Juan Cupelli

University of Strasbourg, Strasburg, Alsace, France

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Publications (7)5.37 Total impact

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    ABSTRACT: PURPOSE To show the characteristics and appearance of different kind of esophageal tumors using pneumoesophageal CT(PN-CT) technique (air distention of the esophagus). METHOD AND MATERIALS 49 patients (age: 43y – 67y) with suspicion of esophageal tumors were examined with PN-CT technique. We achieved esophageal distension using a 14F Foley tube and providing a continuous airflow (20 ml/sec, starting 3sec before CT acquisition). Air flow was sustained for 25 to 30 seconds. Scan direction was craniocaudal and parameters were: 0.5mm collimation, 2mm reconstruction index, 120 Kv, 200mAseg and pitch 0.9). Multiplanar, 3D and virtual endoscopy reconstructions were performed in all patients. Results were compared with surgical findings. RESULTS Significant distension of the esophagus (2 cm or more of diameter) including gastro-esophagic transition zone was achieved in all patients. This distention allows us to perform virtual endoscopic reconstructions.. In 46 patients mural thickening (3mm or more) was identified and measured. All lesions where characterized in size, shape and its location. The other 3 where normal. 41 patients with mural thickening were confirmed as esophageal cancer (1 upper third, 4 mid third and 36 lower third). In the others;3 presented esophageal leiomyoma and 1 Leiomyosarcoma was reported. One inflammatory polyp in the lower third of the esophagus was found. The virtual endoscopic appearance of them where: Esophageal cancer: One or a combinations of the following: lobulated contours in 40(98%), retraction in 12(29%), ulcerations in 35(85%) and heterogeneous enhancementin in 32(78%). Leiomyoma: Smooth walled in 3(100%) non ulcerated in 3(100%) lesion and homogeneous enhancement in 2 (66%) Leiomyosarcoma: poorly lobulated mass with heterogeneous enhancement Inflamatory polyp: Smooth walled polypoid lesion with contrast enhacement CONCLUSION CLINICAL RELEVANCE/APPLICATION To show the differents appearances of esophageal tumors, malignant and non malgignat, in CT virtual endoscopies.
    No preview · Conference Paper · Dec 2008
  • G Bierry · X Buy · P Chandra Mohan · J Cupelli · J.P. Steib · A Gangi
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    ABSTRACT: We report the case of a percutaneous consolidation of a broken vertebral implant (Surgical Titanium Mesh Implants; DePuy Spine, Raynham, MA, USA) by vertebroplasty. Four years after anterior spondylectomy with cage implantation and stabilization with posterior instrumentation, the patient was admitted for excruciating back pain. Radiographs showed fracture of the cage, screw, and rod. An anterior surgical approach was deemed difficult and a percutaneous injection of polymethyl methacrylate into the cage was performed following posterior instrumentation replacement. This seems to be an interesting alternative to the classical anterior surgical approach, which is often difficult in postoperative conditions.
    No preview · Article · Jul 2006 · CardioVascular and Interventional Radiology
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    ABSTRACT: OBJECTIVE: We present three cases of symptomatic high-risk metastases involving the vertebral body treated using infused bipolar radiofrequency ablation either alone or in combination with vertebroplasty. CONCLUSION: In our experience, the bipolar technique can reduce the risk of spinal cord damage in radiofrequency ablation of lesions within 1 cm of neural structures and involving paravertebral soft tissue.
    No preview · Article · Jun 2006 · American Journal of Roentgenology
  • G. Bierry · X. Buy · J. Cupelli · C. Roy · A. Gangi

    No preview · Article · Jan 2006
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    ABSTRACT: With the advent of new imaging technologies and new minimally invasive techniques, it appears that minimally invasive interventions have a bright and exciting future. The interventional radiologist is part of a multidisciplinary team where he/she contributes actively in the management of musculo-skeletal lesions and should play an active role in therapeutic approaches. However, precise patient selection is essential to the success of each of these techniques. The decision to perform one of these procedures should be made by a multidisciplinary team because the choice between these options and alternative methods of treatment depends on several factors including location of the lesion, local and general extent of the disease, pain and functional disability experienced by the patient, and the patient’s state of health and life expectancy.
    No preview · Chapter · Dec 2005
  • X. Buy · G. Bierry · J. Cupelli · S. Guth · C. Roy · A. Gangi

    No preview · Article · Oct 2005 · Journal de Radiologie
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    ABSTRACT: Summary The normal maturation sequence of the pituitary gland involves a serie of physiologic modifications in different moments of life, which are well known by Magnetic Resonance Imaging. These changes in the images are mainly the physiologic hiperintensity in early infancy, pregnancy and postpartum; the relative hypertrophy in infants less than two months old and absolute hypertrophy in adolescence; and finally the upward convexity of the gland in neonates and teenage girls. Is important to know normal appearance of imaging to be able to recognize and diagnostic pathologies that could affect pi- tuitary gland in those periods of life.
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