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The authors have studied the relationship between anatomic and CT sections of the lateral pterygoid muscle in 39 anatomic specimens. Good superimposition of the images was found, which seems important in neoplastic invasion of the infratemporal fossa and which may lead to a pathogenic interpretation of the algo-dysfunctional syndrome of the masticatory apparatus.

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.

To describe the imaging work-up and management of type III endoleaks detected after covered stent-graft treatment of descending thoracic aortic aneurysms.Retrospective study of circumstances surrounding the diagnosis, management and outcome type III endoleaks occuring in 3 of 18 patients following covered stent-graft treatment of descending thoracic aortic aneurysms between April 1998 and July 2005. The endoleaks were detected at a mean follow-up of 22 months (19-24 months) after stent-graft placement.The type III endoleaks were detected on scheduled follow-up CT examinations in asymptomatic patients. Endovascular management was proposed at a mean interval time of 4.4 months (1 week - 11 months) after diagnosis of the endoleak, and was successful in all 3 cases. One patient died 1 month after endovascular repeai of the leak, 1 patient required surgical management at 14 months for new recurrence, and 1 patient had a favorable outcome at 2 months.Follow-up of patients after covered stent-graft treatment of descending thoracic aortic aneurysms is required. Prompt endovascular repair of delayed complications may be possible, but surgical management may become necessary.

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 purpose was to illustrate that single or multirow spiral CT angiography has become the main modality for the examination of the abdominal aorta. Our multidisciplinary group investigates weekly 15 abdominal aortas, with a single slice spiral CT since 1995, and a 4 row detector spiral CT since 1999. CT scans protocols and parameters optimization for the 2 CT systems are described. Indications and results of CT to investigate the various abdominal aortic diseases are illustrated and discussed: aneurisms (pretherapeutic staging, selection of indications of endovascular stent-grafting); obstructive aorto-arteriopathies (pretherapeutic staging, follow up after endovascular revascularization); dissection (diagnosis, pretherapeutic staging, follow up); inflammatory diseases; normal patterns and principal complications after surgery. Situations where multislice CT is superior to single slice CT and compared advantages of MRI are discussed. CT is at the present time the main technique to image abdominal aorta. Multislice CT is especially interesting to explore the whole aorta, poly traumatisms, and to plan and follow up endovascular treatments.

Orientation and morphology of the heart and coronary vessels are the basis of cardiac imaging. Knowledge of the configuration of cardiac cavities within the thorax and of the course of coronary vessels is mandatory in order to plan and carry out magnetic resonance imaging acquisitions and computed tomographic reformations. These anatomical features are described, with focus on useful data for acquisition and interpretation of imaging studies. MR and CT images will be presented.

Bone grafts and bone substitutes must be biocompatible osteoconductors with satisfactory mechanical properties similar to native bone. When the bone treatment is conducted under specific conditions, the elasticity module under infra-maximal loading can be optimized to achieve reproducible values. The purpose of this work was to determine the effect of the cleaning and sterilization process using Osteopure on the biomechanical properties of trabecular bone harvested from human femoral heads.Seventy trabecular bone samples were tested: group 1F (fresh samples); group 1N (after application of Osteopure cleaning); group 1S (after Osteopure cleaning and sterilization). Non-destructive and destructive tests (group 1D) were performed. Two fresh femoral heads were used as controls for the destructive test (group 2). The first non-destructive test was applied directly after section (group 1F). Other samples were then purified with Osteopure treatment and a second non-destructive test was conducted (group 1N). A third non-destructive test was conducted after sterilization with 25 kgray radiation (group 1S). Treatments 1 and 2 were performed by OST Developpement SA (Clermont-Ferrand). Finally a destruction test was applied along the directional axis (group 1D). For the 31 samples in group 2 (control) the destructive test was applied along the directional axis immediately after section. Compression tests were performed at a deformation speed of 3 mm/min for 0.3% deformation.The Young module did not exhibit any significant difference between the three steps of the testing in the three orthogonal directions. The Young module was not significantly different between group 1F and group 2 (controls). Maximal force of compression was significantly different (P0.01). There was a linear relationship between maximal force at rupture and the Young module obtained during destructive tests, for groups 1D and 2 respectively. The compression curves obtained from sterilized samples (group 1D) were not significantly different from those observed for fresh trabecular bone in group 2 (controls).The Young module values measured from 70-673 MPa. For non-destructive tests, the module values were to the order of 64% of those obtained for destructive tests. Decreased maximal force of rupture observed for treated samples in comparison with fresh samples can be explained by the extraction of most of the lipids.The Osteopure method does not alter stiffness of bone allografts. The elasticity module observed in treated bones is close to that observed in fresh bones. Mechanical resistance to compression is however only half the force of compression observed in the hip joint for daily activities. The linear relationship between the elasticity mode and loading required for rupture is not affected by treatment with Osteopure. The advantages related to elimination of prions or viral contamination appear by far to be more important than the minor changes observed in the mechanical characteristics of allografts.

Usually atherosclerotic in origin, aneurysms of the abdominal aorta (AAA) tend to involve the infrarenal aorta. Their biphasic exponential growth pattern, initially slow then accelerated, results in a risk of rupture. Surgical management is recommended for aneurysm diameters of 45-50mm or for growth rates more than 5mm in 6 Months. Imaging is useful for detection and follow-up of nonsurgical aneurysms, presurgical evaluation of aneurysms, and postsurgical follow-up. Frequently asymptomatic, AAA frequently is an incidental finding at the time of abdominal US. The size of the aneurysm sac, the presence of a neck and the size of the iliac arteries are assessed at the time of initial US detection. US is sufficient for follow-up of small aneurysms. Cross sectional imaging evaluation is necessary when surgery is contemplated. Readily available, multidetector row CT scanners with advanced image post-processing capabilities provide all the necessary information prior to surgical or endovascular management: evaluation of the aneurysm sac and neck, iliac and visceral arteries, and adjacent organs. Angiography with graduated catheters remains sometimes indicated. MR angiography provides results similar to CT but is less readily available and is usually reserved for patients with contraindication to iodinated contrast material. While follow-up imaging after surgical management is seldom performed, it is mandatory after endovascular management and includes KUB, Doppler US and CT or MR angiography.

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.

To retrospectively evaluate the contribution of MRI to the diagnosis of arrhythmogenic right ventricular dysplasia (ARVD).Thirty two men and 18 women (mean age: 48.7 years) were imaged using gated spin echo scans and short axis cine MR. References were McKenna criteria (gold standard), and also what we called "strong presumption" which may correspond to early or localized patterns, but correspond to negative McKenna scores.One patient was claustrophobic; another one was lost to follow-up. In reference to McKenna score, diagnosis of ARVD was established in 12 patients (2 of whom had familial dilated biventricular cardiomyopathy with rhythmic expression). Sensitivity, specificity, positive predictive value, negative predictive value and prevalence were respectively: 75%, 75%, 50%, 90% and 25%. Using "strong presumption" criteria, we observed 14 true positives (with sensitivity of 82%, specificity of 87%, PPV of 78%, NPV of 90% and prevalence of 35%).In our group, MRI was always performed before angiography. In our series, right ventricular wall T1W hyperintensity was the most frequent finding.

We conducted a retrospective analysis of short- and mid-term results of endoluminal treatment of obstruction lesions involving the terminal aorta and the initial portions of the iliac arteries in 28 patients.Twenty-eight patients (9 women, 19 men, mean age 57.5 Years) presented 52 obstructive atheromatous lesions of the aorto-iliac bifurcation. The lesions were divided into three topographic groups (9 unilateral lesions, 19 bilateral ostial lesions, 5 widespread lesions of the terminal aorta) and identified as simple (44%) or complex (56%, more than 2 cm in length and/or calcified and/or eccentric).Technical success was achieved in 93% of the cases with only one hematoma of the puncture site. Primary and secondary patencies were 78.9% and 93% after a mean follow-up of 50 Months (range 4-85). Clinical outcome remained good at this term for all cases of technical success but complete resolution of the symptoms was more frequent when a stent was used (84%) than for simple balloon dilatation (49%).Percutaneous treatment of obstructive lesions of the aorto-iliac bifurcation may be proposed when possible as a first-line treatment.

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.

Immunosuppressive treatments may be usefull when Graves' ophthalmopathy is active. We evaluated the interest of hypertrophied muscle T2 weighted signal intensity as an argument of disease activity, to help for the therapeutic decision.46 MRI in 37 patients with Graves' ophthalmopathy were retrospectively studied.During the active phase of the disease, centro-muscular hypersignal was always observed (6 cases); signal intensity was not so bright or even disappeared with immunosuppressive treatment (7 cases). We never observed hypersignal when the disease was inactive (4 cases). When there was no hypersignal on T2 weighted images, the disease was inactive in 70% cases, and of low activity in the other cases.T2 weighted centro-muscular signal intensity analyse helps for the therapeutic decision in Graves' ophthalmopathy.

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.

Polycystic liver disease, which is generally part of the autosomal dominant polycystic kidney disease, is often asymptomatic. We report a case of obstructive jaundice caused by compression of the biliary tract by a large haemorrhagic liver cyst. The patient was a man with sporadic polycystic liver disease without polycystic kidney disease and with normal renal function for his age. Ultrasound combined with cholangio-MRI provided non-invasive confirmation of intracystic bleeding and intrahepatic biliary dilatation. Obstructive jaundice was confirmed by cyst puncture-aspiration which resolved symptoms and normalized biology. The initial treatment of haemorrhagic liver cyst complicating polycystic liver disease must be medical with cyst aspiration-drainage and sclerotherapy to avoid surgery in these fragile patients.

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.

Aneurysms of the duodenopancreatic arcades account for 2 to 3% of all aneurysms of the digestive arteries. Mortality is high due to the risk of rupture and the difficult diagnostic situation.The first case involved a short wide collar aneurysm implanted on the first centimeter of the superior mesenteric artery, associated with tight stenosis of the celiac trunk. The patient complained of diffuse abdominal pain and was treated surgically. In the second case, there was a false aneurysm of the gastroduodenal artery which developed a few months after acute biliary pancreatitis. The aneurysm was treated by exclusion using a transcutaneously delivered endovascular coil prosthesis.These cases illustrate the importance of imaging (magnetic resonance angiography) both for diagnosis and treatment monitoring, allowing early care with very limited morbidity and mortality.

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.

This study describes a method of tracking of human body limbs from a monocular sequence of perspective images. These objects and the associated articulations must be modelled. The principle of the method is based on the interpretation of image features as the three-dimensional perspective projections points of the object model and an iterative process method to compute the model position in accordance with the analysed image. This attitude is filtered (Kalman filter) to predict the model position relative to the next image of the sequence. The image features are extracted locally according to the computed prediction. Tracking experiments, illustrated in this study by a leg cycling sequence, have been conducted to demonstrate the viability of the approach.

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.

Trained users of Rhythmic and Athletic Gymnastic, present kinetic spinal vast extents. Analysis, with pasted cutaneous markers, shows that, according to the codified movement, various segments of the vertebral column are requested and realized important displacements. Nevertheless, to have an homogeneous attitude, some subjects request more either lumbar or thoracic segments, of both. To prevent frequent spinal pain, it is important to realize a preliminary subject selection using their total spine and to improve protection by adapted gymnastic.

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.

Rectal procidentia represents classically only 2% of rectal prolapse in children. This rarity is more apparent than real, because peritoneographies showing the excess of migration of the rectogenital pouch, allows to diagnose more often this pathology. The normal trend of this anomaly of the infant and the young child even if it could be serious with strangulation is usually a spontaneous healing. Accordingly therapeutic indications should be cautious. Surgery is only indicated in confirmed or complicated forms. After analysis of the statistic of 52 observations, the modified Lockhart-Mummery is our prefered procedure. It needs a short and simple surgery and the results appear satisfactory.

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.

Objectifs pedagogiques Savoir reconnaitre et analyser sur les examens d’imagerie en coupe les cavites et parois cardiaques ainsi que les arteres et veines coronaires. Resume L’identification et l’analyse des cavites, des parois cardiaques et des vaisseaux coronaires necessitent des techniques d’acquisition et de reconstruction precises, fondees morphologiquement sur l’orientation du cœur dans le thorax. Les regles qui regissent la realisation de ces plans d’exploration sont exposees et la morphologie cardiaque et vasculaire decrite. Une attention particuliere sera accordee a l’identification des differents segments coronaires, en etablissant des correlations precises entre la terminologie coronarographique et ses correspondances en TDM et IRM. Conclusion La connaissance de l’anatomie radiologique en coupes du cœur et des arteres coronaires est un prealable indispensable a l’interpretation des examens TDM et IRM, qui doit permettre aux participants d’acceder a l’interpretation d’explorations thoraciques pour des pathologies cardio-vasculaires courantes.

Intervertebral disk composite model is unsatisfactory definite in biomechanical behaviour despite multiples technics used. Using histologic and histoenzymology it's possible to determinate proportions of collagen fibers in the different parts of the disk. A trustworthy finite element 3D model is proposed and tried by real experiments.

Optical techniques using single wavelength lasers allow precise study of the superficial displacements of deeper anatomical structures through direct mechanical pull. Two techniques have been used in this study: 1. Double exposure speckle photography. Since 1980 the relationship between the surface displacements and minimal traction applied to the transverse processes of the spine, either unilateral or bilateral, was studied in an attempt to simulate muscular action exerted at this level. 2. Computerised speckle interferometry. This allowed analysis of the deformations between the lumbar vertebrae under vertical compression, shear or torsion outside the usual anatomical planes. This preliminary study outlines the mechanical behaviour and the plasticity of the vertebral structures but has been performed on only a few anatomical specimens thus not allowing statistical analysis. This would require a larger series.

There has been a progressive growth of clinical, anatomical, technical and biomechanical knowledge of the spine which has emerged from both specific and collaborative efforts of many investigators. In the same way many distinguished contributors have at various times elaborated the analysis of vertebral trauma and their names appear in the References to this paper.