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M Alerci

Publications and source records attributed to M Alerci.

At least 19 recordsLinked to original sources
PubMed2004

Extrahepatic arterioportal fistula: three-dimensional reconstruction of computerized tomodensitometric scan for diagnosis and morphologic assessment.

Arterioportal fistulae (APFs) are rare. An asymptomatic APF was suspected by computed tomography. Multiplanar, maximum intensity projection, and surface shaded display reconstructions showed its anatomy. To our knowledge, this is the first report using such reconstructions to analyze the architecture of an extrahepatic APF. Complete assessment of APF can be achieved noninvasively, and initial endovascular treatment can be planned.

Arteriovenous Fistula↗
PubMed1998

Spiral computed tomography: a novel diagnostic approach for investigation of the extracranial cerebral arteries and its complementary role in duplex ultrasonography.

BACKGROUND: For the detection of atherosclerotic lesions of the extracranial cerebral arteries, duplex ultrasonography (US) is an established operator-dependent method, whereas arteriography is associated with the not-insignificant risk of embolic complications. Spiral CT is a promising novel diagnostic tool that allows noninvasive, operator-independent diagnosis of obstruction of extracranial cerebral arteries. The aim of our prospective study was to evaluate in a clinical setting the complementary role of duplex US and spiral CT. METHODS AND RESULTS: We compared the results obtained independently by spiral CT and duplex US in 59 consecutive patients with clinical suspicion of an obstructive lesion affecting the carotid arteries. We analyzed a total of 354 segments from the extracranial carotid arteries, including the common, internal, and external carotid arteries. A total of 4 complete occlusions, 38 severe stenoses (70% to 99%), and 32 moderate stenoses (30% to 69%) were concordantly identified by means of duplex US and spiral CT. In 5 cases in which duplex US did not allow sufficient evaluation of the carotid artery because of a poor US window or severe calcification, spiral CT allowed identification and correct measurement of the stenotic lesion. The comparison of the percentage of stenosis with both methods was good (r=0.91, P=0.024). CONCLUSIONS: Our results indicate that spiral CT of the extracranial cerebral arteries is a promising noninvasive complementary and non-operator-dependent examination. Its application is particularly attractive in cases in which duplex US is not reliable (ie, severe kinking, severe calcification, short neck, and high bifurcation) and particularly when an overall view of the vascular field is required.

Aged↗
PubMed1993

[Castleman's disease].

A 17-year-old girl developed acute colicky periumbilical pain with haematuria. On examination a tightly elastic space-occupying lesion about 10 cm in diameter was palpable around the umbilicus. Erythrocyte sedimentation rate (ESR) was raised to 113 mm in the first hour. There was a microcytic anaemia (8.7 g/dl) and a positive Coombs test. Ultrasonography revealed a periumbilical space-occupying lesion of decreased echogenicity and left hydronephrosis. Computed tomography demonstrated a homogeneous noninfiltrative tumour, about 7 cm in diameter, with increased contrast medium concentration. The tumour, which was covered by peritoneum and well circumscribed, was excised from the base of the mesentery. Histologically it proved to have hyaline-sclerotic changes in the blood vessels and lymphoid and plasma cellular infiltrations, corresponding to a mixed form of Castleman's disease. In a second operation a left nephroureterectomy was performed. The kidney, the regional lymph nodes and the tissue which had caused the stenosis of the ureter all showed the same changes as the tumour. Postoperatively the ESR and the blood count became normal, but the Coombs test remained positive. During a subsequent pregnancy the ESR again rose. The patient has remained symptom-free for 38 months after the second operation.

Adolescent↗
PubMed1993

Chronic oral etoposide in small-cell lung cancer: clinical and pharmacokinetic results.

AIMS: To evaluate antitumour activity, toxicity, pharmacokinetics, and the pharmacodynamic relationship with neutropenia of chronic oral etoposide (E) in patients (pts) with small-cell lung cancer (SCLC) previously untreated with chemotherapy. PATIENTS AND METHODS: Twenty-seven (14 extensive-, 13 limited-stage) pts receiving 100 mg daily of oral E for 21 days every 4 weeks. CBC with differential repeated every week. E plasma levels determined by HPLC method (sensitivity limit: 0.1 microgram/ml) with evaluation during the first cycle of weekly 24-hour drug concentrations. RESULTS: Among 25 evaluable pts, 60% (95% CI: 39%-79%) overall response, 144 and 217 days of median PFS and survival. Dose-limiting non-cumulative neutropenia of high interpatient variability. Linear reduction (30% per week) of absolute neutrophil counts (ANC) up to the 3rd week, recovering the following week. Risk factors for neutropenia (age, PS, serum creatinine and albumin) not identified. High inter-patient variability of 24-hour E plasma levels. A weak correlation between mean 24-hour E plasma levels and ANC nadir or relative decrease of ANC, but higher relative decrease of ANC in pts with 24-hour E plasma levels of > 0.32 microgram/ml. CONCLUSIONS: Chronic oral E is effective in SCLC pts previously untreated with chemotherapy. Careful hematological monitoring is essential to avoid severe myelosuppression. The degree of neutropenia might be related to the maintenance of a critical drug concentration level for a critical period of time.

Administration, Oral↗
PubMed1991

Phase I study of the combination of monthly carboplatin and weekly cisplatin.

Two cycles of the combination of carboplatin (C), given every 4 weeks with weekly doses of cisplatin (P), were administered on an outpatient basis to 28 previously untreated patients. One cycle consisted of one dose of C and 4 doses of P. The toxicity of 250 mg/m2 of C, combined with escalating doses of P (20, 30, 35, 40 mg/m2) was evaluated first. Thrombocytopenia was dose-limiting and cumulative. At the dose level of 40 mg/m2 of P, the median Pt nadirs during the first and second cycles were 190 (range: 44 to 232) x 10(3)/microL and 90 (range: 15 to 165) x 10(3)/microL, respectively. The median delivered dose intensity (DI) of P was 40 mg/m2/wk in the first cycle and 40 mg/m2/wk in the second cycle. In the second part of the study, 40 mg/m2 of P were combined with a C dose adapted to individual renal function according to the formula dose (mg) = AUC x (GFR + 25) where AUC = 4.5 mg/mL/min. The administration of doses of C ranging from 219 to 493 mg/m2 was associated with a more severe and more variable thrombocytopenia, more frequent P delays and decrease of the median delivered DI of P (first cycle: 33 mg/m2/wk; second cycle: 32 mg/m2/wk). At all dose levels, leukopenia was mild to moderate, and neurotoxicity and severe GI toxicity were absent. No significant reductions of the creatinine clearance values were observed. All patients treated at 40 mg/m2 of P suffered from cumulative subjective toxicity during the second month of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Lymph node metastasis of carcinoma of the cervix uteri. Role of lymphography and computerized tomography].

The presence of lymph nodal metastases in the patients affected with carcinoma of the uterine cervix is of the utmost clinical relevance. In the Radiology, Obstetrics and Gynecology Departments of Pavia University we have evaluated the accuracy of lymphangiography and CT in recognizing lymph nodal metastases in 95 patients, 58 of them evaluated preoperatively (49 subsequently submitted to radical hysterectomy). CT accuracy was also evaluated in 37 patients with a clinically suspected relapse of cervical cancer. In the first group the overall results were: 91% accuracy, 88% sensitivity, 92.5% specificity for lymphangiography and 87.9% accuracy, 72.2% sensitivity, and 95% specificity for CT (in 49 patients, stage I-II, submitted to lymphadenectomy, lymphangiographic accuracy was 91%, sensitivity was 88%, specificity 92% versus CT accuracy 85.7%, 44.4% sensitivity, and 95% specificity). In the second group (relapse) CT accuracy, sensitivity and specificity were 94%, 100%, and 91%, respectively. In conclusion, lymphangiography gives better results than CT in the patients with early stages (I-II) of the disease. In advanced stages and relapses CT was found to have high accuracy in demonstrating lymph node status. This information is useful for treatment planning and for avoiding unnecessary surgical exploration.

Adult↗
PubMed1990

Computed tomography of cystic lymphangioma in a wandering spleen.

A large cystic lymphangioma in a wandering spleen was discovered by chance in a young woman, 2 months after she delivered her first child. The clinical finding was that of a pelvic mass, which at CT was found to be a wandering spleen, containing multiple cystic lesions. The diagnosis of cystic lymphangioma was made at the pathological examination of the specimen after splenectomy. The association of cystic lymphangioma in a wandering spleen has not been reported previously.

Adult↗
PubMed1989

Clinical value of computerized tomography (CT) in assessment of recurrent uterine cancers.

Fifty-one patients with a clinically suspected relapse of uterine cancer were evaluated with computerized tomography (CT) in the Departments of Obstetrics/Gynecology and Radiology of the University of Pavia. The accuracy of these scans was always compared with biopsy results (31 cases) or clinical outcome (20 cases). To evaluate the role CT played in the treatment of each patient we divided the results of these examinations into "Confirmative" (when there was clinical evidence of a tumor) and "Diagnostic" (when physical examination and conventional radiologic techniques were inconclusive). Overall diagnostic accuracy was 92%, specificity 80%, and sensitivity 92%. The authors found that CT provides information that is useful for planning treatment and for avoiding unnecessary surgical exploration when a tumor is clinically evident; furthermore, CT was found to be better than conventional diagnostic means in doubtful cases, especially those in which post-therapeutic pelvic fibrosis was not extensive (correct diagnosis is 15 of 19 cases).

Adult↗
PubMed1988

Unusual CT features in ruptures of abdominal aortic aneurysms.

The authors present two cases of impending rupture of abdominal aortic aneurysms correctly diagnosed by means of some unusual CT findings. The clinical signs were not clear. On CT examination, despite the absence of haematomas, minor, but precise, changes allowed the correct diagnosis: loss of definite contours of the aneurysm, non-homogeneous peri-aortic and peri- and para-renal adipose tissue, thickening of the renal fascia and a thin fluid collection over the psoas muscles.

Acute Disease↗
PubMed1988

[Ovarian dermoid cysts. Radiographic fat floating sign and CT diagnosis of chronic rupture].

Unsuspected chronic rupture was discovered during surgical removal of a very large ovarian dermoid cyst. Abdomen X-ray, US and CT examinations were preoperatively performed. Standing X-ray projection of the abdomen allowed the appearing of a new radiographic finding of dermoid cyst, the "fat floating" as the equivalent of the "gravity dependent layering" in US and CT features. This radiographic sign appears as an horizontal line between two soft tissues of different opacity; it is caused by oily and sebaceous fluid floating over serous fluid and over intracystic debris. Literature was reviewed and radiographic findings in dermoid cysts were reconsidered; the sign of "fat floating" could enhance the diagnostic accuracy of abdomen X-ray. So when a pelvic or an abdominal-pelvic mass is discovered in a young woman, standing projection is required for abdomen X-ray. Rupture of a dermoid cyst may happen without notice and chronically; CT has been more accurate than US in evaluating rupture, in particular the peritoneal spread of oily pseudocyst.

Adult↗
PubMed1988

[Computerized tomography in surgically treated lumbar disk hernia. Multicenter study].

Results are reported of a multicenter analytic-statistical CT study on 128 postoperative lumbar herniated disk (HD) cases (50 at L4-L5, 64 at L5-S1, 2 at L3-L4, 12 multiple). CT was performed from 10 days to 204 months (47.7 months of mean) after surgery, in 51 patients without and in 77 with intravenous contrast medium (42 in bolus, 35 in perfusion). In 59 cases (38%) a recurrent hernia was found, and in 8% a new hernia. In 81% of patients epidural fibrous scars were demonstrated, in a rough 50% of cases associated with recurrent/new hernia: posterior fibrosis was found in 81% of cases, while unilaterally, bilaterally, or anteriorly extended fibroses were present in 20%, in 4.7%, and in 29% of cases respectively. In 72% of the patients injected with contrast medium, various kinds of fibrosis contrast enhancement were detected. In 8% neither fibrosis nor recurrent herniation was found. In 22% of cases lateral and/or central bony canal stenosis was present, in 26% vacuum disk, in 9% intracanalar calcifications, in 39% and in 19.5% dural sac stretching and compression respectively. In 5 cases a pseudomeningocele was found, and in 3 only a postoperative diskitis. Fibrosis is an almost inevitable postoperative consequence (4 out of 5 cases); it can be demonstrated by CT with high sensitivity and good specificity. A series of diagnostic criteria, such as the post-contrast media reaction, allow fibrosis to be discriminated from recurrent hernia. However, the possible association must be kept in mind of both diseases and/or of included roots in the scar. Myelography is hardly ever able to supply further resolutive diagnostic elements, while Myelo-CT is sometimes more useful. The importance of bone changes is questionable, with the exception of evident cases of canal stenosis, also because in most cases the radiologist cannot count on a preoperative CT study. Furthermore, the correlation between CT and clinical findings (possible asymptomatic fibrosis) is often difficult, which gives way to contrasting therapeutic attitudes.

Adult↗
PubMed1987

[Thrombosis of the false lumen in acute aortic dissection. CT diagnosis].

Three cases are reported of acute aortic dissection with complete thrombosis of the false channel, which is a very uncommon event in De Bakey's I and II type aortic dissections. The 3 patients entered hospital because of severe thoracic pain without any ECG sign of myocardial infarction. Emergency CT showed evidence of pericardial effusion suggesting hemopericardium, enlargement of the ascending aorta and a peripheral semilunar filling defect which caused a slight deformation of the true channel. On precontrast scans, only one case showed inward displacement of peripheral intimal calcifications and high-density aortic wall. No typical signs of aortic dissection were reported, except in the first patient--where a double contrast filled lumen, separated by an intimal flap was seen. CT findings are individually discussed. It is emphasized that in all patients more than one CT sign was present at a time. The correct evaluation of these signs together with the clinical data could lead to the right diagnosis of aortic dissection in spite of the lack of a filled false channel.

Acute Disease↗
PubMed1986

[Digital angiography: a new method for the study of the left ventricle].

30 patients with a previous myocardial infarction who had undergone diagnostic conventional left ventriculography and coronary arteriography had left ventriculography also performed by digital subtraction angiography after intravenous injection of contrast medium; the mean interval between the two investigations was 2.3 days. The conventional and the digital subtracted left ventricular images were computer-processed; global ejection fraction (obtained by the volumes calculated with the Dodge method) and segmental wall motion (from a quantitative analysis performed according to the Stanford method) were compared. We found a close correlation for the ejection fraction obtained by the two techniques (r = 0.89, p less than 0.01); absolute values proved to be slightly higher in the digital subtraction angiography. Segmental wall motion was significantly correlated too (p less than 0.05 for all the segments of the ventricular silhouette but for the one corresponding to the base of the heart). Digital intravenous angiography provides an accurate and less invasive method to evaluate left ventricular function.

Heart Ventricles↗
PubMed1985

[Intravenous digital ventriculography in the evaluation of left ventricular function in patients with acute myocardial infarct].

Thirty patients with myocardial infarction were studied using Digital Subtraction Ventriculography with Intravenous injection (DSVIV) between 3 and 6 days from myocardial infarction and were checked after 30 and 90 days. The variation of ejection fraction in the controls was not important. The wall motion provided precise indications regarding the infarctual regions. Digital subtraction ventriculography seems to be a very interesting tool in the study of the left ventricle in the evolution of myocardial infarction, thanks to a low invasivity, providing data on ventricular function.

Angiocardiography↗
PubMed1984

[Computerized tomography in the study of malignant tumors of the larynx].

A systematic investigation was carried out on 93 patients suffering from laryngeal tumours who underwent computed tomography and xeroradiography. A comparison is made between CT, xerographic, clinical and endoscopic findings. The value is stressed of functional informations obtained from CT performed during quiet breathing and phonation. The outstanding value of CT is the accuracy in definition of tumor extension and involvement of the laryngeal and paralaryngeal tissues. CT can be useful in diagnosis of regional lymph nodes metastases. The correct evaluation of the tumour is greatly helpful in surgical treatment and radiotherapy planning.

Epiglottis↗
PubMed1984

[X-ray computed tomography in non-neoplastic pathology of the larynx].

The authors describe the CT findings in 57 patients suffering from various non-neoplastic disease of the larynx: chronic laryngitis, pseudotumor, paralysis, post-traumatic lesions, laryngocele, cyst. CT is usefull in evaluating site and extension of the disease, as well as its relations with the surrounding tissues. The densitometric evaluation and the functional tests are important in differential diagnosis with malignant neoplasms.

Adolescent↗