Journal de radiologie, d'electrologie, et de medecine nucleaire最新文献

Pancreatic pseudocysts were observed to simulate a mass in the upper pole of the left kidney in 4 patients. Urographic investigation of these pseudocysts revealed deformities similar in all respects to those produced by a cyst, though in two cases the mass was surrounded by a thick wall. A better definition of the parenchymatous deformity was obtained by the use of true trunk profile nephrotomograms. The value of ultrasonography, using the grey scale, and of transparietal puncture with measurement of amylase levels, is stressed. The authors discuss the problem of establishing the precise location--anterior to, surrounding, or within the kidney--of these pseudocysts.

Neurological and clinical examinations were found to be normal in a woman aged 40 years who had had a single generalized epileptic seizure. Rediological examinations demonstrated a spiral-shaped calcification above and laterally to the left sella turcica. This corresponded to changes in the C 1 segment of the left carotid sinus, which was partly stenosed distally, with left unilateral abnormalities of the circle of Willis and multiple distal stenoses of the left sylvian and vertebro-basilar arteries. Scanning demonstrated that these had been present for a long time, but it is not possible to establish the diagnosis on an etiological basis as no similar radiological findings have been published.

Standard radiological examinations in a woman of 40 years of age with a pneumothorax and chylothorax revealed the presence of a posterior mediastinal mass compressing the oesophagus, and an interstitial syndrome. Retroperitoneal and mediastinal cystic lymphangiomas were found on lymphography. These findings are in accordance with the lymphangiomyomatosis described by Cornog and Enterline in 1966. The similarity between this disease and tuberculous sclerosis is underlined in present-day publications.

Meconium ileus equivalent is a late intestinal occlusion occurring in patients suffering from mucoviscidosis. Three cases are reported in children aged, respectively, 3 years, 6 years and 10 years. In one of the observations (three year old girl), the intestinal obstruction with feces was first manifestation of a mucoviscidosis that was previously undetected. The radiological signs are identical to those found in cases of neonatal meconium ileus: intestinal obstruction and accumulation of closely spaced matter in a distended ileum (terminal part). As in cases of meconium ileus without complications, treatment consisted of enemas with water-soluble products. The high osmotic pressure of these products made it possible to remove the obstruction.

The discovery of multiple polypi in a small child does not necessarily indicate that this is a case of familial adenomatosis. Two cases of juvenile polyposis were confirmed by histological examinations, and their clinical and, more particularly, their radiological characteristics were studied. The only way to explore the full extent of the lesions in a satisfactory manner is by double-contrast examination of the whole colon. The authors stress the value of radiological examinations, though the frequency with which they should be carried out is open to discussion. Review of the published literature reveals that the association of true familial polyposis or adenocarcinomatosis exists in the same family or even in the same patient. Diagnostic difficulties are usually due to the fortuitons co-existence of a lymphoid hyperplasia, the significance of which is still not known.

An analysis was made of the results of C.T. scanning in 43 patients with craniopharyngiomas. Filling of the suprasellar cisternae was observed in most cases, together with dilatation of the lateral ventricles. The appearances of the tumor before and after intravenous injection of the contrast medium are described and the frequency with wich calcification, cysts, and lipid densities were noted is reported. Regular C.T. scanning can define operative indications for craniopharyngiomas as a function of the results obtained.

A case of dysfunctioning of the oesophageal opening is reported. The patient, aged 71 years, had had difficulty in swallowing for a long time, complicated by the recent onset of obvious dysphagia. Radiological examination of the oesophagus revealed the presence of a permanent notch in the posterior wall in the crico-pharyngeal region. The endoscope could not pass through the oesophageal opening but radiocinematography did not reveal any obvious organic lesion. The dysphagia and crico-pharyngeal notch disappeared after myotomy. This case is one the rare examples of pharyngo-oesophageal incoordination wrongly called crico-pharyngeal achalasia, as there does not appear to be any disorder of relaxation of the upper oesophageal sphincter, and this was demonstrated by the postoperative manometric study carried out in our patient.

The authors underline the value of selective superior mesenteric arteriography in the diagnosis of Meckel's diverticulum. In the ten cases reported, seven were found to have a Meckel's diverticulum on operation, while it was absent in the other three. Arteriography was able to diagnose its presence correctly in sex patients, gave a false positive diagnosis in three cases, and was considered to be normal in the last case in which a Meckel's diverticulum was present. Valid radiological signs are extravasation of the contrast medium into the lumen of the digestive tract and the presence of a vitellin artery dividing into a vascular network. The single fact of a hypervascularized zone at the end of the superior mesenteric artery dividing into a vascular network. The single fact of a hypervascularized zone at the end of the superior mesenteric artery without definite artery formation is not as valid and its interpretation is difficult.

Observation of the four cases reported and a review of the published literature suggest that spinal column lipomas can produce two entirely unrelated types of radiological image. 1. An image of cord-like appearance and variable width which joins the filum terminale to the sacrum, and is usually associated with enlargement of the spinal cord at the same level. This image can be demonstrated by both gas myelography and opaque myelography, and is produced by a lipoma of the filum terminale. The cord image is either that of an ectopic spinal cord or that of the lipomatous tumor itself, which joins the filum terminale to the sacrum. A spina bifida is often associated with these tumors, which can be intradural alone, which is very rare, or both intradural and epidural, and are often associated with enlargement of the spinal canal. 2. A fairly specific blocking-type of image which can be seen by opaque myelography, and consists of fringed bands which become progressively shorter from above downwards until being completely blocked. This appearance, which is extremely rare, is peculiar to intramedullary lipomas, the image probably corresponding to the dissociation of the medullary fiber bundles by the tumoral cords.