[Demedicalisation of “Medical prescription of sport”: The Strasbourg programme as Viewed by Sports Educators].

Promoting health by sport has now gone one step further. Integrated into the 2015 Health Act, medical prescription of sport activities is organized locally, as illustrated by the Strasbourg “sport-health prescription” programme, which promotes physical activity for patients with stable chronic diseases within local sports structures. Observation of the real functioning of this programme, based on the practices and descriptions of six sports educators in various structures, reveals demedicalisation in favour of sportification, as sports educators translate the prescription according to their specific institution and policies.

Diagnostic imaging requisition quality when using an electronic medical record: a before-after study.

Diagnostic imaging requisition (DIR) content is legally constrained for care quality and patient safety concerns. A French national indicator, based on administrative and clinical data, has been introduced to monitor nationwide the conformity of such documents (CDIR). The purpose of this study was to assess the effect on CDIR of the deployment of the ORBIS™ electronic medical record at the Tenon hospital (Paris, France).

Diffusion-weighted MR imaging of the breast: advantages and pitfalls.

The aim of this paper is to review all clinical applications of diffusion weighted MR imaging (DWI) for breast pathology. The challenge of DWI is to obtain the best compromise between lesion detection and characterization. Technical factors affecting lesion characterization and detection are detailed including the effect of contrast administration, the choice of number of b and of b(max), the variation of diagnostic performance according to the type and the size of lesion studied.

Impact of MDCT angiography on the management of patients with hemoptysis.

Objective: The aim of this study was to evaluate the ability of MDCT angiography to modify early results in patients undergoing endovascular embolization for hemoptysis.

Materials And Methods: A comparative study was performed of two consecutive cohorts with 200 patients each who were treated by endovascular embolization for severe hemoptysis; one cohort underwent MDCT angiography and the other did not, but patients underwent further exploration with global aortography. We compared the two groups for patients' age and sex and for the volume, cause, and mechanisms of hemoptysis.

[Diffusion-weighted MR imaging of the female pelvis].

Due to technical advances (parallel imaging and new phased-array coils), diffusion-weighted MR imaging can be used to image the female pelvis. Diffusion-weighted (b=1000) images are now acquired as a complement to conventional sequences (T2W, dynamic T1W images after intravenous injection of gadolinium). Diffusion weighted imaging improves the detection of small uterine tumors and the visualization of small implants of peritoneal carcinomatosis, which could play a significant role for tumor staging.

Systemic arterial embolization in patients with hemoptysis: initial experience with ethylene vinyl alcohol copolymer in 15 cases.

Objective: The purpose of this study was a preliminary evaluation of the use of ethylene vinyl alcohol copolymer to treat patients with hemoptysis of systemic arterial origin.

Materials And Methods: We reviewed the cases of 15 consecutively registered patients (10 men, five women; mean age, 53.7 years) who underwent endovascular administration of ethylene vinyl alcohol copolymer in the management of hemoptysis.

Dynamic contrast-enhanced MR imaging to assess physiologic variations of myometrial perfusion.

Purpose: To prospectively evaluate the ability of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to assess physiological microvascular states in normal myometrium.

Materials And Methods: Eighty-five women (62 women of reproductive age, 23 postmenopausal) undergoing DCE-MRI of the pelvis were included. Microvascular parameters for the inner and outer myometrium were analysed using a pharmacokinetic model.

[Value of diffusion-weighted imaging in the evaluation of adnexal tumors].

Purpose: To determine the value of diffusion-weighted imaging (DWI) in the evaluation of adnexal tumors, especially to distinguish between malignant and benign tumors. Materials and methods. Fifty-four patients with pelvic tumors (32 malignant and 22 benign) were referred for MRI of the pelvis.

[Non-masslike enhancement on breast MRI: interpretation pearls].

The MR Breast Imaging Reporting and Data System (BI-RADS) lexicon of the American College of Radiology (ACR) includes a new lesion category defined as non-masslike enhancement. The purpose of this paper is to review the definition of this new entity, illustrate the main imaging features described in the BI-RADS lexicon and to propose a diagnostic approach based on data from the literature in order to achieve diagnosis and optimal patient management.

Accuracy of stereotactic vacuum-assisted breast biopsy with a 10-gauge hand-held system.

Objective: The aim of this study is to evaluate the accuracy and the safety of stereotactic vacuum-assisted breast biopsy with a 10-gauge hand-held portable system.

Materials And Methods: Retrospective data review of 288 consecutive breast lesions that underwent stereotactic 10-gauge hand-held portable vacuum-assisted biopsy from October 2004 through March 2006, was performed. The mean number of core specimens and the percentage of complete radiological removal of the target lesion were analysed.

[Perfusion and diffusion-weighted MR imaging in the early staging and the follow-up of patients with lung cancer].

Tissue characterization is a major and ultimate goal of imaging, whether morphological (Computed Tomography, Magnetic Resonance Imaging) or metabolic (PET-FDG-[18F]). Functional imaging, using the MRI, began several years ago with the perfusion of lung nodules and very recently with diffusion-weighted imaging applied to the lung cancer. The authors review the interest and the place of diffusion-weighted and perfusion MR imaging in the diagnosis, early staging and follow-up of patients with lung cancer.

Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses.

The purpose of this study was to prospectively assess the contribution of diffusion-weighted MR imaging (DWI) for characterizing complex adnexal masses. Seventy-seven women (22-87 years old) with complex adnexal masses (30 benign and 47 malignant) underwent MR imaging including DWI before surgery. Conventional morphological MR imaging criteria were recorded in addition to b(1,000) signal intensity and apparent diffusion coefficient (ADC) measurements of cystic and solid components.

Dynamic contrast-enhanced MR imaging of ovarian neoplasms: current status and future perspectives.

MR imaging is useful for characterizing ovarian tumors. Dynamic contrast-enhanced MR imaging is a promising new technique useful for characterizing perfusion and angiogenesis of ovarian masses. This article describes the dynamic contrast-enhanced MR imaging technique examines the current and future applications of this technique in patients with ovarian tumors.

[How to measure breast density?].

The relation between breast tissue density and cancer risk is well known. Early quantification techniques were based on subjective visual assessment. Quantitative techniques were then developed using planimetric measurements, surface area calculations or volumetric measurements.

[Virtual pleuroscopy of diaphragmatic pleura: myth or reality?].

Purpose: Evaluate the feasibility of the virtual pleuroscopy (VP) in the detection of the pleural plaques.

Method And Materials: Twenty consecutive patients, having asbestos exposure, explored by unenhanced multidetector CT-scan (Siemens, Sensation 16). The imaging parameters were as follows: beam width, 12 mm; beam pitch, 1; and reconstruction thickness, 1mm every 0.

[Imaging of chronic pelvis pain].

This is a review of different diseases implicated in chronic pelvic pain (endometriosis, adenomyosis, pelvic varices, and pelvic chronic inflammatory disease) assessed by different imaging modalities (US, CT, MRI).

Severe hemoptysis of pulmonary arterial origin: signs and role of multidetector row CT angiography.

Background: Hemoptysis of pulmonary arterial origin is a diagnostic challenge in patients admitted to a respiratory ICU (RICU) for treatment of hemoptysis. Its early accurate recognition and treatment reduce morbidity and prevent mortality. Multidetector row CT angiography (MDCTA) is an accurate method for imaging the systemic vascular network.

Hemoptysis complicating Scimitar Syndrome: from diagnosis to treatment.

We report the case of a 24-year-old patient with known scimitar syndrome presenting with hemoptysis. Multidetector CT angiography showed the scimitar vein draining the right lung to the inferior vena cava associated with right lower lobe bronchopulmonary sequestration. The presence of hemoptysis associated with scimitar syndrome is likely secondary to an anomalous systemic arterial blood supply.

[Persistent sciatic artery: possible false negative imaging].

Persistent sciatic artery is a rare congenital malformation due to the lack of regression of the dorsal arterial axis of the embryo that can be revealed by serious complications. We report a case of bilateral persistent sciatic artery revealed by subacute distal ischemia. This case illustrates the possibility of false negative imaging and the importance of ruling out this diagnosis in case of recurrent and apparently idiopathic distal embolism.

Value of dynamic enhanced magnetic resonance imaging for distinguishing between ovarian fibroma and subserous uterine leiomyoma.

Purpose: The purpose of this study was to assess the accuracy of magnetic resonance imaging (MRI), particularly, dynamic MRI, in distinguishing ovarian fibromas from subserous uterine leiomyomas.

Material And Methods: Fifteen ovarian fibromas and 15 subserous uterine leiomyomas were retrospectively reviewed. All MR examinations included dynamic contrast-enhanced (DCE) sequences.

Role of MDCT in identification of the bleeding site and the vessels causing hemoptysis.

Objective: MDCT has improved the management of hemoptysis by providing more precise depiction of bronchial and nonbronchial systemic arteries than conventional CT. The purpose of this article is to review the role of MDCT in the identification of the bleeding site and the vessels causing hemoptysis.

Conclusion: Identification of the origin of the involved systemic arteries (bronchial and nonbronchial) or involved pulmonary artery on MDCT enables the interventional radiologist to treat them, especially in elderly patients with a tortuous aorta and atheroma.

[The TELIF network of Paris-area public hospitals (AP-HP)].

After a feasibility study, the TELIF network (neurosurgical emergencies in the Paris region) was created in November 1994. The goal was to reduce the number of patient transfers among the different hospitals, by teletransmission of computed tomography images between computers located in the emergency departments of general hospitals and the neurosurgery department. The initial goal has been reached, with a 70 % reduction in the number of patient transfers.