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The objective of our study was to evaluate the impact of body mass index (BMI) on dose, diagnostic performance, and image quality of a low-dose CT examination for renal colic.This retrospective study included all patients who underwent a low-dose CT examination for renal colic performed during the year 2012 with automatic tube current modulation, adaptive statistical iterative reconstruction, and a low tube voltage (kV). Three readers independently reviewed all images for the presence of renal colic and evaluated diagnostic confidence and image quality. The results and doses were compared among patients grouped by body mass index (BMI) and between patients with a BMI25 and those with a BMI≥25.Eighty-six patients were included in the study: 39 patients had a BMI25 and 47 had a BMI≥25. No statistically significant difference was found between the accuracy rates for the diagnosis of renal colic when the rates of the three independent readers were averaged for both BMI groups (95.7% vs 96.4%, respectively; p=0.83). Image quality and diagnostic confidence scores were significantly better for patients with a BMI≥25 than for patients with a BMI25 (mean image quality score, 3.7 vs 3.4, p0.001; mean diagnostic confidence score, 2.8 vs 2.5, p0.001). The mean radiation dose for patients with a BMI25 was 2.4 mGy compared with 3.7 mGy for patients with a BMI≥25 (p0.001).The diagnostic performance of our low-dose CT protocol for renal colic was excellent for all patients, and image quality and diagnostic confidence were significantly better for patients with a BMI≥25. However, our protocol also required exposure to a greater dose of radiation for these overweight and obese patients.

Resume Objectifs Evaluer les connaissances des praticiens prescripteurs de scanner en matiere de radioprotection des patients. Materiels et methodes Un questionnaire a ete adresse a l’ensemble des praticiens prescripteurs de scanner de notre hopital. Ce questionnaire comportait plusieurs questions en rapport avec les pratiques et les connaissances des praticiens en matiere de radioprotection des patients. Resultats Quarante-quatre questionnaires ont ete analyses. Tandis que 70 % des praticiens declaraient prendre en compte les risques lies aux rayons X lors de la prescription d’un scanner, seulement 25 % de ceux-ci en informaient le patient. La connaissance des doses delivrees au cours d’un scanner abdomino-pelvien etait mal maitrisee et les risques potentiels lies aux faibles doses de rayons X etaient largement sous-estimes. Enfin, seulement un tiers des praticiens avait beneficie d’une formation a la radioprotection des patients. Conclusion Meme si la majorite des praticiens declare prendre en compte les risques lies aux faibles doses de rayons X, ces risques sont en fait peu ou mal connus. Une diffusion plus large de la formation en radioprotection des patients, notamment au cours du cursus initial des internes, pourrait etre une des solutions pour ameliorer les connaissances des praticiens hospitaliers en matiere de radioprotection des patients.

Pyomyositis is a primitive infection of the skeletal muscle usually caused by Staphylococcus aureus in tropical areas, and associated with immunodeficiency. We report a 49-year-old immunocompetent woman, living in a temperate climate presenting with a pyomyositis of adductor muscles caused by Escherichia coli. Diagnosis was obtained with magnetic resonance imaging (MRI). Disease course was uneventful after surgical debridement and antibiotics. This case report highlights the usefulness of MRI in the diagnosis of pyomyositis.

La Presse Medicale - In Press.Proof corrected by the author Available online since mercredi 27 fevrier 2013

To evaluate the knowledge of physicians prescribing CT examinations on the radiation protection of patients.A questionnaire was distributed to all clinicians on medical staff who prescribe CT examinations. Several questions related to their prescription pattern and their knowledge of radiation protection.Forty-four questionnaires were analyzed. While 70% of physicians claimed that they considered the risks from exposure to ionizing radiation when prescribing a CT examination, only 25% informed their patients about those risks. Knowledge of the radiation dose delivered during CT evaluation of the abdomen and pelvis was poorly understood and the risks related to small doses of radiation were grossly underestimated. Finally, only a third of clinicians had received training with regards to radiation protection.While most clinicians claim that they consider the risks from exposure to ionizing radiation when prescribing a CT examination, the risks are either not well known or not known at all. Increased formation of clinicians with regards to the radiation protection of patients, maybe through a dedicated clinical rotation while in medical school, could be a solution to improve the knowledge of hospital clinicians with regards to radiation protection.

Pyomyositis is a primitive infection of the skeletal muscle usually caused by Staphylococcus aureus in tropical areas, and associated with immunodeficiency. We report a 49-year-old immunocompetent woman, living in a temperate climate presenting with a pyomyositis of adductor muscles caused by Escherichia coli. Diagnosis was obtained with magnetic resonance imaging (MRI). Disease course was uneventful after surgical debridement and antibiotics. This case report highlights the usefulness of MRI in the diagnosis of pyomyositis.

Objectifs Mesurer et comparer la densite de paroi bronchique (DP) lors de differentes bronchopneumopathies. Materiels et methodes Les scanners non injectes en coupes millimetriques de 60 patients (âge moyen 46,8 ± 16,8) ont ete analyses. Les patients etaient repartis en 5 groupes selon leur pathologie : mucoviscidose (n = 16), asthme (n = 14), fumeurs atteints de bron-chopneumopathie chronique obstructive (BPCO) (n = 8), fumeurs a fonction normale (n = 11), patients non fumeurs (n = 11). La DP moyenne de la paroi des deux Bl et des deux B10 a ete mesuree (Myrian, Intrasense, Montpellier) et comparee entre les groupes par une ANOVA repetee. Les DP ont ete correlees aux parametres fonctionnels respiratoires. Resultats Les DP different entre les 5 groupes (mucoviscidose : -251 UH, BPCO : -306 UH, asthme : -380 UH, fumeurs : -462 UH, non fumeurs : -505 UH), (F-ratio = 4,09, p Conclusion La DP est un parametre simple permettant de differencier les bronchopneumopathies. Son substrat pourrait etre l’infiltration parietale en elements cellulaires.

Purpose To prospectively assess how to address requests for ultrasonographic examinations when setting up an on-call teleradiology service. Materials and methods An analytical prospective study was performed from January 2012 to December 2012 inclusively. All requests received for after-hours ultrasonographic examinations during this period were analyzed. Ultrasound requests were classified as being postponable until working hours, replaceable by an alternate cross-sectional imaging modality, or urgent and needing to be performed after hours. Results A total of 176 requests for ultrasonographic examinations were analyzed. They predominantly included requests for abdominal and pelvic ultrasonographic examinations (63%). Thirty-nine requests (22.2%) were considered as postponable, 49 (27.8%) as replaceable and 64 (36.4%) as both postponable and replaceable. Twenty-four requests (13.6%) were considered as urgent; they consisted of 10 requests for venous duplex Doppler ultrasonographic examinations of the lower limbs, eight requests for testicular ultrasonographic examinations, five for pelvic ultrasonographic examinations and one for soft-tissue ultrasonographic examination. In these urgent cases, realistic options were either to transfer the patient to another institution or to train emergency department physicians in ultrasonography for local handling. Conclusion Although the need for addressing requests for ultrasonographic examinations should be taken into account when setting up an on-call teleradiology service, it should not impede such plans.