[MR imaging of coronary arteries: noncontrast free-breathing whole heart acquisition with ultrafast 3D balanced gradient-echo technique]. / Imagerie par résonance magnétique des artères coronaires: acquisition "coeur entier", en respiration libre, sans injection d'agent de contraste et utilisant la séquence 3D en écho de gradient balancé ultrarapide.

The 3D balanced gradient-echo technique is described along with th eimaging protocol for MR imaging of th ecoronary arteries. A 3D volume with spatial resolution of 0.6 x 0.6 x 0.75 mm composed of 140 slices covering the whole heart is acquired over 10 minutes. The main advantage of this whole heart technique is the possibility to image the coronary arteries along their entire course in a single acquisition. Selection of the navigator positions, timing of image acquisition and its duration through the R-R interval are the main factors requiring optimization.

[Role of contrast enhanced US in the evaluation of renal tumors]. / Rôle de l'échographie de contraste dans l'évaluation des tumeurs rénales.

PURPOSE: To evaluate the role of contrast enhanced US in the characterization of renal tumors. Materials and methods. Eighty-six renal tumors (33 solid, 53 cystic) underwent contrast enhanced US after indeterminate CT/MRI (67 lesions) or US (19 lesions). Pathological correlation was available for 42 cases, and follow-up at 3 and 6 months was available for 13 cases. Diagnosis was achieved in 21 cases. Lesions included: 19 renal cell carcinomas (4 conventional, 14 papillary, 1 tubulocystic), 5 oncocytomas, 3 metastases, 6 pseudomasses, and 53 cystic lesions including 6 malignant tumors. RESULTS: Solid tumors were correctly identified in 100% of cases. Characterization of solid tumors was possible with specificity of 92.9% for papillary carcinoma, 57.1% for clear cell carcinoma, and 100% for oncocytoma. The specificity for distinguishing solid benign from solid malignant tumor was 100% based on the presence of hypoechogenicity relative to normal renal parenchyma on delayed imaging. Contrast enhanced US allowed reclassification of 23 indeterminate lesions on conventional US. It is of limited value for large cystic lesions or cystic lesions with extensive wall calcification. CONCLUSION: Contrast enhanced US is easily performed in clinical practice and allows improved characterization of some renal tumors compared to other cross sectional imaging techniques.

[Ataxic hemiparesis due to a cerebellar lacuna]. / Hémiparésie ataxique par lacune cérébelleuse.

The authors report a case of ataxic hemiparesis (dysarthria-clumsy hand syndrome plus crural hemiparesis with homolateral ataxia), secondary to a single cerebellar lacuna (CT scan), in a left rostral para-vermian position in the vicinity of the peduncle and secondary to arterial hypertension. They discuss the nosological aspects of this recently established entity and the origin of particularly severe and persistent dysphagia in their case (cerebellar dysphagia?)

[Cerebral atrophy, diagnosed by tomodensitometry, versus Rorschach organic psychosyndrome in a psychiatric population]. / L'atrophie cérébrale, diagnostiquéé par la tomodensitométrie, face au psychosyndrome organique du Rorschach, dans une population psychiatrique.

In a psychiatric service, this study compares results for the psycho-organic syndrome diagnosed with the Rorschach test to results from brain CT Scan in two groups (20 patients with cerebral atrophy and 20 patients with normal CT Scan). Our results are consistant with previous results mainly for patients with cerebral atrophy as demonstrated by neuro-radiological techniques. Significant differences appear in the discriminative value of isolated signs, a finding which should help in the future to establish a new classification of psycho-organic syndromes associated with cerebral atrophy.

Angiocardiography in congenital subvalvular aortic stenosis: prognosis and operative indications.

Twenty-three patients with congenital subvalvular aortic stenosis are reviewed. The importance of classifying this stenosis into four types based on angiocardiographic findings is stressed, as are the indications for left heart catheterization during the preoperative and postoperative course of the disease. The type of congenital subvalvular aortic stenosis should be an important consideration during the discussion of operative indications in both asymptomatic and symptomatic patients.

Rectal and sigmoid involvement secondary to carcinoma of the prostate.

Three types of involvement of the rectum and recto-sigmoid by carcinoma of the prostate are reviewed through an analysis of eight cases. A fourth type with subserosal metastatic implant of the proximal sigmoid may occasionally be encountered. The roentgenographic findings are not pathognomonic, but are characteristic of extrinsic involvement of the bowel wall. When clinical symptoms are predominantly related to the bowel, carcinoma of the prostate is usually advanced. All patients presented with bone metastases, uretero-hydronephorsis, lack of function of one kidney, or both bone metastases and urinary tract obstruction. Rectoscopy and biopsy are helpful. However, biopsy specimens often show non-diagnostic features in secondary malignancy. Correct diagnosis is important, since there is a difference in treatment of primary carcinoma and of secondary involvement of the rectum by prostatic carcinoma. A diagnostic challenge exists if the patient is evaluated by barium enema examination for primary bowel symptoms, in particular, large bowel obstruction. At this time intravenous pyelography and bone survey for metastases may not be available to suggest the correct diagnosis. More widespread use of barium enema examinations in the evaluation of advanced carcinoma of the prostate is suggested, since the type of rectal disease shown on barium enema study was not clinically suspected in five of eight patients. The prognosis is usually unfavorable because of advanced carcinoma. Survival often does not exceed several months to one year. However, one of our patients is still well after three years of hormonal therapy.

[Radiological study of congenital mono and bicuspid aortic valves (author's transl)]. / Etude radiologique des mono et des bicuspidies aortiques congénitales

Bicuspid aortic valves are much more common than monocuspid valves and diagnosed by A. P. aortography and, above all, lateral views. One may distinguish the true bicuspid valves which include two Valsalva sinuses, often asymmetrical, and bicuspid valves whith a supplementary raphe, the commonest type, in which on angiography, one may distinguish three Valsalva sinuses, one of which is larger than the two others. These cases of bicuspid aortic valve may be associated with other malformations of the aorta or may occur alone. In the latter case, the main risks are aortic valvular stenosis or aortic incompetence.

[Plain film diagnosis in coarctation of the aorta].

The authors emphasize the importance of plain films in showing abnormalities of the aortic arch, which should permit the early radiographic diagnosis of coarctation of the aorta, before the late appearance of rib notching and cardiac enlargement. These anomalies include the elongated aortic arch, the 'figure-3' sign, the 'double indentation' sign, and the dilatation of the ascending aorta. The plain film diagnosis in newborns and infants is difficult, because of subtle or absent change of the aortic arch. Cardiomegaly with left ventricular hypertrophy may give the diagnostic clue.

[Angiographic study of congenital aortic stenosis (author's transl)]. / Etude angiographique des sténoses aortiques congénitales

Left ventriculography is of great interest in the diagnosis and prognosis of congenitalaortic stenosis. It permits one to distinguish valvular stenosis, which is the commonest type, from sub-valvular stenosis, of which there exist 5 main type; type I and II are the commonest, they have a better prognosis than types III and IV. Sub-sigmoid aortography shows the appearance of the sinus of Valsalva, thus whether there exists a tricuspid or bicuspid aortic valve. In all cases, one should seek stenosis at various levels of the aortic outlet and possible myocardiography of the left ventricle, the frequency of which is well known, together with the poor prognosis.