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V Panebianco

Publications and source records attributed to V Panebianco.

49 records · Page 3Linked to original sources
PubMed1990

[Value of superior angiocardiography in the evaluation of the surgical excision of bronchial cancer. Respective role compared to thoracic x-ray computed tomography].

The place of angiography-superior vena cavography in the assessment of the resectability of a lung cancer must be defined in comparison with the data provided by thoracic computed tomography. Sixty-six patients with proximal lung cancers of doubtful resectability were studied by means of angiography and computed tomography and the results of these preoperative investigations were correlated with the operative findings. The sensitivity of these two examinations for the diagnosis of vascular invasion preventing pulmonary resection is poor (53% and 47% respectively). The specificity and positive predictive value of angiography appear to be slightly superior to those of computed tomography (Sp: 96% and 82%, PPV: 78% and 47%, respectively). The diagnostic performance of these two examinations remains poor. Magnetic resonance imaging may replace these two examinations in the future.

Carcinoma, Bronchogenic↗
PubMedDate not supplied

[MR imaging of pancreatic neoplasms].

The role of MR imaging in the assessment of pancreatic adenocarcinoma is in identification, characterization and staging of the neoplastic lesion. Technique optimization is required in order to obtain high qualities images competitive with spiral CT. The choice of imaging protocol is strictly related to the available equipment as well as fast imaging capabilities. Contrast-enhanced study using breath-hold sequences is required if working at high field strength with high gradient performance; on mid-low field strength nonbreath-hold acquisition techniques, using respiratory compensation techniques, can be implemented. The use of fat saturation pulses may increase the sensitivity of MR in detecting pancreatic lesions. Other advantages of MR imaging are represented by the availability of additional noninvasive techniques for the evaluation of the biliary tree (MR-cholangiopancreatography) and splanchnic vessels (MR-angiography). Lesion identification is based on TIw sequences where the lesion appears hypointense compared with the surrounding pancreas; increased lesion-pancreas contrast is obtained when fat suppression is used. On dynamic studies following gadolinium injection, pancreatic tumors are hypovascular compared with surrounding normal pancreatic gland. Problems in correctly defining the size of the lesions may be encountered in patients presenting with inflammatory changes of the pancreatic parenchyma surrounding the carcinoma (epineoplastic pancreatitis). For lesion characterization MRI is not able to characterize focal pancreatic lesions, allowing a differential diagnosis between pancreatic cancer and focal hypertrophic chronic pancreatitis. Even the use of MR-cholangiopancreatography is not helpful for characterizing focal pancreatic masses. MR imaging is accurate in local staging (assessment of peripancreatic fat infiltration) thanks to the higher contrast resolution, but in vascular staging and in the evaluation of lymphnodal involvement it suffers the same limitations as computed tomography. Future perspective are represented by the use of magnetic resonance angiography for the evaluation of vascular encasement and the use of specific contrast agents for lymphadenopathy. Identification of hepatic metastases with MRI has been proven to be high, with sensitivity and specificity comparable to CT. The use of liver-specific contrast agents (either positive or negative) is becoming almost routine and it is proving to further improve the diagnostic value of MRI.

Adenocarcinoma↗
PubMedDate not supplied

[Emergency treatment and diagnosis of appendix mucocele].

The Authors report a case of appendicular mucocele admitted in an emergency setting in the Emergency Department (DEA II). The patient, 78 y-old man, went to attention complaining diffuse abdominal pain: physical examination revealed mild tenderness and right lower quadrant pain to palpation. Rx plain and CT scan demonstrated a right iliac fossa cystic lesion with mural calcification, adherent to the caecum. On basis of imaging, clinical and laboratory findings the patient underwent surgery postoperative diagnosis was mucocele of the appendix. The aim of this report is to discuss the role of imaging and clinical approach in treatment of appendicular mucocele, which is known to be so aspecific in presentation, especially when it occurs in an emergency setting.

Aged↗
PubMedDate not supplied

Therapeutic and prognostic problems in lung cancer with mediastinal lymph node involvement.

From January 1st, 1978 to 31st December, 1981, 28 patients with lung cancer and mediastinal lymph node metastases, underwent surgery. In four patients, only exploration was performed, in five patients, an incomplete resection and in 19 patients, a complete resection (resectability rate 86%). In the first two groups of patients, survival never exceeded two years. In the 'complete resection' group, 78% of the patients survived for one year, 61% for two years and 47% for three years. Patients with adenocarcinoma had a higher three year survival rate than those with squamous cell carcinoma (60% vs. 37%). No 30-day mortality was observed. All patients were treated postoperatively with MACC + BCG. The prognosis of lung cancer classified as N2 is strongly influenced by a series of factors some of which are included in the TNM system. In any case, it would still appear that the best treatment for this kind of tumor is radical surgical resection followed by adjuvant radiotherapy and/or multichemotherapy.

Adenocarcinoma↗
PubMedDate not supplied

[Leiomyosarcoma of the inferior vena cava: description of a new case and review of the literature].

A case of primary leiomyosarcoma of the inter-renal vena cava is reported. This tumor is rare and up to date no more than 100 cases have been reported. Surgical treatment consisted in the removal of vena cava from the iliac veins to the suprahepatic veins with right nephrectomy. Restoration of vena cava and left renal vein continuity was not necessary because of the presence of collateral venous circulation at the time of operation. Venous ligation was haemodynamically well tolerated and the patient is disease-free at one year from operation. However, despite surgical radicality, prognosis remains poor given the frequency of metastases reported in more than 35% of cases.

Female↗
PubMedDate not supplied

[The information management of a radiology department: the development of a new type of software for the archiving of alphanumeric data and images].

The authors report the main characteristics and the goals of the development of the RIS of the II Chair of the Institute of Radiology, La Sapienza University, Rome. The system was developed with a commercial software (4th Dimension), for use with an Ethernet network and Macintosh Apple computers. One of the main problems was to obtain a user-friendly system. The main options of our system are: booking, registration, exam execution, reporting, archives and statistics and system administration. The main characteristics of our RIS is that it allows important images to be archived in limited number and at low resolution. The aim is to use images for consultation and teaching purposes, not for diagnosis which is made on the original images. Low resolution images permit to use limited storage space. Image quality is very similar to that of the original images for the equipment connected on line with the RIS--i.e., US and MR units in our institute. Conventional radiographic and CT images are digitalized by two scanners with maximum resolution of 4k x 4k x 11 bits. To date, good results have been obtained. Our RIS has been used by the medical and non-medical staffs, without any particular instruction and has allowed us to organize and make faster department management and reporting.

Computer Communication Networks↗
PubMedDate not supplied

[Cholangiopancreatography with magnetic resonance in the assessment of pancreatic ducts].

We investigated MR cholangiopancreatography (MRCP) findings in patients with pancreatic conditions, which are mainly diagnosed based on US and CT morphologic findings. Sixty-three patients were submitted to MRCP using a .5T magnet. MRCP was performed with non-breath-hold fat-suppressed 3D turbo spin echo sequences (TR = 3000 ms, TE = 700 ms, ETL = 128, NEX = 6) with 3 min acquisition time. For better depiction of Wirsung duct and secondary ducts in the last 11 patients, a high resolution technique with a 128 x 256 matrix, 8 NEX and 8 min 36 s acquisition time was developed. MRCP images were studied both on MIP reconstructions and on single slices as well as T1- and T2-weighted TSE axial images. The diagnosis was compared with endoscopy, percutaneous procedure or CT findings in all cases. A hypointense focal mass was observed on T1-weighted TSE images in 39 pancreatic carcinoma patients (100%) and parenchymal atrophy was shown in 13 patients (33%); a sudden obstruction of the Wirsung duct was observed in 16 cases (41%) with homogeneous dilatation in 11 cases (28%). A tapered appearance of the distal Wirsung duct was demonstrated in 19 chronic pancreatitis patients, with diffuse patchy signal changes in 12 patients (63%); bead-like appearance of the Wirsung duct was shown in 6 cases (32%) and pseudocysts in 7 cases (37.3%). MRCP is the only imaging method demonstrating pancreatic conditions between carcinoma and pancreatitis, similarly to ERCP.

Adult↗
PubMedDate not supplied

[Biliary complications of liver transplant. Role of cholangiography with magnetic resonance].

INTRODUCTION: Orthotopic liver transplantation is considered the treatment of choice in several hepatic conditions. The five-year patient survival rate is approximately 75%, thanks to progress in both surgical techniques and postoperative medical treatment. Biliary complications are one of the commonest causes of failure and their prompt identification is difficult due to their insidious clinical pattern and to the poor predictive value of a negative US examination. To date, invasive contrast cholangiography (endoscopic retrograde cholangiography and percutaneous transhepatic cholangiography) may be the only way to identify anatomic abnormalities and it is therefore a necessary examination when biliary obstruction is suspected. The aim of our work was to assess the possible role of MR cholangiography in late biliary complications of liver transplanted patients. MATERIAL AND METHODS: Twenty-three liver transplant recipients (11 men and 12 women, mean age: 51.1 years) were submitted to MR cholanglography using non-breath-hold, fat-suppressed three-dimensional turbo spin echo sequences, (TR = 3000 ms, TE = 700 ms, ETL = 128). Our patients presented with clinical, laboratory and US patterns doubtful for biliary obstruction. The diagnostic confirmation was obtained at percutaneous transhepatic cholangiography (four cases), endoscopic retrograde cholangiography (eight cases), T-tube cholangiography (one case) or clinical follow-up (ten cases). RESULTS: No biliary tract abnormalities were detected at MR cholangiography in 11 cases. Twelve strictures were diagnosed in eleven patients (9 anastomotic, two nonanastomotic/intrahepatic and one nonanastomotic/extrahepatic, with associated anastomotic and nonanastomotic strictures in two cases). MR cholangiography correctly defined the stricture site and the dilation of the bile ducts above in all cases, with optimal correlation with contrast cholangiographic findings. The common bile duct below the stricture was visible in 9 of 10 patients with extrahepatic strictures on MR cholangiography and in 8 of 10 patients on contrast cholangiograms. The distal common bile duct was missed on both MR cholangiography and diagnostic percutaneous transhepatic cholangiography in a patient only. The strictures were correctly graded in 8 of 10 patients, with two cases of overestimation. Other findings were a 1-cm stone proximal to the obstructed common bile duct, multiple intrahepatic stones in another case and common bile duct kinking at the anastomosis. CONCLUSIONS: MR cholangiography is a useful imaging method in the follow-up of liver transplant recipients which can assess the biliary obstruction and therefore permit to limit the use of invasive procedure only for interventional purposes.

Biliary Tract Diseases↗