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E Di Cesare

Publications and source records attributed to E Di Cesare.

At least 19 recordsLinked to original sources
PubMed2000

Comparative evaluation of TEE, conventional MRI and contrast-enhanced 3D breath-hold MRA in the post-operative follow-up of dissecting aneurysms.

PURPOSE: To verify the diagnostic potentialities of conventional magnetic resonance imaging (MRI), breath-hold 3D contrast enhanced MR angiography (C3D MRA) and transesophageal echocardiography (TEE) in patients surgically treated for type A aortic dissection. MATERIALS AND METHODS: Twenty-nine patients (21 males and 8 females), surgically treated for type A aortic dissection, were evaluated with MRI using a 1.5 T (GE Horizon Echospeed 8.2) with standard gated SE sequences and breath-hold 3D fast SPGR after intravenous Gd injection (0.2 mmol/kg). 3D MIP reconstruction was obtained. TEE evaluation was performed with a HP 2000 system and a biplane 5 MHz probe. The sizes of aortic root, distal anastomosis, descending aorta and periprosthetic thickening were measured. Regional false lumen and aortic branch involvement were also evaluated. RESULTS: Concordance among TEE, conventional MRI and C3D MRA was observed in the evaluation of aortic root (MRI vs. C3D MRA r = 0.93; MRI vs. TEE r = 0.84; C3D MRA vs. TEE r = 0.84) and descending aorta (r = 0.94, 0.91 and 0.92, respectively). The interobserver variability was also very low. Inadequate agreement was observed for distal anastomosis. C3D MRA was inadequate in the evaluation of periprosthetic thickening; r = 0.73 was obtained between MRI and TEE. For qualitative data: TEE was inadequate in the evaluation of the abdominal aorta and branches. C3D MRA depicted supra-aortic vessel involvement in more cases than the other techniques. CONCLUSION: C3D MRA is a fast and accurate technique in the evaluation of the endoluminal alterations and involvement of the aortic branches. Conventional MRI allows a direct evaluation of the aortic wall and periaortic tissue. TEE is less accurate in the evaluation of aortic branches and abdominal aorta.

Adult↗
PubMed2000

[Antero-posterior lesions of the superior glenoid labrum. Magnetic resonance evaluation].

PURPOSE: To assess MR potentials in the evaluation of superior glenoid labrum disease and possible associated conditions of the rotator cuff and of the anterior mechanism of the shoulder. MATERIAL AND METHODS: We retrospectively evaluated 51 patients (age range 18 to 53 years) with a diagnosis of anteroposterior lesion of the superior glenoid labrum. MR examinations were performed with a 0.2 T permanent magnet and a dedicated coil, using T1- and T2-weighted SE sequences on mostly coronal-oblique planes. Slice thickness was 4 mm. In 8 cases, the examination was completed with intra-articular injection of contrast agent. Twenty-eight patients were submitted to surgery (arthrotomy in 7 cases; arthroscopy in 21 cases). RESULTS: We considered only the cases with surgical confirmation and divided them into 2 groups: 15 patients with isolated alteration of the superior glenoid labrum and 13 patients with an anteroposterior lesion of the glenoid labrum associated with disease of the rotator cuff or of the anterior mechanism of the shoulder. MRI demonstrated 5 cases of superior labrum irregularities at the level of its glenoid insertional portion (type I lesion); 6 cases of detachment of the superior portion of the labrum (type II); 9 cases of bucket handle tear of the superior labrum with involvement of the insertional portion of the long head of the biceps tendon (type III); 8 cases of superior labrum tear extending within the long head of the biceps tendon (type IV). In the patients with associated disease MRI demonstrated supraspinatus tendon tear in 5 cases, lesion of the labrum also in its anteroinferior portion in 1 case, Hill-Sachs intraspongious fracture with involvement of the inferior glenohumeral complex in 1 case, and complete tear of the rotator cuff in 7 cases. Subsequent surgery always confirmed the presence of associated lesions, while the superior labrum lesion was not confirmed in 3 patients. In 4 cases, surgical findings provided a different classification of the lesion type than MRI. DISCUSSION: In the presence of a type I anteroposterior lesion of the superior glenoid labrum, coronal MRI can depict the loss of the triangular shape of the labrum. Type II lesions show detachment of the labrum, which appears on the MR images as a high signal intensity band passing through the labrum with caudocranial orientation. A superior glenoid labrum tear with a low signal intensity area within the joint indicates a type III lesion. Complete tear of the superior glenoid labrum with involvement of the long head of the biceps tendon demonstrated on the coronal T1-weighted SE and T2-weighted GE sequences is a sign of a type IV lesion. CONCLUSIONS: MRI can be a valuable diagnostic technique in type III and IV lesions of the superior glenoid labrum. It often provides important information about the possible presence of associated diseases, especially of the rotator cuff, which are helpful for treatment planning.

Adolescent↗
PubMed2000

[Magnetic resonance angiography with contrast media bolus in the evaluation of aneurysms of the abdominal aorta].

PURPOSE: To investigate the potentials of 3D breath-hold contrast-enhanced Magnetic Resonance Angiography (MRA) in the diagnosis, follow-up and treatment planning of abdominal aortic aneurysms. MATERIAL AND METHODS: Twenty-four patients with infrarenal aortic aneurysm underwent MRA. We used a 1.5 T unit (GE Horizon, Echospeed 8.2), a phased array surface coil and 3D Fast SPGR T1-weighted sequences acquired on the coronal plane during patient breath-hold and after contrast agent i.v. administration. A bolus-test was done before angiography to optimize imaging delay time. After 3D MRA a Fast-SPGR T1-weighted sequence was acquired on the axial plane. The 3D MRA source images were processed with the MIP algorithm. Qualitative and quantitative analyses were carried out. Helical CT was performed in 6 cases and DSA in 7 cases. Surgery was the reference standard in 15 patients. RESULTS: MRA depicted aneurysm thrombosis in 22 cases, carrefour involvement in 18 cases and iliac arteries involvement in 3 cases. Accessory renal arteries were shown in 4 cases; iliac artery stenosis was associated in 5 cases. There was agreement between MR and Helical CT and DSA findings: surgery confirmed MRA results in 15/15 cases. CONCLUSIONS: 3D contrast-enhanced MRA can be considered the method of choice in the follow-up and treatment planning of abdominal aortic aneurysms, because it provides both angiographic and tomographic images: this allows to obtain more information, noninvasively and without the use of ionizing radiations.

Aged↗
PubMed2000

[Groin pain in athletes: role of magnetic resonance].

INTRODUCTION: Aim of our work was to evaluate the diagnostic role and potentials of Magnetic Resonance Imaging (MRI) in the study of groin pain in athletes and in the differential diagnosis among the pathological conditions that cause this syndrome. MATERIAL AND METHODS: MRI examinations were performed with a 1.5 T superconductive magnet, and a 0.2 T permanent magnet. Spin-Echo (SE) T1-w, PD, SE T2-w, Gradient-Echo (GE) T2-w and fat saturation sequences were used, on axial, sagittal and coronal scan planes. We performed MRI on twenty-five athletes (22 men and 3 women; age range 17 to 32 years) with chronic groin pain of questionable origin who had been complaining of it for at least 6 months. In 22 cases, radiographs were available; Computed Tomography (CT) had been performed in 3 cases and Ultrasound (US) in 7 cases. Nine patients were submitted to MRI after the symptoms had disappeared. RESULTS: In all patients, MRI provided an accurate depiction of pubic bone alterations and of adjacent myotendinous structures. In 14 cases, osteitis pubis was diagnosed, which was bilateral in 2 cases only (muscular asymmetry of the rectus abdominis was found in 4 of these patients); 4 patients had myotendinous posttraumatic changes (1 hematoma of the psoas muscle and 3 injuries of the abductor muscles of the thigh); 4 patients presented isolated dysmetria of rectus abdominis muscles, with unilateral involvement of the sacroiliac joint in 1 patient; 3 patients had inguinal hernia, surgically confirmed in all cases. DISCUSSION: Osteitis pubis, intended as reactive intraspongiuos edema of the pubic bones, is the most frequent cause of groin pain in athletes. In the early diagnostic phases, both plain films and CT may be negative or not specific. On the other hand, MRI has always proved to be a valuable diagnostic technique in detecting the osteitic change as an area of low signal intensity on T1-w images and of high and homogeneous signal intensity on T2-w scans without fat suppression. Dysmetria of the straight muscles of the abdomen, which may be associated, is always well depicted by MRI on axial planes. Both posttraumatic and dysmetric changes of the muscular structures adjacent to the pubis are well documented by US and MRI. The latter, however, thanks to its multiplanar capabilities, allows better spatial assessment of the alteration, especially if located at peri-insertional level. Possible associated diseases such as the involvement of the sacroiliac joints are also well shown by MRI. Inguinal hernias are easily demonstrated by MRI, which allows the direct visualization of the hernial sac within the inguinal canal. CONCLUSIONS: In our experience, only MRI can permit an accurate and early diagnosis of the different sport-related pubic conditions. MRI is also a valuable tool in monitoring the alterations with reference to their response to treatment, which may also help bring the athletes back to their activities.

Abdominal Muscles↗
PubMed2000

[Magnetic resonance imaging of hepatic focal lesions: dynamic contrastographic evaluation with gadolinium versus reticulo-endothelial hepato-specific contrast media].

PURPOSE: To compare the potentials of AMI-25 (Endoren) to those of Gadolinium with the dynamic contrast-enhanced technique in the differential diagnosis of focal liver lesions. MATERIAL AND METHODS: Forty patients with at least one focal liver lesion diagnosed at US underwent MRI. We used a 1.5 T unit and employed single-shot half-Fourier T2-weighted FSE and spoiled gradient-echo T1-weighted sequences before and after Gadolinium injection. Multiple acquisitions were obtained during the arterial, portal and delayed phases. Twenty-four to 48 hours later T2*-weighted GRE and SPGR/90 degrees sequences were obtained after AMI-25 administration. In the characterization of solid lesions the gold standard was biopsy performed with a shearing needle; for the diagnosis of angiomas and of 11 metastatic lesions we considered follow-up and clinical data as important diagnostic elements. RESULTS: We found 12 hepatocarcinomas, 14 metastases, 4 cases of focal nodular hyperplasia (FNH), 4 adenomas and 6 angiomas. The diagnosis was correct and confirmed by the conventional examination in all cases but 2 adenomatous lesions and 2 angiomas. Precontrast studies showed slight hyperintensity in 2 of 4 cases of FNH, while the other 2 lesions appeared isointense and were therefore detected only on postcontrast images, where there was contrast agent uptake during the arterial phase and rapid washout. We found only one central scar hyperintense on T2- and hypointense on T1-weighted images. After AMI-25 administration all lesions appeared isointense to surrounding parenchyma on T2* GRE sequences. Adenomas were isointense in the precontrast phase and postcontrast 3 of them showed strong Gadolinium uptake and rapid washout. After AMI-25 two of the 4 lesions were hyperintense while the other two were isointense to the parenchyma. Four of 6 angiomas exhibited a typical pattern characterized by signal hyperintensity on T2-weighted sequences and on AMI-25-enhanced T1- and T2-weighted sequences. Two angiomas were supposed to be of malignant nature but histology showed the presence of a strong fibrotic component. Hepatocarcinomas could be detected on precontrast images. After Gadolinium administration 10 lesions appeared hyperintense in the arterial phase and 2 were hypointense. After AMI-25 all lesions exhibited homogeneous signal hyperintensity and appeared slightly bigger than on Gadolinium-enhanced images. The metastases were only partly demonstrated by MRI. Postgadolinium studies showed 13 lesions with hyperintense signal in the portal phase. AMI-25 administration detected 14 lesions that appeared slightly bigger than on Gadolinium-enhanced images. CONCLUSIONS: AMI-25 can help also in characterizing primary lesions with an atypical signal pattern after contrast agent administration thanks to its intrinsic capability of accumulating in benign lesions. However it remains difficult to characterize well differentiated hepatocarcinomas and adenomas. Finally, AMI-25 improves MR capabilities in detecting secondary lesions and possible satellite nodules.

Adenoma↗
PubMed1999

Magnetic resonance angiography: state of the art.

The recently developed three-dimensional ultrafast sequences are able to acquire the entire aorta or the peripheral district in just 15 s. These sequences offer the possibility to obtain breath-hold images (that avoid breath artifacts) during the contrast medium peak. The technique is called three-dimensional angiography with contrast bolus. To perform the evaluation with this technique, high performance magnet units are needed (high magnetic fields, high gradient with fast ramping times). Clinical indications include the aortic district and especially thoracic aorta diseases and aortic dissections. This technique has great potentialities in the evaluation of the supra-aortic trunks, renal arteries and peripheral district. Shifting the table it is now possible to obtain the contemporary evaluation of both aorta and peripheral district with a single injection of contrast medium. The definition of the arterial district is comparable in many cases to that offered by digital angiography. The combination of magnetic resonance angiography and tomographic magnetic resonance technique is helpful for the endoluminal evaluation (as with digital angiography) and for the study of thrombi and wall as well.

Aortic Dissection↗
PubMed1999

[3-dimensional magnetic resonance angiography in apnea with the rapid infusion of a paramagnetic contrast medium in studying the thoracic aorta].

INTRODUCTION: We investigated the diagnostic accuracy of gadolinium-enhanced 3D MRA in the assessment of thoracic aortic diseases. MATERIAL AND METHODS: Thirty-eight patients with diagnosed or suspected conditions of thoracic aorta were examined with contrast-enhanced MRA. All the examinations were performed with a 1.5 T superconductive magnet acquiring breath-hold 3D fast Gradient-Echo (GE) sequences (TR = 5.9 ms; TE = 1.2 ms; FA = 45 degrees; FOV = 48 cm; thickness = 2-2.5 mm; locs = 30-32; TA = 22-24 s; MA = 512) on the coronal plane. The contrast agent was injected bolus after a bolus-test to evaluate circulation time. RESULTS: Three-dimensional gadolinium-enhanced MRA permitted to correctly diagnose aneurysm in 18 patients, dissection in 13 patients and coarctation in 3 patients. In the former the size and extent of the aneurysmal lumen and its relationship to aortic side branches was demonstrated. As for dissections we evaluated the following parameters: 1) type; 2) presence of intimal flap; 3) thrombosis of the false lumen; 4) dilatation of the aorta; 5) assessment of great vessel origins. MRA data were correlated with those of biplane transesophageal esophageal echocardiography, conventional MRI and spiral CT. In the three patients with aortic coarctation the site of coarctation was correctly identified, the degree of aortic narrowing evaluated and the collateral vessels demonstrated. CONCLUSIONS: In our opinion contrast-enhanced three-dimensional MR angiography should be the screening technique of choice in the evaluation of thoracic aorta thanks to its low invasiveness, short acquisition time, large field of view and morphologic resolution. ECG gating is not needed. Limitations are found in the study of wall and periaortic region which are better evaluated with conventional MR imaging.

Adult↗
PubMed1998

US and MRI in a case of persistent Müllerian duct syndrome.

We report the US and MR appearances in a case of persistent Müllerian duct syndrome, a rare form of inherited male pseudohermaphroditism characterised by the presence of uterus and fallopian tubes in a normally virilised 46XY male.

Child, Preschool↗
PubMed1998

Skin lesions in diabetes mellitus: prevalence and clinical correlations.

With the aim to assess the prevalence and the main clinical correlations of skin lesions in diabetes mellitus, 457 diabetic subjects consecutively attending an outpatient clinic underwent a dermatological examination. Neurovascular foot lesions were excluded. Thirty-five of 64 IDDM patients (54%) had skin alterations mainly consisting of vitiligo (9% of all patients), psoriasis (9%) and eczema (8%). The most frequent skin lesions observed in 240/393 NIDDM subjects (61%) were represented by infections (20% of all patients) and diabetic dermopathy (12.5%), while other lesions were not common. NIDDM patients with skin infections had a worse metabolic control, and those with diabetic dermopathy had a greater prevalence of neuropathy and large vessel disease than patients without skin lesions. These data show that the prevalence of skin diseases in a large, unselected diabetic population is higher than expected and indicate that, in most cases, a careful dermatological examination and a better metabolic control are needed in order to improve quality of life in these patients.

Adolescent↗
PubMed1998

Chronic iliac artery occlusion: treatment with the Strecker stent after PTA.

The purpose of this retrospective study was to evaluate the use of percutaneous transluminal angioplasty (PTA) and subsequent. Strecker stent implantation for the treatment of chronic iliac artery occlusions. A total of 39 patients were subjected to this procedure. The occluded vessels were catheterized, dilated and subjected to stenting in all patients: the length of occlusion varied from 4.5 to 10.5 cm (mean 5.9), lesions were located in common iliac arteries (25), external iliac arteries (10) and in combinations of both (4). Twenty-five patients presented stage II according to Fontaine classification, nine patients stage III and five patients stage IV. The stent was mounted on balloon catheter and introduced through a 9 French sheet (for 8-10 mm stent diameter). After this procedure, 37 out of 39 patients showed a statistically significant increase in the Doppler sonographic ankle-arm index (AAI) (P = 0.001) and improvement of clinical symptoms, while in two patients a complete occlusion resulted due to long dissection not covered by the stent in one case and to stent misplacement in the other case. After stenting, 27 patients improved to stage I, ten patients to stage IIa and two patients showed no changes. Two complications were observed: one groin hematoma and one distal embolization. At a 6-month follow-up, a 89.7% of patency was observed. This study shows that Strecker stent can be successfully employed in addition to PTA to treat occlusions of the iliac arteries.

Angiography, Digital Subtraction↗
PubMed1998

[Superparamagnetic iron oxide in the differential diagnosis of focal hepatic lesions using a 0.5-tesla magnetic resonance apparatus].

INTRODUCTION: We investigated the efficacy of superparamagnetic iron oxide (SPIO) in the characterization of focal liver lesions on MR images by means of quantitative and qualitative analysis. MATERIAL AND METHODS: We examined 60 patients with at least one focal liver lesion on US images. Conventional T1-weighted spin echo (CSE), proton density and T2-weighted MR images were acquired before and after the injection of a SPIO agent (Endorem, slow infusion, 15 micromoles Fe/kg body weight). A qualitative and a quantitative analysis were performed calculating the contrast enhancement rate in different kinds of lesions; the differences were related to the type of sequence statistically using Student's t-test for coupled samples. RESULTS: Excellent correlation was found with biopsy findings in all but two patients who were false positive for hepatocellular carcinoma (scar on cirrhotic liver). T1-weighted sequences after AMI-25 injection were the most specific ones in hemangioma characterization; PD were the most sensitive sequences in the detection and characterization of liver metastases. T2-weighted sequences were helpful only in the detection of focal liver lesions but they were not specific. CONCLUSIONS: In conclusion, SPIO-enhanced MRI is an excellent imaging tool for the differential diagnosis of focal liver lesions, with a good specificity for the differential diagnosis of hemangioma and metastasis. It is also helpful to distinguish benign from malignant lesions.

Contrast Media↗
PubMed1998

[Anterior cruciate ligament tears in athletes: assessment and clinico-diagnostic control with a dedicated system].

INTRODUCTION: We investigated the MR signs of anterior cruciate ligament (ACL) tears and tried to assess the patterns of both the acute and the chronic phases since more MR examinations are currently performed of the knee joint in the hyper and acute post-traumatic stage. MATERIAL AND METHODS: December, 1994, through September, 1997, a hundred and 89 sportsmen with a history of hyper and acute knee trauma were submitted to MRI: one hundred and four of them were followed-up for 3-6 months. The MR examinations were performed with a dedicated unit (Artoscan, Esaote Biomedica, Genoa) using T1-weighted SE, T2-weighted GE and Turbo ME sequences on the sagittal, coronal and axial planes, respectively (3-5 mm slice thickness). RESULTS: Of 189 patients examined in the hyper and acute post-traumatic stage, 101 had a complete ACL tear, 23 had a partial tear and 65 had an enlarged and inhomogeneous ACL: Eighty-five patients underwent surgery, while the other 104 had 3-6 months' follow-up MRI. Twenty-four of the latter had a complete ACL tear, 20 had a partial tear and 60 had no MR finding of ACL interruption, with a more or less inhomogeneous ligament. DISCUSSION: ACL tears are difficult to demonstrate in the acute phase because of perilesional swelling, synovitis and hemorrhage; high-contrast sequences on the axial plane are therefore required. In the chronic stage, an uninterrupted ACL does not necessarily imply that function is preserved, as well as the MR finding of a deflected ligament does not necessarily imply altered biomechanics. CONCLUSIONS: MRI of the knee joint is increasingly used to study hyper and acute ACL tears thanks to the availability of dedicated units. The MR study of ACL tears is not meant to refer the patients to surgery, which pertains to the physical examination, but it allows to assess lesion severity and to show associated injuries in other knee structures.

Acute Disease↗
PubMed1998

[Lipomatous hypertrophy of the interatrial septum: its assessment with TEE, CT and MRI].

BACKGROUND: Lipomatous atrial septal hypertrophy (LHS) is an uncommon condition characterized by the deposition of excessive adipose tissue in the atrial septum. The fossa ovalis is spared by this infiltration of fat. A variety of atrial arrhythmia has been associated with this lesion, which is more common in obese, elderly female patients. Because of the lack of specific symptoms, LHS is the outcome of casual observation during echo-Doppler or autopsy studies. METHODS: We describe the case of a 76-year-old woman who came under our observation due to stroke and atrial arrhythmia. Transesophageal echocardiography clearly revealed lipomatous atrial septal hypertrophy. RESULTS: The MRI confirmed the diagnosis, visualizing the typical "dumbbell" interatrial septum. Computed tomography made it possible to define the anatomic substance of the lesion as "fatty". CONCLUSIONS: Transesophageal echocardiography is the method of choice in the diagnosis of LHS. Other techniques such as RMI or CT-scan can be useful only in selected patients with large fatty infiltration of the atrial wall or marked hypertrophy of the interatrial septum.

Aged↗
PubMed1997

MR study of N2 disease in lung cancer: contrast-enhanced method using gadolinium-DTPA.

OBJECTIVE: In several previous studies, including one of our own, CT and MRI provided similar information on N2 detection in the staging of lung cancer. Both imaging techniques can be considered effective in detecting enlarged mediastinal lymph nodes but the results are often inaccurate when confronted with pathological findings. The purpose of this study was to assess the diagnostic accuracy of gadolinium-DTPA enhanced MRI in the detection of mediastinal lymph nodes in lung cancer. METHODS: A prospective study to compare standard unenhanced MRI and Gd-DTPA enhanced MRI was carried out in patients with diagnosed lung cancer. The study focused on the status of mediastinal lymph nodes. Gd-DTPA was administered at a dosage of 0.2 mmol2/KG before T1 weighted sequences. Qualitative visual analyses of both standard and contrast enhanced MRI images were performed on each patient by 2 independent radiologists. The imaging results were then compared to pathological findings obtained after surgical operation. RESULTS: In the identification of mediastinal lymph node metastases standard MRI was 62% sensitive, 100% specific and 74% accurate whereas Gd-DTPA enhanced MRI was 100% sensitive, 91% specific and 97% accurate. CONCLUSIONS: Gd-DPTA enhanced MRI was more accurate than standard MRI in the detection of metastatic lymph nodes in patients with lung cancer. These initial results can be considered encouraging especially with regards to the reduction of false negative findings although further confirmation is, understandably, required.

Aged↗
PubMed1997

[Description and preliminary clinical assessment of a digital chest radiographic system with selenium detector (Thoravision)].

The authors describe an innovative digital chest imaging system (Thoravision, Philips Medical System) based on a selenium detector directly converting X-rays in electric charges detectable by electrometers, amplified and digitalized to be sent to the imaging processor. The study was performed on a series of up to 7000 digital chest X-ray examinations and a sample of 173 cases was selected on the basis of particular diseases and pathologic patterns. In the latter case, digital and conventional radiographic techniques were compared. According to this analysis, the digital system was slightly superior in detecting anatomical details, small pleural effusions (3 cases) and slight low contrast interstitial pathologic changes, mainly in apical (12 cases) and retrocardiac (19 cases) lung areas. The conventional screen-film system better showed small hilar calcifications (2 cases). From the protection viewpoint, at equivalent entrance doses, .15-.26. Gy/cm2 of dose-area product (DAP) values were reported with the digital system, using a tension of 150 kV in orthogonal projections, which are considerably lower than .25-.70 Gy/cm2 measured with the conventional technique. Moreover, Thoravision permitted to perform up to 100 exposures/hour, using a phantom, and 15-20 digital chest examinations/hour, versus the average 12-15 with the conventional screen-film system. The initial results are very encouraging from the clinical and cost-effectiveness viewpoints, thanks to higher Thoravision productivity and to exam optimization, even though wider and prolonged experience plus a careful study of diagnostic accuracy, sensitivity and specificity in each group of chest conditions is advisable, to assess the real innovative impact of this digital chest imaging system.

Adolescent↗
PubMed1996

No evidence of increased fetal haemoglobin in an adult diabetic population.

Increased fetal haemoglobin levels, which could interfere with glycohaemoglobin assessment, have been observed in some diabetic populations, especially in insulin-treated patients. In this study, we have consecutively examined 1042 adult (aged > 18 y) diabetic subjects (102 IDDM patients, 263 insulin-treated NIDDM patients and 677 non-insulin-treated NIDDM patients) and 156 sex-and age-matched control subjects. Fetal haemoglobin was assessed with a fully automated high performance liquid chromatography (HPLC) device. Its average levels were 0.19% +/- 0.28% in the control group, 0.17% +/- 0.23% in IDDM patients, and 0.19% +/- 0.25% in insulin-treated NIDDM patients; these differences were not significant. Also the percentage of patients with fetal haemoglobin exceeding the 95th percentile of normal values (0.75%) was not different in the various subgroups. In conclusion, in our large cohort of adult diabetic patients, fetal haemoglobin levels are within the normal range, including those who have IDDM or insulin-treated NIDDM. Genetic factors could explain this difference with other reports.

Adult↗