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Biomedical subjects

O Catalano

Publications and source records attributed to O Catalano.

107 records · Page 6Linked to original sources
PubMedDate not supplied

Helical CT findings in patients with hepatocellular carcinoma treated with percutaneous ablation procedures.

Nonsurgical treatment of hepatocellular carcinoma is used worldwide as a result of the early detection and slow growth of this tumor in patients with chronic liver disease. Multiple-phase helical computed tomography is a commonly used method for evaluating the main features related to percutaneous ablation procedures: nodular changes, tumor necrosis, parenchymal changes, complications, and tumor recurrence. Knowledge of all features recognizable after local ablation therapy is mandatory to avoid diagnostic pitfalls and to optimally assess treatment response.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

[Multiple-phase spiral computerized tomography of small hepatocellular carcinoma: technique optimization and diagnostic yield].

PURPOSE: Spiral imaging has dramatically increased the diagnostic capabilities of Computed Tomography (CT) in the evaluation of small hepatocellular carcinomas (HCCs, O < 3 cm). We report our experience with multiple-phase CT of small HCC relative to both examination technique and lesion patterns. We compared the yield of biphasic (arterial-dominant + portal-dominant phases) and triphasic (arterial-dominant + portal-dominant + delayed phases) and also reviewed the literature for a meta-analysis of the techniques used. MATERIAL AND METHODS: December 1996 to July 1998, forty-eight patients with small nodular HCCs were examined--98 nodules in all (range 1-9, mean 2 per patient). After baseline CT, a nonionic contrast agent (350 mgI/mL, 130-140 mL, 4 mL/s) was administered through a power injector and a 16-gauge needle. Biphasic volume images were acquired in 19 subjects (early-phase delay 24 s, venous-phase delay 75 s) and triphasic images in 29 (early-phase delay 24 s, venous-phase delay 60 s, delayed-phase delay 100 s). Retrospectively we assessed the number of nodules detected with each protocol in every phase, nodule conspicuity (graded I-IV) relative to surrounding parenchyma, and nodule patterns in the various phases. Nodule patterns were distinguished into homogeneous, peripheral, central and mixed hyperdensity, and homogeneous hypodensity. RESULTS: Thirty-seven lesions were found in the patients examined with the biphasic technique: baseline images showed 35% of the nodules, arterial images 92%, portal images 76% and combined arterial and portal acquisitions 95%. Sixty-one lesions were found in the patients examined with the triphasic technique: baseline images showed 43% of the nodules, arterial images 93%, portal images 70%, and delayed images 77%; combined arterial and portal acquisitions detected 93% of the nodules, combined arterial and delayed images 95%, combined arterial and delayed images 80%. Finally, 95% of lesions were demonstrated when the three phases were combined. Overall conspicuity grades were I in 44% of cases, II in 28%, III in 18% and IV in 10% of cases at baseline scanning; I in 9%, II in 24%, III in 34% and IV in 33% in the arterial phase; I in 28%, II in 41%, III in 18% and IV in 13% in the portal phase; I in 23%, II in 30%, III in 26% and IV in 21% of cases in the delayed phase. At baseline, 10% of lesions were hyperdense (homogeneously and peripherally in 5% each); mixed density was seen in 8%, and hypodensity in 82%. In the arterial phase, 93% of lesions were hyperdense (homogeneously in 80%, peripherally in 10% and centrally in 3%); mixed density was seen in 5%, and hypodensity in 1%. In the portal phase, 4% of lesions were hyperdense (homogeneously in 1% and centrally in 3%); mixed density was seen in 11%, and hypodensity in 85%. In the delayed phase, the lesions appeared mixed in 11% of cases and hypodense in 89%. CONCLUSIONS: Spiral CT scanning of small HCCs requires dedicated and meticulous technique. Multipassage assessment is mandatory, with 2 or 3 dynamic acquisitions of the whole liver. No major difference in nodule detection was demonstrated between these two options and thus the choice rests with the radiologist's preference. Early CT images proved best for lesion detection, followed by delayed, venous, and baseline studies; lesion recognition depends largely on nodular diameter. The same applies to conspicuity, which however depends on tumor volume less. Lesion patterns are quite typical and constant in all phases and are independent of lesion diameter.

Adult↗
PubMedDate not supplied

[Doppler evaluation of thyroid hemodynamics after intravenous administration of contrast media].

PURPOSE: Duplex Doppler ultrasound allows the evaluation of thyroid gland vascular flow by spectral analysis assessment. The objective of this prospective study was to employ Doppler ultrasound to evaluate the possible functional changes produced in normal subjects following intravenous iodized contrast medium injection. MATERIAL AND METHODS: The study was performed on 30 non-consecutive subjects, enrolled according to some inclusion criteria: male gender, age ranging between 19 and 70 years, absence of chronic liver disease, absence of thyroid disease, absence of sonographic changes in the thyroid gland, negative history for recent intravenous contrast medium administration. All patients were scheduled for a contrast-enhanced CT study. A non-ionic contrast medium (iomeprol) was employed at 350 mgI/mL concentration, 130-140 mL volume, and 2-4 mL/sec. injection rate. The Doppler ultrasound examination was carried out immediately before and about 30 minutes after the CT study. The systolic velocity, diastolic velocity, the resistive index, and the pulsatility index were measured at the level of one of the four thyroid arteries. RESULTS: In most cases a slightly increasing trend of the four parameters considered was noted but none of these showed a statistically significant change. The mean systolic velocity was of 33 cm/sec. in the basal measurement and of 39 cm/sec. in the post-contrast measurement. The variation was positive in 17 cases, negative in 12, and absent in 1. The mean diastolic velocity was of 13 cm/sec. in the pre-contrast evaluation and of 14 cm/sec. in the second evaluation. The change was positive in 14 cases, negative in 12, and absent in 4. The mean resistive index was of 0.55 in the basal analysis and of 0.59 in the post-contrast one. The variation was positive in 20 patients, negative in 9, and absent in 1. The mean pulsatility index was of 0.99 in the basal measurement and of 1.14 in the second measurement. The change was positive in 23 subjects, negative in 5, and absent in 2. CONCLUSION: Our series shows that no significant change in Doppler spectral analysis of thyroid flow is evident after administration of iodized contrast media, at least in euthyroid subjects and with the contrast doses and the examination intervals employed in our study. Doppler ultrasound is confirmed as an accurate and objective procedure in the evaluation of thyroid gland flow and may represent a useful tool in functional studies, as well as clinical applications in the assessment of thyroid gland disorders.

Adult↗
PubMedDate not supplied

[Defecography study of outpouchings of the external wall of the rectum: posterior rectocele and ischio-rectal hernia].

PURPOSE: To report the clinical and defecographic features of posterior rectal wall outpouchings, i.e., posterior rectocele and ischiorectal hernia. MATERIALS AND METHODS: Sixty-six patients with posterior rectal wall outpouching (61 with posterior rectocele and 5 with ischiorectal hernia) were selected among the patients examined in the last two years for defecation disturbance. All patients underwent physical examination, rectoscopy and videodefecography. RESULTS: Posterior rectal wall outpouchings were detected at physical examination in 28 patients and at rectoscopy in 9 patients. Posterior rectocele, more frequent and bigger in men, was usually demonstrated at videodefecography as an outpouching of the lower portion of posterior rectal wall: this finding was visible only in the dynamic phases in 51 patients while it was seen also at rest in 10 patients. In 52 patients, posterior rectocele was associated with other abnormalities--i.e., anterior rectocele (64%), puborectal muscle syndrome (38%), descending perineum (33%), mucosal prolapse (33%) and intussusception (20%). An ischiorectal hernia, defined as a posterolateral ampullar outpouching deeper than 4 cm and already visible at rest, was identified in 5 patients. Descending perineum and anterior rectocele were the most common associated disorders. CONCLUSIONS: We report the clinical and defecographic features of these rectal abnormalities and stress the importance of videodefecography in the real-time study of these morphofunctional disorders.

Adult↗
PubMedDate not supplied

[Pneumoperitoneum caused by thoracic injury].

Among the various causes of free abdominal gas, there should be included those following chest injuries. In these cases, pneumoperitoneum may develop as a consequence of different physio-pathologic mechanisms and can be associated with pneumothorax and/or pneumomediastinum and/or retropneumoperitoneum. Gas can reach the peritoneal cavity in both blunt and penetrating chest traumas, following normal or abnormal pathways, i.e., diaphragmatic interruptions in the former case and congenital defects or post-traumatic diaphragmatic injuries in the latter case. In this trial, the authors investigated the clinical and semiologic meaning of this finding, frequently disregarded in traumatologic literature, which was observed in 6 cases of chest injuries: 4 blunt and 2 penetrating traumas. In this condition, even though conventional radiology remains the method of choice, CT can be considered as an integrative technique of great panorama allowing small amounts of free abdominal gas and related thoracic and abdominal injuries to be demonstrated, especially in the patients in forced supine decubitus, in whom abdominal plain films can be difficult to perform.

Adolescent↗
PubMedDate not supplied

[Functional ano-rectal disorders: associated defecographic findings and related symptoms].

We retrospectively analyzed our latest 564 defecographies to evaluate: the frequency of each single defecographic finding on the total number of patients and in the two sexes; the frequency of the finding as single disorder and in association with other anorectal disorders; the correlation between findings and symptoms. The most common disorders were anterior rectocele (54%), mucosal prolapse (53%), puborectalis muscle syndrome (15%), and intussusception (15%); this order is respected in women (70, 57, 17 and 16% of the study population) but differs in men (mucosal prolapse 42%, puborectalis muscle syndrome 18%, posterior rectocele 14%, and intussusception 14%). Intussusception and puborectalis muscle syndrome were identified as an isolated finding in many cases (55% and 43%, respectively). The most common associations are: posterior rectocele with anterior rectocele (58% of cases), anterior rectocele with mucosal prolapse and vice versa (63% and 64%), intussusception with anterior rectocele (52%), puborectalis muscle syndrome with mucosal prolapse (36%) and with anterior rectocele (49%) and descending perineum syndrome with anterior rectocele (81%) and with mucosal prolapse (70%). The low rate of association among some disorders should be mentioned too for example, mucosal prolapse is associated, with intussusception only in 10% of cases. Clinical-defecographic correlations are less apparent: if some symptoms are found to be more typical of some disorders, this correlation is not pathognomonic and the clinical picture is quite aspecific. We stress the value of a careful correlation between clinical-anamnestic and defecographic findings for the correct evaluation of these disorders.

Adult↗
PubMedDate not supplied

[Perforated carcinoma of the colorectum. Computerized tomography findings].

PURPOSE: To describe the possible CT features of perforated colorectal tumors and to discuss the practical value of detecting this complication. MATERIAL AND METHODS: The CT examinations of 16 patients with perforated large bowel neoplasms were retrospectively reviewed. The most frequent locations were the sigmoid colon (6 cases), the cecum and ascending colon (4 cases) and the descending colon (4 cases). A correlation with barium enema findings was possible in 12 patients while in 14 subjects surgical confirmation was obtained. RESULTS: The colorectal neoplasm was depicted on CT scans in 94% of cases, as a mural thickening or a mass, and was usually in the advanced stage. Phlegmonous tissue was shown only in 19% of the cases, while an abscess was detected in 81%, more frequently appearing as a well-defined fluid-filled collection near the tumor. Large bowel enema was positive for perforated neoplasm only in 5 cases. CONCLUSION: CT demonstrates perforated colorectal tumors better than conventional methods, which is a relevant information for both surgery and prognosis. In the diagnostic phase CT is indicated when clinical and/or barium enema findings are atypical. In the staging phase, the detection of this complication represents a valuable information.

Adult↗
PubMedDate not supplied

[Colonic interposition between kidney and psoas muscle: anatomical variation studied with CT].

Interposition of the colon between kidney and psoas muscle may represent a benign anatomical variant that can be recognized on Computed Tomography (CT) images. In our series including 428 abdominal CT examinations, the position of the bowel in the pararenal space was studied with respect to the kidney and the psoas muscle. To determine the colon position in the pararenal space, three CT scans, at the upper pole, midkidney and lower pole, for each side, were selected. The colonic interposition between the kidney and the psoas muscle was then correlated with patient's age, sex and amount of perinephric fat. The ascending colon was interposed between the kidney and the psoas muscle in 6/428 cases (1.4%), appearing more frequently in adult men. Of these 6 cases, CT showed decreased perinephric fat in three cases, normal in one and increased in two. No case of descending colonic interposition between the kidney and the psoas muscle was demonstrated. CT is a valuable tool to depict this anatomical variation, preventing misdiagnoses and complications arising from interventional procedures.

Adult↗