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Biomedical subjects

R Campani

Publications and source records attributed to R Campani.

126 records · Page 7Linked to original sources
PubMedDate not supplied

[The approach to Achilles tendinopathies in athletes. Echographic aspects].

The recent great diffusion of sports has significantly increased the traumatic pathology of Achilles tendon. Owing to the importance of a correct diagnosis and prognosis and of an adequate therapy (especially for professionals), a clinical and radiological study has been performed. Echotomography has been associated with xeroradiography in 185 athletes with painful symptoms; among these 79 were normal while 106 showed various types of tendinopathies. The main results can be summarized; peritendinitis: non uniform thickening; hyperechogenicity of Kager's triangle; insertional tendinopathies: thickening; calcifications; tendinosis: thickening; degeneration nodules; tendinous ruptures: rough contours of the rupture; degeneration nodules. The good echotomographic results allowed a correct diagnosis in about 85% of the 39 surgically treated patients.

Achilles Tendon↗
PubMedDate not supplied

[Radiologic diagnosis of malignant lymphomas at a supradiaphragmatic site].

The possibility of a radiological diagnosis of supradiaphragmatic localizations of malignant lymphoma are discussed, with particular reference to the employment of special techniques: xeroradiography, bronchography, selective arteriography. A number of examples are presented in detail.

Bronchial Neoplasms↗
PubMedDate not supplied

[Doppler color-echo in the echographic evaluation of solid neoplasms of the breast: 5 years of experience].

In the last 5 years, 1,245 breasts have been examined with conventional and color-Doppler US. To assess color-Doppler capabilities and limitations, the results were critically reviewed only of the 311 patients who were operated and had unquestionable histologic findings. We investigated: 1) the number of "vascular poles", that is the vessels entering the examined mass from the periphery; 2) the presence of vessels with "abnormal" features, that is the vessels with varying diameters and/or with tortuous and erratic course; 3) the presence of vessels even on the mass interface only. The criterion indicated as no. 1, that is the presence of more than a vascular pole, exhibited 90.4% sensitivity and 70.7% prospective and 90.7% retrospective specificity. The criterion indicated as no. 2, that is the presence of vessels with anomalous features exhibited 75.1% sensitivity and 96.9% specificity. Using criterion no. 3 instead of no. 1, sensitivity would be increased from 90.4% to 96.5% but specificity would be decreased from 70.7% (and 90.7% retrospective specificity) to 46.9%, which was considered to be too low relative to the moderate increase in sensitivity. The positive predictive value of the presence of two vascular poles was 85% and that of the presence of vessels with anomalous course was 97.7%. Criteria no. 1 and 2 had 70.7% and 68.8% negative predictive value, respectively. In conclusion, the authors suggest the use of color-Doppler US to add further pieces of information to those obtained with conventional US.

Adult↗
PubMedDate not supplied

[CT in the diagnosis and treatment of lymphoceles following gynecologic cancer surgery].

The staging of gynecologic cancers requires the knowledge of lymph node status and thus pelvic and/or lumbo-aortic lymphadenectomy remains, to date, a widely used procedure. Lymphoceles are a frequent complication of surgical lymph node dissection. They are lymph collections in the retroperitoneum following the continuous drainage of afferent lymph vessels. To assess the incidence of this complication, its CT features and the role of diagnostic imaging to treat lymphoceles, 140 patients were retrospectively evaluated. Forty of them had undergone pelvic and/or lumbo-aortic lymphadenectomy for proved endometrial carcinoma, 51/140 for proved carcinoma of the cervix uteri, and 49/140 for proved malignant epithelial cancer in the ovary. CT exams were performed during the follow-up, not on a systematic basis but only when a recurrence was clinically suspected (117 cases), or in the presence of surgery and/or irradiation complications (11 cases), or to assess the extent of residual lesion during chemo/radiotherapy (12 cases). Fifty-three lymphoceles were observed in 36 patients: they were monolateral in 18 cases and bilateral in 16; in 34 cases the lymphoceles were found in the iliac space and in 3 cases only in the median perivascular lumbo-aortic space. In the patients with clinically suspected recurrence (117 patients, 27 lymphoceles), lymphoceles were associated with the recurrence in 25 cases, while they were the only CT evidence of a mass in 2 patients. In the cases with clinically suspected complications of former irradiation and surgery (11 patients, 3 lymphoceles), lymphoceles were correctly differentiated from abscesses (2 cases), seroceles (1 case), and hematomas (2 cases). In the group of asymptomatic patients monitored for residual disease (12 patients, 5 lymphoceles), lymphoceles were an occasional finding and, since they caused no complications to the urinary and GI tracts, they were never treated. Four asymptomatic patients only, with no evidence of disease, were submitted to transcutaneous aspiration and drainage under CT-US guidance (1.7 procedures per patient), and lymphoceles resolved in 3/4 cases. The only lymphocele recurring more than once required another laparotomy. In our experience, lymphoceles appear as a common sequela of pelvic lymphadenectomy for gynecologic cancer. CT has proved to be a useful diagnostic tool to assess and characterize the lesions, which must be differentiated from other postoperative complications and from recurring tumors. Lymphoceles needed to treatment in most cases and thus only symptomatic patients, with no cancer, were submitted to aspiration and drainage under CT-US guidance; the maneuver was successful on 75% of cases.

Adult↗
PubMedDate not supplied

[Speed of calcaneal ultrasound attenuation in the identification of vertebral fractures in patients with senile osteoporosis].

Vertebral collapse is a frequent complication of osteoporosis with usually severe sequels. We examined a group of female patient with known senile osteoporosis to try to define a subgroup with atraumatic vertebral collapse on the basis of broadband ultrasound attenuation (BUA) values in the heel. 186 patients were submitted to calcaneal ultrasound densitometry and to radiography of the dorsolumbar spine; we also investigated the body mass index and postmenopausal and menopausal ages to identify the variable with the highest correlation with fracture, with the multiple regression statistical analysis. The regression model analysis showed a statistically significant correlation of BUA values (inverse relation) and weight (direct relation) with the risk of collapse (0.967 and 1.075 odds ratio, respectively). We subdivided the patients according to their body mass index and made the receiver operating characteristics (ROC) curves, thus increasing test accuracy, with 45 MHz BUA threshold, 66.67% sensitivity and 71.43% specificity. Calcaneal BUA is a good indicator of atraumatic vertebral collapse in senile osteoporosis patients; when the weight variable is associated, sensitivity, specificity and positive and negative predictive values (66.67%, 71.43% and 66.6% and 71%, respectively) increase, thus helping define this subgroup of patients.

Aged↗
PubMedDate not supplied

[The use of spiral computerized tomography in the study of pancreatic insulinoma: preliminary results].

Insulinomas are usually benign tumors originating in the pancreatic islets: since they are biologically active tumors, insulinomas present at clinics with hypoglycemia caused by increased insulin production. We examined 7 patients with clinically suspected insulinomas with spiral CT to investigate its capabilities in identifying and characterizing this type of lesion. Four patients had abnormal spiral CT findings (true positives); the diagnosis was confirmed at surgery in 3 patients and at instrumental follow-up in the other. The tumors were 12.2 mm in average diameter. CT showed no tumor mass in 3 cases, which was confirmed at angiography and MRI (true negatives). We observed a typical contrast pattern in 50% of cases, namely a ring-like enhancement changing into homogeneous enhancement. Multiplanar and 3D reconstructions were not necessary for lesion identification, but we used them for regional vascular mapping. In our experience, which is limited to few cases and dose not allow any statistically significant conclusion, spiral CT exhibited high sensitivity in the detection and characterization of pancreatic insulinomas which permits to reduce the resort to more invasive angiographic techniques.

Adolescent↗
PubMedDate not supplied

[Spontaneous rupture of the esophagus (Boerhaave syndrome): computerized tomography diagnosis in atypical clinical presentation].

Spontaneous esophageal perforation, or Boerhaave syndrome, is an uncommon finding requiring prompt diagnosis and immediate surgery because of its high mortality rate. The clinical diagnosis in typical cases is based on the symptom triad of Macler: vomiting, strong sudden chest pain and subcutaneous emphysema. We report 4 cases of Boerhaave syndrome with atypical presentation studied with Computed Tomography (CT) to make the correct diagnosis with atypical clinical findings. In each patient, we assessed the clinical symptoms, classifying them as typical and atypical, the diagnostic course leading to diagnosis and CT patterns. The classic symptoms were absent in one patient, while one patient had vomiting only, one had vomiting and chest pain and one had chest pain and cough. Chest radiography was performed in three patients and permitted the diagnosis in one of them only. CT permitted the definitive diagnosis in all cases. When spontaneous esophageal rupture presents with aspecific clinical findings. CT permits its accurate and specific diagnosis. We found atypical CT signs of esophageal rupture, namely pneumopericardium, uncommunicating mediastinal and pleural effusions, and focal pleural effusion in a contralateral cavity. Finally, our finding of a periesophageal mediastinal collection moving to the parietal subpleural space is not reported in the radiological literature. The severity of these findings varies and it is probably related to the increase in intraesophageal pressure affecting the progression of abscessual and hydroaerial collections in different anatomical structures; the time when CT is performed is also important. To conclude, the CT diagnosis of spontaneous esophageal rupture is specific and CT shows lesion site correctly.

Aged↗
PubMedDate not supplied

[Pulmonary iatrogenic lesions in chemotherapy: computerized tomography findings].

PURPOSE: To analyze the lung damage caused by anticancer drug toxicity comparing the pathologic mechanisms, histopathologic response and CT features. MATERIAL AND METHODS: Twenty-one patients (15 men and 6 women aged 21-75 years, mean: 41) were selected from the cancer patients treated with chemotherapy 1990 to 1997 (1400 lung examinations in all). The primary tumors consisted of: 6 testicular, 2 ovarian, 2 breast and 1 renal cancers; 3 non-Hodgkin lymphomas; 1 acute myeloid and 1 chronic lymphatic leukemia; 1 melanoma, 1 uterine leiomyosarcoma, 1 liposarcoma, 1 osteosarcoma and 1 head and neck carcinoma. All the patients underwent a CT examination with contiguous 8-10 mm slices and thin (4-5 mm) detail slices or with the high resolution technique. All the cases had clinical, laboratory and pathologic confirmation of the drug-related lung damage. RESULTS: Four alveolar opacities, 11 interstitial opacities, 2 solitary and 4 multiple nodular lesions were demonstrated. Bleomycin was the most toxic drug in 14/21 cases, the total dose always exceeding 450 mg. Methotrexate followed and then cytosine-arabinoside (both 2/21). Bleomycin was responsible for all nodular lesions, cytosine-arabinoside and interleukin-2 for pulmonary edema. After drug discontinuation and appropriate treatment in 14 cases, we found favourable evolution with restitutio ad integrum (9 cases) or CT findings of clear improvement (5 cases); fibrosis progressed in 6 cases and one patient died. CONCLUSIONS: CT provides important information for the diagnosis of drug-induced lung damage. Despite the nonspecific patterns of the lesions, CT can demonstrate the early, and thus potentially reversible, stages of lung damage. CT is also very helpful in monitoring the onset, resolution, or progression of fibrosis.

Adult↗