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The arteries and veins of the left vagus (VN) and left recurrent laryngeal (RLN) nerves from the thoracic inlet to the subaortic region are described following vascular casting with red colored latex in 6 adult fresh non-embalmed cadavers. In all specimens the anterior bronchoesophageal artery supplied at least one vessel to the VN and RLN in the subaortic region. For the RLN other arterial sources were arteries arising from the aortic arch in 1 specimen, the subclavian artery in 3 specimens, the first intercostal artery in 1 specimen, and the inferior thyroid artery in all specimens. For the VN other arterial sources were arteries arising from the aortic arch in 2 specimens and the inferior thyroid artery in 1 specimen. For both the VN and RLN the veins were located under the pleura and directed towards the internal thoracic vein anteriorly and the thoracic intercostal veins posteriorly. In conclusion, the inferior thyroid artery at the thoracic inlet for the RLN and the anterior bronchoesophageal artery are the more consistent vessels supplying the VN and RLN. Vascular damage occurring during mediastinal lymph node excision to the VN and RLN, especially in the subaortic region, may explain postoperative vocal fold paralysis.

Magnetic resonance imaging (MRI) allows accurate assessment of Crohn's disease (CD), but requires gadolinium injection. Diffusion-weighted (DW)-MRI yields comparable performances in small bowel CD. We compared the accuracy of DW-MR enterocolonography (MREC) and the magnetic resonance index of activity (MaRIA), and performed an external validation of the Clermont score in assessing inflammation in CD.This was an observational prospective study of a single-center cohort. A total of 130 CD patients underwent consecutively MREC with gadolinium injection and DWI sequences between July 2011 and December 2012.Of the 848 evaluated segments (small bowel=352, colon/rectum=496), 175 (20.6%) were active (small bowel=111, colon/rectum=64) defined as MaRIA ≥7. Using a receiver operating characteristic (ROC) curve, we determined an apparent coefficient of diffusion (ADC) threshold of 1.9 × 10(-3) mm(2)/s that yielded a sensitivity and a specificity in discriminating active from nonactive CD of 96.9% and 98.1%, respectively, for the colon/rectum, and 85.9% and 81.6%, respectively, for the ileum. ADC was better correlated to MaRIA ≥7 than related contrast enhancement obtained with injected sequences (P0.001). The Clermont score (=1.646 × bowel thickness-1.321 × ADC+5.613 × edema+8.306 × ulceration+5.039) was highly correlated with the MaRIA (rho=0.99) in ileal CD but not in colonic CD (rho0.80). Interobserver agreement was high with regard to ADC measurement (correlation0.9, P0.001, and concordance0.9, P0001).DW-MREC is a reliable tool to assess inflammation in colonic (ADC) and ileal (Clermont score) CD and its use in daily practice would avoid gadolinium injection.

The purpose of this study was to determine the following: whether the arterial supply of a normal appendix is visible with Doppler sonography; whether the physiologic vasodilatation that accompanies childhood appendicitis is visible; what Doppler patterns appear once necrosis of the appendix has occurred; what Doppler shifts are visible with chronic, recurrent appendicitis; and whether other conditions in the right lower quadrant can mimic the Doppler sonographic patterns of appendicitis.Twenty-five fasting patients without abdominal pain or intestinal disease and 45 patients (1-25 years old; mean, 8 years old) with right lower quadrant pain and suspected appendicitis were examined sonographically, using 5- and 7-MHz linear, color, and pulsed Doppler transducers. Arterial signals were sought within the appendix and neighboring tissues, counted, and classified as sparse (1-2), moderate (3-4), or abundant (4). The resistive index (RI) was measured. Thirty patients who underwent surgery were retained for surgical and pathologic correlation, and only they formed the appendicitis study.A normal appendix was found in 10 patients. Doppler shifts were sparse, and diastolic flow was low or absent (RI, 0.85-1). Acute uncomplicated appendicitis was found in 13 patients, who had abundant color Doppler signals throughout most of the appendix, with high diastolic flow (RI, 0.40-0.77; mean, 0.54). Acute necrotic appendicitis with perforation was found in 11 children, eight of whom showed no signals in the necrotic area at the tip. Few or no signals were seen in the remainder of the appendix (RI, 0.33-0.90; mean, 0.54). In two patients, signals were abundant in the tissues surrounding the appendix. Recurrent or chronic appendicitis was found in three patients, previously diagnosed as having Crohn's disease, psychosomatic illness, or nonspecific abdominal pain. The appendix had Doppler signals confined to the tip (RI, 0.63-0.83; mean, 0.75). Other diagnoses were found in three patients, in whom the appendix was not seen. There were abundant color signals in the intestinal wall and adjacent tissues in the right lower quadrant. Two patients had Crohn's disease, and the third had an unsuspected early pregnancy. The appendix was normal in all.Acute appendicitis is accompanied by inflammatory hypervascularity reflected as an increased number of color signals and higher diastolic Doppler shifts as compared with those found in normal persons. No Doppler shifts are identified in areas of appendiceal ischemia. Other acute inflammation in the right lower quadrant also produces numerous Doppler shifts with high diastolic flow, as does ovulation. Care must be taken to identify the source of these Doppler signals. The changing vascularity of healing, recurrent, and chronic appendicitis promises to further our understanding of the pathogenesis and evolution of this disease.

SummaryBackground Whether diffusion-weighted imaging (DWI)-MRI is of value in detecting and assessing inflammation of ileal Crohn's disease (CD) remains poorly investigated. Aim To compare DWI-MR enterography (MRE) with conventional MRE in estimating inflammation in small bowel CD, to determine an apparent diffusion coefficient (ADC) threshold to differentiate active from non-active lesions and to assess inter-observer agreement. Methods Thirty-one CD patients from the Clermont-Ferrand IBD unit with ileal involvement were consecutively and prospectively included between April and June 2011. All patients underwent DWI-MRI to detect the digestive segment with the most severe lesions, which was then used to calculate the ADC. Qualitative and quantitative results were compared with conventional MRE including MaRIA (Magnetic Resonance Index of Activity) score calculation and independent activity predictors (wall thickening, oedema, ulcers). Each examination was interpreted independently by two radiologists blinded for clinical assessment. Results Seventeen patients (54.8%) had active CD as defined by the MaRIA score ≥7. DWI hyperintensity was highly correlated with disease activity evaluated using conventional MRE (P = 0.001). Qualitative analysis of DW sequences determined sensitivity, specificity, positive predictive value and negative predictive value as 100%, 92.9%, 94.4% and 100% respectively. Quantitative analysis using a cut-off of 1.6 × 10−3 mm²/s for ADC yielded sensitivity and specificity values of, respectively, 82.4% and 100%. Inter-observer agreement was high with regard to DWI hyperintensity (κ = 0.69, accuracy rate = 85.7%) and ADC (correlation = 0.74, P

Opto-electronic systems utilising measurement of displacement of skin markers allows study of movement in the living subject. The authors have used this method in a kinematic study of the thoracic and lumbar spine measuring the displacement of skin markers placed over the spinous processes. It was possible to approach the physiological state of these complex movements once the apparatus had been calibrated to the correct level, and the error margins minimised. Repeated measurements confirmed the reliability of this method even if movement of the skin with respect to the bony reference points introduced some margin of error. Three dimensional displacement of the vertebrae were measured during voluntary movements of the spine demonstrating the complex geometry. Since opto-electronics are non-invasive they constitute an important advance in the study of the kinematics of the spine.

Colitis in neutropenic patients presents with non-specific clinical findings including abdominal pain, fever, diarrhea and abnormal liver function tests. Four diagnoses are relatively more frequent: neutropenic enterocolitis, pseudomembranous colitis, intestinal GVHD and CMV colitis. Knowledge of their respective imaging features combined with epidemiological data frequently leads to the correct diagnosis. The purpose of this paper is to illustrate the imaging features of colitis in neutropenic patients.

According to the ultrasound and MRI findings, supported by planned dissections, the female perineum is organised around the musculofascial system converging towards the fibrous structure of the central perineal tendon (CPT). Behind the CPT the fascial layers form part of a fibrous assembly extending from the ventral surface of the sacrum to the anal complex, prolonging the direction of the sacral concavity downwards and forwards. On the other hand, in front of the CPT the fasciae fuse to form two aponeurotic bands circumscribing the urogenital fossa. The fascial system is reinforced cranially by the structures of the hypogastric sheath and the uterosacral ligaments. The weak point of the urogenital fossa is partly filled by the urethral-clitoridal-vulvar complex. The perineum so formed plays a cardinal role in stabilising the pelvic viscera. Stress is placed on the firmness of the posterior perineum, a key element in pelvic stability. The posterior perineum is often involved in pathological conditions and a good acquaintance with these structures is essential in defining therapeutic indications.

In most cases, fibrolamellar hepatocellular carcinoma has specific and distinctive histopathological features that distinguish it from hepatocellular carcinoma. Magnetic resonance imaging can provide characteristic features to obtain a diagnosis of this entity. We report a case of fibrolamellar hepatocellular carcinoma with a radiological-pathological correlation in a 37 year-old man with chronic viral hepatitis B without cirrhosis who underwent right hepatectomy.

To explain surgical findings, we studied the anatomy of the human humeral medullary canal on a series of 28 bones in 16 patients and 9 dried bones. A methodology is described to find angle of medullary canal on CT scans regarding to an epicondylar reference axis. We found a constant tri-dimensional spiral shape of the medullary canal in the distal part of the bone. The relations between this first description and the literature are discussed.

Background: Patients with severe hyponatremia have a high risk for centropontine myelinolysis (CPM) during treatment, but the incidence rate and risk factors have not been well-assessed. Methods: This study was conducted in a medical intensive care unit (ICU) of a university teaching hospital. All patients with a serum sodium concentration < 120 mmol/l and a serum osmolality level < 250 mosmol/kg upon ICU admission were enrolled in this prospective study and were included if they underwent a baseline brain computerized tomography scan (CT scan) and a follow-up brain magnetic resonance imaging 1 month after admission. The diagnosis of CPM was based on cerebral magnetic resonance imaging findings, i.e. Tl-weighted images with T2-weighted images showing hyperintense signal in the corresponding areas which were not apparent on the initial cerebral CT scan. Results. Of the 22 patients included, 12 were considered as having acute hyponatremia and 8 were chronic alcoholics. In 12 patients, the increase in serum sodium level was < 12 mmol/l in any 24-hour period. CPM was diagnosed in 7/22 patients (31.8%) and was asymptomatic in 4 of them. CPM was present in 4 patients with acute hyponatremia and in 4 chronic alcoholics. It was associated with a lower baseline potassium level (p = 0.05) and NaCI administration during the first 24 hours (p = 0.005). However, non-acute hyponatremia, chronic alcoholism and rapid correction of serum sodium did not appear as risk factors. Conclusion: The incidence rate of CPM following severe hyponatremia is high and can develop even when there is a slow correction of serum sodium level. Hypokalemia is a predisposing factor.

To determine the contribution of computerized tomography (CT) to the management of nontraumatic acute abdomen, to evaluate interobserver agreement and the contribution of CT to cost control, to look for the predictive factors of CT.and method. Ninety prospectively included patients, admitted for nontraumatic acute abdomen and examined by a surgeon, received CT examination. Diagnosis and treatment 1) envisioned before and 2) defined after CT, and 3) finally retained were compared, and the interobserver agreement was calculated after the second reading. The predictive value of the clinical and biological criteria as well as the radiological criteria characterizing these patients was sought.CT was contributive in 68.9% of cases, with a reliable diagnosis and treatment strategy, defined after CT examination, for 92.2% and 90%, respectively. Interobserver agreement was 93.3%. CT contributed to reducing costs in 15.5% of patients, for an additional cost estimated at 104-139 euros. The positive predictive factors of the CT contribution were age over 70 years, localized symptoms, fever, and high CRP.In agreement with the literature, in our study CT appears to be a choice examination to guide patient care in nontraumatic acute abdomen.

The utility of the inferior oblique m. radioanatomical study by a FLASH 3D sequence in magnetic resonance imaging (MRI). Twenty eyes (ten healthy volunteers aged 21-32 years, without any history of significant ocular pathology) were explored by MRI (1 Tesla; cranial coil) and comparisons were made between spin echo (SE) T1 sequence (through the neuro-ocular and coronal planes; thickness of slices = 3 mm) and a gradient echo FLASH 3D sequence (thickness of slices = 1 mm). This enabled a mm by mm reformation of the inferior oblique m through the frontal-oblique plane, made possible by new SE T1 sequences through the same plane. Position, height, and signal of the m. were estimated. The mean frontal angle formed by the muscle and the sagittal axis measured 29 degrees for the right eye and 27 degrees for the left eye. The muscle was always identifiable in the reformation despite its thin dimensions: 1.9 mm (1.5 - 2.8) on the right and 2 mm (1.7 - 2.5) on the left, in low signal silhouetted by the high signal of orbital fat. Thus, thanks to mm by mm reconstructions using FLASH 3D sequence, a good radioanatomic study of the inferior oblique m. by MRI is possible. This could be useful particularly for the strabismus of children.

The prognosis of anorexia nervosa (AN) is severe (death in 2 to 5% of cases). AN is closely linked to episodes of bulimia.A 25 year-old woman suffering from anorexia nervosa was hospitalised for an occlusive syndrome with vomiting, presence of abdominal cramps, absence of hydroaeric sounds and suspension of stools and gas. The biological examinations were normal. The abdominal scan revealed voluminous gastric dilatation. The diagnosis of functional occlusive syndrome was retained. With medical treatment and follow-up in intensive care the gastric dilatation progressively regressed.The periods of restricted nourishment during NA are interspaced by episodes of bulimia and at the origin of sometimes severe digestive complications. The abnormalities in gastric motility can lead to major dilatation of the stomach with the risk of perforation. The onset of abdominal pain in the context of AN during an episode of bulimia must evoke the diagnosis of acute gastric dilatation with major risk of perforation.

Mass systematic screening for alveolar echinococcosis (AE) of the liver in the Haut Cantal endemic area.Targeted population was composed of the members of the Mutualité Sociale Agricole of the area, from 16 to 65 years old. 2077 notifications were sent, corresponding to 20% of the population of this area, defined by a triangle between Egliseneuve d'Entraigues, Riom ès Montagne and Saint Flour. Two screening tests were performed: Elisa serology test and liver ultrasound examination.Participation levels were relatively low-ultrasound: 18.92%, serology: 17%. Among 350 liver examinations, 2 suspicions of AE were found: CT and serology confirmed the diagnosis in the first symptomatic patient; CT and biopsy confirmed the diagnosis in the other asymptomatic patient in whom serology was normal.Ultrasound screening showed at least a 0.57% prevalence of AE, i.e., 2 cases out of 350. This low rate however confirms that Haut Cantal is an endemic area, but with a lower incidence rate than in other endemic areas.

Thrombosis of the superficial dorsal vein of the penis (TSDVP) is a frequent and benign pathology that is often underestimated.A patient consulted for acute erectile dysfunction and pain in the base of the penis due to a TSDVP, which was treated with non-steroidal anti-inflammatory agents and anticoagulants and was followed-up by Doppler ultrasound examination of the penis.Essentially clinical, the diagnosis of TSDVP can benefit from Doppler ultrasound of the penis in difficult cases, because it is a useful tool for correct diagnosis and therapeutic management of the pathology.

Fluoroscopic nonsurgical placement of an expandable polyurethane stent is less invasive than surgery for the treatment of epiphora due to obstruction of the nasolacrimal duct. It needs to be performed with the collaboration of an ophthalmologist, using a high resolution digital subtraction imaging unit.

Dacryographies and CT dacryographies are usually performed after catheterization of a lacrimal canaliculus. We evaluated the quality of opacification on CT scan after simple instillation of contrast medium, without any catheterization.39 patients (78 nasolacrimal ducts) were examined for lacrimal pathways obstruction by CT scan after instillation of diluted contrast medium. Additional CT scan imaging was performed after catheterization when the first study did not provide adequate opacification.CT dacryography after instillation is a well tolerated technique. In our study, it allowed detection of all pathologic lacrimal ducts; 7 normal lacrimal pathways (after catheterization) were not opacified after instillation (false positives). The sensitivity of the method was 100%, its specificity 84%.CT dacryography after instillation is a physiologic, simple and sensitive method to evaluate lacrimal obstruction. We propose it as a first step, catheterization being used only in the absence of opacification after instillation.

The motion of thoracic and lumbar spine segments has been analysed by mean of the skin landmarks method on 14 volunteers (7 males, 7 females). Results demonstrate that: There is no significant difference between male and female. There is either facilitation, or limitation of the motion of the characteristic landmarks of the spinal segments during trunk motion in perpendicular planes. The mobility of the spinal segments is associated with pelvic girdle motion in order to obtain the planed amplitude, and varies with hips abduction. The analysis of the precise mechanisms of relaxing or stretching of the pelvi-spinal musculo-ligamentous structures constitutes a large field of investigation that necessitates the study of other pelvic limbs postures and needs the use of robotic techniques.

To evaluate the frequency, morphology and clinical long term evolution of pineal cysts depicted on MRI.one thousand eight hundred and forty four (1 532 women and 126 men) MRI examinations were retrospectively reviewed. Coronal and sagittal spin echo T1 weighted sequences without and with gadolinium injection were performed, completed with spin echo T2 weighted images when a cystic sellar lesion was suspected. A pineal cyst was diagnosed as a rounded well defined lesion, with fluid signal in an enlarged pineal gland. Follow-up examinations were performed to evaluate the efficacy of the treatment of the sellar lesion.Twenty one epiphyseal cysts (1.27%) were diagnosed in 20 women (1.31%) and one man (0.79%). Their size was 1,2 +/- 0,4 cm (0,3 to 2 cm). They were asymptomatic. In 10 patients, follow-up MRI examinations did not show any change in size. During the clinical follow-up, these twenty-one patients remained asymptomatic (6 months to 5 years).The incidental detection of a pineal cyst at MRI is not exceptional. This lesion's pattern appears characteristic and their reputation of benignity is confirmed in our study.

The influence of various modes of carrying a load of 16 kg (15.69 DaN) on the static positioning of the pelvic girdle and the thoracic and lumbar segments of the spine was examined in seven male subjects. The displacement of cutaneous markers attached to easily palpable skeletal landmarks was recorded using 4 CCD cameras; the data acquired were analysed using an optoelectronic technique (SAGA3). The subjects stood upright on an AMTI biomechanical force platform, from which the ground reaction forces enabled displacements of the centre of gravity axis and thus the moment of the mass carried to be determined. The modes of load carriage examined were: 1) in a case in the left hand; 2) in a case in the right hand; 3) equally in two cases; 4) on the head; 5) in a rucksack; and 6) in an anterior bag. The results showed displacements of the pelvic girdle, the caudal and cranial lumbar segments, and the caudal and cranial thoracic segments in the three orthogonal planes (sagittal, frontal and transverse). The influence of the moment created by the load was seen in the statokinesigrams. The use of external markers using an optoelectronic technique, in association with the ground reaction forces, enables the mode of load carriage to be determined. The results show that the influence of the moment exerted by the mode of load carriage on the gravity axis has important ergonomic consequences.

The motion of the thoracic and lumbar spine segments was analysed by mean of the skin landmarks method in 14 volunteers (7 males, 7 females). The results demonstrated that there was no significant difference between men and women and there was either facilitation or limitation of the motion of the characteristic landmarks of spinal segments during trunk motion in perpendicular planes. The mobility of spinal segments was associated with pelvic girdle motion in order to obtain the planned amplitude, and varied with hip joint abduction. The analysis of the precise mechanisms of relaxing or stretching of the pelvivertebral musculo-ligamentous structures constitutes a large field of investigation that necessitates the study of other lower limb postures and the use of robotic techniques.

Acute embolic renal artery occlusion is usually clinically typical. In case of early diagnosis, an in situ thrombolysis may be effective. As thrombosis often progressively completes a severe renal artery stenosis, the classical clinical description of renal infarction (lumbar pain, hematuria) is frequently not present. The kidney parenchyma downstream from the renal arterial occlusion is not always irreparably lost: collateral circulation may preserve nephron viability, which requires a lower perfusion pressure than glomerular filtration. An iodine, isotopic, or MR gadolinium nephrogram may prove this viability. Over the last 10 years, we attempted 21 percutaneous recanalizations of renal artery occlusion. Mean patient age was 62 years (44-85). All were hypertensive. Serum creatinin level of 17 patients was above 130 micromoles/ml. Three patients were previously hemodialysed. We observed 8 failures, without any complication. Thirteen immediate technical successes occurred, but one rethrombosis occurred at Day 1. Immediate complications were seen in 2 patients: 1 acute pulmonary edema, 1 puncture site false aneurysm. The mean follow up of the 12 technical successes was 26 months (18-60). One rethrombosis occurred at 6 months. Hypertension was unchanged in 4 patients and improved in 8. In all patients with renal insufficiency, a significative improvement of serum creatinine level was observed. It was possible to discontinue hemodialysis in the 3 patients previously hemodialysed. One predictive factor of success was recognized: a short delay (shorter than 90 days) between occlusion and recanalization. Percutaneous recanalization must be proposed in case of renal artery occlusion, especially to avoid vascular azotemia and dialysis, even if the kidney fed by the occluded artery is small.

To compare helical CT-angiography (CTA) and two techniques of MR angiography (MRA) to conventional angiography in aorto-iliac occlusive disease.The abdominal aorta and iliac arteries in 22 patients (4 for preoperative assessment of abdominal aortic aneurysm and 18 for peripheral vascular disease) were imaged using four techniques: digital subtraction angiography ("gold standard"), 2D TOF MR angiography, 3D Gd-enhanced MR angiography and helical CT angiography. Source (CTA and 2D TOF MRA) and MIPed images (after subtraction measures before and after gadolinium injection for 3D Gd-MRA) were reviewed.Sensitivity, specificity and accuracy for the detection of significant (50%) stenosis and occlusion of aorto-iliac arteries were respectively: 38%, 89%, 77% for 2D TOF MRA; 75%, 71%, 72% for 3D Gd-MRA and 95%, 90%, 92% for CTA. Excluding the internal iliac arteries, results were 54%, 96%, 88% for 2D TOF MRA; 96%, 80%, 83% for 3D Gd-MRA and 92%, 93%, 95% for CTA.3D Gd-MRA, a technique with potential for further improvement, is superior to 2D TOF MRA for detecting significant stenosis and occlusion of aorto-iliac arteries. Results at Gd-MRA are nearly similar to those at CTA (after excluding internal iliac arteries). Results at Gd-MRA are not affected by calcified plaque.

To compare the angulation at the origin of dysplastic renal arteries compared to atherosclerotic renal arteries, in order to improve the technique for percutaneous transluminal angioplasty of FMD.Retrospective analysis of 40 aortograms in patients who underwent renal angioplasty for dysplastic stenosis, with comparison with 45 control aortograms (with or without atherosclerotic lesions of the renal arteries). The angle of implantation of the renal arteries was measured relative to the aortic axis in the frontal plane, taking into account only the angulation of its proximal segment. We identified three types of kidneys with regard to their position relative to the renal artery ostium.The angle of implantation of dysplastic renal arteries is significantly sharper compared with the control group (63.8 degrees vs 80.9 degrees, p = 0.0001), irrespective of the side. The angulation did not correlate with the position of the kidney or the direction of the renal artery, suggesting a congenital origin.The angle of implantation of the dysplastic renal arteries relative to the aortic axis in the frontal plane is sharper than the angle measured in non dysplastic renal arteries.

To evaluate long-term results of infrapopliteal percutaneous transluminal angioplasty (PTA) for limb salvage.A retrospective study of 71 consecutive infrapopliteal PTAs in 49 patients with rest pain (n = 20) or ulceration (n = 29) was conducted. In 18 patients, surgical minor amputation or debridment was also performed.Technical success was achieved in 45 patients. Four failures necessitated 2 amputations. One patient died in the postoperative course. Global morbidity rate was 16%, including minor complications in 5 patients and major vascular complications in 3 patients. After technical success during the follow-up (median duration 21 months), restenoses occurred in 4 patients, of whom 3 had a successful re-PTA (clinical success rate 72%). Survival, primary patency, secondary patency and limb salvage rates were, respectively, 75%, 81%, 88% and 87% after 3 years. The only positive predictive factor for primary patency was the presence of diabetes mellitus.Infrapopliteal PTA is a safe and effective procedure, allowing good patency and limb salvage rates with low mortality and morbidity.

The analysis of the displacement of the pelvic girdle, during movements of the trunk in the anatomical orthogonal plans, was carried out by the technique of the cutaneous markers on two series of 7 male subjects and 7 female. The photographs made it possible to objectify angular displacements of reliable singular points and to observe that the abduction of hips determines, according to movements carried out, either a facilitation, or a limitation of displacements observed similar in the two series. The precise mechanism of these variations will have to be analyzed by later studies.

Physiological displacements of the trunk are the addition of these of the pelvic girdle and thoracic and lumbar spine segments. For a long time (3), this conjunction had been noticed but without numbered precisions. The purpose of this communication is to appreciate quantitatively, from a series of 16 subjects, the respective share of each components during lateral bending movements in the frontal plan and movements of rotation in the transverse plan. It results from this work that the pelvic girdle presents as reduced amplitude (4 degrees) in lateral bending on the other hand, displacement predominate to the level of thoracic spine (50 degrees). In rotation pelvic displacements are very important (30 degrees), while the spine so thoracic that lumbar has a weak participation (inferior to 5 degrees). Moderated abduction of hips increases by significant manner the motility of the pelvic girdle.

The overall movement of the trunk is made up of two components, namely the movements of the pelvic girdle and the vertebrae. In the frontal plane, the amplitude of the pelvic movements appears to be relatively limited compared to the vertebral column whereas the pelvis makes the major contribution to the total rotational movement in the axial plane.

In order to evaluate the rotation following radial and ulnar fractures, the authors propose radial, ulnar and humeral landmarks for a CT scan measure of radial and ulnar torsion. In the ulna, the dorsal at the level of the proximal radio-ulnar articulation, as well as the bicondylar axis of the humerus seem to be fair landmarks. Distally, the styloid process is regularly identified and may serve as distal reference for the measure. In the radius, the ventral face of the distal epiphysis is always clearly visualized and seems to be a good landmark; the radial tuberosity, which was primarily chosen as proximal reference, is not consistently identified and cannot be used as landmark. The variation of position of the radial head with respect to the capitulum during pronation needs too know the amount of this movement before the measure if the bicondylar humeral axis is chosen as proximal reference.

Comparative study of static curves of the thoracic and lumbar spine in men and women has been realized under constraints of compression by weightlifting and elongation by exercise to parallel bars. In two athletic practices, curves decrease their arrow, ending to a straighter and more rigid column. This behavior expresses muscular actions. The greatest amplitude of displacement, observed in female series, shows lesser muscular forces in connection with a poor practice of exercises of body building.

The global amplitude of the movements of the trunk is the resultant of the sum of two components: the movements of the pelvic girdle and those of the vertebral segments. In order to assess the precise position of the pelvis in kinetics, we endeavored by the use of skin markers to determine whether reliable measurement points existed. The experiment showed that a line drawn from the median sacral crest at the level of S1 to the highest point of the iliac crest appeared relevant and practical for assessment of the position of the pelvic girdle in the sagittal plane.

The authors report their experience in the study of esophageal carcinoma before surgery by CT. Computed tomography is essential to establish the local extension of the tumor process and thus to allow a better therapeutic management.

Under static loading during weight-lifting, the lumbosacral spine essentially exhibits horizontalisation of the base of the sacrum (superior plateau of S1). We have attempted to elicit the mechanism of this horizontalisation by means of radiographs. These do not demonstrate any movements of the sacroiliac joints or plasticity of the hip bones. However, a symmetrical rotation of the hip joints conditions a retroversion of the pelvic girdle which explains the horizontalisation of the upper sacral plateau. This fixation of the block of the pelvic girdle is under muscular control, so that this mechanism can be improved by appropriate training.

Radiographies of lumbar spine at rest in standing position and upon a force of 100kg were undertaken in 19 young sportsmen. If comparison between two pictures demonstrated important modification in few subjects, statistical study shown only little variations. Clinical studies in weight lifters demonstrated effectively few lesions with a good training, it's possible to modifiate pelvic orientation and this pelvic support permits a optimal posture for the lumbar spine.

The haemangioma, the most common non-cystic hepatic lesion, most often discovered by chance, may in certain situations raise diagnostic problems in imaging. In this article, the authors first demonstrate that the radiological appearance of the hepatic haemangioma, in its typical form, is closely related to three known histological sub-types. They then show that certain atypical features should be known in order to establish a diagnosis. They also observe the potential interactions between the haemangioma, an active vascular lesion, and the adjacent hepatic parenchyma. Finally, they discuss the specific paediatric features of hepatic haemangiomas and illustrate the case of a hepatic angiosarcoma.