Site internet dédié à l'enseignement de l'imagerie en coupes des cardiopathies congénitales

Les cardiopathies congénitales sont des anomalies rares. Les données épidémiologiques actuelles retrouvent une prévalence de 8/1000 naissances toutes cardiopathies confondues. La détection de malformations cardiaques en période anténatale a un impact primordial sur la prise en charge néonatale de ces enfants. Parallèlement, les progrès de la chirurgie cardiaque, l amélioration des techniques de circulation extra-corporelle ainsi que de réanimation pédiatrique, ont permis de traiter des pathologies jusque là létales à plus ou moins court terme. Aujourd hui, beaucoup d enfants nés avec une malformation cardiaque atteignent l âge adulte et ce dans des conditions de vie satisfaisante. Dans les années 80, on a assisté à une révolution radiologique , avec l apparition de scanner multi-barrettes, permettant des acquisitions hélicoïdales et de l IRM. Rapidement, ces techniques sont devenues un moyen robuste d exploration des cardiopathies congénitales. Le radiologue non interventionnel, qui initialement n'était pas directement impliqué dans la prise en charge et le suivi de ces patients, prend alors une place importante au sein de l équipe médico-chirurgicale. Il convient pour cela d être formé, non seulement aux techniques d imagerie cardiaque en coupes mais également d avoir une connaissance précise de l anatomie, de la physiopathologie et des techniques chirurgicales de chaque cardiopathie. Il est admis de tous qu internet est un outil de partage et d enseignement exceptionnel de nos jours. Ce travail a donc consisté en la réalisation d un site internet axé sur l imagerie en coupes des cardiopathies congénitales. Il a pour but de permettre à toutes personnes du corps médical, confronté à ce type de pathologie, d avoir une vision d ensemble de la pathologie ainsi que des différentes modalités d examen utile pour chaque cardiopathie et ce qu ils peuvent en attendre.Congenital heart defects are rare. Current epidemiological data found a prevalence of 8/1000 births, all defects confused. Detection of cardiac malformations in the antenatal period has a crucial impact on neonatal care of these children. Meanwhile, advances in cardiac surgery and improved techniques for both cardiopulmonary bypass and pediatric reanimation, lead to better care for conditions that were letal in a more or less short interval. Today, many children born with heart defects grow to adulthood in satisfactory living conditions. In the 80's, there has been a "radiological revolution " with the advent of both multidetector-row CT-scanner, allowing helical acquisitions, and MRI. Quickly, these techniques have become a robust mean of exploration of congenital heart diseases. The non-interventionist radiologist, who initially was not directly involved in the management and monitoring of these patients, now plays an important role in the medico-surgical team. This requires to be trained, not only to cross sectional cardiac imaging but also to have a precise knowledge of the anatomy, physiology and surgical techniques of each congenital heart disease (CHD). It is admitted by all that the Internet is a fantastic tool for sharing and teaching nowadays. This work consisted in the creation of a website focused on cross sectional imaging of congenital heart diseases. It aims to enable all people in the medical profession, faced with this type of pathology, to have an overview of the disease and the different examination procedures useful for each CHD and what they can obtain from them.AMIENS-BU Santé (800212102) / SudocSudocFranceF

Use of postmortem computed tomography to detect bowel obstruction and its relationship to the cause of death

Bowel distension frequently indicates bowel obstruction, which is a common diagnosis in clinical radiology. Typically, symptoms and complaints lead to radiological examinations and the detection of the etiology. Untreated intestinal obstructions can lead to a fatal outcome through cardiac failure due to septic shock. Certain of these cases undergo medicolegal investigations depending on the case history, the condition of the decedent, the location of the finding, or recent visits to medical professionals. Computed tomography (CT) is a recommended method in clinical radiology for the detection of bowel obstruction, which is indicated by bowel distension and further radiological signs (eg, the whirl sign, which indicates a volvulus). Postmortem CT (PMCT) has increased worldwide, but PMCT differs from clinical CT; thus, the question of whether PMCT is also reliable for the detection of bowel obstruction in decedents or is negatively affected by postmortem modifications should be discussed. This study consists of 10 cases displaying radiological signs of bowel obstruction. Apart from bowel distension, the most common radiological signs (whirl sign, coffee bean sign, bird beak sign, and u-shape sign) are described and depicted. All decedents underwent autopsy and had a postmortem interval of less than 72 hours. Based on these cases, we assess the reliability of PMCT for detecting bowel obstruction and determining its relationship to the cause of death

A look into the past – CT & MRI of wet fixated fetal and neonatal specimen

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Postmortem CT better estimates fetal weight than the Hadlock's formula

No abstract availabl