[Presentation of the French translation of the Breast Imaging Reporting System and Data System (BI-RADS)]. / Présentation de la traduction française du BI-RADS (Breast Imaging Reporting System and Data System).

BI-RADS is a system of assistance to the drafting of the reports more and more used in the world and soon directly implemented on mammography and ultrasound units. The categories of evaluation of the BI-RADS allow a clear synthesis of the descriptive data resulting from the use of the lexicon and invite the radiologist to a reasoned, objective and less intuitive step. They give an action to be taken and responsibility to the radiologist and the referring physicians in the assumption of the patients. The 4th edition of the BI-RADS mammography appeared in 2003, and is now associated with the first editions of the BI-RADS ultrasound and MRI.

Sonography of palpable breast cancer.

PURPOSE: Because of the increasing use of sonography to rule out cancer in women with palpable breast abnormalities, this study was performed to determine the rate of sonographically occult malignancy in this clinical setting. METHODS: Women who were recommended for biopsy based on mammographic and/or clinical findings underwent breast sonography. This study retrospectively analyzed the subset of patients with palpable malignant lesions. Lesions were classified as visible or occult on mammography and sonography. Patients without a tissue diagnosis of tumor were excluded. RESULTS: Of 1,346 masses that underwent biopsy or aspiration, 616 lesions were palpable, and of these, 293 were malignant. Sonography detected all 293 palpable malignant lesions (95% confidence interval for sensitivity, 99-100%). Eighteen lesions were mammographically occult. The median lesion size as determined by sonography was 1.8 cm; for the lesions that were mammographically occult, the median size was 1.6 cm. The most common histopathologic diagnosis for both groups of lesions was infiltrating ductal carcinoma. CONCLUSIONS: All palpable malignant breast lesions were visible by sonography in patients in whom a biopsy was recommended. However, we caution that until the false-negative rate of sonography for equivocal palpable abnormalities is determined prospectively, sonography cannot be accurately applied to rule out malignancy in this setting.

[Internal supporting mammary lamina. Results of the detection of breast lesions]. / Les "soutiens-gorge internes". Conséquences sur le dépistage des lésions mammaires.

In order to stabilize the curves of a surgically remodelled breast, Bustos associated to a periareolar mammaplasty a synthetic internal supporting lamina. At the beginning, in 1985, a smooth perforated silicone sheet was used. Since then, other materials were proposed (radioopaque ou radiotransparent, resorbable or not). Because of their superficial situation, in front of the mammary gland, it was essential to study the consequences of the presence of such a material on the mammographic follow-up. We radiographied all the different types of sheet in vitro, and also in vivo, 3 to 19 months after surgery. At the same time we studied the modifications in the breast tissue, in 117 patients after surgical treatment for ptosis or mammary hypertrophy, using different kinds of incisions (periareolar or anchor-shaped, J or L shaped, inferolateral oblique or lower vertical incisions). We also studied the effects of mammary implants covered with Dacron, since some internal mammary supporting lamina are made with this material. The silicone sheet gives some artifacts and may calcify. The resorbable sheet has no effects on the mammography. The radiotransparent non resorbable ones causes no problems on short terms, but we are not sure whether some calcifications appear on long term or not.

[Echogenic gallbladder sludge: ultrasonographic study and pathological significance in 74 cases (author's transl)]. / Etude échographique du liquide échogène intra-vésiculaire. Signification pathologique à propos de 74 cas.

Correlations between ultrasonographic and clinical and histological findings were studied in 74 patients presenting with echogenic gallbladder sludge. The majority of patients in whom bile examinations had been performed had either pus, blood, biliary sediment, or microcalculi in the bile, but precise identification of the nature of the sludge does not appear to be possible on ultrasonography. Calculi were present in the gallbladder in 39 p. cent of these patients, only 9 p. cent demonstrating the presence of sludge without established liver or biliary lesions. This ultrasonographic image appears, therefore, to be a clinically significant valid finding.

[Diagnostic value of ultrasonography in pancreatic duct dilatation. Results in 29 cases (author's transl)]. / Intérêt du diagnostic échographique de dilatation du canal de Wirsung. Etude de 29 cas.

Results of diagnostic ultrasonography in 29 patients with pancreatic duct dilatation were able to define the value of this procedure in the diagnosis of chronic pancreatitis and particularly cancer of the pancreas. Dilatation of the duct may in fact be the only ultrasonographic sign of a pancreatic lesion. It is now possible to study the pancreatic duct by ultrasonography, and this method of exploration should be employed whenever the pancreas has to be investigated.