Biomedical subjects
Publications and source records attributed to J P Monnier.
Thirty-seven hyperechoic cavernous hemangiomas of the liver were investigated by sonography and angiography. Posterior enhancement of a hyperechoic mass on sonography was correlated with hypervascularity on angiography. Such enhancement was noted in 76.5% of cases and in all angiomas larger than 25 mm in diameter.
The authors present the results of the radiological explorations in 15 cases of benign liver tumors. Ultrasound and/or computed tomography can usually confirm the presence of a hepatic tumor. Arteriography combined with the clinical information suggested the diagnosis. The authors stress the role of the radiological investigations for the follow-up of these tumors.
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Obstruction of the left subclavian artery is one of the rarest causes of the cogenital subclavian steal syndrome with a right-sided aorta. Radiological diagnosis can be made from a standard film which shows the aorta on the right, and a barium examination of the esophagus which demonstrates the absence of any compression posteriorly. Angiographic exploration (aortography, pulmonary angiography) is essential for positive confirmation of diagnosis and to exclude other types of congenital subclavian steal with a right-sided aorta. Certain cardiac malformations may be associated, but forms have been described without any other anomalies as in the case reported, which only became apparent when neurological symptoms developed in adult age.
Two patients were treated surgically for an aneurysm of the celiac artery, one of atheromatous and the other of dysplasic origin. Diagnosis was established by mode B ultrasonography, and confirmed by arteriography and operative findings. Emphasis is placed on the possibility of detecting such lesions, when confronted with an atypical epigastric symptomatology, by means of ultrasonography, particularly by the use of an apparatus in real time. This should enable a more rapid and probably more precise approach to the aorta and large abdominal vessels.
The addition of side holes to the Teflon catheter used for translumbar aortography results in improved flow of contrast material and good visualization of the aorta and brachiocephalic vessels. Details of the technique and precautions for safe use are discussed.
Colonic complications of pancreatitis are not infrequent occurrences, as illustrated by the fact that the authors have personally treated 39 such cases. Lesions are found in the colon at sites which correspond perfectly to diffusion of pancreatic necrotic lesions along mesenteric pathways as described by Meyers. They occur mainly in the left colic flexure (17 cases) and transverse colon (10 cases) but may affect the ascending (6 cases) and descending (4 cases) colon by diffusion of the pancreatitis into the anterior extrarenal space. These topographical characteristics, associated with the extrinsic and inflammatory nature of the lesions, produce a very specific and typical radiological syndrome which should assist diagnosis.
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The superior mesenteric artery was found to be displaced posteriorly in 5 patients with intraperitoneal masses. In 3 cases, the mass was a mesenteric tumor, and in the 2 other cases a tumor arising from the retroperitoneal area which had grown into the mesentery. The authors emphasize, therefore, the value of defining the position of the superior mesenteric artery in the sagittal plane for the topographic diagnosis of intraperitoneal masses. This investigation does not, however, eliminate the possibility of a retroperitoneal origin of the tumoral mass.
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The authors report on a survey of perforation following fibroscopy in the Hôpital Saint-Antoine. A total of 10,600 diagnostic examinations were reviewed and 5 perforations were recorded, to which must be added 2 perforations following oesophageal dilatation. A chesy X-ray, taken within 24 hours of the incident, showed, in most cases, the presence of air in the mediastinum with early signs of subcutaneous emphysema in the cervical or cervicothoracic regions. A hydro-pneumothorax in the right side of the chest was also observed in the cases studied, without air in the mediastinum. Oesophageal transit was studied by means of a water-soluble compound, and showed oesophageal effraction in only 4 cases, and in 3 of these cases it was possible to see the location of the orifice with precision.
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Provided that a rigourous protocol is adopted, exploration of the hepatic veins by echotomography (grey scale) is practically always possible. It should be integrated into every echotomographic study of the liver (parenchyma, biliary tract, portal system and inferior vena cava). The findings cover a narrow range: hepatic veins free, compressed or not visible. This method is harmless, rapid, reproducible and inexpensive.
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Crohn's disease with a predominantly pseudopolypoid presentation is a rare form. The inflammatory polyps are of highly variable topography. They may be located in the colon and the ileum. There are diffuse and localised forms. This pseudopolypoid form of Crohn's disease poses, in addition to diagnostic problems, pathogenic questions, integrating these findings within the context of nonspecific reactions of the colon, secondary to an ulcerating process which may be specific.
Duplicating x-ray films is a matter of interest to all physicians, even if they are not radiologists. The impossibility of a direct reading is a major drawback of reproduction in the form of slides. By contrast, a transparency is an irreplaceable teaching tool. Contact printing of slides on counterpart film is a process within the reach of all departments of radiology. In one single step, this process gives a plate of 100 transparencies on counterpart film costing about 2.20 dollars.
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