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R Campani

Publications and source records attributed to R Campani.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Bone callus: possible assessment with color Doppler ultrasonography. Normal bone healing process].

Conventional US demonstrates bone callus dimensions and structure, which permits to monitor the bone healing process. January, 1993, through May, 1995, we examined 108 patients with simple fractures of humerus, femur and tibia; all the fractures had been treated with an external or intramedullary metallic fixator. All the patients were submitted to conventional and color-Doppler US of the fracture focus on all possible scanning planes. We considered morphological parameters (the presence/absence of vessels, their number and shape) and functional parameters (the resistive index and the presence of a telesystolic notch). Color-Doppler US and the spectral analysis allowed us to add functional data, on bone callus and newly formed bone vascularization, to morphological studies. In the patients with positive fracture evolution, the caliber of afferent vessels progressively increased, their number decreased and branches appeared. The RI progressively increased, up to similar values to those of nutrient vessels (.36 to .90). Within the second month of fracture, a telesystolic notch appears: this indicates a muscular tunic in the vessel wall, meaning a mature, and no longer a newly formed, vessel. The normal evolution of bone healing may be interrupted by several mechanical and biohumoral factors which reportedly act in a similar way by reducing the number of vessels and increasing peripheral resistance in residual vessels because of fibrosclerotic involution of bone healing. Color-Doppler US permits noninvasive, repeatable and nearly real-time monitoring of bone fracture healing, which suggests this technique could be used: -to assess the results of treatment changes (e.g., loading, external fixator adjustments); -to study the definitive callus; -for the medicolegal assessment of delayed bone healing and of pseudoarthrosis; -for real-time treatment planning, according to color-Doppler findings, and to monitor treatment results.

Bony Callus↗
PubMed1996

[Power Doppler in breast diseases: preliminary results].

Since 1993, a new technique called power Doppler or color Doppler energy, based on Doppler signals, has been used to study the vascularization of various organs. Since power Doppler appears to permit better assessment of slow flow than color Doppler, we used this technique to study the vascularization of breast lesions. Seventy-five patients (age range: 33-81 years, mean: 53 years) were examined: 28 had simple or complex cysts, 4 cysts with internal echoes, 1 fibrocystic disease, 3 nodular fibrocystic disease, 12 fibroadenoma, 3 benign microcalcifications, 10 cancer, 3 scarring, 1 recurrent cancer, 7 axillary nodes; 3 young patients with no breast disease were also examined as a control group. All the patients were examined first with B-mode and then with color power Doppler; both during the exam and later on, in the study of similar sections, power Doppler signals were stronger and, in many cases, more numerous. Particularly, with power Doppler, in similar sections, 1-3 more signals were demonstrated in healthy women and 1-4 more signals in fibroadenomas with rich vascularization and in neoplasms, while in 2 cysts perilesional signals were demonstrated only with power Doppler. Color-Doppler semiology of breast lesions was confirmed. Thus, since the signals were stronger with power Doppler, we believe it to be a promising tool in the study of the vascularization of breast lesions which can provide useful diagnostic information as to lesion nature, the results of local treatment and the response to primary medical therapy, as well as in the study of axillary lymph nodes.

Adult↗
PubMed1996

[Diagnostic imaging of phyllodes tumors: preliminary observations].

Phyllodes tumors are rare fibro-epithelial neoplasms; they may be classified as benign, borderline and malignant according to their histologic features of mitotic index, stroma pleomorphism and lesion outline. Their epidemiology is rather different from that of other breast neoplasms, since these lesions most frequently affect white Latin women 45 to 49 years old. The incidence of metastases is strictly correlated with the degree of histologic aggressiveness, although even small lesions, either borderline or with low malignancy, may metastasize. To assess the incidence of this neoplasm and its metastases and to investigate the role of diagnostic imaging, we retrospectively reviewed 8000 mammograms, 2000 sonograms, 1000 color-Doppler sonograms and 4500 CT scans of the chest; 7 phyllodes tumors and 2 metastases were detected. This neoplasm showed no specific characteristics either at mammography or at sonography, whereas rich neovascularization with venous flow and low resistance arterial flow were shown at color-Doppler US. Secondary lesions, first diagnosed at radiography and then studied with CT for number, size and lymph node involvement were: a large solitary mass with no involvement of mediastinal nodes, which was observed 36 months after surgical ablation of the primary lesion and multiple small lesions, involving both lungs, with no mediastinal metastases, diagnosed 42 months after surgical removal of the primary lesion. In both cases the primary neoplasm was histologically classified as borderline and responded to adjuvant therapy. Therefore, our work confirms the polymorphic nature of this condition which is rather difficult to diagnose and whose prognosis is unpredictable. However, even though color-Doppler US may open new diagnostic perspectives, the reliability of conventional radiography and CT in the follow-up of these lesions is nowadays a matter of fact. In our opinion, every case should be followed-up, regardless of the histologic classification of the primary tumor.

Adolescent↗
PubMed1994

Evolving pituitary hormone deficiency is associated with pituitary vasculopathy: dynamic MR study in children with hypopituitarism, diabetes insipidus, and Langerhans cell histiocytosis.

PURPOSE: To assess pituitary vascularization in children with hypopituitarism, central diabetes insipidus (DI), or Langerhans cell histiocytosis. MATERIALS AND METHODS: Dynamic MR images were obtained through the pituitary stalk after injection of gadopentetate dimeglumine in 21 patients (11 boys and 10 girls, aged 4-17 years) and 10 age-matched control subjects. RESULTS: Initial enhancement of the posterior pituitary lobe occurred simultaneously with that of the straight sinus in all subjects except four patients with central DI and a thick stalk. Enhancement of the entire anterior pituitary lobe was statistically significantly prolonged (P < .005) in the four patients with delayed initial posterior pituitary lobe enhancement. CONCLUSION: Fast-framing dynamic MR imaging provides new information on the blood supply of the hypothalamic pituitary area in normal and abnormal pituitary glands. Enhancement times exceeding 20 seconds for the posterior pituitary lobe and 30 seconds for the anterior pituitary lobe may suggest abnormal vascularization in the hypophyseal arteries and portal system.

Adolescent↗
PubMed1994

[Ultrasound densitometry and the index of Jhamaria in the diagnosis of senile osteoporosis].

Over 90% of the calcaneum is made of trabecular bone, whose turnover is high and which is therefore very sensitive to bone metabolism changes. Thus, we evaluated the mineral content of the calcaneum with the semiquantitative Jhamaria index adapted by Aggarwal et al. (1986) and ultrasound measurements. With the latter method, broadband ultrasound attenuation (BUA) values were calculated, which indicate ultrasound signal breadth reduction when passing through the bone. The two techniques were used to examine 99 women, whose age ranged 65-79 years, referred for dorsolumbar pain and suspected senile osteoporosis. This condition was diagnosed with dorsolumbar spine radiographs and considering as osteoporotic only the patients with one or more vertebral collapses. Thus, any other cause of osteopenia was excluded with bone metabolism serourinary indices. The two groups of patients thus obtained (group A: 42 osteoporotic women with vertebral collapse and group B: 57 osteoporotic women with no vertebral collapse) exhibited significantly different Jhamaria index and BUA values (group A: 2.5 +/- 0.9, B: 3.7 +/- 0.96, A: 46.3 +/- 13.6, B: 60.2 +/- 15.6) (p < 0.001). The diagnostic accuracy of calcaneal BUA and Jhamaria indices, in the two groups, was 85.7% and 81%, respectively. The analysis of the mean values showed no significant correlation between BUA and Jhamaria index in the group of patients with vertebral collapse. On the contrary, the correlation of the two indices in the group of patients with no vertebral collapse exhibited slight statistical significance (r = 0.38). To conclude, on the basis of our results the calcaneum is confirmed as a reliable peripheral index of vertebral BMC and ultrasound measurements are suggested as a simple noninvasive method which can be used to diagnose senile osteoporosis.

Aged↗
PubMed1994

[Computerized tomography in the differential diagnosis of non-gynecologic abdomino-pelvic masses].

The female pelvis is an anatomical region where masses can be found originating from pelvic organs, mostly from the genital system or else from abdominal organs and systems, by continuity, by contact or by metastatic spread. The clinician needs to define and characterize a pelvic mass since treatment options can vary greatly. If a malignant pelvic lesion is clinically suspected, ultrasonography is the investigation technique of choice, whose differential diagnosis accuracy is good especially in gynecologic conditions. However, in nongynecologic masses, US diagnostic yield is poorer, which led us to retrospectively review 31 such cases. CT was used to assess the mass origin and tissue characterization to define the clinical role of this method. On the whole, CT yielded good results (80.6% overall diagnostic accuracy, 25/31 cases) which however differed according to the different pathologic conditions. Gastrointestinal system conditions, tumors and inflammations were easy to diagnose with CT (11/15 cases, 73.3%), except for the patients with intestinal cancer spreading to the ovaries, that is, a Krukenberg's lesion, or the cases with an abscess hiding the annexa and thus preventing CT from detecting the mass origin, be it intestinal or annexial. CT diagnostic accuracy was high in extraperitoneal (retro- and properitoneal) masses (8/8 cases, 100%), but much lower (75%, 6/8 cases) in the diagnosis of primary intraperitoneal organs conditions. To conclude, CT is confirmed as an accurate imaging technique in the differential diagnosis of nongynecologic abdominopelvic masses. The mass origin is usually correctly detected and tissue characterization is accurate, which provides the clinician with enough pieces of information for best treatment planning.

Abdominal Neoplasms↗
PubMed1994

[Secondary solid neoplasms in young patients treated for lymphoproliferative diseases: computed tomography findings].

Diagnostic imaging still plays a key role in the follow-up of oncologic patients. In particular, in hemolymphoproliferative disorders, diagnostic imaging is used to differentiate the complications of integrated treatment from possible relapses. Integrated treatments have lengthened the survival of these patients and therefore such long-term complications as secondary--especially solid--tumors are now more frequently observed. We report on two such cases whose onset followed by 6 and 5 1/2 years the end of the initial treatment: the patients had been cured for acute lymphatic leukemia and Hodgkin's lymphoma. In the leukemia patient, CT and MRI demonstrated a large mediastinal mass, which had been an occasional finding at chest film. CT correctly diagnosed the mass and suggested extrapulmonary and extramediastinal localization, since fat cleavages were normal. MRI allowed better characterization of the mass which was isointense to muscle independent of TR. Disease relapse was excluded and surgery allowed the complete ablation of the ganglioneuroma. In the lymphoma patient, a left hypochondrium mass was supposed as an abdominal relapse from Hodgkin's lymphoma. CT allowed the correct diagnosis of gastric adenocarcinoma to be made on the basis of the mass multifocality and marked enhancement, of the infiltration of liver and hepatogastric ligament lymph nodes and finally of peritoneal involvement. Secondary solid tumors are no remote finding in the follow-up of the patients treated for lymphoproliferative disorders. Diagnostic imaging must allow the differential diagnosis especially from relapses and must use the techniques which are most capable of doing so.

Adenocarcinoma↗
PubMed1994

Color Doppler imaging of liver metastases. The value phase-III of a US contrast agent: SH U 508 A (Levovist) Schering.

In a phase-III multicenter clinical trial, the color Doppler vascular patterns were studied of 34 liver metastases in 18 patients before and after the i.v. injection of SH U 508 A (Levovist), with different US units and probes. The patients were selected as having poor color Doppler signals at unenhanced examinations. Lesion size ranged .8 to 9 cm (mean: 3.5 cm). The primary lesion site was the colon in 14 cases, the breast in 8 cases, the lung in 4, the stomach in 4 cases, the ovary in 3 and finally unknown in 4 cases. Each patient received two to four contrast agent injections, with suggested doses and concentrations (10 ml x 300 mg/ml, 8 ml x 400 mgr/ml). No adverse reactions were observed. Thirteen of 34 lesions exhibited no vascular signals at baseline examinations, 10 exhibited some perilesional color spots or small vessel branches, 5 some internal color spots or vessels and 4 small internal and peripheral vessels. After contrast agent infusion, the vascular patterns were better demonstrated in 28/34 lesions and the signal-to-noise ratio was markedly improved, in a concentration-dependent manner, from 40 to 240s. Five lesions remained avascular, 11 exhibited "basket"-like vascular patterns, 10 "internal flow" patterns and finally 10 lesions exhibited both. No major correlation was observed between vascular pattern and lesion size. To conclude, the use of the intravenous contrast agent SH U 508 A (Levovist) appears to be a promising technique to improve the color Doppler demonstration of focal metastatic liver lesions. Nonetheless, further studies on larger series of cases are needed to differentiate the different primary sites of the metastases.

Aged↗
PubMed1993

[Vocal recognition in dental and oral radiology].

Speech reporting benefits by units which can recognize sentences in any natural language in real time. The use of this method in the everyday practice of radiology departments shows its possible application fields. We used the speech recognition method to report orthopantomographic exams in order to evaluate the advantages the method offers to the management and quality of reporting the exams which are difficult to fit in other closed computed reporting systems. Both speech recognition and the conventional reporting method (tape recording and typewriting) were used to report 760 orthopantomographs. The average time needed to make the report, the legibility (or Flesch) index, as adapted for the Italian language, and finally a clinical index (the subjective opinion of 4 odontostomatologists) were evaluated for each exam, with both techniques. Moreover, errors in speech reporting (crude, human and overall errors) were also evaluated. The advantages of speech reporting consisted in the shorter time needed for the report to become available (2.24 vs 2.99 minutes) (p < 0.0005), in the improved Flesch index (30.62 vs 28.9) and in the clinical index. The data obtained from speech reporting in odontostomatologic radiology were useful not only to reduce the mean reporting time of orthopantomographic exams but also to improve report quality by reducing both grammar and transmission mistakes. However, the basic condition for such results to be obtained is the speaker's skills to make a good report.

Humans↗
PubMed1993

[Echography in the study of periskeletal soft tissues: technique, normal and pathologic pictures].

Ultrasonography (US) is the method of choice in the study of normal soft tissue patterns thanks to its intrinsic features. The exam must be performed following strict directions relative to US units (last-generation), to probes (high-frequency, high axial and lateral resolution, focusing), the type of scan (orthogonal and oblique scans), the use of silicon pads. Exam reporting and the exact knowledge of possible image artifacts are of the utmost importance. Normal patterns in the skin, subcutaneous tissue, striate muscles, tendons and bursae, nerves, vessels and bone are reported and correlated with the corresponding US patterns in pathologic conditions. In inflammatory processes, muscles and tendons exhibit blurred, irregular and poorly-defined outlines; neither the anatomical structures nor the tissues nearby are infiltrated. Similar patterns are observed in some benign tumors, while in malignant lesions soft tissue echostructure is more or less alterated and the adjacent tissues are infiltrated. Color-Doppler US yields morphologic and functional information as to pathologic vascularization; typical findings, similar to those obtained by means of angiography, are seen in malignant lesions.

Humans↗