[show abstract][hide abstract] ABSTRACT: Purpose:
The purpose of our study is to determine whether there is a relation between overweight, age, sex, « hospitalised/outpatient » status and a non-inflammatory hypersignal of the subcutaneous lumbosacral adipose tissue in T2-STIR (T2 Short-Tau Inversion-Recovery) MR imaging sequences.
Patients and methods:
106 lumbar MRI, including a T2-STIR and T1 FLAIR (Fluid Attenuated Inversion Recovery) weighted sagittal sequences, were retrospectively taken from the picture archiving and communication system (PACS) of our hospital and then made anonymous and analysed. The presence or absence of a T2-STIR hypersignal within subcutaneous adipose tissue behind the paraspinal muscle aponeurosis was determined. In addition, the weight, thickness of the fat tissue, the administrative status of the patient, the age, sex, time of the examination and, when present, the height of this hypersignal were noted. A uni and multivariate analysis by logistic regression was carried out in order to examine the relationship between the data gathered.
In the examinations selected, 25.5% (n = 27) demonstrated a T2-STIR hypersignal in the subcutaneous tissue. We identified the weight (p <0.023), thickness of the fat tissue (p <0.001), the age of the patient (p<0.017) and the « hospitalised » status (p <0.009) as significant variables associated with this T2-STIR hypersignal. The mean height of the hypersignal was 109.5 millimetres. Five of the 27 patients had an injection of gadolinium chelate and no enhancement was found at this level.
We found a significant link between overweight, age and « hospitalised » status and the non-inflammatory infiltration of lumbar adipose tissue. This phenomenon seems to correspond with an interstitial oedema, related to subcutaneous stasis. This anomaly should not be confused with a local inflammation.
Keywords: Oedema, STIR, lumbar spine, subcutaneous fat, overweight.
[show abstract][hide abstract] ABSTRACT: Group A rotaviruses are a leading cause of neonatal calf diarrhoea worldwide and prevention of this disease includes vaccination against these viruses. In order to highlight the potential selection of rotavirus genotypes due to immune pressure driven by vaccination, the aim of this study was to compare group A rotavirus genotypes circulating in French diarrhoeic calves in rotavirus vaccinated herds (G6P vaccine) with those in non-vaccinated herds during one calving season in 2010. This study showed a high prevalence of rotavirus in both groups with no significant difference between the two. No significant differences regarding G, P and G/P rotavirus genotype distribution between the two groups were observed, with G6, P and G6P genotypes being by far the most prevalent. Moreover, sequence analyses of the VP7 and VP4 partial coding genes of the G6P strains from this study did not allow us to distinguish them according to their origin. This study also showed that other pathogens responsible for calf diarrhoea, such as genogroup III noroviruses and neboviruses, were not more frequently associated with calf diarrhoea in vaccinated herds. Altogether, these results suggest that the studied vaccine did not promote the emergence of rotavirus genotypes or variants different from those of the vaccine or other viruses responsible for calf diarrhoea, such as caliciviruses.
[show abstract][hide abstract] ABSTRACT: The virucidal efficacy of a pulsed light treatment applied to viral suspensions, glass beads and herb powders was studied for the F-RNA bacteriophage MS2. The experimental results obtained demonstrated the high potential of this technology to efficiently decontaminate simple matrices but underlined the complexity of application to complex food matrices.
Food and Environmental Virology 03/2013; · 2.51 Impact Factor
[show abstract][hide abstract] ABSTRACT: Objectif
L’objectif de notre travail est d’évaluer le résultat et le coût global d’une stratégie de traitement des patients atteints d’un carcinome hépatocellulaire (CHC) non résécable non métastatique par chimioembolisation (CHE) avec billes chargées.
Patients et méthodes
L’ensemble des patients traités par CHE avec billes chargées pour un CHC entre janvier 2009 et décembre 2010 dans notre établissement a été inclus dans l’étude. Tous les patients étaient traités selon une stratégie « à la demande » avec évaluation après chaque cure de CHE.
Vingt et un patients ont reçu en moyenne 1,3 cures. La médiane de temps jusqu’à arrêt du traitement et la médiane de survie sans progression étaient de 181 et 295 jours, respectivement. Le traitement a été arrêté chez trois patients (14 %) pour toxicité. D’un point de vue hospitalier, le coût médical direct moyen du traitement s’élevait à 6033 € selon la comptabilité analytique de notre établissement vs 4558 € d’après les tarifs nationaux des groupes homogènes de séjours (p = 0,002).
Le traitement du CHC par CHE avec billes chargées « à la demande » permet un contrôle de la maladie pour certains patients avec un coût insuffisamment valorisé par la tarification à l’activité.
Journal de Radiologie Diagnostique et Interventionnelle. 01/2013; 94(1):52–59.
[show abstract][hide abstract] ABSTRACT: Objectifs
Le but de notre étude est d’évaluer s’il existe une association entre le surpoids, l’âge, le sexe, le statut « hospitalisé/externe » et un hypersignal non inflammatoire du tissu adipeux sous-cutané lombosacré en IRM sur la séquence T2 short-tau inversion-recovery (T2-STIR).
Patients et méthodes
Cent-six IRM lombaires, comprenant une séquence sagittale pondérée T2-STIR et une pondérée T1 FLAIR, ont été extraites rétrospectivement, à partir du système d’archivage de notre l’hôpital, puis anonymisées et analysées. La présence ou non d’un hypersignal T2-STIR au sein des tissus adipeux sous-cutanés en arrière de l’aponévrose des muscles paraspinaux a été recherchée. De même, le poids, l’épaisseur adipeuse, le statut administratif du patient, l’âge, le sexe, l’heure de réalisation de l’examen et, lorsqu’il était présent, la hauteur de cet hypersignal ont été enregistrés. Une analyse uni- et multivariée par régression logistique a été effectuée afin d’examiner les relations entre ces données.
Sur les examens sélectionnés, 25,5 % (n = 27) ont montré un hypersignal T2-STIR dans l’hypoderme. Nous avons identifié le poids (p < 0,023), l’épaisseur adipeuse (p < 0,001), l’âge du patient (p < 0,017) et le statut « hospitalisé » (p < 0,009) comme variables significatives associées à cet hypersignal T2-STIR. La hauteur moyenne de l’hypersignal était 109,5 millimètres. Parmi ces 27 patients, 5 ont eu une injection de chélate de gadolinium ne retrouvant aucun rehaussement à ce niveau.
Nous avons trouvé une association significative entre le surpoids, l’âge et le statut « hospitalisé » et une infiltration non inflammatoire du tissu adipeux lombaire. Ce phénomène semble correspondre à un œdème interstitiel, lié à une stase sous-cutanée. Cette anomalie ne doit pas être confondue avec une inflammation locale.
Journal de Radiologie Diagnostique et Interventionnelle. 01/2013;
[show abstract][hide abstract] ABSTRACT: PURPOSE: The aim of our study was to assess the results and cost of a treatment strategy involving transarterial chemoembolisation with drug eluting beads (DEB-TACE) in patients with unresectable non-metastatic hepatocellular carcinoma (HCC). PATIENTS AND METHODS: This study included all patients treated with DEB-TACE in our hospital between January 2009 and December 2010. All patients received DEB-TACE on demand and were evaluated after each session. RESULTS: Twenty-one patients received an average of 1.3 sessions. The median time to treatment discontinuation and median progression-free survival was 181days and 295days, respectively. Toxicity caused treatment discontinuation in three patients (14%). For the hospital, the average direct cost of treatment was €6,033 according to the analytical accounting system vs. €4,558 according to the official tariffs from the new French Diagnosis-Related Group prospective payment system (P=0.002). CONCLUSION: In the treatment of HCC, on-demand DEB-TACE stabilises the disease in some patients but has not yet been thoroughly evaluated.
[show abstract][hide abstract] ABSTRACT: OBJECTIVE: Retinol-binding protein 4 (rbp4) is an adipokine secreted by adipocytes and liver, whose levels are elevated in type 2 diabetes mellitus (T2DM). Plasma levels of rbp4 and triglycerides are strongly correlated in T2DM. However, we do not know whether this association is direct or indirect via liver fat content, and the link between rbp4 and triglyceride metabolism remains unknown. METHODS AND RESULTS: Liver fat measurement by proton spectroscopy was performed in 221 patients with T2DM, and an in vivo kinetic study with stable isotopes was carried out in 14 patients with T2DM. In multivariate analysis, triglycerides were associated positively with rbp4 (β=0.273, P<0.0001), apolipoprotein (apo) B (β=0.258, P<0.0001), and liver fat (β=0.191, P=0.002) and negatively with high-density lipoprotein cholesterol (β=-0.442, P<0.0001). rbp4 was correlated positively with apoB100 very-low-density lipoprotein (VLDL) pool (r=0.62, P=0.017) and negatively with VLDL-apoB100 total fractional catabolic rate (r=-0.66, P=0.001). In multivariate analysis, rbp4 (P=0.015), plasma triglycerides (P=0.024), and sex (P=0.026) were independently associated with VLDL-apoB100 total fractional catabolic rate. CONCLUSIONS: In T2DM, plasma rbp4 level is associated with plasma triglycerides, independently of liver fat content. There is a strong independent negative correlation between plasma rbp4 and VLDL-apoB100 total fractional catabolic rate. These data suggest that rbp4 may be involved in the pathophysiology of hypertriglyceridemia in T2DM by reducing VLDL catabolism.
Arteriosclerosis Thrombosis and Vascular Biology 10/2012; · 6.34 Impact Factor
[show abstract][hide abstract] ABSTRACT: To assess the heterogeneity of liver fat deposition with MR of the liver in type-2 diabetic (T2D) patients.
We enrolled 121 consecutive T2D patients. The reference standard was 3.0-T (1)H-MR spectroscopy. Hepatic steatosis was defined as liver fat content (LFC) ≥5.56 %. A triple-echo gradient-echo sequence corrected for T1 recovery and T2* decay was used to calculate LFC in left and right livers and hepatic segments. Analyses were performed using a linear mixed model.
Fifty-nine (48.8 %) patients had liver steatosis, whereas 62 (51.2 %) did not. Steatosis was greater in the right than in the left liver (P < 0.0001) [mean difference: 1.32 % (range: 0.01-8.75 %)]. In seven patients (5.8 %), LFC was <5.56 % in one side of the liver, whereas it was ≥5.56 % in the other. Steatosis of the left and right liver was heterogeneous at the segmental level in both non-steatotic (P < 0.001 and P < 0.0001 respectively) and steatotic (P < 0.0001 and P = 0.0002 respectively) patients [mean maximum difference: 3.98 % (range: 0.74-19.32 %)]. In 23 patients (19 %), LFC was <5.56 % in one segment, whereas it was ≥5.56 % in at least one other.
Overall, the mean segmental/lobar variability of steatosis is low. However, segmental variability can sometimes lead to a misdiagnosis.
There is a need for methods quantifying steatosis over a large region. Steatosis is usually greater in the right than left lobe of the liver. Steatosis within both left and right hepatic lobes is segmentally heterogeneous. Segmental variability of steatosis can result in misdiagnosis.
European Radiology 05/2012; 22(10):2161-8. · 3.55 Impact Factor
[show abstract][hide abstract] ABSTRACT: Telomeres are specialized DNA structures located at the ends of chromosomes. Their length is reduced at each cell cycle, especially when the cumulative burden of oxidative stress is high. The purpose of this study was to determine the associations between telomere length and clinical and biological risk factors in ischemic stroke patients. A total of 215 stroke patients hospitalized in the Dijon, France, stroke unit were prospectively and continuously included from January to September, 2004. The telomere length measured from peripheral blood leukocytes--leukocyte telomere length (LTL)--was determined by real-time quantitative polymerase chain reaction. The results were compared with clinical and biological variables of interest collected at admission to find significant associations. Possible relationships between LTL and stroke subtypes were evaluated. A multiple regression that included all the variables significantly associated (p<0.20) with LTL in univariate analysis and age and subtypes of stroke confirmed a significant association with age (p<0.001), homocysteinemia (p=0,049), and levels of both antiphospholipid antibodies (p=0.019) and triglycerides (p=0.007). Linearity was verified and confirmed for each variable. The subtype of stroke did not significantly affect telomere length. We were able to highlight significant associations between LTL and certain cerebrovascular risk factors in a general population of stroke patients. These associations did not depend on the ischemic stroke subtype.
Rejuvenation Research 04/2012; 15(3):274-80. · 2.92 Impact Factor
[show abstract][hide abstract] ABSTRACT: Transarterial chemoembolisation (TACE) is usually performed by injecting an emulsion of a drug and iodised oil. Drug-eluting beads (DEBs) have undeniable pharmacological advantages by offering simultaneous embolisation and sustained release of the drug to the tumour. No data are currently available on liver/biliary injury following DEB-TACE. This study describes and compares liver/biliary injuries encountered with TACE in tumours developed in cirrhotic (hepatocellular carcinoma (HCC)) and non-cirrhotic (endocrine tumours (NETs)) livers.
In consecutive patients treated for a well-differentiated metastatic NET (n=120) or a HCC (n=88), 684 CT- and MR-scans were analysed. Liver/biliary injuries were classified as follows: dilated bile duct, portal vein narrowing, portal venous thrombosis and biloma/liver infarct. A generalised estimating equation logistic regression model was used.
A liver/biliary injury followed 17.2% (82/476) of sessions in 30.8% (64/208) of patients. The occurrence of liver/biliary injury was associated with DEB-TACE (OR=6.63; p<0.001) irrespectively of the tumour type. Biloma/parenchymal infarct was strongly associated with both DEB-TACE (OR=9.78; p=0.002) and NETs (OR: 8.13; p=0.04). Biloma/liver infarcts were managed conservatively but were associated with an increase in serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatases, and gamma glutamyl transpeptidase (p=0.005, p=0.005, p=0.012, and p=0.006, respectively).
Liver/biliary injuries are independently associated with DEB-TACE. Biloma/liver infarct, the most serious injury, is independently associated with both DEB-TACE and NETs. The absence of such an association in TACE of HCC may be explained by the hypertrophied peribiliary plexus observed in cirrhosis, which protects against the ischemic/chemical insult of bile ducts. We suggest caution when using DEB-TACE in the non-cirrhotic liver.
Journal of Hepatology 03/2012; 56(3):609-17. · 9.86 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of this study was to select the best candidate drug for transarterial chemoembolization by in-vitro cytotoxic evaluations of 11 anticancer drugs on three human hepatocellular carcinoma (HCC) cell lines. The SNU-398, HepG2, and SNU-449 human HCC cell lines were exposed for 30 min to 11 concentrations of doxorubicin, epirubicin, idarubicin, mitoxantrone, carboplatin, cisplatin, oxaliplatin, 5-fluorouracil, gemcitabine, mitomycin C, or paclitaxel. Cytotoxicity was measured using a quantitative colorimetric assay. For each drug and cell line, we calculated the drug concentration that caused 90% cell death (IC90). To enable comparisons of drugs with different concentration ranges, we computed the cytotoxic index (CyI) as the ratio of maximal drug concentration of more than IC90. Parameters were estimated using nonlinear regression models. Idarubicin was the most active drug on all three cell lines. With SNU-398 cells, the idarubicin CyI was 2.4-fold, 2.5-fold, 57-fold, 148-fold, and more than 58 748-fold higher than the CyIs of mitoxantrone, epirubicin, doxorubicin, gemcitabine, and other drugs, respectively. With HepG2 cells, the idarubicin CyI was 27-fold, 28-fold, 51-fold, and more than 1343-fold higher than the CyIs of doxorubicin, epirubicin, mitoxantrone, and other drugs, respectively. On the resistant SNU-449 cell line, the idarubicin CyI was 2.9-fold and 14-fold higher than the CyIs of paclitaxel and gemcitabine, respectively, the only other drugs effective on this cell line. Among 11 chemotherapeutic agents including doxorubicin, cisplatin, and epirubicin, the most effective on three HCC cell lines was idarubicin. Further clinical investigations are needed to evaluate the safety and efficacy of idarubicin for transarterial chemoembolization in HCC.
[show abstract][hide abstract] ABSTRACT: To assess the systematic errors in liver methylene fraction (LMF) resulting from fat-fat interference effects with dual- and triple-echo gradient-recalled-echo Dual/Triple GRE) sequences and to test the robustness of these sequences after iron overloading.
Forty type-2 diabetic patients underwent LMF measurement by 3.0T ¹H magnetic resonance spectroscopy (corrected for T1 and T2 decays) as the reference standard and liver fat fraction (%Fat) measurement by four Dual/Triple GRE sequences with 20° and 60° flip angle (α), corrected for T1 recovery. The same four sequences were repeated in eight patients after ferumoxide injection. Corrections for systematic errors were determined from the linear regressions (spectroscopy LMF values over Dual/Triple GRE %Fat values). Robustness was tested using Wilcoxon's signed-rank test.
Fat-fat interference effects produced a ∼10% relative systematic error and T2* decay produced a 1.9%-4.2% absolute systematic error in LMF. When comparing before and after ferumoxide, dual-echo imaging with α = 20° and α = 60°, even when corrected, showed absolute differences of 7.23% [2.81%-10.25%] (P = 0.0117) and 5.65% [1.89%-8.216.8%] (P = 0.0117), respectively; compared to only 1.17% [0.08%-2.83%] (P = 0.0251) and 1.15% [0.37%-2.73%] (P = 0.2626) with triple-echo imaging and α = 20° and α = 60°, respectively.
Triple-echo imaging with α = 60° corrected for both T1 recovery and fat-fat interference effects is robust after superparamagnetic iron oxide (SPIO) administration and can reliably quantify LMF.
Journal of Magnetic Resonance Imaging 01/2011; 33(1):119-27. · 2.57 Impact Factor
[show abstract][hide abstract] ABSTRACT: The purpose of this study was to validate a magnetic resonance imaging (MRI) technique for mapping liver fat, using (1)H magnetic resonance spectroscopy ((1)H-MRS) as the reference standard. In 91 patients with type 2 diabetes, 3.0-T single-voxel point-resolved (1)H-MRS was used to calculate the liver fat fraction (LFF) from the water (4.76 ppm) and methylene (1.33 ppm) peaks, corrected for T1 and T2 decays. LFF (corrected for T1 and T2* decays) was also obtained from the mean signal intensity on a map built from a triple-echo (consecutive in-phase, opposed-phase, and in-phase echo times) breath-hold gradient echo sequence, using basic image calculation functions (arithmetic mean, subtraction, division, multiplication by a numerical factor). Mean LFF was 8.9% (range, 0.9-33.5) by MRI and 8.8% (range, 0-34.1) by (1)H-MRS. Pearson's coefficient was 0.976 (P < 0.0001) and Lin's coefficient was 0.975 (P < 0.0001). Liver segment had no significant influence. With Bland-Altman analysis, 95.6% (87/91) of data points were within the limits of agreement. Given its excellent agreement with (1)H-MRS, our mapping technique can be used for visual and quantitative evaluation of liver fat in everyday practice.
European Radiology 02/2009; 19(7):1786-93. · 3.55 Impact Factor
[show abstract][hide abstract] ABSTRACT: Although previous studies have found that cerebral white matter hyperintensities are associated with balance-gait disorders, no proton magnetic resonance spectroscopy data at the plane of the basal ganglia have been published. We investigated a possible relationship between balance performance and brain metabolite ratios or structural MRI measurements. We also included neuropsychological tests to determine whether such tests are related to structural or metabolic findings. All 80 participants were taken from the cohort of the Three-City study (Dijon-Bordeaux-Montpellier, France). The ratios of N-acetyl-aspartate to creatine (NAA/Cr) and choline to creatine (Cho/Cr) were calculated in the basal ganglia, thalami and insular cortex. We used univariate regression to identify which variables predicted changes in NAA/Cr and Cho/Cr, and completed the analysis with a multiple linear or logistic regression. After the multivariate analysis including hypertension, age, balance-gait, sex, white matter lesions, brain atrophy and body mass index, only balance-gait performance remained statistically significant for NAA/Cr (p=0.01) and for deep white-matter lesions (p=0.02). The Trail-Making Test is independently associated with brain atrophy and periventricular white-matter hyperintensities. Neuronal and axonal integrity at the plane of the basal ganglia is associated with balance and gait in the elderly, whereas brain flexibility is associated with structural MRI brain abnormalities.
Journal of Clinical Neuroscience 01/2009; 15(12):1360-5. · 1.25 Impact Factor
[show abstract][hide abstract] ABSTRACT: To validate a triple-echo gradient-echo sequence for measuring the fat content of the liver, by using hydrogen 1((1)H) magnetic resonance (MR) spectroscopy as the reference standard.
This prospective study was approved by the appropriate ethics committee, and written informed consent was obtained from all patients. In 37 patients with type 2 diabetes (31 men, six women; mean age, 56 years), 3.0-T single-voxel point-resolved (1)H MR spectroscopy of the liver (Couinaud segment VII) was performed to calculate the liver fat fraction from the water (4.7 ppm) and methylene (1.3 ppm) peaks, corrected for T1 and T2 decay. Liver fat fraction was also computed from triple-echo (consecutive in-phase, opposed-phase, and in-phase echo times) breath-hold spoiled gradient-echo sequence (flip angle, 20 degrees), by estimating T2* and relative signal intensity loss between in- and opposed-phase values, corrected for T2* decay. Pearson correlation coefficient, Bland-Altman 95% limit of agreement, and Lin concordance coefficient were calculated.
Mean fat fractions calculated from the triple-echo sequence and (1)H MR spectroscopy were 10% (range, 0.7%-35.6%) and 9.7% (range, 0.2%-34.1%), respectively. Mean T2* time was 14.7 msec (range, 5.4-25.4 msec). Pearson correlation coefficient was 0.989 (P < .0001) and Lin concordance coefficient was 0.988 (P < .0001). With the Bland-Altman method, all data points were within the limits of agreement.
A breath-hold triple-echo gradient-echo sequence with a low flip angle and correction for T2* decay is accurate for quantifying fat in segment VII of the liver. Given its excellent correlation and concordance with (1)H MR spectroscopy, this triple-echo sequence could replace (1)H MR spectroscopy in longitudinal studies.
[show abstract][hide abstract] ABSTRACT: Our objective was to investigate the influence of hypertension on N-acetylaspartate (NAA) and choline (Cho) ratios in brain tissues in a community-dwelling elderly population. Brain flexibility was also evaluated with regard to the same metabolite ratios. Proton magnetic resonance spectroscopy (MRS) and the Trail Making Test (TMT) were performed in 80 subjects (75.7+/-4 years old) from the Three-City Study. Fifty-eight participants had hypertension. The NAA/creatine (Cr) and Cho/Cr ratios were obtained in the insular cortex, the thalami and the deep periventricular white matter. In addition, the B-A score of the TMT was evaluated. Uni- and multi-variate analyses were performed in order to examine the relationships among these data. In the insula and the thalami of the hypertensive group, NAA/Cr ratios were significantly lower (1.39+/-0.23 and 1.52+/-0.23, respectively; p=0.01) than those in the normotensive control group (1.52+/-0.25 and 1.70+/-0.19, respectively; p<0.0001), whereas no such reduction was observed in the periventricular white matter of older hypertensive brains. Moreover, the NAA or Cho ratios were significantly correlated with the TMT B-A scores at the level of the thalami, insula and periventricular white matter. These statistical results were confirmed by the multivariate analysis. In an elderly population, hypertension leads to a reduction in NAA/Cr ratios in the insula and the thalami, possibly due to a decrease in blood flow through small perforating and cortical arteries. The TMT B-A test appears to be relevant not only for the frontal areas but also for more remote areas such as the thalami, the insula and the deep periventricular white matter.
Hypertension Research 10/2008; 31(10):1851-7. · 2.79 Impact Factor