[Value of high frequency (20mhZ) and doppler ultrasound in the diagnosis of pigmented cutaneous tumors]. / Apport de l'échographie haute fréquence (20 MHz) et du doppler dans le diagnostic des tumeurs cutanées pigmentées.

PURPOSE: Diagnosis of pigmented skin tumors is often difficult. The aim of the present study is to evaluate high frequency ultrasound and Doppler ultrasound in the localization and the characterization of these tumors. MATERIAL AND METHODS: One hundred and seventy six pigmented skin tumors including melanocytic and non melanocytic, benign and malignant lesions have been examined before resection using high frequency ultrasound (20MHz probe) and Doppler ultrasound (13MHz probe-Doppler frequency: 7MHz). Imaging data have been correlated with histological data, available in all cases. RESULTS: Tumors seen at ultrasound were hypoechoic lesions, some of which, particularly malignant melanocytic tumors were vascularized. Precise ultrasonographic location of the tumor was correlated to its histological location: epidermis for purely epidermal proliferations (seborrheic keratoses), superficial dermis for dermal proliferations originating from epidermis (benign dermal nevi, melanomas during vertical growth phase, basal cell carcinomas), middle and deep dermis for dermal proliferations originating from dermis (fibrous histiocytomas, angiomas). CONCLUSION: Ultrasound may help in assessing positive and differential diagnosis of pigmented skin tumors as it precises, before histological examination, the exact location of the lesion within the different skin layers and its origin. As far as malignant melanocytic tumors are concerned, high frequency ultrasound and Doppler ultrasound appear promising in diagnosis algorithm and pronosic of these lesions.

[Intraluminal duodenal diverticulum. An unusual duodenal image. Apropos of 3 cases]. / Le diverticule intra-luminal du duodénum. Une image duodénale inhabituelle. A propos de trois observations.

A rarely observed digestive tract disorder, an intraluminal duodenal diverticulum is usually discovered during the course of a barium gastroduodenal follow-through examination. Radiological appearances are characteristic: intraluminal globular opaque image surrounded by a clear border. Clinical signs are absent or non-specific, and surgery is rarely indicated, except when the lesions are poorly tolerated or complications develop.

[Angioscintigraphy in venous pathology. Comparison of isotope angioscintigraphy and radiologic examination]. / L'angioscintigraphie en pathologie veineuse. Confrontation entre l'angioscintigraphie isotopique et l'examen radiologique.

Results of vascular radiology and isotope examinations were compared in 48 patients with suspected ileocaval lesions (37 cases) or affections of the veins of the upper limb or superior vena cava (11 cases). Isotopic examination, which can be performed in ambulatory patients, respects normal hemodynamic conditions, is painless, and can be repeated, was found to give valid results, positive correlations with radiological investigation findings being present in 43 cases. Lack of correlation in the remaining 5 patients could have resulted from the period of time elapsed between the two examinations or the techniques employed during each investigation.

[Tuberculosis of the oesophagus (author's transl)]. / La tuberculose de l'oesophage.

Two cases of tuberculosis of the oesophagus serve as an opportunity to review the clinical and radiological features of this rare condition. Generally situated at the junction of the upper and middle third of the oesophagus, the lesion is found opposite the invaded inter-tracheobronchial mediastinal nodes which may give rise to a fistula. Confirmed by oesophagoscopy, direct bacteriological examination, oesophageal tuberculosis is usually cured without sequelae by antituberculous therapy.

[The use of arteriography in the pharmacological study of a vasodilator substance]. / Artériographie et densitométrie. Intérêt pharmacologique pour l'étude d'une substance vasodilatatrice

The administration of a vasodilator substance is followed by the development of a higher contrast gradient in a given film in comparison with a reference X-ray carried out in the same subject under comparable technical conditions. Comparative densitometric measurement of the contrast gradient in the two successive arteriographic series, one with and one without the injection, arterial or venous, of a vasodilator substance (Couramine-Rutine) represents a valuable method for the study in man of the action of the substance in a visceral territory. The present study was limited to the kedney (79 cases), ans the territory of the superior mesenteric (46 cases). The absence of any densitometric difference between the two renal series at too low doses of vasodilator substance leads to the supposition of the possibility of a threshold dose of pharmacological activity.

[Acute dissection of the ascending aorta and major aortic insufficiency in Marfan's syndrome. Emergency operation with succes]. / Dissection aiguë de l'aorte ascendante et insuffisance aortique majeure dans un syndrome de Marfan. Intervention en urgence avec succés

The authors report the case of acute dissection of the aorta (type I) with sudden aortic incompetence occurring in a young lady of 25 years of age with Marfan's syndrome. An urgent operation had a successful outcome; the ascending aorta was resected in toto, and replaced with a prosthesis, the coronary arteries being reimplanted.

[Arteriography in polyarteritis nodosa. 15 cases (author's transl)]. / L'artériographie dans la périartérite noueuse. A propos de 15 cas

Despite its imperfections, arteriography, when it demonstrates aneurysms, is an important element in diagnosis in all those cases in which histological findings are not definitive. It should be carried out before renal biopsy, given the risk of traumatic rupture of a possible aneurysm. The discovery of isolated distal arterial stenoses is not characteristic, though in the presence of a suggestive clinical picture, amy be considered as an argument in favour of the diagnosis. They occur frequently in the arteries of the digestive tract even in the absence of any abdominal symptoms or signs. Arteriography also has a prognostic value in establishing the extent of arterial lesions and, finally, is useful in the diagnosis of certain complications such as visceral haematomas and digestive haemorrhages. We thus feel that polyarteritis nodosa should be the object of a complete vascular exploration, including aortography with selective renal studies but also coelio-mesenteric opacification. In the light of the clinical context, the distal limb arteries may also be explored. Thus the diagnosis of polyarteritis nodosa is not purely histological but also arteriographic.