Publications by authors named "Flammang A"

Purpose: The high contrast resolution and absent ionizing radiation of interventional magnetic resonance imaging (MRI) can be advantageous for paravertebral sympathetic nerve plexus injections. We assessed the feasibility and technical performance of MRI-guided paravertebral sympathetic injections utilizing augmented reality navigation and 1.5 T MRI scanner.

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In pediatric units, bacteria-producing extended-spectrum-betalactamase (ESBL) have an increasing prevalence among bacteria causing febrile urinary tract infections (UTIs). The purpose of this study was to evaluate the epidemiology of bacteria resistance patterns observed in UTIs, in order to assess the current antibiotic treatment protocols. This study is based upon a single-center retrospective chart review of the cytobacteriological urine cultures performed in UTIs between 1 January and 31 December 2014, in the medical pediatric unit of the Caen University Hospital.

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Bronchiolitis epidemiology. Respiratory syncytial virus is the most important viral pathogen causing acute lower respiratory infection and infants hospitalizations. Other viruses are also identified (métapneumovirus, rhino/enterovirus, coronavirus, influenza, parainfluenza, adenovirus …).

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Objective: Perineural ganglion impar injections are used in the management of pelvic pain syndromes; however, there is no consensus regarding the optimal image guidance. Magnetic resonance imaging (MRI) provides high soft tissue contrast and the potential to directly visualize and target the ganglion. The purpose of this study was to assess the feasibility of MR-guided percutaneous perineural ganglion impar injections.

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Purpose: Diffusion tensor imaging (DTI) metrics of the cervical spinal cord in patients with cervical spondylotic myelopathy (CSM) were compared to those measured in healthy volunteers, using tract-specific region of interests (ROIs) across all cervical intervertebral disc levels.

Methods: Magnetic resonance (MR) imaging of the cervical spinal cord was performed in four patients with CSM and in five healthy volunteers on a 3-T MR scanner. Region-specific fractional anisotropy (FA) and mean diffusivity (MD) were calculated on axial imaging with ROI placement in the anterior, lateral, and posterior regions of the spinal cord.

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Purpose: To assess intrapericardial delivery of microencapsulated, xenogeneic human mesenchymal stem cells (hMSCs) by using x-ray fused with magnetic resonance (MR) imaging (x-ray/MR imaging) guidance as a potential treatment for ischemic cardiovascular disease in an immunocompetent swine model.

Materials And Methods: All animal experiments were approved by the institutional animal care and use committee. Stem cell microencapsulation was performed by using a modified alginate-poly-l-lysine-alginate encapsulation method to include 10% (wt/vol) barium sulfate to create barium-alginate microcapsules (BaCaps) that contained hMSCs.

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Objective: Our purpose is to test the effect of varied in-phase (IP) and opposed-phase (OP) sequence order on characterizing marrow signal changes at 3T.

Materials And Methods: The study was HIPAA compliant and IRB approved. Informed consent was waived.

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Purpose: To evaluate the feasibility of magnetic resonance imaging (MRI)-guided vertebroplasty at 1.5 Tesla using augmented reality image overlay navigation.

Materials And Methods: Twenty-five unilateral vertebroplasties [5 of 25 (20%) thoracic, 20 of 25 (80%) lumbar] were prospectively planned in 5 human cadavers.

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Objective: This study aimed to investigate whether patellofemoral T2 cartilage changes are associated with lateral patellofemoral friction syndrome (PFS), as indicated by an edema-like signal within the superolateral infrapatellar (Hoffa) fat pad.

Methods: In this institutional review board-approved retrospective study of 510 consecutive patients, 49 patients with 50 knee magnetic resonance imaging examinations demonstrating normal or low-grade patellofemoral cartilage abnormalities (whole-organ magnetic resonance imaging score [WORMS] score, ≤2) were included. Twenty-two examinations with PFS (cases) were compared with an age- and sex-matched cohort of 28 examinations without PFS (controls).

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Proper performance of magnetic resonance neurography (MRN) is essential not only to make the examination easier to interpret but also for its accurate evaluation. This article outlines the technical considerations of MRN, various imaging pulse sequences available on current scanners, as well as their relative advantages and disadvantages. In addition, a guide to the optimal use of high-resolution and high-contrast MRN technique is provided, which will aid clinicians in attaining a good-quality examination.

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Purpose: Current pretreatment, 4D imaging techniques are suboptimal in that they sample breathing motion over a very limited "snapshot" in time. Heretofore, long-duration, 4D motion characterization for radiotherapy planning, margin optimization, and validation have been impractical for safety reasons, requiring invasive markers imaged under x-ray fluoroscopy. To characterize 3D tumor motion and associated variability over durations more consistent with treatments, the authors have developed a practical dynamic MRI (dMRI) technique employing two orthogonal planes acquired in a continuous, interleaved fashion.

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Purpose: Current pretreatment, 4D imaging techniques are suboptimal in that they sample breathing motion over a very limited "snap-shot" in time. To potentially address this, the authors have developed a longer-duration MRI and postprocessing technique to derive the average or most-probable state of mobile anatomy and meanwhile capture and convey the observed motion variability.

Methods: Sagittal and coronal multislice, 2D dynamic MRI was acquired in a sequential fashion over extended durations in two abdominal and four lung studies involving healthy volunteers.

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Objective: We demonstrate the clinical use of an MR angiography sequence performed with sparse k-space sampling (MRA), as a method for dynamic contrast-enhanced (DCE)-MRI, and apply it to the assessment of sarcomas for treatment response.

Materials And Methods: Three subjects with sarcomas (2 with osteosarcoma, 1 with high-grade soft tissue sarcomas) underwent MRI after neoadjuvant therapy/prior to surgery, with conventional MRI (T1-weighted, fluid-sensitive, static post-contrast T1-weighted sequences) and DCE-MRI (MRA, time resolution = 7-10 s, TR/TE 2.4/0.

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Purpose: The purpose of this study was to prospectively test the hypothesis that image overlay technology facilitates accurate navigation for magnetic resonance (MR)-guided osseous biopsy.

Materials And Methods: A prototype augmented reality image overlay system was used in conjunction with a clinical 1.5-T MR imaging system.

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Article Synopsis
  • The study aimed to evaluate the feasibility and effectiveness of high-resolution MR-guided posterior femoral cutaneous nerve blocks in patients with chronic perineal pain.
  • A retrospective analysis of 12 nerve blocks in 8 patients showed a 100% technical success rate with effective pain relief and no complications reported.
  • Initial findings suggest that this MR-guided technique is promising, but further research with larger sample sizes is necessary to validate these results.
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Purpose: A clinical augmented reality guidance system was developed for MRI-guided musculoskeletal interventions Magnetic Resonance Image Overlay System (MR-IOS). The purpose of this study was to assess MRI compatibility, system accuracy, technical efficacy, and operator performance of the MR-IOS.

Methods And Materials: The impact of the MR-IOS on the MR environment was assessed by measuring image quality with signal-to-noise ratio (SNR) and signal intensity uniformity with the system in various on/off states.

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Purpose: To prospectively assess overlay technology in providing accurate and efficient targeting for magnetic resonance (MR) imaging-guided shoulder and hip joint arthrography.

Materials And Methods: A prototype augmented reality image overlay system was used in conjunction with a clinical 1.5-T MR imager.

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Objectives: To prospectively assess the technical performance of an augmented reality system for MR-guided spinal injection procedures.

Methods: The augmented reality system was used with a clinical 1.5-T MRI system.

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High-resolution magnetic resonance neurography (MRN) is being increasingly employed for the evaluation of peripheral nerves. We describe a case of spiral groove syndrome (Saturday night palsy) and illustrate the role of advanced 3 Tesla MRN imaging techniques, including three-dimensional diffusion-weighted fat-suppressed reversed fast imaging with steady-state precession and diffusion tensor imaging.

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Objective: The purpose of this study was to prospectively evaluate the accuracy of an augmented reality image overlay system in MRI-guided spinal injection procedures.

Materials And Methods: An augmented reality prototype was used in conjunction with a 1.5-T MRI system.

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Objective: MR neurography (MRN) has increasingly been used in clinical practice for the evaluation of peripheral nerve disease. This article reviews the historic perspective of MRN, the current imaging trends of this modality, and the future directions and applications that have shown potential for improved imaging and diagnostic capabilities.

Conclusion: MRN has come a long way in the past 2 decades.

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Purpose: To evaluate whether the addition of the three-dimensional diffusion-weighted reversed fast imaging with steady state free precession (3D DW-PSIF) sequence improves the identification of peripheral nerves in the distal extremities.

Materials And Methods: Twelve MR neurography (MRN) studies of the distal upper extremity and 12 MRN studies of distal lower extremity were evaluated. From the 24 subjects who were enrolled, 10 had clinically suspected peripheral neuropathy, whereas 14 suffered from various orthopedic diseases and had no clinical signs of neuropathy.

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Diffusion tensor imaging (DTI) in combination with 3D-tractography reconstructions allows studying the neuro-architecture of complex brain malformations in vivo. Prenatal, in utero DTI has been limited by long acquisition times, poor signal to noise ratio and multiple artifacts. Recent developments in hard- and software allow collection of high quality DTI data sets in utero.

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