EMC - Radiologie最新文献

Ultrasonography remains an unusual way of exploring the gastrointestinal tract despite the fact that this imaging technique that uses medium or high frequency transducers offers an exceptional resolution. Therefore, the examination must be realized as close as possible to the bowel segment with transabdominal, transvaginal or transrectal techniques. Peri-digestive alarming signs can be found: inflammation of the mesenteric and omental fat may be observed at the general examination of the peritoneal cavity. Then, high frequency permits a detailed study of the parietal layers. Ultrasound semiology is based not only on abnormal echotexture, appearance and contours, but also on the evaluation of mobility, softness and adhesion. Bowel wall thickening is frequent and each layer must be studied. Clearly, the diagnostic hypothesis depends on clinical and biological circumstances.

Despite a high number - about 7000 cases - of tuberculosis reported in France each year, the diagnosis remains much delayed. Symptoms of pulmonary tuberculosis are non evocative, but the disease is characterized by its chronicity. Thoracic radiography and environmental factors are key points for the diagnosis. Extra pulmonary tuberculosis (20 to 30 percent of all tuberculosis) is more common among foreigners, older patients, HIV patients or patients receiving immunosuppressive treatment including infliximab.

The sacral bone and coccyx are particular entities of the spinal axis due to their lower polar location, arched morphology and unique fused vertebrae composition. These two structures look like a sunken area between both ala ossis ilii. The sacroiliac joint morphology is also complex, and therefore standard X-ray analysis of this region is often complicated, especially when it is obscured by numerous overlapping gaseous zones. Many of these problems have currently been overcome by CT scanning and MRI.

In 2003, the main indication of hysterosalpingography remains female infertility of tubal origin. Selective salpingography may be secondary to an hysterosalpingography that demonstrates a proximal tubal occlusion. Tubal catheterization can thus be undertaken in agreement with both the surgeon and the gynecologist. Hysterosalpingography brings decisive information for both the diagnosis, concerning the location and sometimes the cause of tubal obstruction, and the therapeutic management, since simple selective injection of contrast media may allow re-permeability of fallopian tubes. Tubal re-canalization is reserved to the failure of selective salpingography. Selective salpingography can be proposed as a first-line therapeutic procedure following hysterosalpingography, before more invasive methods (in vitro fertilization, tubal microsurgery).

Medical Imaging is now about to be full digital. Since the beginning of digitalization, the data exchange evolves continuously between equipments from different manufacturers. The need for a standard appeared at the beginning of the eighties and lead to DICOM, the worldwide standard for Medical Imaging which was created at the beginning of the nineties. DICOM may seem too complex; however this is due to the Medical Imaging specificities and to the multiple modalities. Although Medical Imaging professionals do not need to have a full knowledge of DICOM, when buying the equipment some knowledge about it is required for an adequate selection. This paper aims to describe DICOM basis to allow the physician to understand the DICOM conformance statements. Such statements shall be published and made available for users by manufacturers. The conformance statements describes which parts of the standard are implemented and in which way. This paper will also set Digital Medical Imaging in the Healthcare Information System.

Atherosclerosis, as well as spontaneous venous thromboses of the arm, occurs rarely. Upper extremity arteries and veins are therefore less frequently examined in daily practice, compared to those of the lower limbs, or to cervical vessels. However, some specific diseases occur in arm vessels; most can be explored with ultrasound techniques. Follow-up of hemodialysis fistulas is probably the main indication for ultrasonographic examination of upper limb vessels. Some inflammatory, traumatic, or compressive lesions may also be detected and quantified by ultrasound techniques.