Jean-François F Moreau

• M.D., Hy FACR
• CEO at Université Paris Cité

Although image-based human stereotaxis began with Spiegel and Wycis in 1947, the major principles of radiographic stereotaxis were formulated 50 years earlier by the French scientific photographer Gaston Contremoulins. In 1897, frustrated by the high morbidity of bullet extraction from the brain, the Parisian surgeon Charles Rémy asked Contremoulin...

To identify the factor(s) most predictive of pT3 tumor and those most predictive of a positive endorectal magnetic resonance (MR) imaging result in patients with clinically localized prostate cancer. At multivariate analysis, five preoperative clinical parameters-prostate-specific antigen (PSA) level, digital rectal examination (DRE) result, Gleaso...

Deep pelvic endometriosis may lead to severe pain, the treatment of which may require complete surgical resection of lesions. Digestive infiltration is a difficult therapeutic problem. Preoperative diagnosis is difficult and digestive infiltration may remain unknown with incomplete resection and sometimes repeated surgery. Both magnetic resonance i...

The purpose of this study was to describe endorectal sonography and color Doppler sonography features of nonpalpable prostate cancer and to assess the value of endorectal MR imaging for the preoperative local staging of these tumors. Ninety-four patients with nonsuspicious findings on digital rectal examination and a mean prostate-specific antigen...

Renal sinus pathology can be classified into 3 groups: intrinsic lesions that arise from the anatomical components of the sinus (fatty tissue, collecting system, arteries and veins, lymphatic vessels, and nerves); extrinsic lesions that develop within the renal sinus from the renal parenchyma; secondary lesions including metastases and retroperiton...

OBJECTIVE. The purpose of this study was to describe endorectal sonography and color Doppler sonography features of nonpalpable prostate cancer and to assess the value of endorectal MR imaging for the preoperative local staging of these tumors. MATERIALS AND METHODS. Ninety-four patients with nonsuspicious findings on digital rectal examination and...

Benign diseases of the uterus can be evaluated by ultrasound, magnetic resonance imaging (MRI), hysterography, hysterosonography and hysteroscopy. The purpose of this review of the literature is to discuss the role of MRI among the different imaging modalities for the diagnosis of mullerian abnormalities of the uterus, endometrial disease, fibroids...

To describe the technique and results of incision of strictures in anastomotic urinary diversions with a commercially available cutting balloon catheter. Thirty-seven stenoses were treated in 32 patients. Most (28 [88%]) of the patients had undergone surgery for bladder cancer 17.7 months +/- 17.4 (SD) (range, 3-72 months) before incision. Thirteen...

We report a case of renal sarcoidosis revealed by a malignant hypertension associated with renal insufficiency. Ultrasonographic and CT findings are described. The lesions showed multifocal hypoechogenic areas within the renal parenchyma. The disease was pathologically proved after US guided biopsy.

Noninvasive diagnosis of peripheral vascular disease started with the introduction of Doppler technology. The development of high frequency ultrasound and color Doppler imaging allows continuous assessment of vascular disorders along the arterial tree. However, the technique remains operator dependent. It also suffers from anatomic limitations, suc...

Transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) are the two imaging modalities used to describe zonal anatomy and its corresponding diseases. Until a sufficiently sensitive and specific marker becomes available, TRUS and color-Doppler sonography will continue to provide complementary information to PSA assay in patients with norm...

The aim of this study was to describe magnetic resonance (MR) imaging findings in histopathologically proven deep endometriosis infiltrating the uterosacral ligaments, the pouch of Douglas, the rectum or the bladder. Twenty patients presenting with a clinical suspicion of deep endometriosis underwent preoperative MR imaging. Sagittal and axial fast...

Ultrasonography and scintigraphy are the first line diagnostic imaging modalities for the evaluation of thyroid nodules. Scintigraphy provides functional informations, mainly detection of hot nodules. US provides accurate morphologic evaluation and it may sometimes suggest malignancy. US is the modality of choice for follow-up of non resected nodul...

The purpose of this study is to provide an updated pathologic-radiologic classification of cystic renal tumors and to assess imaging diagnostic capabilities. Eighty seven cases of cystic renal tumors explored with multimodality imaging (ultrasonography, CT, MRI, arteriography) and with histopathologic correlation are reported. The most common cysti...

Varicocele can be very easily diagnosed by physical examination and subsequently treated when it is painful or associated with testicular hypotrophy. However, palpability of the spermatic vein and reflux in low grade or even questionable varicoceles can be difficult to assess without imaging modalities. This can be a common problem for all physicia...

Contrast agents improve the diagnostic capability of ultrasonic imaging. Optimized methods for agent administration and quantification of signal enhancement, however, remain under development. The authors' purpose was to develop an in vitro perfusion phantom in order to compare quantification methods. The acoustic response of contrast agent was mea...

The purpose of this study is to provide an updated pathologic-radiologic classification of cystic renal tumors and to assess imaging diagostic capabilities. Eighty seven cases of cystic renal tumors explored with multimodality imaging (ultrasonography, CT, MRI, arteriography) and with histopathologic correlation are reported. The most common cystic...

Power Doppler ultrasound (US) is a new technology that is superior to conventional color Doppler imaging in the detection of blood flow. Because of its greater sensitivity to flow and reduced angle dependence, power Doppler US demonstrates optimal color filling of renal pedicular vessels and allows improved evaluation of the renal parenchymal micro...

Objective: We report three cases of a rare form of cavernoma developed within the wall of the common bile duct. Conclusion: To our knowledge, this kind of portal cavernoma has not been described in the literature. Because the cavernoma may be easily confused with other causes of bile duct wall thickening, color Doppler sonography is mandatory fo...

Color Doppler ultrasonography impact has been constantly growing since its discovery. The recent introduction of efficient and safe ultrasound contrast agents (USCAs) is fully participating to this development. Renal vascular diseases evaluation is facing many technical and anatomical limits. USCAs increase the Doppler signal intensity and the rena...

Settings optimization for ultrasound contrast imaging relies on the physics of microbubbles submitted to an ultrasound beam. Thus, specific settings can be developed and implemented in ultrasound units to improve the diagnostic value of ultrasound contrast agents and limit the artifacts, such as color blooming. This first step has been followed by...

Ultrasound contrast agents (USCAs) are now becoming commercially available. During the past decade, both tolerance and efficacy of microbubble USCAs increased in conjunction with the ultrasound instrumentation. Specific contrast image sequences have been developed to take advantage of the specific microbubble ultrasonic properties. USCAs are well t...

To evaluate the pharmacokinetics of EchoGen (Perflenapent emulsion) comparing two formulations (with and without Poloxamer 403) and two different phase shift activation methods (microfilter and hypobaric). Expired air and blood samples were collected at timed intervals from phase I and phase II studies in volunteers and patients and analyzed by gas...

To assess the diagnostic performance of dodecafluoropentane-enhanced ultrasonography for urinary tract diseases. Twenty patients with insufficient routine examination, assessed by two independent sonographists, were studied with a Toshiba SSA 270A at 3.75 MHz after administration of Perflenapent emulsion (EchoGen) 0.05 mL/kg i.v. The series encompa...

Contrast agents have been used in ultrasonography for about 30 years, but the risk of toxicity and the inefficacy of certain agents has long limited their use. The recent development of well-tolerated agents which cross the pulmonary capillary barrier after peripheral intravenous injection has made the use of contrast agents possible in routine cli...

To compare results of color Doppler-guided ultrasonography (CDUS) versus those of systematic biopsies in 591 patients with an elevated serum PSA level and to correlate them with digital rectal examination (DRE) findings. Biopsies were directed into hypervascularized (CDUS+) or hypovascularized (CDUS-) hypoechoic peripheral zone nodules (443 cases)....

Color Doppler ultrasound (CDUS) seems to be an effective imaging technique for the diagnosis of renal vascular diseases. It is already the modality of choice for the detection of acute renal vein thrombosis and nonocclusive intrarenal vascular disorders including iatrogenic arteriovenous fistula and false aneurysm, particularly in patients with imp...

Obstructive azoospermia represents approximately 10 % of cases of male hypofertility. It is classified according to the volume of ejaculate. When the latter is normal a proximal obstruction is suspected. Scrotal sonography can help to detect dilation of the epididymal head when clinical findings are equivocal. Ejaculatory duct obstruction (EDO) is...

Purpose: The concept of contrast agents has been extended to ultrasonography (US) almost 30 years ago. Due to technical limitations, the development of US contrast agents (USCA) was slow until the last decade. The ideal USCA should be nontoxic, i.v. injectable, capable to cross the pulmonary capillary bed after a peripheral injection, and be stabl...

We report a case of venous rupture complicating percutaneous transluminal angioplasty (PTA) applied on a failed dialysis vascular access (VA) in a patient on chronic steroid therapy. This complication resulted in a rapidly growing hematoma which was successfully controlled by a prolonged reinflation of the balloon catheter at the angioplasty site....

Color Doppler sonography (CDS) of the male genital tract includes imaging of the prostate gland, of the cavernosal arteries and of the scrotum. It represents a unique means of significantly increasing the predictive positive value of hypoechoic nodules originating in the peripheral zone. In patients with a normal DRE and a PSA level between 4 and 1...

Unusual fat-containing renal tumors in a series of 27 cases comprised five categories: atypical and complicated angiomyolipomas (AMLs) (n = 15), including AMLs with extrarenal growth (n = 5), AMLs with undetectable fat (n = 4), and hemorrhagic AMLs (n = 6); fat-containing renal cell carcinomas (RCCs) (n = 9); lipoma (n = 1); liposarcoma (n = 1); an...

Ultrasonography has clinical utility for detection of structural abnormalities in the kidney and for diagnosis of diseases associated with altered renal function and blood flow. Contrast agents increase the backscatter signal to provide enhancement of Doppler and, in some instances, gray-scale images. EchoGen® (perflenapent) emulsion is a new phase...

Use of digital images is growing in medical imaging. To be efficient, up-to-date concepts such as distributed informatics and client/server architecture must be used. Interoperability and networks adapted to the data involved in medical imaging are prerequisites to the implementation of such concepts. This necessitates official and de facto standar...

Penile vascular imaging has been based for years on pharmacoangiography and pharmacocavernosometry. Doppler sonography of the cavernosal arteries has received considerable attention since its description in 1985. Color Doppler imaging further stimulated interest in this non invasive method, as it permitted more accurate measurement of systolic and...

In 24 patients presenting with 55 renal lesions (mean size, 20.8 mm), single-breath-hold (SBH) fast spin-echo (FSE) techniques allowing T1 and T2 images to be produced within 20 and 23 sec, respectively, were compared with routine non-breath-hold (NBH) spin-echo (SE) T1 and NBH-FSE T2 sequences. Contrast-to-noise ratios (CNRs) measured from SBH-FSE...

To evaluate the accuracy of endorectal magnetic resonance imaging (MRI) with fast spin-echo sequences in the local staging of clinically localized prostate cancer. Seventy-one patients with a clinical T1 (18 patients) or T2 tumour (53 patients) underwent endorectal MRI 2-12 weeks before radical prostatectomy. Extraprostatic tumour was diagnosed if...

Within 18 month, 83 solid breast nodules were biopsied with a long throw biopsy gun with 18 gauge needle (Monopty, Bard Urological, Covington) and a 13 Mhz real time AU 530 (Easote Biomedica, Italy) for the ultrasound guidance. The biopsy procedure was well tolerated with no serious complications, and with no insufficient material. US guided biopsy...

We determined the long-term outcome of a new technique for incising ureterointestinal anastomotic strictures using a transrenal percutaneously inserted papillotome. Procedures using fluoroscopic and endoscopic guidance were compared. Of 33 stenoses incised in 30 patients 15 were in ileal conduit diversions and 15 were in enterocystoplasties. The pa...

Two cases of focal acute pyelonephritis presenting with an unusual pseudo-tumoral appearance on CT are reported. The lesions exhibited a focal intra-parenchymal homogeneous round-shape mass without any other parenchymal or perirenal fat CT abnormalities. The final diagnosis of focal acute pyelonephritis was confirmed on following CT scans which dem...

Doppler ultrasonography is a noninvasive method of evaluating the anatomical and functional parameters of vascular shunts for haemodialysis. In stenosis of the vascular shunt the technique is excellent for the diagnosis and quantification of the effects of stenosis on flow through the fistula. The detection of these lesions should be made on clinic...

Obstruction of the seminal tract is observed in 10 to 15% of men presenting with azoospermia or severe oligozoospermia (sperm count <1 million/ml) and with a normal FSH level. When ejaculate volume is normal, scrotal ultrasonography can detect, when clinical examination is unconclusive, enlarged hypoechoic epididymis or dilatation of the epididymal...

Renal cell carcinoma (RCC) is the most common malignant renal parenchymal tumour, accounting for about 86% of all primary malignant renal neoplasms [1,2].

Teleteaching aims to help universities and nonacademic institutions improve, update and upgrade their educational programs for a better control of health care cost-effectiveness in developed or developing countries. A multicontinental multilingual service therefore could be offered through multimedia information superhighways and telebroadcasting n...

One hundred eighty-seven native kidneys in 96 patients were examined with color Doppler ultrasound (US) to (a) determine the color Doppler US characteristics of renovascular disorders and (b) assess the value of color Doppler US in detection of such disorders. Correlative angiography or computed tomography was performed in 94 patients. The followin...

The development of an endorectal surface coil now permits a partial study of the anatomical model developed by McNeal. Axial and coronal views, which were used to establish the model can be obtained in a short period of time with fast spin echo sequences. Axial views are performed along the proximal urethra and coronal views are performed along the...

Due to the development of the duplex mode, combining ultrasound images with Doppler recording, and especially the development of flow colour coding. Doppler is now increasingly used to investigate the kidney and male genital tract. It is now the technique of choice in the initial diagnosis of certain renal diseases: primary renal vein thrombosis, i...

The aim of this study was to assess the magnetic resonance imaging (MRI) characteristics of 13 benign complex renal cysts using T1 and T2-weighted images and contrast-enhanced images. The results have been compared to CT and ultrasonographic findings in all cases and correlated with histopathologic data in 12 cases. Five groups have been defined ac...

Correas J-M, Chabriais J, Melki P, Helcnon O, Di Paola M, Di Paola R, Moreau J-F. Gd-DOTA renal pharmacokinetic study by factor analysis in transplanted human kidney and in phantom. Invest Radiol 1994;29:S174-S176.

Correas J-M, Chabriais J, Melki P, Helcnon O, Di Paola M, Di Paola R, Moreau J-F. Gd-DOTA renal pharmacokinetic study by factor analysis in transplanted human kidney and in phantom. Invest Radiol 1994;29:S174-S176. (C) Lippincott-Raven Publishers.

We report two incide ntal observations of radiocontrast-induced sialadenitis which occurred in a patient with normal renal function and in another patient undergoing chronic haemodialysis. Our first observation consisted of parotid gland, enlargement noted 1 h after contrast injection and which presaged anaphy lactoid shock. In the second cast sali...

The assessment of tumor extension in 20 patients with cancers of the prostate at a clinical stage A or B included MRI with a body coil before prostatectomy. Transverse and coronal T1-weighted sections with injections of gadopentate dimeglumine (gadolinium) and fat suppression were systematically taken to assess the vascularity of the various region...

The accuracy of color Doppler US (CDUS) for the detection of main renal transplant artery stenoses is excellent (Se 92%; SP 99%). Whereas the sensitivity of CDUS is still unsatisfactory for the detection of arterial branch stenosis (Se 70%), it has become higher than previously reported because of the ability of color flow images to identify hemody...

Despite significant progress, vascular access remains a major concern for nephrologists. For the last 6 years we have used as temporary vascular access silastic twin catheters implanted into the internal jugular vein based on Canaud's method. We have developed in 15 patients an ultrasound-guided method using an ultrasonic Doppler to improve access...

From 1978 to 1991 we observed 10 patients who developed femoral arteriovenous fistula after venous puncture for hemodialysis. The fistula most often appeared after several punctures, but 3 developed after a single puncture. Diagnosis was made on the basis of local observation and auscultation of the vessel (bruit + thrill n = 10, hematoma n = 4, pu...

Transient vascular access for hemodialysis is a daily problem in nephrology. Internal jugular twin catheters using Canaud's technique is the method of reference, which we have applied since 1987. In 3 cases where the internal jugular route was impraticable, twin catheters via the femoral route were used. The catheter was placed by percutaneous rout...

Ultrasonography (US) has become the gold standard of the preoperative detection of parathyroid masses. Provided that it is performed by sonographists aware of the normal and pathological anatomy of the neck, US can detect more than 80 per cent of the parathyroid masses. Ectopic masses, especially when they are intramediastinal, are rare but their d...

The authors report their experience with computed tomography (CT) in 27 cases of cervical suppurations. The diagnosis was confirmed surgically in 24 cases and by the improvement of clinical signs and CT after antibiotics in 3. Two types of CT features were identified: collected abscesses (n = 22) visualized as encapsulated heterogeneous hypodense f...

Ultrasonography (US) has become the gold standard of the preoperative detection of parathyroid masses. Provided that it is performed by sonographists aware of the normal and pathological anatomy of the neck, US can detect more than 80 per cent of the parathyroid masses. Ectopic masses, especially when they are intramediastinal, are rare but their d...

Indications of echo Doppler exploration of the male genital organs with colour imaging are presented. For the prostate, this technique is used to study the vascularization of hypoechogenic nodules of the peripheral zone where colour images are particularly interesting to assess non-palpable nodules. In such cases, the positive predictive value for...

A comparative study of the resistivity indices (RI) obtained in both kidneys has been carried out in 30 controls and 60 patients with suspected unilateral acute obstruction of the upper urinary tract. Doppler findings (difference in the mean RI of both kidneys, delta RI) in the pathologic population have been systematically correlated to the data y...

It is widely believed that demonstration of fat within a well-marginated renal tumor at computed tomography (CT) is highly suggestive of angiomyolipoma and can rule out renal cell carcinoma. The authors describe a patient in whom CT demonstrated a solid mass containing calcifications and small amounts of fat. Renal cell carcinoma was diagnosed at p...

The recent technical developments in magnetic resonance imaging (MRI) and the use of paramagnetic contrast media (gadolinium compounds) have considerably improved the performances of MRI for the detection and characterization of renal tumors. MRI does not have specific merits for the diagnosis of the typical form of cancer, nor for the detection of...

We report a peculiar case of radiocontrast induced anaphylactoid shock following an intravenous pyelography, which was announced by an hyperacute bilateral parotid enlargement as the sole prodrome. From a review of the literature, two clinical presentation of iodide-induced sialadenitis are individualized according to their pathogenesis. In patient...

Hematuria is defined as the presence of blood in urine. Its site of origin can be in any point of the urinary tract. Its discovery leads to clinical, biological and radiological investigations. The causes of hematuria are dominated, in terms of frequency, by urinary infection and lithiasis. The risk of associated lesions, especially of a tumor, mus...

We compared the value of T2-weighted and Gd-DOTA-enhanced T1-weighted images for the detection and characterisation of 33 small renal masses (14 clear cell carcinomas, 6 angiomyolipomas, 3 angiomyomas, 4 adenomas, 3 papillary carcinomas, 3 oncocytomas, 1 haemorrhagic cyst). Dynamic enhanced MRI was performed to study the tumoral vascular supply (19...

Thirty patients presenting with a clinical stage A or B cancer underwent TRUS and MRI with a body coil prior to radical prostatectomy. Imaging and pathology were correlated to assess the limits of TRUS and MRI in pre-operative staging of prostatic carcinoma. Results showed that TRUS and MRI had a sensitivity of 42 and 66% and a specificity of 89 an...