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Biomedical subjects

G Angelelli

Publications and source records attributed to G Angelelli.

At least 37 records · Page 2Linked to original sources
PubMed1997

[The echographic assessment of traumatic rib lesions].

INTRODUCTION: Conventional frontal radiography is mandatory in trauma patients and usually sufficient to detect rib fractures, even though the alignment of bone fragments or projection difficulties may sometimes hinder their depiction. Therefore, there exists moderate disagreement between clinically suspected rib fractures and radiographic findings. MATERIALS AND METHODS: We report our personal experience with US in the detection of rib conditions (fractures and bruises), missed at preliminary radiography. Five symptomatic patients with suspected rib fractures underwent radiographic and US studies. All patients were examined with a real time unit (RT 2800, GE Medical Systems, Milwaukee, USA) with a 7.5 MHz linear probe. RESULTS AND CONCLUSION: US demonstrated rib fractures in 4 patients with negative radiographic findings and a parosteal hematoma in one patient. We conclude that US can detect the rib fractures missed at conventional radiography and show rib cartilage conditions, costochondral dislocations and parosteal hematomas. Therefore we suggest the routine use of this technique in all chest trauma patients, as a useful complement to frontal radiographs, for both management and forensic purposes.

Adult↗
PubMed1996

Improved accuracy of computed tomography in local staging of rectal cancer using water enema.

A new technique in the preoperative staging computed tomography of rectal cancer using a water enema to promote full distension of the rectum was compared with standard CT in a non-randomised blind study. One hundred and twenty-one patients were enrolled. There were 57 in the water enema CT group and 64 in the standard group. The stage of the disease was assessed following strict criteria and tested against the pathological examination of the resected specimen. Water enema CT was significantly more accurate than standard CT with an accuracy of 84.2% vs. 62.5% (Kappa: 0.56 vs. 0.33: Kappa Weighted: 0.93 vs. 0.84). The diagnostic gain was mainly evident in the identification of rectal wall invasion within or beyond the muscle layer (94.7 vs. 61). The increased accuracy was 33.7% (CL95: 17-49; P < 0.001). The results indicate that water enema CT should replace CT for staging rectal cancer and may offer an alternative to endorectal ultrasound.

Adult↗
PubMed1996

[Computerized tomography in craniocerebral, maxillofacial, cervical, and spinal gunshot wounds. Part II--Clinical contribution and medico- legal aspects].

To assess the diagnostic and medicolegal contribution of Computed Tomography (CT) in patients with craniocerebral, maxillofacial, neck and spine gunshot wounds, we submitted to CT 106 patients with gunshot wounds examined over a 7-year period (February, 1988 to December, 1994). Twenty-four of them had craniocerebral injuries (23%), 9 maxillofacial (8%), 8 neck (8%) and 10 vertebral (9%) injuries. Emergency CT demonstrated the mechanism of the injury, the bullet path and site, the site of bone and/or metallic fragments, and damage extent. In all perforating cranioencephalic injuries (n = 7) intracerebral or extrathecal bone fragments were demonstrated adjacent to the bullet entrance and exit holes, respectively. In injury monitoring. CT showed injury evolution, retained fragments and complications, thus enabling damage extent assessment. High Resolution Computed Tomography (HRCT) was useful in locating minute orbitary retrobulbar and intraspinal fragments. Magnetic Resonance (MR) Imaging in postoperative patients proved a valuable tool to assess the extent of spinal cord damage. To conclude, CT is a useful technique to examine the patients with gunshot wounds, which helps plan adequate treatment and solve complex medicolegal problems.

Adolescent↗
PubMed1995

[Classification, significance and sequelae of posttraumatic "occult" bone and cartilage fractures of the knee. The role of magnetic resonance].

Magnetic Resonance Imaging (MRI) shows, in the post-traumatic knee, a fairly high number of bone and cartilage injuries missed by conventional radiography and therefore called occult. Our aim is to classify these injuries, to correlate their site and distribution with associated menisco-ligamentous injuries and with trauma mechanisms. Thirty-eight patients with a history of acute knee trauma and negative X-ray findings were examined with MRI within 15 days of trauma. 1.5- and 0.5-T units and SE T1-weighted GE T2*-weighted and SE T2-weighted sequences were used. The injuries were classified as intraosseous and osteochondral bruises or fractures. Twenty-three patients with menisco-ligamentous injuries were submitted to therapeutic arthroscopy; the sites of bone and cartilage injuries depicted with MRI were studied with arthroscopy. Seven patients were followed-up with MRI at 6-12 months to investigate subchondral injury evolution: 5 of 7 patients were also submitted to arthroscopy. MRI showed a statistically significant correlation between site and distribution of bone and cartilage injuries and between internal derangement and trauma mechanisms, i.e., contusion, distortion, stress. In our experience, MRI could identify and characterize occult subchondral injuries, thus allowing appropriate treatment.

Adolescent↗
PubMed1994

[Portal thrombosis: the diagnostic and therapeutic aspects and clinical cases].

The authors report their experience, from 1983 to 1992, in the treatment of portal vein thrombosis and discuss various aetiological factor of obstruction also underlining the frequent and important association with portal hypertension. The authors emphasize the crucial role of the modern diagnostic techniques such as endoscopy and imaging radiology (U.S., C.T., angiography). Although these techniques not always allow a conclusive evidence in relation to aetiology, however, it is possible to have a rationale for the treatment, i.e. medical, sclerotherapeutic or surgical. As related to the surgical procedures, the authors--based on their personal experience--believe the best are the non-derivative ones.

Anti-Bacterial Agents↗
PubMed1993

Validity of echographic evaluation of cartilage in gonarthrosis. Preliminary report.

We studied an echographic technique by which precise reproducible measurements of articular cartilage thickness of the knee is possible. Two groups of individuals were studied: a group of 18 patients with gonarthrosis and a control group of 10 normal individuals. The group of 18 patients with gonarthrosis was studied by ultrasound (US) before knee prosthesis surgery. The cartilage thickness was measured within the weight-bearing area. US re-evaluation and histological measurements were made on the pathological specimen following the operation. Results of pre- and post-operative US data were compared with histological data. A good correlation between these measurements was found [P(t) > 10%]. In order to have comparative reference values of the articular cartilage within the weight-bearing area of the femoral trochlea a group of 10 control subjects was also studied with US as above. We found that the articular cartilage thickness of the femoral trochlea in the weight-bearing area has a mean of 2.2 +/- 0.3 mm for the lateral condyle and 2.3 +/- 0.2 mm for the medial condyle. The intra-observer and inter-observer difference in measurements was evaluated with Student's t-test. Our data demonstrate that US measurements of articular cartilage thickness of femoral condyles is a sensitive and reproducible technique which permits early diagnosis and management of knee arthropathy as well as quantification of cartilage damage.

Adolescent↗
PubMed1993

[The diagnostic and therapeutic strategies in neoplasms of the adrenal cortex: the authors' own experience].

The Authors report their limited series of neoplasms of the adrenal cortex, and underline the decisive role of the modern diagnostics based on imaging techniques (US--TC--NMR). These, in fact, often allow a good definition also in the non-functioning adrenal masses incidentally discovered (incidentalomas). The authors emphasize the high quality of such diagnostic methods offering a good reliability in discriminating the nature of the adrenal mass. These undeniable diagnostic advantages have a positive impact on the surgical strategy, allowing together with a careful morphological study of the lesion, to program in detail possible demolitive operations. The authors finally underline the importance of the surgical access: they are persuaded the best is the bilateral under-rib incision. This surgical approach assures a complete exploration of the abdominal and pelvic cavity; moreover, it allows to face every complication.

Adenoma↗
PubMed1991

Echographic study of Tietze's syndrome.

An echographic study of Tietze's syndrome was carried out. Three patients with clinical evidence of Tietze's syndrome were examined. Ten normal volunteers were studied as controls. In Tietze's syndrome a dishomogeneous increase of the echogenicity in pathological cartilage and an increased thickness vs. the opposite normal side were observed. A moderate thickness and a decreased echogenicity of surrounding soft tissues was observed in one case.

Adolescent↗
PubMed1991

[The role of computerized tomography in the study of duodenal carcinoma].

Seven patients suffering from carcinoma of the lower portion of duodenum were examined by means of CT. Water was used as oral contrast medium. In all patients CT showed parietal thickening in the lesion site, with hyperdense (4 cases) or isodense (3 cases) patterns with respect to adjacent normal walls; irregularities on the inner surface were also demonstrated. CT correctly staged the tumor in 5/7 patients (70%), showing pancreatic infiltration in 5 cases--in 1 case associated with hepatic metastases--, vena caval infiltration in 1 patient, and right anterior pararenal fascia involvement in 1 case. In 2 patients the relationship between duodenal carcinoma and pancreas could not be evaluated. CT is suggested for the patients with suspected neoplastic pathologic conditions of the duodenum thanks to its capabilities of showing extraparietal lesion spread, as well as adjacent organs infiltration, adjacent vessels involvement, and distant metastases.

Adenocarcinoma↗
PubMed1991

[The potentials of computed tomography in the study of mechanical ileus of the small intestine].

Eighteen patients were examined; they were suffering from small bowel obstruction due to adhesions (7 cases), hernia (3 cases), carcinoma (2 cases), metastasis from melanoma (1 case), radiation enteritis (2 cases), intramural hematoma (2 cases), and peritoneal carcinosis (1 case). CT capabilities in showing the site and the cause of obstruction were evaluated. CT was performed after conventional radiology in 13 cases, while in 5 cases it was the first exam and demonstrated the condition as an occasional finding. In all cases i.v. contrast agents were administered. Filling of the intestinal loop by oral contrast agent was never performed since the hypodense fluid present in the distended intestinal loops allowed good evaluation of intestinal walls. CT always showed the level of the obstruction thanks to the presence of the distended loops (phi: 4-8 cm) above the condition and of collapsed loops below. In 8/18 cases (44%) it was possible to show the cause of the obstruction. Those due to neoplasms, herniae and intramural hematomas were correctly diagnosed. On the contrary, it was not possible to identify the cause of the obstructions due to adhesions, radiation enteritis and peritoneal metastases because of the absence, in such cases, of specific parietal alterations. According to our results, CT is suitable in patients suffering from small bowel obstruction because it allows: to always show the site of the obstruction and, in some cases, its cause; to diagnose closed loop obstructions; to obtain a simultaneous staging in neoplastic patients.

Contrast Media↗
PubMed1990

Rectal carcinoma: CT staging with water as contrast medium.

Computed tomography (CT) was used to study 42 patients with rectal carcinoma. Water was used as a contrast medium for studying the local extent of tumor in all patients. Scans were read prospectively without knowledge of the histologic staging and then compared with pathologic specimens. CT depicted the tumor in all patients. Comparison of CT and histologic results (following the Dukes classification) showed that disease was correctly staged as A in three of four patients, as B in eight of 12, as C in 15 of 17, and as D in nine of nine. Overall, carcinoma was correctly staged with CT in 35 of 42 patients (diagnostic accuracy, 83.3%). The accuracy in the assessment of local invasion was 97.6% (41 of 42). In the detection of lymph node involvement, the accuracy was 78.6% (sensitivity, 88%; specificity, 64.7%). CT is recommended in the preoperative staging of rectal carcinoma and as an aid in choosing the appropriate therapy. The use of water enema and complete distention of the rectum are reliable techniques for improving the accuracy of CT in the assessment of local invasion by cancer.

Adult↗
PubMed1990

[Echography in the study of adenopathies of the upper abdomen].

Four-hundred eighty-five patients underwent US examination; 183 of them had gastric cancer, 239 colorectal cancer, 38 pancreatic cancer, 11 esophageal cancer, and 14 had gastric lymphoma. All patients underwent surgery. In 95 cases fine-needle biopsy under US guidance was performed. Lymphadenopathies were classified by the criteria proposed by Yoshinaka et al., type I: poorly-defined borders, diffuse internal echoes; type II: well-defined borders, diffuse internal echoes; type III: well-defined borders, notchings, strong internal echoes. Twenty/twenty-nine type I, 66/98 type II, and 39/43 type III adenopathies were found to be neoplasm-positive. Of 73 patients with adenopathy from gastric cancer, 9 were type I, 42 were type II, and 22 were type III (183 patients examined); of 9 patients with adenopathy from esophageal cancer, 7 were type II and 2 were type III (11 patients examined); of 48 patients with adenopathy from colorectal cancer, 5 were type I, 28 were type II, and 15 were type III (239 patients examined); of 29 patients with adenopathy from pancreatic cancer, 7 were type I, 18 were type II, and 4 were type III (38 patients examined); finally, of 11 patients with adenopathy from gastric lymphoma, 8 were type I, and 3 were type II (14 patients examined). The relationship between US and pathology was possible from a statistical point of view only. Type I lymphadenopathies seem to suggest lymphomatous involvement, whereas type III ones suggest metastatic involvement. US is a valid approach method, which must be supported by other investigation techniques--e.g., CT and lymphography--in order to avoid high false-negative percentages.

Abdominal Neoplasms↗
PubMed1990

[Echography in the study of sialolithiasis].

The US results are reported of 38 patients affected with sialolithiasis of the major salivary glands (37 cases of submandibular and 1 of parotid location). Sonography allowed all intraparenchymal calculi to be detected, as well as 59% of intraductal calculi. Associated US pathological features were: gland swelling in 36 cases (94%); ductal ectasia in 14 cases (61%); irregular echo structural arrangement of glandular parenchyma in 3 patients with multiple stones. US can be considered an useful diagnostic tool in sialolithiasis, for it allows the alterations in glandular structure in the late stages to be evaluated. Moreover, it may be repeated as often as necessary in the cases with multiple and/or recurrent stones.

Adolescent↗
PubMed1990

[The CT aspects and pathological correlations in gastric adenocarcinoma and lymphoma].

CT morphology of malignant pathologies of the stomach was evaluated by filling the stomach with water. Fifty-three patients were examined who were affected with carcinoma, and 12 with lymphoma. Carcinomas either determined parietal thickening of 7 mm to 3 cm or appeared as endoluminal vegetations with a big implant base. Neoplastic tissue had higher density than adjacent gastric wall in 80% of the cases, and the same density in the extant 20%. Only mucinous carcinomas appeared as isodense, the other histological types being hyperdense. The patients with gastric lymphoma presented with small endoluminal vegetations or parietal thickening of 6 mm to 2 cm. Lymphomatous infiltrates had lower density than normal adjacent gastric wall in 65% of the cases, and the same density in the extant 35%. CT allowed even small lesions to be identified in malignant gastric diseases; nonetheless, the method is to be considered a complementary technique to conventional radiology or endoscopy. The attenuation value of parietal alterations helps distinguish gastric carcinomas from lymphomas, because of the hyperdense/hypodense aspect of the lesion. On the contrary, a gastric carcinoma or lymphoma cannot be diagnosed when the tumor has the same density as adjacent gastric wall.

Adenocarcinoma↗