Intussusception in adults is a rare condition often associated with a pathological lead point, which is frequently malignant but can occasionally be benign, such as colonic lipomas. We report the case of a 60-year-old male who presented with colicky abdominal pain, and a computed tomography (CT) revealed a colo-colic intussusception caused by a 6 cm lipoma in the transverse colon, accompanied by ischemic changes in the colonic mucosa. The patient underwent a right hemicolectomy, and histopathology confirmed the benign nature of the lesion. This case highlights the importance of early recognition and surgical intervention to prevent complications and rule out malignancy, especially in rare presentations like intussusception caused by lipomas.

Hepatic capsular retraction is an imaging feature that deserves the attention of the radiologist. Hepatic capsular retraction is associated with a number of hepatic lesions, benign or malignant, treated or untreated. The purpose of this pictorial review is to discuss the most common benign and malignant hepatic lesions associated with this feature with an emphasis on magnetic resonance imaging (MRI).

OBJECTIVE:The purpose of this study was to assess the feasibility and diagnostic performance of an unenhanced MR angiography sequence (Syngo Native Space, Siemens Healthcare) to detect and quantify lower-limb peripheral arterial disease (PAD), with gadolinium-enhanced MR angiography (CE-MRA) as the reference standard.SUBJECTS AND METHODS:Fifty-one patients known to have lower-limb arteriopathy were included in this prospective study. For every patient, we performed Native sequence and CE-MRA on a 1.5-T system. We evaluated examination duration, image quality, and location, number, and severity of lesions.RESULTS:Examination duration was longer for Native sequence (mean, 39.6 min, vs 10 min for CE-MRA). Image quality was significantly better for CE-MRA, with 92% of images listed as good to excellent for CE-MRA, compared to 53% for Native. Sensitivity, specificity, negative predictive value (NPV), and accuracy of Native were respectively 75%, 95%, 89%, and 88% for all mixed levels; 52%, 97%, 88%, and 87% for aortoiliac level; 87%, 99%, 95%, and 92% for femoropopliteal level; and 82%, 87%, 87%, and 85% for subpopliteal level. If we considered only patients with Leriche and Fontaine stage II arteriopathy, Native results were slightly better, with respective specificities and NPVs of 96% and 91% for all mixed levels; 98% and 90% for aortoiliac level; 98% and 93% for femoropopliteal level; and 91% and 90% for subpopliteal level.CONCLUSION:Unenhanced MR angiography, cheaper than CE-MRA, showed in our study a good NPV, which suggests its utility as first-line test to screen for PAD, especially in patients at risk of nephrogenic systemic fibrosis.

OBJECTIVE:The purpose of this research was to assess the feasibility and performance of an unenhanced 3D balanced steady-state free precession (SSFP) sequence, compared with contrast-enhanced MR angiography (CEMRA), which is the reference standard to detect and quantify renal artery stenoses (RAS).SUBJECTS AND METHODS:Fifty-one patients were included in this prospective study. Balanced SSFP sequence (Native) and CEMRA were performed using a 1.5-T magnet. Signal quality and stenosis grade were assessed per segment for renal arteries and for ostia of celiac trunk and superior mesenteric artery (SMA). We compared signal quality of Native and CEMRA. Sensitivity, specificity, negative predictive value (NPV), and accuracy were also calculated.RESULTS:Evaluation involved 114 renal arteries, 51 celiac trunks, and 51 SMAs. By use of CEMRA, 20 significant stenoses were found for renal arteries, 10 stenoses and three occlusions for celiac trunk, and three stenoses for SMA. At artery-by-artery analysis, sensitivity, specificity, accuracy, and NPV of the balanced SSFP sequence in detecting stenosis were respectively 85%, 96%, 94%, and 96% for renal arteries; 100%, 97%, 98%, and 100% for celiac trunk; and 100%, 100%, 100%, and 100% for SMA. No significant difference of signal quality was found for the entire examination and for the different segments evaluated except for hilar and intrarenal branches, which showed better signal quality on balanced SSFP sequence.CONCLUSION:The NPV results in our study suggest that unenhanced balanced SSFP MR angiography can be the first-choice imaging method to exclude RAS in patients at high risk of nephrogenic systemic fibrosis. However, when stenosis is found, other imaging modalities are necessary for better estimation.

OBJECTIVES:CT-guided transthoracic lung biopsy is widely used in pulmonary lesions diagnosis. This technique rarely entails severe complications such as pneumothorax and pulmonary hemorrhage which call for adequate candidates screening. The aim of our study is to statistically assess risk factors related to these two main complications, and determine the best diagnostic workup.MATERIALS AND METHODS:This retrospective study includes 110 patients who underwent CT-guided transthoracic biopsy of a pulmonary lesion. Rates of pneumothorax and pulmonary hemorrhage, as well as their severity, were evaluated, and a correlation with factors related to patients, lesions and biopsy technique were statistically analyzed.RESULTS:Higher rates of complications are significantly found with multiple punctures (pneumothorax risk multiplied by 7.4), longer intra-parenchymal needle tract (5 and 7% higher risk of pneumothorax and hemorrhage for every 1 mm increase in depth), and with smaller lesions (2 and 5% lower risk respectively for pneumothorax and hemorrhage for every 1 cm increase in lesion size). The presence of an interposing rib is associated with a higher rate of hemorrhage.CONCLUSION:Transthoracic lung biopsy is a minimally invasive technique. However, the presence of associated risk factors must lead to consider another diagnostic method.

Les angiomes veineux sont des malformations vasculaires veineuses (MV) congénitales rares ayant une prédilection crâniofaciale. Les angiomes veineux géants et intra-oraux peuvent être symptomatiquement sévères et nécessiter un traitement agressif. La thérapie actuelle est basée sur la sclérothérapie, combinée ou non à la chirurgie. Nous rapportons le cas d’un patient connu avoir une MV énorme de la face et de la langue traitée avec succès dans notre département par embolisation, sclérothérapie, et chirurgie maxillofaciale, en insistant sur l’intérêt du Surgiflo dans la sclérothérapie.

Cavernous hemangiomas are rare congenital venous malformations having propensity for the head and neck. These venous malformations, especially the large and intraoral ones, may cause severe symptoms requiring aggressive treatment. Today, the main treatment is based on sclerotherapy, associated or no with surgery. We report on a patient presenting an enormous venous malformation of the face and tongue, which was treated successfully in our department by embolization, sclerotherapy and maxillo-facial surgery, with a special focus on Surgiflo in our technique.

Imaging techniques are in permanent evolution and so are their respective sensitivities. We present a case of a patient who had three abdominal CT scans over 10 years for the detection of pancreatic insulinomas. The first was made on an incremental CT and showed no lesion, the second on a single-slice helical CT which revealed a single centimetric tumor of the head of the pancreas, and the third on 64-slice CT which revealed 5 infracentimetric tumors. We do not know if all were present at the first scan but it is possible that these small tumors could have been missed on thick CT scan slices with overlap. The ideal imaging technique for the detection of endocrine pancreatic tumor is not known yet. The detection rates in the latest publications are 80% for CT scans and 70% for MRI, but there is a slight preference for CT scan because of its larger availability and higher resolution.

Hydatidosis is a parasitic disease found worldwide, particularly in Mediterranean countries, caused by Echinococcus granulosis infection. Humans are an intermediate and accidental host in the cycle of this parasite. The hydatid pulmonary arterial embolism is extremely rare, usually arising in the heart or the liver. We report a case of hydatid pulmonary embolism explored with multidetector scanner and MRI, and confirmed at pathology of the operative specimen. To our knowledge, this is the first case of inaugural hydatid pulmonary arterial embolism found on CT scan establishing the diagnosis of the disease in a patient who had no other location of hydatid cyst. (C) 2009 Elsevier Masson SAS. All rights reserved.

Vertebro-basilar dissections represent a rare but severe cause of posterior vascular accident and constitute 3 to 7% of non-traumatic subarachnoid hemorrhage. Digital angiography is classically the standard method for diagnosing of arterial dissections but CT and MR angiography are recently widely used as non-invasive and accurate ways of diagnosis. We report a case of atypical subarachnoid hemorrhage, with focus on contribution of the different techniques.

Les dissections vertébrobasilaires représentent une cause rare mais grave d’accident vasculaire postérieur et constituent 3 à 7 % des hémorragies méningées non traumatiques. L’angiographie numérisée est classiquement l’imagerie de choix pour les dissections artérielles mais l’angioscanner et l’angio-IRM s’imposent comme moyens diagnostiques non invasifs et très sensibles. Nous rapportons une observation d’hémorragie méningée (HM) atypique, en insistant sur la contribution des différentes techniques.

Prenatal DiagnosisVolume 28, Issue 5 p. 463-465 Research Letter Correlation between ultrasound and pathological examination in a prenatal diagnosis of Cri du Chat syndrome associated with partial trisomy 17q A. G. Cordier, A. G. Cordier AP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorC. Braidy, C. Braidy AP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorJ. M. Levaillant, J. M. Levaillant AP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorS. Brisset, S. Brisset Univ Paris Sud, UMR-S0782, Clamart, France INSERM, U 782, Clamart, France AP-HP, Service de Génétique et Reproduction, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorM. L. Maurin, M. L. Maurin Univ Paris Sud, UMR-S0782, Clamart, France INSERM, U 782, Clamart, France AP-HP, Service de Génétique et Reproduction, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorA. E. Mas, A. E. Mas INSERM, U 782, Clamart, France AP-HP, Service d'Anatomie Pathologique, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorR. Frydman, R. Frydman AP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, France Univ Paris Sud, UMR-S0782, Clamart, France INSERM, U 782, Clamart, FranceSearch for more papers by this authorG. Tachdjian, G. Tachdjian Univ Paris Sud, UMR-S0782, Clamart, France INSERM, U 782, Clamart, France AP-HP, Service de Génétique et Reproduction, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorO. Picone, Corresponding Author O. Picone [email protected] AP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, France Univ Paris Sud, UMR-S0782, Clamart, France INSERM, U 782, Clamart, FranceAP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, F-92140, France.Search for more papers by this author A. G. Cordier, A. G. Cordier AP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorC. Braidy, C. Braidy AP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorJ. M. Levaillant, J. M. Levaillant AP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorS. Brisset, S. Brisset Univ Paris Sud, UMR-S0782, Clamart, France INSERM, U 782, Clamart, France AP-HP, Service de Génétique et Reproduction, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorM. L. Maurin, M. L. Maurin Univ Paris Sud, UMR-S0782, Clamart, France INSERM, U 782, Clamart, France AP-HP, Service de Génétique et Reproduction, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorA. E. Mas, A. E. Mas INSERM, U 782, Clamart, France AP-HP, Service d'Anatomie Pathologique, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorR. Frydman, R. Frydman AP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, France Univ Paris Sud, UMR-S0782, Clamart, France INSERM, U 782, Clamart, FranceSearch for more papers by this authorG. Tachdjian, G. Tachdjian Univ Paris Sud, UMR-S0782, Clamart, France INSERM, U 782, Clamart, France AP-HP, Service de Génétique et Reproduction, Hôpital Antoine Béclère, Clamart, FranceSearch for more papers by this authorO. Picone, Corresponding Author O. Picone [email protected] AP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, France Univ Paris Sud, UMR-S0782, Clamart, France INSERM, U 782, Clamart, FranceAP-HP, Service de Gynécologie Obstétrique, Hôpital Antoine Béclère, Clamart, F-92140, France.Search for more papers by this author First published: 28 April 2008 https://doi.org/10.1002/pd.2003Citations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCES Brisset S, Kasakyan S, Coulomb L'Hermine A, et al. 2006. De novo monosomy 9p24.3-pter and trisomy 17q24.3-qter characterised by microarray comparative genomic hybridisation in a fetus with an increased nuchal translucency. Prenat Diagn 26: 206–213. Chen CP, Lee CC, Chang TY, Town DD, Wang W. 2004. Prenatal diagnosis of mosaic distal 5p and review of literature. Prenat Diagn 24: 50–57. Church DM, Bengtsson U, Nielsen KV, Wasmuth JJ, Niebuhr E. 1995. Molecular definition of deletions of different segments of distal 5p that result in distinct phenotypic features. Am J Hum Genet 56: 1162–1172. Gersh M, Goodart SA, Pastzor LM, Harris DJ, Weiss L, Overhauser J. 1995. Evidence for a distinct region causing a cat-like cry in patients with 5p deletions. Am J Hum Genet 56: 1404–1410. Kelly BD, Becker K, Kermode V, et al. 2002. Dysmorphic features and learning disability in an adult male with pure partial trisomy 17q24-q25 due to terminal duplication. Am J Med Genet 112: 217–220. Mainardi PC, Perfumo C, Cali A, et al. 2001. Clinical and molecular characterisation of 80 patients with 5p deletion : genotype-phenotype correlation. J Med Genet 38: 151–158. Naccache NF, Vianna-Morgante AM, Richieri-Costa A. 1984. Brief clinical report : duplication of distal 17q : report of an observation. Am J Med Genet 17: 633–639. Niebuhr E. 1978. The cri du chat syndrome. Epidemiology cytogenetics and clinical features. Hum Genet 44: 227–275. Sarri C, Gyftodimou J, Avramopoulos D, et al. 1997. Partial trisomy 17q22-qter and partial monosomy Xq27-qter in a girl with a de novo unbalanced translocation due to a post zygotic error: case report and review of the literature on partial trisomy 17qter. Am J Med Genet 70: 87–94. Citing Literature Volume28, Issue5May 2008Pages 463-465 ReferencesRelatedInformation

To promote the interest of the kinetics of tumor markers in the follow-up of cancers, we first evaluated the place of these markers in cancerology with a questionnaire dedicated to oncologists and biologists practising in general hospitals. Then, we Listed and compared the software existing between 2002 and 2004 and able to plot kinetics from the raw values of tumor markers. In a second time, we established the necessary conditions for an ideal software. The conclusion of this evaluation was that good tools exist but they have to improve in order to be more practical and widely used by all the intervening experts in cancerology. The kinetic profile of tumor markers must now belong to the medical file of patients suffering from cancer. (C) 2008 Publie par Elsevier Masson SAS.

Nephelometry, which is considered as the reference method for serum proteins determination requires a specific equipment. The majority of protein determinations are therefore carried out on biochemistry automats using turbidimetry. The objective of a CNBH group (Collège national de biochimie des hôpitaux) was to compare nephelometry and turbidimetry for 7 automats: 2 nephelometers, the BN Prospec (Dade-Behring) and Immage (Beckman-Coulter) and 5 biochemistry systems using turbidimetry, the Integra and Modular (Roche Diagnostics), the LX20 (Beckman-Coulter), RXL (Dade-Behring) and AU (Olympus). The study was based on the determination of sera collections (albumin, ApoA, CRP, haptoglobin, IgM, transthyretin) of 140 samples each: 110 limpid samples and 30 samples called HLI (hemolytic, lipemic or icteric). Fifteen hospitals took part to this work. An ANOVA analysis on limpid samples and quality control sera concluded to an "automat" effect for the 6 tested proteins but did not show a "method" effect, (i.e. nephelometry versus turbidimetry). On the other hand, the transferability of the results was expected to be better and an effort on the choice of the antibodies and the standardization procedures should be made.

Evaluer l’importance du passage d’un protocole de six à 12 prélèvements randomisés ainsi que l’importance des prélèvements supplémentaires dans une anomalie échographique suspecte. Nous avons évalué pour 561 biopsies, l’âge du patient, le taux du PSA sérique, le pourcentage de PSA libre sur total, la densité du PSA, le résultat du toucher rectal, le poids de la prostate, son aspect échographique, le nombre de prélèvements et leur répartition, la survenue d’une complication grave. Une anomalie de la prostate périphérique, un dépassement capsulaire ou une adénopathie juxta prostatique ont été considérés comme suspects en échographie. La biopsie était positive chez 231 patients (41,2 %). Le nombre de prélèvements n’a pas augmenté les biopsies positives de façon significative que chez les patients ayant un poids inférieur à 40 grammes. Une échographie suspecte avait une sensibilité de 29 % et une spécificité de 90 %. Un prélèvement spécifique dans une anomalie périphérique, n’a été indispensable, que dans un cas où les prélèvements randomisés étaient négatifs. Malgré l’apport limité des prélèvements supplémentaires randomisés ou justifiés par une anomalie échographique, nous pensons qu’ils doivent continuer à être pratiqués car ils n’augmentent pas de façon significative les complications.

Permettre l’apprentissage de la sémiologie en écho-Doppler des différentes pathologies neurovasculaires. Un grand nombre de cas d’écho-Doppler bien documentés illustrant la sémiologie des pathologies neurovasculaires, est présenté sous forme d’images figées et/ou de séquences dynamiques et ayant dans la majorité des cas une confrontation par angiographie ou angio-IRM. La multiplicité des cas cliniques permet de couvrir toute la pathologie neurovasculaire : les sténoses, occlusions et dissections carotidiennes et vertébrales ; les anomalies de la carotide externe ; sténose ulcérée de la carotide interne ; les vols vertébro-sous-claviers ; les fistules carotido-caverneuses ; les tumeurs glomiques ; les occlusions de l’artère carotide primitive avec carotide interne et externe perméables en sus-bulbaire et circulant en sens inverse, l’une alimentant l’autre. Les sténoses du tronc artériel brachio-céphalique et de la carotide interne traitées par angioplastie et stent. Les thromboses veineuses. Ces différents cas cliniques bien commentés permettent un bon apprentissage des différents éléments sémiologiques de la pathologie neurovasculaire à l’étage cervical.