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Objective Some patients (10 % – 32 %) with a positive guaiac fecal occult blood test (gFOBT) do not undergo the recommended colonoscopy. The aim of this study was to compare video capsule endoscopy (VCE) and computed tomography colonography (CTC) in terms of participation rate and detection outcomes when offered to patients with a positive gFOBT who did not undergo the recommended colonoscopy. Methods An invitation letter offering CTC or VCE was sent to selected patients after randomization. Acceptance of the proposed (or alternative) procedure and procedure results were recorded. Sample size was evaluated according to the hypothesis of a 13 % increase of participation with VCE. Results A total of 756 patients were targeted. Following the invitation letter, 5.0 % (19/378) of patients underwent the proposed VCE and 7.4 % (28/378) underwent CTC, ( P = 0.18). Following the letter, 9.8 % (37/378) of patients in the VCE group underwent a diagnostic procedure (19 VCE, 1 CTC, 17 colonoscopy) vs. 10.8 % in the CTC group (41/378: 28 CTC, 13 colonoscopy; P = 0.55). There were more potentially neoplastic lesions diagnosed in the VCE group than in the CTC group (12/20 [60.0 %] vs. 8/28 [28.6 %]; P = 0.04). Thus, 15/20 noninvasive procedures in the VCE group (19 VCE, 1 CTC; 75.0 %) vs. 10/28 in the CTC group (35.7 %; P = 0.01) resulted in a recommendation of further colonoscopy, but only 10/25 patients actually underwent this proposed colonoscopy. Conclusion Patients with a positive gFOBT result who do not undergo the recommended colonoscopy are difficult to recruit to the screening program and simply proposing an additional, less-invasive procedure, such as VCE or CTC, is not an effective strategy. ClinicalTrials.govNCT02558881TRIAL REGISTRATION: Randomized, controlled trial NCT02558881 at clinicaltrials.gov.

Rationale and objectives To evaluate the quality of images of the aorta and visceral arteries made at a high level of spatial resolution with thin slices and an optimized acquisition time by three-dimensional contrast-enhanced magnetic resonance angiography (3D CE-MRA). Materials and methods 3D CE-MRA with a 1.4-mm slice thickness and 512-pixel base matrix was done on 62 consecutive patients with a 1.5-T magnetic resonance imaging MRI unit. A bolus test with a power injector was used to calculate the optimal scan delay time. For quantitative evaluation, the signal-to-noise ratio (SNR) was measured in 3 regions of interest. Qualitative image analysis was evaluated independently by two radiologists and graded on a scale of 0–3. Separate analyses were done for the aorta and distal visceral arterial branches. Results The means SNR values were respectively 56.2 ± 15.2 (mean ± SD) for the aorta, 59.2 ± 15.1 for the celiac trunk, and 57 ± 15.2 for the superior mesenteric artery, with a homogeneous distribution ( P = .99). Consistent enhancement was confirmed by the lack of statistically significant differences between the SNR values. The average score for vessel visualization on source images ranged from good to excellent for different segments. After post-processing of images, the average score for distal arterial segments was significantly improved. The overall agreement between the 2 reviewers in the visualization of definite artery segments was excellent ( k = .91). Conclusion 3D CE-MRA with a 512-pixel base matrix and thin slices can be applied in a reproducible way with excellent depiction and delineation of small vessels. Such a protocol could be used routinely.

Resume Introduction Les syndromes de dedoublement medullaire (split cord malformation : SCM) se caracterisent par la division en deux parties de la moelle epiniere : les hemi-moelles peuvent etre, chacune dans un sac dural propre (SCM ou diastematomyelie de type I) ou bien etre dans un sac unique (SCM ou diastematomyelie de type II). Elles peuvent survenir de facon isolee ou s’associer plus volontiers a d’autres malformations medullaires, du squelette ou des teguments. Classiques chez l’enfant, leur decouverte chez l’adulte est beaucoup plus rare. Methode Nous rapportons les observations de deux femmes, de 40 et 54 ans, chez lesquelles fut revele un deboublement de la moelle epiniere de type II. Resultats La premiere patiente se plaignait de lombo-sciatalgies chroniques et de troubles imperieux mictionnels ; l’examen clinique decouvrit un syndrome radiculaire avec abolition du reflexe achilleen gauche ansi qu’une hyperpilositie lombaire. L’IRM mit en evidence une hernie discale L5/S1 exclue ainsi qu’un deboublement partiel de la moelle epiniere en regard de L3, associe a un spina bifida et une moelle attachee basse. La seconde patiente souffrait depuis 6 ans de lombalgies avec irradiation douloureuse perineale ; l’examen physique decouvrit un angiome cutane lombaire ; l’IRM revela un dedoublement medullaire dorsolombaire, de D12 a L1, associe a un spina bifida. Aucun eperon osseux ou fibreux fut mis en evidence dans les deux cas. En raison de l’absence de deficit moteur, aucune decision chirurgicale ne fut retenue. Conclusion Au travers de ces deux observations, nous proposons une revue de la litterature de 90 dossiers de diastematomyelie revelee a l’âge adulte.

International audience; Because radiation from flames is often the dominant mechanism for wildfire spread, detailed information on flame properties is required. The proposed procedure combines a spectrally resolved radiation model for simulating the line-of-sight infrared emission intensity and spectroscopy data and uses a genetic algorithm (GA) to determine a set of flame properties, allowing optimal agreement between model and outdoor experiments. GA calibration and sensitivity analysis were conducted using well-defined reference flames. The combined GA/radiation model was used with emission data to estimate the effective properties of flames from the combustion of woody fuel beds from 0.5 to 4 m in thickness. Experimental results show that the contribution of soot particles to flame emission increases with flame thickness. The GA was found to be robust and efficient in providing relevant flame properties from line-of-sight intensities on the infrared spectrum of radiation.

Background The purpose of this prospective study was to assess the value of contrast-enhanced magnetic resonance cholangiography with mangafodipir trisodium perfusion for detection and localization of trauma-induced and postoperative bile duct leaks. Methods Eleven patients with suspected bile duct leaks after trauma (n=5) or surgery (n=6) were included. Patients with suspected leaks after cholecystectomy were excluded. All patients underwent contrast-enhanced magnetic resonance cholangiography with two-dimensional axial and three-dimensional coronal gradient-echo images acquired 1 to 3 hours after intravenous administration of mangafodipir trisodium perfusion. Contrast-enhanced magnetic resonance cholangiography findings were correlated with direct cholangiography obtained in all patients, including endoscopic retrograde (n=7) and percutaneous transhepatic cholangiography (n=4). Results Biliary tract enhancement was identified in all patients on contrast-enhanced magnetic resonance cholangiography. Peritoneal cavity fluid and bile collections that contained extravasated mangafodipir trisodium (increased signal intensity on gradient-echo sequences) were demonstrated in 6 patients. Direct cholangiography confirmed the presence of bile duct leaks in these 6 patients and the absence of bile duct leaks in 5 patients. There was no false-negative or false-positive contrast-enhanced magnetic resonance cholangiography. Conclusions Mangafodipir-enhanced magnetic resonance cholangiography is a noninvasive technique that can provide functional biliary information with excellent depiction of bile duct leaks.