B. Dupas

Aortic involvement in recent‐onset giant cell (temporal) arteritis: A case–control prospective study using helical aortic computed tomodensitometric scan

OBJECTIVE The prevalence of the involvement of large vessels in giant cell arteritis (GCA) is 3-13%. Aortitis is the most serious complication of GCA. Computed tomodensitometric (CT) scan allows analysis of both the aortic wall and endoluminal part of the aorta. Therefore, we conducted a study using CT scan to analyze aortic abnormalities in patients with recent-onset GCA. METHODS This prospective controlled study compared patients with biopsy-proven GCA with a matched control group based on sex, age, and cardiovascular risk factors. During the 4-week period following diagnosis of GCA, patients underwent an aortic CT scan. The aortic imaging results were blindly compared between both groups. RESULTS From January 5, 1998 to January 11, 1999, 22 patients and 22 controls were screened by CT scan for aortic involvement. Thickening of the aortic wall was more frequent among patients than controls (45.4% versus 13.6%; P = 0.02). Aortic thickening (mean 3.3 mm) was located on the ascending part of the thoracic aorta in 22.7% of the patients, with no evidence of thickening in the controls (P = 0.05). Thickening of the abdominal aortic wall was noted in 27.3% of the patients and none of the controls (P = 0.02). CONCLUSION This study suggests that inflammatory aortic thickening, detected by CT scan, occurs frequently at the time of diagnosis of GCA, and that this condition predominantly occurs on the ascending part of the aorta.

Angiomagnetic resonance imaging of iliofemorocaval venous thrombosis.

Although magnetic resonance imaging has been proposed for the diagnosis of deep venous thrombosis (DVT), its role in diagnostic strategy remains to be defined. We compared prospectively magnetic resonance angiography (MRA) with two-dimensional time-of-flight with contrast venography (CV) and colour duplex sonography (CDS) in 25 patients with DVT of the pelvis confirmed by CV. All patients were examined by CV (gold standard) and MRA and 17 by CDS. These studies were compared for DVT diagnosis in the pelvis and inferior vena cava and analysis of thrombotic spread. MRA was positive in 25 patients whose DVT was diagnosed by CV (100% sensitivity). MRA sensitivity and negative predictive value were 100%, specificity 98.5% and positive predictive value 97.5% for the diagnosis of thrombosis at each anatomic level. There were discrepancies between MRA and CV (2 false-positive results for 2 venous segments) and between CDS and CV (2 false-positive and 3 false-negative results). CV was uninterpretable for 8.8% of segments and CDS was often technically limited to the pelvic level, whereas all venous segments explored were analysable in MRA. MRA gave excellent results for positive diagnosis and DVT spread. MRA is a potentially valuable technique for assessing iliofemorocaval venous thrombosis.

Diagnostic étiologique des thromboses de l’aorte : à propos de 11 nouveaux cas

10 iagnostic étiologique des thromboses de l’aorte : propos de 11 nouveaux cas . Connault a,∗, C. Durant a, B. Dupas b, M.-A. Pistorius a, Y. oueffic c, B. Planchon a, M. Hamidou a Service de médecine interne, Hôtel-Dieu, CHU de Nantes, 1, lace Alexis-Ricordeau, 44093 Nantes cedex 1, France Service de radiologie centrale, Hôtel-Dieu, CHU de Nantes, rance Service de chirurgie vasculaire, hôtel Guillaume et René aënnec, CHU de Nantes, France

Diagnostic différentiel des agénésies et des thromboses anciennes de la veine cave inférieure : à propos de 4 cas

S. Zuily a,b,c,∗, V. Bravetti a, L. Saadi a, M. Sosa d, C. Selton-Suty c, F. Plenat e, J.-P. Villemot d, D. Wahl a,b a Service de médecine interne et vasculaire, hôpitaux de Brabois, CHU de Nancy, France b Inserm U734, faculté de médecine, université Henri-Poincaré Nancy-1, France c Département de cardiologie médicale, hôpitaux de Brabois, CHU de Nancy, France d Service de chirurgie vasculaire, hôpitaux de Brabois, CHU de Nancy, France e Laboratoire d’anatomie et cytologie pathologiques, hôpitaux de Brabois, CHU de Nancy, France ∗Auteur correspondant.