

Objectives: To evaluate the role, efficacy and safety of pelvic embolization in the management of severe postpartum hemorrhage in women with placenta accreta, increta or percreta.

Methods: The clinical files and angiographic examinations of 12 consecutive women with placenta accreta (n=4), increta (n=2) or percreta (n=6) who were treated with pelvic embolization because of severe primary (n=10) or secondary (n=2) postpartum hemorrhage were reviewed. Before embolization, four women had complete placental conservation, four had partial placental conservation, three had an extirpative approach and one had hysterectomy after failed partial conservative approach.

Preoperative detection of hepatic metastases: comparison of diffusion-weighted, T2-weighted fast spin echo and gadolinium-enhanced MR imaging using surgical and histopathologic findings as standard of reference.

Purpose: The purpose of this study was to retrospectively compare the respective sensitivities of diffusion-weighted (DW), T2-weighted fast spin-echo (T2WFSE) and gadolinium chelate-enhanced MR imaging in the preoperative detection of hepatic metastases using intraoperative ultrasonographic and histopathologic findings as the standard of reference.

Materials And Methods: Twenty-seven patients with 64 surgically and histopathologically proven hepatic metastases had MR imaging of the liver, including DW, T2WFSE and dynamic gadolinium chelate-enhanced MR imaging. Images from each MR sequence were separately analyzed by two readers with disagreements resolved by consensus readings.

Persistent postpartum haemorrhage after failed arterial ligation: value of pelvic embolisation.

Objectives: To evaluate the role and efficacy of pelvic embolisation in the treatment of persistent postpartum haemorrhage after failed arterial ligation and to identify the complications of this procedure in this specific population.

Methods: The clinical files and angiographic examinations of 12 consecutive women (mean age 32 years) who were treated with pelvic embolisation because of persistent, severe postpartum haemorrhage after failed arterial ligation were reviewed.

Results: Angiography revealed that persistent bleeding was due to incomplete arterial ligation (n = 4) or the presence of newly developed anastomotic routes (n = 8).

Suspected anastomotic recurrence of Crohn disease after ileocolic resection: evaluation with CT enteroclysis.

Purpose: To determine the utility of computed tomographic (CT) enteroclysis for characterization of the status of the anastomotic site in patients with Crohn disease who had previously undergone ileocolic resection.

Materials And Methods: Written informed consent was prospectively obtained from all patients, and the institutional review board approved the study protocol. CT enteroclysis findings in 40 patients with Crohn disease who had previously undergone ileocolic resection were evaluated independently by two readers.

Free-breathing diffusion-weighted single-shot echo-planar MR imaging using parallel imaging (GRAPPA 2) and high b value for the detection of primary rectal adenocarcinoma.

Our objective was to determine the diagnostic accuracy of a free-breathing diffusion-weighted single-shot echo-planar magnetic resonance imaging (FBDW-SSEPI) technique with parallel imaging and high diffusion factor value (b = 1000 s/mm2) in the detection of primary rectal adenocarcinomas. Thirty-one patients (14M and 17F; mean age 67 years) with histopathologically proven primary rectal adenocarcinomas and 31 patients without rectal malignancies (14M and 17F; mean age 63.6 years) were examined with FBDW-SSEPI (repetition time (TR/echo time (TE) 3900/91 ms, gradient strength 45 mT/m, acquisition time 2 min) at 1.

Differentiation between true focal liver lesions and pseudolesions in patients with fatty liver: evaluation of helical CT criteria.

Objective: To determine the potential of helical CT for differentiating true lesions from pseudolesions in patients with fatty liver.

Methods: Helical CT of 44 patients with diffuse fatty liver (22 with true lesions; 22 with pseudolesions) were reviewed by two observers with regard to morphological features of visible lesions. Univariate analysis was used to detect discriminating criteria for the diagnosis of true lesions.

Cardiac troponin and skeletal muscle oxygenation in severe post-partum haemorrhage.

Introduction: Cardiac troponin has been shown to be elevated in one-half of the parturients admitted for post-partum haemorrhage. The purpose of the study was to assess whether increased cardiac troponin was associated with a simultaneous alteration in haemoglobin tissue oxygen saturation in peripheral muscles in post-partum haemorrhage.

Methods: Tissue haemoglobin oxygen saturation of thenar eminence muscle (StO2) was measured via near-infrared spectroscopy technology.

CT enteroclysis features of uncomplicated celiac disease: retrospective analysis of 44 patients.

Purpose: To describe the computed tomographic (CT) enteroclysis features of uncomplicated celiac disease (CD) and to determine the most indicative appearance of this condition by using a retrospective case-control study.

Materials And Methods: This study had institutional review board approval. The CT enteroclysis examinations of 44 consecutive patients with proved uncomplicated CD (21 men, 23 women; mean age, 44.

Life-threatening intra-abdominal hemorrhage from left superior colonic artery pseudoaneurysm after percutaneous renal biopsy: successful treatment with superselective arterial embolization.

Life-threatening intra-abdominal hemorrhage following ultrasonographically guided percutaneous renal biopsy is extremely rare and, most of the time, is due to renal vascular injury. Injury of other abdominal arteries during percutaneous renal biopsy is exceedingly rare. We report herein a case of left superior colonic artery injury during ultrasonographically guided percutaneous renal biopsy, which was responsible for pseudoaneurysm formation and subsequent intra-abdominal hemorrhage and gastrointestinal bleeding.

Crohn's disease: multi-detector row CT-enteroclysis appearance of the appendix.

The objective of our retrospective study was to determine the MDCT-enteroclysis appearance of the appendix in patients with Crohn's disease and to correlate this appearance with the status of the disease. We reviewed the MDCT-enteroclysis examinations of 76 patients with Crohn's disease. Images were analyzed for visualization of the appendix, largest axial diameter of the appendix and degrees of enhancement.

[Imaging of gastrointestinal stromal tumors].

Gastrointestinal stromal tumors (GIST) arising from interstitial cells of Cajal, represent the first type of solid tumor, which is very sensitive to a specific molecularly targeted tyrosine kinase receptor blocker (i. e., imatinib).

Multi-detector row CT of patients with acute intestinal bleeding: a new perspective using multiplanar and MIP reformations from submillimeter isotropic voxels.

Acute intestinal bleeding is a severe condition, with a mortality rate of up to 40% in case of associated hemodynamic instability. The diagnosis of acute intestinal bleeding is often challenging and to date, there is no definite consensus upon the most appropriate technique for this specific diagnosis. This pictorial essay illustrates our preliminary use of multiplanar (MPR) and maximum intensity projection (MIP) reformations using MDCT scanner with submillimeter and isotropic voxels as an adjunct to axial images in patients with acute intestinal bleeding.

Severe primary postpartum hemorrhage due to genital tract laceration after operative vaginal delivery: successful treatment with transcatheter arterial embolization.

The purpose of this study was to report our experience in the management of severe primary postpartum hemorrhage due to genital tract laceration following operative vaginal delivery with forceps using pelvic transcatheter arterial embolization (TAE). Ten women (mean age, 31.9 years) with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps were treated with TAE.

Abdominopelvic extra-enteric findings at computed tomography enteroclysis: a retrospective evaluation of 430 consecutive patients.

Background: Our objective was to retrospectively determine the frequency with which CT enteroclysis (CTE) shows abdominopelvic extra-enteric abnormalities and to analyze how such findings had actually and prospectively affected patient's care.

Methods: The CTE examinations of 430 consecutive patients were retrospectively and blindly reviewed for the presence of possible pathologic conditions that might have affected abdominopelvic organs other than the small bowel. Extra-enteric abnormalities were categorized as negligible or important and correlated with patient's outcome and thus classified as having or not influenced patient's care.

Uterine conservation despite severe sepsis in a case of placenta accreta first treated conservatively: 3-month delayed successful removal of the placenta.

Objective: To report a case of successful delayed removal of a placenta accreta first treated conservatively. Secondary infectious complications can occur after conservative management in cases of placenta accreta, most often leading to hysterectomy.

Design: Case report.