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BackgroundRheumatoid arthritis (RA) is characterized by endothelial activation (EA), endothelial dysfunction and vascular inflammation, leading to accelerated atherosclerosis. In the last decade, a renewed interest in cryotherapy - local or whole body - has emerged. Although growing evidence demonstrated that ice cryotherapy reduces not only pain but also disease progression, whether such therapy might blunt disorders of the systemic vasculature is unknown.ObjectivesThe aim of our study was to determine the effects of a subchronic treatment with ice cryotherapy on aortic leucocyte infiltration and markers of endothelial activation in the rat adjuvant-induced arthritis (AIA) model.MethodsAIA was induced by injection of Mycobacterium butyricum in Freund’s incomplete adjuvant at the base of the tail in 6-week-old male Lewis rats. AIA rats were treated or not with ice applied on paws, from the onset of arthritis to the acute inflammatory stage of the disease, twice a day for 14 days. Arthritis score and paw skin temperature were daily monitored. At the end of the treatment, leucocyte infiltration and the different cell subsets (monocytes/macrophages, neutrophils, CD4+ and CD8+ T cells producing or not IL-17A) were measured in thoracic aorta using flow cytometry. Relative mRNA expression of cytokines/chemokines (IL-6, TNF-α, CXCL-1, MIP-1α (CCL-3), MCP-1 (CCL-2)) and adhesion molecules (ICAM-1, VCAM-1) was analyzed in thoracic aorta by RT-qPCR. X-Ray analysis of hind paws was performed to assign a radiographic score.ResultsTreatment with ice cryotherapy, that decreased skin surface temperature from 28.6 ± 0.3°C to 18.5 ± 0.2°C, reduced arthritis score (-36%, p+, CD8+ and Tc17 cell aortic infiltration as compared to untreated AIA. By contrast, ice had no effect on endothelial activation markers except VCAM-1 mRNA expression that was significantly increased (p+ and CD8+ T cells in aorta and arthritis score.ConclusionIn the model of AIA that reproduces arterial wall inflammation recently characterized in rheumatoid arthritis by PET/CT [1], local ice cryotherapy exerts not only local beneficial effects on the joints but also systemic benefits on vascular inflammation in large vessels. These results suggest that reduction of vascular comorbidities might be a new output of ice cryotherapy used as an adjunctive therapy in RA.References[1]Agca et al. Rheumatology (Oxford) (2021)Disclosure of InterestsNone declared.

Introduction La polyarthrite rhumatoide (PR) est caracterisee par une surmortalite d’origine cardiovasculaire, qui est la consequence d’une dysfonction et d’une activation endotheliales (infiltration vasculaire par les cellules de l’immunite), et d’une inflammation vasculaire. Ces dernieres annees, un regain d’interet pour la cryotherapie locale ou corps entier en tant que therapie d’appoint a emerge. Alors que des donnees existent en faveur d’un effet positif de la cryotherapie locale sur la douleur et l’activite de la maladie, l’effet de ce type de strategie sur le risque cardiovasculaire est pour l’instant inconnu. L’objectif de notre etude a ete d’evaluer l’effet d’un traitement par cryotherapie locale (par spray froid) sur l’inflammation vasculaire, l’activation endotheliale et la dysfonction endotheliale dans le modele d’arthrite induite par adjuvant chez le rat (AIA). Materiels et methodes Le modele AIA a ete induit par injection de Mycobacterium butyricum en suspension dans l’adjuvant incomplet de Freund a la base de la queue de rats Lewis âges de 6 semaines. Un groupe controle (n = 15) a recu le volume equivalent en serum physiologique. Des les premiers signes d’arthrite (j10), les rats (n = 10–15) ont ete traites ou non par l’application de spray froid sur les pattes arriere, deux fois par jour pendant 14 jours. Le score arthritique a ete mesure quotidiennement. A la fin du traitement (J24), l’expression de l’ARNm des cytokines/chimiokines (IL-6, TNF-α, CXCL-1, MIP-1α, MCP-1), des marqueurs d’activation endotheliale (ICAM-1, VCAM-1) et de dysfonction endotheliale (Arginase-2, eNOS, COX-2, p22phox, p47phox) a ete evaluee dans l’aorte thoracique par qRT-PCR. Les taux sanguins de cytokines (IL-6, IL-1β, TNF-α, IL-17A) ont ete mesures (Luminex ou ELISA). Resultats Compares aux rats controles, les rats AIA presentent une arthrite severe (score 4.4/6), associee a une expression augmentee au niveau vasculaire des marqueurs de dysfonction endotheliale, d’IL-6, TNF-α, CXCL-1 mais pas de MIP-1α, MCP-1, ICAM-1 et VCAM-1. Compare au groupe AIA non traite, le traitement par cryotherapie a significativement reduit le score arthritique a j24 (−38 %, p Discussion A la phase maximale de l’inflammation, le modele AIA se caracterise par une expression augmentee des cytokines vasculaires et des marqueurs de dysfonction endotheliale mais pas des marqueurs d’activation endotheliale. Un traitement chronique par cryotherapie locale permet non seulement de reduire la severite de l’arthrite mais aussi de reduire l’expression des cytokines au niveau vasculaire ainsi que des proteines impliquees dans la dysfonction endotheliale. Conclusion La cryotherapie locale exerce un effet anti-inflammatoire au niveau de la vasculature systemique, suggerant que cette strategie pourrait avoir un interet dans la prise en charge des comorbidites vasculaires en cas de PR.

Background:The control of joint destruction caused by rheumatoid arthritis (RA) is a key issue in the treatment of this disease. Recent evidence showed that radiographic progression of joint damage occur despite a sharp decrease in disease activity and the use of aggressive Disease Modifying Anti-Rheumatic Drug (DMARD) therapies [1]. Whether alternative treatments such as cryotherapy may have beneficial effects on joint destruction at the early stages of the disease remains to be demonstrated, but such strategy would be of interest as it would not interfere with DMARDs treatment.Objectives:The aim of this study was to evaluate the effect of a 14-days-treatment of local cryotherapy on radiological outcomes in rat adjuvant induced arthritis.Methods:Adjuvant-induced arthritis (AIA) was induced in 6-weeks old male Lewis rats by injection ofMycobacterium butyricumin Freund’s incomplete adjuvant at the basis of the tail. A control group received saline. At the onset of arthritis, AIA rats were treated or not by application of cryotherapy on paws using either a cold spray or ice, twice a day for 14 days. Arthritis score and paws skin temperature was daily monitored. At the end of treatment, radiological exam of hind paws was performed and a score taking into account (swelling, osteoporosis, cartilage destruction, bone erosion, bone destruction and new bone formation) was assigned, according to Ackermanet al[2]. Circulating levels of cytokines (IL-6, IL-1β, TNF-α) was measured by Magpix Luminex kit.Results:Compared to untreated AIA, local cryotherapy significantly reduced the progression of arthritis score, whatever the modality (pConclusion:These data demonstrated that local cryotherapy had positive effects on structural damage in adjuvant-induced arthritis. The mechanisms involved remain now to be determined. These results suggest that local cryotherapy would be an interesting complement to conventional DMARDs in early RA.References:[1] Ten Klooster, P. M.et al.Radiographic progression can still occur in individual patients with low or moderate disease activity in the current treat-to-target paradigm: real-world data from the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry.Arthritis Res. Ther.21, 237 (2019).[2] Ackerman, N. R.et al.Effects of naproxen on connective tissue changes in the adjuvant arthritic rat.Arthritis Rheum.22, 1365–1374 (1979).Disclosure of Interests:Célian Peyronnel: None declared, Valentin Petitcolin: None declared, Perle Totoson: None declared, Hélène Martin: None declared, Frank Verhoeven: None declared, Céline Demougeot Grant/research support from: With an institutional support from Pfizer.

Resume L’hemangiome, lesion hepatique non kystique la plus frequente et de decouverte fortuite dans la majorite des cas, peut dans certaines situations poser des problemes diagnostiques en imagerie. Dans cet article, nous montrerons tout d’abord que l’aspect radiologique de l’hemangiome hepatique, dans sa forme typique, apparait intimement lie aux trois sous-types histologiques connus. Puis, nous verrons que certaines atypies doivent etre connues pour etablir un diagnostic. Nous observerons egalement les interactions potentielles entre l’hemangiome, la lesion vasculaire active et le parenchyme hepatique adjacent. Enfin, nous verrons les particularites pediatriques des hemangiomes hepatiques et illustrerons le cas d’un angiosarcome hepatique.

Objective To assess the value of magnetic resonance cholangiography with gadobenate dimeglumine (Gd-BOPTA) where there is a suspicion of bile leakage in the post-liver transplant patient. Patients and methods Eight patients who had undergone a liver transplant underwent 14 MR cholangiograms, five of whom presented bile leakage while the other three had no biliary system complications. The results were compared to conventional bile duct opacification (by endoscopy or t-tube cholangiogram). The analysis covered whether there was opacification of the common bile duct and intrahepatic bile ducts on T1-weighted sequences after an injection of Gd-BOPTA on delayed biliary excretion phase sequences that were carried out on average 74 min after the injection. Enhancing perihepatic collections were also taken into account. Results Opacification of the bile ducts on delayed-phase MR cholangiogram sequences was always seen in the absence of bile leakage, and was never found when leakage was present. Enhancing perihepatic collections pointed to bile leakage every time. Conclusion Gd-BOPTA-enhanced MR cholangiography is a simple and non-invasive technique for detecting bile leakage in the post-liver transplant patient.

Resume L’encephalopathie posterieure reversible (EPR) est une maladie rare mais severe du systeme nerveux central. Son contexte de survenue et son mode d’expression sont caracterises par un grand polymorphisme clinique, rendant le diagnostic parfois difficile. L’imagerie tomodensitometrique et/ou par resonance magnetique est souvent caracteristique, ce qui permet d’evoquer le diagnostic dans un contexte clinique evocateur. Certains aspects moins typiques doivent cependant etre connus afin de ne pas meconnaitre cette affection, dont l’evolution est conditionnee par la precocite du traitement.

One per cent of cases of mechanical occlusion of the small intestine are caused by internal hernias, the rarest type being an internal hernia through the broad ligament of the uterus, and representing approximately 5% of cases. While "conventional" treatment of mechanical occlusions of the small intestine is based on laparotomy, a laparoscopic approach is feasible in nearly half of cases, with an acceptable rate of morbidity. Preoperative diagnosis has for a long time been difficult but the usefulness has recently been emphasized of computed tomography. We report the cases of two patients who presented an internal hernia of the right broad ligament diagnosed with CT who afterwards underwent laparoscopic surgery.

Abdominal wall endometriosis is unusual and mostly occurs in scars following Cesarean section. Although malignant transformation is rare, it must be recognized in order to benefit from radical resection. We report a very rare case of mixed endometrioid and serous carcinoma developing in a Cesarean section endometriosis scar and the way we managed it using surgery and chemotherapy. 18-FDG PET-CT imaging was performed to correctly stage the disease.

Hepatic necrosis after ethanol ablation for hepatocellular carcinoma (HCC), although rare, is well known and described, particularly in patients with chronic liver disease. The present report describes a rare case of massive hepatic necrosis with partial gastric, splenic, and pancreatic infarctions after local treatment of liver HCC with ethanol ablation and discusses the reasons for this complication. With the increasing use of percutaneous techniques to treat liver tumors, it is imperative for the interventional radiologist to be aware of the potential vascular complications of these techniques. An appreciation of vascular anatomy via multidetector computed tomography (CT) and/or magnetic resonance (MR) angiography is important when planning image-guided interventions.

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

Purpose. To review the histological features of 26 circumscribed liver lesions associated with liver capsule retraction and discuss the differential diagnosis while evaluating for the presence of fibrous stromal reaction. Materials and methods. Retrospective study performed between January 2005 and June 2008 including 26 patients: 18 males and 6 females, without history of cancer, aged between 42 and 82 years (mean age: 64.5 years), presenting with liver capsule retraction adjacent to a circumscribed liver lesion detected on CT or MRI. A single lesion was present in 17 patients, and multiple lesions were present in 9 patients. All liver lesions were biopsied with semi-quantitative evaluation of fibrous stromal reaction. Results. Twenty-one patients had benign or malignant liver tumors and 5 patients had confluent hepatic fibrosis. Twenty of 21 liver tumors were malignant (95.2%): 3 intra-hepatic cholangiocarcinoma, 17 cases of metastatic disease including colorectal carcinoma (n=8), bronchogenic carcinoma (n=1), pancreatic carcinoma (n=4), esophageal carcinoma (n=1), breast carcinoma (n=1), gallbladder carcinoma (1) and endocrine neoplasm of the pancreas (n=1), and 1 case of liver sclerosing angioma (n=1). There was no case of hepatoma. Excluding the 5 cases of confluent hepatic fibrosis, fibrous stromal reaction was present in 15 of 21 cases. Conclusion. The presence of capsular retraction next to a circumscribed liver lesion, while non-specific, is suspicious. In keeping with previous reports, metastases were frequently the cause and intrahepatic cholangiocarcinoma was the most frequent primary tumor. In patients with chronic hepatocellular disease, confluent fibrosis was a frequent etiology. The fibrous component of the underlying malignant lesion along with its subcapsular location appear to be determining factors in the development of capsular retraction.

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

International audience; Objectives: Compare tomosynthesis to mammography, ultrasound, MRI, and histology for the detection and staging of BI-RADS 4—5 anomalies, as a function of breast composition, lesion location, size, and histology.Patients and methods: Seventy-five patients underwent mammography, tomosynthesis, ultrasound, and MRI. The diagnostic accuracy of the different examinations was compared.Results: The sensitivities for detection were as follows: 92.5% with MRI, 79% for ultrasound, 75% for tomosynthesis, and 59.5% for mammography. Tomosynthesis improves the sensitivity of mammography (P = 0.00013), but not the specificity. The detection of multifocality and multicentricity was improved, but not significantly. Tomosynthesis identified more lesions than mammography in 10% of cases and improved lesion staging irrespective of the density, but was still inferior to MRI. The detection of ductal neoplasia was superior with tomosynthesis than with mammography (P = 0.016), but this was not the case with lobular cancer. The visualization of masses was improved with tomosynthesis (P = 0.00012), but not microcalcifications. Tomosynthesis was capable of differentiating lesions of all sizes, but the smaller lesions were easier to see. Lesion sizes measured with tomosynthesis, excluding the spicules, concurred with histological dimensions. Spicules lead to an overestimation of the size.Conclusion: In our series, tomosynthesis found more lesions than mammography in 10% of patients, resulting in an adaption of the surgical plan.

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

International audience

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

Posterior reversible encephalopathy syndrome (PRES) is a rare but severe condition of the central nervous system. It develops in a variety of clinical settings and it has diverse patterns of expression, which can sometimes make diagnosis difficult. Characteristic features are often demonstrated on computed tomography imaging and/or magnetic resonance imaging, meaning that when there is a suspicious clinical picture, this diagnosis should suggest itself. However, clinicians should be aware of some of the less typical features in order to more fully understand this condition, in which early treatment is key to good clinical progress.

Peribiliary cysts are common in patients with chronic liver disease. Ambiguous imaging features and association with cirrhosis-induced hyperbilirubinemia may lead to misdiagnose an obstructive jaundice. Magnetic resonance cholangiopancreatography (MRCP) may be a useful sequence by showing small cystic structures with a specific periportal distribution on both sides of the portal veins, which do not communicate with the biliary ducts. These abnormalities may be recognized in order to avoid unnecessary endoscopic retrograde cholangiography.

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

To review the histological features of 26 circumscribed liver lesions associated with liver capsule retraction and discuss the differential diagnosis while evaluating for the presence of fibrous stromal reaction. Materials and methods. Retrospective study performed between January 2005 and June 2008 including 26 patients: 18 males and 6 females, without history of cancer, aged between 42 and 82 years (mean age: 64.5 years), presenting with liver capsule retraction adjacent to a circumscribed liver lesion detected on CT or MRI. A single lesion was present in 17 patients, and multiple lesions were present in 9 patients. All liver lesions were biopsied with semi-quantitative evaluation of fibrous stromal reaction.Twenty-one patients had benign or malignant liver tumors and 5 patients had confluent hepatic fibrosis. Twenty of 21 liver tumors were malignant (95.2%): 3 intra-hepatic cholangiocarcinoma, 17 cases of metastatic disease including colorectal carcinoma (n=8), bronchogenic carcinoma (n=1), pancreatic carcinoma (n=4), esophageal carcinoma (n=1), breast carcinoma (n=1), gallbladder carcinoma (1) and endocrine neoplasm of the pancreas (n=1), and 1 case of liver sclerosing angioma (n=1). There was no case of hepatoma. Excluding the 5 cases of confluent hepatic fibrosis, fibrous stromal reaction was present in 15 of 21 cases.The presence of capsular retraction next to a circumscribed liver lesion, while non-specific, is suspicious. In keeping with previous reports, metastases were frequently the cause and intrahepatic cholangiocarcinoma was the most frequent primary tumor. In patients with chronic hepatocellular disease, confluent fibrosis was a frequent etiology. The fibrous component of the underlying malignant lesion along with its subcapsular location appear to be determining factors in the development of capsular retraction.

Epithelioid hemangioendothelioma of the liver is a very rare vascular tumour in children with intermediate malignant potential. We present a case in which the typical imaging appearances of coalescent peripheral hepatic masses with capsular retraction contributed to the diagnosis. A positron emission tomography-CT (PET-CT) procedure was performed in staging the disease with a strong suspicion of coeliac nodal involvement confirmed after laparotomy and histological analysis. Our case is unique because of the rarity of the disease, the young age of the child, and proven nodal metastases at initial diagnosis. The use of PET-CT allows better staging at initial diagnosis and thus better management with improved follow-up in these patients.

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

To measure breast radiation dose from multidetector CT using three different low dose protocols and compare it to a standard two view chest examination. To compare the number of pulmonary nodules detected at low and standard dose.Thermoluminescent dosimetry was used to measure the absorbed dose on a phantom (Rando) and 10 patients. Then, we compared the standard dose to the low dose examinations. The Wilcoxon rank test and the kappa test were used to assess differences in the detection of nodules.The absorbed dose of these low dose protocols correspond to the radiation dose for the acquisition of two to ten chest radiographs (two views). This study suggests that only the 30 mA protocol is sufficient for the detection of all pulmonary nodules; nodules smaller than 5 mm were overlooked at 10 mA.A good image quality can be obtained with low dose protocols at multidetector CT (correspond to 2 to 10 chest radiographs).

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

To determine the evolution of the diameter of the thoracic aorta with age in order to detect dilatation more reliably by imaging, we performed a retrospective analysis of the MRI examinations of the normal thoracic aorta of 66 subjects aged 44.1+/-19.1 years (range 19.1-82.4 years) obtained between 1991 and 2000 on a Magnetom SP 42 1T apparatus (Siemens) using T1-weighted spin echo sequences with electrocardiographic synchronization. Sixteen measurements were made in the axial plane, the oblique sagittal plane in the axis of the aortic arch, and the oblique frontal plane perpendicular to the latter at the level of the ascending aorta, the arch and the descending thoracic aorta. We found an increase in the thoracic aorta diameter and a significant relationship between this diameter and the age of our subjects, wherever the measure was performed. However, there was no systematic correlation between aortic diameter and age. The aortic diameter evolved with age and a marked difference seemed to exist in measurements made in groups younger and older than 40 years. This study, conducted on a small population of 66 patients, thus helps to define a normal aortic diameter, thereby making the diagnosis of pathological dilatation of the aorta more reliable.

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