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C Zuiani

Publications and source records attributed to C Zuiani.

At least 37 records · Page 2Linked to original sources
PubMed1996

Large core biopsy for diagnostic and prognostic evaluation of invasive breast carcinomas.

Large core biopsy is a recently introduced method for pre-operative evaluation of breast lumps. The aim of this study was to evaluate the usefulness of this technique in providing pre-operative diagnostic and prognostic information that can lead to a correct line of treatment. We compared 41 cases of breast carcinomas diagnosed both by core biopsies and surgically removed samples. A high (93%) diagnostic agreement was obtained. Moreover, we found a significant correlation for mitotic count (r = 0.76), oestrogen receptor (r = 0.78), progesterone receptor (r = 0.80), p53 (r = 0.86) and c-erbB-2 (r = 0.90) analysis between core biopsy and definitive surgical pathology. An agreement for histological grading evaluation between the two techniques was obtained in 32 out of 40 cases (k = 0.65) whereas in the other cases, a lower grade was assigned by evaluating core biopsies. These findings suggest that percutaneous core breast biopsy is a valid tool for pre-operative management of breast lesions, but this should be confirmed in larger, prospective studies.

Adult↗
PubMed1996

[Magnetic resonance with fat-saturation sequences in studying the upper abdomen: the normal semeiological aspects].

The fat-saturation (FAT-SAT) MR technique decreases the signal intensity of fat in tissues, though yielding the T1, T2 and proton-density (PD) information available on spin-echo (SE) sequences. To investigate the potentials of FAT-SAT sequences in MRI of the upper abdomen, the authors carried out a prospective study including 129 subjects, namely 12 normal volunteers and 117 patients with different abdominal conditions. The patients were submitted to T1-weighted SE sequences (TR 500-600 ms, TE 15 ms), T2W SE (TR 1600-1730 ms, TE 80 ms) and PD SE (TR 1600-1730 ms, TE 20 ms). The images obtained with and without fat suppression were compared both qualitatively and quantitatively, with a special emphasis on the normal anatomy of the upper abdomen: we investigated the efficacy of subcutaneous and retroperitoneal fat suppression (116/129 cases, 90%), the reduction in respiratory and chemical shift artifacts (112/129 cases, 87%) and the better visualization of parenchyma (119/129 cases, 93%) and of other abdominal structures. Concerning the quantitative study, we calculated the signal-to-noise ratio (S/N) for liver, spleen, pancreas, adrenal glands, renal cortex and medulla, the improvement of contrast in these organs after retroperitoneal fat suppression (conspicuity) and the increase in contrast between organs (dynamic range). The statistical analysis showed significant differences between the sequences with and those without fat suppression. Correlations were found between observers' and quantitative evaluations, suggesting that the better yield of FAT-SAT sequences is probably due to three factors: 1) retroperitoneal and subcutaneous fat suppression; 2) increase in S/N ratio for pancreas and renal cortex on T1W images; 3) reduction in the dynamic range of signal intensity, which increases contrast between pancreas, adrenal glands and renal cortex relative to adjacent structures, especially on T2W or PD sequences. The results of this study suggest that FAT-SAT sequences are useful because fat suppression increases contrast and improves image quality, reducing respiratory and chemical shift artifacts.

Abdomen↗
PubMed1996

[Functional mapping of the motor and primary sensorial cortex using magnetic resonance techniques. I. Preliminary data].

Functional Magnetic Resonance Imaging (fMRI) techniques sensitive to the local changes in blood flow, volume and oxygenation accompanying neuronal activation are powerful tools to investigate the human brain function. Experiments were performed on 10 right-handed healthy volunteers (age range: 20-39 years), using a 1.5 T whole-body MRI system. Two oblique contiguous planes were investigated along the central sulcus of the left hemisphere. Functional images were acquired using a Gradient Echo sequence while the subjects repetitively performed sequential finger to thumb opposition movements of the right hand or mental imagery of a visual scene. Twelve images for each task were obtained over a 6-min experimental period; they were then analyzed with the software provided by the manufacturer. In all the subjects small areas were activated in both the precentral and postcentral gyrus, mean percentage signal increases during finger movement being 10.7% and 3.8%, respectively. These values are fairly higher than literature ones. However several factors, such as voxel volume, are involved in determining the measured signal increase during activation. Moreover, in most cases the software procedures provided with the MR equipment to analyze the functional images imply subjective choices. It is thus necessary to implement new software packages for the analysis of fMRI images to apply more appropriate statistical procedures and to obtain more homogeneous and objective final information.

Adult↗
PubMed1996

[Functional mapping of the motor and primary sensorial cortex using magnetic resonance techniques. II. Image analysis techniques].

Functional Magnetic Resonance Imaging (fMRI) techniques to investigate brain function are now available on clinical MR systems. However, the software packages provided with the MR equipment to analyze the functional images are often inadequate. In the present study, two registration algorithms for correcting motion artifacts and three procedures of statistical analysis (t-test, correlation analysis, Kolmogorov-Smirnov test) were compared using programs implemented on a graphic workstation. For both registration algorithms, transformation parameters for in plane translations and rotation of images were significantly affected by the task, being higher during sequential finger movements than during the control (visual imagery) condition. Regions of interest were identified on the anatomical images and their boundaries automatically projected on functional images. The number of significantly activated pixels in the pre- and postcentral areas was not significantly different after the registration with the two procedures. The percentage of pixels of the pre- and postcentral areas whose signal intensity was significantly different between the two tasks decreased with respect to the adopted threshold of significance as a power function. For an area identified outside the brain, the same relation was linear: no activated pixel was found for p < 0.001. The application of the t-test or of the correlation analysis yielded similar results. The analysis of the profile of mean normalized signal intensity showed higher increases in signal intensities during the motor task in the precentral gyrus than in the postcentral gyrus. This appears to be due to a greater number of activated pixels during motor performance. The application of registration procedures, the identification of the regions of interest on the basis of the anatomical images and appropriate statistical analyses allow a more detailed characterization of task-related activation.

Adult↗
PubMed1993

[The use of automatic devices for ultrasonography-guided histologic biopsy of breast lesions].

The authors report their experience with the use of biopsy guns for the histologic sampling of breast lesions. Cytologic sampling by means of FNAB has been preferred so far because it was thought to be simpler, less risky and more reliable. Nevertheless, cytologic sampling exhibits several drawbacks--e.g., the need of repeated punctures to get sufficient cell material, frequent problems in diagnosing benign lesions and the decisive influence of the operator's skills. The use of biopsy guns for histologic sampling solves the above problems, because the value of the sample is not affected by the operator's skills; moreover, fewer punctures are needed and their value does not depend on lesion nature. Our series of cases includes 65 patients who underwent histologic sampling for suspected lesions over 10 months. A hundred and seventy-two samples were collected and 77 lesions were diagnosed, 47 of them malignant and 30 benign (fibroadenomas, fibrocystic changes, epitheliosis). Sensitivity, specificity and diagnostic accuracy of the method were 93.6%, 100% and 96.1%, respectively, with 6.4% false negative due to 3 cases where the lesion was not centred due to misguidance.

Adult↗
PubMed1993

[The dose and quality program in mammography (DQM). Results of the study carried out in 20 Fruili-Venezia Giulia centers].

Recently, 20 breast centers in Friuli Venezia Giulia have been investigated for the mammography optimization program known as DQM (Dose and Quality in Mammography). This was the second trial, the first one dating 1987-1988 and including only 10 centers. The chosen parameters were evaluated by means of a performance phantom containing 15 details, a Victoreen 660 ionizing camera, a star pattern and several plexiglass phantoms of different thickness. Statistical-methodological data were collected by means of a questionnaire. The results of the trial were communicated to each center as well as directions for future improvements. All centers were found to use mammographic equipment with a molybdenum anode and the film-screen combination; 18 center use grids daily, while 11 can perform direct radiographic magnification. Only 40% of the examined centers use a dedicated daylight printer. The overall quality of the radiographic image was seen to be acceptable, as 8 or more details of 15 hidden in the phantom were visualized, in 16 of 20 centers. The mean glandular dose was below the minimum threshold in all centers: in 45% of cases it was below 1.5 mGy. The setting of the automatic exposition control system was found to be poor, especially that of the adjustment related to breast thickness. Acceptability thresholds were met only by 31% of the examined centers (density variations < 20%). Notwithstanding the identification of areas where improvements can be made also from a methodological point of view, we can conclude that the quality provided by regional breast centers is definitely adequate. Good image quality and acceptable doses were observed in 80% of the centers. The results are significant and encouraging when compared with those from the first DQM trial carried out in our region, which confirms the value of periodical quality programs.

Italy↗
PubMed1989

Ultrasonography in oncology. A review.

The applications of ultrasonography (US) in oncology have rapidly increased during the past few years. Technical improvements, development of new technologies, easy availability, and non-invasiveness are some of the reasons for the rapid diffusion of US. Nowadays a large number of malignancies, both superficial and deep-seated, can be examined by US. In order to give an overview of the present role of US in oncology it is necessary to discuss many different topics including tissue characterization, diagnostic role, staging, follow-up and future developments.

Humans↗
PubMed1989

[High-risk focal breast lesions in echography and mammography].

Proliferative breast diseases include a group of lesions which occupy an intermediate position between benign and malignant lesions and are extremely likely to develop into carcinomas. The authors studied 81 patients who had been surgically biopsied on the basis of mammographic and/or US findings. In 33/81 (40.7%) of them proliferative lesions were diagnosed at histology. Mammography was able to identify 18/33 lesions (54.5%) versus US 26/33 (81.8%). On the basis of these findings, a group of patients at risk for cancer could be identified. As a matter of fact, proliferative lesions, especially those presenting with atypical hyperplasia, are associated with a higher risk of developing into carcinomas than those presenting with typical features. For these patients, the authors suggest more frequent clinical and instrumental screening.

Adult↗
PubMed1988

[Dynamic ultrasonic hysteroscopy].

An attempt was made to establish Dynamic Echohysteroscopy (DEHS) diagnostic criteria for the study of female genital apparatus, as recently proposed. DEHS consists of a pelvic ultrasonography during and following an injection of physiological solution in the uterine cavity. Since this technique does not use X-rays, it has been proven useful to study female infertility. The authors have studied the normal and pathological aspects of 33 patients who underwent both DEHS and hysterosalpingography (HSG) (comparison diagnostic test). The results lead to the following conclusions: 1) DEHS can be considered a useful alternative to HSG, in the evaluation of uterine pathology; 2) in the evaluation of tubal pathology, DEHS has fewer diagnostic possibilities than HSG. Nevertheless, DEHS indirectly allows the patency of at least one tube.

Adult↗
PubMed1988

[The role of computerized tomography in the diagnosis of postoperative intervertebral diskitis].

Six patients with diskitis following lumbar disk surgery were investigated by Computed Tomography (CT). Four patients underwent CT in a rather early phase of the disease (5-37 days after the onset of the symptoms): a posterior paravertebral fluid collection was always recognized, while the plain film was normal. Later on (2-4 months), the classical signs of diskitis were evident, with both CT and the plain film. The collection was always present at CT. A reintervention, performed on 3 patients, revealed the purulent content of the collections. It seems reasonable to suggest a relationship between the collection and the subsequent diskitis; the collection is probably an early sign of the disease. Its detection is of great value, because it could allow an immediate and adequate therapy. The authors stress the usefulness of performing CT in an early phase on this kind of symptomatic patients.

Adult↗
PubMed1987

[Instrumental diagnosis of non-glandular superficial inflammation].

The study of soft tissues has greatly improved since the introduction of ultrasonography (US) and computed tomography (CT). In order to define the role of instrumental investigations, 51 patients affected by non glandular superficial soft tissue masses underwent US and 9 were also examined with CT. US proved to be accurate to define the size, the structure of the mass (93%), the benign or malignant nature (91%). US was also useful for percutaneous biopsy. However, US cannot be considered the only investigation because it does not give enough data about bony and articular structures: a conventional X-ray film must be performed in order to define the relation of the mass with the adjacent bone and to clarify the possible presence of fatty tissue in a solid mass shown at US. CT has a role in case of large masses, surrounding a bone diaphysis, when the malignant nature is suspected and to define the relationship with vessels and muscles.

Abscess↗