[Dual energy X-ray absorptiometry as a guide for treatment of a staghorn kidney stone]. / Une application de la tomodensitométrie en double énergie dans le traitement d'un calcul coralliforme.

We report the history of a patient who presented a radiodense large staghorn kidney stone which was investigated by dual energy CT. Dual energy CT showed that this stone consisted of uric and calcic compounds. The patient received a specific treatment combining chemical lysis and lithotripsy active on uric and calcic parts respectively, leading to a complete noninvasive destruction of the stone. It seemed that lithotripsy performed at first step allowed for efficient lysis by chemical agent.

Dual source CT: cardio-pulmonary applications.

Dual source CT is a last generation scanner which allows for coronary imaging without beta-blocker because high quality images are feasible even at high heart rates. Furthermore, with this equipment, dual energy becomes possible in a single acquisition and triple rule-out imaging can be performed in clinical routine. The radiation dose remains limited in comparison with single-source CT because of different efficient mechanisms.

[Cardiac anatomy and the radiologist]. / En 2006, le radiologue devrait connaître l'anatomie du coeur.

We report a case of myocardial infarction due to occlusion of the left anterior descending artery seen on a routine chest CT performed in order to exclude aortic dissection. This underscores the need for the radiologist to look at the heart and coronary arteries on each thoracic CT-scan, even if acquired without EKG-gating.

Using dual-detector helical CT angiography to detect deep venous thrombosis in patients with suspicion of pulmonary embolism: diagnostic value and additional findings.

OBJECTIVE: The purpose of this study was to assess the value of dual-slice helical CT angiography in detecting deep venous thrombosis in patients in whom acute pulmonary embolism was suspected and to describe the additional extrathoracic findings. SUBJECTS AND METHODS: Sixty-five consecutive patients were examined for suspected pulmonary embolism using helical CT of the chest (2.7-mm collimation; table speed, 7.5 mm/sec; 100-140 mL of contrast medium injected at a rate of 3 mL/sec) followed by CT of the lower limbs (6.5-mm collimation; table speed, 10 mm/sec) without any additional contrast medium injection. Sequential scanning of the abdomen was performed using 10-mm collimation and an interval of 40 mm. Color Doppler sonography of the lower limbs was done within 24 hr of CT by two radiologists who were unaware of CT findings. Results of CT venography were compared with those of Doppler sonography and with phlebography or repeated focalized sonography in cases of discrepancy. RESULTS: Twenty-two patients had pulmonary embolism revealed on chest CT. Sixteen patients had a deep venous thrombosis. Thirteen patients with pulmonary embolism had a deep venous thrombosis. Three patients with deep venous thrombosis had no pulmonary embolism. Sensitivity and specificity for diagnosing deep venous thrombosis with CT was 93% and 97%, respectively (kappa = 0.88). Additional extrathoracic findings were observed in four patients. CONCLUSION: Combined CT venography with dual-slice scanning is an accurate method to diagnose deep venous thrombosis that may reveal additional imaging findings in some patients with possible pulmonary embolism.

Arthritis and hidradenitis suppurativa diagnosed in a 48-year-old man.

We report the case of a 48-year-old man who presented with an erosive, seronegative, HLA-B27-negative, peripheral polyarthritis, associated with hidradenitis suppurativa of axillae and buttocks. The pertinent literature is reviewed. This paper is the second devoted to this topic in a radiological journal and the first to document erosion of the posterior aspect of the calcaneus.

Camurati-Engelmann disease: a late and sporadic case with metaphyseal involvement.

A 40-year-old white man with a 3-year history of mild to severe right thigh and knee pain was referred for radiographic investigation. Radiographs show a fusiform, bilaterally symmetrical enlargement of the diaphyses and metaphyses of the long bones (femur, tibia, fibula, radius and ulna). A narrowed medullary cavity is illustrated on CT scan of the femur. All bones show periosteal and endosteal bone formation. There is no history of familial involvement, trauma, infection or systemic illness. Blood chemistry could not point out any abnormality. Radiographic findings and clinical history suggest the diagnosis of Camurati-Engelmann disease, also known as progressive diaphyseal dysplasia (PDD). This case is of interest because of its rare metaphyseal involvement, mild form and sporadic presentation.