[Value of sonography in the diagnosis and follow-up of patients with cryptogenic inflammatory bowel diseases in current practice: review of a 10-year experience in a community hospital]. / Intérêt de l'échographie dans le diagnostic et le suivi des maladies inflammatoires cryptogénétiques de l'intestin en pratique courante. A propos de dix années d'expérience d'un service d'imagerie générale hospitalier privé.

Inflammatory bowel diseases (IBD) are chronic inflammatory diseases of the bowel that are of unknown etiology. These diseases either progress with intermittent flare-ups interrupted by periods of remission or on a chronic active progressive mode. IBDs include Crohn disease (CD) and ulcerative colitis (UC). Clinical and imaging diagnosis often is challenging, hence explaining the frequent time delay between onset of disease and initiation of therapy. Clinical evaluation is characterized by three consecutive steps: consider a diagnosis of IBD; exclude other causes of inflammatory bowel disease; differentiate CD from UC since a definitive curative surgical treatment is available for UC. US is non-invasive, widely available, easy to perform, and relatively inexpensive and thus represents a significant advance in the evaluation of these three steps. The role of US in the evaluation of patients with suspected IBD will be reviewed.

[Quantification of hepatic arterial and portal venous flow using ultrasound contrast agents for early detection of liver metastases of colorectal cancers]. / Quantification des débits hépatiques artériel et porte à l'aide des produits de contraste ultrasonores: application au diagnostic précoce des métastases hépatiques des cancers colorectaux.

PURPOSE: To quantify liver blood flow using US contrast agents and to evaluate arterial and portal changes in control patients and patients with liver metastases. MATERIALS AND METHODS: Twenty eight patients were included in this study, 8 controls (M0) and 20 patients with liver metastases from colon carcinoma (M+). Hepatic blood flow from hepatic artery and portal vein were determined using quantification of enhancement after contrast injection using Power Doppler US. The ratio of enhancement rise from artery and vein allows calculation of Contrast Enhanced Doppler Perfusion Index (CEDPI) as previously described for Doppler Perfusion Index (DPI). RESULTS: A significant difference was noted for CEDPI between controls (0.49 +/- 0.07) and liver with metastases (0.70 +/- 0.12). CONCLUSION: This functional method of evaluation of liver blood flow was easy to perform, and would be valuable for early detection of overt micro-metastases before anatomical changes observed by conventional imaging. This is helpful for accurate staging of colon carcinoma.

[Imaging of osteoarticular diseases of the anterior chest wall]. / Imagerie des affections ostéo-articulaires de la paroi thoracique antérieure.

The purpose of this paper is to present a pictorial display of osseous and articular lesions of the anterior chest wall. The role of CT and MR imaging in such disorders is emphasized. Imaging of the anterior thoracic wall by plain films is particularly difficult. However numerous disorders may be encountered. They include inflammatory hyperostosis and sclerosis of the clavicle and the sternum, condensing osteitis and post-traumatic osteolysis of the clavicle, radiation osteitis of the sternum and the ribs, septic arthritis of the sternoclavicular joint, primary and secondary tumors of the sternum and the ribs. We illustrate a spectrum of such lesions in which CT and MR imaging provides acute evaluation of both soft tissue and bone details.

[Initial locoregional chemotherapy in recurrent and locoregional advanced or inoperable stages of pelvic uterine and anorectal cancers]. / Chimiothérapie locorégionale initiale dans les récidives et les formes locorégionales avancées ou inopérables des cancers pelviens utérins et anorectaux.

The authors report their 12 years of experience of intra arterial chemotherapy in pelvic recurrences and inoperable advanced stages of uterine carcinoma, rectal cancer and anal cancer. In squamous cell cancers the drug associations were mitomycin C, bleomycin, fluorouracil and folinic acid and cisplatin. In adenocarcinoma the same protocol contained no bleomycin. Drugs were infused for a 48 hours period in continuous infusion. The dosages were the same than in the intravenous regimens. Twenty patients with pelvic recurrences were included in this retrospective study: six were uterine cancers, fourteen were colo rectal cancers and two had advanced stage uterine cancer. Pain decreased in 10/14 patients with ano-rectal cancer pre sacral recurrence. Partial response was observed in 12 patients. Complete secondary surgical resection was possible in 4/14 rectal cancers and 6/6 uterine cancer recurrences. Chemotherapy induced a pathological complete response in 4/6 uterine cervix carcinoma recurrences. These observations led to perform pelvic intra arterial chemotherapy as first line treatment of locally-advanced inoperable pelvic tumors: 11 uterine cancers and five ano-rectal cancers. The objective were: tumor reduction before radiotherapy or surgery, tumor sterilization, decrease tumor volume for better radiation dosimetry, increase the chance of organ-preservation. The observation of tumor reduction in this small number of patients does not allow to draw definite conclusions. However the introduction of intra arterial pelvic chemotherapy as first line treatment of inoperable pelvic cancer warrants further studies.

[CRST syndrome with diffuse peri- and intra-articular calcifications. Value of x-ray computed tomography]. / CRST syndrome avec calcifications péri et intra-articulaires diffuses. Intérêt de la scanographie.

A patient with calcinosis universalis presented extensive calcifications involving fingers, shoulders, thoracic wall and cervical spine. Computed tomography imaging appeared to be a highly valid method of investigation of calcification of soft tissues and allowed detection of an intra-articular scapulohumeral calcium-provoked effusion.

[Role of computed tomography in the radiologic exploration of the pterygomaxillary fossa]. / L'apport de la scanographie dans l'exploration radiologique de la fosse ptérygo-maxillaire.

The authors show the interest of C.T. examination of pterygo-maxillary region, principally in the pre-therapeutic staging of the maxillo-facial neoplasy. The anatomical division of the fossa in four regions (pterygoïd muscle area, lateropharyngeal area, pterygo-palatine fossa and retro-maxillary-malar area) can be easily applied to C.T. study. Cuts must be taken axially, in the orbito-meatal plane, and coronally always if possible, before and after administration of contrast medium. Six, out of thirty six cases studied were demonstrative. It appears that C.T. examination must be performed immediately after conventional radiology in the staging of maxillo-facial neoplasy. It shows with considerable accuracy not only the bony involvement, but also the extension in the soft tissues (interest of the densitometric study of fat) and aeric structures. It sometimes brings the solution of special clinical problems (Trismus, neuralgia of the facial nerve).