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C Fugazzola

Publications and source records attributed to C Fugazzola.

At least 55 records · Page 3Linked to original sources

[The distal spleno-renal anastomosis of Warren (author's transl)].

This is a report on 28 Warren-Shunts, 17 of these patients had undergone clinical, hematological and angiographic controls 2--46 (mean 10) months after the operation. The critical evaluation of the results shows that the Warren derivation, which is selective at the moment of operation, develops in the following time some hepatofugal circulation. This is a more radical effect than the intended drainage of the gastro-esophageal venous bed alone.

Adult↗

Accuracy of computed tomography in the screening of obstructive jaundice.

Percutaneous transhepatic cholangiography (PTC) has come back into greater use thanks to Chiba's needle. PTC, however, is useful only in obstructive jaundice (OJ). Since in OJ the dilatation of the intrahepatic biliary tract (IHBTD) is constant, the authors discussed CTs reliability in evaluating IHBTD in a series of 33 patients with OJ studied with PTC. The threshold of CT diagnosis of IHBTD was found to be equal to a doubled caliber of the normal biliary tract. This value is reached by 85% of the patients 2 weeks after the onset of OJ and in 98% between 2 and 3 weeks. CT is therefore usable as a screening method of PTC, as long as it is not performed before 2 weeks after the onset of OJ. After 2 weeks, if CT does not reveal IHBTD, it is possible to exclude OJ.

Bile Ducts, Intrahepatic↗

[The role of computed axial tomography in pancreatic emergencies (author's transl)].

The role of CT in acute diseases of the pancreas is discussed, in the light of personal experience (25 cases). In acute pancreatitis (22 cases), CT was useful in particular for: differential diagnosis between the necrotic-hemorrhagic type and the edematous type; detection of extra-pancreatic collections and evaluation of their extent; post-operative follow-up of necrotic-hemorrhagic pancreatitis. In the other more rare empergencies (3 cases), CT could recognize respectively the rupture of an infected pseudo-cyst, and intra-cystic hemorrhage, a mediastinitis due to the spread of ascitic fluid containing pancreatic enzymes into the mediastinum. CT always provided diagnostic information which the other radiological techniques did not provide; therefore in acute diseases of the pancreas CT is the method of choice.

Acute Disease↗

[Distal termino-lateral spleno-renal anastomosis, using the Warren technic].

The authors describe 23 cases of distal splenorenal derivation after Warren. Of these patients, 17 received a complete followup clinical hematological and angiographic examination at an average remove of 10 months after surgery. The authors discuss their results and submit that the Warren operation, while really selcetive in most cases when performed, in the long run tends to shung rather too much blood away from the liver; in other words, the effectiveness of the shunt tends to exceed the intended drainage,which should be restricted to the gastro-esophageal vascular bed.

Adult↗

Selective arterial embolization in renal tumors.

Selective arterial embolization with Gelfoam was performed in 45 cases of hypernephroma. In 33 cases this technique has been utilized as preoperative procedure and almost always (97%) nephrectomy was facilitated: 97% of the cases had slight or moderate operative bleeding; in 82% of the cases separation of the tumor-containing kidney from adjacent tissues was easy. Embolization has been employed in 12 inoperable patients and was effective mainly in management of bleeding. Angiographic controls after embolization (from 13 to 162 days) were performed 8 times and it was assessed that the efficacy of the procedure on primary tumor growth is limited in time by renal artery revascularization. The embolized patients never presented severe complications, except several episodes of transitory renal failure.

Adenocarcinoma↗

Angiographic diagnosis of endocrine tumors of the pancreas.

The angiographic findings in 18 patients with endocrine tumors of the pancreas are analyzed. A literature review (262 cases) is performed in order to assess the accuracy of angiography in diagnosing islet cell tumors, in particular multiple and small (less than 1 cm) lesions. Problems of differential diagnosis of pancreatic and extrapancreatic structures and lesions are discussed.

Adenocarcinoma↗

Critical evaluation of renal masses' angiography.

152 consecutive space occupying renal lesions (54 cancers, 66 single or multiple cysts, 18 pseudotumors, 8 inflammatory lesions, 3 hydronephroses, 3 hehatomas) were studied by selective angiography, considering the signs noted in the three phases: arterial, nephrographic, and venous. The frequency of each of these angiographic signs in the different forms of renal pathology was evaluated. Based on this study, pathognomonic angiographic signs were identified for the various types of pathology. For each angiographic sign the 'diagnostic value' was calculated in order to differentiate malignant from benign space-occupying lesions. Dependent on the angiographic phase they are in, these signs constitute the arterial, nephrographic, and venous 'symptom constellation' characteristic of each lesion. The relationship between angiographic signs and either histologic type or size of tumor were analyzed. The causes of false positives and false negatives were investigated. The value of certain angiographic signs for a correct diagnosis of the cases judged as suspect or misinterpreted was discussed.

Angiography↗

[Angiographic signs of the small intestine (two cases) (author's transl)].

The authors describe 2 cases of ileal carcinoid. They evaluate the advantages of selective angiography over the traditional radiologic methods, considering their cases and the 39 found in the literature. The angiographic signs of the lesions localized to the bowel wall are rather scarse and non-specific. The signs of mesenteric infiltration, which is precocious and conspicuous in this type of tumour, are more significant. Liver metastases, which are very frequent, are hypervascularized. The angiographic pattern may be similar to that found in some inflammatory diseases, but can be differentiated from that of other neoplasms of the small intestine.

Adult↗

[99mTc-MIBI characterization of breast microcalcifications. Correlations with scintigraphic and histopathologic findings].

INTRODUCTION: Microcalcifications which do not belong to focal lesions are a difficult diagnostic problem to solve with mammography. We investigated the yield of 99mTc-Sestamibi (MIBI) scintigraphy in the assessment of the benign or malignant nature of these lesions and compared nuclear medicine with histologic and immuno-histochemical findings. MATERIAL AND METHODS: Twenty-seven areas of microcalcifications (0.3-5 cm in largest diameter) were considered; no solid masses or cysts were detected by mammography and sonography. The mammographic features of these microcalcifications were suggestive of malignancy in 3 cases and of benignity in 14; the diagnosis was questionable in the other 10 cases. MIBI scintigraphy was considered positive for malignancy when there was tracer uptake in the breast. Cytologic samples of all lesions were obtained with fine-needle aspiration under stereotactic guidance. Histology was performed in the 13 lesions considered malignant or dubious at mammography, independent of their cytology; histology was combined with immunohistochemical tests to assess intracellular mitochondria count and the number of vessels. The other 14 lesions, which were benign at mammography and cytology, were followed-up yearly for two years, and no change in clinical or radiological findings was demonstrated. RESULTS: Histology diagnosed 8 ductal carcinomas (3 invasive carcinomas and 5 carcinomas in situ) and 5 benign lesions (1 sclerosing adenosis and 4 fibrocystic diseases, 3 of them associated with ductal hyperplasia). Scintigraphy was positive in 4/8 malignant lesions (3/3 invasive carcinomas, 1-3.5 cm in largest diameter; 1/5 carcinomas in situ, 5 cm in largest diameter) and negative in 4/5 benign lesions (we had one false positive in a fibrocystic disease associated with ductal hyperplasia). Tracer uptake was observed in all lesions with a high intracellular mitochondria count, except for 2 carcinomas in situ (0.3 and 0.8 cm in largest diameter, respectively); no benign or malignant lesion was well vascularized. Scintigraphy was negative also in the other 14 benign lesions with no histology. CONCLUSIONS: 99mTc-MIBI scintigraphy was able to characterize both invasive ductal carcinomas and benign lesions, which results hold even though our series was small because of the selection criteria we used. Thus, all invasive ductal carcinomas were identified and we had only one false positive (1/19) in benign lesions. In contrast, the technique was inadequate in carcinomas in situ, probably because their size and biological patterns vary greatly. Thus, scintigraphy was negative in 4/5 lesions (all < 1 cm O) and positive in only 1/5 (5 cm O). Therefore we conclude that 99mTc-MIBI scintigraphy cannot replace stereotactically-guided fine-needle aspiration in breast microcalcifications with questionable mammographic findings.

Adult↗

[Magnetic resonance in the study of aseptic necrosis of the femur head].

Avascular necrosis (AVN) of the femoral head is a common clinical problem due to the frequent use of corticosteroids and to the high incidence of hip fractures from osteoporosis and traumas. In order to demonstrate MR diagnostic capabilities, 31 patients (62 hips) were studied with MR imaging, CT, and conventional radiology. The patients had already been diagnosed as having AVN of the femoral head, or the condition was clinically suspected. MR staging of the disease was compared with CT staging and with plain radiographs. The authors suggest new MR staging method and adapt the radiographic classification developed by Ficat, Arlet, and Lecestre. The results of this comparative study demonstrate MR imaging to be most appropriate in the patients with equivocal/negative radiological/CT findings. On the contrary, MR imaging is unnecessary when AVN has already been diagnosed by means of other imaging modalities, because in these advanced cases MR diagnostic contribution either equals or is inferior to that of CT and conventional radiology.

Adult↗