Most gastroplasties performed to replace the esophagus are vascularized by the right gastroepiploic artery alone. Its origin, course and anatomical relations are classical and subject to little variation. Conversely, its mode of termination and relations to the left gastroepiploic artery have received quite different descriptions in the literature. This report describes the radiological anatomy of the right gastroepiploic artery based on arteriograms in 50 subjects. The right gastroepiploic artery was much larger (diameter 1.7 to 2.6 mm at its origin) than the left (absent in 3 cases) in our series. Direct end-to-end anastomosis of these two arteries, as described in classical reports, was found in only 23.5% of cases.
A retrospective study of 18 immunodepressed patients with acute invasive pulmonary aspergillosis enabled the radiologic picture of this increasingly frequent opportunist affection to be described, and different manifestations of the disease as a function of underlying conditions to be determined. Two groups could be distinguished: the first of patients with malignant blood diseases (n = 10) when the "aplasia" factor was dominant; the second of patients without blood diseases (n = 8) when the immunodepression was usually induced by a recent increase in corticoid therapy. Neutropenia was not a finding in any of these patients. The most frequent radiologic finding was single or multiple round excavating foci, these corresponding to zones of bronchopneumonia containing aspergillus filaments with central tissue necrosis forming the "target" lesion. The aplasia was distinguished by the multiplicity of lesions and their excavation following aplasia in the shape of a crescent due to sequestrum formation. Prognosis was related to severity of subjacent lesions. In the 2nd group, lesions could be single and nodular; prognosis was improved by the possibility of reducing immunodepression factors.
A prospective study in 60 consecutive patients evaluated gain in quality of image using ECG servo-assistance during pulmonary digital subtraction angiography (PDSA). Two groups of 30 comparable patients were randomly allocated to examination with ECG servo-assistance or three images per second technique. Criteria for assessment of quality of image were defined and used to compare results. No significant difference were noted and ECG servo-assistance failed to improve images during PDSA.
This technique of anti-cancer treatment of hepatic cancers has a twofold interest: it delivers local chemotherapy in direct contact with the tumours and it allows repeated access to the blood supply of the liver without the need for surgery. This second point is particularly emphasized in the form of a technical description of the method of approach to the hepatic arterial system, which is as non-aggressive as possible and which allows permanent vascular access. This study, which required close collaboration between the departments of Vascular Radiology, Radiotherapy and Surgery, was initially considered as a feasibility study of a technique enabling the simple use of implantable vascular access sites.
A case of sarcoidosis with lesions also localized to the cranial region is reported, and 21 similar cases published in the literature reviewed. Lesions are usually seen as small lacunae in the cranial vault, and are commonly associated with neurologic and cutaneous manifestations of the disease. They appear to be very rare but their frequency is probably underestimated. Their detection is facilitated by the use of technetium scintigraphy.
Over a 6-year period 23 patients with massive haemoptysis were treated at the Hôpital Tenon, Paris. Eighteen of these, usually considered "non-surgical" cases, underwent emergency embolization of the bronchial artery (B.A.E.). The immediate outcome was favourable in 14 patients; 4 died of early recurrence. B.A.E. therefore appears to be a valuable treatment of massive haemoptysis in "non-surgical" patients or in patients awaiting transfer to a thoracic surgery unit. However, because of the failure rate, B.A.E. cannot compete with thoracic surgery in its classical indications, and its effectiveness and safety should be compared with those of balloon catheter endobronchial tamponade in "non-surgical" patients.
A 24-year-old man presented clinically confirmed Behcet's disease. He developed thoracic pain accompanied by hemoptyses as a result of thromboses and aneurysm formation in the pulmonary artery. The presence of these aneurysms was suggested by perihilar images on standard radiography, and confirmed by pulmonary arteriography findings and results of histological examination of the operative specimen. Radiological and anatomical evidence of the presence of bronchial endarteritis lesions was also obtained.
The clinical predominance of varicoceles on the left side first induced radiologists to perform phlebographic examinations of the left spermatic vein. This procedure can easily be performed since the orifice of the left spermatic vein is nearly always on the lower side of the renal vein.
The authors describe 5 cases of bi-apical pulmonary fibrosis occurring during the course of ankylosing spondylitis. In 4 patients the lesions were advanced and detected during pneumological investigations. In the 5th patient, the lesions were at an early stage and were discovered during a retrospective study of 100 case-reports of patients with ankylosing spondylitis. Radiological signs were morphologically similar: localized pulmonary lesions of the two apices, of the retractile type and with a fibrous hilar framework, bullous images that were more or less extensive, raising of the two hili with compensatory distention at both bases, and pleural lesions consisting of thickening of both pleurae at the apices. The mean age of the patients at the time these lesions appear is 60 years, and they occur about 20 years after the onset of the articular disorder. These fibro-bullous lesions can be complicated by aspergillosis (20%) of pneumothorax (8%). The principal differential diagnosis is advanced tuberculous disease in the lung apices, and this explains why these patients have often been prescribed antituberculosis therapy.