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. Serment-d'hippocrate, Au moment d'être admis à exercer la médecine, je promets et je jure d'être fidèle aux lois de l'honneur et de la probité. Mon premier souci sera de rétablir, de préserver ou de promouvoir la santé dans tous ses éléments, physiques et mentaux

, Je respecterai toutes les personnes, leur autonomie et leur volonté, sans aucune discrimination selon leur état ou leurs convictions. J'interviendrai pour les protéger si elles sont affaiblies, vulnérables ou menacées dans leur intégrité ou leur dignité. Même sous la contrainte

, J'informerai les patients des décisions envisagées, de leurs raisons et de leurs

, Je donnerai mes soins à l'indigent et à quiconque me les demandera. Je ne me laisserai

, Reçu à l'intérieur des maisons, je respecterai les secrets des foyers et ma conduite ne servira pas à corrompre les moeurs

, Je ne prolongerai pas abusivement les agonies. Je ne provoquerai jamais la mort délibérément

, Je préserverai l'indépendance nécessaire à l'accomplissement de ma mission

, J'apporterai mon aide à mes confrères ainsi qu'à leurs familles dans l'adversité

, Que les hommes et mes confrères m'accordent leur estime si je suis fidèle à mes promesses ; que je sois déshonoré et méprisé si j'y manque

. Matériel and . Méthodes, La mise en évidence récente de dépôts intracérébraux de gadolinium pourrait modifier cette règle. L'objectif de l'étude a été d'évaluer la performance diagnostique d'une IRM sans injection de contraste (IRMC-) dans le suivi évolutif des GVO chez l'enfant

, 25 cas de progression tumorale et 25 cas de stabilité mentionnés dans la conclusion du compterendu IRM (référence) ont été sélectionnés et couplés avec les examens précédents respectifs (50 paires d'examen). Pour l'évaluation de l'évolution tumorale, ces examens ont été analysés en aveugle par 2 radiologues à l'aide de critères quantitatifs et qualitatifs, en excluant la série IRMC+, Cette étude rétrospective a été réalisée dans un centre de référence pédiatrique des GVO en accord avec le comité éthique local. 17 patients suivis par au moins 5 IRMC+ entre 2001 et 2017 ont été inclus (atteints ou non de NF1)

, L'âge moyen au moment du diagnostic était de 5,4 ±3.4 ans. La durée moyenne de suivi était de 6, vol.7

. Le-nombre-moyen, La sensibilité des IRMC-était de 84-88 % (IC 95% : 63,9-97,5%), la spécificité de 91,3-100% (IC 95% : 72-100%), la VPP était de 91,7 % pour le 1 er lecteur, de 100% pour le second, la VPN était de 87,5% pour le 1 er lecteur, de 85,2% pour le second. Il y avait un excellent accord inter-observateur (kappa= 0, vol.87

, La variation du volume tumoral et les critères qualitatifs (dilatation ventriculaire) sont le plus souvent suffisants pour apprécier l'évolutivité tumorale