Prevalence of thyroid hemiagenesis: ultrasound screening in normal children.

UNLABELLED: While performing a systematic ultrasound study of the thyroid gland volume for the evaluation of iodine deficiency in 2845 normal Belgian school children, we found an absence of the left lobe in 6 children (4 girls and 2 boys). There was no association with other thyroid malformations or dysfunction. CONCLUSION: This first systematic ultrasound evaluation of thyroid hemiagenesis in normal children established a prevalence of thyroid hemiagenesis of 0.2% and confirmed the female predominance and higher incidence of agenesis of the left lobe.

[Computed tomography-guided diagnostic puncture in abdominal pathology]. / Ponction diagnostique sous contrôle tomodensitométrique en pathologie abdominale.

Technological improvements (short-time acquisition and reconstruction, CT, spiral technique) together with better puncture material and a general trend towards less invasive surgical procedures have had a combined effect to a wider scope of applications for percutaneous punctures under CT-guidance. In this paper, we analyze and discuss recent data in the literature on puncture material, indications and results. The relevant choice of the needle model and its diameter, depending on the organ and suspected pathology, as well as the point of entry and the puncture track are key factors granting procedure safety, ambulatory use and good diagnostic results.

Calcified, cystic brain metastases.

Calcifications are uncommon in metastases. Adenocarcinoma, osteopenic, osteosarcoma, lung and breast carcinoma can be the origin. A rare case of calcified cystic brain metastasis deriving from papillary cystadenocarcinoma is reported.

The radiologic investigation of dysphagia.

The fundamentals of the radiologic investigation of dysphagia using barium are described. Emphasis is given on videofluoroscopy. The clinical perspective of the dysphagic patient as well as the methods of examination are described. Results are exposed in terms of functional and structural analysis. Some examples of common normal and pathological findings are given.

Cystitis glandularis occurring in neurofibromatosis.

A case of cystitis glandularis occurring concurrently with a neurilemmoma of low malignant potential in a patient with neurofibromatosis is presented. The co-existence of these two conditions made it difficult to distinguish between local recurrence of the neurilemmoma and malignant change in the cystitis glandularis. Repeated biopsies were required to solve this problem. The pathological and radiological features are described.

Complete appendicular inversion: the "inside-out" appendix. An unusual presentation of Crohn's disease. A case report and review of the literature.

Intussusception of the appendix into the caecum is an uncommon condition and the diagnosis is rarely made preoperatively. Specific anatomic requirements as well as pathological conditions that cause irritation or increased peristalsis should be present for this event to occur. A case is discussed in which the diagnosis was made preoperatively by barium enema and in which the lead point was a large inflammatory polyp due to Crohn's disease. It appeared in this case that inflation at the time of the barium enema resulted in reduction of the intussusception.

Ossifying fibroma of the long bones. Radiological diagnosis, differential diagnosis and management implications.

We report a case of ossifying fibroma of the long bones (OFLB). This lesion, occurring mainly during the first decade of life, typically affects the tibial diaphysis and clinically presents as a painless bony enlargement. Radiographic features include an osteolytic cortical expansion, containing diffuse calcifications, and separated from the medullary by a thick cortical rim. CT appears to be the examination of choice to define these signs and permits differentiation from monostotic fibrous dysplasia and from adamantinoma (by demonstrating the presence or absence of diffuse high attenuation values). The importance of making the differential diagnosis is stressed, as prognosis and management of OFLB, fibrous dysplasia and adamantinoma may vary considerably.

Oesophageal intramural pseudodiverticulosis with similar lesions in the duodenum.

Oesophageal intramural pseudodiverticulosis is characterized by a segmental or diffuse distribution of numerous small outpouchings varying in size from 1 to 5 mm. Review of previously described cases revealed a significant incidence of associated debilitating systemic disorders such as diabetes mellitus, malignancy, alcoholism and tuberculosis. No record could be found in the literature of a similar process occurring in other parts of the gastro-intestinal tract. A case is reported of a severe alcoholic who, on a barium swallow, in addition to the changes of oesophageal intramural pseudodiverticulosis, presented with a large duodenal ulcer and similar outpouchings in the first and second parts of the duodenum.

Peliosis of the spleen.

The authors present a case of splenic peliosis in a 32-year-old woman who had been treated with steroids for asthma. The ultrasound, computed tomographic (CT), and angiographic findings of this entity are herein illustrated.

Tissue characterization of atheromatous plaques: correlation between ultrasound image and histological findings.

Fifty-four atheromatous plaques of carotid arteries, obtained at autopsy, were scanned with a high-resolution real-time instrument, then histologically examined. Comparison between atherogenesis assessed first by histology then by ultrasonography allowed us to differentiate young from old plaques. An old plaque is characterized by a dense heterogeneous echo pattern and irregular borders or ulceration. Previous studies have shown a correlation between the presence of hemorrhage and ulceration of atheromatous plaques in the carotid, and the frequency of cerebral complications. Since these characteristics were mainly found in older plaques, we consider them to be the most important ones clinically.

Semilunar osteoblastic metastases in breast carcinoma. A new radiological sign.

Forty-seven cases of osteoblastic skeletal metastases were examined, of which 26 were from primary carcinoma of the breast. In two of these cases the metastases were of an unusual semicircular configuration. In each case the patient survived for at least four years after the discovery of metastases. This appearance may represent a better form of host response to metastatic disease.

Spondylolysis of the axis. A case report and review of the literature.

Bilateral congenital defects in the pedicles of the second cervical vertebra were noted on conventional X-rays and tomography of a 42-year-old male. He had been assaulted after which he suffered upper neck and occipital pain. Subsequent CT scanning demonstrated the incomplete nature of the axis defects. This is felt to be important in prognosticating the likelihood of spondylolisthesis formation and counselling the patient with regard to acceptable future physical activity. The role of CT examination for this purpose has not been stressed before. The importance of differentiation from old trauma is emphasized.

Imaging of colorectal carcinoma.

The authors present a short overview on the state of the art of detection, diagnosis, operative staging and post-operative follow-up of colorectal carcinoma by barium studies, echography, CT and MR. Current concepts about these matters are briefly described and discussed according to the author's experience.

Evaluation of time interval difference digital subtraction fluoroscopy in patients with cystic fibrosis.

In this study the potential of thoracic subtraction fluoroscopy has been evaluated on the basis of our experience with this functional imaging modality in patients presenting with cystic fibrosis. The method, which consists of subtracting dynamic digital fluoroscopic images of the breathing chest in the time interval difference (TID) mode, applies to the study of the lucency variations during the respiratory cycle and provides dynamic functional information about ventilation and/or perfusion and diaphragmatic kinetics, without any injection and with minimal irradiation. To assess the validity of the TID procedure, our results were compared with standard roentgenography, clinical data, and scintigraphic findings, with emphasis on the latter. The limitations and advantages of TID compared with scintigraphy are discussed. Three groups of discrepancies emerge which do not discredit TID. TID offers rather the advantage of providing anatomic pictures and unique dynamic information, which is emphasized.

Yersinia enterocolitica and Crohn's disease. A case report.

A case of simultaneous infection with Yersinia enterocolitica and Crohn's disease is described. Only 1 similar case has been reported. The similarities between the two conditions and the differentiating features are described.

Cavernous haemangioma of the jejunum. A case report and approach to obscure chronic gastro-intestinal bleeding.

A 31-year-old woman who had been investigated for almost lifelong iron deficiency anaemia caused by chronic gastro-intestinal blood loss was found to have a large cavernous haemangioma of the jejunum. The literature relating to the latter is reviewed and a diagnostic approach to obscure gastro-intestinal bleeding considered.