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Biomedical subjects

L E Derchi

Publications and source records attributed to L E Derchi.

125 records · Page 7Linked to original sources
PubMed1983

Ultrasonographic appearances of gastric cancer.

In 32 patients with known gastric cancer involving different segments of the stomach, an attempt was made to image the tumour by ultrasonography. Identification of the lesion was possible in 31/32 cases. The tumour always appeared as a focal or diffuse thickening of the gastric wall, with irregular outer margins and luminal echoes; in many cases, a "target" pattern was seen. Although ultrasonography cannot be considered a sensitive test in the diagnosis of gastric cancer, knowledge of the possible appearances of tumours in all different portions of the stomach is important, since this method is often used as the first imaging procedure in a large variety of abdominal complaints, and clinically unsuspected gastric carcinomas may be imaged first by it.

Adolescent↗
PubMed1983

Sonographic staging of gastric cancer.

The sonographic images obtained in 32 patients with known gastric cancer, who were referred to sonography for evaluation of liver metastases and in whom a specific attempt was made in order to visualize the tumor, were reviewed and evaluated for the extent of exogastric neoplasm. Surgical correlation was available in 21 cases. Sonography allowed identification in five of seven patients who had distant metastases, 12 of 15 who had lymphadenopathy, and nine of 12 patients who had direct spread to structures surrounding the tumor; ascites was always correctly identified. In only one case, a false-positive diagnosis of lymph nodes metastases was made. These results indicate that sonography has good specificity in the staging of gastric cancer and that, when patients are referred for evaluation of liver metastases, it is worthwhile to gather useful additional information about tumor extent by performing a complete sonographic examination of the abdomen and pelvis and by making an attempt to visualize the primary neoplasm and its relations to surrounding organs.

Humans↗
PubMed1983

[Value of ultrasonics and computerized axial tomography in the staging of renal neoplasms].

Sonographic (US) and computed tomographic (CT) images obtained in 47 patients with renal cancer have been reviewed; attention was paid to detection of neoplastic spread to structures surrounding the tumor, presence of lymph node metastases and of thrombosis of renal vessels and to identification of distant metastases. The results of the revision process were then compared with surgical or autoptic findings. In a relatively high number of patients, a complete examination of the upper abdomen could not be performed by US, due to patient habitus or bowel gas; on the contrary, a diagnostic study could be obtained by CT in virtually all cases. Furthermore, differentiation of stage I and stage II lesions could never be obtained by US; only CT gave this possibility. As regards the sensitivity of the two methods, in patients with stage III or stage IV disease, US showed relatively lower sensitivity in the diagnosis of lymph node metastases, but it was significantly less sensitive in the study of distant metastases. On the contrary, the specificity of the two imaging methods was similar, and US gave better results in the evaluation of renal vein or inferior vena cava thrombosis.

Adult↗
PubMed1982

CT cholangiography in suspected Caroli's disease.

Two patients in whom computed tomography (CT) and sonography suggested the diagnosis of Caroli's disease are reported. The biliary/nonbiliary nature of the hepatic cysts was evident on a CT scan of the liver obtained immediately after intravenous cholangiography. This allowed an accurate analysis of the relationship of the biliary ducts to the cysts and easy identification of contrast medium, where present, within them. The use of this technique may avoid more invasive procedures that, although accurate in defining anatomic changes of the biliary ducts, may cause infection in patients with biliary stasis and cholangitis.

Bile Ducts, Intrahepatic↗
PubMed1982

Ultrasonic findings of subcutaneous emphysema: a case report.

We have recently examined a patient in whom sonographic visualization of the most lateral part of the right lobe of the liver was impossible due to the presence of subcutaneous emphysema of the right flank. To our knowledge, this is the first ultrasonic report of this condition.

Emphysema↗
PubMedDate not supplied

Transvaginal ultrasonography of nongynecologic pelvic lesions.

Transvaginal ultrasonography (TVUS) is one of the preferred imaging modalities in patients with gynecologic problems because of its high diagnostic accuracy, noninvasiveness, and wide availability. In endovaginal scanning, the problem of sonic attenuation is much less significant than with the transabdominal approach in the evaluation of the viscera in the true pelvis. Placement of high-frequency, high-resolution probes within the vagina allows accurate assessment of all anatomic structures of the female reproductive tract within the pelvis, and, incidentally, a variety of pathologic conditions affecting the intestinal tract, the urinary system, the pelvic walls, vessels, lymph nodes, and peritoneum can be assessed by this technique. In this article, we show the appearances of nongynecologic lesions of the female pelvis as imaged with TVUS and discuss the clinical indications to this kind of study and the role of TVUS in guiding interventional maneuvers through the vaginal vault. All endovaginal scans were taken with transducers at frequencies of 5.0-7.5 MHz.

Crohn Disease↗
PubMedDate not supplied

Spiral CT of the abdomen after distention of small bowel loops with transparent enema in patients with Crohn's disease.

BACKGROUND: [corrected] To evaluate the capability of a computed tomographic (CT) technique that combines distention of the small bowel loops with a transparent enema with contrast-enhanced spiral CT of the abdomen in patients with Crohn's disease. METHODS: We evaluated the abdomen with spiral CT after distention of the small bowel loops with a transparent enema of methylcellulose in 40 patients consecutively referred for radiologic evaluation of Crohn's disease of the small bowel. Fluid was infused through a nasojejunal catheter with a peristaltic pump. Ultrasonography was used to prevent bowel overdistention and detect arrival of methylcellulose to the cecum. Contrast-enhanced spiral CT of the abdomen was then performed, and the degree of contrast enhancement and the thickness of the walls of the involved loops were evaluated. A series of 10 patients with retrograde distention of the last ileal loop from large bowel water enema was used as a control. The results of the CT were compared with those of conventional radiographic small bowel studies. RESULTS: The normal small bowel wall was 1.9-2.5 mm thick (mean = 2. 1 mm); density values of the normal enhanced wall varied between 25 and 60 HU (mean = 32 HU) and presented a homogeneous structure. Bowel segments involved by the disease were 4-12.5 mm thick (mean = 9.2 mm), had density values of 75-150 HU (mean = 105 HU), and showed a multilayered appearance. Compared with conventional radiography, CT detected longer lesions or additional segments involved by the disease process in 14 cases, 11 additional fistulas, two abscesses, and mesenteric changes in 21 cases. CONCLUSIONS: The small bowel CT enema technique provides good results in the study of patients with Crohn's disease and can be used to evaluate patients with advanced lesions.

Adult↗
PubMedDate not supplied

Ultrasound and CT findings in two cases of hemangioma of the adrenal gland.

The ultrasound and CT findings in two patients with hemangioma of the adrenal gland are presented. Ultrasound showed large masses with heterogeneous nonspecific structural pattern. Unenhanced CT demonstrated lesions with hypodense centers and thick irregular peripheries with higher density. A few small peripheral calcifications were noted in one patient. Following contrast medium injection, patchy enhancement of the peripheral zone of the tumor was seen in both cases.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

MR imaging of adrenal myelolipomas.

The magnetic resonance (MR) images in six patients with seven adrenal myelolipomas are presented. Four lesions involved the right gland, and three the left; they ranged from 3 to 12.5 cm in diameter. Magnetic resonance was able to image all lesions. Using T1-weighted sequences, three structural patterns were observed; (a) homogeneous masses with intensity equal to adjacent fat (three cases); (b) heterogeneous masses with fat intensity areas and areas similar to renal cortex (two cases); and (c) nodules quite different from fat, hypointense to the liver (two cases). On T2-weighted images, myelolipomas were slightly hypointense to fat and either hypo- or isointense to the liver. A comparison with the results of CT studies was possible in all cases, and good correlation with determination of the presence and quantity of fat density tissues within the lesions was observed. However, MR imaging did not seem to help in diagnosing adrenal myelolipoma in patients with equivocal CT findings, and needle biopsy is still needed in difficult cases.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

Gradient echo MRI of portal vein thrombosis.

The MR appearance of thrombosis of the portal vein and its branches using gradient echo (GRE) sequences is described. The study consists of two separate parts. In the first part, five normal volunteers were examined to select the optimal section plane for each portal vessel to be studied. Given the "time of flight" effect of GRE sequences, a scan plane perpendicular to the direction of flow was used to obtain maximal signal enhancement of flowing blood. In the second part of the study, 13 patients with thrombosis of the portal system diagnosed by Doppler sonography, CT, and digital subtraction angiography were examined with the GRE technique. Gradient echo MR confirmed the presence and defined the extent of vessel thrombosis with high diagnostic accuracy. In addition, it proved accurate in detecting portosystemic collaterals. We concluded that the GRE technique can be effectively used as a complement to conventional SE MR to further delineate portal vessels.

Adult↗
PubMedDate not supplied

Malignant melanoma of soft tissues (clear cell sarcoma) of the foot. Is MRI able to perform a specific diagnosis? Report of one case and review of the radiological literature.

The magnetic resonance (MR) findings in malignant melanoma of soft tissues, also called clear cell sarcoma of tendons and aponeuroses, have been described as a focal abnormality with a specific MR pattern of increased signal intensity (relative to normal muscle) on T1 weighted sequences and variably decreased signal intensity on T2 weighted sequences (relative to surrounding fat). We have reported here a case of malignant melanoma of soft tissues of the foot, studied with ultrasonography (US) and MR, in which MR showed T1-hypointensity, T2-hyperintensity and marked gadolinium uptake. We have described the relationship between the intracytoplasmic melanin amount of and these atypical MR findings.

Adolescent↗
PubMedDate not supplied

[Long biceps brachii instability. Role of ultrasonography].

INTRODUCTION: Dislocation of the long head of biceps tendon, including subluxation to displacement out of the bicipital groove, is an uncommon cause of shoulder pain. We investigated the role of US in the diagnosis of this condition. MATERIAL AND METHODS: We examined eight patients with dislocation of the long head of biceps tendon: seven had a displaced, and one a subluxated tendon. All patients had early radiographic and US studies of the shoulder; then, three (37%) were submitted to CT-arthrography and two (25%) to MRI. US was performed at 7.5-13 MHz frequency, CT-arthrography with a volumetric acquisition technique and MRI with a surface coil at 1.5 T. Three patients with tendon dislocation had surgical confirmation of the diagnosis. RESULTS: Dislocation of the long head of biceps tendon was always diagnosed with US in all our eight patients; CT-arthrography and MRI confirmed the US findings. In the patient with subluxation of the long head of biceps tendon, US showed the tendon displaced over the lesser tuberosity whereas, in the 7 cases of complete luxations, the groove was empty and the tendon displaced medially. At CT-arthrography, the tendon was well outlined by contrast medium within its sheath. In dislocations, it was close to the anterior aspect of the humeral head. In two cases of dislocation, MRI showed both the empty bicipital sulcus and the medial tendon displacement. The subscapularis tendon tear was always associated with tendon dislocation; a supraspinatus tendon tear was observed in 6 cases. CONCLUSIONS: When imaging a painful shoulder, we should investigate the integrity and course of the long head of biceps tendon. In clinical practice, dislocation of this tendon can be reliably diagnosed with US. CT-arthrography and MRI should be used only to supplement inconclusive US studies.

Aged↗