Biomedical subjects
Publications and source records attributed to N Villari.
The authors report their experience using CT examination in implantology, outlining the advantages of this method in the study of the perimplantar bone, both in cases undergoing a favourable evolution and in those with an unsatisfactory outcome.
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Magnetic resonance evaluation of 28 cases of pituitary adenomas has shown remarkable accuracy. Compared with HR-CT, MR gives comparable results in tumour identification. MR better demonstrates the suprasellar extension of macroadenomas and their relationship to the visual pathway and is more effective in showing direct and indirect signs of microadenomas. HR-CT however better recognized bone abnormalities of the sella turcica, due to adenomas. A typical increased signal intensity has been demonstrated in most of the adenomas studied.
CT findings regarding chest wall recurrences in 19 breast cancers previously treated with radical mastectomy are reported. CT provides detailed information on the endothoracic extension of the tumoral spread.
The abdominal C. T. of 128 patients (45 women and 83 men) aged more than 25, without any history of renal disease, have been analyzed by an evaluation computer. By the measure of the areas of kidney in each C. T. scan, the volume of the whole organ has been calculated. In men the volume resulted to be cm3 167 +/- 84,6 (M. +/- S.D.) for the right kidney and cm3 170 +/- 58 for the left one. In women it was cm3 142 +/- 54,9 for the right kidney and cm3 156 +/- 54,5 for the left one. The volumes of the organs collected into 3 classes according to their dimension, have been compared to the 3 somatic types of the subjects (Mega, Medium, Micro) obtained following the Brian & coll. method. Using a test for a monotonic trend for two ordered variables, no significant association has been demonstrated between the volume of the kidney and the human somatic type.
Three cases of cystic dilatation of the biliary tract of 1st, 4th and 5th type are reported here according to the classification established by Longmire and Hadad amended. In two patients the diagnosis was carried out through ultrasound examination and confirmed, in one case, by intraveinous cholangiography associated to computed tomography (and by peroperatory cholangiogram in the other one). In the third patient suffering from Caroli's disease the diagnosis was carried out during peroperating cholangiography. The possibilities of the different methods in diagnosing cystic dilatations of the biliary tract are discussed and therapeutic problems are taken into consideration.
The vascular impressions on the renal pelvis and caliceal system may assume an important role in the study of some patients with hematuria and renal pain of unclear origin. 50 patients presenting vascular impressions on the calices and renal pelvis have been studied. In 12 patients (24%) the impressions were bilateral and in 38 (76%) unilateral: in 35 patients (70%) the right kidney was involved. In each patient the morphological pyelocaliceal variations have been studied with cine-roentgen-dynamic investigations and in 30 angiography was also performed. Interesting results have been obtained with cine-roentgenographic investigations during forced diuresis allowing differentiation between intrinsic and extrinsic lesions of the renal collecting structures, without resorting to more complex investigations such as angiography.
A mediastinal mass consisting of haematopoietic tissue and situated in the paravertebral area has been demonstrated in an osteomyelosclerotic patient with diffuse extramedullary haematopoiesis. The internal structure of the mediastinal mass was shown by CT, so a correct diagnosis was made without any invasive procedure.
The files and the roentgenographic documentation of 624 patients affected by Hodgkin's disease have been reviewed. The presence and location of involved nodes in the different lymph node chains of the mediastinum have been determined and correlated with the distribution of the main anatomoclinic prognostic parameters of the disease. Feminine sex, histology of nodular sclerosis, presence of constitutional symptoms and age younger than 36 were found to be significantly more frequent in patients with mediastinal adenopathies than in patients with a normal mediastinum. Patients with mediastinal adenopathy at presentation were also more likely develop pulmonary involvement as first evidence of new manifestation of disease after the primary treatment. A different probability to be affected by disease was evident among the different lymph node groups in the mediastinum. The involvement of hilar nodes appeared to accompany a more advanced stage of disease and to favour the adjacent lung extension.
The results of ultrasound and computer tomography in 150 patients with possible focal liver disease were compared. Ultrasound was more sensitive than CT in detecting lesions but similar information on the nature of the lesions was obtained with both methods. CT provided more complete information than US on the extent of the lesion. Thus, CT and US are supplementary in the evaluation of focal liver disease. Because of the higher sensitivity US should be the first examination, followed, if clinically indicated, by CT confirmation and possible further information regarding the extent of the lesion.
The value of CT and lymphography of the retroperitoneum was compared in 31 patients with testicular tumors. In no patient with normal or equivocal lymphography was more information gained by CT. In abnormal cases, the presence of metastatic deposits was well detected at both examinations, but CT proved more useful in defining the exact extent of the tumor and facilitated the proper arrangement of the irradiation fields. A strategy in the sequence of investigation in testicular tumors is suggested, aiming to save CT time when CT information is not likely to be of significance for treatment planning.
The diagnostic efficacy of mammography and physical examination, separately and considered together, are evaluated in 912 cases of breast cancer detected at the Center for Social Diseases of the Florence District, where there is a mass-screening program (110 cases) and a diagnostic service for self-referred women (810 cases). The overall sensitivity of the 2 methods increases with age; the trends of diagnostic efficacies of mammography and palpation according to age are similar, except in the 40-44 year age group, in which physical examination has a lower percentage of false-negative cases. In the screening group, there is a greater proportion of nonpalpable cancers and mammography has a larger diagnostic efficacy except in the 40-44 year age group. These results agree with the better sensitivity of mammography in smaller lesion (TI) and with the larger proportion of noninterpretable mammographies in younger women, because of the density of mammalian glands.
After an anatomical and anatomo-radiological introduction, the authors describe the morphological aspect of the thoracic duct examined by means of lymphangiography performed during computed tomographic examinations.
Two cases are presented in which epatography occurred following lymphangiography. The morphologic findings and their changes in subsequent controls are described. Attention is pointed on the uncommon persistance of epatography for a few months from lymphangiography.
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The association of pharmaco-angiography with norepinephrine and transcatheter arterial embolization is a technique used to obstruct arteries invaded by renal carcinoma. We treated 4 patients with this method before nephrectomy and recommend its use as a complement to an operation for renal carcinoma or as definitive treatment in poor surgical candidates.
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