[en] Thirty volunteers were examined with high-resolution tomodensitometry to determine the normal aspects and the variants of pulmonary parenchyma. High-resolution tomodensitometry provides thru GOUGH sections of pulmonary parenchyma. These are essentially pulmonary vessels which normally define pulmonary parenchyma (mainly lobular arteries and perilobular veins). The authors define the regions of pulmonary parenchyma observed and describe the possible artifacts at the level of pulmonary parenchyma that can lead to errors in diagnosis. Finally, the authors point out the importance of the gravito-dependence and its repercussions on the semiology of pulmonary parenchyma. The definition of normal parenchyma in high resolution tomodensitometry is essential in order to deal with the pathologic abnormalities of pulmonary parenchyma

[en] Four years ago, the authors thought that MR imaging should be the method of choice to visualize the vocal organ, because of its capability in soft-tissue contrast and its three-dimensional approach. In this paper, the authors attempt to prove this through a prospective study. Disease in 90 consecutive patients with biopsy-proved laryngeal malignancy was staged with CT and MR to assess the in-depth involvement to submucosa, ligamental, and cartilaginous surroundings. The CT sections were oriented according to the plane of the vocal cords during the passage of an iodine bolus. MR was performed on a Magniscan with a special surface coil of a saddle configuration. Compared to our head coil, the saddle coil had a 40% improvement in signal-to-noise ratio so that strap muscles could be seen on T1-weighted images. The comparative ability in staging with CT and MR has been tested in seven areas of interest: pre-epiglottic space, paraglottic space, anterior commissure, cartilages, subglottic region, perilaryngeal tissues, cervical lymph nodes. The first 5 areas (key zones of extension) offer important data for the possibility of reconstructive surgery. On each area the matched data allow the use of the McNemar test

[en] Any of the numerous anatomical variants and variations observed in the thorax can be a radiological pitfall. The pitfalls produced by such variants can be either obvious, such as a curved brachiocephalic trunk artery, or more subtle, like those created by abnormal pulmonary returns or the upper recess of the pericardium. Variations of the horizontal fissure and of the triangular ligament have been better known since high-resolution millimetric sections have been used. Must we still say that the lesser fissure is horizontal and the oblique fissure complete, when detailed CT studies reverse statistics and make a predominant pattern out of a variation. Our work is both too thorough and not complete enough, according to the reader's point of view, as are all studies of pitfalls and variants. However, we hope that this collection of variant portraits, will be our contribution to the state of the art in thoracic CT

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[en] This paper reports on the utility of MR imaging in the staging of lung cancers. This prospective study was conducted to test the sensitivity of the two methods with respect to the extension (T) and lymph node involvement (N). A prospective and comparative study included 202 consecutive lung cancer stagings. The results of CT and MR imaging were compared with surgical evaluation with total nodal dissection and pathologic findings. The distinction between N2 and N3 (of clinical and prognostic importance) was done. MR imaging was performed with T1- and T2-weighted images at 0.5T. The results showed poor sensitivities for the T (58%-68%) and N (63%-68%) evaluation. MR imaging has better sensitivities but the magnitude of the difference in sensitivities is relatively low according to the McNemar test. The significance is of higher magnitude. for the T2/T3-T4 extension with MR imaging (and even better with surface coil) versus CT, but the surgical consequences ar minor (en bloc resection). MR imaging is superior to CT with its three-dimensional demonstrations and the T2 qualitative differentiations. This superiority is of statistical significance but not of diagnostic significance, so that the utility of MR imaging appears only when CT remains inconclusive, especially for the relations with mediastinal vascular structures. MR imaging is expected to give an answer in difficult cases after CT staging. Another goal for MR imaging could be to avoid the false thoracotomies due to pleural metastases

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[en] The files of 50 consecutive patients (1987-89) operated for abdominal aortic aneurysm (AAA) and examined with CT were studied. The criteria for inclusion were surgical features. - CT can be made more accurate for the study of AAA: - Thus the location of the neck of the aneurysm relative to the renal arteries was defined in 94% of all cases. - In addition, CT yields information about the wall of the aneurysm, whether it be thickened (3 inflammatory aneurysms were properly diagnosed) or, more importantly, weakened (solution of continuity in the wall in the prior-to-rupture appearance). - Owing to the quality of its performances and to its noninvasive character, CT with contrast injection was regarded as an essential technique for the preoperative assessment of abdominal aortic aneurysm in most cases. The examination must be carried out strictly, especially for the contiguous sections of the renal arteries and their extension to the crural arch. - As it demonstrates weakened areas more easily, a more accurate study of the aneurysmal wall with CT might increase the surgical indications for some smaller aneurysms, the potential evolution of which does not seem to be associated with their diameter only

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No abstract available