[Emergency pediatric thoracic radiology]. / Imagerie thoracique en urgence chez l'enfant.

Pediatric thoracic emergencies are frequent and may be due to a large spectrum of lesions including traumatic and non traumatic pathologies, such as foreign bodies, mediastinal tumors, pulmonary infections, asthma, pneumothorax and delayed manifestations of congenital chest malformations. Emergencies require rapid diagnosis to make a treatment plan and in most cases, radiology plays an essential role. Plain chest radiographs remain the initial study with inspiratory films. In certain circumstances, the use of expiratory films is absolutely necessary. Ultrasonogragraphy is the primary modality for evaluation of pleural effusions. Computed tomography (CT), with volume acquisition and more rapid scanning, is a technique capable of imaging the lungs and mediastinum with excellent spatial resolution in the pediatric population. CT provides more information than chest radiographs. This explains the increasing indications of CT in the evaluation of pediatric thoracic emergencies, more particularly traumatic emergencies.

[Sonography of thoracic diseases in children]. / L'échographie dans la pathologie thoracique de l'enfant.

This article reviews the major indications for chest sonography in children. Sonography should be performed after chest radiographs have been obtained in order to assess the need for further imaging with CT and/or MRI. Sonography allows accurate assessment of the pleural compartment especially for evaluation of pleural effusions, the diaphragm, peripheral lung lesions and anterior, middle and postero-inferior mediastinal lesions. Imaging of the thymus is emphasized because normal thymus can mimic pathologic situations and tumors may arise within the thymus. This technique allows tissue characterization and it is superior to other modalities in characterization of fluid. Sonography may be used to guide aspirations and biopsies. Sonography of the chest is the modality of choice in children because of its lack of ionizing radiation and ease to perform.

Indications for digital fluorography and storage-phosphor plates in pediatrics: certainties and questionable points.

We have used two digital imaging systems: digital fluorography and the phosphor plates system. The respective indications for each technique in pediatric practice are presented hereafter. Digital fluorography is highly recommended by dynamic examinations, and phosphor plates are highly recommended for conventional studies, if the spatial resolution is mandatory. Either digital fluorography or phosphor plates can be used for contrast studies. In pediatric radiology, if the spatial resolution is not mandatory, digital fluorography is suggested to reduce the radiation dose, and if using a small fields of view is possible, digital fluorography may be carefully discussed. Digital radiography is supported neither to be better than classical radiology nor to compensate for technician's mistakes. It is aimed to improve the department's functioning and, above all, to accommodate future innovations. Images can be transferred or archived through networks. This is a main prospect in the coming years.

[Parameningeal cervical rhabdomyosarcoma in the neonatal period]. / Rhabdomyosarcome cervival paraméningé en période néonatale.

A case of parameningeal cervical rhabdomyosarcoma with severe bone destruction is reported in a 3 month-old infant; symptoms were present at birth. The treatment consisted of exclusive intensive chemotherapy. The outcome was favourable with complete tumor regression and vertebral bone reconstruction. The child was on complete remission without sequellae two years later.

[Primary germinal tumors of the central nervous system]. / Tumeurs germinales primitives du système nerveux central.

Primary intra-cranial germ-cell tumors are a rare and heterogeneous group of neoplasms, identical to germ-cell tumors of gonads and other organs. These tumors arise along the midline, from the supra-sellar cistern to the pineal gland, and have neurological, ophthalmological, and endocrinological expression. The diagnosis is established by detection of increased levels of tumoral markers and/or by histological examination. The treatment includes chemotherapy, radiotherapy and surgery.

[Brain stem tumors in children]. / Tumeurs du tronc cérébral de l'enfant.

Gliomas involving the brain stem represent 10% of pediatric central nervous system neoplasms. They result in multiple cranial nerve involvement, long tracts signs, cerebellar signs, usually with no evidence of raising in intracranial pressure. The diagnosis is established by computed tomographic scan and magnetic resonance imaging. Classic management consists in conventional radiation therapy but the prognosis is very dismal with a five year survival rate about 30%.

[Growth hormone deficiency by transection of the pituitary stalk. Value of magnetic resonance imaging. Report of 2 cases]. / Déficit en hormone de croissance par interruption de la tige pituitaire. Intérêt de l'imagerie par résonance magnétique. A propos de deux observations.

In 2 boys, aged 3 and 13 years, suffering from severe growth failure, endocrine evaluation showed growth hormone deficiency and central hypothyroidism without diabetes insipidus. Magnetic resonance imaging demonstrated a transection of the pituitary stalk, and the presence of an ectopic neurohypophyseal nodule.

[A rare case of bladder exstrophy with a completely malformed complex in a girl]. / Un cas inhabituel d'extrophie vésicale avec ensemble malformatif complexe chez une fille.

Report of the observation of a female newborn presenting a complex malformative set: distal anorectal malformation without fistula; bladder exstrophy without epispadias, with cutaneous bridge; congenital urethrovaginal fistula; malformative sexual ambiguity with bulky genital tubercle, whole urethra, urethral meatus on the apex of the genital tubercle, associated with a mid labial genital joint and a high genital orifice; unilateral multicystic kidney; vertebral abnormalities with supernumerary thoracolumbar vertebrae; no karyotype abnormalities and no familial pathological history; no endocrine abnormalities. The therapeutic multistage program permitted a good reconstruction of the different lesion, particularly with bladder functioning witch in hope a good continence with two years of follow-up. No similar case is reviewed in the literature.

[Prenatal diagnostic imaging of abdominal cysts. Report of 9 cases]. / Images kystiques abdominales de diagnostic anténatal. A propos de 9 cas.

The authors report on 9 cases of cystic lesion detected by fetal ultrasound echography, uropathies and bowel dilatations having been excluded. The lesions were detected at a fairly advanced stage of pregnancy, during the 3rd trimester and involved 8 girls and 1 boy. Investigation of possible chromosomal and associated anomalies was carried out in each case. Analysis confirmed the frequency of ovarian cysts in the female subjects (6), but also demonstrated the following: 1 case of bowel duplication, 1 cystic Meckel diverticulum, 1 liver biliary cyst (boy). The etiology and diagnostic difficulties and the approach to be adopted are noted. The authors emphasize the frequent signs of complications, especially as regards ovarian cysts. A thorough clinical examination and echographic detection and confirmation of the lesions is indicated followed by early surgical intervention if the cyst persists; so that, particularly in the case of ovarian cysts, the organ in question is preserved to the maximum.

[MRI features of expansive processes of soft tissues. Contribution to etiologic diagnosis. Apropos of 32 cases]. / Séméiologie IRM des processus expansifs des parties molles. Apport au diagnostic étiologique. A propos de 32 observations.

This study concerns the investigation of 32 soft-tissue tumors by MRI, subsequently verified by biopsies or surgery (n = 28) or other investigations (n = 4). MRI can suggest the diagnosis in some cases: lipomas cysts, hematomas, neuromas, desmoid tumors, hemangiomas, by contrast analysis and morphologic aspects; sometimes, malignant lesions are suspected on particular anatomic criteria. MRI is excellent in the evaluation of local extension. MRI can therefore be performed when the staging of soft tissue tumor is incompletely provided by other investigations (CT or US).

[Cutis marmorata telangiectatica congenita with body asymmetry]. / Cutis marmorata telangiectatica congenita avec asymétrie corporelle.

One case of Cutis marmorata telangiectatica congenita (CMTC) is reported with cutaneous signs, corporal asymmetry, macrocephaly and cerebral vascular malformation. This syndrome allows to recognize a particular type of CMTC and its relationship with other angiomatosis.