Biomedical subjects
Publications and source records attributed to C Delgoffe.
A case of a 6-year-old boy with a painful dorsal scoliosis secondary to an osteoid osteoma in a rib is described. Surgical excision was performed and the scoliosis decreased. Such cases are very rare.
Four patients with deep visceral actinomycosis infections presented evidence of extension to the thoracic or abdominal wall. Investigation of the chronic parietal suppuration by CT scan imaging allowed definition of the nature and extent of parietal infiltration, and notably to demonstrate its anatomical continuity with the often unrecognized deep focus: chronic lung disease, appendicular or colon mass, chronic genital infection in patients with intra-uterine device.
The most common type of gastric metastases secondary to carcinoma of the breast is the one showing a linitis plastica appearance. The roentgenologic aspect when performing an upper gastrointestinal examination with barium contrast is typical and allows the differential diagnosis with the primitive linitis. The linitis plastica type of metastatic breast carcinoma results from transmural infiltration of the stomach wall with initial deposit of tumor cells in the submucosal or subserosal regions. CT provide valuable information concerning the metastatic spread.
The authors describe the radiologic appearance of annulo-aortic ectasia in 26 patients who had plain chest radiography and aorto-seriography. Two also underwent C.T. Aortography is the most performing method to appreciate the extent of aortic ectasia, the perturbations of the aortic root and to diagnose acute or chronic dissections. Aortography remains a most valuable complement of echocardiography for preoperative staging.
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By means of a review of a series of 30 cases of hepatic alveolar echinococcosis, the authors propose a classification of the various sonographic patterns; they point out the heterogeneous form which associate necrosis and calcification inside an hyperechoic mass and is the most frequent. The interest of ultrasonography for detection of lesions, its limits for diagnosis of extension, the contribution of percutaneous biopsy are discussed, as its place in the survey of the affection.
Radiologic findings are described in 4 cases of annular pancreas in adults. The value of double contrast exploration of the duodenum is emphasized, this showing the characteristic image of "curtain-loop" stenosis of the right D2 border with associated marked dilatation of the suprastenotic duodenal zone. Ultrasound imaging shows features suggestive of the liquid distended genu superius. The onset of acute pancreatitis on an annular pancreas leads to images of pseudo-cystic necrosis and/or calcifications suggestive of the diagnosis because of their localization on ultrasound or C.T. examination.
The authors recall the main pathologic and physiopathologic data necessary to understand the angiographic patterns of hepatic alveolar echinococcosis, by means of a rereading of a personal series of 37 cases. They show that this affection has a diagnostic angiographic shape which associate four signs: avascular aspect of the lesions, regular invasion of vessels, presence of a collateral circulation, absence of neovascularisation. Digestive angiography stays a good diagnostic method for the parasitosis, when epidemiological context, ultrasound or CT scan gave no explicit conclusion. It keeps an interest in the preoperative evaluation and in the supervision of portal vein.
The place of standard CT scan imaging more particularly when combined with double contrast arthrography, is defined in the preoperative screening of patients with anterior instability of the shoulder. The joint scan provides complete data on the anatomic elements of the shoulder lesion, particularly with reference to the glenoidal labrum and the anterior capsular structure. It is also of major diagnostic value in painful subluxations.
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In the Noonan syndrome various anomalies can be demonstrated radiologically. Of particular interest are cardiovascular lesions, such as atypical pulmonary stenosis, hypertrophic cardiomyopathy and the lymphangiectasias. Skeletal anomalies can be found, including retardation of bone maturation and sternal abnormalities. Other anomalies concern the urinary tract (pyeloureteral stenosis) and the digestive system. Radiological diagnostic procedures allow to disclose various elements of this polymalformative syndrome. They should be performed whenever suggestive clinical signs are present, e.g. hypertelorism, gonadal dysgenesis, down-slanting palpebral fissures and shield-like chest.
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The authors report a 5 year-old child in whom lesions of the inferior metaphyses of the femur and superior metaphyses of the tibia were observed after successive pheochromocytomas. The aspect of the lesions, their improvement after surgical treatment of the tumors, the data in the literature and histologic findings suggest that a bone ischemia was induced by impaired microcirculation with infarction of the metaphyses.
Intramural pseudo-diverticulosis of the oesophagus is the result of an anomaly of the deep glands of the oesophagus, the pathogenicity of which is open to debate. A rare lesion, it is often unrecognised on endoscopy, but presents characteristic features on double-contrast examination.
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