Jacques Drouillard

Normal Variants of the Sella Turcica

Complete study of the sella turcica requires multidirectional tomography. The authors have studied 200 radiographs of normal adults and noted the percentage of variants of each anatomical feature on both standard radiographs and tomograms. The greatest drawback of the standard radiograph is the difficulty in objectively evaluating the effect of pneumatization and/or a septum of the sphenoid sinus on the sellar floor. In this series the floor was concave in 58% of patients, flat in 32.5%, and convex in 9.5%. Lesions which simulate erosion of the posteromedial part of the lamina dura correspond to thinning of the central portion of the base of the dorsum sellae.

Ultrasonography of hepatic cavernous haemangiomas

Cavernous haemangiomas, the most frequent benign tumours of the liver, are discussed by the authors in connection with 50 personal cases and surveillance of 35 solitary hyperechoic nodules less than 3 cm diam. without clinical or biological abnormalities. All the diagnostic images are reviewed but attention is focussed on ultrasound. All US patterns may be observed, but if the lesion is less than 3 cm, the echostructure is often hyperechoic and homogeneous. In view of their asymptomatic nature and the absence of risk of evolution for these small hyperechoic lesions, it appears legitimate to propose surveillance merely by US if there are no clinical symptoms and if liver function tests are normal.

Hepatic lipomas: Ultrasound and computed tomographic findings

Five cases of solitary hepatic lipoma are described. These rare tumors have ultrasound (US) and computed tomographic (CT) characteristics that suggest the diagnosis. As imaged by US, hepatic lipomas always correspond to a highly echogenic, well-limited lesion with posterior attenuation. Precontrast CT scans reveal a low-density lesion (−20 to −70 HU); following contrast material injection, the tumor density may either remain negative (pure hepatic lipoma) or become positive (limit, 40 HU) when there is an associated adenomatous component. Hepatic lipomas involve no risk of degeneration, and follow-up by US is sufficient.A case of lipoma of the falciform ligament and a case of a hepatic pseudolipoma are also described; sonograms were negative in both instances, and CT was required for diagnosis.

Non-vaterian duodenal adenomas: Report of 24 cases and review of the literature

Twenty-four cases of duodenal adenomas which did not originate at the ampulla of Vater are discussed. The radiographic and clinical features of these lesions are presented together with a review of 120 cases previously reported in the literature. The role of barium studies and endoscopy in the evaluation of these adenomas is emphasized. A diameter of more than 5 cm represents a criterion favoring malignant degeneration of such non-Vaterian adenomas.