[Value of CT scanning in the investigation of thoracic sarcoidosis]. / Apport de la TDM dans l'exploration de la sarcoïdose thoracique.

INTRODUCTION: Sarcoidosis is a systemic disease of unknown aetiology that includes a pulmonary or mediastinal component in 90% of cases. The aim of this study is to clarify the contribution of thoracic CT scanning in the diagnosis and differential diagnosis of sarcoidosis and its role in the follow-up and the evaluation of the activity of the disease. METHODS: It is a retrospective study of 39 patients with histologically confirmed sarcoidosis. All patients had one or more thoracic CT scans. RESULTS: The most common parenchymatous lesions were lymphatic micronodules and peri-bronchovascular thickening. The right paratracheal chain and the hilar nodes were the most frequently involved. CONCLUSIONS: The CT scan is better than the chest x-ray at studying the parenchymal lesions and lymph node involvement in sarcoidosis. It helps in the differential diagnosis of sarcoidosis and other granulomatous disorders, especially tuberculosis. It also allows follow up of patients for the detection of complications, particularly fibrosis. Its role in the assessment of disease activity remains controversial.

[Audit procedure of radiology reports in a hospital service]. / Procédure d'audit des comptes-rendus radiologiques d'un service hospitalier.

PURPOSE: Presentation of a clinical audit of the radiology reports in our institution. MATERIAL: and methods: This audit has been performed in several steps: launching the project, elaboration of the reference book, elaboration of the protocol, analysis of the results, improvements made. RESULTS: Several dysfunctions were detected: typing errors, the lack of sentences explaining the procedure of examination, the lack of negative pertinent elements, the lack of synthesis. Several interventions were made: checking on the screen of the computer the report before signing it, purchase of personal voice recorders, restructuring the interpretation room. Other interventions are considered: structured data entry, P.A.C.S. systems CONCLUSION: This audit has allowed the modification of the process for realisation of the radiology reports and the stimulation of the medical team, thus improving the quality of our work.

[Elaboration of a tool for an audit of radiology reports]. / Elaboration d'un référentiel pour un Audit des comptes-rendus radiologiques.

PURPOSE: Elaboration of a tool for an Audit of radiology reports in a department of radiology. Materials and methods. We have made a grid and a guide to evaluate the relevance and the quality of the radiology reports. We have tested this tool on 120 reports from in-patients of the gastroenterology department. The test has been done by two radiologists (blinded test) to verify if the answers were identical. We have calculated for each item the Kappa coefficient (inter-observer agreement). RESULTS: This study has validated most of the items of our grid, some have been deleted, and others modified. CONCLUSION: Our study shows that our tool can evaluate the radiology reports of a radiology department, an audit can thus be conducted using that tool.

[Radiological and clinical aspects of bronchogenic lung cysts: 4 case reports]. / Aspects radio-cliniques des kystes bronchogéniques pulmonaires. A propos de 4 cas.

Bronchogenic lung cysts are exceptional. We report four cases which raised a problem of differential diagnosis. Our patients included four women and a young boy (age range 12 - 36 years). The first patient consulted for bloody purulent sputum in a context of an infectious syndrome. The second patient had lower right-sided chest pain. The cyst was a fortuitous discovery in the other two cases. In one case, the chest x-ray disclosed a thin-walled cavity of the upper right lobe, confirmed on the CT scan which also evidenced intracavitary partitions. In two other cases, the chest x-ray showed a liquid-filled opacity (one in the lower right lobe and the other in the upper right lobe) and no further specificity on the CT scan. In the last case, a liquid-air cavity was evidenced. Upper right lobectomy was performed for the case with an air-filled cavity and tumorectomy for the other cases. Pathology reported bronchogenic cyst in all cases. The radiological and clinical presentations observed in patients with bronchogenic lung cysts, with or without tracheobronchial communication, are polymorphous, often raising problems of differential diagnosis.