[Sickle cell anemia: how to interpret a radiological bone lesion].
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Anemia, Sickle Cell↗
Biomedical subjects
J F Briant
Publications and source records attributed to J F Briant.
[Functional cerebral neuro-imaging at 1.5 Tesla. The results of visual, sensorimotor and auditory stimulations].
Functional activation of the cerebral cortex can be observed with a standard 1.5 Tesla MRI magnet. We used a repeated FLASH 2D one-section sequence with a long echo (TE = 60 ms) and a small passing band. Modification of regional cerebral oxygenation due to neurone activation seems to be the main source of contrast. Sensorimotor stimulation was effected by an unusual mobilization of the fingers. Visual stimulation was performed by intermittent lightings at a frequency of 8 Hz. Auditory stimulation relied on listening to speech sounds. Signal increases were localized on the cerebral cortex with precise anatomico-functional correlation. Using a clinical 1.5 Tesla magnet requires an adequate treatment of data. Thus, stimulated cerebral activity can be portrayed by MRI therapy opening a new way for anatomico-functional cerebral studies.
Acoustic Stimulation↗
[Metaphyseal cupping in an African infant].
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Birth Injuries↗
[Epidermoid cysts of the spleen. Apropos of two cases: review of the literature].
Benign cysts of the spleen (excepting parasites) are rare. Less than 10% of the cases involve epidermoid cysts, as the two cases reported here. These lesions are often asymptomatic and can lead unspecific clinical manifestations. The diagnosis is based on echography and abdominal computed tomography. Generally, imagery can eliminate a hydatic cyst of the spleen but cannot differentiate between different types of non-parasite cysts. Major complications including rupture and intracystic haemorrhage, malignant transformation and the impossibility of obtaining a preoperative histological diagnosis make surgery the only possible treatment. A conservative approach with partial splenectomy is the usual option, but total splenectomy may be required. The question of whether surgery is always necessary for small asymptomatic cysts of the spleen in under debate. Certain authors suggest that only regular echographic monitoring is necessary.
Adolescent↗
[Ischemic cerebral vascular accidents in young subjects and livedo reticularis. Apropos of a case of Sneddon's syndrome or Divry-Van Bogaert's syndrome].
The authors report the case of a 28-year-old patient presenting with successive ischaemic cerebral vascular accidents, preceded by the appearance of a livedo reticulare, without any laboratory signs of an inflammatory syndrome. Since Sneddon, and before him Divry and Von Bogaert, patients with this dermatosis are known to have an increased frequency of ischaemic cerebral vascular accidents. This syndrome, considered for a long time to be minimally aggressive, appears to be a very serious disease, leading to a bedridden state and dementia. The prognosis for these patients, all young (30-40 years), therefore appears to be very poor. Any case of livedo reticulare requires the search for cerebral neurological lesions. After a complete neurological examination, imaging therefore has an important major in the assessment of cerebral lesions due to this corticomeningeal angiomatosis. CT scan and MRI are useful in this initial assessment and in the subsequent follow-up of patients. In cases with frank neurological lesions, cerebral arterial exploration is essential with demonstration of lesions of the midcerebral arteries and activation of collateral vascular anastomoses and their helicine vessels. The prognosis is based on the extent of these lesions. Cerebral biopsy may demonstrate a non-inflammatory endothelial cellular proliferation of midcerebral vessels.
Adult↗
[Spontaneous intramural hematoma of the esophagus. Apropos of a case].
The authors report a case of spontaneous intramural haematoma of the oesophagus. This is a rare observation which usually occurs in association with oesophageal hyperpressure and sometimes with impaired haemostasis. The strategy for diagnosis is based on tomodensitography and also endosonography and magnetic resonance imagery.
Aged↗
[Marchiafava-Bignami's disease with a favourable course. Apropos of a case].
A resolving form of Marchiafava-Bignami disease is reported. This patient with a history of chronic alcoholism was hospitalised for a recent demential syndrome. Clinical examination did not show any signs of interhemispheric disconnection LP and EEG were normal. CT examination showed a low density area in the corpus callosum without any other anomaly. MRI examination confirmed the cystic area of the corpus callosum. The Marchiafava-Bignami disease was easily suggested on the basis imaging and clinical signs. Interhemispheric disconnection is not always found so MRI and CT examinations seem to be very useful tools for early diagnosis of Marchiafava-Bignami in the same way as neuropsychological tests.
Adult↗
[Value and limits of tomodensitometry applied to the diagnosis of sacroiliitis in young adults: study of 200 cases].
Diagnosis of sacroiliitis may be difficult to establish in patients under 25 years of age since growth is not yet completed and joint damage is often still minor. A prospective study of 200 subjects with a median age of 22 years was carried out to compare the value of CT scan and conventional radiology. The study population included 32 healthy subjects and 168 consecutive patients with presumptive spondylarthropathy including 36 with bilateral sacroiliitis and 8 with unilateral sacroiliitis. Conventional roentgenograms and CT scans were performed in every patient. Blind reading of roentgenograms and CT scans was carried out by two pairs of observers with differing experience. CT scan provided no additional information when reading was done by experienced observers: rates of mistaken and doubtful results were similar with both investigations (10%); specificity of both tests was comparable (90%) but sensitivity was significantly greater for CT scan (91.2%) than for conventional roentgenograms (71.6%), reflecting improved detection of roentgenographically occult sacroiliitis. Less experienced observers obtained better results with CT scans, illustrating the ease of interpretation of CT scan images. Analysis of false-positive CT scans revealed that normal variations and, above all, features due to as yet uncompleted growth were the main sources of mistakes. These mistakes cancelled the advantage of increased sensitivity of CT scan studies and explained why CT scan failed to improve diagnosis.
Adult↗
[Eosinophilic gastroenteritis. Apropos of a case].
The authors report a new case of this rare and not well-know disease, the eosinophilic gastroenteritis. The medical imaging techniques allowed to correlate all the clinical signs to the observed parietal lesions.
Abdominal Pain↗
[Reexpansion unilateral pulmonary edema].
One case of unilateral pulmonary oedema a vacuo is reported and the 38 cases published in the literature are reviewed. Contributing factors are essential, the main ones being the duration and severity of lung collapse and the rate of reexpansion. The clinical signs and symptoms are described, together with the various possible courses of the disease, and the severity factors are deduced from 8 lethal cases. A therapeutic approach is proposed but not formalised, since pathophysiological data are still scarce.
Adult↗
[Unusual radiologic aspect of a hydatid cyst].
The authors report us about an unusual hydatid cyst of the liver. Ultrasound, CT and MRI exams were used, and showed an unusual fatty component inside the lesion. The development of the disease in steatosic liver is not enough to explain the unusual density.
Diagnosis, Differential↗