[Detection and quantification of carotid atheroma. Respective value of vascular ultrasonography, spectrum analysis and digital intravenous angiography]. / Dépistage et quantification de l'athérome carotidien. Intérêts respectifs de l'échotomographie vasculaire, de l'analyse spectrale et de l'angiographie numérisée intraveineuse.

This retrospective study involved 37 subjects who were examined by means of intravenous digitalised angiography, vascular ultrasonography and spectral analysis of the Doppler signal. The last two examinations were found to give the most precise images and functional information. The concordances between angiography and ultrasonography on the one hand and spectral analysis on the other were 82 and 90 per cent. The authors have established a protocol in order to limit and systematize these examinations during screening for carotid atheroma: the risk factors are weighted; a score is obtained by summation; depending on the value of this score and the patient's age, the investigation procedure is pursued or not. The sequence always consists of ultrasonography followed by spectral analysis when plaque is detected and by angiography when the plaque is stenotic or ulcerated. In symptomatic patients, ultrasonography and digitalised angiography are performed routinely.

[X-ray computed tomography of extrahepatic cholestasis]. / Etude tomodensitométrique des cholostases extra-hépatiques.

Findings in a series of 53 examinations performed in patients with extrahepatic cholestasis demonstrated the value of computed tomography exploration to determine mechanisms and etiology of biliary tract affections. Sensitivity of the CT scan for detection of biliary tract dilatations was equivalent to that obtained by ultrasound, and was even higher for certain types of patient (obese, distended, etc.). Results of this study combined with data in the literature enables precise diagnostic criteria to be established when determining etiology of these dilatations, which require investigation by a CT scan when ultrasound imaging proves unsatisfactory.

[X-ray computed tomography and primary thoracic seminoma]. / Tomodensitométrie et séminome primitif thoracique.

The primitive thoracic seminoma is a rare tumor. Given their low frequency, these tumour have rarely been the object of C.T. exploration. It determines the compressive effect on neighbouring organs, the volume and extensive character of the tumor. C.T. exploration allows proper surveillance after therapeutic.

[Measurement of antetorsion of the femoral neck by ultrasonics. Comparison with x-ray computed tomography]. / Mesure de l'antétorsion du col fémoral par échographie. Comparaison avec la tomodensitométrie.

A method of measurement of femoral anteversion using ultrasounds is presented. It is easily reproducible and non-irradiating. It was tested in 100 hips and compared with measurement by tomodensitometry. The results were similar. Both methods were tested in dry bones and the results again were comparable. It is concluded that ultrasound measurements are reliable and without danger and should be used in preference.

[Aneurysm of the abdominal aorta in infants. Apropos of a case]. / Anévrisme de l'aorte abdominale du nourrisson. A propos d'un cas.

The sudden development of an abdominal mass following umbilical artery catheterization during neonatal reanimation in a 1-month-old infant of an alcoholic mother was found to be due to an aneurysm of the abdominal aorta. Diagnosis was established by computed tomography and confirmed by arteriography. In the absence of any pathological examination, surgical treatment having been temporarily delayed, a mycotic origin for the aneurysm was suggested by the conditions of onset. A review of the 13 cases of primary mycotic aneurysms of the abdominal aorta in infants reported in the literature emphasizes the rare but serious nature of these lesions at this age.

[The value of tomodensitometric studies in the diagnosis of the herniated lumbar disk. Apropos of 155 operated disks]. / Valeur de l'examen tomodensitométrique dans le diagnostic des hernies discales lombaires. A propos de 155 disques opérés.

Correlation of radiological and pathological findings in 155 cases of operated herniated discs emphasizes the value of a CT scan in the diagnosis of these lesions. Imaging by the scanner is a safe and relatively low-cost procedure and its reliability is identical to that of other conventional exploratory methods. It should, therefore, become the initial examination conducted during investigation of sciatica thought to be of discal origin. Reliability of results has varied between 85 and 90 p. 100, according to the author, for this essentially simple and atraumatic method. Confirmation of the presence of a hernia requires the observance of clear signs: material of discal density amputating the spinal canal and spreading over the dural sheath. False negatives or positives usually occur in borderline cases or in previously operated patients. Differences in clinical and computed tomography findings, with undoubted absence of signs on the scan image, require further investigation by radiculography.

[Irradiation of the patient and its costs in the usual diagnostic procedures for disk hernia. Radiculography, spinal phlebography and tomodensitometry]. / Etude de l'irradiation du patient et du coût dans les procédures diagnostiques usuelles des hernies discales. Radiculographie, phlébographie rachidienne et tomodensitométrie.

Three methods are currently employed for the diagnosis of sciatica due to disc lesions: radiculography, spinal phlebography, and computed tomography. Though their indications vary according to the author, it seemed worthwhile to compare radiation delivered by each of them, because of the often young age of the patients. Dosimetric studies using a Rando Phantom enabled calculation of doses to the skin, spinal cord, and gonads. Results indicated that low doses were delivered by the scanner, relatively high doses by spinal phlebography, and intermediate doses by radiculography. These findings suggest that the initial examination preoperatively in cases of simple sciatica due to herniated disc should be a CT scan whenever possible. Phlebography, on the contrary, and particularly in young women, should be used only exceptionally, as a result of the high doses delivered to the ovaries even during technically simple explorations.

[Tomodensitometry and pancreatic pathology]. / Tomodensitométrie et pathologie pancréatique.

Computed tomography is currently the most effective method for investigating the pancreas. Though far from superseding ultrasonography, which should always precede it, possible insufficiences of this examination can be corrected and doubtful images clarified. Its greatest usefulness is in acute pancreatitis, as the size of the lesion can be defined as well as subsequent therapeutic measures. It also appears to be the most reliable examination for chronic pancreatitis or cancer of the pancreas at the present time, but their differential diagnosis can raise problems when certain localized hypertrophic lesions exist. However, diagnosis of a pancreatic lesion is only possible when it deforms the gland or modifies its density, and it is illusory to expect early detection of lesions less than 2 or 3 cm in diameter, particularly in cancer cases.