Introduction L’utilisation de la classification CAD-RADS 2.0 est recommandée pour les comptes rendus de TDM cardiaques centrés sur les coronaires par plusieurs sociétés savantes. Données récentes Dans un premier temps, cet article rappelle les bases de la classification CAD-RADS 2.0 permettant son utilisation : la détection et la caractérisation des plaques, la quantification de la sévérité des sténoses et l’évaluation de la charge athéromateuse globale. Est ensuite présenté le rationnel scientifique qui sous-tend la nécessité de son utilisation pratique pour les imageurs ainsi que les arguments pour convaincre les médecins correspondants demandeurs de s’y intéresser afin qu’ils l’intègrent dans leur pratique clinique. Conclusion L’utilisation de la classification CAD-RADS comme moyen de communication cardiologue/radiologue est un outil utile pour améliorer la prise en charge des patients.

To evaluate the ability of ECG-gated spin-echo (SE)-MR imaging vs. cine-MR imaging to assess coarctation of the aorta, 11 patients aged 15-45 years, with known or suspected coarctation of the aorta, and five patients suspected of re-stenosis or postoperative false-aneurysms after coarctation repair were examined by multisection SE-MR imaging and single-section multiphase cine-MR imaging on a 1.0 Tesla device. Aortography was performed in 15, and surgery in 14 of these 16 patients. Qualitatively, the location, severity, and length of the coarctation were shown in all cases with MR imaging, as well as the relationship with the arteries arising from the aortic arch. The respective sensitivities and specificities in the assessment of severity of stenoses were 86% and 100% for SE MR images, and 100% and 100% for cine-MR images. Cine-MR imaging was superior to SE imaging in stenosis diameter assessment with contrast angiography as reference, as well as to identify the site of leakage in cases of postoperative pseudoaneurysm. Pre-stenotic dilation or post-stenotic aneurysm, collateral channels, and associated malformations were better identified on SE images. Quantitatively, a better stenosis diameter correlation was found between cine-MR images and angiography than between SE-MR images and angiography (r=0.99 vs. r=0.78; p=0.001 vs. p=0.004), related to overestimation of stenoses with SE-MR imaging. The use of a combination of spin-echo and cine-MR imaging correlates well with conventional angiographic findings in this small series of patients with coarctation of aorta or postoperative pseudoaneurysmal complications. Cine-MRI can provide anatomic information that is equivalent to angiography for surgical planning.

Prior information to patients concerning the risks associated with intravenous injection of contrast media for diagnostic imaging is rarely performed in France. Purpose: Evaluate patients' desire for information about risks of intravenous injection of contrast material and its impact on their level of confidence. Material and methods: Two hundred and twenty seven adult patients, while awaiting a CT scan with injection, read an information form reviewing the risks associated with intravenous injection of contrast material. They filled out an answer sheath concerning their desire to be informed and the impact of that information on their level of confidence. Two levels of risk were evaluated, one where the risk of death was included and one where the risk of death was not included. Results: Eighty six percent of patients wished to be informed about the risks; eleven per cent felt they became more anxious after being informed, irrespective of the mention or not of the risk of death. Conclusion: Patients wish to be informed about the risks associated with the intravenous injection of contrast material. This information seems to create only mild anxiety.

UNLABELLED Prior information to patients concerning the risks associated with intravenous injection of contrast media for diagnostic imaging is rarely performed in France. PURPOSE Evaluate patients' desire for information about risks of intravenous injection of contrast material and its impact on their level of confidence. MATERIAL AND METHODS Two hundred and twenty seven adult patients, while awaiting a CT scan with injection, read an information form reviewing the risks associated with intravenous injection of contrast material. They filled out an answer sheath concerning their desire to be informed and the impact of that information on their level of confidence. Two levels of risk were evaluated, one where the risk of death was included and one where the risk of death was not included. RESULTS Eighty six percent of patients wished to be informed about the risks; eleven per cent felt they became more anxious after being informed, irrespective of the mention or not of the risk of death. CONCLUSION Patients wish to be informed about the risks associated with the intravenous injection of contrast material. This information seems to create only mild anxiety.

Purpose: The aim of this study was to determine discriminating CT and HRCT features between mycobacterial pulmonary tuberculosis and nontuberculous mycobacterial (NTMB) pulmonary infections in patients with AIDS.Method: CT and HRCT scans of 52 AIDS patients with culture-proven mycobacterial infection [29 with Mycobacterium tuberculosis (MTB) and 23 with NTMB] without concomitant pulmonary infection were reviewed by two observers.Results: Nodular opacities, mainly centrilobular in distribution, were the most common finding, seen in 21 (72%) and 15 (65%) of patients with MTB and NTMB, respectively. A lower lobe predominance of centrilobular nodules was seen more commonly in NTMB (p < 0.03). Ground-glass attenuation was seen in 5 (17%) and 11 (48%) of patients with MTB and NTMB, respectively (p = 0.03). Ground-glass opacities and bronchial wall thickening affected a larger number of lobes in NTMB (p < 0.01), while centrilobular nodules involved more lobes in MTB (p < 0.01). A higher prevalence of unilateral lung involvement was seen in MTB (12 patients, 44%) than NTMB (1 patient, 5%) (p < 0.01). Enlarged lymph nodes were more frequent in patients with MTB than in those with NTMB (22, 76% vs. 10, 43%, respectively) (p < 0.02).Conclusion: NTMB infection and pulmonary tuberculosis display different CT and HRCT patterns in AIDS patients, but there is considerable overlap in CT findings.

The results of MR angiography at 1.0 T with digital intraarterial angiography in the screening of patients with suspected renal hypertension were compared. In this first phase of the study, 10 volunteers underwent examination with both two-dimensional (2D) with traveling saturation time-of-flight (TOF) magnetic resonance angiography (MRA) with various parameters to develop a protocol for evaluation of the renal arteries. In the second phase, 36 patients with suspected renovascular hypertension underwent both 2D TOF MRA and intraarterial digital angiography to evaluate the clinical value of MRA. The degree of stenosis was graded with a two-point scale. In volunteers, using 2D acquisitions C/N ratios indicated the best flip angle as being 55 degrees (p = .02). MRA showed 100% (70/70) of all main arteries and 86% (6/7) of all accessory renal arteries seen on angiography. MRA had a sensitivity of 94% (15/16) and a specificity of 98% (60/61) for detection of stenoses of greater than 50% present in 14 patients. 2D-TOF MRA at 1.0 T shows promise in the noninvasive diagnosis of patients with suspected renovascular hypertension.

Purpose : To evaluate magnetic resonance venography (MRV) in the detection of cervical/mediastinal venous thrombosis (CMVT). Methods: MR venograms were performed in 20 patients suspected for CMVT. 2D-TOF MR venography was used for all studies. MR and conventional venographic/surgical data were collected prospectively and analyzed in a blinded manner comparatively to other corroborative studies: venography (n = 8), color-Doppler studies (n = 15), CT (n = 12), and/or surgery (n = 6). Results: MRV was 100% sensitive and 100% specific in the diagnosis of venous thrombosis (VT) of the cervical/mediastinal veins, present in fourteen patients, and 93% accurate in grading the extension of CMVT. MR images showed a greater number of collateral vessels than detected by contrast venography in case of complete cervical/mediastinal venous thrombosis. Conclusion: The positive diagnosis and extent of GMVT can be accurately diagnosed by a non-invasive method such as MRV.

PURPOSETo evaluate magnetic resonance venography (MRV) in the detection of cervical/mediastinal venous thrombosis (CMVT).METHODSMR venograms were performed in 20 patients suspected for CMVT. 2D-TOF MR venography was used for all studies. MR and conventional venographic/surgical data were collected prospectively and analyzed in a blinded manner comparatively to other corroborative studies: venography (n = 8), color-Doppler studies (n = 15), CT (n = 12), and/or surgery (n = 6).RESULTSMRV was 100% sensitive and 100% specific in the diagnosis of venous thrombosis (VT) of the cervical/mediastinal veins, present in fourteen patients, and 93% accurate in grading the extension of CMVT. MR images showed a greater number of collateral vessels than detected by contrast venography in case of complete cervical/mediastinal venous thrombosis.CONCLUSIONThe positive diagnosis and extent of CMVT can be accurately diagnosed by a non-invasive method such as MRV.

OBJECTIVE:This study was designed to compare the diagnostic value of MR venography and color Doppler sonography in the assessment of deep venous thrombosis. SUBJECTS AND METHODS:MR venograms and color Doppler examinations were obtained in 37 patients either with suspected deep venous thrombosis of the lower limbs or pelvis or with pulmonary embolism. Two-dimensional time-of-flight venography was used for all studies. MR and color Doppler data were collected prospectively and analyzed in a blinded manner. In a subset of 21 patients, MR venography and color Doppler sonography were prospectively compared with contrast-enhanced venography. RESULTS:When compared with contrast-enhanced venography, MR venography was 100% sensitive and 100% specific in the diagnosis of deep venous thrombosis above the knee. Color Doppler imaging depicted 13 of 15 cases of deep venous thrombosis and 5 of 6 venous examinations that had normal results, yielding a sensitivity and a specificity of 87% and 83%, respectively. The differences in sensitivity and specificity between MR venography and color Doppler sonography were not statistically significant. MR venography was 95% sensitive and 99% specific in detecting the extension of deep venous thrombosis, compared with the 46% sensitivity and 100% specificity of color Doppler sonography (differences in sensitivity, p < .01). MR images showed 29 collateral vessels, whereas only 21 were detected by contrast-enhanced venography (p < .04). CONCLUSION:MR venography seems to be more accurate than color Doppler sonography in detecting the extension of deep venous thrombosis. The positive diagnosis and extent of deep venous thrombosis can be easily detected and monitored by a noninvasive technique such as MR venography.

Radiation therapy (RT) is one of the cornerstones in cancer treatment and approximately half of all patients will receive some form of RT during the course of their cancer management. Response evaluation after RT and follow-up imaging with 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) can be complicated by RT-induced acute, chronic or consequential effects. There is a general consensus that 18F-FDG PET/CT for response evaluation should be delayed for 12 weeks after completing RT to minimize the risk of false-positive findings. Radiation-induced late side effects in normal tissue can take years to develop and eventually cause symptoms that on imaging can potentially mimic recurrent disease. Imaging findings in radiation induced injuries depend on the normal tissue included in the irradiated volume and the radiation therapy regime including the total dose delivered, dose per fraction and treatment schedule. The intent for radiation therapy should be taken in consideration when evaluating the response on imaging, that is palliative vs curative or neoadjuvant vs adjuvant RT. Imaging findings can further be distorted by altered anatomy and sequelae following surgery within the radiation field. An awareness of common PET/CT-induced changes/injuries is essential when interpreting 18F-FDG PET/CT as well as obtaining a complete medical history, as patients are occasionally scanned for an unrelated cause to previously RT treated malignancy. In addition, secondary malignancies due to carcinogenic effects of radiation exposure in long-term cancer survivors should not be overlooked. 18F-FDG PET/CT can be very useful in response evaluation and follow-up in patients treated with RT, however, variants and pitfalls are common and it is important to remember that radiation-induced injury is often a diagnosis of exclusion.