Common origin of the arterial blood flow for an arteriovenous medullar fistula and the anterior spinal artery: a case report.

A common origin of the blood supply to a dural arteriovenous malformation and to the spinal cord from the same segmental artery is very rare. This obviously contraindicates embolization of the fistula. Demonstrating the location of the normal spinal blood supply system is therefore mandatory to avoid postoperative complications. The visualization of the normal blood vessels can be masked by a steal phenomenon, but it must at all costs be obtained. The authors describe one such case.

Primary left atrial angiosarcoma: follow-up by magnetic resonance imaging.

We report the case of a primary left atrial angiosarcoma followed by MRI over a period of 1 year. The tumor was lobulated, with an initial central hyperintensity on T1-weighted images which disappeared after radiotherapy. Compared with other imaging modalities, MRI offered the most accurate information about the location, extent, and outcome under treatment.

Post-pneumonectomy evaluation of the chest: a prospective comparative study of MRI with CT.

A comparative study of 11 pneumonectomized patients was undertaken in order to evaluate the respective advantages and drawbacks of MRI and CT in post-operative follow-up. Nine patients were healthy at the time of the study and two presented with tumor recurrence. MR examination included 500/40 ms axial, and frontal 800/40-80 ms or 1300/60-120 ms nongated spin echo sequences. MRI was slightly more efficient in identifying vascular stump and main nodal stations, and detected better than CT tumoral and metastatic spread in cancer recurrences. It was as informative as CT in evaluating postpneumonectomy space and bronchial stump. It was noncontributory in the detection of calcifications. Although clips were visible with MRI, their location was less definite than with CT, a potential pitfall when radiotherapy is planned.

MRI in the pre-operative assessment of tracheal cylindroma. Case report.

Compared with malignant neoplasms of the chest, benign tumours are quite rare; cylindroma (or salivary gland adenoma) is exceptional. The apparent histological benignancy belies its high potential for invasiveness. This can, in some cases, lead to extensive, non-conservative surgery. By a different approach in the imaging of the chest, Magnetic Resonance Imaging in this condition may provide an accurate pre-operative assessment. We present a case in which MRI provided the information necessary for the surgical approach, and describe its accuracy and the results obtained.

Fine needle aspiration of retroperitoneal human dirofilariasis with a pseudotumoral presentation.

The accidental finding of a pseudotumoral para-aortic mass in a 60-year-old woman led to the performance of a fine needle aspiration (FNA) biopsy under ultrasonographic guidance. The milky aspirate was centrifuged and processed as a cell block. The examination of sections confirmed the lymphatic origin of the sample, but also revealed some unexpected parasitic structures. While a complete identification could not be made on a few sections, the morphologic and epidemiologic evidence suggested Dirofilaria repens. The mass was surgically removed and identified as an adenolymphocele, which appears to be a new localization of dirofilariasis in humans. This case emphasizes the utility of FNA in diagnosing such unexpected findings without the use for exploratory surgery.

[Feasibility study of the Doppler exploration of the renal artery]. / Etude de faisabilité de l'exploration Doppler de l'artère rénale.

Using arteriography as a reference, the authors investigate the feasibility of pulsed doppler exploration of the normal or pathological renal arteries in 46 successive patients. The poor sensitivity of pulsed doppler, mainly due to the considerable anatomical variations of the renal pedicle, does not currently allow using this technique for the detection of renal arterial stenosis. When combined with angiography, pulsed doppler becomes a definite asset in therapeutic radiology to help in the choice of a treatment and in follow-up.

[Cervico-occipital injury and bilateral paralysis of cranial nerve XII. Apropos of a case]. / Traumatisme cervico-occipital et paralysie bilatérale du XII. A propos d'un cas.

A patient with bilateral traumatic hypoglossal palsy is presented. Evaluation of the atlanto-occipital articulation is difficult. Prompt radiographic diagnosis of this injury can be made by computed tomography. In this case, there was bony avulsion of the alar ligament from the occipital condyle. We suggest a severe blow to the head in a lateral direction.

[MRI evaluation of placenta accreta treated by embolization. Apropos of a case. Review of the literature]. / Evaluation IRM d'un placenta accreta traité par embolisation. A propos d'un cas. Revue de la littérature.

Placenta accreta results from an abnormal attachment of the placenta to the uterine myometrium. The reported incidence in literature is variable, with an average of 1/7000 pregnancies. This condition is associated with a significant risk of bleeding at the time of delivery, usually requiring hysterectomy. Sonography associated with color Doppler is useful for diagnosis, but MRI can be used successfully to evaluate the degree of placental tissue invading into the myometrium, the serosa, and for follow-up after conservative management. To our knowledge, only two cases of placenta accreta evaluated with MR and six cases of placenta accreta treated by embolization have been reported in the literature. The authors report one case of placenta accreta treated successfully by embolization, and followed-up by MRI.

[Arteriovenous fistulas complicating in situ venous femoropopliteal bypass. A sample case]. / Fistules artério-veineuses compliquant un pontage fémoro-poplité veineux in situ. Une observation exemplaire.

Arteriovenous communications are a rare but specific complication of in situ saphenous vein arterial bypass. In this bypass procedure, some collaterals of the saphenous vein may remain patent. In this report, a characteristic example illustrates this complication. Local and general manifestations secondary to the development of these fistulas must be prevented by complementary surgical or radiological obliteration.

[Post-traumatic paraosteoarthropathy of the hip. Analysis with x-ray computed tomography and 3-dimensional reconstruction. 2 cases]. / Paraostéoarthropathie de hanche post-traumatique. Analyse en TDM et reconstruction 3D. A partir de 2 observations.

Two cases of paraosteoarthropathy developed soon after hip trauma and without associated spinal disorders are described. CT perfectly discriminates ectopic bone formation from osseous fragments and calcified hematoma. These lesions display different signs and have different locations, which allows an easy differentiation. The aetiology of these traumatic osteomas (hip trauma associated with surgical repair in one case coma in the other) is compared to literature. The effectiveness of CT with 3D reconstruction is emphasized in paraosteoarthropathy and hip trauma screening.

[Late empyema after pneumonectomy. Demonstration in x-ray computed tomography]. / Empyème tardif après pneumonectomie. Démonstration en tomodensitométrie.

The authors describe CT signs of a thoracic empyema, developed several years after a pneumonectomy. The disappearance of the concavity of post-pneumonectomy space in contact with mediastinum, associated to the absence of retraction of the hemithorax are the main signs of the diagnosis.

[Percutaneous retrieval of catheters migrated in the circulatory system]. / Récupération par voie percutanée des cathéters migrés dans le système circulatoire.

The migration of catheter in the central venous system is a rare but serious iatrogenic complication. At short term this life threatening complication induces arythmias and then infectious, thrombotic and mechanical complications. Simple interventional procedures, rapidly achieved can prevent these complications.

[Evaluation of elementary radiologic images of Crohn's ileitis. Retrospective study of a homogeneous series of 238 double-contrast transits in the small intestine]. / Evaluation des images radiologiques élémentaires de l'iléite de Crohn. Etude rétrospective d'une série homogène de 238 transits du grêle en double contraste.

An homogeneous series of 238 double contrast examinations of the small bowel were reviewed. In this study, 32 regional enteritis (RE) were encountered. Statement of different semiologic signs of RE was established. This study exhibited various signs in RE; some of them were observed in various other enteritis (mainly tumors, ischemia and variation enteritis). Sensitivity varies between 6 and 84%. Highest values are noted with ulcerations, nodules, narrowing of the lumen wall. Specificity and predictive values vary from 64% to 100%. The best results are obtained with graduate lesions, fistulae, skipped area and cobblestone. Only graduate lesions are really pathognomonical but uncommon lesions. Analysis of double contrast small bowel examination has to be compared with the whole medical report in order to improve diagnosis accuracy.

[Evaluation of digital subtraction angiography, ultrasonography and Doppler velocimetry versus conventional angiography in the femoral bifurcation]. / Evaluation de l'angiographie numérisée, de l'échographie et de la vélocimétrie Doppler par rapport à l'angiographie conventionnelle au niveau du carrefour fémoral.

Thirty patients were examined by 4 procedures, conventional angiography (C.A.), peripheric intravenous digital subtraction angiography (D.S.A.), ultrasonography and Doppler on femoral artery bifurcation. These arteries are divided into several sections on which findings were classified into three or five categories. There is an excellent correlation between conventional and digital angiograms. Various results of D.S.A. versus C.A. were obtained in 2% of these sections. More differences were noticed between C.A. and Doppler (7%), C.A. and ultrasonography (10%). There is a positive correlation of D.S.A. versus C.A. With Doppler and ultrasonography, arterial map is difficult to establish especially in case of many stenoses of the iliac arteries or thrombosis on femoral superficialis arteries.

[Spontaneous rupture of the bladder. Apropos of 2 cases with an unusual presentation]. / Rupture spontanée de vessie. A propos de deux cas de présentation inhabituelle.

Spontaneous bladder ruptures is the accepted term of bladder rupture not associated with trauma. This rare condition occurs when an obstacle to urinary outflow is associated with a diseased bladder wall. The diagnosis is usually made on the retrograde cystogram. We report two cases of atypical spontaneous bladder rupture with intravesical herniation of the small bowel. The diagnosis was not suspected clinically but was made on CT and MRI.

[Ischemic orchiditis: review of 5 cases diagnosed by color Doppler ultrasonography]. / Orchites ischémiques: A propos de 5 cas diagnostiqués en écho-Doppler couleur.

PURPOSE: To study color-doppler ultrasoundfeatures of testicular infarction caused by orchiepididymitis, a severe complication of orchiepididymitis. MATERIAL: and Methods. Five patients were included over a 2 year period. All presented with more than 24 hours of pain. A final diagnosis of testicular infarction caused by orchiepididymitis and color doppler ultrasound was available in all cases. RESULTS: All patients showed doppler ultrasound signs of testicular ischemia. Either vascularisation was not detectable or intratesticular resistive index was increased with a negative diastolic flow. Orchidectomy was performed in all patients. CONCLUSION: Color doppler examination of the scrotum should include measurement of intratesticular resistive index. An elevated RI can be suggestive of ischemia.

[Endometrial imaging]. / L'endomètre: quelle imagerie?

The diagnostic value of endovaginal sonography in benign or malignant endometrial pathology is high, increased by sonohysterography. Sonohysterography is useful in the diagnosis of endometrial thickness and to determine further investigations. MRI is accurate in the uterine adenomyosis diagnosis and is the imaging modality of choice for the preoperative endometrial cancer staging.

[Endoluminal angioplasty of iliac obstruction. Immediate results and cumulative patency at 2 years in 23 patients]. / Angioplastie endoluminale des oblitérations iliaques. Résultats immédiats et perméabilité cumulée à 2 ans chez 23 patients.

23 patients with obstruction of one or both main iliac arteries underwent one or more transluminal angioplasties by catheterization via the obstructed vessel. 26 iliac arteries were thus reopened. The length of obstructions varied from 1 to 10 cm. The majority of the obstructions were of recent onset whilst in 6 cases the presumed date was more than 6 months previously. In all cases potency was obtained with normal follow-up angiograms in 20 cases, and a residual though not hemodynamically significant stenosis in 6 cases. All patients were followed up by Doppler and in the majority of cases by venous digital angiography, with a follow-up at the present time of 6 months to 2 years. 2 patients underwent surgery because of reobstruction occurring 2 and 13 months after dilatation. Cumulative patency is 79% in 2 years, similar to results obtained by surgery. These results show that iliac angioplasty, a simple procedure, may avoid or delay surgery, and that it should be widely used in this precise anatomical indication.

[Role of arteriography and x-ray computed tomography in the current evaluation of pigmented villonodular synovitis]. / Place de l'artériographie et de la tomodensitométrie dans le bilan actuel des synovites villo-nodulaires pigmentées.

The angiographic characteristics of five surgically proven cases of pigmented villonodular synovitis are reported. A CT scan was performed in one case. CT scan arthrography is very useful when it demonstrates regions of high attenuation. The angiography never demonstrated in the five cases capillary blush nor arteriovenous shunting, but a regular hypervascular mass. These findings are helpful for the surgeon suggesting the best surgical approach and the best site of biopsy.

[Optochiasmatic tuberculoma and MRI. 2 cases]. / Tuberculomes opto-chiasmatiques et IRM. Deux observations.

Two cases are reported of optochiasmatic tuberculoma, an exceptional complication difficult to diagnose in the absence of any tuberculous context. Although diagnosis of the optochiasmatic occupying process is simple by scan or NMR imaging, it is generally difficult to identify the chiasma in a process of this type. It is therefore impossible to recognize the two forms of these tuberculomas: intra- and peri-chiasmatic histologic types, and yet these have an incidence on therapy and prognosis. Surgical exploration is justified when the diagnosis remains in doubt or when the functional prognosis is implicated.