[Breast cancer screening imaging: what do we do]. / Dépistage du cancer du sein : quelle imagerie pour quelles femmes?

The purpose of this review is to evaluate the value of different breast imaging technics and their place for individual and mass screening of breast cancer according to the randomized studies on digital mammography and ultrasound screening. Analogic and numerical mammograms are validated for screening of women aged from 50 and 74 years. The additional value of ultrasound is therefore proven when the increased risk is moderate. When risk is higher (genetic or familial), MRI is the method of choice associated with conventional imaging. Individual screening is recommended before 50 for women aged from 45 and 50 and for those over 74 using the same procedures as organized screening.

Hepatic abscess caused by Brucella US, CT and MRI findings: case report and review of the literature.

The authors describe the findings detected by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) in a 42-year-old patient with a hepatic abscess due to brucellosis. This localization by Brucella (hepatic brucelloma) is quite rare and very often is asymptomatic. A review of the medical literature shows only 40 cases of an hepatic abscess due to brucellosis. The findings demonstrated by US, CT and MRI can offer important diagnostic elements, albeit not specific, which should, together with a positive serologic test, confirm the diagnosis.

[Treatement of colorectal obstruction with self-expanding metallic stents under fluoroscopic guidance]. / Traitement de l'occlusion colique tissulaire par prothèse métallique auto-expansible sous contrôle fluoroscopique.

PURPOSE: To prospectively evaluate fluoroscopic-assisted insertion of self-expanding metallic stents before surgery or for palliative treatment of soft tissue colorectal obstruction. Materials and methods. From January 1999 to October 2000, 18 consecutive patients with colorectal obstruction were included in the study. Treatment with self-expanding metallic stent was either the first line of treatment before surgery (n=8) (group I) or purely palliative (n=10) (group II). Colic stenosis was located proximal to the sigmoid in seven cases. RESULTS: Technical success was achieved in 83.3% of cases and colic decompression was observed after 48 hours in all patients with a stent. Thirty days mortality and stent related complications were respectively 0% and 37.5% for group I, and 20% and 50% for group II. All complications were minor except for one colic perforation by a guidewire. CONCLUSION: Stent insertion was effective and provided relief of colic obstruction in the majority of cases. Randomized studies would be necessary to demonstrate a definitive reduction in mortality and morbidity with this technique as compared to the classical surgical approach.

[Fluid-fluid level in a non functioning and hemorragic neuro-endocrine islet-cell tumor of the pancreas: MRI features]. / Niveau liquide-liquide dans une tumeur neuro-endocrine du pancréas non fonctionnelle et hémorragique: aspects en IRM.

The authors report the MR features of a non functioning and hemorragic islet-cell tumor of the pancreas. This tumor was composed of a central cystic component with a fluid-fluid level seen on T1- and T2-weighted images and a peripheral hypervascular soft tissue component which showed hyperintensity on T2-weighted images with fat saturation.

[MRI of an afferent loop syndrome presenting as obstructive icterus]. / IRM d'un syndrome de l'anse afférente révélé par un ictère obstructif.

The afferent loop syndrome corresponds to an acute or chronic obstruction of the afferent loop following a partial gastrectomy with Billroth II gastro-jejunal anastomosis. We describe the case of a 77-year-old man with history of partial gastrectomy for peptic ulcer disease performed 31 years ago and currently admitted for jaundice and poor general status. MR imaging showed dilatation of biliary and pancreatic ducts and showed a soft tissue mass between the afferent loop and the residual stomach. Endoscopy showed complete obstruction of the afferent loop by a biopsy-proven adenocarcinoma. The patient died of sepsis shortly after endoscopy of septicemia.

[Macroscopic intrahepatic portosystemic venous shunt: review of the literature and reclassification]. / Shunts veineux portosystemiques intrahepatiques macroscopiques: revue de la litterature et reclassification.

Macroscopic intrahepatic portosystemic venous shunts (IHPSS) are defined as communications between the portal and the systemic venous circulation, measuring more than 1mm in diameter, and at least partially located inside the liver. Four different types can be identified based on anatomical, clinical, and pathophysiological criteria. Type I includes patent paraumbilical veins, located in the liver, and commonly encountered in portal hypertension. Types II, III, and IV are much less common and have been reported in only 47 publications in the entire French and English literature. They include shunts, unique or multiple, between a portal branch and a hepatic vein, located either in two adjacent liver segments (type II) or in non-adjacent liver segments (type III). Type IV corresponds to any tubular communication developed between the right portal branch and the inferior vena cava. The exceptional patent ductus venosus or a patent umbilical vein should not be considered as IHPSS since their course is strictly extrahepatic.

[Radiologic aspects of the complications of duodenal diverticula]. / Aspects radiologiques des complications des diverticules duodénaux.

The duodenum is the second most common site, after the colon, for intestinal diverticulae. This condition is most often asymptomatic and is usually an accidental finding. Complications, with variable clinical presentations, may occur in up to 5% of such individuals. We report a retrospective analysis of 5 patients who presented with complicated duodenal diverticular disease. The complications, either isolated or multiple, consisted of bezoar formation (n = 2), diverticulitis (n = 2), extrinsic compression of the common bile duct (n = 3), perforation (n = 1), choledocholithiasis (n = 1), and an abnormality of the bilio-pancreatic ductal convergence (n = 1). The radiological aspects, in particular, the magnetic resonance imaging (MRI) features are reviewed. These are, to our knowledge, the first descriptions of MRI and magnetic resonance cholangiopancreatographic (MRCP) findings in complicated duodenal diverticular disease. MRI facilitates precise delineation of the complicated duodenal diverticulum while MRCP allows assessment of the effects on the biliary and pancreatic ducts.

Hepatitis A virus sequence detected in clotting factor concentrates associated with disease transmission.

Since the early 1990s hepatitis A virus (HAV) infections among recipients of solvent-detergent treated factor VIII concentrates have occurred in Europe, South Africa and the United States. A review of the epidemiological and laboratory-based investigations of the outbreaks in Germany and Ireland were consistent with transmission by factor concentrates but limited information about transmission based upon nucleic acid sequences was obtained, and no clear chain of transmission could be established. Within the United States, hepatitis A infections associated with solvent detergent concentrate occurred in a single patient in 1993, and a cluster of cases in 1995. Although the 1993 factor concentrate was positive for virus, samples from the patient were not available. The virus present in the cluster of 1995 factor VIII patients, the factor concentrate they received, and the original plasma pool was identical, while the virus identified in the factor IX patient differed by a single base.