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The pulmonary hernia is a rare entity defined by protrusion of pulmonary tissue through an abnormal weakness of the thoracic wall. We describe a case of spontaneous pulmonary hernia associated with osseous sternocostal abnormalities in a patient with a Recklinghausen disease.

We describe the MRI features of a rhinoscleroma with orbital extension. This benign bacterial and granulomatous lesion of the paranasal sinuses gave homogeneous low intensity on T2-weighted images and enhanced with gadolinium. It could simulate a malignant sinonasal tumour or a fungal sinusitis; the diagnosis must be considered in patients from endemic areas.

Ruptured abdominal aortic aneurysm is the major surgical emergency in the retroperitoneal compartment. Rupture of an abdominal aortic aneurysm is always fatal without urgent operative repair. Computed tomography is the reference standard for the diagnosis of ruptured abdominal aortic aneurysm in hemodynamically stable patients. At CT, the diagnosis is based on the combination of abdominal aortic aneurysm and extraluminal retroperitoneal blood. Retroperitoneal hemorrhage usually demonstrates both isodense and hyperdense areas. In most cases hemorrhage is located in psoas compartments and perirenal space. In the case of ruptured abdominal aortic aneurysm other findings may be demonstrated such as focal interruption of the aortic wall and active extravasation of contrast media in the retroperitoneal compartments. Inflammatory abdominal aortic aneurysm, that may present as acute abdominal pain, should be recognized and differentiated from ruptured abdominal aortic aneurysm. Inflammatory abdominal aortic aneurysm is characterized by a fibrotic process around the abdominal aorta that may entrap adjacent structures such as ureters, duodenum and inferior vena cava. Aortic dissection, mycotic aneurysm, and inferior vena cava thrombosis are less common. Complications occurring after emergency aneurysm replacement are also considered.

The diagnosis of acute pancreatitis is based on clinical examination and basic laboratory tests. The main role of sonography in acute pancreatitis is to evaluate gallstones and small fluid collections. However, sonography is frequently difficult due to intestinal ileus related to pancreatitis. CT is indicated early in the clinical course of acute severe pancreatitis when the diagnosis is uncertain or when complications such as abscess, hemorrhage, or necrosis, are suspected. In addition, CT may be used to assess the prognosis and follow-up of patients.

Interventional radiology used in acute abdominal diseases has demonstrated its efficacy in most emergency cases especially in patients at high risk for surgery. Percutaneous drainage is a reference standard for abscesses located within the abdomen and pelvis with high success rates of up to 80%. The diagnosis and treatment of gastrointestinal hemorrhage have changed over the past two decades, with decreased diagnostic examinations and advances in pharmacologic therapy and improved endoscopic techniques. On the other hand, embolization techniques and new procedures such as trans jugular intra hepatic porto systemic shunt have been developed. Arterial embolisation in many situations such as blunt or direct trauma, obstetric or post operative hemorrhage, can be used as an effective easy and relatively safe technique with high success rates to stop bleeding and save the organ. Percutaneous drainage and angiographic techniques adapted to biliary and urinary tree have also been developed as well as endoscopic procedures, allowing treatment of stenoses by balloon dilatation, or plastic or metal prostheses. Indications, technical aspects, complications and limits of these various procedures are presented.

Radiologic evaluation of abdominal trauma must provide a quick and accurate assessment of the lesions in order to improve the management of the patient. The technique used varies depending on the mechanism of the trauma (blunt trauma or stab wounds) and the hemodynamic status. Radiologic evaluation is usually performed in blunt trauma whereas stab wound trauma is usually explored surgically. The various techniques available are standard radiographs, ultrasonography, computed tomography and arteriography. The role of magnetic resonance imaging in the immediate evaluation is still not well defined. It appears to be a useful method in the delayed evaluation of diaphragmatic trauma. Computed tomography is the method most commonly performed in trauma patients. This technique is accurate and allows correct assessment of the lesions. The disadvantages are the radiation induced and the need for a hemodynamically stable patient. The aim of the radiologic evaluation is to provide the clinicians with an accurate description of the lesions. It can help in the management of the patient usually in association with clinical and laboratory data. It can also guide interventional procedures (drainage, embolization...). Finally, it allows radiographic follow-up when conservative treatment is performed.

Intraperitoneal vascular lesions constitute severe causes of acute abdomen. These disorders include ischemia and infarction of colon and small bowel and abdominal hemorrhage. In case of intestinal ischemia, the radiologic procedures are performed in order to establish the diagnostic, identify the site of ischemia, and detect the etiology of ischemia. Plain radiography of the abdomen, ultrasonography, CT scan and angiography may be performed. In case of intestinal hemorrhage, angiography may be performed when endoscopy fails to establish the diagnosis. Embolization can be performed in selected cases.

Infectious disease is a common cause of acute abdomen. The diagnosis is based on clinical examination and basic laboratory tests. However, medical imaging routinely performed according to the clinical findings is frequently useful. Hepatic and splenic abscesses are correctly demonstrated by ultrasonography and computed tomography. Ultrasonography is the reference standard for the diagnosis of acute cholecystitis. The US examination is also performed for the diagnosis of appendicitis and its complications. Ultrasonography and barium enerna are commonly performed for the evaluation of signoid diverticulitis. Computed tomography is the reference standard to determine medical or surgical procedures.

Emergency pelvic imaging is currently based on transabdominal and transvaginal sonography. Life threatening emergencies such as ectopic pregnancy and annexial torsion can be diagnosed by these technics. Doppler imaging (pulsed Doppler and color encoded) improve the diagnostic efficacy in an emergency context. Evaluation of pelvic inflammatory disease, cyst bleeding and placental disruption in best obtained by US because of its simplicity, safety and low cost.

Acute abdominal disorders are common reasons for consultation at the emergency department. The diagnosis of all acute abdominal disorders begins with a careful history and physical examination. When appropriate, the clinical examination should be supplemented by conventional plain abdominal radiography. Gastrointestinal perforation and obstruction are very commonly encountered in the diagnosis of acute abdomen. Plain abdominal radiographs are the initial diagnostic methods of choice. In some circumstances, ultrasonography and CT may be valuable for the evaluation of the cause of abdominal disorder.

Acute renal disease, in the absence of trauma, consist of acute renal obstruction, renal infection or a combination of the two. The diagnosis of acute renal colic is usually performed with ultrasound or excretory urography whereas parenchymal involvement in renal infection is best demonstrated on computed tomography images. The aim of radiologic investigations is to look for complications in order to guide the treatment, particularly percutaneous procedures. Other less common acute renal diseases include renal vein thrombosis optimally analyzed with contrast injection to demonstrate renal function, and spontaneous renal hemorrhage, which implies careful renal assessment looking for a small tumor. Acute psoas compartment diseases include hematomas and abscesses. Computed tomography is the best diagnostic tool and the examination of choice for the follow-up lesions and to guide percutaneous drainage.

Inflammatory aneurysm of the abdominal aorta (IAAA) is a variant of atherosclerotic aneurysm that is characterized by inflammatory and/or fibrotic changes in the periaortic regions of the retroperitoneum [1, 2]. These inflammatory and/or fibrotic changes are probably the result of a local autoallergic reaction to certain components of atherosclerotic plaques [2]. This distinct entity has important implications, as the periaortic fibrotic tissue adherent to ureters, the duodenum, and the inferior vena cava may complicate surgical repair [1, 2]. The purpose of this essay is to illustrate the CT appearance of IAAA, with emphasis on the identification of IAAA and differentiation from conventional aortic aneurysms, evaluation of the involvement of adjacent structures by the periaortic fibrosis, and evaluation of the retroperitoneum after aneurysmal repair to analyze the resolution or the persistence of the periaortic fibrosis.

Purpose: To look for central nervous system abnormalities as possible causes of intractable hiccups., Methods: Of a series of 50 patients with chronic (ie, lasting more than 48 hours) hiccups, a prospective study identified a subgroup of 9 patients with no clinical or gastroesophageal abnormalities (according to endoscopy, pH monitoring and manometry). We performed in all 9 patients brain and upper cervical cord MR examination with precontrast and postcontrast T1- and T2-weighted sequences. A study of the last cranial nerves was done with thin T2-weighted imaging (constructive interference in a steady state sequence). The cervical cord and parapharyngeal space were systematically explored using coronal T2- and sagittal T1-weighted imaging., Results: Five of these 9 patients had definite MR abnormalities located in the temporal lobe (3 cases), cerebellopontine angle (1 case), or areas of high signal intensity compatible with demyelination (1 case). The relationship between hiccups and infratentorial abnormalities in 2 cases was doubtful (vascular loop and prominent posterior condylar canal). MR findings in 2 cases were considered normal., Conclusions: Brain MR is a useful investigation in patients with chronic hiccups when gastroesophageal lesions are either excluded or too mild to account for an intractable hiccup.

An uncommon complication of laparoscopic Nissen fundoplication is reported. Suture of the anterior Nissen wrap to the junction of upper and lesser parts of the greater curvature resulted in plication and mediogastric stenosis demonstrated at barium meal.

The purpose of this study was to analyse with 3D TOF MR angiography the anatomical variants of the circle of Willis (CW) in 109 consecutive patients. In all cases, the quality of exams was sufficient to analyse the anatomy of CW. Nevertheless, MRA over estimated hypoplastic segments because incomplete CW were more frequently demonstrated with MRA than in anatomic literature. This lack of MRA sensitivity was related to artifacts as MIP artifacts and blood flow artifacts. MRA sensitivity was improved by analysis of partitions with MIP reconstructions.

Radiation therapy is considered as the treatment of choice for early stage laryngeal cancer. However, a few patients, after several years, develop severe life threatening complications, like edema or chondronecrosis. The clinical examination or endoscopy follow up may be difficult. CT and MR imaging can show the exact diagnosis depicting exquisitely the anatomy of the larynx. But at the beginning, the abnormalities are radiographically subtle and their diagnosis may be difficult because of artefacts due to patient dyspnea and mucous secretions. The main suggestive imaging features for suspecting a chondronecrosis seem to be the lost of normal signal hyperintensity on T1 MR imaging or a focal lack of cortical bone on CT scans, just adjacent to a focal swelling of the pharyngo-larynx mucosa. The barium pharyngography remains the best imaging diagnosis procedure for depicting associated abnormal communication between the digestive tract and the adjacent spaces or the cartilages of the larynx. Therefore, when the diagnosis is delayed, only salvage total laryngectomy can stop the infectious process. We report one case of a cricoid cartilage chondronecrosis eleven years after radiation therapy for laryngeal cancer.

An unusual case of mucormycosis is presented: a cutaneous form characterized by an extension to the soft tissues of the face with a noticeable involvement of facial lymph nodes. The successive CT studies enable the description of the lesions and their follow-up.

Massive haemoptysis, usually related to lesions of bronchial arteries, is a life-threatening complication of chest lesions. Embolization of bronchial arteries demonstrates immediate favourable results in at least 90% of cases. The main complications of embolization of bronchial arteries are medullary strokes. Consequently it is mandatory to visualize the anterior spinal artery in order to avoid its embolization. Massive haemoptysis of pulmonary arterial origin is far less common. It is also feasible to perform the embolization of the abnormal pulmonary artery in order to control the haemoptysis.

We describe a case of localized macronodular tuberculosis of the liver, the so-called hepatic tuberculoma. Liver US scan demonstrated an hypoechoic well-delineated lesion of the left liver lobe. Liver CT scan demonstrated a hypodense lesion before and after contrast enhancement. Liver MR scan demonstrated a lesion hypointense to liver on T1-weighted images and isointense to liver on T2-weighted images.

Pubalgia is a painful syndrome of the groin which particularly affects young athletes. Although soccer players are the athletes most often affected, they are not alone. Also included in this group are fencers, tennis players and rugbymen. This ailment is associated with varying degrees of lesions of the muscles of the lower frontal abdomen, pubic symphysis and adductor muscles. The clinical diagnosis is confirmed by standard X-rays which can show radiological anomalies of the pubic symphysis in cases of microtraumatic pubic osteo-arthropathy or insertion tendinitis. Scintigraphic anomalies occur earlier than radiological anomalies and return to normal before them; thus allowing confirmation of healing even when the radiographs are still abnormal. Sonogram and MRI can be advantageous in the detection of a lesion of the abdominal muscles or adductor muscles. MRI can also detect a lesion of the pubic symphysis. The principal differential diagnosis is pubic osteitis. Treatment is medical and combines rest, analgesics and anti-inflammatories. Surgery, namely Nesovic's operation, is reserved for those forms resistant to medical treatment, and must be bilateral.

Purpose: The value of computed tomography (CT) for differentiating benign from malignant causes of nontraumatic acute vertebral collapse (AVC) (associated with pain of less than 3 months duration) was evaluated., Materials and Methods: The CT findings of 34 benign (osteoporotic) and 32 malignant (metastatic or myelomatous) nontraumatic AVCs were compared., Results: The following CT findings were significantly more frequent in benign AVCs: cortical fractures of the vertebral body without cortical bone destruction, retropulsion of a bone fragment of the posterior cortex of the vertebral body into the spinal canal, fracture lines within the cancellous bone of the vertebral body, an intravertebral vacuum phenomenon, and a thin diffuse paraspinal soft-tissue mass (PSTM). The following CT findings were significantly more frequent in malignant AVCs: destruction of the anterolateral or posterior cortical bone of the vertebral body, destruction of the cancellous bone of the vertebral body, destruction of a vertebral pedicle, a focal PSTM, and an epidural mass., Conclusion: CT can help distinguish benign from malignant causes of nontraumatic AVC.

Wrist injuries are an extremely common occurrence. The origin of these injuries may be due to a fracture of the two bones of the forearm or the wrist bones, which may sometimes require specific X-rays views. They are rarely responsible for a dislocation of the wrist. Strains wrists may be misdiagnosed and may result in instability of the wrist. The initial examination of all wrist injuries should systematically include the following four views: (1) a PAview of the wrist in pronation (with the palm facing downward). (2) a lateral view according to the Meyrueis technique. (3) an oblique view. (4) a scaphoid view. An additional, fifth view with the wrist in supination (with the palm facing upward) may be required. If there is clinical evidence of instability of the wrist or if the initial examination results in a probably strained wrist, a further more complete radiological examination can then be undertaken. This examination, known as "the instability examination" includes stress views, which can allow detection of a discrete instability of the wrist. Finally, it is sometimes necessary to carry out this examination in a bilateral and comparative manner.

Purpose: To describe the magnetic resonance (MR) imaging features of hepatic adenoma and correlate these findings with histopathologic findings., Materials and Methods: MR findings of 51 pathologically proved hepatic adenomas in 29 consecutive patients were retrospectively analyzed. T1- and T2-weighted spin-echo (SE) images were obtained in all patients, and contrast material-enhanced MR images were obtained in 16 patients., Results: At pathologic analysis, a peripheral rim, observed in 16 (31%) hepatic adenomas, corresponded to pseudocapsule, and tumor heterogeneity, observed in 26 (51%) lesions, corresponded to hemorrhagic necrosis and peliosis. Hyperintensity on T1-weighted SE images was observed in 30 (59%) adenomas; 10 (67%) of 15 hepatic adenomas were hyperintense on contrast-enhanced gradient-echo images, and 13 (45%) of 29 were hyperintense on delayed contrast-enhanced T1-weighted SE images., Conclusion: Presence of a peripheral rim, heterogeneity, and hyperintensity are common features of hepatic adenoma.

Menetrier's disease is an uncommon condition of unknown etiology, characterized by a hyperplasia of the gastric mucosal folds. The first case of gastroduodenal intussusception complicating Menetrier's disease is reported herein. Barium study and computed tomography (CT) helped in the diagnosis of intussusception but the nature of the underlying disease was not determined until histological examination of the gastric specimen was performed.

This article details many of the latest developments in the field of musculoskeletal interventional radiology. Some of the topics included in this discussion are percutaneous biopsy of musculoskeletal lesions, automated percutaneous discectomy, facet joint arthrography, percutaneous vertebroplasty, and percutaneous drainage of abscesses.

Although endoscopy is the fundamental examination for exploration of the esophagus, imaging study (CT scan, barium swallow) retains numerous indications. It completes the endoscopic study in the assessment of space-occupying lesions and investigates functional disorders of the oesophagus. Barium swallow associated with the administration of glucagon has a therapeutic role in food obstruction. Endoscopic ultrasonography allows direct evaluation of the local extension of oesophageal masses. Percutaneous ultrasonography sometimes facilitates the study of the lower oesophagus in children and the cervical oesophagus.

Although endoscopy has replaced radiology for the diagnosis of diseases of the oesophagus, postoperative imaging still remains essential. The radiological investigation depends on the initial disease, and its technique is adapted to the suspected complication and the type of operation performed. Immediately postoperatively, a barium swallow allows verification of the surgery before reintroducing food. The early diagnosis of possible complications is based on the barium swallow and CT scan. At a longer interval after the operation, medical imaging, particularly barium swallow, allows anatomical and functional postoperative surveillance. Relapses of the initial disease, particularly neoplastic recurrences can be distinguished from an intercurrent disease or a mechanical complication due to the operation.

Purpose: To compare three-dimensional time-of-flight magnetic resonance (MR) angiography, MR imaging, and transfemoral four-vessel angiography in diagnosis and follow-up of cervical artery dissection., Materials and Methods: Eighteen patients with 19 extracranial internal carotid artery and five vertebral artery dissections were included in this prospective study. Blind interpretation of MR and angiographic images was made by two independent radiologists., Results: MR angiography was more accurate than MR imaging in diagnosis of carotid dissection, although the difference was not statistically significant. In carotid artery dissection, respective sensitivity and specificity were 95% and 99% for MR angiography and 84% and 99% for MR imaging and in vertebral artery dissection were 20% and 100% for MR angiography and 60% and 98% for MR imaging., Conclusion: MR angiography is a reliable, noninvasive method for use in diagnosis and follow-up of extracranial internal carotid artery dissection. In vertebral artery dissection, however, conventional angiography remains useful.

The radiologic imaging of esophageal cysts in adults is described. These rare cysts are often an incidental finding. They can lead to severe airway or digestive obstruction. Rare cases of rupture and haemorrhage are described. The authors report a case of cervical esophageal duplication, investigated by pharyngography, sonography, CT and MRI. A cystic mass located between the esophagus and trachea was depicted. Pharyngography and MRI showed the communication of the superior pole of the mass with the cervico-esophageal junction as a midline vertical tract. The upper extremity of the tract opened at the antero-medical portion of the retro-cricoïd region. The other diagnostic possibilities were excluded, especially fourth branchial pouch fistulae.

The authors report a case of cervical schwannoma with an atypical clinical expression, site and imaging features. The anteromedian lesion lying in the prevertebral and retropharyngeal spaces accounts for its clinical expression in the form of dysphagia. The target appearance on computed tomography and on the T2-weighted MRI sequence was suggestive of a neurofibroma and was due to deposition of fibrin and haemorrhagic exudates in the center of the lesion. The presence of a prevertebral ansa cervicalis in front of the long muscles of the neck, between the longus capitis and longus colli muscles, accounts for the vertical, elongated appearance of this tumour involving the prevertebral space.

Medical imaging defines the local, regional and metastatic spread of cancers of the oesophagus, guiding the therapeutic approach and, in particular, the indication for surgery. CT scan and echoendoscopy are currently the reference examinations. MRI provides complementary elements. After treatment, imaging is performed to detect operative complications and recurrence.

This study of the topographic distribution of tumoral and pseudotumoral lesions of the proximal femur shows that certain lesions have a preferential site, for example osteoid osteoma affects the internal cortex of the neck and diaphysis or the intertrochanteric zone; chondroblastoma occurs in zones of epiphyseal ossification of the head; fibrous dysplasia affects the femoral neck, while sparing the epiphyseal femoral head and trochanters. The island of osteosclerosis is situated, at least partially, in the support fan; so-called physiological cysts are situated on or above the midline of the neck and below the basicapital line. Osteolytic or mixed metastases preferentially involve Ward's triangle in the femoral neck and the intertrochanteric region. The sites of these lesions therefore appears to depend on the bony architecture which, in turn, is dependent on mechanical stresses. However, this purely morphological study fails to demonstrate whether mechanical stresses influence the development of these lesions.

The frequency of life-threatening complications induced by Swan-Ganz catheter is estimated at 2% to 17%. Pseudoaneurysm formation secondary to traumatic injury of the pulmonary artery is rare (0.66% to 2%), but carries a high risk of hemorrhagie. Recognition of possible lesions should be based on clinical data and predisposing factors. Diagnostic and therapeutic investigations should be rapidly performed. Embolization is the best treatment giving very good results. Should acute hemorrhage occur in the operating room, emergency vascular occlusion can be carried out by the use of the Swan-Ganz catheter.

Nuclear magnetic resonance has shed new light on our understanding of osteonecrosis of the femoral head. It is at present the most sensitive and most specific imaging technique for the diagnosis of this condition. Studies involving correlations between MR images and anatomical findings have facilitated the understanding of tissue changes responsible for magnetic appearances. However, all problems are not resolved. At an early stage, fortunately almost always asymptomatic, false negative MRI or MR findings similar to those of algoneurodystrophy of the hip can be encountered. The aim of this article is to pinpoint the current status of these questions on the basis of a review of the recent literature. The contribution of MRI with injection of Gadolinium and future prospects are also discussed.

Eight cases of spinal sarcoma complicating Paget's disease seen in different centers were reviewed. Clinical and radiological features of this condition were determined on the basis of these 8 cases and of 51 previously published cases. In the current series as well as in previous reports, most cases involved the lumbar and sacral spine and manifested as low back pain with sciatica and early development of neurological deficits. Roentgenographic diagnosis proved difficult because of the anatomic complexity of the spine and architectural changes characteristic of the pagetic bone. The most common radiological features was a mixed pattern with both sclerosis and central osteolysis. Computed tomography performed in one patient of current series disclosed osteolysis of the sacrum (not visible on plain roentgenograms) with tumor spread to adjacent soft tissues. Features shared by spinal and nonspinal sarcomas complicating Paget's disease include advanced mean age of patients, predominance of osteogenic sarcomas among histologic forms, increased risk of sarcoma in polyostotic Paget's disease, and a very grim prognosis. Development of a neurological deficit in a patient with Paget's disease is an unusual occurrence which should suggest sarcomatous transformation. Roentgenographic changes are difficult to identify on plain films of the spine and consequently CT scan studies are warranted whenever a sarcoma is suspected.

The authors report the case of puerperal thrombosis of the right ovarian vein complicated by recurrent small pulmonary emboli in a 32 year old woman. The clinical features of this rare condition are reviewed. The echographic, angiographic and CT scan and magnetic resonance imaging abnormalities are described. The authors underline the value of non-invasive radiological investigations for early diagnosis. The patient was rapidly improved by medical therapy with antibiotics and heparin.

Olfactory neuroblastoma, a nerve tumour arising in the olfactory mucosa, is a relatively easy diagnosis in the case of a mass centered around the cribriform plate. It is more difficult to diagnose in its exceptional ectopic forms (maxillary sinus) in the absence of any cytological and histochemical arguments (fibrils, olfactory rosettes). Its local malignancy is variable with a 42% 5-year survival for stage C and metastases in 30% of cases (principally cervical nodes, bone and liver). The role of imaging is to define the criteria of a mass syndrome and to perform the preoperative staging in a case of apparently simple sinus obstruction.

Neurofibromatosis is classified into two types. Type 1, NF1 or von Recklinghausen's disease, consists of skin and bone lesions as well as central nervous system tumours arising at the expense of glial tissue: optic tract gliomas, glioblastomas, astrocytomas and "hamartomas". Type 2 consists almost exclusively of CNS tumours arising at the expense of nerve envelopes: Schwannomas, meningiomas.

Osteomyelitis of the skull base is a rare, but serious disease whose incidence is tending to increase. It affects the marrow of the temporal, occipital and sphenoid bones and is generally secondary to Pseudomonas aeruginosa infection of the external auditory meatus. Based on a clinical case, the authors recall the difficulty of establishing the positive diagnosis and the possible confusion with neoplastic disease, hence the fundamental role of biopsies. They also review the literature on this subject.

In 13 patients presenting as lethal midline granuloma (LMG), computed tomography proved essential for determining the extent of the disease, guiding biopsy and planning radiotherapy. Magnetic resonance imaging (MRI) was also helpful for the latter, because it could distinguish fluid retained within the paranasal sinuses from solid masses and tumour from granulation tissue; it was of little value for detecting bone lysis. Eight of the 13 patients proved to have T-cell lymphoma, two had Crohn's disease, in one the lesion was factitious and two had granulomas without diagnostic histological features.

Thirty-two vertebral hemangiomas (VHs) were evaluated with nonenhanced computed tomography (CT), T1-weighted magnetic resonance (MR) imaging, CT enhanced with contrast material, and selective spinal arteriography. The stroma between the osseous trabeculae was found to correspond to either fatty tissue or soft tissue or both. All 11 asymptomatic VHs showed complete fatty stroma at CT and increased signal intensity at MR imaging. In contrast, all four compressive VHs had soft-tissue attenuation at CT. Three compressive VHs showed low signal intensity on MR images. Predominantly fatty stroma at CT and increased signal intensity at MR imaging were associated with normal or only slightly increased vascularization at selective spinal arteriography or contrast-enhanced CT, while soft-tissue stroma at CT and low signal intensity at MR imaging were associated with distinct hypervascularization. The authors' experience suggests that fatty VHs may represent inactive forms of VH, while soft-tissue content at CT and low signal intensity at MR imaging may indicate a more active vascular lesion with potential to compress the spinal cord. CT and MR imaging may be especially valuable for evaluating patients with clinical signs or symptoms of uncertain origin and findings compatible with VH at plain radiography.

With use of fluoroscopy, new techniques of percutaneous synovial biopsy (PSB) of large joints of limbs (other than the knee) were developed. PSB was performed on outpatients with the use of local anesthesia. Eighty-four biopsies (hip, 57; shoulder, 10; elbow, six; wrist, five; and ankle, six) were performed. With experience, modifications evolved in the PSB technique. The main technical refinements were use of a Tru-Cut needle introduced through a Jamshidi trephine needle, placement of the cutting window parallel to the anterior aspect of the joint, and selection of an optimal approach and biopsy site. With these improvements, the success rate for obtaining synovial membrane was raised from 48% to 81%. No complications were encountered.

10 patients with symptoms of mandibular neuralgia formed the basis of this study. They were studied by both enhanced CT and MRI. MRI, better than CT, easily permits distinction between intrinsic and extrinsic lesions and detects involvement of the cavernous sinus and meninges. Moreover, because of its multiplanar imaging capability, and ability to portray exquisite anatomic details and characteristic tissue signal intensity, MRI is helpful in the evaluation of tumor involvement for biopsy and preoperative planning for these deep tumours.

The recent advances in imaging of the temporomandibular joint (TMJ), especially the introduction of MR imaging and surface colls allowing precise visualization of superficial structures led us to reconsider the different techniques used in this very complex anatomical region, due to both its morphology and function. We also tried to determine their respective role, especially in the study of TMJ dysfunction syndromes, that represent the most frequent pathology of this region. Conventional radiography allows us to appreciate the overall amplitude of the joint movements, and to study bone abnormalities, but CT is much more precise in the study of cortical bone. In TMJ dysfunction, the joint itself is studied by either arthrography or MRI, but both techniques have their limitations and remain complementary in some aspects, which are detailed here, so that the choice between them depends on availability and therapeutic indications.

The authors present a typical case of Mondor's disease of the superior external quadrant of the breast. They discuss two specific points: --the absence of superior-internal venous drainage; --the radiological picture given by a thrombosed vein.