[MR imaging in spinal cord injury]. / Apport de l'imagerie par résonance magnétique dans les traumatismes médullaires.

PURPOSE: To describe MR features of spinal trauma and assess the value of MR imaging in the prognosis. MATERIAL AND METHODS: Retrospective confrontation between initial and follow up MRI findings and clinical features in 7 young patients with spinal cord injury. RESULTS: Five lesions were due to motor vehicle accidents and 2 lesions were secondary to falls. Five patients had multiple associated injuries, 1 patient had associated spinal vertebrae injury, the last had Spinal Cord injury Without Radiological Abnormalities (SCIWRA). A motor deficit was noted in 5 cases of paraplegia, a case of monoplegia and a case of tetraparesia. The initial MRI showed in 3 cases intramedullary hemorrhage, cord edema in 2 cases and spinal cord compression and contusion in 1 case. Initial MRI was not done in the remaining case. No cord transection was noted. Outcomes were marked by lack of significant neurological recovery with complications due to bed confinement in 5 cases, and complete neurolgical recovery in two cases. In follow up, MR findings included post traumatic cystic lesion (2 cases), "ad integrum" restitution (1 case), segmental atrophy with gliosis (2 cases) and myelomalacia in the 2 other cases. CONCLUSION: MR may offer new possibilities in establishing the prognosis for neurological recovery. Our study demonstrated a good correlation between imaging findings, clinical features and outcomes. A hemorrhagic contusion in the acute stage indicated a poor prognosis while a focal hyperintense area on T2-weighted images may resolve.

[Magnetic resonance imaging features of desmoplastic cerebral ganglioglioma of infancy: report of 1 case]. / Imagerie par résonance magnétique du gangliogliome desmoplastique infantile cérébral: à propos d'un cas.

Desmoplastic infantile ganglioglioma is a rare intracranial tumor of infancy, characterized by solid and cystic component, voluminous size and supratentorial location. These tumors are diagnosed usually below the age of 2 years. We report 1 case of desmoplastic ganglioglioma in 13-year-old male. Computed tomography and magnetic resonance imaging diagnosed supratentorial mixed cystic and solid tumor, which presented as a large cystic component with intense contrast enhancement of a mural nodule. The tumor was surgically removed, and histology revealed desmoplastic ganglioglioma. The patient had a good follow up. This observation emphasizes the possibility of desmoplastic ganglioglioma in older infants. It mustn't be considered as a specific entity of very young age infant and must be recognized in older infant because it may be misdiagnosed as malignant glioma. Despite the pseudo malignant appearance, these tumors have a good prognosis after surgery and when excision is complete they don't led to recurrences.

[Atypic radiologic aspect of a renal cell carcinoma in children]. / Présentation radiologique atypique d'un carcinome à cellules claires du rein chez l'enfant.

Renal cell carcinoma is rare in children and is usually found in late childhood. The authors report on an exceptional case of renal cell carcinoma in a 10-year-old girl. The radiological aspect is misleading and has not been previously reported in the literature. Renal cortex was thin because of congenital megalo-ureter, so the tumor developed entirely into excretory cavities (to the proximal ureter), while a primitive urothelial disease (tumoral or inflammatory) was first evoked. The atrophied cortex was the tumoral starting point which prolapsed into excretory cavities, upraising the urothelial epithelium.

[Abdominal wall abscess as the presenting sign in carcinoma of the colon: report of 4 cases]. / Abcès pariétal abdominal révélateur de néoplasie colique: présentation de 4 cas.

PURPOSE: We report four cases of unusual presentation of colonic cancer revealed by an abscess of the abdominal wall. MATERIALS AND METHODS: Our study included 3 men and 1 women ranging in age from 33 to 66 years presenting with abdominal wall abscess (in the left anterior abdominal wall in 2 patients and in the quadratus lumborum muscle in the other 2 patients). Our cases were listed from the departments of radiology and abdominal surgery of Sahloul hospital from 1995 through 2000. Ultrasonography (US) and computed tomography (CT) were performed in all cases; barium enema in three. RESULTS: US and CT revealed segmental colonic wall thickening (left colon in three patients and right colon in one patient). The diagnosis of colonic cancer was reached by colonoscopy with biopsy in all 4 cases. All of our patients underwent surgical treatment. CONCLUSION: In this era of newer diagnostic imaging modalities, US and CT must frequently be used in the evaluation of patients with abdominal wall abscess, to depict intra-abdominal infection and especially malignant lesion causing abdominal wall abscess.

[MRI findings in the diagnosis of pseudotumoral humeral hydatid]. / Apport de l'IRM dans le diagnostic d'une hydatidose humérale pseudo-tumorale.

Hydatidosis of bone is rare. Vertebral localizations predominate. Standard imaging may be misleading, suggestive of a malignant tumor or infection. We present the case of a patient with a humeral hydatid. This localization is very rare and presents an unusual radiographic aspect. Computed tomography produces an image suggestive of a tumor. The correct diagnosis can be established with MRI, particularly with the STIR sequence. In our patient, MRI enabled us to establish the diagnosis preoperatively and evaluate extension. MRI has been found to be highly contributive to the diagnosis of hydatidosis of bone and for assessment of intra- and peri-osseous extension.

[Intralingual dermoid cyst: imaging features of a giant cyst]. / Kyste dermoïde de la langue: aspects en imagerie d'un kyste géant.

Dermoid cysts of the oral cavity are rare and most commonly involve the floor of mouth. Intralingual dermoid cysts are extremely rare and usually large at the time of diagnosis in adult patients. We report the case of 6 year old girl with macroglossia and swallowing and respiratory difficulties due to a giant intralingual dermoid cyst. Ultrasonography showed a large cystic intralingual lesion. MRI allowed accurate evaluation of the size, the extension and the relationship of the cystic mass with adjacent structures, the fat component of the cystic mass confirmed the dermoid origin. This case illustrates the diagnostic contribution of US and MRI in this disease.

[Abdominal actinomycosis. Report of 4 clinical cases studied with radiography]. / Actinomycose abdominale. A propos de 4 observations radiocliniques.

We report 4 cases of pathologically proven abdominal actinomycosis. US and CT demonstrated an infiltrative abdominal mass with ill-defined margins and heterogeneous enhancement after IV contrast. The ileo-cecal region was involved in one case; the mass appeared following cholecystectomy and recurred 3 years after surgical resection in one case; and no predisposing factor was identified in the 2 other cases. In one of these, recurrence was observed 12 years after the first episode. Actinomycosis must be included in the differential diagnosis of invasive abdominal lesions with "malignant" appearance.