[Emphysematous pyelonephritis. 2 new cases].
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Biomedical subjects
Publications and source records attributed to P Pastaud.
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In connection with 141 cases of parotid tumours, 21 adenopathies of the parotid region and 22 cases of parotitis, the authors define the role of ultrasonography in the exploration of the salivary glands. Use of simple criteria permits differentiation of benign from malignant tumours with a good degree of sensitivity (79.8% in our series). This score allows ultrasonography to be offered as the first complementary examination when dealing with a tumefaction of the parotid region. When ultrasonographic findings evoke a malignant lesion, a CT scan seems necessary to evaluate any extension in depth. In contrast, ultrasonography does not appear justified in cases of parotitis or lithiasic pathologies.
Repeated bronchopneumopathies are the principal manifestation of congenital esophagotracheal fistulae detected at a late stage. Diagnosis is suggested by air distention of the esophagus on the thoracic image. Esophageal barium swallow examination in the standing position is usually negative: esophageal transit is too rapid, the diameter of the fistula is too small, and its ascending pathway does not allow filling by the contrast medium. Examinations should be conducted in precubitus, after the passage of an esophageal sound, employing barium sulphate as the contrast medium, and with a horizontal beam and profile projection. Kinetic exploration, employing ampliphotography is necessary. The fistula pathway is seen as a thin opaque line, oblique from above forwards, and pushing from the anterior surface of the esophagus to the posterior surface of the trachea. There is associated filling of the tracheobronchial tract.
A group of 21 adults patients with soft tissues sarcomas of the extremities were studied by CT. CT was a diagnostic procedure in only one case. However it has always permitted a precise local work-up particularly in demonstrating the vasculo-nervous connections of the lesions. The place of CT with regard to the other radiological procedures is discussed. by its contribution to the locoregional and general pretherapeutic work-up and to a better determination of radiotherapeutical dosimetry, CT appears to have an up standing place in the staging and the follow-up of soft tissues sarcomas.
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Scanner imagine pre-operatively in 27 patients with hyperparathyroidism provided assessment of the sensitivity (92 p.cent) and diagnostic precision (92.5 p.cent) of this investigational method. The need for a strict methodology and the advantages gained by high resolution and angioscanning programmes are emphasized. After analyzing the results, a review of the published literature enables the advantages and the limits of the scanner X to be defined, and a strategy for exploration of parathyroid adenomas to be proposed.