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  1. Article: Avulsion of the Ossification Center of the Iliac Crest in a Sporty Teenager: Multimodal Imaging Approach with Emphasis on the Role of the oZTEo MRI Pseudo-CT Sequence.

    Rahier, Quentin / Debehogne, Géraldine / Lecouvet, Frédéric E

    Journal of the Belgian Society of Radiology

    2024  Volume 108, Issue 1, Page(s) 42

    Abstract: Teaching point: ...

    Abstract Teaching point:
    Language English
    Publishing date 2024-04-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2834839-4
    ISSN 2514-8281
    ISSN 2514-8281
    DOI 10.5334/jbsr.3542
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  2. Article ; Online: Non-traumatic complete cervical spine dislocation with severe fixed kyphosis: successful multidisciplinary approach to a challenging case.

    Lecouvet, Camille / Geradon, Pierre / Banse, Xavier / Rausin, Gauthier / Guyot, Nicolas / Lecouvet, Frederic E

    Journal of medical case reports

    2024  Volume 18, Issue 1, Page(s) 138

    Abstract: Background: To our knowledge, there is no previous report in the literature of non-traumatic neglected complete cervical spine dislocation characterized by anterior spondyloptosis of C4, extreme head drop, and irreducible cervicothoracic kyphosis.: ... ...

    Abstract Background: To our knowledge, there is no previous report in the literature of non-traumatic neglected complete cervical spine dislocation characterized by anterior spondyloptosis of C4, extreme head drop, and irreducible cervicothoracic kyphosis.
    Case presentation: We report the case of a 33-year-old Caucasian man with a 17-year history of severe immune polymyositis and regular physiotherapy who presented with severe non-reducible kyphosis of the cervicothoracic junction and progressive tetraparesia for several weeks after a physiotherapy session. Radiographs, computed tomography, and magnetic resonance imaging revealed a complete dislocation at the C4-C5 level, with C4 spondyloptosis, kyphotic angulation, spinal cord compression, and severe myelopathy. Due to recent worsening of neurological symptoms, an invasive treatment strategy was indicated. The patient's neurological status and spinal deformity greatly complicated the anesthetic and surgical management, which was planned after extensive multidisciplinary discussion and relied on close collaboration between the orthopedic surgeon and the anesthetist. Regarding anesthesia, difficult airway access was expected due to severe cervical angulation, limited mouth opening, and thyromental distance, with high risk of difficult ventilation and intubation. Patient management was further complicated by a theoretical risk of neurogenic shock, motor and sensory deterioration, instability due to position changes during surgery, and postoperative respiratory failure. Regarding surgery, a multistage approach was carefully planned. After a failed attempt at closed reduction, a three-stage surgical procedure was performed to reduce displacement and stabilize the spine, resulting in correct spinal realignment and fixation. Progressive complete neurological recovery was observed.
    Conclusion: This case illustrates the successful management of a critical situation based on a multidisciplinary collaboration involving radiologists, anesthesiologists, and spine surgeons.
    MeSH term(s) Male ; Humans ; Adult ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Cervical Vertebrae/injuries ; Spinal Cord Compression/diagnostic imaging ; Spinal Cord Compression/etiology ; Spinal Cord Compression/surgery ; Spinal Injuries/complications ; Radiography ; Kyphosis/diagnostic imaging ; Kyphosis/etiology ; Kyphosis/surgery
    Language English
    Publishing date 2024-04-01
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2269805-X
    ISSN 1752-1947 ; 1752-1947
    ISSN (online) 1752-1947
    ISSN 1752-1947
    DOI 10.1186/s13256-024-04446-x
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  3. Article ; Online: Whole-Body MR Imaging: Musculoskeletal Applications.

    Lecouvet, Frédéric E

    Radiology

    2016  Volume 279, Issue 2, Page(s) 345–365

    Abstract: Whole-body magnetic resonance (MR) imaging has been evaluated in many oncologic and rheumatologic indications and is emerging as a powerful tool for early diagnosis, quantification of disease extent, therapeutic decision making, and treatment monitoring. ...

    Abstract Whole-body magnetic resonance (MR) imaging has been evaluated in many oncologic and rheumatologic indications and is emerging as a powerful tool for early diagnosis, quantification of disease extent, therapeutic decision making, and treatment monitoring. This development of whole-body MR imaging comes at a time marked by the rapid development of modern, powerful, but expensive and potentially toxic treatments. In oncology, the feasibility and diagnostic performance of diffusion-weighted imaging (DWI) applied to the whole body largely contribute to the effectiveness of whole-body MR imaging. The concurrent acquisition of both anatomic and functional DWI sequences provides an intrinsically "hybrid" dimension to whole-body MR imaging studies, allowing a sensitive and specific diagnosis of bone involvement by metastases, multiple myeloma, and lymphoma, and evaluation of treatment response, representing a promising biomarker. In arthritis of the axial skeleton, mainly spondyloarthropathies, whole-body MR imaging reveals additional lesions compared with limited axial (lumbar and pelvic) studies, especially in the thoracic spine and thoracic wall, pelvic and shoulder girdles, and peripheral entheses and joints. This article provides an overview of technical aspects of whole-body MR imaging and practical recommendations for the interpretation of whole-body MR imaging studies. It reviews the currently established and potential indications for whole-body MR imaging in oncology and rheumatology, discussing the diagnostic performance, advantages, and drawbacks of the technique, and its potential roles in comparison to other imaging modalities.
    MeSH term(s) Algorithms ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging/methods ; Musculoskeletal Diseases/diagnosis ; Whole Body Imaging/methods
    Language English
    Publishing date 2016-05
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 80324-8
    ISSN 1527-1315 ; 0033-8419
    ISSN (online) 1527-1315
    ISSN 0033-8419
    DOI 10.1148/radiol.2016142084
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  4. Article ; Online: Clinical Applications and Controversies of Whole-Body MRI:

    Ahlawat, Shivani / Debs, Patrick / Amini, Behrang / Lecouvet, Frédéric E / Omoumi, Patrick / Wessell, Daniel E

    AJR. American journal of roentgenology

    2022  Volume 220, Issue 4, Page(s) 463–475

    Abstract: Whole-body MRI (WB-MRI) is increasing in clinical acceptance and utilization for a range of indications. WB-MRI is currently an established screening tool for children and adults at high risk of developing malignancy, with the strongest supporting ... ...

    Abstract Whole-body MRI (WB-MRI) is increasing in clinical acceptance and utilization for a range of indications. WB-MRI is currently an established screening tool for children and adults at high risk of developing malignancy, with the strongest supporting evidence in patients with Li-Fraumeni syndrome. WB-MRI has been added to professional society guidelines for staging disease in patients with certain malignancies including multiple myeloma and has been proposed as a technique to screen for metastatic disease in patients with visceral malignancies including prostate cancer and breast cancer. Emerging data support the utility of WB-MRI in children with malignancies such as Ewing sarcoma, in adults with myxoid liposarcoma, and in pregnant patients with occult or newly detected malignancy. WB-MRI can further help evaluate disease extent and treatment response in patients with nononcologic conditions such as chronic nonbacterial osteomyelitis, myopathy, inflammatory arthritis, and fever of unknown origin. This
    MeSH term(s) Male ; Child ; Pregnancy ; Humans ; Adult ; Magnetic Resonance Imaging/methods ; Whole Body Imaging/methods ; Prostatic Neoplasms ; Li-Fraumeni Syndrome ; Breast Neoplasms
    Language English
    Publishing date 2022-09-28
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 82076-3
    ISSN 1546-3141 ; 0361-803X ; 0092-5381
    ISSN (online) 1546-3141
    ISSN 0361-803X ; 0092-5381
    DOI 10.2214/AJR.22.28229
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  5. Article ; Online: 3D Whole-Body MRI of the Musculoskeletal System.

    Pasoglou, Vassiliki / Van Nieuwenhove, Sandy / Peeters, Frank / Duchêne, Gaetan / Kirchgesner, Thomas / Lecouvet, Frederic E

    Seminars in musculoskeletal radiology

    2021  Volume 25, Issue 3, Page(s) 441–454

    Abstract: With its outstanding soft tissue contrast, spatial resolution, and multiplanar capacities, magnetic resonance imaging (MRI) has become a widely used technique. Whole-body MRI (WB-MRI) has been introduced among diagnostic methods for the staging and ... ...

    Abstract With its outstanding soft tissue contrast, spatial resolution, and multiplanar capacities, magnetic resonance imaging (MRI) has become a widely used technique. Whole-body MRI (WB-MRI) has been introduced among diagnostic methods for the staging and follow-up assessment in oncologic patients, and international guidelines recommend its use. In nononcologic applications, WB-MRI is as a promising imaging tool in inflammatory diseases, such as seronegative arthritis and inflammatory myopathies. Technological advances have facilitated the introduction of three-dimensional (3D) almost isotropic sequences in MRI examinations covering the whole body. The possibility to reformat 3D images in any plane with equal or almost equal resolution offers comprehensive understanding of the anatomy, easier disease detection and characterization, and finally contributes to correct treatment planning. This article illustrates the basic principles, advantages, and limitations of the 3D approach in WB-MRI examinations and provides a short review of the literature.
    MeSH term(s) Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Musculoskeletal System/diagnostic imaging ; Whole Body Imaging
    Language English
    Publishing date 2021-09-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1360919-1
    ISSN 1098-898X ; 1089-7860
    ISSN (online) 1098-898X
    ISSN 1089-7860
    DOI 10.1055/s-0041-1730401
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  6. Article ; Online: Review of diffusion-weighted imaging and dynamic contrast-enhanced MRI for multiple myeloma and its precursors (monoclonal gammopathy of undetermined significance and smouldering myeloma).

    Van Den Berghe, Thomas / Verstraete, Koenraad L / Lecouvet, Frédéric E / Lejoly, Maryse / Dutoit, Julie

    Skeletal radiology

    2021  Volume 51, Issue 1, Page(s) 101–122

    Abstract: The last decades, increasing research has been conducted on dynamic contrast-enhanced and diffusion-weighted MRI techniques in multiple myeloma and its precursors. Apart from anatomical sequences which are prone to interpretation errors due to anatomical ...

    Abstract The last decades, increasing research has been conducted on dynamic contrast-enhanced and diffusion-weighted MRI techniques in multiple myeloma and its precursors. Apart from anatomical sequences which are prone to interpretation errors due to anatomical variants, other pathologies and subjective evaluation of signal intensities, dynamic contrast-enhanced and diffusion-weighted MRI provide additional information on microenvironmental changes in bone marrow and are helpful in the diagnosis, staging and follow-up of plasma cell dyscrasias. Diffusion-weighted imaging provides information on diffusion (restriction) of water molecules in bone marrow and in malignant infiltration. Qualitative evaluation by visually assessing images with different diffusion sensitising gradients and quantitative evaluation of the apparent diffusion coefficient are studied extensively. Dynamic contrast-enhanced imaging provides information on bone marrow vascularisation, perfusion, capillary resistance, vascular permeability and interstitial space, which are systematically altered in different disease stages and can be evaluated in a qualitative and a (semi-)quantitative manner. Both diffusion restriction and abnormal dynamic contrast-enhanced MRI parameters are early biomarkers of malignancy or disease progression in focal lesions or in regions with diffuse abnormal signal intensities. The added value for both techniques lies in better detection and/or characterisation of abnormal bone marrow otherwise missed or misdiagnosed on anatomical MRI sequences. Increased detection rates of focal lesions or diffuse bone marrow infiltration upstage patients to higher disease stages, provide earlier access to therapy and slower disease progression and allow closer monitoring of high-risk patients. Despite promising results, variations in imaging protocols, scanner types and post-processing methods are large, thus hampering universal applicability and reproducibility of quantitative imaging parameters. The myeloma response assessment and diagnosis system and the international myeloma working group provide a systematic multicentre approach on imaging and propose which parameters to use in multiple myeloma and its precursors in an attempt to overcome the pitfalls of dynamic contrast-enhanced and diffusion-weighted imaging.Single sentence summary statementDiffusion-weighted imaging and dynamic contrast-enhanced MRI provide important additional information to standard anatomical MRI techniques for diagnosis, staging and follow-up of patients with plasma cell dyscrasias, although some precautions should be taken on standardisation of imaging protocols to improve reproducibility and application in multiple centres.
    MeSH term(s) Contrast Media ; Diffusion Magnetic Resonance Imaging ; Humans ; Magnetic Resonance Imaging ; Monoclonal Gammopathy of Undetermined Significance/diagnostic imaging ; Multiple Myeloma/diagnostic imaging ; Paraproteinemias ; Reproducibility of Results
    Chemical Substances Contrast Media
    Language English
    Publishing date 2021-09-14
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 527592-1
    ISSN 1432-2161 ; 0364-2348
    ISSN (online) 1432-2161
    ISSN 0364-2348
    DOI 10.1007/s00256-021-03903-8
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  7. Article: The "birth of death": MRI step-by-step reveals the early appearance of a bone marrow infarct.

    Barakat, Elie / Guischer, Nathalie / Houssiau, Frédéric / Lecouvet, Frederic E

    Acta radiologica open

    2019  Volume 8, Issue 3, Page(s) 2058460119834691

    Abstract: The magnetic resonance imaging (MRI) appearance of an "established" bone marrow infarct is well-known, consisting of an area of preserved bone marrow signal surrounded by a serpiginous line. We report the uncommon observation of the very early phases of ... ...

    Abstract The magnetic resonance imaging (MRI) appearance of an "established" bone marrow infarct is well-known, consisting of an area of preserved bone marrow signal surrounded by a serpiginous line. We report the uncommon observation of the very early phases of appearance of a bone marrow infarct, showing its progressive de novo appearance on MR images paralleling clinical symptoms and high-dose systemic steroid administration in a young female patient, presenting with acute knee pain. The initial knee MR examination performed one week after pain onset showed no abnormality. One week later, a second examination showed subtle ill-defined dotted signal abnormalities of the bone marrow of uncertain significance, of high signal on PDFS sequences. A third MR study obtained again one week later showed more evident findings with confluence of the high signal "dots" into a serpiginous line with a geographical appearance of the lesion, corresponding to the typical MRI presentation of bone marrow infarcts. Follow-up MRI at seven weeks showed definitive stability of this bone marrow infarct. A whole-body MRI performed for whole skeleton screening revealed multiple bone marrow infarcts typical for systemic avascular necrosis. This case represents a novel observation of the "birth" of a bone marrow infarct, from early intriguing changes to its typical ring-shaped appearance on MR images. It also reminds of the key role of MRI for early diagnosis of bone marrow infarcts and illustrates the emerging role of whole-body MRI for the detection of multifocal, asymptomatic skeletal involvement by ischemic lesions in systemic osteonecrosis.
    Language English
    Publishing date 2019-03-27
    Publishing country England
    Document type Case Reports
    ZDB-ID 2818429-4
    ISSN 2058-4601
    ISSN 2058-4601
    DOI 10.1177/2058460119834691
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  8. Article ; Online: Soft tissue recurrence of an osteoid osteoma: an exceptional observation.

    Wacheul, Emilie / Leemrijse, Thibaut / Galant, Christine / Malghem, Jacques / Lecouvet, Frédéric E

    Skeletal radiology

    2020  Volume 50, Issue 4, Page(s) 827–833

    Abstract: We report the observation of the soft tissue recurrence of an osteoid osteoma (OO) in a 26-year-old man initially complaining of post-traumatic pain and swelling of the right ankle. A first arthroscopic resection was performed after the misdiagnosis of " ... ...

    Abstract We report the observation of the soft tissue recurrence of an osteoid osteoma (OO) in a 26-year-old man initially complaining of post-traumatic pain and swelling of the right ankle. A first arthroscopic resection was performed after the misdiagnosis of "bone irregularities" observed on computed tomography (CT) and magnetic resonance imaging (MRI). The diagnosis of OO was made by histological analysis of the resection material. The patient became asymptomatic for 5 years until the symptoms progressively recurred. Follow-up MRI and CT studies demonstrated a nodular bony focus within the periarticular soft tissues of the ankle. The lesion was removed, and histological analysis confirmed the diagnosis of a whole viable OO. This observation likely resulted from the displacement of the initial lesion during the initial arthroscopic procedure. This case report highlights the possibility of recurrence of OO in the soft tissues.
    MeSH term(s) Adult ; Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm Recurrence, Local/diagnostic imaging ; Neoplasm Recurrence, Local/surgery ; Osteoma, Osteoid/diagnostic imaging ; Osteoma, Osteoid/surgery ; Tomography, X-Ray Computed
    Language English
    Publishing date 2020-09-23
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 527592-1
    ISSN 1432-2161 ; 0364-2348
    ISSN (online) 1432-2161
    ISSN 0364-2348
    DOI 10.1007/s00256-020-03609-3
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  9. Article ; Online: Higher sensitivity with the lever sign test for diagnosis of anterior cruciate ligament rupture in the emergency department.

    Guiraud, Kevin / Silvestre, Guillaume / Bastin, Christophe / Lecouvet, Frederic E / Benitez Masip, Adrian / Boyadzhiev, Dimitar / Meert, Philippe / Thienpont, Emmanuel

    Archives of orthopaedic and trauma surgery

    2021  Volume 142, Issue 8, Page(s) 1979–1983

    Abstract: Introduction: The objective of this study was to assess the diagnostic value of the "lever sign test" to diagnose ACL rupture and to compare this test to the two most commonly used, the Lachman and anterior drawer test.: Method: This prospective ... ...

    Abstract Introduction: The objective of this study was to assess the diagnostic value of the "lever sign test" to diagnose ACL rupture and to compare this test to the two most commonly used, the Lachman and anterior drawer test.
    Method: This prospective study was performed in the ED of the Cliniques Universitaires Saint-Luc (Brussels, Belgium) from March 2017 to May 2019. 52 patients were included undergoing knee trauma, within 8 days, with an initial radiograph excluding a fracture (except Segond fracture or tibial spine fracture). On clinical investigation, patients showed a positive lever sign test and/or a positive Lachman test and/or a positive anterior drawer test. Exclusion criteria were a complete rupture of the knee extensor mechanism and patellar dislocation. All the physicians involved in this study were residents in training. An MRI was performed within 3 weeks for all included patients after the clinical examination. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were investigated for all three tests with MRI used as our reference standard.
    Results: Forty out of 52 patients suffered an ACL rupture (77%) and 12 did not (23%). The sensitivity, specificity, PPV and NPV of the lever sign test were respectively 92.5%, 25% 82% and 50%. Those of the Lachman test were 54%, 54.5%, 81% and 25%, and those of the anterior drawer test were 56%, 82%, 90.5% and 37.5%. Twelve out of 40 ACL ruptures (30%) were diagnosed exclusively with a positive lever sign test.
    Conclusion: When investigating acute ACL ruptures (< 8 days) in the ED, the lever sign test offers a sensitivity of 92.5%, far superior to that of other well-known clinical tests. The lever sign test is relatively pain-free, easy to perform and its visual interpretation requires less experience. Positive lever sign test at the ED should lead to an MRI to combine high clinical sensitivity with high MRI specificity.
    MeSH term(s) Anterior Cruciate Ligament/diagnostic imaging ; Anterior Cruciate Ligament Injuries/diagnosis ; Anterior Cruciate Ligament Injuries/diagnostic imaging ; Emergency Service, Hospital ; Humans ; Knee Joint ; Magnetic Resonance Imaging ; Physical Examination/methods ; Prospective Studies ; Rupture/diagnosis ; Rupture/diagnostic imaging ; Sensitivity and Specificity
    Language English
    Publishing date 2021-09-12
    Publishing country Germany
    Document type Comparative Study ; Journal Article
    ZDB-ID 80407-1
    ISSN 1434-3916 ; 0003-9330 ; 0344-8444
    ISSN (online) 1434-3916
    ISSN 0003-9330 ; 0344-8444
    DOI 10.1007/s00402-021-04154-x
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  10. Article ; Online: Whole-body magnetic resonance imaging in inflammatory diseases: Where are we now? Results of an International Survey by the European Society of Musculoskeletal Radiology.

    Giraudo, Chiara / Lecouvet, Frederic E / Cotten, Anne / Eshed, Iris / Jans, Lennart / Jurik, Anne Grethe / Maas, Mario / Weber, Michael / Sudoł-Szopińska, Iwona

    European journal of radiology

    2021  Volume 136, Page(s) 109533

    Abstract: Purpose: To investigate the current role of WB-MRI for rheumatic inflammatory diseases in clinical practice using a survey addressed to musculoskeletal radiologists.: Methods: A survey composed of 61 questions, subdivided in three sections, ... ...

    Abstract Purpose: To investigate the current role of WB-MRI for rheumatic inflammatory diseases in clinical practice using a survey addressed to musculoskeletal radiologists.
    Methods: A survey composed of 61 questions, subdivided in three sections, demographics (five questions), application of WB-MRI for inflammatory musculoskeletal diseases in adults and children (28 questions: 7 open and 21 multiple choice for each subgroup) was distributed via the European Society of Musculoskeletal Radiology (ESSR) from July 2 to December 31, 2018 to radiologists working in academic, private, and public workplaces. Comparisons among the different workplaces were performed using the Chi-squared and the Kruskal-Wallis test for nominal and ordinal data, respectively (p < 0.05).
    Results: Seventy-two participants out of the 1779 (4%) members of the ESSR with 10.4 ± 7.9 years of experience in musculoskeletal imaging, replied to at least one question. 30.6% and 12.3% of the respondents performed at least 50 WB-MRI examinations per year in adults and children, respectively. The most frequent indications were myositis in adults and chronic recurrent multifocal osteomyelitis (CRMO) in children, the latter mostly in academic centers (p = 0.013). The ESSR Arthrits Subcommitte's protocol was applied by half of the participants and especially radiologists working in private practice used it for adults (p = 0.025). Contrast medium was rarely used for adults particularly by academics (p = 0.04). Diffusion Weighted Imaging was applied for children mostly in private practice (p = 0.01) although, overall, it plays a marginal role. Scoring systems were rarely used. Ongoing research is limited.
    Conclusion: WB-MRI is not routinely applied for musculoskeletal inflammatory diseases. The most frequent indications are myositis and CRMO.
    MeSH term(s) Adult ; Child ; Humans ; Magnetic Resonance Imaging ; Osteomyelitis ; Radiology ; Surveys and Questionnaires ; Whole Body Imaging
    Language English
    Publishing date 2021-01-09
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 138815-0
    ISSN 1872-7727 ; 0720-048X
    ISSN (online) 1872-7727
    ISSN 0720-048X
    DOI 10.1016/j.ejrad.2021.109533
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