Biomedical subjects
Publications and source records attributed to G Rizzatto.
The authors report the ultrasonographic findings in a case of pelvic lipomatosis presenting with pathognomonic radiographic features. Ultrasound alone may exclude other lesions but cannot make a specific diagnosis because the sonographic appearance of fat is often conflicting. Ultrasonography should be of value as a follow-up examination in patients with definite risk of progressive ureteral obstruction.
We report the findings on computed tomography (CT) in idiopathic and secondary retroperitoneal fibrosis in 7 patients. In all cases CT showed the fibrotic mass, accurately defining its extent and the involvement of adjacent anatomic structures. The densitometric and anatomopathologic aspects were correlated; contrast uptake was less in areas thought to be dense in collagen than it was in areas with more vascular regions of inflammatory change. CT assessed the extent and nature of the fibrotic plaque.
In 246 controlled jaundiced patients, the value of ultrasonography was confirmed. The differentiation of medical from surgical jaundice was 96% accurate. There was an increase in the overall accuracy due to technological developments and better scanning techniques. Nevertheless important diagnostic problems are still unresolved. Although the precise location of the obstructing lesion was determined in 86% of surgical case, the cause was established in only 69%. In medical jaundice diagnostic findings were observed only in congestive liver due to chronic heart failure and in some cases of cirrhosis.
Ultrasonography was used to evaluate 18 proven cases of carcinoma of the gall-bladder and a prospective diagnosis was correctly achieved in 88.8%. The ultrasonographic findings may be classified into primary and associated. The diagnostic role of ultrasonography is considered and a flow-chart of further investigations is suggested. The diagnostic limits for early detection are underlined.
The authors refer the results of angiography in 46 patients with proven pancreatic carcinoma. Based on the prospective report there were 40 correct diagnoses, giving an overall accuracy of 86.95%. The incidence of the angiographic features has been investigated; basing on these findings the possibility of a radical surgery was suggested. 24 of these patients have undergone echotomography. The authors compare the results of the two investigations, concluding that these are complementary in diagnosis and prediction of resectability (invasion of great vessels, secondary deposits to the liver). Echotomography allows to recognize a large number of small dimension carcinomas, suggesting its use in the screening of those patients with suspected pancreatic neoplasm. Angiography is still essential to perform radical surgery.
Considering the different points of view about the echotomographic findings in pancreatic carcinoma, the authors refer their results about 89 controlled cases (38 normal pancreas and 51 pancreatic carcinomas). The pancreatic space was correctly identified as normal in 37/38 cases. Echotomography also revealed the presence of 48 pancreatic carcinomas; it gave 3 false negative and 3 false positive results; in 21 cases the size of the tumour was 5 cm or less. In a large number of cases echotomography has correctly defined the extent of the lesion by evaluating its size, the secondary liver localization (95% of accuracy) and the vascular involvement (compressions on the inferior vena cava and obstruction of the splenic vein). Basing on the echotomographic findings the authors classify the pancreatic carcinoma in 2 main types.
The authors illustrate all the different scanning techniques for the kidney and review the normal anatomic patterns in every scanning plane. Using gray scale machines, high-frequency long focussed transducers and appropriate gain settings, it is possible to obtain well defined images, with high resolution; these allow to recognize the renal margins, the cortex, the medulla and the renal sinus structures. The large number of scanning planes, both longitudinal and transverse, allow a detailed evaluation of the normal renal anatomy, the relationships of the kidneys with the neighbouring structures (fasciae, ligaments, fat and vessels) and organs (liver, adrenals, spleen and pancreas) are well recognized. The authors systematically introduce the different echotomographic aspects of the normal kidney. Echotomography can also inform about the renal position and size.
The authors illustrate the diagnostic possibilities of echography in the evaluation of the nontraumatic abdominal emergencies. They first refer about the methods of investigation and the scanning techniques. Then they illustrate the value of echography in the evaluation of the acute cholecystitis and pancreatitis pointing out the sensitivity of this procedure to the detection of the spread of the infections to the peritoneum and to the retroperitoneal spaces. The authors also present the echographic findings in the acute pathology of the retroperitoneum and of the female pelvic organs. Finally they emphasize the diagnostic value of ultrasounds in the search of the abdominal causes of the acute anemia and of the fever of unknown origin and as a preliminary investigation in case of actue renal failure.
A new way of scanning the kidney by ultrasonography is the posterior oblique longitudinal scan. This provides new information about renal anatomy, especially the renal aspect of the parenchyma and the hilus in its vertical axis. It supplies useful diagnostic information particularly in pseudotumours, hydronephrosis, and lipomatosis.
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