[Follow up of total hip prothesis: storage phosphor versus screen-film radiography]. / Confrontation du couple écran-film conventionnel et des plaques au phosphore dans le suivi des prothèses de hanches.

PURPOSE: Digital radiography may lead to interpretation difficulties in patients with hip prosthesis, especially when initial evaluation was performed using screen film radiography. The purpose of this study was to evaluate inter-observer and inter-technique reproducibility comparing digital and screen-film radiography. MATERIAL AND METHODS: Twenty-eight patients with unilateral (n=24) or bilateral (n=4) hip prosthesis (total=32 prostheses) underwent screen-film and digital (storage phosphor) radiography. The bone-cement and metal-cement interfaces were evaluated for the presence of a lucent line in 14 different sectors reclassified into 3 regions. This evaluation was performed by two independent readers. Inter-observer and inter-technique reproducibility were calculated using kappa values. RESULTS: The inter-observer reproducibility was negligible, poor or average with Kappa values ranging from 0.07 to 0.47. The degree of agreement between the two methods was poor, average or good for both observers with Kappa values ranging from 0.10 to 0.66. CONCLUSION: Although inter-technique agreement is not high, it is better than inter-observer agreement. Therefore, storage phosphor technique should not be rejected for total hip prosthesis follow-up, even though previous films were screen-film radiographs.

[Imaging of the lumbar spine]. / Imagerie du rachis lombaire.

The role of conventional radiographs in the evaluation of the lumbar spine remains unchanged. The respective place of CT and MRI in the evaluation of lumbar spine disorders has not significantly changed in spite of technical advances. However, their diagnostic capabilities have improved.

[Preoperative evaluation of renal carcinoma using multi-detector CT]. / Bilan préopératoire des cancers du rein en scanner volumique.

When laparoscopic nephrectomy is performed, the limited visibility of many anatomical structures requires additional pre-operative information. However, most of this information can be highlighted by Multislice-CT which depicts all the vascular structures while providing an essential road mapping for the surgeon. Besides underlining arterial abnormalities, this technique allows to depict venous pathways and tumoral invasion. This review illustrates the various potential applications of Multislice-CT in the evaluation of renal tumors.

MR imaging evaluation of suprascapular nerve entrapment.

The aim of this study was to assess the significance of muscular edema, atrophy, and fatty changes in the diagnosis of suprascapular nerve entrapment (SSNE), and to confirm muscular edema as the most significant sign of neuropathy. A retrospective study of 18 patients with suprascapular nerve entrapment was performed. All patients underwent electromyographic studies and MR imaging with a 1.5-T Echo Speed system (General Electric, Milwaukee, Wis.). The diagnosis of muscle edema was reached when muscles presented a high signal on T2-weighted fast spin-echo (SE) fat-suppressed images. Muscular trophicity and fatty changes were analyzed on a sagittal oblique cut using SE T1-weighted images. Intra- and inter-observer reproducibility using kappa test, sensitivity, and specificity were analyzed, together with negative and positive predictive value of each criterion. The topographic diagnosis was correct as edema affected the infraspinatus muscle alone when the suprascapular nerve was entrapped at the spinoglenoid notch. Both the supraspinatus and infraspinatus muscles were affected when nerve was compressed at the suprascapular notch. Sensitivity and specificity of muscular edema were, respectively, 94.5 and 100%. Muscular atrophy sensitivity and specificity were 81 and 80%, respectively. Fatty changes sensitivity and specificity were 25 and 96%, respectively. Muscular edema seems to be a more sensitive sign of SSNE than muscle atrophy and fatty changes when compared with EMG results. Magnetic resonance imaging can reach a positive, topographic, and etiologic diagnosis of SSNE.

[Role of multiarray scanner in the choice of therapeutic strategy in kidney cancer. Report of a case of kidney tumor with double thrombus in inferior vena cava]. / Intérêt du scanner multibarrette dans le choix de la stratégie thérapeutique du cancer du rein. A propos d'un cas de tumeur du rein avec double thrombus de la veine cave inférieure.

Renal cancer with caval thrombus is a disease which requires precise preoperative assessment, in order to adapt the surgical technique to the stage and extent of the disease. Recent developments in CT imaging, spiral acquisition and, more recently, the multiarray technique, allow a high quality evaluation. In the light of a case of right renal tumour with bifocal caval extension, the authors discuss the valuable contribution of this imaging modality in the staging assessment and evaluation of arterial (single or multiple artery, anatomical situation in relation to the left renal vein, presence of early bifurcations, etc.), and venous structures (renal vein, genital vein, extension of the thrombus, lumbar vein and hepatic vein). Improvements in CT imaging constitute a major progress in the staging of renal cancers with caval thrombus and make a considerable contribution to the choice of treatment strategy.

[Value of volume rendering in musculo-skeletal disorders]. / Intérêt de la technique de rendu volumique en pathologie ostéo-articulaire.

Three dimensional imaging is increasingly important for evaluation of anatomic relationships and extent of disease, for treatment planning and for follow-up evaluation. The volume rendering technique allows creation of accurate 3D images that can be used for several clinical applications especially in musculo-skeletal disorders such as evaluation of tumors or fractures. This article describes the methods used for volume rendering technique and focuses on the specific aspects of volume rendering applied to musculo-skeletal applications.

[Radiography of the upper limb revisited: the shoulder and the wrist]. / La radiologie du membre supérieur revisitée: l'épaule et le poignet.

CT scan and MR imaging are the most efficient techniques to evaluate the upper limb, however, standard radiography remains a valuable method to explore this anatomical region. In most situations, it is sufficient to allow a precise diagnosis and determine therapeutic protocols. However, this method can present a real diagnostic value only when it is guided by medical history and clinical data. The purpose of this work is to propose a practical approach for radiographic evaluation of the shoulder and the wrist, suited to the main clinical situations. CT-scan and MR imaging correlations will help to understand radiographic findings.

[Multislice CT: principles and new CT-scan applications]. / Scanners multicoupes: principes et nouvelles applications scanographiques.

The introduction of new array detector technology for multislice CT improves CT-scan capabilities. Compared to single-slice helical CT, this technique offers three significant advantages: the pitch can be increased by a factor of 4, resulting in shorter acquisition times and contrast media saving, the temporal and spatial resolution are improved and the slice thickness can be freely and retrospectively selected. This technique promises to revolutionize radiological practice, just as spiral systems did a decade ago. Multislice CT is particularly suitable for exploring the chest, the heart and the vessels. It is also specially useful for musculo-skeletal explorations and trauma patients.