S. Riehm

CHRU de Strasbourg, Strasburg, Alsace, France

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Publications (69)63.51 Total impact

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    ABSTRACT: To compare diagnostic performances for cholesteatoma diagnosis of incremental MRI protocols including non-echo planar diffusion-weighted imaging (DWI) performed on 3T and 1.5T scanners.
    Journal of neuroradiology. Journal de neuroradiologie. 07/2014;
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    ABSTRACT: Here we report a case of pseudotumoral recurrence of allergic fungal sinusitis with involvement of the skull base that was successfully treated with systemic corticosteroids and itraconazole without surgery. This report discusses the sometimes misleading radiological and clinical features as well as the diagnostic and therapeutic challenges of a condition that should be recognized by ENT specialists, neurosurgeons, ophtalmologists and radiologists.
    B-ENT 01/2014; 10(1):75-9. · 0.08 Impact Factor
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    ABSTRACT: IntroductionBrown tumors are uncommon osteolytic lesions directly related to the increased osteoclastic activity due to hyperparathyroidism.Case reportA 37-year-old woman presented with hypercalcemia related to primary hyperparathyroidism. Multiple and bilateral maxillary osteolytic lesions showing intense fluorodesoxyglucose (FDG) uptake were noted in a positron emission tomography computed tomography (PET-CT). Diagnosis of maxillary brown tumors was discussed and confirmed by both orthopantomogram and magnetic resonance imaging. Left inferior parathyroid adenoma was detected by both cervical ultrasonography and parathyroid scintigraphy, and then surgically treated with consequent improvement of hyperparathyroidism.Conclusion Our case emphasizes the necessity of a multidisciplinary diagnostic approach to optimize the interpretation of the available imaging, especially in unusual and unrecognized pathology as brown tumors.
    La Revue de Médecine Interne. 06/2013; 34(6):377–381.
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    ABSTRACT: Aim: The aim of this paper was to evaluate the clinical usefulness of [18F]FDG PET/CT for treatment efficacy assessment in patients with severe multisystemic phenotype of sarcoidosis with special emphasis on sinonasal involvement. Methods: Thirteen patients with biopsy-proven sinonasal sarcoidosis (SNS) who underwent two [18F]FDG-PET/CT were selected. PET/CT results were correlated with nasal endoscopy, biology and conventional imaging techniques (CT, MRI). Four and nine patients underwent first PET/CT before beginning treatment and during CS therapy, respectively. On the other hand, ten and three patients underwent second PET/CT during CS and after treatment withdrawal, respectively. The mean duration of clinical and endoscopic follow-up after the second scintigraphic examination was 51 months. Results: Eleven out of 13 selected patients presented with pathological nasal endoscopy at inclusion. Among them: 1) 5 showed persistent endoscopic abnormalities at follow-up evaluation. Radiological and PET/CT imaging was consistent with these results in 4 and 5 patients, respectively; 2) 2 showed a complete endoscopic, radiologic and PET/CT normalization after CS treatment; 3) 4 showed important alterations of the sinonasal structures preventing a definitive diagnosis by endoscopic and radiologic techniques. PET/CT suggested a residual inflammatory disease in two cases. No scintigraphic abnormalities were detected in the other 2 patients. Scintigraphic results were finally confirmed by a mean follow-up of 51 months. No pathologic sinonasal [18F]FDG uptake was observed in the remaining 2/13 patients who showed doubtful endoscopic and radiologic results during primary evaluation. The stability of endoscopic results without clinical and biological evolution was observed during 39 and 38 months of follow-up after the second PET/CT. Conclusion: [18F]FDG PET/CT seems to be a valuable non-invasive imaging technique able to evaluate the response to treatment in aggressive SNS, identifying persistent active disease even in those patients with destructive sinonasal aftereffects and/or with atypical therapeutic evolution. Finally, [18F]FDG PET/CT could be clinically useful to modulate CS treatment eventually integrating immunosuppressive drugs.
    The quarterly journal of nuclear medicine and molecular imaging: official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of... 04/2013; · 1.92 Impact Factor
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    ABSTRACT: INTRODUCTION: Brown tumors are uncommon osteolytic lesions directly related to the increased osteoclastic activity due to hyperparathyroidism. CASE REPORT: A 37-year-old woman presented with hypercalcemia related to primary hyperparathyroidism. Multiple and bilateral maxillary osteolytic lesions showing intense fluorodesoxyglucose (FDG) uptake were noted in a positron emission tomography computed tomography (PET-CT). Diagnosis of maxillary brown tumors was discussed and confirmed by both orthopantomogram and magnetic resonance imaging. Left inferior parathyroid adenoma was detected by both cervical ultrasonography and parathyroid scintigraphy, and then surgically treated with consequent improvement of hyperparathyroidism. CONCLUSION: Our case emphasizes the necessity of a multidisciplinary diagnostic approach to optimize the interpretation of the available imaging, especially in unusual and unrecognized pathology as brown tumors.
    La Revue de Médecine Interne 03/2013; · 0.90 Impact Factor
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    ABSTRACT: This is a report of six cases of respiratory epithelial adenomatoid hamartoma of the nasal cavities that were characterized by: symptoms of nasal obstruction and dysosmia; endoscopic appearances of bilateral nasal polyposis affecting the olfactory clefts; CT imaging showing enlargement of the olfactory clefts; MRI (rarely reported in the literature) revealing clearly delineated cerebriform tissue filling in the olfactory clefts; histological confirmation in all cases; and recovery after surgical endoscopic resection without the need for associated sinus surgery.
    Journal of Neuroradiology 12/2012; · 1.24 Impact Factor
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    S Riehm, F Veillon
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    ABSTRACT: Sinonasal and temporal bone infections may extend to the skull, skull base, meninges, pericerebral spaces, brain parenchyma, dural sinuses, deep cerebral or cortical veins, intracranial arteries and cranial nerves either via contiguous or hematogeneous spread. The site of infection dictates the sites of potential complications: orbital with ethmoid sinusitis, cavernous sinus thrombophlebitis and oculomotor palsies with sphenoid sinusitis, transverse sinus thrombophlebitis with mastoiditis and superior sagittal sinus thrombophlebitis with frontal sinusitis. All may result in brain abscess. Congenital and acquired defects of the skull and meninges, with or without associated meningocele or meningoencephalocele, perilymphatic fistulas, and some anomalies of the inner ear may predispose to the intracranial extension of ENT infections.
    Journal de Radiologie 11/2011; 92(11):995-1014. · 0.35 Impact Factor
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    ABSTRACT: Sarcoidosis is a non-caseating granulomatous disease of unknown origin, principally affecting the respiratory tract. Sarcoidosis of the upper respiratory tract (SURT) includes sino-nasal sarcoidosis (SNS) and pharyngo-laryngeal sarcoidosis (PLS). SURT may be isolated or, more often, part of multisystemic sarcoidosis. Its clinical symptomatology is protean and non specific. The natural history, course and prognosis are poorly understood and unpredictable. The treatment has not yet been standardised and the long-term therapeutic results are often disappointing. In this work, we try to make a synthesis of our experience and publications, and the data in the existing international literature, to improve the diagnosis and therapeutic management of SURT. The usefulness of both morphological and functional imaging techniques, in particular 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT), is evaluated for use in the management of the severe phenotypes of sarcoidosis such as SURT. Even if guided biopsy remains necessary for confirmation of SURT, medical imaging plays an important role in the management of this disease: CT imaging allows the description of SNS and classification into two stages that correlate well with the severity, reversibility and course of the sino-nasal involvement, 18F-FDG PET/CT, providing a complete morpho-functional mapping of active inflammatory lesions, could be a useful technique in patients with biopsy-proven SURT, for both diagnosis and follow up of medical treatment.
    Revue des Maladies Respiratoires 02/2011; 28(2):164-73. · 0.50 Impact Factor
  • Médecine des Maladies Métaboliques 02/2011; 5(1):53–54.
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    European Journal of Nuclear Medicine 01/2011; 38(5):983-4. · 4.53 Impact Factor
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    ABSTRACT: Introduction Sarcoidosis is a non-caseating granulomatous disease of unknown origin, principally affecting the respiratory tract. Background Sarcoidosis of the upper respiratory tract (SURT) includes sino-nasal sarcoidosis (SNS) and pharyngo-laryngeal sarcoidosis (PLS). SURT may be isolated or, more often, part of multisystemic sarcoidosis. Its clinical symptomatology is protean and non specific. The natural history, course and prognosis are poorly understood and unpredictable. The treatment has not yet been standardised and the long-term therapeutic results are often disappointing. Viewpoint In this work, we try to make a synthesis of our experience and publications, and the data in the existing international literature, to improve the diagnosis and therapeutic management of SURT. The usefulness of both morphological and functional imaging techniques, in particular 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT), is evaluated for use in the management of the severe phenotypes of sarcoidosis such as SURT. Conclusions Even if guided biopsy remains necessary for confirmation of SURT, medical imaging plays an important role in the management of this disease: CT imaging allows the description of SNS and classification into two stages that correlate well with the severity, reversibility and course of the sino-nasal involvement, 18F-FDG PET/CT, providing a complete morpho-functional mapping of active inflammatory lesions, could be a useful technique in patients with biopsy-proven SURT, for both diagnosis and follow up of medical treatment.
    Revue Des Maladies Respiratoires - REV MAL RESPIR. 01/2011; 28(2):164-173.
  • Russian Literature. 01/2011; 5(1):53-54.
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    ABSTRACT: PURPOSE: This study aimed to evaluate the value of diffusion-weighted imaging (DWI) and gadolinium-enhanced dynamic magnetic resonance imaging (MRI) for differentiating benign and malignant parotid gland tumors, and for characterizing the various histological types (pleomorphic adenoma, and Warthin's and malignant tumors). PATIENTS AND METHODS: This retrospective study involved 60 patients with suspected parotid gland tumors (mean age: 59.4 years), and was carried out from April 2005 to February 2008. All had undergone pathological examination. All MRI examinations were performed using the Siemens Magnetom Avanto 1.5T MRI system. Non-enhanced T1-weighted (T1W), gadolinium-enhanced fat-suppressed T1W and T2-weighted (T2W) images were obtained for all 60 patients, with diffusion-weighted echoplanar imaging (DW-EPI) and apparent diffusion coefficient (ADC) evaluation in 59 patients, and gadolinium-enhanced dynamic MRI sequences in 51 patients. Interpretation was carried out by two experienced radiologists (the first evaluation used T1W, gadolinium-enhanced fat-suppressed T1W and T2W images; the second evaluation used T1W, T2W, DWI and dynamic MRI) and, for each case, the benign/malignant nature of the tumor and its histological type were determined. RESULTS: After the second reading, increases were noted in sensitivity, specificity, malignant positive predictive value (PPV) and negative predictive value (NPV), as well as in accuracy (90-100% for the first observer, and 90-97% for the second observer). Interobserver reliability also showed a significant increase from the first to the second reading (kappa=0.63 to 0.87, respectively). CONCLUSION: Gadolinium-enhanced dynamic MRI and DW-EPI with ADC evaluation improved the performance of MRI in distinguishing between benign and malignant parotid gland tumors, and characterizing the different histological types of benign tumors (pleomorphic adenoma and Warthin's), thus leading to greater consensus in interpretation of the images.
    Journal of Neuroradiology 06/2010; · 1.24 Impact Factor
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    ABSTRACT: The facial nerve is responsible for the motor innervation of the face. It has a visceral motor function (lacrimal, submandibular, sublingual glands and secretion of the nose); it conveys a great part of the taste fibers, participates to the general sensory of the auricle (skin of the concha) and the wall of the external auditory meatus. The facial mimic, production of tears, nasal flow and salivation all depend on the facial nerve. In order to image the facial nerve it is mandatory to be knowledgeable about its normal anatomy including the course of its efferent and afferent fibers and about relevant technical considerations regarding CT and MR to be able to achieve high-resolution images of the nerve.
    European journal of radiology 05/2010; 74(2):341-8. · 2.65 Impact Factor
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    ABSTRACT: To compare two potential diagnoses of a temporal bone pseudotumour: an inflammatory myofibroblastic tumour and Wegener's granulomatosis. A case of Wegener's granulomatosis that mimicked an inflammatory myofibroblastic tumour is reported. The clinical presentation, staging of the disease, histology, and follow-up are analysed. Histopathology of the temporal bone failed to provide an accurate diagnosis, even after immunocytochemical analyses. The diagnosis of Wegener's granulomatosis was suspected after biopsy of a pulmonary mass and was confirmed by the presence of anti-neutrophil cytoplasmic antibodies in blood samples. Irrespective of the aetiology, a pseudotumour of the temporal bone should always be investigated by biology and radiology. Radiological investigations will allow staging of the disease and specific localisation for biopsies.
    B-ENT 01/2010; 6(2):135-8. · 0.08 Impact Factor
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    ABSTRACT: Attempt to describe and analyse the radiological and nuclear medicine patterns of sinonasal sarcoidosis (SNS) still poorly reported in the literature. Retrospective single institution study of 22 consecutive patients with symptomatic biopsy-proven SNS to evaluate the interest of CT, MRI, (67)Ga scintigraphy and (18)F-FDG PET/CT for diagnosis and therapeutic follow-up. Nodules of the septum and turbinates are the most suggestive CT and MRI features. Other CT features such as sinusal filling, mucosal thickening, osteosclerosis or destructive sinonasal lesions are not specific and depend on clinical context and evolutive stage of SNS. (18)F-FDG PET/CT provides complete morphofunctional mapping of active inflammatory sites related to sarcoidosis with a better diagnostic sensitivity (100%) compared to (67)Gallium scintigraphy (75%). The changes in (18)F-FDG uptake intensity could reflect the efficacy of treatment. SNS is an uncommon and probably underdiagnosed phenotype of sarcoidosis. Even if guided biopsy remains necessary for SNS confirmation, medical imaging plays an important role in diagnosis and therapeutic follow-up. CT features with nodules of the septum and/or turbinates are suggestive of SNS contrary to other nonspecific CT findings. CT imaging is directly related severity, reversibility and course of SNS and provide an original radiological staging system in order to predict patient clinical outcome. PET/CT may be used for diagnosis assessement but also to monitor treatment response in a given clinical context, in a patient with histopathologically-proven SNS. Prospective and long term studies are necessary to validate these preliminary results.
    Journal of Neuroradiology 12/2009; 37(3):172-81. · 1.24 Impact Factor
  • Journal de Radiologie 11/2009; 90(11 Pt 1):1737-9. · 0.35 Impact Factor
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    ABSTRACT: Branchio-oculo-facial syndrome (BOFS) is an autosomal-dominant condition characterized by three main features, respectively: branchial defects, ocular anomalies, and craniofacial defects including cleft lip and/or palate (CL/P). We report on one family with three affected, and two sporadic cases that have been found to carry missense mutations in the newly reported BOFS gene: TFAP2A. This report confirms the involvement of this transcription factor in this developmental syndrome with clinical variability. Moreover, we present CT scan temporal bone anomalies in the familial cases, related to branchial arch defects, highlighting the importance of radiological investigations for differential diagnosis.
    American Journal of Medical Genetics Part A 09/2009; 149A(10):2141-6. · 2.30 Impact Factor
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    ABSTRACT: Middle ear adenomatous tumors (MEAT) are rare tumors which can be begin or malignant and can present a neuroendocrine differentiation. Their radiological aspect is very similar to glomus tympanicum (GT) which are the most common tumoral lesions of the middle ear. We present several radiological and clinical findings that could help radiologists to accurately identify MEAT. We retrospectively reviewed the radiological and clinical findings of three patients with MEAT and of eight patients with GT. Diagnostic was obtained after surgical resection in all cases. All patients had high resolution CT and MR of the middle ear associated with a subtracted digital carotid angiography. Tumor location, size, extension, signal intensity, and enhancement were analysed. From the medical records of the patients, clinical manifestations (hearing loss, tinnitus), evolution length and recurrences were noted. MEAT and GT appeared as tissular lesion with significant enhancement on CT and MR. A vascular blush was present on angiography in all cases of GT and absent from all cases of MEAT. A close relationship between the tumor and the Jacobson's nerve or its branches was identified in all cases of GT. Pulsatile tinnitus was present in all patients with GT and absent in all patients with MEAT. A middle ear tissular lesion clearly separated from the Jacobson nerve or its branches, showing significant enhancement after contrast medium injection but with a normal angiography, should make one suspicious for MEAT.
    Journal of Neuroradiology 07/2009; 37(2):116-21. · 1.24 Impact Factor
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    ABSTRACT: A retrospective study was conducted on a cohort of 15 patients who underwent surgery because cholesteatoma or abscess was suspected. All patients had MR imaging prior to surgery with diffusion-weighted images (DWI) from which the apparent diffusion coefficient (ADC) value was calculated. Using this technique, we were able to determine 3 distinct ADC value ranges corresponding to the 3 groups of lesions found at surgery (pure cholesteatoma, cholesteatoma with infection, and abscess or infection). This needs to be confirmed by further studies with a wider range of patients.
    American Journal of Neuroradiology 03/2009; 30(6):1123-6. · 3.17 Impact Factor