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Alveolar proteinosis is a rare pulmonary disease characterized by intra-alveolar accumulation of surfactant composed of lipoproteinaceous material, related to a lack of surfactant resorption by alveolar macrophages. Crazy paving pattern is characteristic, but not specific. The multinodular forms of this affection remain exceptional.

IntroductionLa thrombose veineuse est la formation d’un thrombus au niveau d’une veine, souvent du mollet, plus rarement au niveau d’une veine ilio-femorale a la suite d’une stase veineuse, d’une lesion de la paroi vasculaire ou d’une alteration de la composition du sang. Elle est rare chez l’enfant, souvent diagnostiquee avec un retard susceptible d’entrainer des complications a court et long terme [1] et touche avant tout les veines des membres superieurs [2]. Nous rapportons [...]

Resume Objectifs Evaluation de la vertebroplastie percutanee (VPP) dans le traitement des fractures osteoporotiques resistantes au traitement medical. Materiel et methode Etude retrospective monocentrique de 2002 a 2005. L’efficacite a ete evaluee par l’echelle visuelle analogique (EVA) de Huskisson. Resultats 77 vertebres ont ete traitees chez 50 patients. Le suivi moyen etait de 12,9 mois (1 - 36 mois). On observait une diminution significative (p Conclusion La vertebroplastie est une technique sure et efficace dans le traitement des fractures vertebrales osteoporotiques hyperalgiques.

Resume Objectif Decrire les caracteristiques en imagerie des pseudo-tumeurs inflammatoires hepatiques. Introduction Les pseudo-tumeurs inflammatoires sont des lesions benignes rares pouvant mimer en imagerie l’aspect d’une atteinte neoplasique. Leur diagnostic est le plus souvent redresse par l’etude histologique de la piece chirurgicale motivee par une semeiologie radiologique suspecte et atypique. Materiel et Methode Etude retrospective entre 1998 et 2006 de pseudo-tumeurs inflammatoires hepatiques prouvees histologiquement. Les techniques radiologiques employees comportaient l’echographie, l’echographie de contraste, le scanner helicoidal et l’imagerie par resonance magnetique (IRM). Resultats 7 lesions (Taille moyenne : 61,4 mm) etaient identifiees chez 6 patients (Âge moyen : 66 ans). Les examens cliniques et biologiques etaient aspecifiques. Nous disposions de 5 echographies dont 1 avec contraste, 5 tomodensitometries et 3 IRM. En echographie, toutes les tumeurs etaient hypoechogenes sans rehaussement apres injection de Levovist®. En scanner, elles etaient principalement hypodenses avant injection. Le rehaussement apres injection intraveineuse d’iode etait inconstant, tardif et modere. En IRM, les lesions etaient iso ou discretement hyperintenses en T2, iso ou hypointenses en T1 avec un discret rehaussement peripherique au temps tardif. Conclusion Ce diagnostic differentiel doit etre connu des radiologues et peut etre evoque dans un contexte inflammatoire chronique avec une masse hepatique ne presentant pas les caracteristiques d’une tumeur hepatique specifique mais celles d’une lesion partiellement fibreuse avec prise de contraste tardive.

Resume Objectifs Evaluer l’efficacite de l’embolisation endovasculaire pour des patients ayant une hemorragie gastro-intestinale haute aigue et non variqueuse ne pouvant etre traitee par voie endoscopique ainsi que les facteurs susceptibles d’influer sur la mortalite. Materiels et methodes Etude retrospective ayant inclus sur une periode de 4 ans une cohorte historique de 37 patients consecutifs (22 hommes), ayant un âge moyen de 69,2 ans (extremes = 22-93). L’hemorragie etait le plus souvent d’origine ulcereuse (54 %). Les succes technique, clinique primaire et clinique secondaire ainsi que les complications etaient calcules. Plusieurs parametres cliniques et angiographiques etaient compares au taux de mortalite precoce au moyen des tests de Kruskal-Wallis ou Fisher. Resultats Les taux de succes technique, clinique primaire, clinique secondaire et de complications etaient respectivement egaux a 89,2 %, 83,8 %, 88,9 % et 10,8 %. Le taux de mortalite precoce etait de 32,4 %. Les scores APACHE II et IGS II etaient fortement correles avec la mortalite (respectivement p = 0,001 et p = 0,003). Conclusion L’embolisation par voie endovasculaire chez des patients presentant une hemorragie arterielle aigue gastro-intestinale haute ne pouvant pas etre traitee par endoscopie, est efficace. La mortalite reste cependant elevee en raison d’une alteration de l’etat clinique des patients.

Hepatic macronodular mycobacteriosis is rare. Its diagnosis is challenging and is most often proposed on the basis of histological analysis. Final diagnosis, except for germ-proven cases, is made in conjunction with clinical, biological, and radiological arguments. We retrospectively report the MR features of ten hepatic lesions discovered on five patients. MRI is sensitive but has a low specificity in demonstrating pseudotumoral lesions most often exhibiting hypointensity on the T1-weighted sequence, hyperintensity on the T2-weighted sequence, and a slight rim enhancement after gadolinium-enhanced T1-weighted sequences.

Nineteen months after a Whipple procedure for pancreatic carcinoma, a 79-year-old woman developed recurrent tumoral strictures of the bile ducts and afferent Roux-en-Y limb with resultant jaundice, cholangitis, and liver abscess. Transhepatic abscess and biliary drainages were performed first. Afferent loop obstruction was too far from biliary anastomosis to be crossed via the transhepatic route. Percutaneous jejunostomy and stenting were performed to relieve the malignant afferent loop syndrome. After initial relief of symptoms, jaundice recurred in relation to peritoneal carcinomatosis progression and was treated with percutaneous jejunostomy drainage until patient's death. Therapeutic options of tumoral occlusion of afferent loops are reviewed.

Pseudoaneurysms of the lumbar arteries are infrequent, and are most often found incidentally after trauma to the lumbar spine. More rarely, they are an iatrogenic complication from diagnostic or therapeutic procedures, particularly of the kidney. Their rupture can cause rapid clinical deterioration by retroperitoneal hemorrhage, and therefore their diagnosis and treatment must be rapid. We report two cases of lumbar artery false aneurysms arising as a complication during the treatment of infectious disciitis. The diagnoses were established via CT and immediately followed by expeditious treatment by selective arterial embolization.

Resume Nous rapportons le trente-deuxieme cas d’agenesie congenitale de la veine porte, decouvert chez une malade de 18 ans qui est associe a de multiples foyers hepatiques d’hyperplasie nodulaire focale. Des associations avec diverses tumeurs hepatiques ont ete decrites dans la moitie des observations publiees d’agenesie congenitale de la veine porte. La genese de cette association tumorale semble resulter de la privation hepatique en flux portal et de l’augmentation secondaire du flux arteriel. Cette derniere, en provoquant d’importantes perturbations vasculaires et nutritives, est en effet susceptible d’entrainer un remodelage tissulaire architectural.

Ameloblastoma is the most frequent of the odontogenic tumors. We report a case of a giant ameloblastoma involving the maxillary region and describe its ultrasonography and computed tomography findings.

Renal lymphatic fistulas are rare and, in most cases, of parasitic origin. We report a case of a reversible uro-lymphatic fistula, which was demonstrated by CT and was felt to be secondary to a radiolucent calculus.

The authors describe the findings detected by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) in a 42-year-old patient with a hepatic abscess due to brucellosis. This localization by Brucella (hepatic brucelloma) is quite rare and very often is asymptomatic. A review of the medical literature shows only 40 cases of an hepatic abscess due to brucellosis. The findings demonstrated by US, CT and MRI can offer important diagnostic elements, albeit not specific, which should, together with a positive serologic test, confirm the diagnosis.

Double inferior vena cava is a rare congenital anomaly. Its association with caval thrombosis is rarely reported. The authors report the case of a 36 year old woman who presented a double inferior vena cava that one was thrombosed and associated with a wide left adrenal mass, in order to precise the role of medical imaging in the management of this pathology.

Lipomas are the second most common benign, non-epithelial tumor of the gastrointestinal tract after leiomyoma. They can grow at all levels of digestive tract with a variable frequency. This involvement may be single or multiple in one or more segments. These lesions with a low development can rarely cause serious complications requiring prompt treatment. Therapeutic decision is guided by symptoms and tumor size. Conventional radiography with digestive opacification allows locating the tumor. On cross-sectional imaging, lipomas appear as homogeneous fatty tumors or rarely with internal fine septa. Computed tomography and magnetic resonance imaging allow the final diagnosis of lipomas in its uncomplicated forms.

The rupture of the spleen, not secondary to external trauma, is rare. Two cases are reported. The first case occurred in a patient with an aggressive form of lymphoma, and the second in a patient following a colonoscopy. In the rare occurrences of spontaneous rupture, radiological imaging, in particular by computed tomography, will lead to the diagnosis and help in deciding the correct treatment.

Diffuse retroperitoneal fibrosis (RPF) is a rare inflammatory process. We report on two known cases of RPF, without evidence of involvement of the urinary tract or of the venous system. A computed tomography (CT)-guided biopsy was performed in each case, and the histological findings eliminated other pathological processes, particularly those of malignant origin. In both cases, a therapy with cortisone was instituted, and a follow-up with CT at 6 months has demonstrated a regression of the pathology of more than 50%.

Colocolic intussusception in the adult, caused by a tumoral process, is a rare clinical event. We have studied two adults clinically presenting with a mass in the right iliac fossa, which was produced in one case by a carcinoma involving the right colon and in the other case involving the sigmoid. Multi-slice spiral CT imaging showed the presence of a colocolic intussusception-the tumoral characteristics of the lesion eliminated the possibility of a lipoma-and it allowed a satisfactory presurgical evaluation of the pathological process.

We report three cases of women who came to our observation suffering from a feeling of heaviness in the pelvic floor. Ultrasonography showed, in all cases, a cystic formation, medially located under the umbilicus, suggesting the presence of a cyst of the urachus. Computed tomography and magnetic resonance imaging, however, thanks to a more definite topographic evaluation, allowed elimination of this diagnosis in two patients with history of previous abdominal surgery.

We evaluated and compared the radiological images of the spine of 111 patients affected by myeloma, bone metastases, and fractures secondary to osteoporosis demonstrated in low-dose computed tomographic (CT) scans and those demonstrated in conventional radiographic studies. From the analysis of the data obtained, it appears that the duration of the CT procedure is definitely shorter and that its diagnostic sensitivity is superior to that of conventional radiography. We should mention that the dose of radiation delivered by CT scanning does not constitute an unfavorable element in patients, usually elderly, for whom CT scanning was indicated.

The inguinal herniation of a bladder diverticulum is a rare entity. We report two cases and describe the findings observed by computed tomography, which allowed demonstration of the site and contents of the hernia.

Renal artery pseudoaneurysms are infrequent and are most often secondary to surgical or percutaneous renal biopsies. Their rupture can cause rapid clinical deterioration by massive haemorrhage. Diagnosis and treatment must, therefore, be rapid. Currently, surgical treatment remains the gold standard in most institutions while paediatric cases of endovascular embolization have seldom been described. We report a 13-month-old infant with a post-biopsy renal pseudoaneurysm successfully treated by selective arterial embolization.

Among the various causative agents of an abscess of the liver, Klebsiella is a frequent and well-known cause, and its imaging findings have been described in the past decades. We report two cases of this type of abscess, which were of interest because of associated findings indicating a subhepatic thrombophlebitis of the liver, a process which could have explained the development of a concomitant pulmonary infectious process.

The complicated diverticula of the ileum are a rare cause of an acute abdomen. We report on a case in whom the CT imaging leads to the surgical removal of the ileocecal segment.

The spreading of a cervical infection to the mediastinum is a complication rarely observed, and its prognosis is still very severe. The infectious spreading follows known anatomical tracts, leading to the invasion of definite mediastinal spaces. The cervicothoracic scanning is the ideal procedure leading to the diagnosis, the localization of the infectious sites, and to the demonstration of an abscess and the presence of air in the mediastinum. We report a case of a patient in whom the early use of specific imaging and of proper aggressive surgical intervention did not allow the elimination of a fatal outcome.

Reported is a new case of a Kaposi's sarcoma involving only the colorectal area in an HIV-negative patient presenting with hemorrhagic rectocolitis. The colonoscopic examination and the radiological imaging showed the presence of multiple nodular pseudopolypoid formations in the rectum, which suggested, in the differential diagnosis, primarily a malignant non-Hodgkin lymphoma.

To assess perflubron for magnetic resonance (MR) imaging in the abdomen and pelvis in a multicenter trial.MR images were obtained in 127 subjects before and after ingestion of perflubron with T1-, proton-density-, and T2-weighted sequences at 0.38, 1.0, or 1.5 T. Postcontrast images were compared with baseline images, and percentage of additional bowel darkened, distinction of bowel from adjacent tissue, and change in image artifact were graded.Perflubron increased the bowel darkening in over 92% of subjects with all sequences and field strengths. It improved definition of the left lobe of the liver and body and tail of the pancreas in 67%, 29%, and 42% of subjects, respectively, and of the uterus and bladder in 80% and 76%. Abnormal tissue was more conspicuous in 69% of subjects. Highest scores were achieved when the upper abdomen was imaged 5-30 minutes and the pelvis 10-40 minutes after ingestion. No image artifacts or side effects were attributed to perflubron.Perflubron is safe, and its efficacy was unaffected by pulse sequences, magnetic field strength, or time delay.

Very high frequency (13 MHz) ultrasonographic examination of the neck successfully visualized one or more normal lymph nodes (weakly echoic oval structures with an echoic central hilum) in 67.6% of 1000 healthy volunteers. Efficacy was not related to recent ear, nose, and throat infection, sex, or age. The longitudinal-transverse diameter ratio was greater than or equal to 2 in 86.2% of cases. No signal was detected with color Doppler imaging. One or more thyroid nodules were also identified in 34.7% of the subjects: the frequency was 44% in women and 42% in subjects over 50 years of age.

Endoscopic reflux therapy has gained more and more popularity, and the use of this method is increasing. These imaging patterns (well known by pediatric radiologists) should be known by the general radiologist as the first young patients treated 20 years ago are now adults.

The solitary intraperitoneal fibrous tumor is a rare lesion, almost exclusively benign. We report on three cases with different ultrasound, computed tomography and magnetic resonance imaging findings, related to the fibrous and/or cellular histological composition of the tumor. Because of the minimal, but real, possibility of a recurrence after the surgical intervention, a follow-up by radiological imaging is recommended.

To evaluate renal function before and after suprarenal inferior vena cava (IVC) filter placement.We describe, in a personal series of 13 consecutive cases (all of them stage IV cancer patients, one LGM filter, one Antheor filter, 11 Greenfield filters) in our institution, two cases of fatal renal vein thrombosis after placement of a suprarenal filter. Evaluation of renal function was based on serum urea (in mmol/L; normal 3.30-6.60), serum creatinine (in micromol/L; normal115.1), and calculation of serum creatinine clearance.This study suggests that in advanced-stage cancer patients who have a single functional kidney, renal functional insufficiency, or previous renal vein thrombosis, IVC filter placement above the renal veins may not be appropriate. Suprarenal filter placement should be performed only after analysis of predicted survival, after detailed discussions with the patient, and most importantly after renal function evaluation.

We present three cases of endometriosis developing in the abdominal wall following cesarean section. The patients were examined by Doppler ultrasonography (US) and magnetic resonance imaging (MRI). The object is to describe the US and MRI findings of the lesion and evaluate their role in the diagnosis and management. In our opinion, a single procedure is sufficient in evaluating the lesion and in reaching the diagnosis.

Clinical, radiographic (mammograms), and ultrasonographic data were compared retrospectively for 171 patients to evaluate the utility of ultrasound for the follow-up of breast cancer patients treated medically or by conservative surgery. When used to follow patients treated medically by induction or exclusive chemotherapy, ultrasonography accurately quantified tumor and nodal regression. After conservative surgery, sonograms are ideal to diagnose (and sometimes to treat) early complications such as hematoma, lymphocele, and abscess. Ultrasonography was more sensitive than mammography for the detection of late complications and benign lesions, but was insufficient for the detection of recurrent disease (95.5% sensitivity for radiography vs 90% for ultrasonography). After radical surgery and breast reconstruction, ultrasonography is the only procedure required for follow-up of patients with breast implants because it can determine the size and penetration of cutaneous recurrences. The fact that 30% of patients treated by lumpectomy and irradiation ultimately develop malignant or benign abnormalities justifies systematic ultrasonography for the follow-up of treated breast cancers. All sonographically demonstrable abnormalities warrant ultrasound-guided puncture biopsy.

The lipomatous tumors of the adrenals are hormonally inactive lesions, often of a benign nature, such as myelolipomas, lipomas, angiomyolipomas, or mature teratomas, and are rarely malignant, such as liposarcomas. The importance of recognizing their characteristic radiological images, which would lead to their correct treatment, is fundamental since there has been an increase in the demonstration of this lesion, often detected incidentally. The various imaging procedures, although not allowing to formulate a histological diagnosis, nonetheless permit to determine the volume of the tumoral mass and their evolution. These two factors are of significant importance in the planning of the correct surgical procedure, while a third important factor is the proper evaluation of the symptoms presented by the patient. Regarding the treatment, on the basis of our own experience, which agrees with that of other authors, the surgical removal of any lesion greater than 5 cm is mandatory.

We report six cases of lipomas of the right colon, of which one was affected by two lesions. Two cases presented with episodes of partial occlusion; the others did not present with particular symptoms. The diagnoses were based on imaging by computed tomography, which demonstrated an intraluminal formation of fatty density, not associated with tissual components or hypervascularization.

We report a case of a patient admitted to our hospital for acute pelvic pain. Ultrasounds and abdominal CT scan found a voluminous mass situated in the upper urinary bladder and contiguous to the uterus and to the ovaries. Magnetic resonance imaging identified a pedicle connecting the uterus to the mass which had an aspect of a necrobiotic leiomyoma. Laparoscopic surgery confirmed the diagnosis of acute torsion of a subserous uterine leiomyoma.

Pelvic magnetic resonance is a simple and non-invasive imaging technique for dynamic and static assessment of the pelvic floor. The morphology of the support system is assessed by T2-weighted images. Dynamic sequences are used to assess pelvic prolapse. In this study we illustrate the normal and pathologic features of the levator ani muscle which represents the main active support of pelvic organs. Furthermore we describe the different types of prolapses, floor by floor, and the different staging techniques.

An aortic embolus of cement occurred in a 72-year-old woman after lumbar percutaneous vertebroplasty for breast cancer metastasis. A CT scan during the procedure revealed cement migration into the aorta via the lumbar artery. The cement embolus in the aorta, along with the hook-shaped cement fragment in the lumbar artery, was asymptomatic. Thereafter, a CT scan 4 months later still showed the presence of cement in the aorta and the lumbar artery at the level of the vertebroplasty. The patient is free of complaints after 4 months without anticoagulant treatment. This rare complication occurred because the collateral arterial supplies to the breast metastasis and the retrograde migration of cement during the vertebroplasty were not recognized. Proper techniques can minimize the risk of arterial embolism caused by cement during the procedure.

We report the 32nd case of congenital absence of portal vein in an 18-year-old female adult associated with multiple focal nodular hyperplasia of the liver. The association of various hepatic tumors has been observed in half of the publications about congenital absence of portal vein. Hepatic tumors seem to result from systemic diversion of portal vein flow with a resultant increase of arterial flow causing important vascular and nutritif changes the liver and consequent parenchymal transformation.

We report on the case of a patient admitted for epigastric pain. An abdominal ultrasound revealed a voluminous cystic lesion of the left hepatic lobe. In magnetic resonance imaging, the mass had a liquid–liquid level that was spontaneously hyperintense on T 1 -weighted images and hypointense on T 2 -weighted images. Magnetic resonance cholangiography identified bilateral intrahepatic bile duct dilatation. A left hepatectomy finally revealed a mucinous cystadenoma with pseudo-ovarian stroma that had a pedunculated intraductal extension to the biliary convergence.

A series of 50 patients presenting with lumbar discogenic disease, and treated by percutaneous discectomy using the Dekompressor system (Stryker, Kalamazoo, MI, USA), were followed for more than 6 months, by analyzing the evolution of the painful symptomatology with the visual analog scale (VAS) system. All patients had been under treatment with analgesic or anti-inflammatory agents. The intensity of the pain was measured 2, 7, 30, and 180 days after the percutaneous discectomy. An improvement in the painful symptomatology of less than 30%, observed in 11 cases and in 1 case of epidural pathology, was considered an unsuccessful result. A decrease of the pain of more than 70% was observed in 72% of cases, either with the end of the symptoms of pain as noted in 79.5% of patients or with a marked reduction of the medical treatments obtained in 21.5%. The results obtained were already almost definitive at the seventh day of follow-up, and further controls rarely demonstrated an improvement in the pain. The location of the herniated disc is a parameter which appears to be very important in the efficacy of percutaneous discectomy. We noted an improvement of more than 70% in 79% of the posterolateral foraminal or extraforaminal hernias, although these favorable results were observed only in 50% of the posteromedian hernias.

We report a series of six benign peripheral neurogenic tumors (five schwannomas and one neurofibroma) studied by 3D ultrasonography (US) and magnetic resonance imaging (MRI). The findings demonstrated by US and MRI are variable, but usually permit the diagnosis of benign nervous tumor without prejudging the final histological diagnosis. MRI does not bring forward further complementary images to those observed at US, which is limited by its dependence on its operator. The use of 3D US will be sufficient for the diagnosis and preoperative evaluation of a lesion when it is possible to furnish the volumetric data and the tools necessary for data analysis in a single document (in a CD).