François Mignon

Life-threatening spontaneous psoas haematoma treated by transcatheter arterial embolization.

Abstract. We report two cases of large spontaneous psoas haematoma in patients on anticoagulant therapy. Active bleeding was well demonstrated on spiral CT. Transcatheter arterial embolization was used successfully to stop bleeding. The diagnostic strategy, the relevance of spiral computed tomography and our therapeutic approach to this complication are discussed.

Occlusive arterial disease of abdominal aorta and lower extremities Comparison of helical CT angiography with transcatheter angiography

The purpose of this study was to evaluate helical CT angiography in the assessment of occlusive arterial disease of abdominal aorta and the lower extremities. Sixteen patients underwent both transcatheter angiography and helical CT. Helical CT was inconclusive in 6.2% of segments whereas angiography was inconclusive in 5%. The overall sensitivity of helical CT was 91% and specificity 93%. Segmental analysis found a sensitivity of 43% in infrapopliteal arteries, and a specificity of 86%.

Late presentation of solitary contralateral adrenal metastasis of renal cell carcinoma

Abstract. We report a case of renal cell carcinoma with solitary metachronous contralateral adrenal metastasis occurring 23 years after radical nephrectomy. The patient was treated with adrenalectomy. He is alive with no evidence of disease 1 year postoperatively. Solitary metachronous contralateral adrenal metastases from renal cell carcinoma are rare clinical conditions that may occur very late. Metastasectomy is advocated and is probably beneficial for limited metastatic renal cell cancer.

Unusual mammographic and ultrasonographic findings in fibromatosis of the breast

Abstract. Fibromatosis of the breast is an uncommon disease, most often appearing as an aggressive lesion mimicking carcinoma on mammography. We describe, in an asymptomatic 40-year-old woman, an unusual imaging appearance of fibromatosis of the breast mimicking a benign lesion at mammographic and sonographic studies.

Anomalous origin of the left coronary artery arising from the pulmonary trunk: report of an adult case with long-term follow-up after surgery

Abstract. An anomalous origin of the left coronary artery arising from the pulmonary artery is a congenital malformation rarely described in adults. We report the case of a 65-year-old patient with this anomaly. Clinical presentation, imaging identification (coronary angiogram, MRI and electron-beam CT), surgical treatment and angiographic long-term follow-up are described.

Head and neck cancer patients with pulmonary nodules: value and role of CT-guided transthoracic needle aspiration biopsies.

To evaluate transthoracic needle aspiration biopsies of pulmonary lesions in patients with squamous cell cancer of head and neck.

The Treated Thorax in Patients with Hematological Malignancies

Thoracic complications and changes are frequent in patients with hematological malignancies. In those patients with advanced hematological malignancies pulmonary complications, mostly related to chemotherapy, can be a leading cause of death. Tenholder and Hooper found that 98% of leukemic patients showed pulmonary complications at autopsy (TENHOLDER and HOOPER 1980). Of note however, in recent years the frequency of radiation-induced complications has decreased. As the number of survivors increases, several late effects of treatment are becoming evident, some of them — second malignancies, cardiovascular complications — emerging as a major threat to the survival of these patients. To offer the best in patient care, it is imperative to understand the natural history of the disease as well as the treatment related complications and changes. In this chapter, post-therapeutic thoracic changes after chemotherapy and radiation therapy are discussed and illustrated.

THO-WP-4 Embolies pulmonaires non cruoriques : ce que le radiologue doit savoir

Objectifs Reconnaitre les differentes embolies pulmonaires non cruoriques. Connaitre les differentes modalites d’imagerie (radiographie de thorax, scintigraphie pulmonaire, tomodensitometrie multibarette, angiographie pulmonaire) et leurs resultats qui permettront de diagnostiquer une embolie pulmonaire non cruorique (tumorales microscopiques et macroscopiques, les septiques, gazeuses, graisseuses, corps etranger, ciment, mercure). Connaitre les elements qui permettront de les differencier des embolies pulmonaires cruoriques. Points cles A l’issue de ce poster, le lecteur doit etre capable de reconnaitre ces differentes entites en fonction du contexte et tableau clinique. Il doit connaitre leur aspect en imagerie qui permettra de les distinguer des embolies pulmonaires cruoriques.

DIG-WS-15 Ischemie colique transmurale : aspects cliniques et tomodensitometriques

Objectifs Revue des aspects cliniques et tomodensitometriques des ischemies coliques transmurales. Materiels et methodes Revue retrospective des ischemies coliques transmurales qui ont beneficie d’une colectomie dans notre institution de 2004 a 2006. Les elements cliniques ont ete revus. Les criteres tomodensitometriques analyses par deux radiologues etaient la distribution, la localisation, l’epaisseur de la paroi, la presence d’une pneumatose, de gaz dans le systeme porte, de densification de la graisse, d’epanchement peritoneal (aerique ou liquidien). L’aspect tomodensitometrique a ete correle a l’histologie. Resultats Quatorze patients etaient identifies. L’âge moyen etait de 68 ans (36-86 ans). Dix d’entre eux presentaient une HTA (71 %). Six etaient en etat de choc (42 %) et 4 etaient hemodialyses (28 %). Neuf (64 %) sont decedes. L’ischemie etait colique chez 10 patients (71 %). Dans 7 cas la paroi etait epaissie (50 %) et dans 7 cas etait consideree d’epaisseur normale ou fine (50 %). Une pneumatose etait presente chez 11 patients (78 %) avec dans 5 cas une aeroportie (36 %). La graisse pericolique etait toujours densifiee et 12 presentaient un epanchement liquidien (82 %). Conclusion Le pronostic des ischemies coliques transmurales est severe. L’atteinte colique droite est predominante. Une epaisseur parietale normale, voire fine, n’est pas rare, mais est le plus souvent associee a une pneumatose.

SEIN16 Les differentes facettes des vaisseaux en pathologie mammaire

Objectifs Decrire les differentes pathologies, benignes ou malignes, pouvant affecter ou etre en relation avec les vaisseaux de la glande mammaire. Materiels et methodes Il s’agit d’un travail original, qui exposera differentes anomalies « vasculaires » ou « pseudo-vasculaires » du sein : 1) les tumeurs vasculaires type hemangiome et angiosarcome, 2) les PASH (pseudoangiomatous stromal hyperplasia) dans leurs formes microscopiques et macroscopiques, 3) les hematomes post-traumatiques, 4) les varices et malfromations arterio-veineuses, 5) la maladie de Mondor, et 6) les calcifications vasculaires. Resultats Cette presentation didactive et interactive exposera des cas d’anomalies vasculaires et pseudo-vasculaires, en presentant les aspects cliniques, mammographiques, echographiques, IRM avec correlations histologiques. Conclusion Differentes anomalies vasculaires et pseudo-vasculaires peuvent affecter la glande mammaire. Ce travail familiarisera le radiologue avec ces differentes entites.