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P Pavone

Publications and source records attributed to P Pavone.

At least 55 records · Page 3Linked to original sources
PubMed2000

[Calcified renal metastases: their etiology, pathogenesis, computed tomographic aspects and differential diagnosis].

PURPOSE: To describe CT findings of calcified renal metastases focusing on differential diagnosis problems. MATERIAL AND METHODS: We retrospectively reviewed abdominal CT scans of 8000 patients with tumor, performed from 1984 to 1998. Among the 58 renal metastases, 9 showed a calcific component. We evaluated the location, morphostructural pattern, histology of the primary lesion, the synchronous or metachronous character and the type of treatment. All the lesions were pathologically proved. RESULTS: The primary histotype of the 9 metastases was as follows: 4 mucin-producing adenocarcinomas of the large bowel, 1 gastric mucinous adenocarcinoma, 1 chondrosarcoma, 1 osteosarcoma, 1 melanoma, 1 papillary thyroid carcinoma. In all the cases the renal metastasis was unilateral and unifocal. Granular multiple calcifications were demonstrated within the metastases of mucin-producing adenocarcinoma of the large bowel (3), within the metastasis of chondrosarcoma (1) and of melanoma (1). Diffuse "star-like" calcifications were demonstrated in renal metastases of mucin-producing adenocarcinoma of the large bowel and of gastric mucinous adenocarcinoma (1). Peripheral "egg-shell" calcifications were demonstrated in renal metastasis from papillary thyroid carcinoma (1). Completely calcified monofocal calcification was demonstrated in renal metastasis from osteosarcoma (1). DISCUSSION AND CONCLUSIONS: Calcified renal metastases are rare lesions related to specific oncotypes. The differential diagnosis (carcinoma with calcifications, osteosarcoma, chondrosarcoma, nephrocalcinosis, granulomatosis, hydatidosis etc.) is particularly difficult because of the aspecificity of the morphostructural pattern. Diagnosis is based on a history of specific oncotypes (papillary and mucin-secreting carcinomas, osteosarcoma and chondrosarcoma), but in most cases it requires pathologic confirmation.

Aged↗
PubMed2000

[Gastric tumors with fatty components. CT findings and differential diagnosis].

PURPOSE: To assess the role of CT in diagnosing and characterizing gastric fatty tumors. MATERIAL AND METHODS: We reviewed the CT scans of 16 patients (8 men, 8 women, mean age 52 years) with gastric fatty tumors (11 lipomas, 3 liposarcomas, 1 angiolipoma, 1 teratoma) examined from 1990 to 1999. The differential diagnosis considered primary and secondary lipomatosis, carcinoma engulfing the perivisceral fat and thus mimicking a liposarcoma, mesenchymal gastric and primary peritoneal tumors. RESULTS: Lipomas involved the fundus (7/11), the body (3/11), the antrum (1/11). Multifocality was found in one case. Lesions size ranged 25 to 65 mm (mean 35 mm). All the lipomas showed homogeneous structure with negative (-30 -100) HU values. A pseudocapsule was demonstrated in 7/11 cases. No infiltrative growth was demonstrated. The angiolipoma located in the fundus showed a vascular component with strong contrast enhancement. All the liposarcomas were bigger than 10 cm and there was a strong correlation between pathologic specimen and CT findings. The differentiated liposarcomas showed the classic heterogeneous fatty density; on the contrary the myxoid and the pleomorphic types showed an aspecific structure with necrotic/cystic changes, mostly demonstrated in the myxoid type. The teratoma was a solid mass with fatty, solid, necrotic and calcified components. CONCLUSION: CT allows the diagnosis and characterization of gastric fatty tumors. The preoperative diagnosis of lipomas plays a major clinical role because it often makes surgery unnecessary.

Adult↗
PubMed2000

[Tridimensional (3D) reconstruction in the osteoarticular area].

Three-dimensional reconstruction techniques have been used since the development of computed tomography. In skeletal radiology they have been used to better visualize fractures and spatial relationships between fragments in maxillo-facial surgery. Aim of this paper is to illustrate the most important reconstruction techniques and their application in skeletal radiology. Images can be obtained by means of a Spiral CT scanner with the following parameters: collimation/pitch/reconstruction interval 2/1/1. Acquired images are sent to a workstation with a software running on a Window NT platform Vitrea 2.01 (Vital Images, USA) equipped with Volume Rendering algorithm. SSD as well as MPR and curved reformatted reconstruction algorithms is available at the CT console. Three-dimensional reconstruction have been shown to be useful for the diagnosis and for a preoperative planning. Other applications of three-dimensional reconstruction techniques are prosthesis engineering and biomechanic research. 3D images help the communication between radiologist and surgeons. Technical advances in acquisition methods and in reconstruction algorithms are needed to improve image quality and use in skeletal radiology.

Arthrography↗
PubMed2000

[Rotator cuff rupture. Diagnostic imaging].

Conventional radiography, ultrasound, Magnetic Resonance (MR), Arthrography Computed Tomography (Arthro-CT) and Arthrography Magnetic Resonance (Arthro-MR) are available for diagnosis of rotator cuff tears. Our purpose is to assess the specificity and sensitivity of these examinations and if they could give to the surgeon all the informations to select the more accurate treatment. We have evaluated retrospectively the images of 68 patients, 43 male and 25 female (average age 51 years), which then have been surgically treated for rotator cuff pathology. On the basis of our findings, we think that conventional radiography and ultrasound are excellent in a first evaluation. MR images, particularly in the coronal and sagittal oblique planes, are able to demonstrate partial or complete rotator cuff tears. The use of intra-articular contrast medium (arthro-CT, arthro-MR) should be reserved for partial lesions on specific cases.

Adult↗
PubMed2000

[Shoulder instability: diagnostic imaging].

Shoulder instability is often diagnosed among athletes; two clinical forms are distinguished: anatomical instability, with recurrent luxation of the shoulder, and functional instability, with pain, articular "click" and sensation of instability. Lesions of periarticular soft tissues (capsula, fibrocartilaginous labrum, gleno-humeral ligaments and rotator cuff) are common in both forms, while lesions of bone structures (humeral head and glenoid of scapula) are typical of shoulder with previous dislocation. Purpose of our retrospective study was to verify the value of magnetic resonance (MRI) and computed arthrography (arthro-CT) in diagnosing these lesions in 57 patients suffering from shoulder instability. On the basis of our results and experience we think that in a preoperative evaluation of an unstable shoulder, arthro-CT and arthro-MRI are more accurate because the intra-articular injection of a contrast medium better identifies lesions of capsula, gleno-humeral ligaments and fibrocartilaginous labrum. In other circumstances, such as the study of the shoulder for legal purposes, MRI is preferable because it offers an accurate and global evaluation of periarticular structures.

Adolescent↗
PubMed2000

[Shoulder diseases in throwing athletes: radiologic assessment and surgical correlation].

Lesions of the shoulder, especially rotator cuff tears and glenoid labrum (SLAP) lesions, are commonly caused by traumatic episodes in athletes such as repeated trauma from throwing. The available radiological methods are MRI, CT and MR arthrography. Twelve athletes suffering from shoulder pain or instability have been studied and then underwent successful treatment in arthroscopy. On the basis of our results and experience, we think that MR, especially with intra-articular injection of contrast medium, is the best examination because it offers an accurate evaluation of both rotator cuff and glenoid labrum. Nevertheless difficulties are often encountered and definitive diagnosis sometime rests on arthroscopic exploration.

Adolescent↗
PubMed2000

[Wrist trauma: diagnostic imaging].

Wrist injury is common throughout life and, although history and physical examination provide important information regarding the type of lesion, a radiological study is essential to determine a specific diagnosis. Conventional radiography plays a central role in the wrist injuries but the diffusion of more sensitive methodics offers new possibilities. Our purpose is to evaluate the role of computed tomography (CT), magnetic resonance (MR) and arthrography in wrist trauma. We retrospectively examined the images of 45 patients with wrist injuries: in every patients a radiological examination in 4 standard projections was executed while in 25, 9 and 11 patients CT,MR and arthrography were performed. On the basis of our findings we think that conventional radiography is often sufficient for diagnosis of bone lesions even if CT sometimes is required to detect subtle fractures. MR has an high sensitivity not only for abnormalities of soft tissues, including interosseous ligaments and triangular fibrocartilage, but also bony abnormalities such as occult fractures and early osteonecrosis. Arthrography still remains the best procedure for evaluating lesions of triangular fibrocartilage and intercarpal ligaments especially in a preoperative phase.

Adolescent↗
PubMed2000

[Injuries of the cruciate ligament of the knee: diagnostic contribution of MR and spiral CT].

Lesions of cruciate ligament are common after knee trauma of different degree of gravity. Lesions evaluation is possible thanks to CT and MRI. Our purpose is to verify their value in diagnosis of cruciate ligaments lesions. We retrospectively evaluated 160 patients (80 CT and 80 MRI) with subsequent diagnosis of cruciate ligaments injury. CT and MRI were performed in the acute phase and in the subacute phase within 2-3 weeks from trauma. On the basis of our results CT and MRI shown a reduced sensitivity in acute phase owing to the intraarticular haemorrhage; in this phase MRI gives more information about fibres interruption. In subacute or chronic phase, both methods are correct in recognising the lesions but MRI is more sensitive and accurate. It is a real wish that, with more MRI machines diffusion, this method will be preferred in the study of cruciate ligaments both in acute phase and subacute-chronic phase.

Adolescent↗
PubMed2000

[Meniscal injuries of the knee. Diagnostic imaging].

Nowadays, treatment of meniscal tears is conservative with removal only of the broken part of meniscus. For this reason, before arthroscopy, the orthopaedic surgeon needs for an accurate preoperative diagnosis that could be obtained with computed tomography (CT) and magnetic resonance (MR). Our purpose is to value the actual role of CT and MR in diagnosis of meniscal tears. We retrospectively evaluated CT and MR images of 128 patients (average age 32 years) who then underwent arthroscopy. On the basis of our findings CT and MR have been shown to be very accurate to detect meniscal tears, even if with both methodics false positives and false negatives are possible. Nevertheless, MR is able to give high resolution multiplanar images without using ionising radiations and is preferable because of its high accuracy in recognising associated lesions of ligaments or articular cartilage.

Adolescent↗
PubMed2000

[Femoro-patellar instability: radiologic assessment].

To propose a simple and reproducible radiological evaluation of the patellofemoral instability that enables the orthopaedic in choosing the best therapy. The radiographs and CT examinations of 55 patients, 38 female and 17 male (range 18-32 years) have been evaluated retrospectively. Twenty-height of them underwent surgical treatment for patellar instability. A radiological protocol which includes conventional radiographs in two projections and a CT examination both in extension, with and without quadriceps contraction, and in flexion at 20 degrees allows to give all the informations one's need for evaluating patellar height and mobility, trochlear dysplasia, valgism of the knee and the degree of excessive lateral position of the anterior tibial tuberosity. It's a simple, quick, accurate and reproducible protocol to do, even with different radiological systems.

Adolescent↗
PubMed2000

[Spiral CT and MR in injuries of the ankle and the foot].

Conventional radiography is the first radiological examination in injuries of ankle and foot, but often it has normal findings or it is difficult to execute for critical conditions of patients. Our purpose was to assess the value of CT and MRI in injuries of ankle and foot; we retrospectively reviewed the MR and CT images from 48 patients (age range 18-55 years), whose 16 had a major trauma with other skeletal segment lesions and the remaining a minor trauma limited to ankle and foot. On the basis of our results and experience, we think that in major trauma CT and MRI have similar findings about preoperative evaluation of fractures even if MR better identifies ischemia of fragments, subcortical contusions and lesions of ligaments, capsula or tendons. In minor trauma, MR is superior to CT because it can diagnose lesions of bone and periarticular structures that are difficult or impossible to identify with other instrumental examinations.

Adolescent↗
PubMed2000

[Spiral CT in maxillo-facial trauma].

Fractures of facial skeleton are common in a busy emergency department in often requires careful radiological study before surgical treatment. Radiographic evaluation of facial injuries is especially challenging because the complex facial structure results in a confusing overlapping of densities on the radiograph. Instead Spiral-CT enables obtaining images on different planes so that even subtle or complex fractures may be evaluated in the best way. Moreover, associated lesions of important organs can be diagnosed. Our purpose is to verify the value of Spiral-CT in traumatology of facial skeleton. We have evaluated retrospectively the images of 82 patients admitted for facial trauma. On the basis of our findings we think that conventional radiography should be reserved only for light traumas of superficial structures (nose, zygomatic arch, body of jaw); in the remaining cases Spiral-CT should be the first radiological examination.

Adolescent↗
PubMed2000

[Cervical spine injuries: diagnostic imaging].

In past few years, traumas of cervical spine have increased, chiefly owing to rise of road accidents. Nevertheless, only in a small percentage of cases lesions of cervical spine occur and, in order to reduce many negative radiographs, a careful clinical examination is required. Our purpose is to verify the value of radiology in evaluation of acute trauma of cervical spine and to propose an adequate radiological protocol. In the course of two years (1998-99), 376 patients were admitted in consequence of cervical trauma of different degree of gravity. In all patients, conventional radiographs were obtained, in 93 a computed tomography (CT) examination was executed and only in 18 patients with neurological symptoms a magnetic resonance (MR) was required. Fractures of cervical spine wee identified in 91 cases and in patients in which MR images were obtained, neurological lesions of various severity were diagnosed. On the basis of our results, we think that, in a clinical suspicion of cervical spine lesions, a conventional radiographic study has first to be performed even if often good radiographs aren't obtained for technical difficulties. If doubts persist on conventional radiographs or a fractures has already been diagnosed on radiographs but we want to verify its stability, a CT needs to be performed. MR is required if neurological symptoms are present in order to diagnose lesions of spinal marrow, nerve roots or ligaments.

Adolescent↗
PubMed1999

MRI of the biliary and pancreatic ducts.

Magnetic resonance Cholangiopancreatography (MRCP) is a non-invasive imaging technique able to provide projectional images of the bile ducts. Different sequences, using both breath-hold and non-breath-hold acquisition techniques, have been employed in order to obtain MRCP images. The authors discuss technical aspects, considering both three-dimensional non-breath-hold techniques and two-dimensional breath-hold, multi-slice and thick slab sequences. Clinical applications of MRCP are evaluated, presenting data from both the literature and personal experience. The main indication for MRCP study is represented by the evaluation of common bile duct obstruction, with the aim of assessing the presence of the obstruction (accuracy 85-100%) and, subsequently, its level (accuracy 91-100%) and its cause. The utility of associating conventional MR images to MRCP in malignant strictures, in order to characterize and stage the malignant lesion, is also discussed. Finally, data are presented regarding the indications and the utility of MR-pancreatography in the evaluation of patients with pancreatic duct anomalies and chronic pancreatitis.

Bile Duct Diseases↗
PubMed1999

MR cholangiopancreatography in malignant biliary obstruction.

Malignant lesions of the biliary tract are a frequent occurrence, typically presenting with clinical findings of obstructive jaundice. The authors discuss the role of MR cholangiopancreatography (MRCP) as a second level diagnostic technique, which can provide information regarding not only the location, but also the cause of the obstruction. This can be obtained if MRCP is considered as part of a complete study of the upper abdomen, with acquisition of T1- and T2-weighted images. The "all-in-one" approach may provide the identification, characterization, and staging of the lesion, giving the clinician all the information necessary for the planning of adequate treatment. Typical MR features of cholangiocarcinoma are provided, as well as conventional MR and MRCP findings in pancreatic carcinoma, periampullary carcinoma, and biliary obstruction secondary to hilar lymphadenopathy and metastatic lesions.

Bile Duct Neoplasms↗
PubMed1999

Focal neurological deficits in children with beta-thalassemia major.

The hematologic disorder beta-thalassemia major is relatively common in Southern Italy. Stroke is a well described, though infrequently reported, complication of this disorder. We now report our experience regarding 300 children with beta-thalassemia major examined at the University of Catania, Italy, over a 20-year period. We encountered 9 patients (3%; 3 males, 6 females) with beta-thalassemia major who had hemorrhagic stroke. Two groups of patients can be identified: group 1 (2 patients 22%) with early-onset post-transfusion hemorrhage and group 2 (7 patients 77%) with delayed post-transfusion hemorrhage. In the first group, the hemorrhage occurred within 48 hours following blood transfusion. In the second group, hemorrhage occurred 7-15 days from last transfusion. In 5 patients out of 7 of this second group the first transfusion and ictal event both occurred after age five, suggesting prolonged chronic anemia might play a role in the hemorrhage.

Adolescent↗