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Biomedical subjects

G Angelelli

Publications and source records attributed to G Angelelli.

At least 55 records · Page 3Linked to original sources

[Evaluation of the gastric wall with x-ray computed tomography].

A CT study of the stomach was carried out on 122 patients: 50 normals, 44 carcinomas, 8 lymphomas, 4 polyps, 2 leiomyomas, 14 varices. In order to evaluate the gastric wall, the stomach was filled with 400 cc of water. In normal patients, the technique proposed enabled a good study of the gastric wall, improving the visualisation of the inner surface. Even if small in size, lesions in patients affected by pathology were recognizable in all cases. It was also possible to recognize small pathological parietal thickening and the mucous or submucous extension of the lesions. The results obtained suggest that filling the stomach with water is a technique to be recommended for CT evaluation of the gastric wall.

Carcinoma↗

CT of the bowel: use of water to enhance depiction.

To enhance computed tomography (CT) of the bowel walls, water was administered into the colon through the rectum in 42 patients: 16 with rectal cancer, 22 with other colon carcinomas, and four with tumors originating in the pelvic organs. The technique provided a good evaluation of the bowel walls; the presence and extension of the intestinal tumors was assessed in all cases, and infiltrations of the bowel wall from the pelvic tumors were excluded.

Adult↗

[Echography in the study of renal tuberculosis].

34 patients suffering from renal tuberculosis of different degree were examined by ultrasound. The ultrasonographic aspects were compared with the urographic pictures. It was not possible to show by ultrasound the papillar erosions at the initial stage of the infection. In the advanced stage it was possible to evaluate the alterations of the excretory system and the parenchymal damage. The role of the method to study the tuberculous kidney, not visualized at urography, is essential. The typical aspect caused by the coarctated pelvis with dilated calyces allows nearly always to formulate a diagnosis. The achieved results make ultrasonography a very important investigation for the diagnosis and the prognosis of the renal tuberculous infection.

Adolescent↗

Hepatic involvement in hereditary hemorrhagic telangiectasia: CT findings.

Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber disease, is an autosomal-dominant vascular disease characterized by mucocutaneous or visceral angiodysplastic lesions (telangiectases and arteriovenous malformations) that may be widely distributed throughout the cardiovascular system. The recognition of mucocutaneous telangiectases, the occurrence of spontaneous and recurrent episodes of epistaxis, the presence of visceral involvement, and a family history of this disease are the clinical criteria that allow diagnosis. In comparison with skin, lungs, gastrointestinal tract, and brain involvement, hepatic involvement defined by clinical criteria alone has long been considered uncommon. Our experience with a large group of HHT patients, even those asymptomatic for liver involvement, demonstrates that it is more frequent than reported and is characterized by the presence of intrahepatic shunts, disseminated intraparenchymal telangiectases, and other vascular lesions. Congestive cardiac failure, portal hypertension, portosystemic encephalopathy, cholangitis, and atypical cirrhosis have been reported as possible serious complications related to this condition. Thus, a correct diagnosis is important, and diagnostic imaging has a fundamental role in detecting alterations involving the liver. The possibilities to perform a multiphasic study and to provide high-quality multiplanar and angiographic reconstructions, gives multidetector row helical computed tomography the ability to detect and characterize the complex anatomopathologic alterations typical of this disease.

Humans↗

Water enema transvaginal ultrasound for local staging of stenotic rectal carcinoma.

BACKGROUND: To increase the value of ultrasound in the staging of stenotic rectal carcinoma. METHODS: Water enema transvaginal ultrasound (WE-TVUS) was performed in 21 consecutive female patients with severely stenotic rectal tumor (adenocarcinoma histologically proved) who were selected on the basis of clinical and double-contrast barium enema study. All patients underwent surgery, and histopathologic correlation was possible. RESULTS: Rectal tumors were well demonstrated in all cases, and a good correlation between perirectal neoplastic infiltration, and lymph node involvement at WE-TVUS and histologic data were observed. Compared with histologic results, WE-TVUS correctly staged 19 of 21 tumors (overall accuracy = 90%); one case was understaged (T4 as T3) and one case was overstaged (T3 as T4). In the detection of lymph node involvement, the sensitivity was 50% and specificity was 78%. CONCLUSION: WE-TVUS is a potentially valuable technique for defining the local extension of severely stenotic rectal tumors in women.

Adenocarcinoma↗

Reverse engineering techniques applied to a human skull, for CAD 3D reconstruction and physical replication by rapid prototyping.

The production of a copy of an existing object of complex shape is one of the typical applications of the integration between two modern computer-based technologies, reverse engineering (RE) and rapid prototyping (RP). The method is extremely versatile and can be used in various applicative domains (e.g. replacement of anatomical parts with artificial prostheses, replication of skeletal remains). Two different acquisition techniques of images of a skull, by laser and by CT scan, were compared to ascertain which enabled more accurate reproduction of the original specimen. The skull was chosen due to it being the body part most often used in medico-legal investigations (for personal identification, skull-photo superimposition techniques, forensic art, etc). Comparison between the copy and the original yielded satisfactory results for both techniques. However, CT scanning demonstrated some advantages over the laser technique, as it provided a cleaner point cloud, enabling shorter pre-reproduction processing times, as well as data on the internal parts, which resulted in the reproduction of a more faithful copy.

Biomedical Engineering↗

[Computerized tomography in the study of the diabetic kidney].

PURPOSE: We investigated whether any morphometric or densitometric changes are detectable in the kidneys of type 2 diabetic patients. MATERIAL AND METHODS: We retrospectively reviewed the CT findings of 40 diabetic patients and of 20 non-diabetics (the control group) submitted to triphasic helical CT for different abdominal conditions. The type 2 diabetic patients were 23 men and 17 women, mean age 62 years, while the nondiabetic controls were 12 men and 8 women, mean age 58 years. All the CT images were analyzed using the Multiplanar Reconstruction (MPR) software. We classified the diabetic patients as either nephropathic or non-nephropathic based on laboratory signs of renal disease, and divided them into three groups based on the duration of their diabetes (0-5 years, 5-10 years, > 10 years). We evaluated morphometric features, such as the presence of parenchymal or vascular calcifications, axial and coronal renal diameters, coronal renal area, and corticomedullary ratio, and densitometric and functional features, such as unenhanced renal density, cortical and medullary density in the arterial phase, parenchymal density in the nephrographic phase, and contrast elimination. We also compared the results in our subgroups of patients with those in the controls. RESULTS: Both renal diameters on axial sections and cortical density in the arterial phase were significantly lower in the nephropathic group (p < 0.05) than in nonnephropathic patients and controls. The patients with shorter duration of their diabetes had significantly greater axial diameters (p < 0.05); a longer-standing disease correlated significantly (p < 0.05) with smaller axial diameters of kidneys and lower cortical density in the arterial phase. No significant correlation was found for any other parameter. CONCLUSIONS: Renal diameters on axial and coronal sections and cortical density in the arterial phase can be useful indices of early nephropathy in diabetic patients. Further studies are warranted to make these findings suitable for use in clinical practice.

Adult↗

[Benign and malignant gastric ulcer: CT findings].

PURPOSE: To evaluate the differential CT aspects of benign and malignant gastric ulcers. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 54 patients with gastric ulcerative lesions, 47 with malignant lesions (38 adenocarcinomas, 9 lymphomas) and 7 with benign lesions. All patients underwent histological examination. CT scanning was performed with a helical scanner Picker PQ 2000, before and after intravenous contrast material administration and after adequate stomach distension, achieved by drinking at least 400 ml of water; 2 ml/kg of intravenous contrast was injected at a rate of 3.5 ml/s. After contrast administration two-phase dynamic scans were performed with a scan delay of 30O and 50O. The parameters considered were: lesion size and localization, extension of the ulcer into or beyond the body of the stomach, focal wall thickness, contrast enhancement of the ulcer, perigastric tissue morphology, presence of lymphoadenopathies and liver metastases. RESULTS: The ulcer size and localization were not significative in the differential diagnosis of benign or malignant ulcers. In 46 patients the ulcer extended within the body of the stomach (38 adenocarcinomas and 8 lymphomas), in 8 cases beyond (7 benign ulcers and 1 initial lymphoma). In 46 cases of malignant ulcers there were focal wall thickenings (> 5mm), in 1 case of initial lymphoma and in all cases of benign ulcers the thickness of the wall was normal. Contrast enhancement of the lesion was observed in 25 cases, all of which were adenocarcinomas. 33 patients had perigastric tissue abnormalites (32 with malignant lesions and 1 with benign ulcer). Lymphoadenopathies and liver metastases were detected in 30 cases and always associated to malignant ulcers. DISCUSSION AND CONCLUSIONS: The improved CT technology allows to recognize gastric ulcer. Ulcer extension into stomach body; focal wall thickening; contrast enhancement of the lesion, lymphoadenopaties and liver metastases are significative in malignant gastric ulcers. The lack of these abnormalities is characteristic of benign gastric ulcers but can be also observed in early malignant lesions.

Adult↗

[The normal aspect of the suprapatellar bursa in echography of the knee].

Sonography is suitable to recognize fluids in the suprapatellar bursa, which can represent an indirect sign of intra-articular knee effusion. In order to obtain the physiologic parameters of suprapatellar bursa, 50 healthy volunteers, 38 sedentary and 12 sportsmen, were evaluated by means of US. The bursa was recognizable in 8/50 cases (16%) with quadriceps in prolapse (mean thickness: 1.8 mm, mean length: 20.5 mm), and in 23/50 cases (46%) with quadriceps in contraction (mean thickness: 2.6 mm, mean length: 22.6 mm). Suprapatellar bursal thickness ranged 1-4 mm, and its length ranged 12-44 mm. The suprapatellar bursa appeared as a well-defined hypoechoic band, cranial to patella, anterior to the distal femoral shaft, and posterior to quadriceps tendon. Quadriceps contraction increases both thickness and length of bursal swelling (1 and 2 mm, respectively, on the average). When sportsmen were compared with sedentary subjects, suprapatellar bursa diameters were observed not to change, but the bursal itself was evident in 3/12 (25%) and in 8/12 (66%) of cases, according to whether the quadriceps was in prolapse or in contraction. Bursal contents were homogeneously anechoic and bursal outline smooth and regular in all cases (23/23). Bursal morphology was symmetric, in 23/23 cases, in length, regularity of outline, and echogenicity of contents. Thickness alone resulted asymmetrical in 2/23 subjects (8%), even though variations were less than or equal to 2 mm. In conclusion, we can consider as pathologic features: thickness greater than 3-4 mm, asymmetry greater than 2 mm, irregular outline, and inhomogeneous contents. These parameters must be examined in pathologic subjects and further research is mandatory.

Adolescent↗

Hereditary haemorrhagic telangiectasia: study of hepatic vascular alterations with multi-detector row helical CT and reconstruction programs.

PURPOSE: To evaluate hepatic alterations in patients affected by Hereditary Haemorrhagic Telangiectasia (HHT) by using multidetectorrow helical CT (MDCT) and new reconstruction programs. MATERIALS AND METHODS: An MDCT multiphasic study of the liver was performed in 105 consecutive patients: 89 considered to be affected by HHT and 16 with suspicion of disease alone. The scan delay was determined by using a test bolus of contrast material. The CT examination was performed with a triphasic technique (double arterial phase and portal venous phase). Multiplanar and angiographic reconstructions were then obtained, and the images checked for the presence of shunts, hepatic perfusion disorders, vascular lesions (telangiectases and large confluent vascular masses), indirect signs of portal hypertension, and anatomical vascular variants. RESULTS: Hepatic vascular alterations were found in 78/105 cases (67/89 patients affected by HHT and 11/16 patients with clinical suspicion alone). Therefore HHT diagnosis was excluded in 5 patients. 78/100 (78%) patients with HHT had intrahepatic vascular alterations: arterioportal shunts in 40/78 (51.2%), arteriosystemic shunts in 16/78 (20.5%), and both shunt types in 22/78 (28.3%). Intraparenchymal perfusion disorders were found in 46/78 (58.9%) patients. Telangiectases were recognised in 50/78 (64.1%) patients. Large confluent vascular masses (LCVMs) were identified in 20/78 (25.6%) patients. Indirect signs of portal hypertension were found in 46/78 (58.9%) cases. Variant hepatic arterial anatomy was present in 38/100 cases (38%). CONCLUSIONS: Multiphasic MDCT and the new reconstruction programs enable the identification and characterisation of the complex vascular alterations typical of HHT.

Adolescent↗