165 renal carcinomas: accuracy of imaging for diagnosis and spread--cost efficiency.

Based on a study of 165 cases of renal carcinoma, we compare the relative diagnosis efficiency of different methods: intravenous urography (IVU), ultrasound (U.S.), arteriography and computed tomography (C.T.). Our evidence enables us to assert the excellent diagnostic accuracy of ultrasound and the superiority of computed tomography for good staging of renal carcinoma. The cost efficient methods for the evaluation of this tumour are intravenous urography (to show and localize the renal mass), ultrasound (to assert the echogenic structure) and computed tomography (to establish the diagnosis of carcinoma and judge its spread).

[Clarification of the ultrasound features of benign kidney tumors. Apropos of 10 cases]. / Mise au point sur l'aspect échographique des tumeurs bénignes du rein. A propos de dix cas.

Benign tumours of the kidney are rare conditions; their pre-operative diagnosis is of great importance, as in many cases it avoids the need for a total or even extended nephrectomy. The authors report 10 cases of benign renal tumours, which were explored by ultrasound and confirmed: an adenoma, a haemangiopericytoma, 4 angiomyolipomas, 2 oncocytomas and 2 multilocular cysts. The ultrasound appearance of these tumours does not seem to be specific. The angiomyolipoma only had a typical appearance in two cases, while the other two cases had an appearance no different from an adenocarcinoma or from another benign tumour.

[Value of ultrasonography in the diagnosis of renal abscesses. Results in 13 cases (author's transl)]. / Apport de l'échographie dans le diagnostic des abcès du rein. A propos de treize observations.

The results of ultrasonography recordings in 13 patients with renal abscesses are described: the image of the abscess is that of a cavity, of mixed structural composition, located inside the renal parenchyma. Ultrasonography has great diagnostic value, can be used to guide the aspiration needle and therapeutic procedures, and permits effective follow-up of the course of the disease. Chronic abscesses develop thick borders which give an ultrasonographic appearance similar to that of a necrotic cancer. In the perinephric phlegmon the cavity compresses the capsule. The pyonephrotic kidney is large and heterogenous in appearance. The clinical picture and the results of guided needle puncture are the essential features for diagnosis.

[Echographic study of thoracic lumps in 9 operated cases (author's transl)]. / Etude échographique des masses thoraciques. A propos de 9 cas opérés.

The authors report 9 cases of thoracic lumps investigated by echography in children and adults and operated later. The ulta-sonic study of intra-thoracic lumps is possible thanks to the echographic "windows" which are described; mediastinal and parenchymal lumps can thereby be investigated provided that they have a direct contact point with the chest wall. The echographic examination cannot reveal the histological nature of the lump but it is interesting in that in case of a liquid content it can assert its benignity, all with a technique simple and easy to use especially in children. The reliability of this examination seems good, the echostructure of the lesion being correctly defined in the 9 cases and in the 14 observations in the literature which are summed up.

[Cerebro-costo-mandibular syndrome. Three new cases (author's transl)]. / Le syndrome cérébro-costo-mandibulaire. Trois nouvelles observations.

The cerebro-costo-mandibular syndrome combines bucco-mandibular abnormalities similar to those of the Pierre Robin syndrome, delayed psychomotor development and characteristic costal malformations. On each side, several ribs are interrupted in their dorsal portion. In the three children studied here, there were only eleven pairs of ribs. This brings the number of cases in the literature to twelve. The prognosis of the cerebro-costo-mandibular syndrome is severe, since eight of the children described died during the first months of life.

[The radiological diagnosis of pyelocaliceal tumors. Accent placed on the value of arteriography, especially after the angiotensin test (author's transl)]. / Le diagnostic radiologique des tumeurs pyélo-calicielles. Accent mis sur l'intérêt de l'artériographie, surtout après epreuve a l'angiotensine

From a study of 22 cases of excretory pathway tumors, which had undergone simple selective arteriography, complemented in certain cases by an angiotensin test, the authors were able to draw the following conclusions: -In those forms which show a pyelocaliceal lacuna on intravenous pyelography, arteriography does not help in making a diagnosis; in particular it does not help in distinguishing malignant forms from benign forms. It is therefore of no practical value and is not indicated in such cases. -In those forms showing caliceal amputation or a non functioning kidney on intravenous pyleography, arteriography nearly always enables the diagnosis of a tumor and confirms considerable parenchymal invasion. Its practical value is evident and it seems that it is always indicated in such cases. -Interpretation of the documents must always be thorough, looking for minor signs, while being aware of possible causes of error.