[Polysplenia with duplication of the inferior vena cava. Apropos of a case]. / Polysplénie avec duplication de la veine cave inférieure. A propos d'un cas.

A case of polysplenia fortuitously discovered in an adult by sonography, then studied by computed tomography and inferior vena cavography, is reported. In the absence of cardiac anomalies, the different elements of the syndrome are discussed: multiple spleens, abdominal heterotaxia and vascular malformations. The duplication of the inferior vena cava is exceptional in this disease. Its original characteristic is shown by the cavography and brought to its embryologic origin.

[The thorax of patients in diving accidents. Radiologic study]. / Le thorax de l'accidenté de plongée. Etude radiologique.

On the basis of a series including 185 files on diving accidents gathered between 1981 and 1988, the authors carry out a radiological study of the thoracic signs observed after drowning and lung overpressure. The typical radiological form and the various clinical forms of drowning and lung overpressure are described in this article. Emergency plain thoracic radiography in bed in the method of choice. However, the existence of many false-negative findings leads to proposing a study with computed tomography (CT) after initial treatment in order to better assess the lesions and to characterize the accident. The utility of radiology is also demonstrated for the follow-up of evolution. Lastly, the authors lay stress on the necessity to prevent such accidents, to which radiologists can contribute by detecting thoracic lesions (dystrophy and other evolutive lesions) for which diving is contraindicated.

[Lipoblastic meningioma. An uncommon benign tumor]. / Méningiome lipoblastique. Une tumeur bénigne surprenante.

Often mentioned and not much documented, the lipoblastic meningioma is an unusual extra-axial benign tumor. It has spontaneously hypodensity in CT and appears with a high signal in MRI in T1-weighted sequence. Its vascularisation is rich and shows a strong contrast intake. Its resection is known as easy and its prognosis is excellent. The authors report here the observation of a 65 year old women having a lipoblastic meningioma. Literature is gone through and differential diagnoses are considered.

[Correlations between the clinical test/MRI/arthroscopy in acute knee injuries]. / Corrélations examen clinique/IRM/arthroscopie dans le genou traumatique aigu.

Authors study retrospectively 81 cases of isolated recent (less than three months) knee traumas. These include clinical aspects, NMR, arthroscopy. Clinical examinations have been graded: 1. possible lesion; 2. likely lesions; 3. confirmed lesions. Clinical examinations and NMR results are compared to arthroscopy considered as reference. Clinical examination of acute traumatic knee is essential. Nevertheless, its value for detecting precise lesions is poor, except for knee locking well correlated with meniscal tears. Results show that NMR provide better results than clinical examination. NMR is reliable for detecting tears of posterior cruciate ligament, tears of posterior horn of menisci (sensibility: 93%; specificity: 80%). Its results are less effective for appreciation of lesion of anterior cruciate ligament (sensibility: 88%; specificity: 78%) because of partial tears and functional but not morphologic damage. It is the only method able to evidence osteochondral injuries and soft-tissues associated lesions in traumatic knees. Emergency NMR scans show results no differences in results compared with routine examinations. However, one should keep in mind that negative NMR cannot exclude small cartilaginous lesions and partial tears of anterior cruciate ligament. According to these results and the known qualities of NMR (non invasive), we propose that this type of investigation should be more largely included in diagnostic attitude for acute injured knee. Emergency diagnostic arthroscopy could be efficiently replaced by NMR knee examination.

[Role of MRI in spinal and spinal cord emergencies]. / Place de l'IRM dans l'urgence rachidienne et médullaire.

Out of 137 cases concerning the spine and spine cord, the authors demonstrate that MRI is nowadays fully integrated in urgency investigations. In all cord compression suspicions and in spine trauma investigations, it's place is found. Coil and software improvements allow to put CT and MR scanning delays on a line. This study underlines the necessity of being equipped with non magnetic life support systems allowing management of very fragile patients. In traumas, MR provides the lesion's authentification, it's type, it's unique localisation or not, and therefore an early functional prognosis. The discovery of spine cord involving lesions in neoplastic conditions allows to follow a therapeutic strateging for maintaining the motor function. In the end, the authors discuss about practical utility of MR in scuba diving decompression accidents. No lesion of the spine cord has been demonstrated in 25 patients, probably because of technical insufficiency.

[Neurocysticercosis of spinal manifestation. Apropos of a case]. / Neurocysticercose à révélation spinale. A propos d'un cas.

A case of spinal extramedullary cysticercosis with location in basal cisterns is reported. It was revealed by a severe sciatalgia and studied with MR imaging which is precious for the diagnosis and the follow-up. Cerebral cisternal arachnoiditis is the main problem in this racemose form where long medical treatment is necessary.

[Correlations between clinical examination/MRI/arthroscopy in the acute traumatic knee]. / Corrélations examen clinique/IRM/arthroscopie dans le genou traumatique aigu.

Authors study retrospectively 81 cases of isolated recent (less than three months) knee traumas. These include clinical aspects, NMR, arthroscopy. Clinical examinations have been graded: 1. possible lesion; 2. likely lesions; 3. confirmed lesions. Clinical examinations and NMR results are compared to arthroscopy considered as reference. Clinical examination of acute traumatic knee is essential. Nevertheless, its value for detecting precise lesions is poor, except for knee locking well correlated with meniscal tears. Results show that NMR provide better results than clinical examination. NMR is reliable for detecting tears of posterior cruciate ligament, tears of posterior horn of menisci (sensibility: 93%; specificity: 80%). Its results are less effective for appreciation of lesion of anterior cruciate ligament (sensibility: 88%; specificity: 78%) because of partial tears and functional but not morphologic damage. It is the only method able to evidence osteochondral injuries and soft-tissues associated lesions in traumatic knees. Emergency NMR scans show results no differences in results compared with routine examinations. However, one should keep in mind that negative NMR cannot exclude small cartilaginous lesions and partial tears of anterior cruciate ligament. According to these results and the known qualities of NMR (non invasive), we propose that this type of investigation should be more largely included in diagnostic attitude for acute injured knee. Emergency diagnostic arthroscopy could be efficiently replaced by NMR knee examination.

[Dermoid cyst of the mediastinum fistulized into the bronchi (author's transl)]. / Kyste dermoïde du médiastin fistulisé dans les bronches. A propos d'un cas.

The authors report a case of dermoid cyst of the mediastinum fistulized into the bronchi. This case was peculiar by virtue of its confusing clinical, radiological and biological characteristics which rendered the diagnosis difficult and in showing the value of bronchography in demonstrating the existence of the bronchocystic fistula. This excavated and fistulized tumor could be determined only after thoracotomy, confirming the primordial role of surgery in pathology of this type.

[Radiologic aspects of pneumonectomies]. / Aspects radiologiques des pneumonectomies.

Pneumonectomy is very important in the treatment of bronchial cancer and is responsible for considerable changes in thoracic images. A study based on 28 pneumonectomy cases has enabled us to define the normal radiographic and scanographic features of pneumonectomy sites as well as the main specific complications. Primary follow-up consists of standard X-rays, while computed tomography allows a good analysis of the anatomical course. Computed tomography is also useful in late medical follow-up, especially when a recurrence is noticed clinically.

[Sequestral osteitis with fracture of the mandibular angle occurring secondarily to the extraction of a wisdom tooth. Apropos of a case]. / Ostéite séquestrante avec fracture de l'angle mandibulaire survenue secondairement après l'extraction d'une dent de sagesse. A propos d'un cas.

The authors report on a case of sequestrated osteitis complicated by a fracture of the angle of the mandible, following the avulsion of a wisdom tooth in a 20 year old man. The treatment consisted of an intermaxillary fixation of the mandibular arche lasting 40 days accompanied by wide-spectrum antibiotic therapy for 15 days, until such time as the ESR and blood count values returned to normal. In three months resorbtion of the sequestrated necrotic bone and disappearance of the osteitic cavity was noted, all of which was indicative of a satisfactory result. From the aetiological point of view it was possible to confirm by way of a routine X-ray taken 5 days after the extraction that the lesions had developed of their own accord, thus eliminating surgery and trauma as causes. The problem of what causes maxillary osteitis remains, and in particular, the role played by local anaesthetics containing adrenaline.

[The adipose tissue of the pelvis in imaging technics]. / Le tissu adipeux du pelvis en imagerie.

Fat is a fundamental contrast agent in pelvic imaging. The features of fat are typical on CT and MRI but vary on ultrasonography according to the physical characteristics and histology. The study of pelvic fat is of great importance in pelvic exploration because fat outlines both the normal structures and their borders. Involvement or masking of the pelvic fat is a good marker of carcinologic spread. Changes in pelvic fat may also be observe in inflammatory diseases. Specific diseases of fatty pelvic connective tissue such as lipomatosis and liposarcomas, are classically described. Teratomas with a fatty component derived from pelvic structures (ovaries) are easily diagnosed using imaging methods.