Pilocytic astrocytoma mimicking cavernous angioma: Imaging features and histological characteristics.

Pilocytic astrocytoma (PA) commonly occurs during the first two decades of life. Typical locations include cerebellum, optic nerve, optic chiasm/hypothalamus and brainstem. PA should be considered in the differential diagnosis of patients with brain tumors manifesting with hemorrhagic onset. We report a case of a hemorrhagic onset of cerebellar PA in a young adult with imaging findings mimicking cavernous angioma. We also discuss imaging features and histological characteristics with a focus on the etiology of the hemorrhagic onset.

[Imaging of acute cerebellitis in children. Report of 4 cases]. / Imagerie des cérébellites aiguës chez l'enfant. A propos de 4 observations.

Acute cerebellitis is one of the main causes of acute cerebellar dysfunction in children. It is either infectious, usually viral, post-infectious or post vaccinal in etiology. Diagnosing acute cerebellitis may be difficult in patients with only subtle cerebellar signs and when cerebro-spinal fluid examination is normal. MRI is the most adequate imaging technique to demonstrate cerebellar involvement. The authors report the clinical and neuro-imaging findings in 4 paediatric cases. Patient's age varied from 2 to 7 years and predominant clinical symptoms were fever, headache and vomiting; ataxia was noted only in 2 cases. Viral serologic tests were negative in 3 cases and demonstrated Epstein-Barr virus in 1. Initial MRI examination (2 cases) demonstrated increased intensity on T2W and Flair sequences of the cerebellar gray matter with pial enhancement. Clinical outcome was good with complete resolution of symptoms in 3 cases and persistent mild right upper limb paresis in one. The resolution of the signal abnormality was well demonstrated on MRI in one case, suggesting an inflammatory etiology with moderate residual cerebellar atrophy.

[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.

[Pseudotumoral form of abdominal tuberculosis: report of four cases]. / La tuberculose abdominale pseudo-tumorale.

PURPOSE: To report the imaging features of four cases of pseudo-tumoral abdominal tuberculosis in order to demonstrate diagnostic difficulties, even in endemic areas, despite expanding imaging modalities. MATERIAL AND METHODS: We have retrospectively reviewed four cases investigated in our hospital between 1998 and 2002. The first case concerned a 2 year and 6 month old boy admitted for a right iliac fossa mass. The other patients were 43 and 48 year old women admitted for epigastric mass and persistent epigastric pain with past history of treated tuberculosis respectively. The last was an 86 year old man investigated because progressive worsening of general health. Sonography (US) and computed tomography (CT) were performed in all four cases. RESULTS: Involvement of the ileocaecal region was noted in three cases. Large intestinal hypervascular mass in the pediatric case, heterogeneous mass with porta hepatis lymph node in the patient with past history of treated tuberculosis, pseudotumoral caecal wall thickening in the third case. The multiloculated pattern of the epigastric mass and its location initially suggested a diagnosis of pancreatic tumor. CONCLUSION: Abdominal tuberculosis is rare even in endemic areas. This diagnosis must be considered when imaging modalities depict a hypervascular soft tissue mass on Doppler examination with peripheral enhancement on CT scan.

[Hydatid cyst of soft tissues: MR imaging findings (Report of three cases)]. / Kyste hydatique des tissus mous: apport de l'IRM (A propos de trois observations).

Three cases of hydatid disease of the soft tissues are reported. All presented as soft tissue lesions in the neck and lower extremities. All three cases were studied with ultrasound (US) and magnetic resonance (MR) imaging techniques. Two patients presented with multivesicular lesions, which were considered diagnostic for hydatid disease. The third showed a lesion with hypoechoic solid and lobulated pattern mimicking lymph node. MR outlined the cystic pattern with intense peripheral enhancement and was suggestive of an infected cystic lesion. Surgery was performed in all three cases. Hydatid disease presenting in the soft tissues can be diagnosed with confidence, when US and/or MR shows multivesicular lesions. MR appears to be the most useful imaging technique when a complex or solid pattern is present. Enhancement of the peri-cystic soft tissues can be considered as a suggestive MR feature of soft tissue hydatid disease.

[Magnetic resonance imaging features of cystic meningiomas. Report of four cases]. / Aspects en imagerie par resonance magnetique des méningiomes kystiques. A propos de quatre cas.

Four cases of cystic meningioma are reported, and the imaging features and diagnostic pitfalls of cystic meningiomas are reviewed. Cystic meningiomas are infrequent tumors and remain difficult to diagnose in spite of advanced imaging techniques. Our patients were between 15 and 58 years of age, and underwent CT and MR imaging. In all the four cases, the meningiomas were supratentorial and included Nauta type I, type II and type III tumors.

[Kidney carbuncle: diagnostic, bacteriological and therapeutic considerations. Apropos of 11 cases]. / L'anthrax du rein: considérations diagnostiques, bactériologiques et thérapeutiques. A propos de 11 cas.

Renal carbuncle is a cortical lesion following bacteremia, occurring in patient without any urologic known problems. The analysis of 11 consecutive renal carbuncles showed that one should consider the diagnosis of renal carbuncle in young patients with flank pain, fever, and absence of significant leucocyturia. Our study confirms that renal carbuncle is always caused by staphylococcus aureus and that treatment is based on appropriate antibiotherapy. Isolation of the bacteria was difficult unless ponction of carbuncle under ultrasound control was performed. The usefulness of ultrasonography for the diagnosis of renal carbuncle and for its distinction from other suppurative renal lesions is emphasized.

[Renal and perirenal abscess and urinary tract obstruction caused by Torulopsis glabrata infection]. / Abcès rénal et périrénal et obstruction du tractus urinaire d'origine fongique à Torulopsis glabrata.

We report a case of renal and perinephretic abscesses due to Torulopsis glabrata, in a diabetic women. Fungal obstruction of upper urinary tract was associated. One must maintain a high suspicion for fungal infection when suppurative renal process occurs in a diabetic patient, especially when obstruction and absence of bacteria are noted.