P Champsaur

Aix-Marseille Université, Marsiglia, Provence-Alpes-Côte d'Azur, France

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Publications (165)184.96 Total impact

  • Muscle & Nerve 03/2015; DOI:10.1002/mus.24649 · 2.31 Impact Factor
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    ABSTRACT: OBJECTIVE. The purpose of this study is to compare the diagnostic performance and radiation exposure of flat-panel CT arthrography for cartilage defect detection in the ankle joint to standard MDCT arthrography, using gross anatomy and thermoluminescent dosimetry as reference standards. MATERIALS AND METHODS. Ten cadaveric ankle specimens were obtained from individuals who had willed their bodies to science. Five milliliters of a mixture of diluted ioxaglate and saline were injected. Specimens were examined consecutively with the use of flat-panel CT and MDCT. Radiation doses of flat-panel CT and MDCT were recorded using thermoluminescent dosimeters. Flat-panel CT and MDCT arthrography examinations were blinded and randomly evaluated by two musculoskeletal radiologists in consensus. In each ankle specimen, eight cartilage areas were assessed separately: medial talar surface, medial talar trochlea, lateral talar trochlea, lateral talar surface, tibial malleolus, medial tibial pla-fond, lateral tibial plafond, and fibular malleolus. Findings at flat-panel CT and MDCT arthrography were compared with macroscopic assessments in 80 cartilage areas. RESULTS. For the detection of cartilage lesions, flat-panel CT showed a sensitivity of 80%, specificity of 98%, and accuracy of 94%, and MDCT arthrography showed a sensitivity of 55%, specificity of 98%, and accuracy of 88%. Flat-panel CT and MDCT arthrography showed almost perfect (κ = 0.83) and substantial (κ = 0.65) agreement, respectively, with anatomic examination. Radiation dose was significantly lower for flat-panel CT (mean, 2.1 mGy; range, 1.1-3.0 mGy) than for MDCT (mean, 47.2 mGy; range, 39.3-53.8 mGy) (p < 0.01). CONCLUSION. Flat-panel CT arthrography is accurate for detecting cartilage defects in the ankle joint and is an alternative to MDCT arthrography that may have better diagnostic performance and may permit the use of a lower radiation dose.
    American Journal of Roentgenology 11/2014; 203(5):1069-74. DOI:10.2214/AJR.13.12163 · 2.74 Impact Factor
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    ABSTRACT: This study aimed to determine (1) whether: gender, morphotype, or etiology are correlated with the shape of the proximal femur in patients with advanced hip osteoarthritis and (2) is there any clinical predictive factors of potential abnormal anatomy of the hip at the time of total hip arthroplasty (THA)? We reviewed 689 European hips of patients who underwent THA for primary osteoarthritis (OA) or avascular necrosis (AVN), between 2000 and 2005. The patients were stratified according to their (1) Morphotype, (2) Gender, and (3) Etiology for undergoing THA. Two independent observers measured the following four anatomical parameters on preoperative CT-scans: neck shaft angle (NSA) and femoral neck version, femoral offset and lower-limb torsion. Our results showed that both morphotype and etiology, but not gender or body mass index, were correlated with femoral anatomical parameters. Two types of patients were identified as "at risk" for abnormal hip anatomy: (1) AVN-Endomorphic patients (2) OA-Ectomorphic patients. Etiology of the advanced hip osteoarthritis and patients' morphotype may predict the proximal femur anatomy at the time of THA.
    Surgical and Radiologic Anatomy 09/2014; 37(2). DOI:10.1007/s00276-014-1368-5 · 1.33 Impact Factor
  • Morphologie 09/2014; 98(322):112. DOI:10.1016/j.morpho.2014.04.037
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    ABSTRACT: Despite advances in the understanding of anterior shoulder instability, recurrence rates after arthroscopic and open surgery have been reported to be as high as 30%. A successful operative outcome for patients with anterior shoulder instability requires the surgeon to perform a complete preoperative evaluation based on a thorough physical examination and advanced imaging techniques. In addition to the Bankart lesion, the treating surgeon must be aware of other copathologies, such as bony lesions of the glenoid or humeral head, humeral avulsion of the glenohumeral ligament, and articular cartilage defects that can occur in concert with capsular pathology and may necessitate a change in surgical strategy. This article focuses specifically on the osseous, labroligamentous, cartilage, and rotator cuff lesions demonstrated on preoperative imaging that are important to recognize in the preoperative work-up to optimize surgical outcomes for anterior instability.
    Seminars in musculoskeletal radiology 09/2014; 18(4):398-403. DOI:10.1055/s-0034-1384828 · 0.95 Impact Factor
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    ABSTRACT: Purpose The purpose was to study the anatomy of the humeral head, more specifically the retroversion of the humeral head and the orientation of the intertubercular sulcus, using CT scan, and to make correlations between those two entities of the proximal humerus. Methods Sixty dry adult humeri from an osteological collection underwent CT scan from the proximal to the distal extremity. The measurements obtained by CT-reformation were recorded by two independent radiologists. We determined the humeral head axis, the transepicondylar axis, the retroversion of the humeral head, and the orientation of the intertubercular sulcus (ITS). Statistical analysis using SPSS determined the Pearson correlation coefficient. Results The CT scan measurements were similar to those in the literature, and thus allowed us to validate CT scan assessment. Statistical analysis showed a significant reverse correlation [the coefficient of correlation was −0.37 (p = 0.004)] between the retroversion of the humeral head and the orientation of the intertubercular sulcus: the more the retroversion of the humeral head increases, the more the angle of the orientation of the ITS decreases. Conclusions To the best of our knowledge, this reverse correlation between the retroversion of the humeral head and the orientation of the intertubercular sulcus has never been described. This new anatomical data might be helpful for orthopedic surgery.
    Surgical and Radiologic Anatomy 08/2014; 37(4). DOI:10.1007/s00276-014-1354-y · 1.33 Impact Factor
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    ABSTRACT: The objective of the study was to determine the preferential territories of drainage of skin areas of the face and neck. This knowledge can guide the strategies of diagnostic (search for primary tumor skin to cervical lymphadenopathy) and treatment (determination of the extent of neck dissection to achieve in case of skin tumor). This is a retrospective study of the surgical procedures of sentinel node research between January 2003 and April 2011. The lymphoscintigraphic and intraoperative localization of the initial tumor site and sentinel lymph node were collected. One hundred and thirty-seven patients were included in the study. The parotid gland is a privileged territory of drainage of the head and neck skin. At cervical level, the submental region drains the lower and median part of the face (lips and chin). The posterior segments (IIb and V sector) were represented for the posterior locations of the head (ear, vertex), and cervical region.
    Morphologie 03/2014; DOI:10.1016/j.morpho.2014.01.001
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    ABSTRACT: Sarcoidosis is a multisystem granulomatous disease of unknown cause that commonly involves the spleen. Sarcoid can produce either homogeneous splenomegaly or multiple splenic nodules. Although other organ system involvement usually occurs, this is not invariable. Herein, we report on the clinical, histological, and radiological features-including sonography and MRI-of an isolated splenic sarcoidosis that mimicked neoplastic disease in a 37-year-old female. Knowledge of this atypical sonographic presentation may prevent unnecessary splenectomy. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound, 2013.
    Journal of Clinical Ultrasound 01/2014; 42(1). DOI:10.1002/jcu.22031 · 0.80 Impact Factor
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    ABSTRACT: Background The incidence of critical limb ischemia increases with the aging of the population. Two-thirds of patients with critical limb ischemia present with trophic disorders. Revascularization decreases the rate of amputation. Infected wounds with exposure of the tendons, bones, or points of articulation cannot heal in spite of bridging and local debridement. Surgery associated with a distal venous bypass or recanalization and a free flap makes it possible to cover major tissue loss and offers a hemodynamic advantage by increasing the flow of the bypass, thanks to the vascular bed added by the flap. It is a complex surgery because of the multiplicity of anastomoses on the same arterial axis, with a risk of thrombosis and complications related to the venous autograft. To mitigate these disadvantages, we propose a new surgical method based on the use of a single anatomic unit, the epiploic bypass flap (BF), based on the gastroepiploic artery (GEA) as the inflow for a bypass and a free flap. The objective of this work was to analyze the anatomic feasibility of an epiploic BF and to determine its limits. Methods One hundred anatomic preparations were conducted with a measure of the internal and external diameters and the lengths of GEA and its branches and a radiograph after injection of a radiopaque product. A first clinical application was carried out. Results According to the data, our study confirms the anatomic feasibility of a BF. The average available length of GEA is 245 mm (range: 210–280 mm). The average proximal diameter is 3 mm, and the distal diameter is 1.5 mm. The most distal epiploic branch that feeds the bypass is approximately 180 mm (range: 161–195 mm) of the origin of the GEA. The anatomic unit based on the GEA provides an arterial graft that is relatively long and a large flap that is both malleable and resistant to infection. Conclusions Epiploic BF is a surgical technique that allows for distal revascularization and a simultaneous cover of the limb extremity. This technique can be useful in patients requiring a distal revascularization associated with a cutaneous cover.
    Annals of Vascular Surgery 01/2014; 28(5):1128–1138. · 1.03 Impact Factor
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    ABSTRACT: Introduction The objective of the study was to determine the preferential territories of drainage of skin areas of the face and neck. This knowledge can guide the strategies of diagnostic (search for primary tumor skin to cervical lymphadenopathy) and treatment (determination of the extent of neck dissection to achieve in case of skin tumor). Materials and methods This is a retrospective study of the surgical procedures of sentinel node research between January 2003 and April 2011. The lymphoscintigraphic and intraoperative localization of the initial tumor site and sentinel lymph node were collected. Results and discussion One hundred and thirty-seven patients were included in the study. The parotid gland is a privileged territory of drainage of the head and neck skin. At cervical level, the submental region drains the lower and median part of the face (lips and chin). The posterior segments (IIb and V sector) were represented for the posterior locations of the head (ear, vertex), and cervical region.
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    ABSTRACT: The incidence of critical limb ischemia increases with the ageing of the population. Two thirds of the patients present trophic disorders. Revascularization decreases the rate of amputation. The wounds infected with exposure of the tendons, bones or articulations cannot heal in spite of a bridging and local debridement. Surgery associating a distal venous bypass or recanalisation and a free flap makes it possible to treat the losses of substances and presents a hemodynamic advantage, by increasing the flow of the bypass, thanks to the vascular bed added by the flap. It is a complex surgery because of the multiplicity of anastomoses on the same arterial axis, with a risk of thromboses and complications related to the venous autograft. To mitigate these disadvantages, we proposed a new surgical method based on the use of a single anatomical unit, the epiploic bypass flap (BF), based on the gastroepiploic artery (GEA) as the inflow for a bypass and a free flap. The objective of this work was to analyze the anatomical feasibility of an epiploic bypass flap and to determine its limits. 100 anatomical preparations were carried out with a measure of the internal and external diameters and the lengths of GEA and its branches as well as an X-ray after injection of a radiopaque product. A first clinical application was carried out. According to the data analysis our study confirms the anatomical feasibility of a bypass flap. The average available length of GEA is 245 mm (210-280 mm). The average proximal diameter is 3 mm and the distal one is 1.5 mm. The most distal epiploic branch which feeds the bypass is approximately 180 mm (161-195 mm) of the origin of the gastroepiploic artery. The anatomical unit based on the GEA provides an arterial graft relatively long and a large flap, malleable and resistant to infection. Epiploic bypass flap is a surgical technique which allows distal revascularization and a simultaneous cover of the limb extremity. This technique can be useful in patients requiring a distal revascularization associated with a cutaneous cover.
    Annals of Vascular Surgery 12/2013; DOI:10.1016/j.avsg.2013.10.003 · 1.03 Impact Factor
  • Morphologie 10/2013; 97(s 318–319):85. DOI:10.1016/j.morpho.2013.09.063
  • Morphologie 10/2013; 97(s 318–319):74. DOI:10.1016/j.morpho.2013.09.036
  • Morphologie 10/2013; 97(s 318–319):76–77. DOI:10.1016/j.morpho.2013.09.042
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    ABSTRACT: Study Design: compression biomechanical tests using fresh cadaveric thoracolumbar motion segments.Objective: The purpose of this study was to determine if the combination of bone texture parameters using Bone Micro Architecture (BMA), and Bone Mineral Density (BMD) measurement by dual-energy X-ray absorptiometry ( DXA) provided a better prediction of vertebral fracture than BMD evaluation alone.Summary of Background Data: Bone strength is routinely evaluated using BMD, as measured by DXA. Currently, there is an ongoing debate about the strengths and limitations of bone densitometry in clinical practice. In order to properly assess the fracture risk, other factors are important to be taken into account such as the macro- and microarchitecture of the bone. Recently, a new high-resolution X-ray device with direct digitization, named BMA (BMA™, D3A Medical Systems), has been developed to provide a better precision of texture parameters than those previously obtained on digitized films.Methods: Twenty seven 3-level thoraco-lumbar motion segments (T11, T12, L1 and L2, L3, L4) of excised spines, obtained at the Anatomy Department, were studied using BMA to estimate three textural parameters: fractal parameter H-mean, co-occurrence and runlength matrices, DXA to measure BMD, and mechanical compression tests to failure. All specimens were examined by computed tomography before and after compression.The prediction of the vertebral failure load was evaluated using multiple regression analysesResults: Twenty-seven vertebral fractures were observed with a mean failure load of 2636.3 N (SD, 996 N). Fractal parameter Hmean, co-occurrence, and run-length matrices were each significantly correlated with BMD (p<0.01) and bone strength (p<0.01). Combining bone texture parameters and BMD significantly improved the fracture load prediction from adjusted r=0.701 to adjusted r=0.806 (p<0.01).Conclusion: In these excised vertebrae, the combination of bone texture parameters withBMD demonstrated a better performance in the failure load prediction than that of BMD alone.
    Spine 07/2013; DOI:10.1097/BRS.0b013e3182a28fa9 · 2.45 Impact Factor
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    ABSTRACT: PURPOSE: Femoral neck fracture is a major public health problem in elderly persons, representing the main source of osteoporosis-related mortality and morbidity. In this study, we aimed at comparing radiographic texture analysis with three-dimensional (3D) microarchitecture in human femurs, and at evaluating whether bone texture analysis improved the assessment of the femoral neck fracture risk other than that obtainable by bone mineral density (BMD). MATERIALS AND METHODS: Thirteen osteoporotic femoral heads from patients who fractured their femoral neck and twelve non-fractured femoral heads from osteoarthritic patients were studied using respectively (1) a new high-resolution digital X-ray device (BMA™, D3A Medical Systems) allowing for bone texture analysis with fractal parameter Hmean, and (2) a micro-computed tomograph (CT) for 3D microarchitecture. BMD was measured postoperatively by DXA in all patients in the contralateral femur. RESULTS: In these femoral heads, we found that fractal parameter Hmean was correlated with 3D microarchitecture parameters: bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular separation (Tb.Sp) and fractal dimension (FD) respectively (p<0.05). Then, fractal parameter Hmean was significantly lower in the femoral heads from the fractured group than from the non-fractured group (p<0.01). Finally, multiple regression analysis showed that combining bone texture analysis and total hip BMD significantly improved the estimation of the femoral neck fracture risk from adjusted r(2)=0.46 to adjusted r(2)=0.67 (p<0.05). CONCLUSION: Radiographic bone texture analysis was correlated with 3D microarchitecture parameters in the femoral head, provided accurate discrimination between the femoral heads from the fractured and non-fractured groups, and significantly improved the estimation of the femoral neck fracture risk when combined with BMD.
    European journal of radiology 06/2013; 82(9). DOI:10.1016/j.ejrad.2013.04.042 · 2.16 Impact Factor
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    ABSTRACT: OBJECTIVES: To determine whether ultrasound allows precise assessment of the course and relations of the dorsal cutaneous branch of the ulnar nerve (DCBUN). METHODS: This work, initially undertaken in cadavers, was followed by high-resolution ultrasound study in 20 healthy adult volunteers (40 nerves) by two musculoskeletal radiologists in consensus. Location and course of the DCBUN and its relations to adjacent anatomical structures were analysed. RESULTS: The DCBUN was consistently identified along its entire course by ultrasound. Mean cross-sectional area of the nerve was 1.6 mm(2) (range 1.1-2.2). The level at which the DCBUN branches from the ulnar nerve was located a mean of 57 mm (range 40-80) proximal to the ulnar styloid process and 11 mm (range 7-15) radial to the medial border of the ulna. The DCBUN then crossed the medial border of the ulna a mean of 14 mm (range 6-25) proximal to the ulnar styloid process. CONCLUSION: The DCBUN is clearly depicted by ultrasound. Precise mapping of its anatomical course could have significant clinical applications, such as preventing injury during surgery of the ulnar side of the wrist or helping in the diagnosis of chronic pain of the ulnar side of the hand. KEY POINTS: • The dorsal cutaneous branch of the ulnar nerve (DCBUN) is often injured. • The DCBUN originates from the ulnar nerve in the distal third of the forearm. • It can be clearly depicted by ultrasound. • The level at which the DCBUN crosses the ulna is variable. • Precise mapping of its anatomical course could have significant clinical applications.
    European Radiology 04/2013; 23(8). DOI:10.1007/s00330-013-2832-z · 4.34 Impact Factor
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    ABSTRACT: Fracture of the proximal femur is a major public health problem in elderly persons. It has recently been suggested that combining texture analysis and bone mineral density measurement improves the failure load prediction in human femurs. In this study, we aimed to compare bone texture analysis with three-dimensional (3D) microarchitecture and mechanical properties of trabecular bone in osteoporotic femurs. Eight femoral heads from osteoporotic patients who fractured their femoral neck provided 31 bone cores. Bone samples were studied using a new high-resolution digital X-ray device (BMA™, D3A Medical Systems) allowing for texture analysis with fractal parameter H (mean), and were examined using micro-computed tomography (microCT) for 3D microarchitecture. Finally, uniaxial compression tests to failure were performed to estimate failure load and apparent modulus of bone samples. The fractal parameter H (mean) was strongly correlated with bone volume fraction (BV/TV) (r = 0.84) and trabecular thickness (Tb.Th) (r = 0.91) (p < 0.01). H (mean) was also markedly correlated with failure load (r = 0.84) and apparent modulus (r = 0.71) of core samples (p < 0.01). Bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) demonstrated significant correlations with failure load (r = 0.85 and 0.72, respectively) and apparent modulus (r = 0.72 and 0.64, respectively) (p < 0.01). Overall, the best predictors of failure load were H (mean), bone volume fraction, and trabecular thickness, with r (2) coefficients of 0.83, 0.76, and 0.80 respectively. This study shows that the fractal parameter H (mean) is correlated with 3D microCT parameters and mechanical properties of femoral head bone samples, which suggests that radiographic texture analysis is a suitable approach for trabecular bone microarchitecture assessment in osteoporotic femurs.
    Journal of Bone and Mineral Metabolism 08/2012; 31(1). DOI:10.1007/s00774-012-0375-z · 2.11 Impact Factor
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    ABSTRACT: L’imagerie par résonance magnétique (IRM) du genou occupe aujourd’hui une place centrale dans la stratégie diagnostique devant une suspicion clinique de lésion ligamentaire du genou. Elle est particulièrement incontournable pour le bilan du pivot central et des lésions méniscales éventuellement associées. L’objectif de cette mise au point est de présenter les différents signes IRM directs et indirects de rupture du ligament croisé antérieur (LCA), puis de définir les lésions associées. Les aspects anatomiques et cliniques sont également exposés afin de mieux comprendre l’apport de l’IRM dans la conduite diagnostique et dans la prise en charge thérapeutique de la rupture du LCA.
    05/2012; 93(5):357–367. DOI:10.1016/j.jradio.2011.02.030
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    ABSTRACT: When faced with a clinical suspicion of knee ligament injury, MRI nowadays has a central role in the diagnostic strategy. In particular, it is essential for assessing the cruciate ligaments and any associated meniscal tears. The objective of this review is to present the various direct and indirect MRI signs of tearing of the anterior cruciate ligament (ACL) and then describe the lesions associated with it. The anatomical and clinical aspects are also discussed so that the contribution of MRI to the diagnosis and therapeutic management of an ACL tear can be better understood.
    04/2012; 93(5):331-41. DOI:10.1016/j.diii.2012.02.003

Publication Stats

867 Citations
184.96 Total Impact Points

Institutions

  • 2004–2014
    • Aix-Marseille Université
      • Faculté de Médecine
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 2013
    • Laboratoire d’Informatique Fondamentale de Marseille
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 2005–2013
    • Assistance Publique Hôpitaux de Marseille
      • Service de cardiologie
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 1997–1999
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
  • 1995–1997
    • IOAPC
      Lutetia Parisorum, Île-de-France, France