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Biomedical subjects

E Squillaci

Publications and source records attributed to E Squillaci.

At least 37 records · Page 2Linked to original sources
PubMed1993

[MR staging in renal neoplasms. Comparison with surgical data].

Forty-six patients bearing renal lesions were studied with magnetic resonance (MR) imaging. A superconductive magnet (1.5 T) was used to stage the lesions according to Robson's criteria. A positive correlation between MR and pathologic results was observed in 40 cases. MR imaging overstaged 4 lesions: 2 of them for suspected infiltration of perirenal fat (MR stage II, versus pathologic stage I), one was a false-positive finding for lymph node metastasis (MR stage IIIb, versus pathologic stage II) and another one for suspected bowel loop infiltration (MR stage IVa, versus pathologic stage II). Two lesions were understaged: in one case bowel loop infiltration was missed by MR imaging (MR stage II, versus pathologic stage IVa) and another one for a false-negative lymph node metastasis (MR stage II, versus pathologic stage IIIb). In all the cases with involvement of renal vein and vena cava, MR imaging correctly demonstrated the presence of neoplastic thrombi.

Adult↗
PubMed1992

[The stenotic-occlusive anatomy and pathology of the renal arteries. Their evaluation by magnetic resonance angiography].

Magnetic resonance angiography of the renal arteries was performed in 10 healthy subjects, 10 patients with renal artery stenosis and 2 patients with accessory renal artery (1 unilateral, 1 bilateral). All patients selected among 35 subjects with suspected renovascular hypertension had previously undergone digital subtraction angiography. Four patients were studied before and after percutaneous transluminal angioplasty. MRA was performed with time-of-flight technique, with 2D and 3D FISP and 2D FLASH gradient-echo sequences. Digital subtraction angiography demonstrated stenoses ranging 40% to 90% in 10 cases, 7 unilateral (1 transplanted kidney) and 3 bilateral. RA correctly depicted > 90% stenoses in 5 cases, between 50% and 90% stenoses in 2 cases and < 50% in 2 cases. Four stenoses were not properly graded (3 over-graded and 1 not visualized because distal to ostium). Diagnostic accuracy was 71% for unilateral stenoses and 66% for bilateral stenoses (overall accuracy 69.2%).

Adult↗
PubMed1992

[Percutaneous transluminal renal angioplasty of the solitary kidney].

We report on our experience with percutaneous transluminal angioplasty (PTA) of the renal artery in solitary kidney patients. PTA was performed on 31 subjects (mean age: 52 years): 7 had a solitary kidney because of nephrectomy and 24 had a solitary functioning kidney. Patients were selected with clinical and laboratory examinations first and then with angiography. PTA was employed to treat renal artery stenoses 60%-95% of the whole arterial lumen. The procedure has been considered technically successful in 29 cases, with 77%-33% reduction of the mean amount of stenosis. As to the clinical evaluation of the results, blood pressure and creatinine values variations were considered. Of the 25 patients on follow-up, 13 appeared to be treated (52%), 8 improved (32%) and 4 unchanged (18%). On the whole, we observed 5 complications (2 hematomas at the approach site, 1 intimal dissection and 2 segmental infarcts), with a 23.4% rate comparable with PTA complications in non-solitary kidney patients. The good revascularization, the reduction in blood pressure values, the very small percentage of complications point to PTA of the renal artery as the procedure of choice in solitary kidney patients.

Adult↗
PubMed1992

[Oral contrast media in the study of the esophagus with magnetic resonance. Proposal of a new preparation].

The major problem in MRI of the esophagus is the lack of a reliable oral contrast agent. To determine the value of Gd-DTPA as an oral contrast medium for the esophagus as a part of phase III clinical trial, 17 patients (10 esophageal neoplasms, 4 neoplasms of the pharyngo-laryngeal tract, 3 Zenker's diverticula) underwent MRI. The oral contrast medium is proposed in a new preparation: 5 cc of oral Gd-DTPA were emulsionated with 30 g of a low-density barium paste for esophageal CT (3% p/v). High signal intensity in the esophageal lumen was observed in all patients and in all sequences. In neoplastic lesions, the c.m. improved the definition of both the level of stenosis and the longitudinal extent of the lesion. In diverticula, the real and the false lumen could be demonstrated. In one patient the exam could not be completed. No adverse reactions were observed.

Administration, Oral↗
PubMed1992

[Role of MR in characterizing expansive lesions of the adrenal gland].

Five patients with adrenal tumors (20 metastases, 12 adenomas, 8 myelolipomas, 6 primary tumors, 4 pheochromocytomas, and 1 hyperplasia) were studied by means of MRI with SE sequences. Twenty of them underwent dynamic study with GE sequences after i.v. injection of paramagnetic contrast media. Sixteen of 20 metastases exhibited low signal intensity on T1 and high signal on T2. One patient had low signal on both T1 and T2. Two lesions in patients with melanoma showed high signal in T1; in 1 case, the lesion exhibited a hemorrhagic area. Signal from adenomas was low in T1- and T2-weighted pulse sequences in 10/12 patients, while in the extant 2 cases signal was higher in T2. Myelolipomas had hyperintense signal on T1-weighted images in 5 cases and isointense signal with the renal cortex in the extant 3 cases. Pheochromocytomas and primary tumors appeared hypointense on T1 and hyperintense on T2. In 3 CT questionable cases, MRI showed the adrenal origin of the lesion. Dynamic study with GE sequences after Gd-DTPA injection showed low enhancement and fast washout in adenomas, while malignant lesions had higher enhancement and slower washout. In our study, MRI allowed to correctly characterize 11/12 adenomas, with only 1 false negative in a metastatic lesion.

Adrenal Gland Neoplasms↗
PubMed1992

[Magnetic resonance angiography in the study of abdominal neoplasms. Preliminary experience].

This study was designed to evaluate MRA imaging as a potential non-invasive method to study vascular infiltration in patients with abdominal neoplasms. Forty-three patients with abdominal tumors proven by CT and/or MRI were examined with MRA and subsequently with angiography. Of 15 cases of liver tumor, MRA allowed poor intratumoral vascularization to be demonstrated in 1 patient only, but it always provided a characteristic sign--i.e., the complete absence of flow in the hepatic segments infiltrated by the tumor and the evidence of pericapsular neovascularization. In 8 cases portal vein involvement was observed (4 cases of compression/dislocation, 2 cases of infiltration and 2 of thrombosis). In all cases MRA allowed the relationship between tumor and venous structures to be evaluated. It also demonstrated collateral vessel formations in 8 patients with cancrocirrhosis. Two cases of thrombosis and 3 infiltrations of the vena cava were demonstrated. Neither hepatic artery nor intrahepatic arterial vascularization could be correctly evaluated. Of 10 cases of renal tumors and in 3 of adrenal tumors, renal vein infiltration was seen in 4 cases and compression in 3, with only 1 false-positive finding. In these patients and in those with retroperitoneal masses, MRA provided valuable information on the relationship between tumor and vascular structures and was useful in detecting collateral vessels. In our experience, MRA is to be considered as a complementary technique to be performed after CT or MRI when additional information is needed as to the relationship between tumor and vascular structures. In the preoperative evaluation of abdominal neoplasm, angiography remains the gold standard, in spite of its invasiveness.

Abdominal Neoplasms↗
PubMed1992

[Preoperative staging and recurrence of rectal tumors. Comparison of transrectal ultrasonography and magnetic resonance].

The accuracy of transrectal US (TRUS) and of MRI was evaluated in the preoperative staging and in local recurrences of rectal cancers. Fifty-four patients were examined: 45, with known rectal cancer, for preoperative staging, and 9 for the evaluation of local recurrences. Nineteen patients were examined with MRI in basal conditions, 21 after rectal air enema and 5 after paramagnetic contrast enema (Gd-DTPA). The following parameters were evaluated for preoperative staging: wall infiltration, invasion of perirectal fat and adjacent structures, lymph node involvement. Morphologic and signal intensity (on MRI) changes were evaluated for the diagnosis of local recurrences. TRUS provided 2 false positives. In the same patients, basal MRI results were poor, owing to difficult demonstration of the different wall layers, while in the patients studied after air enema, the lesion was hyperintense. In 20 patients with a fat-infiltrating tumor, TRUS provided 3 false negatives and 2 false positives; basal MRI yielded poor results, while air enema and paramagnetic contrast enema clearly demonstrated all fat-infiltrating lesions, with only one false positive.

Air↗
PubMed1991

[The presurgical staging of soft-tissue sarcomas of the extremities: imaging diagnosis].

The authors studied 43 patients affected with soft tissue sarcomas to evaluate the accuracy of different imaging modalities in predicting resectability. Locations included lower (30) and upper (11) limbs, axillary (2) and gluteal (2) regions. MR imaging was performed on 37 patients, CT on 35 and US on 30. All patients were preliminarily subjected to conventional radiographic examination. MR imaging proved to be the most reliable modality because it allowed the lesion site to be correctly determined relative to both anatomical compartments and lesion spread; its relationships to joints and vascular structures were also depicted. Intravenous administration of Gd-DTPA (to 9 patients) allowed important information to be gained as to identifying and quantifying tumoral necrosis, and made it possible to discriminate tumoral component from perilesional edema. In our experience, CT was shown to overstage the T parameter--due to difficult distinction of edemigen component, even with a careful use of angio-CT. On the contrary, CT was the modality of choice in recognizing bone cortical infiltrations, even small ones, and in identifying pulmonary metastases. US played a role in the staging of these neoplasms thanks to its recognizing even small lesions and, in case of suspected vascular involvement, it allowed even small infiltrations of the vascular wall to be demonstrated.

Adolescent↗
PubMed1991

[Stage I and II cervical carcinoma. Study with magnetic resonance and transrectal echography].

Twenty-five patients with histologically-proven cervical carcinoma (clinical stages I and II according to FIGO classification system) were studied by means of transrectal US (TRUS) and MR imaging (MRI) at 1.5 T, to evaluate the primary tumor and measure its size. Stage Ib cancers were divided into small 4 (less than 4 cm) and large (greater than 4 cm). The patients with large Ib and those with stage II lesions were administered preoperative radiation therapy. All the patients underwent TRUS, MRI, and clinical examination under sedation; they were subsequently operated. Stage Ia and small Ib patients underwent therapeutic surgery, while large Ib and stage II cases had surgical exploration for pathologic staging. The tumor was correctly identified and measured in 22 patients with MRI, and in 20 cases with TRUS. Tumoral involvement of parametria and uterine ligaments was demonstrated in 75% of cases by MRI and in 62.5% of patients by TRUS. Vaginal involvement was demonstrated by MRI in 77.8% of cases and by TRUS in 66.6% of patients. Tumor size could be evaluated more accurately than with clinical examination under sedation, while the results were poorer in the demonstration of tumor spread into uterus and parametria.

Female↗
PubMed1990

CT demonstration of peritoneal metastases after intraperitoneal injection of contrast media.

Thirty-three patients with ovarian carcinoma who had no evidence of metastases or ascites demonstrated on computed tomography (CT) with and without contrast agent were examined with CT after injection of approximately 3000 cc of a 2.4% solution of nonionic contrast media into the peritoneum. After intraperitoneal injection with CT (IPC CT), 22 were diagnosed as having intraperitoneal metastases. Of these, 19 were found to be true positives and 3 false negatives. Three other patients diagnosed as normal were found to have metastases. In all patients the peritoneum was well outlined and generally any metastases smaller than 1 cm were demonstrated. It was possible to identify compartmentalization of the peritoneum and to determine the location of the lesion to be in the peritoneum or the extraperitoneal space. This information is necessary in the planning of chemotherapy, particularly endoperitoneal chemotherapy. Tiny metastases to the omentum or adherent loops of small bowel could not be seen well.

Female↗
PubMed1990

[Magnetic resonance angiography of the vessels of the neck. Study technique and normal anatomy].

Magnetic Resonance Angiography (MRA) is a new diagnostic technique which allows vascular structures to be studied atraumatically and without any contrast medium. Its basic principles are reported in the present paper, together with the results of a preliminary study of normal neck anatomy. Twenty healthy volunteers and 10 patients with no cerebral vascular diseases underwent this MRA study. Internal and common carotid arteries were always well visualized, while external carotid was demonstrated in 87% of cases. Among intracranial vessels, the middle cerebral artery was clearly depicted in 63% of cases, while the anterior cerebral artery was visible in 18% of the study population only.

Arteries↗
PubMed1989

[Magnetic resonance in hepatic lesions. Experience with a 1.5-T magnetic field].

Forty-one patients with histologically proven hepatic lesions (6 cysts, 6 hemangiomas, 8 hepatomas, 19 metastases and 2 negative cases) were studied with Magnetic Resonance (MR) imaging at 1.5 T, and with US and CT. This prospective study was aimed at evaluating: the comparative accuracy of MR, US and CT; the sensitivity and specificity of spin-echo (SE) vs FISP pulse sequences; the efficacy of T1 and T2 relaxation time values in differentiating hemangiomas from hepatomas and metastases. MR diagnostic accuracy was 94.7% vs 89.4% of CT and 84.2% of US. FISP sequences provided 60% sensitivity and 66% specificity. T2 relaxation time values were statistically significant (p less than 0.05) in differentiating hemangiomas (T2 range: 80.9-218.9 ms) from hepatomas (T2 range: 59.4-83.2 ms). The differences in mean T2 values between hemangiomas and metastases (T2 range 54.3-177.3 ms) were not statistically significant (p greater than 0.25).

Carcinoma, Hepatocellular↗
PubMed1989

[Transvaginal echography: initial experiences in oncologic gynecology].

The authors report their initial experience in a selected group of 30 patients with suspected gynecological neoplasms (10 ovarian tumors, 8 recurrences of ovarian tumors, 6 cervical carcinomas, 3 ovarian cysts, 3 fibromyomas) who underwent both transabdominal (US) and transvaginal (TV) sonography. All the scans were retrospectively reviewed. In 18 cases US and TV provided equivalent information as to the organ of origin of the mass, while TV was more useful in 9 cases, and US in 3 cases. The anatomical relationship of the mass to the adjacent organs was better demonstrated by TV in 15 cases, while in 15 cases the information provided by US and TV was equivalent. The two techniques yielded the same results as to the internal architectural details of the mass in 9 cases, while TV was superior in 18 cases and US in 3 cases. TV allowed the early identification of: small amounts of free fluid in the cul-de-sac in 3 cases, compression of the ureter in 1 case, and compression of the uterine vessels in 1 case. These findings had not been demonstrated by US. Our preliminary results indicate that adjuvant TV sonography provides important diagnostic information in gynecological neoplasms in about 39% of patients.

Adult↗
PubMed1988

Recurrence of ovarian and uterine neoplasms: diagnosis with transrectal US.

Twenty-one patients with clinically suspected recurrence of ovarian (n = 3) or uterine (n = 18) carcinoma were examined with suprapubic ultrasound (US) and transrectal US with high-frequency linear probes. The examinations were performed 3, 6, 9, and 15 months after surgery and radiation therapy. Eight patients underwent radiation therapy before surgery and ten after surgery; three underwent only surgery. Criteria for recurrence included increased anteroposterior diameter of the vaginal cuff (greater than 2.2 cm); structural alterations or presence of a mass in the vaginal cuff; and infiltration of the rectovaginal septum, bladder, and parametria. Transrectal US findings were true positive for recurrence in nine cases, true negative in ten, and false positive in two. US findings were true positive in three cases, true negative in seven, false positive in two, and false negative in three. In six cases results from US were technically poor, and no diagnosis could be made. Transrectal US was highly sensitive in detection of pelvic recurrent carcinomas, while US had little diagnostic value. The authors believe transrectal US can replace US in the evaluation of patients at risk for recurrent pelvic neoplasm.

Adult↗
PubMed1986

[Ultrasonic diagnosis, staging and follow-up of prostatic neoplasms].

120 patients with clinical suspected prostatic neoplasm were evaluate by transrectal linear sonography. 26 normal glands, 57 hypertrophic adenomas and 37 adenocarcinomas were recognized. We had 17 false positive cases for adenocarcinoma in hypertrophic adenomas. We had no false negatives. All diagnosis were confirmed bioptically, by CT or surgically. The findings of 37 adenocarcinomas are examined. The US criteria for early diagnosis (T1-T2), advantages and limits of transrectal linear probe in staging and follow-up, are discussed.

Adenocarcinoma↗
PubMed1986

[Comparative study of hepatic metastasis with different modality ultrasound scanners].

57 patients affected by liver metastases were examined with different types of dynamic ultrasound scanners (linear-sector-convex) in order to assess the advantages and the limits of each scanner and to evaluate if a better diagnostic accuracy is possible by using 2 types of scanner in the same patient. The results were estimated at 3 different levels: quantitative analysis where we considered only the presence or not of liver metastases; complex quantitative analysis where we also evaluate number and site of the metastases; qualitative structural analysis where we compared the ultrasonographic appearance of the metastases. All the results were evaluated by a personal computer with a special program and a statistical analysis was elaborated.

False Negative Reactions↗