Assessment of patient's peak skin dose during abdominopelvic embolization using radiochromic (Gafchromic) films.

PURPOSE: To assess the value of the routine use of radiochromic films in abdominopelvic embolization procedures to improve patient follow-up. METHODS: A total of 55 patients who underwent transcatheter abdominopelvic embolization were prospectively included. Six types of procedures were evaluated including hepatic chemoembolization (HCE), gonadal veins embolization (GVE), uterine elective embolization (UEE), uterine urgent embolization (UUE), abdominal elective embolization (AEE), and abdominal urgent embolization (AUE). Dosimetric indicators (DIs) such as air-kerma (AK) and kerma-area-product (KAP) were collected and peak skin dose (PSD) was measured with radiochromic films. Correlations between PSD and DIs were searched for. RESULTS: The mean (±standard deviation [SD]) PSD for the various procedures were: 1033±502 mGy for HCE; 476±271 mGy for GVE; 460±171 mGy for UEE; 531±263 mGy for UUE; 708±896 mGy for AEE; 683±392 mGy for AUE. Strong correlations were observed between PSD and DIs (r=0.974 for AK and r=0.925 for KAP). PSD was>2Gy in one procedure and all procedures (7/132) procedures resulted in AK>2Gy, mostly for HCE and AEE. CONCLUSION: Dosimetry using radiochromic film is only appropriate for HCE, AEE and AUE, whereas dose-mapping systems present a more suitable solution for all embolizations including those with AK that occasionally exceed 2Gy.

Impact of the calibration conditions of XR-RV3 films on peak skin dose measurements in interventional radiology.

In this study, the impact of radiochromic films' (XR-RV3) calibration on PSD measurements was investigated under various peak kilovoltage (kVp) and additional filtration conditions. Films were calibrated free-in-air for six beam qualities with Allura Xper FD20 system (Philips). Six calibration curves (CCs) were constructed. Each beam quality was characterized in terms of mean energy (ME) in the air, with table, with table and water phantom using Monte Carlo simulations. A cohort of 155 patient films from cardiology (37) and vascular (118) procedures were read with each CC. Routine calibration beam quality was taken as reference (DoseNorm). Overall, it was observed that for a wider ME difference between the exposed film and the CC used, a larger deviation (from -28% to +41%) was observed. The choice of beam quality for the calibration is a key point when additional filtration and kVp are automatically controlled in clinical conditions.

[Thrombophlebitis of the left ovarian vein diagnosed by phlebocavography. Fibrinolysis in situ]. / Thrombophlébite de la veine ovarienne gauche diagnostiquée par phlébocavographie. Fibrinolyse in situ.

Ovarian vein thrombophlebitis is a rare condition but may be underdiagnosed because it is sometimes asymptomatic. The authors report a case of left ovarian vein thrombophlebitis complicated by pulmonary embolism, which was diagnosed by phlebography and treated by local thrombolysis.

[Lipomatous hypertrophy of the interatrial septum. Apropos of 3 cases and review of the literature]. / Hypertrophie lipomateuse du septum interauriculaire. A propos de 3 cas et revue de la littérature.

Lipomatous hypertrophy of the interatrial septum is characterised by an accumulation of fatty tissue in the interatrial septum. The authors report three cases, one presenting with sinus tachycardia and the other two being chance findings. Echocardiography associated with cardiac computerised tomography or magnetic resonance imaging usually confirms the diagnosis. In half the cases, supraventricular arrhythmias and suggestive P wave abnormalities are observed on the electrocardiogram. The diagnostic value of transoesophageal echocardiography is emphasised; it demonstrates the massive forms which may obstruct flow from the superior vena cava into the right atrium. The authors observe a discrepancy between the prevalence of this condition in autopsy series (about 1%) and the small number of cases described at echocardiography, suggesting that the diagnosis is probably missed.

[Arteriovenous fistula caused by spontaneous rupture of an aortic or iliac aneurysm in the iliocaval venous system. Apropos of 2 cases]. / Fistule artério-veineuse par rupture spontanée d'un anévrysme aortique ou iliaque dans l'axe veineux ilio-cave. A propos de 2 observations.

The authors report two cases of arteriovenous fistula due to spontaneous rupture of an aortic or iliac aneurysm into the iliocaval venous axis. This is a rare complication of atheromatous aneurysm (less than 4% of ruptured aneurysms), often difficult to diagnose as the clinical presentation may be obscure. Although aortography is the reference diagnostic investigation, color Doppler ultrasonography enabled visualisation of the arteriovenous communication and provided an accurate diagnosis in one recent case. Treatment of these aortocaval fistulae is always surgical. The prognosis and immediate operative mortality depend mainly on the presence of an associated retroperitoneal rupture.

[Bilateral multifocal renal oncocytoma]. / Oncocytome rénal multifocal bilatéral.

We report a case of a bilateral multifocal renal oncocytoma and describe the features of different radiographic techniques emphasising the value of magnetic resonance imaging. This benign tumor is rare. Its preoperative differential diagnosis with renal cell carcinoma is very difficult, especially as its surgical treatment should be conservative.

Computed tomography of lethal midline granuloma. 5 case reports.

Five cases of lethal midline granuloma are evaluated with computed tomography. CT examination is indispensable to appreciate extension of facial lesions, and detect lymphoma often associated.