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We aimed to examine the relationship between forearm muscle cross-sectional area (MCSA), muscle force, or rate of torque development (RTD) and 2 estimated radius bone strength indices - compressive bone strength index (BSI) at the wrist and strength strain index in torsion (SSIp) at the shaft - in healthy middle-aged males and females. Distal (4%) and shaft (65%) sites of nondominant forearms were scanned using peripheral quantitative computed tomography (pQCT) in a sample of 48 adults (mean age ± SD, 49.4 ± 2.4 y) to obtain estimated bone strength indices and MCSA. Muscle force, measured by grip dynamometry and wrist flexion RTD, was obtained using an isokinetic dynamometer. Hierarchical linear regressions, adjusted for weight, explained 27% and 36% of the BSI variance at the 4% site in males and premenopausal females, respectively ( p < 0.05). At the radius shaft, weight explained 26% ( p < 0.05) and 83% ( p < 0.01) of SSIp variance. The unique variance of BSI explained by MCSA was 16% in males ( p < 0.05) and 31% in females ( p < 0.01). Grip force predicted variance in SSIp in males ( p < 0.01) and BSI in females ( p < 0.05). RTD did not explain any variance in BSI or SSIp. Body weight was the only significant predictor ( p < 0.05) of SSIp in females. Although forearm muscle size and grip strength are associated with estimates of radius bone strength at midlife, this relationship appears to be sex dependent. The differences observed between muscle size and strength properties and bone strength at distal and shaft sites of the radius suggest a property-, sex-, and site-specific relationship between muscle and bone in the forearm. [ABSTRACT FROM AUTHOR]

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Abstract: Camptocormia, cormoptosis and bent spine syndrome all describe subjects with an involuntary forward stoop. Clinical examination differentiates between acquired fixed kyphosis of skeletal origin and reducible kyphosis that is secondary to a neuromuscular disorder. Parkinson''s disease, with abnormal muscle tone, and narrowing of the lumbar canal which leads patients to relieve pain when walking by leaning forward are the most common neurological causes. When these disorders have been excluded, a muscular condition must be considered: (a) either a diffuse myopathy of inflammatory origin (polymyositis) or endocrine origin (myxoedema, osteomalacia); (b) or a congenital myopathy (Steinert disease or myotonic dystrophy, girdle myopathy, fascioscapulohumeral myopathy) that mainly affects the spinal muscles, or a late-onset paravertebral myopathy that probably belongs to the group of girdle myopathies. Computed tomography is the key investigation in such cases. It shows diffuse, heterogeneous fatty infiltration, that may be an early stage or may mainly affect the distal paravertebral muscles while leaving muscle mass intact. [Copyright &y& Elsevier]

L'ostéome ostéoïde est une tumeur osseuse bénigne qui affecte les adultes jeunes et se localise préférentiellement au niveau des os longs. La localisation intra-articulaire est rare et atteint le plus souvent la hanche. La symptomatologie clinique est alors atypique et peut faire errer le diagnostic constituant un défi diagnostique pour les cliniciens. Nous rapportons deux observations d'ostéome ostéoïde intra-articulaires de la hanche chez deux hommes âgés 24 et 45 ans, révélés par des douleurs de la hanche gauche de type inflammatoire évoluant depuis un an et un an et demi respectivement. Chez les deux patients, le tableau atypique de l'ostéome ostéoïde a été à l'origine d'un retard diagnostic. La tomodensitométrie est dans cette indication l'examen le plus spécifique qui a permis d'évoquer le diagnostic d'ostéome ostéoïde. Une fois le diagnostic est posé, l'exérèse chirurgicale à ciel ouvert a permis la guérison avec disparition totale des douleurs. L'examen histologique a confirmé le diagnostic final d'ostéome ostéoïde intra-articulaire dans les deux cas. [ABSTRACT FROM AUTHOR]

Résumé: Objectifs: La camptocormie ou mieux, cormoptose, caractérise un malade qui penche son buste vers l’avant de façon involontaire et réductible. À propos de 63 malades, nous souhaiterions préciser les étiologies de ce symptôme. Méthode: Tous les dossiers de malades explorés dans le service pour « camptocormie », entre 1995 et 2006 ont été colligés. Les malades ont eu un examen clinique, un électromyogramme (EMG), un dosage des CPK, un examen tomodensitométrique, une biopsie musculaire chirurgicale. Résultats: Soixante-trois dossiers ont été sélectionnés : 46 femmes et 17 hommes de 70 ± 6,9 ans d’âge moyen. Parmi, 40 malades avaient une myopathie paravertébrale isolée caractérisée par une infiltration graisseuse de type myopathique des muscles spinaux. En TDM, 40 % des malades présentaient de discrètes anomalies à type d’infiltration graisseuse débutante des muscles fessiers, des muscles de la loge postérieure de la cuisse et du mollet associées aux anomalies des muscles paravertébraux. L’étude anatomopathologique objectivait, sur les muscles paravertébraux, la fibrose lobulaire endomysiale précédemment décrite et excluait une autre dystrophie musculaire. Vingt-trois malades (14 femmes, neuf hommes) présentaient une autre affection neurologique, ou une myopathie plus étendue, de diagnostic certain. Pour ces patients, la cormoptose était tout de même au premier plan du tableau clinique et représentait le motif de consultation initial. Conclusion: La myopathie paravertébrale de révélation tardive est à l’origine, dans notre série, de 64 % des cormoptoses réductibles. Le diagnostic positif repose essentiellement sur la tomodensitométrie qui montre l’hypodensité hétérogène des muscles paravertébraux. [Copyright &y& Elsevier]

Copyright of Bulletin de la Société de Pathologie Exotique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To determine whether epilepsy is caused by Taenia solium cysticercosis in The Gambia. Methods Case–control study testing samples collected from 210 people with epilepsy and 420 matched controls by sex and age ±5 years from 69 different places around the country during the period October 2008–March 2009. All serum samples were subjected to an antigen detection ELISA (Ag-ELISA) and electro-immunotransfer blot (EITB), and the seropositives were further CT-scanned to determine the presence of cysticerci in the brain. Results Although not significantly different ( P = 0.668), circulating Taenia antigen was found by Ag-ELISA in 1.4% (95% CI: 0.3–4.1) of people with epilepsy and in 1.9% (95% CI: 0.8–3.7) of the controls. A non-significant ( P = 0.4718) odds ratio of association 0.75 (95% CI: 0.13–3.15) between epilepsy and the presence of Taenia antigens was found. All 630 serum samples turned out seronegative by the EITB test. There were no intracranial cysts or cyst-like structures detected among the nine CT-scanned Ag-ELISA seropositives. Conclusion Epilepsy appears not to be caused by cysticercosis in The Gambia. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Gastrointestinal manifestations of Henoch-Schönlein purpura (HSP) in adults may be severe. Data about treatment are controversial and the outcome is seldom described. Methods: Twenty-three patients with gastrointestinal manifestations of HSP (ACR criteria) were retrospectively studied. We proposed to use clinical and radiological (CT scan) severity scores to assess the usefulness and the efficacy of corticosteroid therapy. Results: Age at onset ranged from 16 to 80years (median 39). Gastrointestinal manifestations included abdominal pain (96%), vomiting (52%), gastrointestinal bleeding (39%), diarrhoea (13%) and intestinal obstruction (9%). Scores of disease clinical severity were calculated in 21patients. Fourteen, three and four had severe, intermediate and mild disease, respectively. Ten patients in the group with severe clinical involvement underwent CT scan that showed severe radiological involvement (parietal thickening of several bowel loops of the same segment or several segments with ileal involvement). Eleven patients out of 14 with clinically severe disease were given corticosteroids. Two patients out of three with intermediate and three patients out of four with mild scores also received corticosteroids. The others received supportive care. In-patients with severe clinical scores, gastrointestinal symptoms improved within 2 days when they were given corticosteroids and within 12.3 days without corticosteroids (p <0.0002). No side effect was observed with steroid therapy. Conclusion: These results suggest that corticosteroids may reduce abdominal symptoms of HSP in adults with clinically severe disease. They are safe when CT scan is performed. [Copyright &y& Elsevier]

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Copyright of IRBM is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Colon & Rectum is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: We report a case of bilateral hearing loss in a child, caused by osteogenesis imperfecta and we evaluate CT scan findings. A 12-year-old child consulted for bilateral hearing loss. A computed tomography scan of the petrous temporal bone showed bilateral extensive unmineralized bone involving the cochleae, vestibules, and semicircular canals extending to the internal auditory canals. Osteogenesis imperfecta of the temporal bone is a genetic connective tissue disorder with increased bone fragility, low bone mass, and other extraskeletal manifestations. Hearing loss is rare in the first 2 decades of life, but it is one of the frequent features of this disorder in adult patients. Thin-section CT scans of the temporal bone show a remarkable proliferation of unmineralized bone involving the otic capsule. This demineralization is similar to that observed in the cochlear form of otospongiosis. [Copyright &y& Elsevier]

Summary: The aim was to examine the bony maxillary structures by computed tomographic measurements in newborns with unilateral cleft lip and palate before cheiloplasty. Analysis of maxillary bone was performed and size parameters were measured by computed-tomographic analysis in 12 infants with unilateral cleft lip and palate. We compared the bony maxillary length and the bony maxillary width between the cleft side and the healthy side. For eight patients, the bony maxillary length was different between the cleft side and the healthy side. For three patients, the bony maxillary width was different between the incisor alveolar structure in the cleft side and the healthy side. For six patients, the bony maxillary width was different between the canine alveolar structure in the cleft side and the healthy side. We noted an asymmetry without hypoplasy in bony maxillary structure in newborns before cheiloplasty. The data can serve as the starting point for a control and later evaluation on the efficiency of different therapeutic approaches of alveolar and maxillary development in children with cleft lip and palate. [Copyright &y& Elsevier]

Abstract: We report the case of a 38-year-old man admitted at the emergency department for abdominal pain of abrupt onset. Computed tomographic examination revealed a spontaneous isolated dissection of the superior mesenteric artery and an anevrysm of the coeliac artery caused by the arcuate ligament. Outcome was favorable under conservative medical treatment and a three months follow-up was uneventful. This observation offers the opportunity to present recent insights concerning this pathology. [Copyright &y& Elsevier]

Whether dietary fat influences the interaction between liver fat, visceral adipose tissue (VAT), and metabolic risk is unclear. Thus, we sought to determine the independent associations between 1 and 10 d dietary fat intake, liver fat, and VAT on insulin sensitivity using a cross-sectional design. Liver fat score (LFS) was assessed by computed tomography and VAT by magnetic resonance imaging in 42 abdominally obese older men. Insulin sensitivity was measured by the hyperinsulinemic-euglycemic clamp technique. Diet composition was determined from self-recorded diet records for 1 and 10 d preceding the assessment of LFS. LFS was positively associated with the 10 d average fat and alcohol intake, but not with any 1 d average dietary variables. VAT (r = -0.36) and LFS (r = -0.32) were both negatively correlated with insulin sensitivity (p < 0.05). When LFS and VAT were entered in the same model, only VAT was an independent predictor of insulin sensitivity (p < 0.05). Control for the average 10 d alcohol consumption and fat intake improved the association between insulin sensitivity and LFS (from r = -0.32, p > 0.10 to r = -0.49, p < 0.05), but not VAT. In fact, after control for the 10 d dietary variables, both LFS and VAT were independent predictors of insulin sensitivity (p < 0.05). This was not true for any of the 1 d dietary intake variables. In conclusion, liver fat is associated with dietary fat intake and alcohol consumption over 10 d, but not 1 d. Furthermore, dietary habits may influence the relationship between liver fat and insulin sensitivity. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The objective of our work is to study the clinical features and the management of pulmonary embolism in a cardiology department. Material and methods: It is a retrospective study including 43 patients between 1993 and 2003 in the cardiology department of a Tunisian hospital for acute pulmonary embolism. Results: The most common clinical signs were dyspnea, pleural pain and deep venous thrombosis. The most common physical signs were tachypnea and tachycardia. Electrocardiographic abnormalities were found in 38 patients (88.4%). Chest X-ray was abnormal in 25 patients (60.5%). The arterial blood gas found hypoxia and\or hypocapnia in 95% of cases. D-dimer was high in almost totality of patients (96%). US doppler of deep leg veins was positive in more than 40% of patients. Transthoracic echocardiography was normal in more than 40% of the patients. Lung scan noted a high or very high probability in 87% of cases. Pulmonary helical CT was positive in majority of cases. Unfractionated heparin was administered to about 75% of patients and low-molecular-weight-heparin was prescribed at only 40% of patients. Conclusion: Management of pulmonary embolism in our cardiology department is characterized by the frequent use of non invasive techniques on the diagnostic view and appeal to héparine on the therapeutic view. [Copyright &y& Elsevier]

Abstract: Recent technological innovations modify the diagnosis opportunities of multislice CT angiography. Emergency chest pain management is therefore optimised and still oriented by clinical presentation. Aortic CT angiography allows the diagnosis and classification of aortic dissection or intramural haematoma. It also shows the extension to aortic thoracoabdominal branches and visceral involvement. Pulmonary embolism diagnosis will be completed by scanographic evaluation of its seriousness. Chest pain caused by pulmonary or digestive diseases will also be documented. A late phase imaging seems useful to diagnose acute myocardial pathology. [Copyright &y& Elsevier]

Summary: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is increasingly used to treat advanced Parkinson''s disease (PD). The optimal method for targeting the STN before implanting the definitive DBS electrode is still a matter of debates. Beside methods of direct visualization of the nucleus based on stereotactic magnetic resonance imaging (MRI), the most often used technique for targeting STN consists in recording single-cell activity along exploratory tracks of 10–15mm in length, centered on the theoretical or MRI-defined target coordinates. Single-unit recordings with a microelectrode present various drawbacks. They are time-consuming if correctly performed and a single-cell precision is probably superfluous, taking into account the size of the implanted electrode. In this study, we present an original method of recording and quantification of a multi-unit signal recorded intraoperatively with a semi-microelectrode for targeting the STN. Twelve patients with advanced PD have been included and assessed clinically before and one year after bilateral STN–DBS electrode implantation guided by multi-unit electrophysiological recordings. After one year of chronic stimulation, all patients showed a marked clinical improvement. The motor score of the unified Parkinson''s disease rating scale decreased by more than 57% and the required levodopa-equivalent daily dose by 59.5% in on-stimulation off-medication condition compared to off-stimulation off-medication condition. The accuracy of STN–DBS lead placement was confirmed on postoperative computed tomography (CT) scans, which were fused to preoperative T2-weighted MRI. The boundaries of the STN were easily determined by an increase in multi-unit signal amplitude, which was observed on average from 0.492mm below the rostral border of the STN down to 0.325mm above its caudal border. Signal amplitude significantly increased at the both rostral and caudal STN margins (P <0.05) and the level of neuronal activity easily distinguished inside from outside the nucleus. This study showed that STN boundaries could be adequately determined on the basis of intraoperative multi-unit recording with a semi-microelectrode. The accuracy of our method used for positioning DBS electrodes into the STN was confirmed both on CT–MRI fusion images and on the rate of therapeutic efficacy. [Copyright &y& Elsevier]

Abstract: Vasospasm is the leading cause of sequelae or deaths after aneurysmal subarachnoid haemorrhage. Vasospasm occurs 2–10 days after haemorrhage and that justifies close monitoring during this period. Because clinical signs appear often to late to reverse ischaemia, paraclinic tools have been developed. Arteriography is the historical gold standard for diagnosis but no clear validated rules exist to measure vessel sections. Diagnosis of vasospasm is, thus, relatively subjective and only reflects one moment of arteries status. Transcranial doppler is a non-invasive and easily repeatable method but sensibility and specificity for vasospasm diagnosis are low compared to arteriography. However, day-to-day changes of arterial blood cells velocities can help to determine vasospasm risk and/or indicate time for arteriography. CT-scanner, PET-scan or IRM can help to evaluate ratio between perfusion and metabolism. Nevertheless, as arteriography, it is only a one-time measurement without control of treatment effects. Waiting for improvement of diagnosis techniques, arteriography stays the gold standard. To choose the right moment for invasive methods, intensivists need to use clinical and transcranial doppler data and start treatment as early as possible to be efficacious. [Copyright &y& Elsevier]

Abstract: Osteoid osteoma is a small tumour, always benign, consisting of a small focus of osteoblastic hyperactivity surrounded by a zone of sclerosis. Located preferentially on the long bones, femur and tibia, carpal localisation is rare but if present it usually affects the scaphoid. We present a case of double localization of an osteoid osteoma in the lunate bone, presenting as gradually increasing pain in the wrist over the course of 18 months. Standard radiology and tomodensitometry of the wrist showed two central lucencies of the lunate without rupture of the cortex. Curettage of the lesion and packing of the resultant defect with cancellous bone resulted in disappearance of the lesions with good functional recovery. The clinical, radiological and therapeutic aspects will be discussed by the authors. [Copyright &y& Elsevier]

Abstract: Extradural hematoma of the posterior fossa is an uncommon complication of pediatric head injuries. Its prognosis has radically improved due to computed tomography. The authors report four cases of traumatic extradural hematoma of the posterior fossa concerning 18-months to 16-years old girls. The main clinical symptoms were those suggesting intracranial hypertension. Computed tomography, performed in all cases, leaded to the diagnosis. In three cases, there was occipital fracture, and the last case was, associated supratentorial lesions. Surgical evacuation of hematoma was performed in all cases, within less than six days. Good outcome was recorded among all children. [Copyright &y& Elsevier]

Abstract: Purpose: To evaluate the value of ultrasound and computed tomography in the diagnosis and treatment of primitive psoas abscess in children. Patients and methods: We retrospectively studied 20 cases of primitive psoas abscess seen between 1987 and 2005. All children were investigated by abdominal ultrasound and computed tomography. Percutaneous drainage of the abscess was performed in 15 cases. Results: The mean age of the children was 7.8 years (range: 11 months-12 years). Fever and pain were the presenting symptoms. Ultrasonography established the diagnosis in all patients. CT confirmed the diagnosis and allowed a percutaneous needle aspiration in all cases. Staphylococcus auerus was isolated in 19 patients and streptococcus in 1 patient. The catheter drainage was successful in 14 cases. A surgical drainage was necessary for four children. The two other patients were treated with only antibiotic. Conclusion: US and CT are useful for accurate diagnosis of primitive psoas abscess in children. CT-guided percutaneous drainage is a safe and effective alternative to surgery in the management of primitive psoas abscess. [Copyright &y& Elsevier]

Twenty-one consecutive patients with osteoid osteoma treated with computed tomography-guided radiofrequency ablation, after failed conservative treatment, were retrospectively reviewed. The diagnosis was based on typical clinical and imaging features. Radiofrequency ablation of osteoid osteomas was undertaken by heating the tip of the electrode to 90°C for three sessions of 2 min each. Follow-up evaluation included clinical examination and questionnaire, and radiographic evaluation was conducted on the first month, 12th month, and at the latest examination. Within the first 24 h post-procedure, pain was improved in all patients. Seven patients had pain relief within the first 3 days, 11 patients within the first week, and 3 patients within 2 weeks post-procedure. A month after the procedure, no patient had difficulty regarding self-care and daily activities. At a mean follow-up of 29 months (range 12–60 months), early or late complications and signs of local recurrence were not observed. [ABSTRACT FROM AUTHOR]

Résumé: Objectifs: La biopsie percutanée des lésions rachidiennes est une technique efficace et bien évaluée. Jusqu''à présent, les séries publiées ont rarement dépassé la centaine de patients. Il n''existe pas de consensus sur les facteurs influençant le rendement diagnostique. Nous rapportons notre série des biopsies rachidiennes percutanées dans le but de rechercher des facteurs prédictifs du succès diagnostique de cette méthode. Méthodes: Pendant une période allant de novembre 2001 à août 2005, nous avons procédé à 229 biopsies rachidiennes percutanées chez 201 patients. Toutes les biopsies ont été guidées par tomodensitométrie (TDM). Le côté de la biopsie a été choisi en fonction de l''extension de la lésion. Dans les lésions médianes ou à extension bilatérale, nous avons choisi le côté droit. Le point de ponction et le trajet de l''aiguille de biopsie ont été déterminés par TDM grâce à des coupes axiales et à des coupes latérales au scout view. Résultats: Le rendement diagnostique n''était corrélé ni à l''âge, ni au sexe, ni au type ou au diamètre de l''aiguille de biopsie, ni au type de lésion, ni à son étage ou à son siège. Le rendement diagnostique des biopsies répétées a été très largement inférieur à celui d''une première biopsie. Conclusions: Si le rendement diagnostique de cette biopsie ne dépend pas des variables étudiées, la voie d''abord choisie peut varier selon le niveau, le siège et les caractéristiques de la lésion rachidienne. [Copyright &y& Elsevier]

Résumé: La localisation carpienne des ostéomes ostéoïdes est rare. Le tableau clinique est celui d''une ténosynovite à la présentation atypique, fonction de la localisation de la tumeur. Cela fait errer le diagnostic, d''autant que la douleur, dans nos deux cas, est survenue après un traumatisme. Les examens complémentaires classiques se révèlent souvent non contributifs. La tomodensitométrie en coupes fines, qui peut être couplée à l''IRM, est dans cette indication l''examen le plus spécifique. Elle peut montrer une image typique en cocarde, en préciser la localisation et rechercher une atteinte articulaire. Le traitement est l''exérèse chirurgicale complète, associée ou non à une arthrodèse intracarpienne dans le même temps opératoire en cas d''effraction articulaire étendue. [Copyright &y& Elsevier]

Abstract: Objective: Develop the methodology of data acquisition and processing for functional hepatobiliary scintigraphic imaging in normal mice. Material and methods: The scintigraphic study was done on 11 female adult CD1 mice under gazeous anaesthesia using a small animal dedicated gamma-camera. A dynamic serie of 40 frames with 1 minute per frame was acquired after injection of Tc-99m mebrofenin. Two individuals were used for tomodensitometric morphological acquisitions using an X-ray micro-CT and the injection of a contrast agent and contributed to the choice of the scintigraphic regions of interest. Four analytical models: corrected and deconvolved hepatogram (A), bi-compartmental model (B), fast kinetics compartmental model (C) and factorial analysis (D) were applied to the scintigraphic data starting from areas of interest centered to the cardiac cavities and the liver. Results: The mebrofenin kinetics is characterized by a time of the maximum tmax ranging between 4.5 and 4.6 min, a time of the center of gravity tcdg from 6.2 to 7.0 min, a half-life of exponential decay t1/2decr from 5.4 to 6.8 min, a fraction of hepatic extraction of 100%. Uptake and excretion half-lives are 2.3 and 5.8 min for the bicompratmental model and are 3.2 and 3.3 min for the fast kinetics compartmental model. Comparisons do not find significant differences between the right and left livers nor between models A, B, C and D for uptake time constants nor between models A, B and D for excretion time constants. Conclusion: Reference values of hepatobiliary function in normal CD1 mice were obtained using different compartmental models. [Copyright &y& Elsevier]

Abstract: Among the three types of soft tissue and skins infections (cellulitis, necrotising cellulitis and necrotising fasciitis) only the necrotising injuries are commonly managed in intensive care unit. Location, depth and severity of these potentially life threatening infections may vary and cannot be predicted on clinical grounds No microbiological deduction can be made from clinical signs. A mixed aerobic–anaerobic flora is cultured in 40 to 80% of the cases. Magnetic resonance imaging and CT-scan are the best techniques to assess the diagnosis and determine the extension of infection. However, these exams should not delay surgical treatment. Fifteen to 30% of the patients die. Three parameters play a key role in the prognosis: ability of the physician to recognise the disease and to evaluate the severity of infection, early onset of antimicrobial therapy, and most of all early surgical debridement. [Copyright &y& Elsevier]

Abstract: Due to recent efforts in improving spatial and temporal resolution in imaging techniques, it is now possible to get relevant information about brain perfusion and metabolism in humans. This information can significantly impact on brain pathophysiology, diagnosis assessment and therapy options, particularly in patients having brain ischemia. Among these imaging and metabolism techniques are dynamic perfusion computed tomography, perfusion MRI, positron emission tomography and NMR spectroscopic imaging. The goal of this article is an overview of these four techniques, with their own technical description, advantages and drawbacks. Details are provided about brain parameters given by each technique and their clinical relevance, the accessibility of the technique in the emergency setting and the optimal window to use it during the patient''s evolution. [Copyright &y& Elsevier]

Abstract: Chilaïditi''s syndrome is the association of a radiological and clinical semiology of the interposition of large colon or small intestine between the lower side of diaphragm and liver. We report the case of a 32-year-old woman, primigravida, who undergone a caesarean section at 39 weeks of amenorrhoea, for a clinical picture of persistent abdominal pain and a beginning hepatic cytolysis. The patient presented one day after the ceasarean section an occlusive syndrome of the small intestine. The etiology of the occlusion of the small intestine in post-partum was a Chilaïditi''s syndrome with inter hepatodiaphragmatic incarceration of the small intestine discovered at the computed tomography. An exploratory laparotomy confirmed and permitted to treat Chilaïditi''s syndrome complicated by an occlusion. [Copyright &y& Elsevier]

Abstract: Introduction. – The purpose of this study was to identify, through recursive partitioning, clinically relevant criteria which predict the need for acute neurosurgical intervention in a group of patients with mild head injury. Materials and methods. – A retrospective cohort of all adult patients, from April 2000 to March 2001, who sustained a blunt trauma and underwent head CT scan, was reviewed. The following inclusion criteria for mild head injury were used: initial Glasgow Coma Scale (GCS) ranging from 13 to 15; no loss of consciousness lasting more than one hour; no obvious skull fracture; a cranial CT scan performed. We collected demographic and trauma related data, interventions and outcome. Univariate and multivariate analyses were undertaken. In parallel, recursive partitioning was carried out using all variables to elaborate a decision algorithm. Results. – There were 405 patients in the sample. CT identified lesions in 12% of patients. Twelve patients (3%) required acute neurosurgical intervention. The recursive partitioning analysis identified three significant sequential nodes: deterioration of the GCS; an initial GCS of 13 vs 14 or 15; and the presence of associated injuries or comorbid conditions. Conclusions. – A simple three step rule predicts the need for acute neurosurgical intervention based on clinical findings: a deteriorating GCS; an initial GCS of 13; and the presence of associated injuries or comorbid conditions. [Copyright &y& Elsevier]

Abstract: Thoracic computed tomography using multislice scanner technology, with which contiguous high resolution sections less than 1 mm thickness can be obtained, makes evaluation of almost all the bronchial tree and lung parenchyma possible. The use of specific imaging methods allows measurement of the surface of the bronchial lumen and the thickness of its walls, as well as determination of lung attenuation values and volumes, adding quantitative functional data to morphological findings. These achievements have already allowed important advances and open the way to major breakthroughs in the understanding of the pathophysiology of asthma. [Copyright &y& Elsevier]

Abstract: Objectives. – To clarify the contribution of the doppler and the CT in the balance aetiology of a fever of the post-partum and to connect it with a thrombophlebitis of ovarian vein. Patients and methods. – Five patients presented there post-partum a fever with pointed abdominal painful syndrome. A doppler and a CT were performed. Results. – Doppler showed a hypoechoic tubular structure located forward and laterally with regard to the psoas with a flat spectre in pulsed Doppler in every case. CT confirmed the diagnosis of a thrombophlebitis of the right ovarian vein in three cases and left in two cases. Evolution after anticoagulation and an antibiotic therapy was favourable with regression of clinical signs and doppler evaluation. Conclusion. – In front of any fever of the post-partum, it is necessary to evoke a thrombophlebitis of the vein ovarian, although it is about a rare aetiology. In spite of the superiority of the CT-scan and RP imaging for such a diagnosis, doppler is a simple and reproducible diagnostic tool for the monitoring which must be practised in first intention. [Copyright &y& Elsevier]

Abstract: Soft tissue sarcomas are uncommon heterogeneous group of tumour derived from mesenchym. The most common location is the lower extremity, but they can occur in the upper extremity, and abdominal and chest walls. The first radiological evaluation may include plain films and ultrasonography in viewing to assess the probability of soft tissue sarcomas. MRI with contrast is the main modality to evaluate these lesions and choose which part of tumour must be biopsied. Computer tomography (CT) is secondary used to perform core needle biopsy and detect lung metastases. The role of PET begins to be more clear in case of need global assessment before radical surgery. A multidisciplinary approach is essential to perform rational treatment planning and avoid partial surgery. [Copyright &y& Elsevier]

Abstract: Bronchopulmonary dysplasia (BPD) is now characterized by a disturbance of lung development. The major sequels have moved from airways to deep lung. However, symptoms analysis, explorations and therapeutics still focused on the conducting airways involvement. New methods must be found to assess alveolar growing … if it would be possible or even indicated to modify a favorable outcome in most children. Explorations of BDP children are indicated in case of unusual evolution. Indeed, it is possible to predict several pattern of respiratory outcome in regard of duration of oxygen supply. Only mild exacerbations are expected in the first years of life of highly premature children with at least moderate BDP (breathing room air at 36 week post menstrual age): in these cases, early radiological verification and lung function when children is old enough to perform simple tests are sufficient. Initially more severe forms are characterized by a high risk of respiratory decompensation during the first two years of life, and these children almost have bronchial hyper-reactivity and fixed radiological abnormalities, with in addition moderate bronchial obstruction and exercise limitation. In such cases, regular evaluation of pulmonary function is indicated. In cases of unexpected outcome (more frequent exacerbations, severe functional obstruction or diffused abnormal radiological findings), investigations have to be completed. [Copyright &y& Elsevier]

Abstract: To report a retrospective study concerning the impact of fused 18F-fluorodeoxy-D-glucose (FDG)-hybrid positron emission tomography (PET) and computed tomography (CT) images on three-dimensional conformal radiation therapy (3D-CRT) planning for patients with non-small-cell lung cancer (NSCLC). Patients and methods. – One hundred and one patients consecutively treated for stages I–III NSCLC were studied. Each patient underwent CT and FDG-hybrid PET for simulation treatment in the same radiation treatment position. Images were coregistered using five fiducial markers. Target volume delineation was initially performed on the CT images and the corresponding FDG-PET data were subsequently used as an overlay to the CT data to define target volume. Results. – FDG-PET identified previously undetected distant metastatic disease in 8 patients making them ineligible for curative CRT (one patient presented some positive uptakes corresponding to concomitant pulmonary tuberculosis). Another patient was ineligible for curative treatment because fused CT/PET images demonstrated excessively extensive intrathoracic disease. The gross tumor volume (GTV) was decreased by CT/PET image fusion in 21 patients (23%) and was increased in 24 patients (26%). The GTV reduction was≥25% in 7 patients because CT/PET image fusion reduced pulmonary GTV in 6 patients (3 patients with atelectasis) and mediastinal nodal GTV in 1 patient. The GTV increase was≥25% in 14 patients due to an increase of the pulmonary GTV in 11 patients (4 patients with atelectasis) and detection of occult mediastinal lymph node involvement in 3 patients. Among 81 patients receiving a total dose≥60 Gy at ICRU point, after CT/PET image fusion, the percentage of total lung volume receiving more than 20 Gy (VL20) increased in 15 cases and decreased in 22 cases. The percentage of total heart volume receiving more than 36 Gy increased in 8 patients and decreased in 14 patients. The spinal cord volume receiving at least 45 Gy (2 patients) decreased. After multivariate analysis, one single independent factor made significant effect of FDG/PET on the modification of the size of the GTV: tumor with atelectasis (P =0.0001). Conclusion. – Our study confirms that integrated hybrid PET/CT in the treatment position and coregistered images have an impact on treatment planning and management of patients with NSCLC. FDG images using dedicated PET scanners with modern image fusion techniques and respiration-gated acquisition protocols could improve CT/PET image coregistration. However, prospective studies with histological correlation are necessary and the impact on treatment outcome remains to be demonstrated. [Copyright &y& Elsevier]

Copyright of EMC-Oto-rhino-laryngologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: A case of ileocecal herniation through the foramen of Winslow is presented. This is an uncommun type of internal hernia and the diagnosis is difficult. From this case, clinical signs, imaging procedures and treatement options are discussed. [Copyright &y& Elsevier]

Copyright of EMC-Radiologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Pneumorachis, defined as the presence of air within the spinal canal, has rarely been described, and is exceptionally due to thoracic trauma. We report the case of a 37-year-old patient who sustained a motor vehicule accident. The chest CT-scan showed a bilateral-hemothorax, a small right pneumothorax, rib fractures, and a fracture of the fourth thoracic vertebra associated with air in the spinal canal extending from T6 to L2. The fracture of T4 associated with the pleural lesion is probably responsible for the pneumorachis. Possible pathogenic mechanisms of this rare blunt chest complication are discussed. [Copyright &y& Elsevier]

Abstract: We report a new case of aggressive meningioma without dural attachment occurring in a three-year-old girl. We emphasize the rarity of meningiomas in children and the absence of the female predominance associated whit meningioma in adults and we describe their pathological and radiological features. [Copyright &y& Elsevier]

This report describes a sporadic case of dysplasia epiphysealis hemimelica that developed in the proximal tibia of a 21-month-old girl. Three years after the surgical intervention the patient has made complete clinical recovery with a normal range of motion, a walk with no limping or pain, no leg length discrepancy or angular knee deformity. Even though the proximal tibia does not represent an infrequently involved site, we report the clinical, pathological and radiological features of our case both for the extreme rarity of dysplasia epiphysealis hemimelica and the very young age of the patient. The authors underline also the role of magnetic resonance imaging in the diagnosis, management and follow-up of this very rare condition. [Copyright &y& Elsevier]