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C Procacci

Publications and source records attributed to C Procacci.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Role and limits of diagnostic imaging in the staging of lung cancer].

A total of 474 histologically proved Lung Cancers (LC) were evaluated by Conventional Radiology (CR) and Computed Tomography (CT) in order to assess the role of these two diagnostic modalities in the staging of LC. In 196/474 LC it was possible also to refer, for the evaluation of the diagnostic reliability, to the surgical control. The CR features of LC both at stage III (13% of the global series) and at stage I-peripheral T1 (16% of the global series) presented very high positive and negative predictive values (90% and 95%, retrospectively); in these cases it was considered useless to perform CT. The CT grading showed a high negative predictive value in excluding stage III caused respectively by grade T3 (91.5%) and grade N2 (93.5%). As to the staging, the CT assessment of the stage I and II showed a high predictive value (91.5%). On the other hand, the CT assessment of stage III presented an unsatisfactory predictive value (71%), due to the low predictive value in grade T3 (71.5%), poor in grade N2 (57.5%). The increase of the value threshold mediastinal adenopathies from 1 to 2 cm, leads to a great improvement of this predictive value (92%). The CT reliability was matched with the two different surgical "philosophies" (non aggressive or aggressive); surgery was excluded or performed according to the presence of omo-lateral mediastinal adenopathy. A correct advice to perform surgery was achieved in 33.5% (non aggressive "philosophy") and 43.8% (aggressive "philosophy") of cases; surgery was correctly excluded respectively in 49.6% and 45.9%. The resort to mediastinoscopy was advised in 7.8% and 1.3% of the cases respectively. In both "philosophies" the error of under-staging was lower (2.5%), than that of over-staging (6.6%).

Diagnostic Errors↗
PubMed1984

C. T. criteria of the differential diagnosis in primary retroperitoneal masses.

This personal series of 44 primary retroperitoneal masses (P.R.P.M.) studied by C. T. is analyzed. The reliability of C. T. in the identification (44/44), characterization (43/44) and origin evaluation (41/44) of P.R.P.M. has been absolutely satisfactory. In particular, those criteria of C. T. diagnosis which may be utilized in the evaluation of the origin of upper abdominal masses are thoroughly described. The evaluation of the involvement (non invasive; invasive) of adjacent viscera has been achieved in 22/38 P.R.P.M. verified at operation. The evaluation of tumour resectability has been less reliable due to the high incidence of under-diagnosis (60% in our personal experience). C. T. may be used in addition as an aid to different diagnostic techniques (percutaneous guided needle biopsy) or to therapy (drainage of retroperitoneal abscesses). C. T. is absolutely necessary in the follow-up of P.R.P.M. after surgery, radiotherapy or chemotherapy.

Adrenal Gland Neoplasms↗
PubMed1983

[Retroperitoneal tumors. Tactics, technics and surgical results].

Out of 33 cases of retroperitoneal tumours (TRP), collected throughout 11 years (1970-1981), 8 (24%) resulted benign, 25 (76%) malignant. Liposarcoma resulted the most frequent tumour. In 11 of the 25 cases of malignant TRP (44%), a radical removal of the tumour was performed; in 8 (32%), a palliative demolition, and in the remaining 6 (24%) a simple diagnostic laparotomy. In 10 of the 19 demolitive operations (53%) the removal was extended to contiguous organs: kidney, adrenal glands, colon, pancreas, spleen, bladder, stomach. The postoperative mortality was 6%. The cases of recurrence after operations considered radical were 5 (45%). Out of the 8 patients suffering from benign neoformations, 7 underwent simple removal, and result recovered. The global survival for malignant TRP was 20% after 5 years and 8% after 10 years; as related to the cases subjected to radical removal, it results 45% and 18% respectively. The Authors maintain the essential function of computerized axial tomography (TAC) in the preoperative anatomo-topographic outlining of the retroperitoneal mass and in the early recognition of the remote recurrences. An aggressive surgical behaviour seems to be presently the primary therapeutical solution; nevertheless, the encouraging results obtained through the complementary treatment (radiotherapy and chemotherapy) command the necessity of a pluridisciplinary management of the treatment of TRP as an essential condition for the improvement of the remote results.

Adult↗
PubMed1983

[Contribution of computerized axial tomography in the study of splenic injuries].

The splenic traumatic from a retrospective study of splenic traumatic lesions, they had the opportunity to observe in the last 2 years, emphasize the importance of T.A.C. (Computed Axial Tomograph). Such inspection, quick to be executed and non-invading, allows a thorough study of abdomen, and is a guide to a correct surgical option.

Adolescent↗
PubMed1982

Choice between US and CT in the radiological approach to the renal masses.

The diagnostic reliability of ultrasound (US) and computed tomography (CT) has been analyzed in 114 patients with renal masses (RM) detected by urography and consequently submitted to both exams. A flowchart is suggested in order to avoid useless examinations; accordingly, the US examination is always justified in the study of RM as opposed to the CT examination (requested only in 50% of RM) and angiography (requested only in 35% of RM).

Angiography↗
PubMed1979

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↗
PubMed1979

[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↗
PubMed1978

Computed tomography in surgical pancreatic emergencies.

The findings observed with computed tomography (CT) in such pancreatic emergencies as necrotic-hemorrhagic pancreatitis, pancreatic abscess, broken pseudocyst, and pancreatic ascites with mediastinitis are presented. The value of CT in these conditions, which often require surgical intervention, is discussed. Computed tomography appears to be the ideal diagnostic procedure, especially for surgical treatment planning in pancreatic abscess. No deaths occurred in a group of pancreatic abscesses treated surgically with CT assistance.

Abscess↗
PubMedDate not supplied

Left pulmonary artery sling in the adult: case report and review of the literature.

The aberrant left pulmonary artery is a serious anomaly in neonates; in the adult it is most often an incidental finding. One case is reported, incidentally discovered in the diagnostic workup of a patient with a vertebral lytic lesion. This vascular anomaly, mimicking a mediastinal adenopathy on the chest roentgenogram, which also showed a peripheral lung malignancy, was better assessed by an esophagogram (indentation on the posterior tracheal wall as well as on the anterior esophageal wall) along with fluoroscopy which showed the lesion to be pulsating. Its thorough anatomic evaluation was allowed by computed tomography (CT), performed for the staging of the lung tumor. The latter proves the choice modality due to its capability to provide precise information on all the different structures existing in a given cross-section.

Aged↗
PubMedDate not supplied

Cystic pancreatic masses: cross-sectional imaging observations and serial follow-up.

BACKGROUND: We retrospectively reviewed the imaging features of a series of patients with cystic pancreatic masses, the majority of whom underwent imaging surveillance. METHODS: Imaging data from 30 patients with known cystic pancreatic masses were reviewed. Nine patients had surgical and/or cytologic classification. Of the 21 who were not operated on, all underwent serial imaging surveillance. Of these, five had corroborative endoscopic retrograde cholangiopancreatography and 16 were followed by only computed tomography and/or magnetic resonance imaging. RESULTS: In the nonoperated group, mean follow-up time was 30 months (3-144 months). Two patients demonstrated growth, and the remainder remain stable. In the patients who underwent surgery, invasive carcinoma was found in those with lesions larger than 4 cm, involvement of the main pancreatic duct, or visible solid components on the imaging study. Smaller lesions were benign. CONCLUSION: In patients with suspected cystic pancreatic neoplasms, surveillance might be possible if lesions are smaller than 2.5 cm, spare the main pancreatic duct, and demonstrate no solid components.

Adenocarcinoma↗
PubMedDate not supplied

Afferent loop syndrome presenting as enterolith after Billroth II subtotal gastrectomy: a case report.

We present a rare late-onset (after 24 years) complication of gastric surgery with a combination of afferent loop syndrome associated with a large duodenal stone. The patient, who had undergone Billroth II partial gastrectomy for benign ulcer 24 years before, developed abdominal pain in the right upper quadrant, associated with nausea, vomiting, and high grade fever. Abnormal laboratory values included elevated liver function test, suggesting a pressure-related phenomenon. Leukocytosis and a high level of platelets were also found. Only computed tomography and endoscopy of the upper gastrointestinal tract confirmed the diagnosis of a huge stone in the dilated duodenal afferent loop. To our knowledge, a case like this has not been reported previously in the literature.

Afferent Loop Syndrome↗
PubMedDate not supplied

Serous cystadenoma of the pancreas: report of 30 cases with emphasis on the imaging findings.

PURPOSE: Our goal was to evaluate retrospectively 30 cases of serous cystadenoma (SCA) to determine its main imaging features as well as to discuss the differential diagnosis problems versus the other cystic lesions of the pancreas. METHOD: Thirty SCAs were analyzed; they were all benign lesions, proven at surgery. Twenty-three tumors were evaluated with US, 26 with CT, and 5 with MRI. RESULTS: Three different morphostructural patterns were identified: microlacunar (n = 19), mixed (n = 6), and macrolacunar (n = 5). The diagnosis of SCA, possible in either the microlacunar or the mixed patterns, was achieved in 74% of cases with US (17/23) and in 61.5% with CT (16/26). Among the 19 patients evaluated with both modalities, the joint information allowed a correct diagnosis in 16 cases (84%). The five macrolacunar tumors were undistinguishable from other cystic masses of the pancreas. CONCLUSION: The diagnosis of SCA can be considered certain in the microlacunar, likely in the mixed, and not possible in the macrolacunar type.

Adolescent↗