[Neuroimaging in pediatric epilepsy]. / L'imagerie par résonance magnétique dans l'exploration des épilepsies de l'enfant.

The main causes of epilepsy in children are cortical malformations (hemimegalencephaly, cortical dysplasia, lissencephaly, etc.) and phakomatosis (tuberous sclerosis, Sturge-Weber disease, neurofibromatosis type 1, etc.), perinatal ischemia, traumatisms, infections, mesial temporal sclerosis, metabolic diseases, and tumors. Imaging indications are precise, including partial seizures and a pathological electroencephalogram. Twenty-five percent of these epilepsy cases are pharmacoresistant. Indeed, MRI is essential to consider surgical treatment, allowing one to localize potential epileptogenic anatomic lesions. The protocol includes sequences in three planes of space, weighted in T1, T2, Flair, T1 inversion-recovery, and T1 after gadolinium injection. MRI findings are characteristic for some tumors, but most malformations are subtle. Consequently recent techniques (spectroscopy, diffusion, etc.) are crucial when conventional MRI is not sufficient. The aim of this article is to illustrate, with a substantive image revue, this wide diversity of etiologies in pediatric epilepsy, in order to help the attendee recognize MRI findings, also discussing the role of newer imaging modalities in this field.

Double lumen remodelling balloon: a new technique for treatment of bifurcation aneurysms.

Bifurcation aneurysms (carotid bifurcation aneurysms, top of basilar artery aneurysms and middle cerebral artery aneurysms) are frequently treated by endovascular treatment (EVT) but their treatment is sometimes difficult singularly when the neck is wide. The "remodelling technique" is used for the treatment of these difficult aneurysms. However, the use of this technique is more complicated in bifurcation aneurysms compared to side-wall aneurysms. It is effectively necessary to protect in the same time the aneurysm neck, the parent vessel, and also the collateral branches. We present endovascular treatment of two cases of bifurcation aneurysms using a new technique of remodelling for endovascular treatment of bifurcation aneurysms by using a double lumen balloon.

[Pelvic MRI at 3.0 Tesla]. / IRM pelvienne à 3T.

High resolution MR imaging is ideal for pelvic imaging. To achieve good image quality at 3.0 Tesla MR, one may not simply import protocols used at 1.5 Tesla MR. Issues specific to 3.0 Tesla MR imaging must be considered including chemical shift, magnetic susceptibility, dielectric effect, specific absorption rates (SAR), motion artifacts and optimal echo time (TE) and repetition tome (TR) to achieve the desired tissue contrast. High quality pelvic MRI (prostate, rectum, and female pelvis) at 3.0 Tesla is possible. In addition, it offers potential advantages due to its ability to provide excellent vascular imaging and advances with functional imaging (diffusion, spectroscopy). This article discusses the parameters required to achieve quality pelvic imaging at 3.0 Tesla, the specifics of high-field MR imaging, and illustrates achievable clinical results.