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Biomedical subjects

E Iannicelli

Publications and source records attributed to E Iannicelli.

30 records · Page 2Linked to original sources
PubMed1982

Ultrasound and computed tomography in staging of bladder tumours.

Eighty-seven patients with proven bladder tumours were retrospectively reviewed with ultrasound (US) and computed tomography (CT), in order to define the stage of the neoplasm. The tumours were divided into three groups with respect to the TNM classification system. Results indicate that US could predict an exact staging of the bladder tumours in 80.6% of cases in the first group (P1), 68.9% of cases in the second group (P2 - P3), and 90.0% of cases in the third group (P4). CT could predict an exact staging in 61.3% of the bladder tumours in the first group, 91.1% in the second group, and 90.0% in the third group. This finding suggests that the capability of US in detecting bladder tumours in stage P1 may avoid the use of CT, while in subsequent stages CT becomes valuable for the evaluation of extravesical invasions and lymph node metastasis.

Adult↗
PubMedDate not supplied

The role of MRI in the intestinal complications in cystic fibrosis.

Fibrosing colonopathy is a complication recently detected in children with cystic fibrosis (CF), and is thought to be associated with the use of high-strength pancreatic enzymes. The goal of this study was to evaluate the effectiveness of magnetic resonance (MR) in detecting possible pathologic gut findings in patients with CF under pancreatic enzyme treatment. Twenty-five patients with CF and pancreatic insufficiency, all under treatment with high-dose pancreatic enzymes, were studied by MR. MR was performed on a 1.5-T magnet by T1-weighted, 2D-FLASH fat-suppression, breath-hold sequences before and after intravenous administration of gadolinium, and by T2-weighted Turbo Spin-Echo (TSE) and Half-Fourier Acquisition Single-Shot Turbo Spin Echo (HASTE) fat-suppression, breath-hold sequences. A superparamagnetic negative oral contrast agent was given 1.5 h before the examination. MR showed a wall thickening of the terminal ileum and the ascending colon (>4-12 mm) in 22 patients; nine of them (wall thickness >4-6 mm) showed both a moderate hyperintensity of the bowel wall on T2-weighted sequences and an enhancement after intravenous gadolinium on T1-weighted sequences; 13 patients (wall thickness >6-12 mm) showed both a great wall enhancement after intravenous gadolinium and an increased signal intensity of the bowel wall on T2-weighted sequences. Fecal impaction without bowel wall involvement was detected in three patients. MR proved to be a useful, noninvasive, diagnostic tool for the evaluation of patients with CF and fibrosing colonopathy. The signal hyperintensity on T2-weighted sequences and the great wall enhancement after intravenous gadolinium administration indicating an acute edematous condition, provide the clinicians useful information for the therapeutic adjustment.

Adolescent↗
PubMedDate not supplied

[Multiple prostatic biopsies in the "gray zone" of the specific prostatic antigen].

PURPOSE: Aim of our study was to identify cases of undetected prostatic cancer in patients with normal findings at digital examination and transrectal US, and prostate specific antigen (PSA) values ranging 4-10 ng/mL. MATERIAL AND METHODS: Two hundred and ninety patients were submitted to transrectal US and random bilateral prostatic biopsy; 3 samples were collected from each side of the gland using 16-Gauge thru-cut needles. Of the 290 patients who gave fully informed consent, we selected 34 whose age ranged 56 to 76 years (mean: 64). Inclusion criteria were PSA 4-10 ng/mL, PSAD cut-off 0.15, free/total PSA ratio 15-25%, and normal findings at digital examination and transrectal US. PSA velocity was calculated collecting 3 blood samples every 30 days for 2 months. RESULTS: Five of the 34 selected patients (15%) had prostatic cancer, and 2 (6%) Pin (1 Pin 1 and 1 Pin 2). As for the other 27 patients, biopsy demonstrated 4 (12%) cases of prostatitis and 23 (62%) cases of BPH. PSA values increased in all patients with positive histology, versus only 6 (22%) of those with negative histology. PSAD was 0.15 or greater in 3 of 7 prostatic cancer patients. Free/total PSA ratio never exceeded the cut-off value. Gleason score ranged 2 to 4. CONCLUSIONS: Our findings confirm that prostatic biopsy can detect tumors also in areas which appear normal at transrectal US and digital examination, and that PSA rate increases in patients with positive histology. Finally, the actual clinical role of prostatic biopsy relative to all other diagnostic imaging techniques remains to be defined.

Aged↗
PubMedDate not supplied

[Role of MR cholangiopancreatography in the evaluation of biliary disease].

PURPOSE: To evaluate the diagnostic accuracy of MR cholangiopancreatography (MRCP) in biliary tree patology in comparison with percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangiopancreatography (ERCP) and surgical findings. MATERIALS AND METHODS: Forty-six patients , with clinical and laboratory findings suggestive of biliary tree pathology, and after an abdominal US, underwent MRCP with a 1.5 T superconductive magnet equipped with a phased-array body coil. MR exam was performed with baseline sequences for the examination of the upper abdomen, followed by specific MRCP sequences and, in cases of suspected neoplastic disease, completed with abdominal sequences after a bolus injection of paramagnetic contrast. RESULTS: MRCP showed normal findings in 16/46 patients, biliary duct dilatation in 25/46 patients (7 choledocolithiasis, 10 benign obstructions and 8 neoplastic stenoses) and stenoses without dilatation of biliary tree in 5/46 patients. In 25 patients with biliary duct dilatation, CPRM correctly identified the level of in 100% of patients (25/25) and the nature in 88% of patients (22/25). In 5 patients with stenosis without dilatation of biliary tree, CPRM identified 2 true positives (sclerosing cholangitis), 2 false positives and 1 patient is still in follow-up. CONCLUSIONS: In our experience MRCP proved to be highly accurate as fundamental diagnostic step in patients with clinical and laboratory findings suggestive of biliary disease. The workload of ERCP, invasive method with risk of complications, in the diagnosis stage could therefore be reduced and its use be reserved for therapeutic indications.

Adult↗
PubMedDate not supplied

[Echographic aspects of kidney diseases and comparisons with needle biopsy].

A study of 38 patients who underwent renal biopsy was designed to correlate the sonographic features of the kidney with the histologic changes in various renal parenchymal diseases. This research was performed in order to determine if sonography could be useful in the diagnosis and differentiation of renal parenchymal diseases. The ultrasound examination was based on the evaluation of some codified parameters: renal dimension, parenchymal thickness, cortical echogenicity and medullary dimension. There was no correlation between the specific sonographic features and the type of renal medical disease. In 28 patients (74%) with clinical and histological signs, sonography showed morphostructural alterations of the kidney.

Adolescent↗
PubMedDate not supplied

[Diagnostic imaging in the evaluation of pelvic complications in intestinal diseases].

During 12 consecutive months, 680 patients with recent pelvic symptoms were examined with ultrasonography (US). In 44 patients we found evidence of intestinal disease; 19 of them exhibited pelvic complications--11 pelvic abscesses, 3 enterovesical fistulas, 2 enterovaginal fistulas and 1 enterovesicle fistula; in 11 cases the inflammation spread to the surrounding organs. Of these 19 patients, 8 had an intestinal disease in their case history, whereas symptom onset was recent in the other 11 patients. In the latter group US yielded the first diagnostic information showing a bowel disease and other diagnostic examinations with different techniques were therefore performed. In 15 patients US indicated which type of bowel disease had caused the pelvic complications, while in 4 patients US showed a bowel disease without differentiating diverticular disease from neoplasms. In all patients US results were compared with X-ray and CT findings. In 17 patients the diagnoses were confirmed at surgery. The results we obtained from this study indicate US as an accurate method to detect not only the various pelvic conditions but also to differentiate pelvic complications of intestinal conditions from diseases originating in the pelvic organs.

Abscess↗
PubMedDate not supplied

[Assessment with magnetic resonance of laryngeal and oropharyngeal movements during phonation].

The latest MR units are provided with the Turbo-Field-Echo technique which permits gradient-echo imaging with very short TE and TR and is optimized to yield the highest possible image quality within a very short acquisition time--i.e., less than 5 seconds. This dynamic study was aimed at depicting normal laryngeal and oropharyngeal movements during maximal inspiration and the prolonged uttering of vowels, in both a normal and a loud voice. We examined 10 healthy volunteers (7 men and 3 women) with an 0.5-T superconductive unit (Gyroscan T5 III, Philips Medical System). We used Turbo-Field-Echo sequences with the following acquisition parameters: TR 12 ms, TE 6 ms, flip angle 30 degrees, 4 acquisitions, acquisition time: 5 seconds. A single coronal scan was acquired at the larynx, while a midsagittal scan and 2 coronal scans were acquired at the oropharynx. The volunteers were asked to breathe in long and deep, to prolong the emission of the vowel [i] during laryngeal studies and to prolong the emission of the fundamental vowels [a], [i] and [u] in a normal (50 db) and a loud (70 db) voice during oropharyngeal studies. The movements of true and false vocal cords were clearly depicted in all the volunteers, and the activity of the different anatomical structures of the oropharyngeal cavity (lips, tongue, hard and soft palate, pharynx and epiglottis) was also demonstrated. During vowel production in a loud voice, the vocal tract was enlarged at the oral cavity for the vowels [a] and [u] and at the pharynx for the vowel [i]. To conclude, fast MRI with midsagittal scans is the best imaging modality to study different vocal tract patterns during speech and can thus replace midsagittal radiography and xeroradiography in the study of vowel production.

Adult↗