[Heart and heart-lung transplants thorax complications: major radiologic forms]. / Complications thoraciques des greffes pulmonaires et cardiopulmonaires: principaux aspects radiologiques.

Bipulmonary and cardiopulmonary transplantations are among the most difficult to perform, with a 10-year survival rate estimated at 33%. This low rate can be attributed to thoracic complications that can be classified into three distinct groups: 1) early complications, occurring in the first 30 days after transplantation (hemothorax, diaphragmatic paralysis, reperfusion edema, hydric overloading, acute rejection); 2) late complications that occur beyond the first month (bronchiolitis obliterans syndrome, bronchic stenosis, sirolimus-induced lung disorders, initial disease recurrence); and 3) infections classed separately because of their high morbidity and mortality (thoracic wall abscess, bacterial and viral pneumonia, CMV, pneumocystosis, Aspergillus necrotizing bronchitis). Imaging is essential in screening and diagnosing these complications as part of the clinician's monitoring throughout the rest of the transplant recipient's life. In diagnosis, combined with clinical and biological data, imaging has its place in delaying the onset of these diseases.

[Anatomy of the heart and coronary arteries]. / Anatomie du coeur et des artères coronaires.

Orientation and morphology of the heart and coronary vessels are the basis of cardiac imaging. Knowledge of the configuration of cardiac cavities within the thorax and of the course of coronary vessels is mandatory in order to plan and carry out magnetic resonance imaging acquisitions and computed tomographic reformations. These anatomical features are described, with focus on useful data for acquisition and interpretation of imaging studies. MR and CT images will be presented.

[Quantitative angiography: update for peripheral vascular applications]. / Angiographie quantitative: mise au point pour des applications vasculaires périphériques.

Visual estimation of vessel diameter is unreliable and observer-dependent. With digital angiography, software for accurate quantification of arterial diameter are available. They allow: (1) selection of equipment of appropriate size (balloons, stents, etc) during revascularization procedures, (2) objective evaluation of the results of such procedures, (3) comparison between follow-up measurements and initial measurements and (4) provide reproducible data in the case of multicenter studies. The widespread availability of digital systems has been accompanied by a dramatic increase in the number of software packages for quantification. The present article reviews some of the currently available methods for quantification, presents the advantages and pitfalls of each system, and outlines their limits.

Long-term follow-up of Vena Tech-LGM filter: predictors and frequency of caval occlusion.

PURPOSE: To report the frequency of caval occlusion after Vena Tech-LGM filter placement and identify related factors and their potential clinical significance. MATERIALS AND METHODS: The filter was inserted into 243 patients, 142 of whom met inclusion criteria for this prospective study. Follow-up examinations performed every 2 years included clinical evaluation, plain frontal radiography of the abdomen, duplex scanning of the inferior vena cava (IVC), and/or phlebocavography. RESULTS: A progressive decrease in IVC patency was observed, reaching 66.8% at 9 years of follow-up. Complete caval occlusion occurred in 28 patients and was significantly (P < 10(-6)) associated with retraction in 24 cases. Caval occlusion was not related to age, sex, pulmonary embolism (PE), deep venous thrombosis level, underlying conditions predisposing to a thromboembolic disease before filter insertion, the level of filter placement, use of anticoagulant therapy, and death during follow-up. PE with anticoagulation failure was a predictive factor (P = .016) of subsequent filter occlusion during follow-up as compared to all other clinical indications for filter placement. Filter patency at 9 years of follow-up was 35.2% in the PE group with anticoagulation failure and 80% for other patients (odds ratio, 2.5; 95% confidence interval 1.16-5.4). CONCLUSION: PE with anticoagulation failure was the only factor predictive of subsequent caval occlusion observed in patients after Vena Tech-LGM filter placement. Caval occlusion was also related to Vena Tech-LGM filter retraction, which usually occurred at the time of occlusion.

[Imaging of the pleura]. / Imagerie de la plèvre.

We review the respective informations yielded to the physician bu the different techniques of medical imaging (conventional radiography, ultrasounds, and computed tomography) according to the presentation of pleural diseases. Conventional radiography is always useful for diagnosis. Ultrasound is useful to confirm and localize pleural effusion. Computed tomography contributes to precise the location of pneumothorax and pleural effusion, and the possible underlying pulmonary disorders. Computed tomography also allows to precisely characterize the different types of pleural thickening, including malignant mesothelioma.

Pericardial effusion associated with asbestos exposure.

The case history is presented of a 60 year old man who developed a pericardial effusion. Chest radiography showed pleural thickening and calcification. Pericardiotomy was performed and revealed nonspecific inflammatory lesions. Occupational exposure to asbestos and exclusion of other causes led to the diagnosis of benign asbestos pericardial effusion.

[Value of plain abdominal radiography for evaluating the patency of LGM caval filters]. / Valeur du cliché de l'abdomen sans préparation (ASP) pour apprécier la perméabilité des filtres caves LGM.

OBJECTIVES: To evaluate the value of plain abdominal X-Ray to detect vena Tech LGM filter occlusion or patency during follow-up. METHODS: Eighty-nine patients were followed in a prospective study for 2 to 6 years after vena Tech LGM filter implantation. The control examination consisted in a clinical examination, a plain abdominal X-Ray (to measure expansion index = diameter/height of the filter and to detect migration and angulation) and a Doppler ultrasonography and/or a cavography to appreciate filter patency. RESULTS: 175 plain abdominal X-Ray, 172 Doppler ultrasonographies and 28 cavographies were done. Sensitivity and specificity of retraction to suspect a filter obstruction were respectively: 82.3% and 86.1%; if expansion index was lower or equal to 0.34 its sensitivity and specificity were 100% and 92.1%. The negative predictive values of retraction and of the association retraction-migration to exclude a filter obstruction were 85.1% and 96%. CONCLUSION: Absence of migration or retraction on plain abdominal X-Ray during the follow-up is highly predictive of filter patency. This limits the use of Doppler ultrasonography and cavography.