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M Scialpi

Publications and source records attributed to M Scialpi.

34 records · Page 2Linked to original sources
PubMed1995

[Computed tomography in gunshot trauma. I. Ballistics elements and the mechanisms of the lesions].

The knowledge of wound ballistics and of wounding mechanisms is mandatory for the radiologist to interpret the CT findings of gunshot wounds. The severity of a bullet wound depends on the characteristics of the tissue it goes through, i.e., tissue elasticity, density, thickness of the wounded body part, the type of tissue, its specific gravity, internal cohesiveness and anatomical relationships, as well as on missile characteristics, i.e., mass, shape, fragmentation and deformation. Bullet velocity is certainly a major factor in wounding, but it is only one factor. Two major wounding mechanisms exist the crushing of the bullet-struck tissue (forming the permanent cavity) and radial stretching (forming a temporary cavity). Bullet "yaw" is defined as the angle between the long axis of the bullet and its flight path. The yaw is directly proportional to tissue crushing and stretching: the wider the yaw, the most severe tissue crushing and stretching and, therefore, the more severe tissue damage. The basic knowledge of these concepts is of the utmost importance to understand the CT findings of gunshot wounds and can help physicians study and treat gunshot wounds.

Firearms↗
PubMed1993

Rectal carcinoma: preoperative staging and detection of postoperative local recurrence with transrectal and transvaginal ultrasound.

Transrectal ultrasound (TRUS) was performed preoperatively in 35 patients with rectal carcinoma and the results were compared to histologic findings. In the same group, postoperative studies were performed in 22 patients; in women, transvaginal ultrasound (TVUS) was added to the transrectal study. According to Duke's classification modified by Astler-Coller, in relation to the "T" parameter, TRUS correctly staged 33 of 35 neoplasms (accuracy, 94.3%); one was overstaged and one was understaged. In detection of lymph node involvement, accuracy was 74% (sensitivity 69%, specificity 73.9%). Recurrent local tumors, histologically confirmed, developed in two of 22 postoperative patients who had undergone curative anterior resection. This study demonstrates that TRUS is an accurate method in preoperative staging of rectal carcinoma. In the prospective study, the role of follow-up TRUS and TVUS in detection of local recurrences is evaluated.

Adult↗
PubMed1993

[Transvaginal echography in the study of the rectum. A new method with rectal distension with water].

Transrectal sonography (TRUS) accurately assesses the depth of invasion in the staging of rectal carcinomas. However, the method is limited in the evaluation of upper rectal and highly stenotic rectal cancers. These conditions can be demonstrated in female patients by transvaginal sonography (TVUS) with a 5-MHz convex probe. Conventional TVUS becomes even more accurate when the rectum is distended with water. Twenty-one asymptomatic female patients were examined in a prospective study to assess the value of conventional versus water-distended TVUS. Water improves rectal depiction because it eliminates air and fecal artifacts. In our series, the rectum was demonstrated from anum to rectosigmoid junction in all cases. The whole rectal outline could also be demonstrated. Besides rectal lumen evaluation, the method allowed rectal wall layers and perirectal fat to be detailed. Subsequently, 14 female patients were examined--8 during the preoperative staging and 6 during the follow-up. In preoperative patients, the extent of stenosing rectal cancer and perirectal fat infiltration were assessed; in postoperative patients rectal recurrences were excluded. In conclusion, TVUS with rectal distension by means of water is a new diagnostic procedure which can markedly improve the US imaging of highly stenosing rectal cancers.

Aged↗
PubMed1992

[Echography in the study of the neonatal hip: the diagnostic-therapeutic implications of type-IIa (borderline) findings].

Sonography (US) is a useful method in the early diagnosis of congenital hip dislocation; X-ray examination exhibits limitations due to high false-positive and false-negative rates. The advantages of US include: non-invasiveness, direct visualization of muscle and cartilage, dynamic demonstration of anatomical structures, and possible diagnosis in neonatal age. Therefore, US can be used as a screening or targeted diagnostic technique in selected newborns with clinical suspicion and/or risk factors. In this paper the authors report their experience in 1271 patients (721 females, 550 males), aged 1 day to 7 months, who were examined with US for the diagnosis of congenital hip dislocation. The newborns were divided into two groups at first examination: a) the screening group included 524 consecutive newborns (F = 266, M = 258) from S. Chiara Regional Hospital in Trento, and b) a selected group of 747 newborns (F = 455, M = 292) with clinical suspicion and/or risk factors, who had been selected in the Trento area. According to Graf's classification, the results of US in 2542 neonatal hips, were: 2346 (92.3%) normal hips, 171 (6.1%) type IIa hips, and 24 (1.6%) pathological hips. In the selected group (1494 hips) we observed: 1351 (90.4%) normal, 119 (8%) type IIa, and 24 (1.6%) pathological hips (IIb, IIc, D, III). In the screening group (1048 hips) we detected: 995 (95%) normal hips (Ia/Ib), 52 (4.9%) type IIa, and 1 (0.1%) pathological hips (D). Our experience suggests that US is a useful method in selected newborns with clinical suspicion of congenital hip dislocation and/or risk factors. US limitations consists in the dispersion of type IIa hips. Moreover, the need emerged for complete cooperation between pediatrician, radiologist, and orthopedist to optimize the cost/benefit ratio.

Female↗
PubMed1992

[A rare case of idiopathic staghorn urolithiasis in childhood. Imaging diagnosis].

The authors describe one case of kidney staghorn lithiasis in a little patient 1 1/2 years old, as complication of a megacalycosis with associated pyelo-ureteral junction dysplasia. They underline the value of ultrasound both as a first examination and, particularly, in the follow up because of the non invasivity of the technique and the correct information about the persistence of calculi and dilatation.

Follow-Up Studies↗
PubMed1991

[Mega-poly-calicosis. Apropos of a case with prenatal and postnatal diagnosis].

We report the first published case of megapolycalicosis with prenatal ultrasound diagnosis. Pyeloureteral junction dysplasia was observed only after delivery. The etiopathogenesis of megapolycalicosis (MPC) and its hypothetical association with uretero-pelvic junction obstruction are discussed. Presence of polycalicosis, good glomerular filtration and absence of compensatory controlateral renal hypertrophy are determinant in the diagnosis.

Diagnosis, Differential↗
PubMedDate not supplied

A new method for study of the rectum using transvaginal ultrasound with water enema.

BACKGROUND: To propose a new method for the ultrasound study of the rectum. METHODS: Twenty-one healthy female patients, 58-72 years old, were examined. To achieve optimal filling and distention of the rectum, the examination was performed with the patient in the right lateral decubitus position. After placing the probe into the vagina, 1000-1500 mL of water warmed to 35 degrees C was introduced into the rectum through a cannula. After the rectum was completely full, the cannula was extracted. Images were obtained before and after rectum distention on the transverse plane by using a 5.0-MHz convex radial endocavitary probe. RESULTS: Using water eliminated air and fecal artifacts, so rectal wall layers were reliably demonstrated, with the rectal ampulla well distended. In addition, the rectum in whole circumferential extension and the perirectum fat were clearly visualized. CONCLUSION: This new method is useful for study of the rectum.

Adipose Tissue↗
PubMedDate not supplied

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↗
PubMedDate not supplied

[Gunshot wounds of the cranium studied with computerized tomography. Personal experience in 23 cases].

INTRODUCTION: Gunshot wounds to the head are usually mortal injuries. Their frequency has been increasing in the last years because of increasing crime rates. Gunshot wounds to the head require close clinical and diagnostic cooperation of the neurosurgeon and radiologist, detailed assessment of skull and brain damage, and finally prompt treatment. Emergency Computed Tomography (CT) makes a useful tool for depicting bullet course and brain damage, and thus helps plan treatment. We investigated the CT signs of subdural hematoma, lacerocontusive focus, subarachnoid hemorrhage, hemoencephalus, skull bone fracture and thecal hollow and report them as an aid to the neurosurgeon and the radiologist, for best treatment planning, and in an attempt to establish useful prognostic criteria. MATERIAL AND METHODS: We retrospectively reviewed 23 cases of gunshot injuries to the head studied with CT at the Emergency Unit of Loreto Mare Hospital in Naples, Italy. Twenty patients were men and 3 women; their mean age was 31 years (range: 18-49). Three women and 2 men had been injured accidentally by wandering bullets, and one case was an attempted suicide; all the other cases resulted from shootings. CT slices were 10 mm thick, with 8 mm gap (5 mm in complex injuries and when posterior cranial fossa was involved); all scans were unenhanced. RESULTS: We found 22 penetrating gunshot wounds: 13 of them with thecal entry hole and intracranial bullet retention and 9 with an entry and an exit hole. One case was a superficial wound. Crash skull fractures were seen in 22 cases and they were fragmented in 12, with overlapping thecal fragments in 4, and with deep fragments in 2 cases. There were scattered bone splinters in 3 cases and the bullet was retained in the mastoid bone in one case. Lacerocontusive foci were assessed in 22 cases, brain swelling in 20, subarachnoid hemorrhage in 19, brain hematoma in 15, blood in the ventricular system in 9, pneumoencephalus in 7, air bubbles along the bullet course in 7, impression on ventricula and linear structures in 7, interhemispheric blood in 5, and finally blood effusion in Sylvian scissure in 4 cases. DISCUSSION AND CONCLUSIONS: Gunshot wounds to the head are complex and severe traumas with high mortality rates because of both early and late effects and complications. CT provides the neurosurgeon with abundant findings for diagnosis and surgical planning, which may result in improved survival rates. In these patients emergency CT plays a fundamental diagnostic role in depicting brain damage and thus remains the method of choice for thorough, rapid and accurate brain and skull studies, as well as to detect possible injury to the chest and abdomen.

Adolescent↗
PubMedDate not supplied

MR findings in a case of exogastric stromal tumor of the stomach.

A case of gastrointestinal stromal tumor of stomach investigated with US, CT, and MRI is reported. On imaging, the neoplasm arises from the wall of the gastric fundus and appears well circumscribed and sharply demarcated from the adjacent structures. MRI provides an excellent means of evaluating the site and extension of this neoplasm and enables accurate surgical planning. The authors stress that there has been recently widespread scientific and clinical interest in GIST (gastrointestinal stromal tumor) because its principal pathogenetic defect has been identified and a specific molecular inhibitor of GIST has been developed.

Aged↗
PubMedDate not supplied

[Opportunistic infections in AIDS. The pulmonary manifestations].

The initial and follow-up chest radiographs of 31 patients with the acquired immunodeficiency syndrome (AIDS) were reviewed to assess the spectrum and frequency of opportunistic pulmonary infections. In our series, the most common pulmonary infections seen on chest films were: Pneumocystis carinii pneumonia (PCP) (n = 17), PCP associated with Cytomegalovirus (CMV) (n = 2), PCP associated with Mycobacterium avium-intracellulare (MAI) (n = 1), Mycobacterium tuberculosis (n = 7), CMV (n = 2), MAI (n = 1) and Cryptococcus neoformans (n = 1). Diffuse or focal interstitial infiltrate is the most common finding in PCP; bilateral focal or multilobar interstitial infiltrates are also frequently observed: they are usually caused by PCP or by PCP associated with CMV. Infiltrating cavitating lesions and multiple interstitial well-defined nodules < 10 mm diameter were seen only in Mycobacterium tuberculosis infections. Normal chest findings and/or pleural effusions were uncommon; no case exhibited pulmonary cysts on initial radiographs. In this retrospective study we emphasize the high incidence of Mycobacterium tuberculosis infections; other pulmonary infections are emerging in AIDS. The X-ray patterns of pulmonary infections in AIDS must be known for a prompt and accurate diagnosis and to plan the appropriate treatment.

AIDS-Related Opportunistic Infections↗