Quantification of carotid stenoses using 3D morphometer, CT angiography and conventional angiography.

BACKGROUND: The aim of this study is to compare the performances of 3D morphometer (M3D) regarding the quantification of extracranial carotid stenoses with selective 2D conventional angiography (reference technique) and spiral CT scan. METHODS: It is a prospective study, including 15 patients (mean age 75) presenting a symptomatic carotid lesion detected via duplex Doppler to be operated. Patients had to hold their breath for 20 seconds. Twenty-nine carotid bifurcations were studied by means of M3D and 2D conventional angiography (15 patients). Only 10 patients (19 bifurcations) underwent a CT scan. The measures were performed on a visual display unit by measuring the pixels as per the NASCET technique. Diameters (MIP technique) and surfaces (reformated axial slices) were measured. RESULTS: With MIP technique, a good correlation was found 20 times in 29 (69%) (overestimation: n=8/29) between M3D and angiography, but only in 9 of 19 cases (47%) between CT scan and angiography. Unlike with M3D, the slices re-oriented with CT scan gave better correlations: 15 times in 19 (79%). With the CT scan, the measures were impossible 8 times on MIP technique, and twice on reformated slices for calcified tight stenoses. Therefore, the quantification by means of spiral CT scan is easier by planimetry on slices. CONCLUSIONS: The reliability of these 3D explorations regarding quantification remains uncertain. The use of a morphometer, provided that technical adaptations are made, could replace selective sequences in multiple incidences that become accessible in the post-treatment period, with an acquisition field larger than the one of the CT scan.

[A severely disturbed lipid profile]. / Un bilan lipidique très perturbé

We report here the case of a 30-year-old woman presenting a disturbed lipid profile since her childhood. The rarity of this pathology (Anderson' disease or chylomicron retention disease) and its recent recognition explain its late detection in this case. The description of the biochemical profile is interesting especially the low level of vitamin A and E which explains the severity of the disease. A vitamin enriched-diet may be useful.

Iliac aneurysm in a child complicating umbilical artery catheterization.

We report a case of an iliac artery aneurysm in a 9-year-old girl due to Staphylococcus aureus infection of an umbilical arterial catheter inserted at birth. After resection-anastomosis of the iliac artery the postoperative course was uneventful and hemodynamic data remain normal at 2 years. A review of the literature indicates that the prognosis of infective aortoiliac aneurysm is poor in children, except when the aneurysm is located solely in the iliac artery. Arterial continuity should be restored as late as possible after infection using a technique consistent with normal growth of the artery in the child.