EMC - Radiologie最新文献

Hand traumas are very frequent. Standard radiography is the principal means used for their investigation. Non-articular fractures should be distinguished from articular fractures since the latter may need surgical intervention. In terms of morphology and function, the thumb differs from long fingers. The major part of hand lesions are blunt, simple, stable, non-displaced or reduced by traction, and orthopedically treated.

A variety of hepatic or pancreatic diseases may have an impact on the status of the portal venous system so that a functional and morphological evaluation of the portal venous system is needed in such conditions. Accurate evaluation of the portal venous system is critical in the evaluation and the follow-up of candidates to hepatic transplantation or transhepatic intrahepatic portosystemic shunt placement. A specific imaging technique should be adequately chosen as adapted to the current indication. Ultrasonography coupled with duplex Doppler is the first-line investigation carried out for the diagnosis and follow-up of portal thrombosis. Multidetector helicoid computed tomography allows morphological and functional approach of the portal venous system. In case of portal thrombosis, this technique may show the extent, potential consequences and possible causes of the portal thrombosis. Magnetic resonance imaging presents similar performances for the visualization of the portal system; furthermore, this technique has a higher efficacy in characterizing liver and pancreas complicated by a portal thrombosis. This technique is useful for the detection of venous complications after hepatic transplantation. More invasive procedures such as transhepatic percutaneous portography, and transjugular portography are limited to some specific indications.

The upper limb is divided in three distinct anatomical parts: the arm, the elbow, and the forearm. The aim of this article is to describe the skeletal anatomy with notification of the most common pitfalls and variations on the basis of conventional radiography and CT scan, in addition to an approach of soft tissue anatomy on the basis of ultrasonography, CT scan, and MRI.

The frequency of drug-induced lung toxicity is increasing. Diagnosis is complex due to numerous involved drugs and to various anatomo-clinical manifestations. Radiograph and lung CT scans are important tools for the diagnosis. Drug-induced lung diseases mainly include oedema with or without diffuse alveolar damage, pulmonary hemorrhage, non specific interstitial pneumonia, organizing pneumonia, hypersensitivity reaction, eosinophilic pneumonia and obliterative bronchiolitis. For each of these manifestations, we reviewed the drugs most frequently involved, the radiographic appearance and CT findings. The main lung radiologic manifestations, were described in the most common drugs that cause lung toxicity such as bleomycin, busulfan, cyclophosphamide, methotrexate, amiodarone, nitrofurantoin, gold salts and minocycline.

Diagnosis of renal tumours is built-up on clinical findings such as age, symptoms and US findings such as volume and spread of the tumour. The most commonly encountered, between 18 months and 5 years of age, is the Wilms’s tumour which may be associated with congenital abnormalities. Diagnosis of other kidney tumours may be difficult. The tumours of the urinary tract are rare, revealed by hematuria. The most common is rhabdomyosarcoma of the bladder. Diagnosis requires US examination, opacification of the collecting system and MRI.

Accuracy of MRI in knee disorders is now well established, especially in menisci or ligamentous tears. During the past decade, significant advances were made in diagnostic criteria, pitfalls and limitations. After reviewing technical considerations of performing routine explorations of a traumatic knee, we review imaging and diagnostic difficulties of menisci lesions. Next we describe anterior and posterior cruciate ligament tears, and review their direct and indirect signs. Finally, we tackle injuries of the medial and lateral supporting structures of the knee.

Inflammatory pancreatitis refers to those pancreatic lesions that can occur with some autoimmune diseases, with an eosinophilic infiltration, during infection by Human Immunodeficiency Virus, and following abdominal radiotherapy. Differences exist between their specific clinical, biological, radiological, and histological patterns and those of the calcifying chronic pancreatitis; such differences must be taken into account for ensuring adequate therapy. Most of the time, autoimmune pancreatitis appears as a hypo-echogenic mass, hypo-attenuated on CT scans, hypo-intense on T1 weighted images, hyper-intense on T2, with a late enhancement after injection. Ductal changes are irregular stenoses only causing moderate upstream dilatation. Diagnosis is based on histological examination, showing a periductal inflammatory infiltration, constituted, in particular, of T lymphocytes. Eosinophilic pancreatitis is a histo-pathologically diagnosed pseudo-tumoral mass occurring in an atopic context, with increased IgEs. Both pancreatitis need corticoid-based therapy. Patients with Acquired Immune Deficiency Syndrome may develop pancreatic damages, acute most of the time, but also chronic and with ductal modifications and a pancreatic fibrosis of unknown aetiology to date. Finally, abdominal radiotherapy may cause chronic pancreatitis, occurring several years following the irradiation.

Haemophilia is characterized by abnormal blood coagulation. Hemoarthrosis is a particularly characteristic abnormality in haemophilias, occurring in the early years of life, leading to the haemophilic arthropathy. The most altered joints are generally the knee, the elbow, the ankle and the hip. In this paper, we will present the usual radiographic and MRI features of this disease for which early and adequate management is of utmost importance.

Dental imaging examinations must be adapted to the indication and to the area to be analyzed; panoramic radiography is an essential examination for broad coverage of dental and osseous structures; intra-oral radiographic examinations are indicated for a detailed screening of a particular area or for periodontal analysis. Orthodontic assessment includes the cephalometric projection and if necessary a radiography of the hand; tomodensitometry with the addition of specialized software has become one of the preferential examinations for the study of dental arches and facial bones, in particular before and after implant placement. In particular, it allows to determine the specific features of and relationships between dental diseases and jaw pathology. MRI may be required in tumoral pathologies and in the diseases that affect the temporal-mandibular joint.