Biomedical subjects
Publications and source records attributed to G Gualdi.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Computed Tomography (CT) and Magnetic Resonance (MR) permit the acquirement of important diagnostic elements for the anatomo-topographic staging of substernal goiters, and for their characterization. The authors compared data obtained by CT and MR with intraoperative anatomo-topographic findings and definitive histology in 28 patients with substernal goiters. CT was performed in all these patients while MR only in 9. The results obtained showed an accuracy of 85.7% for CT and 100% for MR regarding the anatomo-topographic correspondence with intraoperative findings, without a significant statistical difference between these two diagnostic procedures. MR is more accurate than CT in showing the vascular dislocations. CT and MR have an accuracy of 82.1% and 77.7% respectively comparing their findings with histologic results obtained in operative specimens, without a significant statistical difference. In conclusion MR has to be considered the more accurate diagnostic procedure and therefore recommended in the study of patients with substernal goiters, while CT can be performed only in selected patients.
Eighteen patients with Zollinger-Ellison syndrome were studied with 111In-pentetreotide SPECT in order to localize gastrinoma, the tumour responsible for this pathology. NMR imaging was also carried out. Eight patients were operated. 111In-pentetreotide was reinjected 4 hours before operation and the radioactivity of the excised tumours counted. The nature of the withdrawn tissues was assessed by immunohistochemistry (chromogranina A). The scintigraphy was repeated 3-6 months after surgery. 111In pentetreotide SPECT was more sensitive than NMR. It was also absolutely specific because all the radioactive tumours excised showed positive chromogranin A staining. The radioactivity/gram counted in gastrinomas exceeded 10 fold the hepatic and biliary radioactivity and 20-100 folds the radioactivity of blood and omentum. In all the operated patients but three, the scintigraphy performed after surgery did not detect tumours. However complete eradication did not occur, because though 3-6 months after surgery the gastrinemia was significantly lower with respect to pre-surgery results it did not return to normal values in all patients but two.