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B Damascelli

Publications and source records attributed to B Damascelli.

84 records · Page 5Linked to original sources

Carbon dioxide digital subtraction angiography in oncological-interventional radiology.

AIMS AND BACKGROUND: The aim of this work is to demonstrate the usefulness of carbon dioxide, used as contrast agent, in special indications in vascular interventional oncological procedures. METHODS: We studied 40 patients with digital subtraction angiography enhanced with CO2 as a contrast agent. At the same time we utilized also, in all cases, jodinated contrast agent to evaluate the different opacification gradient, the different viscosity range and the different perfusion. RESULTS: The low viscosity of CO2 allows demonstration of the presence of even minimal blood losses in gastrointestinal tumors and enhances arteriovenous shunts in hepatocellular carcinoma. Carbon dioxide can also be employed to assess the patency of small-sized catheters for chemotherapy infusion which do not allow easy injection of the traditional iodinated contrast agents characterized by high viscosity. CONCLUSION: Carboangiographic study combined to digital subtraction angiography can clear some diagnostic problems and is further method to assess the outcome of angiographic interventional procedures in oncology.

Adult↗

Transthoracic fine needle aspiration biopsy in pulmonary lesions. Updated results.

An investigation was carried out on 271 patients who underwent transthoracic fine needle aspiration biopsy ( FNAB ) for suspected pulmonary lesions in a four-year period; 80% of them had a malignant tumor. The histologic control of the cytologic diagnoses made on the transthoracic FNAB was possible in over 50% of the cases. The sensitivity and predictive value for positive results were, respectively, 0.890 and 0.995, whereas the typing accuracy verified in 58 cases on the surgical specimen was 0.76. The comparison of the data obtained from the most recent case material with that of early observations confirmed the high sensitivity of transthoracic FNAB in the detection and characterization of malignant lesions in the lungs. The sensitivity was almost identical for primary tumors, 0.90, and metastatic disease, 0.88. Furthermore, over the years the data showed an improvement in the results due to the experience gained, the combined use of cytology and histology and the application of histochemical methods. More sophisticated methods, such as immunocytochemistry and electron microscopy, were essential to the final diagnosis in only a few cases.

Biopsy, Needle↗

Fine needle aspiration biopsy cytology of primary and metastatic pulmonary tumors.

A total of 130 patients with clinically suspected primary or secondary malignant neoplasms of the lung underwent fine needle aspiration biopsy under fluoroscopic control. The cases included 80 primary malignant tumors of the lung, 35 metastatic deposits, 14 nonneoplastic lesions and 1 benign tumor. The cytologic diagnoses were confirmed histologically in 56 cases and clinically in 74. Among the latter, the cytologic findings were comparable to the histology of the primary tumor in 19 cases with metastatic pulmonary lesions; in five cases, the extrapulmonary primary was identified on the basis of the cytologic study of the metastatic pulmonary lesion. The diagnostic sensitivity was 0.91 because of a false-negative result in a case of bronchial carcinoid, and the diagnostic specificity was 0.95. The predictive value was 0.99 for positive results because of a false-positive diagnosis given on a chondroid hamartoma and 0.70 for negative results. The sensitivity was 0.92 for primary malignancies and 0.89 for metastases. The cytologic typing accuracy of the 32 cases with histologically confirmed primary carcinoma of the lung was 0.65. Large-cell carcinoma and adenocarcinoma were the types that were cytologically unidentifiable most frequently. No major complications caused by the procedure were recorded in the present series.

Adult↗

[Diagnostic imaging of liver metastasis].

The early diagnosis and monitoring of hepatic metastases are now achieved by different imaging modalities, some using ionizing radiations (computed tomography and angiography), some based on other energy sources (sonography and magnetic resonance), but all coming within the radiological area, which offers concrete possibilities of integration and the necessary organization. These modalities are sometimes used only for percutaneous histological samplings with minimal invasiveness. The progress in hepatic resective surgery and the possibility of orthotopic liver transplantation for some neoplastic histotypes, together with the alternatives provided by interventional radiology, have brought a continuous updating of the specialist' interest in the morphological and functional definition of hepatic metastatic disease, with the specific aim of choosing the best therapeutic strategy. Hepatic metastases have the greatest impact on the survival of patients with gastrointestinal neoplasms, especially colonic adenocarcinoma. Intraoperative sonography and CT arterial portography currently provide greatest diagnostic sensitivity in terms of spatial resolution but cannot be considered as methods of choice, the former for obvious reasons and the latter because of its invasiveness and complexity. The alternatives are to be sought in spiral CT and the new MR sequences which can undoubtedly provide a decisive improvement in the diagnostic standards currently available. Profoundly changed, but no less important, is the role of angiography, which still provides the anatomical support for hepatic surgery and the means for alternative treatments, such as chemoembolization and continuous infusional chemotherapy.

Angiography↗