[Duplex Doppler ultrasonography of intra-renal arteries. Normal and pathological aspects]. / Echo-Doppler pulsé des artères intra-rénales. Aspects normaux et pathologiques.

Duplex Doppler ultrasonography may explore renal perfusion in frequent diseases such as renal obstruction, reno-vascular hypertension, acute or chronic renal failure or diabetic renal complications by measuring Pourcelot's resistive index (RI) of renal parenchyma arteries for each kidney. A statistical and prospective study was performed on 574 patients. In healthy patients, the RI values, equal for each kidney were included in 0.45 and 0.7 (mean RI = 0.59). For other values, there was a renal pathology. Patients with idiopathic hypertension (mean RI = 0.59) or non obstructive dilatation (mean RI = 0.61) did not have an RI significantly different from healthy patients. In cases of renal obstruction, there was a significant increase in the RI for the pathological kidney (mean RI of 0.73). The sensitivity and the specificity was 100% for acute obstructions examined during the first 48 hours. In contrast, in case of renal artery stenosis greater than 70% there was a significant decrease in the RI for pathological kidney. So the RI increased significantly in both kidneys: when there was renal failure with active disease within the tubulo-interstitial compartment (mean RI of 0.77); in all cases of diabetic nephropathy (mean RI of 0.74) where the RI increased early before laboratory signs. Duplex Doppler ultrasonography may be an original method for renal explorations by providing not only morphological data but also physiological data with the perfusion study.

[Multiple valvular fibromyxomas disclosed by cerebral vascular complication. Apropos of a case]. / Fibro-myxomes valvulaires multiples révélés par un accident vasculaire cérébral. A propos d'une observation.

The authors report the case of a 36 year-old patient, hospitalized for a regressive cerebral vascular accident. Ultrasound determination of an embolic cardiopathy will disclose the presence of mitral valve tumors, confirmed at surgery which, in addition, will show aortic valve tumors. These tumors are papillary fibro-elastomas (fibro-myxomas) as shown on pathological examination. A propos of this case, as compared to data from the literature, we remind of the rarity of this benign tumor, isolated most of the time, and the discovery of which on ultrasonography, results in surgical excision because of its very high embolic potential.