Ultrasound and computed tomographic findings in pancreatic metastases.

This is a retrospective study of a series of seven patients with pancreatic metastases studied by ultrasonography and computed tomography. They were detected during tumor staging, or in the follow-up period of over 10 years of patients with advanced known malignancy. Lesions were multiple in two patients and solitary in five; solid in six cases and cystic in one. Clinically, four cases were asymptomatic and three cases presented with jaundice or epigastric pain. Ultrasonography and computed tomography findings were non-specific. Consequently it was not possible to differentiate solitary metastases from primary solid adenocarcinoma and cystadenocarcinoma of the pancreas. In these cases, computed tomography- or ultrasonography-guided biopsies had to be performed to obtain histological proof. However, multiple lesions discovered in a patient with a known malignancy can be assumed to be due to metastases.

Diagnosis and categorization of small bowel neoplasms: role of computed tomography.

A retrospective study of 35 patients with small bowel neoplasms studied by computed tomography (CT) was performed. The tumor detection rate was 80%. Using the findings reported in the literature, an adequate histological diagnosis could be performed in 69% of the cases by CT. Lipomas, leiomyomas, leiomyosarcomas, and carcinoid tumors were well-recognized, but adenocarcinomas and lymphomas were often mistaken one for the other. An accurate preoperative staging was performed in 61% of the cases. CT failed to detect 75% of the invaded lymph nodes, 25% of the liver metastases, and 25% of the tumoral growth beyond the bowel wall. Despite major limitations in preoperative staging, a good detection rate and some features allowing a specific diagnosis advocate using CT along with the barium examination when clinical history suggests a small bowel tumor.

Bronchial carcinoma following pulmonary and thoracic wall actinomycosis: report on one case with emphasis on CT findings.

A case of bronchial carcinoma following pulmonary and thoracic wall actinomycosis is presented. Although pulmonary defense mechanisms are known to decrease with actimyces infection, the development of malignancy following chronic inflammation as in our case, has not in our knowledge been previously reported.

The value of MRI in the study of spinal extradural arachnoid cysts.

Two cases of extradural arachnoid cyst in the spinal canal were diagnosed by magnetic resonance imaging (MRI). MRI correctly characterized the extradural location of the cysts as well as the cyst contents as CSF, thus establishing the diagnosis. MRI may be of predictive value in the postoperative prognosis.

[MRI and surgery of epilepsy]. / I.R.M. et chirurgie de l'épilepsie.

The evaluation of M.R.I. in the presurgical management of epilepsies requires establishing the significance of the abnormal signals. In 15 cases, correlations among M.R.I., electrophysiological data obtained by chronic intracerebral recordings and histological examination were studied. Abnormalities were detected by M.R.I. in 12 cases (80%). An accurate epileptic-focus topographical orientation was obtained by M.R.I. in 10 cases. But M.R.I. findings did not coincide with functional data obtained by S.E.E.G. recordings. Abnormalities detected by M.R.I. led to rectify the previous hypothesis about the epileptic focus localization in two cases. One false positive and one case of incomplete data would have been misleading if S.E.E.G. had not been performed. M.R.I. abnormalities included two morphological changes and ten high intensity T2 signals. The increased T2 intensity was more often focal (9) than diffuse (1). Among the 8 cases of increased T2 intensity correlated to the epileptic focus, 1 was histologically normal, 3 corresponded to specific lesions (astrocytoma: 1, hamartoma: 2) and 4 corresponded to non specific lesions (gliosis: 2, spongiosis: 2). When M.R.I. was normal at the site of the epileptic focus, either no alteration (2) or non specific lesions (2) were found. Uncus herniation could not be identified with M.R.I. M.R.I. has proven sensitive, detecting small epileptogenic lesions missed by C.T. Moreover in some cases, high T2 signals have been correlated topographically with the epileptic focus and histologically with non specific lesions. These signals are more likely related to a functional phenomenon such as an increase in water content than to the histopathological findings themselves.