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C Zuiani

Publications and source records attributed to C Zuiani.

49 records · Page 3Linked to original sources

[3-dimensional craniofacial computerized tomography].

Computed tomography allows today to reconstruct three-dimensional (3D) images from axial scans. The authors report their experience in cranio-facial pathology achieved in two Departments of Radiology (University of Trieste, Italy and University of Stanford, California). 3D images have been realized using two different softwares, one of which allows to reconstruct both soft tissue and bone structures. The applications in maxillo-facial traumas, cranio-facial malformations and head tumours are discussed. 3D images turned out to be very useful for the optimal visualization and for the spatial demonstration of the lesion and have potential applications in cranio-facial surgery and radiotherapy.

Facial Bones↗

Magnetic resonance imaging and 67Ga scan versus computed tomography in the staging and in the monitoring of mediastinal malignant lymphoma: a prospective pilot study.

PURPOSE: To assess the potential value of magnetic resonance imaging (MRI) combined with 67Ga single-photon emission computed tomography (SPECT) versus computed tomography (CT) in the staging and in the monitoring of mediastinal malignant lymphoma. MATERIALS AND METHODS: Twenty-three patients, referred to our institute for the evaluation of lymphoma, underwent CT, 67Ga scan, and MRI between April 1993 and February 1996 at sequential intervals. The tests studied (MRI, 67Ga, and CT) were performed according to the following schedule: 1) before start of therapy; 2) after four courses of chemotherapy; and 3) 2, 6, 12, and 18 months after the end of treatment. RESULTS: All patients studied at the time of diagnosis had abnormal gallium accumulation in the mediastinum as well as pathologic CT and pathologic signal intensity at MRI. Six months after the end of treatment full consistency was found between the results of MRI and SPECT, whereas during treatment and 2 months after the end of therapy MRI and 67Ga scan were not in agreement in nine patients. In the 23 patients in follow-up, in CT there were nine false-positive and three false-negative findings; in SPECT three false negatives; in MRI one false positive and one false negative. CONCLUSION: MRI can give morphologic information similar to CT, even superior due to multiplanarity and with major precision in the distinction between fibrosis and active disease. MRI is thus an alternative to CT. The association with SPECT allows a great diagnostic accuracy in the positive and negative predictive value.

Adolescent↗

Staging of pelvic endometriosis based on MRI findings versus laparoscopic classification according to the American Fertility Society.

BACKGROUND: Preoperative staging of pelvic endometriosis helps the gynecologist plan therapy and offers a prognosis to patients. We compared a staging system of pelvic endometriosis based on magnetic resonance imaging (MRI) findings with the American Fertility Society (AFS) laparoscopic classification. METHODS: Forty-four consecutive females with clinically suspected endometriosis underwent MRI examination to demonstrate the presence of endometriomas and pelvic implants. Laparoscopy was performed within 2 weeks. An MRI score was developed to classify endometriosis into four classes comparable to those of AFS laparoscopic staging. Concordance between MRI and laparoscopic classification was evaluated with kappa statistics. RESULTS: Laparoscopy confirmed 60 of 61 endometriomas detected by MRI. Implants were discovered in 20 of 44 patients with MRI and in 23 of 44 with laparoscopy. MRI detected 50 endometrial implants of 65 detected by laparoscopy (76.9%). With regard to endometriosis staging, we obtained a concordance between MRI and AFS classification in 42 of 44 patients (kappa = 0.913). CONCLUSION: Although MRI has limitations such as suboptimal depiction of small implants and adhesions, this technique is very useful to guide laparoscopy. Moreover, the optimal concordance (95%) between our proposed MRI staging and the AFS laparoscopic classification demonstrated a new advantage of MRI in preoperative staging of endometriosis.

Adult↗

[Ultrasonography and computerized tomography in the diagnosis of renal metastasis].

The US and CT findings of renal metastases are described in a series of 26 patients. US findings were round or oval masses ranging in diameter from 1.5 cm to 8 cm (mean: 4.2 cm); in only 21.2% of cases lesion diameters were less than or equal to 3 cm. In most patients (84.8%) the metastatic lesions were hypo-isoechoic, while in the extant cases they were either mildly hyperechoic or inhomogeneous. CT findings were round masses with variable diameters (1 cm to 8 cm; mean: 2.7 cm); in most cases (86.4%) lesions diameters were less than or equal to 3 cm. The latter finding was in significant disagreement with US results. CT densities were within the soft-tissue range, and always hypodense if compared to normal renal parenchyma in contrast-enhanced scans. Few cases of perirenal metastases were observed. US sensitivity was only 57%, much lower than that of CT; the latter method yielded no false negatives. CT showed metastatic lesions in patients with normal US findings; in 2 cases a greater number of lesions was detected with CT than with US. Our results are in substantial agreement with literature data, as far as US and CT findings are concerned; however, a lower incidence of bilateral cases was observed in our series than in previous reports. Our results support the primary role of CT in the detection of renal metastases thanks to its high sensitivity and to its allowing the simultaneous evaluation of other organs.

Humans↗

[Ultrasonic-guided fine-needle biopsy of osteolytic lesions].

Percutaneous biopsy of lytic lesions of the bone, in the past pertaining to orthopedic surgeons, has now become a part of interventional radiology. Fluoroscopic guidance has simplified its execution. US does not, under normal conditions, allow an accurate examination of the skeleton; on the other hand, when the bone tissue is replaced by soft tissue, US can easily demonstrate the presence of a tumefaction, caused by a lytic lesion, and determine its characteristics. Eleven patients with lytic lesions (recognized on plain film) underwent US. The lesions were demonstrated. In such cases, biopsy is essential to define their benign or malignant nature, in the latter case if primitive or metastatic, and their histology as well. US is a simple guide to the biopsy of noncorticalized lytic lesions, and it offers consistent advantages over fluoroscopic guidance--i.e. it is easier to perform, it requires no X-ray exposure, it provides with three-dimensional images, the guide is performed in real time, and a choice of the most appropriate (non-necrotic) areas is possible.

Biopsy, Needle↗

Percutaneous large core needle biopsy versus surgical biopsy in the diagnosis of breast lesions.

OBJECTIVE: To value LCNB accuracy in the determination of morphobiological parameters and as an alternative to the open SB diagnostic procedure of breast lesions. SETTING: University Hospital, Italy. SUBJECTS: From May 1992 to February 1995 196 biopsies have been performed. The diameter of the neoplasms examined varied from 0.6 to 7 cm with an average of 1.9 cm. MAIN OUTCOME MEASURES: The accuracy of the two methods in the evaluation of histological degree, receptor state, protein c-erb B2 and p53 were compared. RESULTS: No inadequate sampling were ever recorded. LCNB has shown values of 97% sensitivity and 100% specificity. The positivity and negativity predicted values obtained were 100% and 89% respectively. Retrospectively 70 sample-cases of carcinoma were selected and the morphobiological parameters evaluated. The correlation coefficients for the data obtained with SB and LCNB in the evaluation of Progesteron and Oestrogen receptor expression, protein c-erb B2 and p53 were excellent. Furthermore it was noted that LCNB allows a saving of at least 1/3 of the cost vs intraoperative SB. CONCLUSIONS: Percutaneous LCNB has high diagnostic accuracy for histological classification. LCNB has the same accuracy as SB for morphobiological parameters. The cost of LCNB is markedly lower than SB.

Adult↗

[Magnetic resonance of the elbow: technique optimization and definitions of normal anatomical features and their variations].

INTRODUCTION: MRI is a very accurate technique to study the elbow joint, tendon, ligament and chondral structures. In the last years elbow disorders were described by several MR investigators, while we studied MR capabilities in depicting normal elbow anatomy. This investigation might permit the correct differentiation of normal from abnormal MR patterns. MATERIAL AND METHODS: Eleven healthy volunteers (6 men and 5 women, mean age: 27.5 years) were examined. All studies were performed on a 1.5 T imager (Magnetom SP 4000) with two types of receiver: the knee coil was used in 7 volunteers examined in the prone position, with the arm above their head, the elbow extended and the forearm supine and the shoulder coil was used in 4 volunteers examined in the prone position, with the arm above their head, the elbow flexed and the forearm prone. We acquired T1-weighted SE sequences (TR/TE = 690/15 ms, FA 90 degrees, MA 256 x 512, NEX 2,20 3-mm sections with .3-mm interslice gap, FOV 20-22 cm) on the axial, coronal and sagittal planes and T2-weighted GE sequences (TR/TE = 450/10 ms, MA 256 x 256, 3 NEX, 18 4-mm sections with .4-mm interslice gap, FOV 13-18 cm) on the coronal plane. Two MR-expert radiologists studied the images and identified the main anatomical structures of the elbow and 12 smaller reference elements (2 anatomical variants, 4 ligaments, 3 nerves and 3 arteries) describing their MR appearance and pointing out the most effective planes for their representation. Finally, the image quality of the knee coil was compared with that of the shoulder coil. RESULTS: All bones were clearly depicted on the coronal and axial planes, while the semilunar groove and its anatomical variants were best seen on the sagittal plane. The joint cartilage was best depicted on the coronal plane with T2-weighted GE sequences. Collateral ligaments were best seen with the elbow extended and the forearm supine (knee coil), on coronal T1-weighted SE images, where the radial and ulnar collateral ligaments were visible in 71.4% and 85.7% of the subjects, respectively. Annular ligaments, muscles and tendons were best demonstrated on the axial plane with the elbow extended and the forearm supine (knee coil), while the triceps tendon was best recognized on the sagittal plane with the elbow flexed and the forearm prone (shoulder coil). Vessels and nerves were also best seen on the axial plane with the elbow extended and the forearm supine; in particular, the median nerve was visible in 71.4% of the subjects. DISCUSSION AND CONCLUSION: MRI is very effective in representing elbow anatomical structures. Its accuracy depends on elbow (flexed or extended) and forearm (prone or supine) position. The coronal images with the elbow extended and the forearm supine (knee coil) are the most effective to show the ligaments and the joint surfaces between the radial head and the coronoid process of ulna with the capitellum and trochlea of distal humerus, while the axial images best depicted the muscles, vessels and nerves. The coronal and axial planes, with the elbow flexed and the forearm prone (shoulder coil) are poorly effective for anatomical detailing, even though this position is more comfortable for the patient, while the sagittal plane is best suited to depict the triceps tendon. This position may be used when the elbow cannot be fully extended or when the triceps tendon is studied.

Adult↗