With the advent of helical CT, the capability of noninvasive imaging of the thoracic aorta has been enhanced considerably. In this article, we describe the potential of helical CT using dual-slice technology to evaluate thoracic aortic diseases such dissection, aneurysm, trauma, infection, inflammation, thromboembolic disease, and postoperative complications. Technical considerations for optimal CT imaging as well as limitations of helical CT are highlighted.

Adult↗

PubMedDate not supplied

Unusual radiologic findings in the thorax after radiation therapy.

Radiation therapy is used to treat many intrathoracic and chest wall malignancies. A variety of changes may occur after radiation therapy to the thorax. Radiation therapy produces dramatic effects in the lung. Pulmonary necrosis is an uncommon, severe, late complication of adjuvant postoperative radiation therapy. Bronchiolitis obliterans with organizing pneumonia is a distinct clinicopathologic entity characterized by patchy, migratory, peripheral air-space infiltrates. Radiation therapy can also cause spontaneous pneumothorax, mesothelioma, and lung cancer. In the mediastinum, radiation therapy may cause thymic cysts, calcified lymph nodes, and esophageal injuries. Cardiovascular complications of radiation therapy are often delayed and insidious. Premature coronary artery stenosis occurs after radiation therapy to the mediastinum. Radiation therapy may also give rise to calcifications of the ascending aorta, pericardial disease, valvular injuries, and conduction abnormalities. Women who undergo thoracic irradiation before the age of 30 years have a high risk of developing a second breast cancer. Radiation-induced sarcomas are an infrequent but well-recognized complication of radiation therapy. Other chest wall injuries due to radiation therapy are osteochondroma and rib or clavicle fractures. Knowledge of the imaging features of injuries caused by radiation therapy can prevent misinterpretation as recurrent tumor and may facilitate further treatment.

Bone and Bones↗

PubMedDate not supplied

Vasculitis with mesangial IgA deposits complicating relapsing polychondritis.

The authors report the case of a patient presenting with cutaneous, renal and neurologic vasculitis in the course of relapsing polychondritis (RPC). A 78-year-old man presented with a palpable purpura of the lower limbs, high fever arthralgias, delirium, and nephrotic syndrome. He had a history of relapsing polychondritis treated by corticosteroids. Renal biopsy showed diffuse endo- and extracapillary proliferative glomerulonephritis with mesangial IgA deposits. A spectacular regression of the symptoms was observed in response to pulse intravenous methylprednisolone. Relapsing polychondritis is complicated by vasculitis in 25% of the cases. This vasculitis is characterized by cutaneous, neurologic and renal manifestations, usually occurring in elderly patients. Renal involvement is characterized by segmental and focal or diffuse necrotizing glomerulonephritis. The mesangial IgA deposits observed in our patient are rarely present in the course of RPC. Renal manifestations identify severe forms of RPC, justifying systematic screening for renal complications.

Aged↗

PubMedDate not supplied

[Acute angiitis following penicillin therapy. Apropos of a case of arteriographic regression of intrarenal aneurysmal lesions].

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Adolescent↗

PubMedDate not supplied

[Nephrotic syndrome disclosing AIDS].

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Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

[Value of the kidney revascularization in renovascular hypertension with kidney failure].

The effects of renal revascularization on blood pressure and renal function were evaluated in 8 hypertensive patients with renal impairment and renal artery stenosis in both kidneys (6 cases) or in a solitary kidney (2 cases). Mean age was 66 +/- 7 years. The mean duration of arterial hypertension was 13 +/- 8 years. In spite of treatment with 3 antihypertensive drugs (or more in 5 cases) blood pressure values ranged from 170-90 to 260-150 mmHg. Adding captopril (in 3 cases) or minoxidil (in 1 case) resulted in control of hypertension in 1 patient and further deterioration of renal function in 2. Two patients underwent surgery after failure of percutaneous transluminal angioplasty. There were 6 revascularizations and 2 nephrectomies with contralateral revascularization. One patient died post-operatively. In the remaining 7 patients, the hypertension was controlled with one or two drugs and the renal function remained stable or improved over a mean follow-up period of 2 years. We consider that these results warrant radiological exploration in all patients, even old, with renal impairment and drug-resistant hypertension. Renal revascularization must be performed as early as possible in view of the rapid degradation of renal function under medical treatment in these patients.

Acute Kidney Injury↗