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Biomedical subjects

P Colletti

Publications and source records attributed to P Colletti.

32 records · Page 2Linked to original sources
PubMed1988

Acute pancreatitis: secondary findings on hepatobiliary scintigraphy.

Review of hepatobiliary scintigrams in patients with serologically documented pancreatitis revealed scintigraphic abnormalities in 19 of 21 studies (90%) in 19 patients. Abnormalities included duodenal loop widening (14/21 or 65%) and duodenogastric reflux (10/21 or 48%). Total biliary obstruction was seen in five studies, thereby precluding evaluation of the gastrointestinal phase in these patients. Excluding these, duodenal loop widening and duodenogastric reflux were seen in 88% and 63% of patients respectively. We evaluated three patients in whom initial scans showed obstruction, but repeat examination showed resolution of obstruction following passage of common duct stone, with duodenal loop widening and duodenogastric reflux suggestive of acute pancreatitis. Duodenal loop widening as demonstrated by hepatobiliary scintigraphy is a sign of pancreatic enlargement in acute pancreatitis, whereas duodenogastric reflux appears to be an indirect manifestation of an adjacent inflammatory process.

Acute Disease↗
PubMed1988

Comparison of computer and non-computer-assisted technologies in noninvasive cardiac imaging.

We compared gated magnetic resonance imaging (MRI) and dynamic computed tomography (DCT) with two-dimensional cardiac ultrasound (ECHO) to assess differences in diagnostic information. Magnetic resonance imaging was performed in 41 patients; ECHO in 36, and DCT in 28 patients with various pathologic conditions. We measured the left and right ventricular (LV, RV) long and short axes (LA, SA), LV free wall and septal thickness (WT, ST) at end systole (ES) and end diastole (ED) on the apical four-chamber view (ECHO) or appropriate transaxial slice (MRI, DCT) on a subset of 14 patients. Paired-sample analysis of these three techniques, in this preliminary data, yields statistically different results as follows: LV SA: MRI versus ECHO at ED and ES (P less than 0.001 and 0.005); WT: MR versus ECHO at ES (P less than 0.002); CT versus ECHO at ED and ES (P less than 0.05 and 0.01); ST: MRI versus ECHO at ED and ES (P less than 0.001), and CT versus ECHO at ES (P less than 0.05). Thus, CT and MRI yield similar quantitative data, but both differ in varying degree from ECHO measurements. Differential accuracies and utilities of these techniques warrant further careful investigation.

Echocardiography↗
PubMed1987

Aortic ejection fraction: a new hemodynamic parameter and its relationship to aortic insufficiency.

Pulsations of the ascending aorta during fluoroscopy in patients with aortic insufficiency (AI) have been described. The authors present their observations of a similar phenomenon in patients who have AI undergoing scintiangiography. In addition, this paper describes a technique to validate and quantitate this finding. They studied 17 patients with documented AI and 14 subjects of a control group. First-pass studies were acquired in the RAO 15 degrees projection. Regions of interest were placed over the proximal aorta during systole and diastole. An aortic ejection fraction (AF) was determined. The calculated AEF data were correlated with the presence or absence of AI. The mean AEF from the 17 AI patients was 27.1 +/- 7.2%, while the mean for the non-AI group was 12.0 +/- 6.5% with p less than .001. An AEF of 18% separates the two groups with a sensitivity, specificity, and accuracy of 88%, 86%, and 87% respectively. Preliminary data demonstrate a mean reduction in AEF of 12.2 percentage points in 7 AI patients who underwent aortic valve replacement. The AEF may be a useful new parameter to evaluate hemodynamic changes associated with aortic valve replacement in patients with aortic insufficiency.

Adult↗
PubMed1987

Sonographic features of amebic and pyogenic liver abscesses: a blinded comparison.

We blindly compared the sonographic findings in amebic (112 lesions) and pyogenic (30 lesions) liver abscesses. Two sonographic features were significantly more prevalent in amebic abscesses: the lesions had a round or oval shape and the lesions had an echogenicity that was lower than that of normal liver and were internally homogeneous on high-gain scans. Amebic abscesses were round or oval in 92 instances (82%), while 18 pyogenic abscesses (60%) (p less than .01) had these shapes. Fifty-nine (58%) of 101 amebic abscesses displayed low echogenicity and homogeneous internal echoes with high-gain settings compared with nine (36%) of 25 pyogenic abscesses (p less than .04). Despite these different sonographic patterns, image findings alone were inadequate in distinguishing pyogenic from amebic liver abscesses. However, when the sonographic findings were coupled with clinical and laboratory data, a correct diagnosis was possible in 83 (86%) of 96 patients with amebic abscess. It appears that, although some sonographic features of amebic abscess differ from those of pyogenic abscess, these differences are not sufficient to allow a specific diagnosis on the basis of sonography alone. Sonography can expedite abscess detection and, when coupled with clinical and laboratory data, can aid in differentiating pyogenic from amebic liver abscesses.

Humans↗
PubMed1986

Pelvic lesion simulated by asymmetric marrow uptake following umbilical artery injection of technetium-99m sulfur colloid.

There is avid first-pass extraction of Tc-99m sulfur colloid by bone marrow. This factor must be considered when injection of the isotope is made via an unusual route. Tc-99m sulfur colloid was injected via an umbilical artery catheter into an infant's left iliac artery, causing marked marrow uptake in the left pelvis. The paucity of uptake on the right side of the pelvis simulated metastatic replacement of the marrow. A repeat study done via the jugular vein demonstrated no abnormalities of pelvic marrow uptake.

Bone Marrow↗
PubMed1984

Thallium 201 exercise scintigraphy for detection of multivessel coronary artery disease after transmural myocardial infarction.

Fifty patients with prior transmural myocardial infarction were studied with cardiac catheterization, coronary angiography, and thallium 201 exercise perfusion scintigraphy.Obstructive coronary disease involved two or three vessels in 37 patients. The sensitivity of a positive electrocardiographic test during exercise for detecting multivessel coronary disease was only 40 percent (15/37), and the sensitivity of a reversible defect on (201)Tl perfusion scintigraphy was 48 percent (18/37). The combination of exercise testing and (201)Tl scintigraphy detected multivessel coronary disease in 75 percent (28/37) (P < .05).New perfusion defects occurred in 61 percent (13/21) of patients with inferior myocardial infarction and multivessel coronary disease whereas it occurred in only 35 percent (5/14) of patients with prior anterior infarction and multivessel coronary disease (P < .05).(201)Tl exercise perfusion scintigraphy appears to be more sensitive for detecting significant multivessel coronary disease in the presence of previous inferior infarction compared with previous anterior infarction.Combined graded exercise testing and (201)Tl perfusion scintigraphy can reliably detect the presence of significant multivessel coronary disease after transmural myocardial infarction.

Adult↗
PubMed1983

Posttraumatic intrahepatic biloma: sonographic diagnosis.

Posttraumatic intrahepatic biliary cysts or bilomas were once thought to be rare. With increased use of sonography and 99mTc-HIDA cholescintigraphy, this entity will probably be detected more often. Preoperative sonographic diagnosis of posttraumatic biloma was made in five patients. A well circumscribed, anechoic hepatic lesion with excellent distal sonic enhancement strongly suggests the diagnosis. Cholescintigraphy especially using delayed scans or percutaneous aspiration, can confirm the diagnosis.

Adult↗
PubMed1982

Sonography in the diagnosis and management of hepatic amebic abscess in children.

Hepatic amebic abscess is a potentially fatal infection which is difficult to diagnose in children. Sonography is an ideal non-invasive imaging tool which can prove invaluable in the diagnosis and management of hepatic amebic abscess. Sonographic findings should suggest the correct diagnosis in most instances. This allows prompt initiation of therapy, forestalling life-threatening complications. Sonography is also an extremely useful non-invasive means of following response to therapy in children with hepatic amebic abscesses.

Child↗
PubMed1982

Sonography of pyogenic splenic abscess.

Pyogenic splenic abscess is an uncommon lesion associated with high mortality. Diagnosis may be difficult, especially in deep-seated abscesses. Plain radiographs and nuclear medicine techniques may be helpful, but can be insufficiently specific. Sonography, which images morphologic changes, is useful in assessing splenic abscesses. Five of six abscesses had a predominantly anechoic pattern with internal foci of higher echogenicity. In one gas-containing lesion, there were high amplitude echoes throughout the abscess. The abscesses were easily distinguishable from the surrounding homogeneous normal spleen. Sonography, while not definitive, is an effective tool in reaching an early diagnosis of splenic abscess. This allows prompt splenectomy, ameliorating prognosis.

Abscess↗
PubMed1980

Efficacy and tolerance of ceruletide in radiography of the small intestine.

In a study of 30 patients, the intramuscular injection of ceruletide (0.3 microgram/kg) was safe and effective and resulted in a substantial decrease in the transit time required for the passage of barium to the ileocecal area. The median intestinal transit time following injection of ceruletide was 15 minutes as comapred to 80 minutes following a saline placebo. Adverse reactions were minimal and self-limiting.

Ceruletide↗
PubMedDate not supplied

MR findings in patients with acute tibial plateau fractures.

OBJECTIVE: The purpose of this study was to demonstrate the MRI findings associated with acute tibial plateau fractures. MATERIALS AND METHODS: MR scans of 29 patients with acute tibial plateau fractures were analyzed retrospectively. The images were evaluated for the presence of injuries involving the menisci, cruciate and collateral ligaments. The presence of a lipohemarthrosis or a simple joint effusion was also noted. The tibial plateau fractures were classified according to the scheme devised by Schatzker. RESULTS: Evidence of internal derangement of the knee was found in 28 (97%) patients. Tibial collateral ligament (55%) injuries and lateral meniscus (45%) tears were noted most frequently. Medial meniscus tears were seen in 21% and fibular collateral ligament injuries were diagnosed in 34%. Forty-one percent had anterior cruciate ligament injuries while the posterior cruciate ligament was injured in 28%. Twelve (41%) patients demonstrated the characteristic MRI features of a lipohemarthrosis. Simple joint effusions were found in the remaining 17 (59%) patients. CONCLUSION: MR imaging in patients with acute tibial plateau fractures commonly demonstrates associated ligamentous and meniscal injuries. By imaging in multiple planes, MRI can aid in the accurate characterization of tibial plateau fracture patterns and severity.

Adult↗
PubMedDate not supplied

MR imaging of neurocysticercosis.

Magnetic resonance (MR) was performed in 50 patients with neurocysticercosis. Comparison was made with other neuroradiological imaging modalities including CT, myelography, CT ventriculography, and CT myelocisternography. Eighteen patients were found to have intraventricular cysts. In several patients, these were multiple and 22 intraventricular cysts were discovered. Although 4 of the 22 ventricular cysts were missed by MR, T1-weighted images can play a significant role in the early detection of intraventricular cysticercosis cysts, showing the cyst wall (9 of 22), a high intensity mural nodule (6 of 22), and increased signal intensity of the cyst fluid (5 of 22). Cisternal cysts (14 cysts in 10 patients) could be identified; they appear similar to intraventricular cysts, but mural nodules are infrequently seen (1 of 14). Twenty-nine patients had 69 parenchymal cysts. An attempt was made to assess the viability of these parenchymal lesions by matching the CT and MR findings with the Escobar pathologic staging system. Neuroimaging findings seemed compatible with early parenchymal lesions in the vesicular stage in 11 instances. Findings in cases with later stage cysts tend to support the concept that a dying larva provokes pronounced inflammatory reaction in the adjacent brain. Computed tomography remains the superior modality for depicting parenchymal calcifications within dead larvae. A case of a spinal cysticercosis cyst demonstrated with MR (in a patient with extensive intracranial cisternal cysts and a fourth ventricular cyst) is described.

Adolescent↗
PubMedDate not supplied

MR imaging of pineal region neoplasms.

Twenty-eight patients with tumor of the pineal region underwent magnetic resonance (MR) examination. Gadolinium DTPA was given to 13 patients. Histologic confirmation was obtained in all patients, including 10 germinomas, 4 pineocytomas, 4 pineoblastomas, 5 astrocytomas, 2 teratomas, 1 choriocarcinoma, 1 mixed germ cell tumor, and 1 metastasis from breast carcinoma. Pineal region neoplasms have remarkable heterogeneity in both histopathologic and MR appearances. Gadolinium DTPA enhanced MR increases the specificity of diagnosing pineal region neoplasms. In addition, Gd-DTPA provides better delineation of the tumor margin and demonstrates cystic components of the neoplasm. Our approach to pineal region neoplasms is to make a decision about whether stereotaxic biopsy or surgery should be performed on a certain patient. When a pineal region neoplasm is diagnosed as benign, such as a benign teratoma, on the basis of imaging, surgery is performed to resect the entire lesion. When a definitive diagnosis is not possible, sterotaxic biopsy is performed to obtain histological diagnosis for treatment planning. Gadolinium DTPA enhanced MR plays an extremely important role in target selection in stereotaxic biopsy of pineal region neoplasms and is also useful in the early detection of intracranial seeding. Spinal seeding is demonstrated on MR as well, thus alleviating the need for a contrast myelogram. Finally, Gd-DTPA enhanced MR can be used to monitor the effects of the various treatment modalities employed for pineal region neoplasms.

Adolescent↗