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F Ferrozzi

Publications and source records attributed to F Ferrozzi.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Spiral CT in maxillo-facial trauma].

Fractures of facial skeleton are common in a busy emergency department in often requires careful radiological study before surgical treatment. Radiographic evaluation of facial injuries is especially challenging because the complex facial structure results in a confusing overlapping of densities on the radiograph. Instead Spiral-CT enables obtaining images on different planes so that even subtle or complex fractures may be evaluated in the best way. Moreover, associated lesions of important organs can be diagnosed. Our purpose is to verify the value of Spiral-CT in traumatology of facial skeleton. We have evaluated retrospectively the images of 82 patients admitted for facial trauma. On the basis of our findings we think that conventional radiography should be reserved only for light traumas of superficial structures (nose, zygomatic arch, body of jaw); in the remaining cases Spiral-CT should be the first radiological examination.

Adolescent↗
PubMed2000

[Cervical spine injuries: diagnostic imaging].

In past few years, traumas of cervical spine have increased, chiefly owing to rise of road accidents. Nevertheless, only in a small percentage of cases lesions of cervical spine occur and, in order to reduce many negative radiographs, a careful clinical examination is required. Our purpose is to verify the value of radiology in evaluation of acute trauma of cervical spine and to propose an adequate radiological protocol. In the course of two years (1998-99), 376 patients were admitted in consequence of cervical trauma of different degree of gravity. In all patients, conventional radiographs were obtained, in 93 a computed tomography (CT) examination was executed and only in 18 patients with neurological symptoms a magnetic resonance (MR) was required. Fractures of cervical spine wee identified in 91 cases and in patients in which MR images were obtained, neurological lesions of various severity were diagnosed. On the basis of our results, we think that, in a clinical suspicion of cervical spine lesions, a conventional radiographic study has first to be performed even if often good radiographs aren't obtained for technical difficulties. If doubts persist on conventional radiographs or a fractures has already been diagnosed on radiographs but we want to verify its stability, a CT needs to be performed. MR is required if neurological symptoms are present in order to diagnose lesions of spinal marrow, nerve roots or ligaments.

Adolescent↗
PubMed1999

Foreign-body granuloma of the kidney: CT, MR and pathologic correlation.

The differential diagnosis of renal masses containing fatty foci is limited to a small number of well-defined tumors, angiomyolipoma being the most frequent. In recent years clear cell carcinomas with intratumoral fatty foci have been reported, due to either entrapment of local fat or to regressive adipose metaplasia. Demonstration of focal calcifications is a valuable sign, being relatively common in carcinomas while rare in more benign lesions. We report a case of a foreign-body granuloma of the kidney, containing both calcifications and foci of fat. The value of this case, in our opinion, is that it demonstrates that detection of the previously mentioned features in a renal mass does not necessarily imply a presumptive diagnosis of renal cell carcinoma.

Aged↗
PubMed1999

[Upper cervical spine fracture: sources of misdiagnosis].

PURPOSE: Missing cervical spine fractures during the initial plain film study may lead to severe neurological complications for patients and to medicolegal responsibilities for the physician. The upper cervical spine tract (C1-C2) is considered to be at high risk for misdiagnoses. We decided to investigate the possible causes of mistake in the cases of missed fractures on the initial plain film, performed in the emergency room. MATERIAL AND METHODS: We retrospectively reviewed the radiological reports, the original plain films and the CT findings, of 32 patients with upper cervical (C1-C2) fractures, admitted January 1994 to December 1998. Twenty-eight of these patients (87.5%) had multisystem trauma, 4 (12.5%) had minor craniocervical trauma. None of these patients had neurological signs correlated to the cervical injuries, 30 of them had normal consciousness and reported only neck pain, 2 of them were unconscious for the associated head trauma and were hospitalized in the intensive care unit. All the patients with normal consciousness underwent conventional three-view cervical spine radiography; the two unconscious patients in the intensive care unit were submitted to bedside examination with an anteroposterior and a lateral views of the cervical spine. All patients underwent spiral CT of the upper cervical tract. RESULTS: In 9 of 32 patients (28%) a cervical fracture was missed on the plain film and CT was performed only because of persistent neck pain. We found 2 Jefferson's fractures, 2 type II dens fractures, one type I dens fracture and 4 hangman's fractures. In 8 of the 9 patients (89%) the fracture was potentially unstable. Misdiagnoses resulted from overlapping bone structures (3%), suboptimal film quality (3%), satisfaction of search phenomenon (3%), missed mild tilting of the dens (6%), missed double cortex sign (16%), missed C1-C2 lateral subluxation (6%) and marked osteoporosis (3%). Prevertebral soft tissue swelling was not seen in any of the 9 cases of missed fractures. Considering the group of patients with C1-C2 fractures separately, the false negative rate is 28%, which corresponds to 10.7% of the total number of patients with cervical fractures and dislocations examined during the same period. CONCLUSIONS: Among the causes of false-negative interpretation, osteoporosis, suboptimal film quality due to associated fractures and overlapping bone structures must be considered unavoidable. On the other hand these possibilities should be indicated on the X-ray report because, if painful symptoms persist, a CT exam is strongly advised. Subtle alterations like dens tilting, double cortex sign, lateral subluxation of C1 and prevertebral soft tissue swelling should be regarded as highly suspicious for fracture. Missing these lesions might be considered a true diagnostic mistake with possible legal consequences, which may also expose the patient to the risk of neurological complications. The satisfaction of search phenomenon can be avoided only by trying to use a search pattern for every film, which includes checking all the visible anatomical structures even in the presence of a particularly evident lesion. In all questionable cases or high-risk fracture patients, even with an apparently negative plain film, it is advisable to perform CT instead of additional plain films. Finally, in all the patients treated in the intensive care unit for head trauma, an upper cervical CT scan should be routinely carried out at the same time as the brain scan.

Cervical Vertebrae↗
PubMed1999

[Mesenchymal tumors of the pancreas: computed tomography patterns].

PURPOSE: To report the CT patterns of pancreatic mesenchymal lesions and to investigate the capabilities and limitations of this technique in terms of characterization. MATERIAL AND METHODS: We selected the CT examinations of 23 patients from all CT examinations of the pancreas performed from 1986 to 1998. The patients were 10 to 85 years old and all lesions but two (1 lipoma and 1 lymphoma) had pathologic confirmation. Two lymphangiomas, 2 lipomas, 4 Schwannomas (SCH), 1 plexiform neurofibroma, 1 cystic teratoma, 1 pancreatoblastoma, 9 non-Hodgkin's lymphomas (NHL), 1 undifferentiated sarcoma and 2 leiomyosarcomas were diagnosed. RESULTS: Lipomas had typically homogeneous negative HU values, and NHL a homogeneous hypodense pattern with mild contrast enhancement, with no necrosis or calcifications in both diffuse and nodular forms; SCH had variable appearance, with water/slightly negative HU numbers or highly enhanced patterns with a central necrotic core depending on the main Antoni A or B histology. Lymphangiomas appeared as complex cysts, with thin and regular or calcified walls and intracystic septa, while the plexiform neurofibroma had near-water homogeneous density with mild contrast enhancement and an infiltrating growth pattern. Our teratoma had multiple calcifications, mucinous and lipid components. The pancreatoblastoma, sarcomas, and leiomyosarcomas exhibited no specific findings. CONCLUSIONS: In selected cases, CT can provide virtually diagnostic information (lipoma and teratoma), or at least highly suggestive findings (NHL, plexiform neurofibroma, lymphangioma). Moreover, knowledge of the variable morphostructural patterns of mesenchymal histotypes (SCH, sarcoma etc.) permits to include them in the differential diagnosis of pancreatic masses.

Adolescent↗
PubMed1999

[An assessment of abdominal fatty tissue distribution in obese children. A comparison between echography and computed tomography].

PURPOSE: Computed tomography (CT) and, more recently, ultrasound (US), have proved excellent tools for quantifying adipose tissue distribution. Body fat distribution is an important factor in the treatment of obesity and its complications. We investigated the correlation between CT and US measurements in pediatric obesity. MATERIAL AND METHODS: Forty obese children and adolescents aged 4.1-14.8 years were submitted to CT and US. Intra-abdominal, subcutaneous and total body fat were calculated (in cm2), with the CT image analysis software. The rectus muscle-spine and rectus muscle-aorta distances, as indicative of visceral fat thickness, were measured on US images with(out) compression. The distance between skin-fat and fat-rectus muscle interfaces was measured as subcutaneous fat thickness. We also compared US-CT findings with other morphometric variables--i.e., patient's (ideal) body weight and skin fold measures. RESULTS: At US, the rectus muscle-aorta and rectus muscle-spine distances ranged 2.4-7.5 cm (mean: 4.47 cm) and 3.6-8.9 cm (mean: 5.79 cm), respectively. The skin-rectus muscle distance ranged 1.2-7.5 cm (mean: 3.14 cm). A statistically significant correlation was found between the CT measurement of visceral fat and the aorta-rectus muscle and rectus muscle-spine distances (r = 0.80 and 0.74, respectively). The US measurements of subcutaneous fat were correlated with CT subcutaneous fat area (r = 0.82). No correlation was found between overweight, as calculated by body mass index, and CT or US fat. CONCLUSION: Our findings indicate that US is as useful as CT in evaluating body fat distribution in pediatric obesity.

Abdomen↗
PubMed1998

Hepatic malignant fibrous histiocytoma: CT findings.

Although malignant fibrous histiocytoma represents the most common soft tissue sarcoma in adults, its origination in visceral organs is very unusual and the liver is an exceptional site of involvement, with only 22 cases reported in the last 12 years. This controversial tumour, first described in 1964, probably originates from undifferentiated mesenchymal cells and has five different histological subtypes: storiform pleomorphic, myxoid, giant cells, inflammatory and angiomatoid. We describe herein the rather variable CT findings of three malignant fibrous histiocytomas of the liver and discuss their differential diagnosis.

Aged↗
PubMed1998

[Extracerebral neoplastic manifestations in neurofibromatosis 1: integrated diagnostic imaging].

PURPOSE: To analyze the extracerebral manifestations of type 1 neurofibromatosis (NF-1), with special reference to peripheral nerve tumors. MATERIAL AND METHODS: The findings of 376 NF-1 patients (194 men and 182 women; age range: 0.1-48 years, mean: 8.1) were retrospectively reviewed. The patients had been submitted to abdominopelvic and superficial US and, in case of abnormal US findings or in the presence of symptoms, to CT and/or MRI. In addition, we considered 5 more patients (2 men and 3 women; age range: 50-72 years, mean: 64.4) with incomplete forms of NF-1 diagnosed after the finding of nerve sheath tumors. Biopsy (12 cases), surgery (10 cases), or clinical-instrumental follow-up were the study criteria. RESULTS: In the first group of patients we identified 91 cutaneous, 222 subcutaneous, 11 pendulous and 25 internal neurofibromas. Plexiform neurofibromas were found in the neck (1 case), chest (6 cases), abdomen (16), pelvis (8). We also found 1 benign and 1 malignant Schwannomas, 2 nerve sheath fibrosarcomas, 1 dopamine-producing sympatoma and 1 spermacytoma. As for the second group of patients, we had 2 Schwannomas, 1 pulmonary neurofibroma, and 2 multiple plexiform neurofibromas. The neurofibromas exhibited homogeneous US hypoechogenicity or slight echogenicity, with little contrast enhancement at CT. MR showed peripheral hyperintensity and central hypointensity on T2-weighted sequences and marked contrast enhancement after gadolinium, sometimes with mostly central uptake. The plexiform neurofibromas, which are typical of NF-1, had poorly-defined or infiltrating margins, with similar findings to the previous ones but sometimes with less homogeneous patterns at both US and CT. The Schwannomas, which are a less common finding in NF-1, exhibited different features at MRI and CT, namely pseudo-liquid or solid-inhomogeneous patterns with irregular and inhomogeneous contrast enhancement relative to the Antoni A/B tumor component. In the malignant lesions we observed infiltrating patterns, with irregular and inhomogeneous contrast enhancement, arranged asymmetrically relative to the contralateral lesion. CONCLUSIONS: Extra-axial neoplasms are a frequent finding in NF-1. Despite the extremely variable appearances of some lesions (particularly Schwannomas), the typical plexiform neurofibroma exhibits characteristic patterns. The diagnosis of malignancy often requires bioptic confirmation.

Adolescent↗
PubMed1998

[Ovarian lymphoma. Findings with ultrasonography, computerized tomography and magnetic resonance].

PURPOSE: Lymphomatous ovarian involvement is an uncommon event, both for primary and systemic lymphoma. It presents different diagnostic and therapeutic implications from the more common ovarian epithelial cancer. We investigated the role of imaging techniques in the diagnosis of these lesions. MATERIAL AND METHODS: Eight patients, aged 13 to 70 years (mean: 47) were selected from all the CT examinations performed from 1986 to 1996 to assess the most typical imaging patterns. All the patients underwent a CT examination, with contiguous 8 or 10 mm thick slices and thin (4-5 mm) detailing slices; iodinated contrast agents were administered in 6 cases. Six patients were also examined with sonography (US). Lastly, 3 patients underwent a MR examination, 2 of them with paramagnetic contrast agent. RESULTS: All the patients were affected with non-Hodgkin lymphoma (6 diffuse lymphomas--1 lymphoplasmocytoid, 2 Burkitt, 1 large cells, 1 large and oat cells, 1 immunoblastic large cells, 2 follicular large cells lymphomas). Two patients had primary lesions and the other 6 had a systemic lymphoma; ovarian involvement was bilateral in 6 cases. The lesion size always exceeded 5 cm. Ascitis was present in only one case. The US patterns of the lesions were aspecific, homogeneous and hypoechoic; color Doppler US showed mild vascularization. CT showed clear-cut lesions, hypodense and with mild contrast enhancement in all cases. Spin-echo MRI showed homogeneous masses which were moderately hypointense on T1-weighted images and slightly hyperintense on T2-weighted images. Gd-T1-weighted images showed mild enhancement. DISCUSSION: The differential diagnosis of ovarian primary lymphoma is usually made with ovarian epithelial neoplasms, which normally have a complex structure with cystic or necrotic areas and solid components usually enhancing after contrast agent administration. Also sarcomas and, in children, neuroblastomas usually have an inhomogeneous structure. In ovarian involvement with systemic lymphoma the concrurrent finding of adenopathy can help the diagnosis. CONCLUSIONS: Despite the absence of typical imaging patterns, we emphasize the importance of considering ovarian lymphoma in the differential diagnosis of ovarian cancers, especially if bilateral and homogeneous, without ascitis. These findings, uncommon in ovarian epithelial tumors, can help to make the correct diagnosis.

Adolescent↗