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

The results obtained in a series of 200 patients, using the transjugular approach to the common bile duct for the differential diagnosis of cholestasis, are presented and discussed. 1. The advantages of the method are: --the simplicity of the technique and the rapidity with which it can be mastered, the negligeable investment required; --the safety in use if the only contra-indication is respected: recent acute infection of the biliary tract; --the possibility of obtaining a cholangiography and a liver needle-biopsy at the same time, even in cases with disorders of the blood. 2. The limitation of the method is the failure to visualize the CBD, which is seen in 30% of cases when the latter is not dilated by an obstruction. 3. The respective indications for either transjugular cholangiography or retrograde catheterization of the papilla can be defined. 4. A preliminary series of 37 explorations of the portal system by the transjugular approach with embolization of bleeding oesophageal varices is reported.

2600 abdominal ultrasound examinations done over a period of one year were reviewed. Six cases of adrenal tumors were amongst them and proved to be two carcinomas, two simple cysts and two metastases of bronchial carcinoma. The ultrasonic signs of adrenal tumors are discussed. Ultrasonography is recommended as a fairly good screening test in looking for adrenal tumors.

The authors describe a case of Marshall-Smith's syndrome in which there was a facial dysmorphic syndrome and considerable acceleration of bone maturation (24 months to 15 days). The infant had chronic respiratory distress and the aetiology of this condition is discussed, one possibility being a pneumopathy from repeated deglutition provoked by the micro-retrognathism. Hormonal investigations were normal. Contrary to the data in the first published reports, there was a pathological increase in size, as noted in subsequent observations by Weaver. Differential diagnosis is discussed in relation to patients with non-endocrine constitutional bony diseases. The cause of this syndrome is unknown.

Aorto-iliac aneurysms produce ureteric obstrucation by different mechanisms: deviation, compression and, above all, encirclement by peri-aneurysmal fibrosis. Whilst it is rare to find this as the cause for apparently primary ureteric obstruction, individuals with aorto-iliac aneumrysms quite often show evidence of ureteral abnormalities. The two cases presented illustrate these two possibilities. Routine pre-operative urography, or seven better a urographic phase of arteriography, is therefore suggested.

The authors studied 577 records of rheumatoid arthritis examined radiologically in the Department of Radiology B of Cochin Hospital: 165 patients showed evidence of lesions of the cervical spine. The risk of cervical involvement in rheumatoid arthritis is thus not negligeable: 28%. This involvement may occur at any time during the course of the disease and presents as pain or by rare and more or less slight neurological manifestations. Radiologically emphasis must be placed upon the orientation points of straight and lateral films, and the value of lateral films with the neck in flexion. Atlanto-axial dislocation is the commonest lesion, usually measured by the distance separating the anterior arch of the atlas from the odontoid peg. However, other lesions are possible, in particular involvement of the lateral masses and erosion or destruction of the odontoid. It is astonishing to discover large dislocations (of up to 10 mm) which remain well-tolerated, with minimal clinical signs. However, it is the neurological risk of quadriplegia (even though minimal) which remains the constant worry since it may result from the slightest trauma or forced movement of the neck. Fixation, usually posterior occipital C1-C2, may be indicated. It is thus necessary to carry out a routine radiological examination of C1-C2 at reasonable intervals during the clinical surveillance of a patient with rheumatoid arthritis.

The authors report a case of cancer of the kidney of intermittent development for which nephro-urotomography was negative. They stress the interest of: --preliminary echotomography in patients with palpable masses in the left hypochondrium; --pharmaco-angiography for improved visualization of masses that are only weakly opaque; --a rapid infusion technique, proposed by various authors, which appears to be the most appropriate for the study of this type of mass which is mainly intermittent in its development.