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Biomedical subjects

V Spina

Publications and source records attributed to V Spina.

At least 37 records · Page 2Linked to original sources
PubMed1996

Osteosarcoma of the scaphoid. A case report and review of the literature.

We describe a case of osteosarcoma of the scaphoid bone, which to our knowledge is only the second reported case of osteosarcoma in the carpus. A 38-year-old man complained of intense pain in the right wrist and had curettage and a bone graft for a lesion in the scaphoid. Histological examination showed this to be an osteosarcoma. Below-elbow amputation was performed and adjuvant chemotherapy given. There has been no evidence of recurrence or metastases at 33 months after amputation.

Adult↗
PubMed1996

[Interactive atlas with magnetic resonance on CD-ROM for Macintosh].

Computer assisted education in radiology has been increasingly used during the past ten years and now complements traditional learning resources. Magnetic Resonance Imaging (MRI) of musculoskeletal anatomy, and particularly of joints, lends itself naturally to learning modules on computer. This paper describes the design, development and use of an interactive computer assisted teaching module of MR joint anatomy on CD-ROM for Macintosh: to date, we have used this atlas for ankle and elbow anatomy. The atlas is divided into three main sections: MR anatomy, traditional anatomy and a quiz. On each MR image, any anatomical detail can be identified clicking on it with the mouse. Buttons allow to visualize cross-reference points and to go directly on the desired image. If the student wants to look at anatomical drawings of the last identified structure, a button retrieves all the cards in the traditional anatomy section containing that structure. Finally, the student can make his own self-assessment, verifying his learning immediately with the exam mode: the software makes a random selection of 10 MR images where an anatomical structure must be indicated: if the answer is wrong, the software gives the right one and shows the misinterpreted structure. Then, the student is given a total score for his performance. The computer assisted teaching modules present some advantages: the images can be viewed in a given sequence (like traditional learning resources) or in any self-paced, customized way; this possibility, together with the friendly interface of Macintosh computers could make learning more active and pleasant.

Anatomy↗
PubMed1994

[The epiphyseal involvement of metaphyseal bone sarcomas in patients with fertile growth plates. A magnetic resonance assessment].

The growth plate is thought to be capable of limiting tumor spread. To assess the presence and extent of epiphyseal involvement in bone tumors, the plain radiographs and the MR images of 41 patients with metaphyseal sarcoma and radiographically apparent growth plate were studied. The results were compared with surgical, microscopic and histologic findings. Histology demonstrated that in 3 patients the tumor did not reach the growth plate, in 25 the epiphysis was involved while in 13 cases the tumor reached the physis but did not spread to the epiphysis. In the latter group of patients, histology demonstrated a microinfiltration of the physis in 5 cases. Radiography and MR sensitivities were 77.2% and 100%, respectively, while specificity was 94% for both methods. Histology showed that the epiphysis was involved in 25/41 cases (61%) and the growth plate in 30/41 (73%). Our results show that the growth plate does not usually act as a barrier against tumor spread and that MRI is the diagnostic tool of choice in the assessment of epiphyseal spread in metaphyseal tumors even though it cannot detect growth plate microinfiltrations.

Adolescent↗
PubMed1993

[The pharmacological options for an immediate intervention in threatened premature labor].

The following preparations, with different mechanism of action, have been comparatively tested for induction of immediate tocolysis in case of threatened preterm labour: Hyoscine butylbromide, ritodrine, ketoprofen and the association of ritodrine with ketoprofen. Hyoscine butylbromide was found to be very easy to handle, but its myolytic effect is modest. Ritodrine and ketoprofen have shown a high and quantitatively similar tocolytic power. But even better results have been achieved with the association of ritodrine with ketoprofen which has shown a total myolytic effect. The authors suggest some hypotheses concerning the mechanism of action of these drugs, and some precautions for their correct clinical use.

Adolescent↗
PubMed1993

[Clinical evaluation of DHEA-S plasma levels and possible therapeutic value of the hormone in the third trimester].

Three groups of women were studied. The first included women without obstetric or systemic pathology; in these, plasma concentrations of progesterone, E, and DHEA-S were assayed at 30-40 weeks of pregnancy. The second group comprised women after physiological first delivery at term, and in these the plasma levels of the same hormones were assessed. In the third group, comprising women at 38 weeks of pregnancy with unripened cervix and DHEA-S plasma levels that were by 1-2 weeks below those of women with ripened cervix of the same gestational age, the effect of repeated perfusion with DHEA-S was examined.

Adult↗
PubMed1993

[Echography in diseases of the rotator cuff].

The diagnostic accuracy of shoulder US was investigated in 69 patients with a "painful shoulder" and the results compared with those of MR imaging. In our experience, US exhibited 95% sensitivity, 69% specificity, 83% positive predictive value, 90% negative predictive value and 85% accuracy. The analysis of the single US patterns proved the difficult distinction of small tears from focal tears, whereas complete ruptures were always easy to identify. In summary, all cases of rotator cuff degeneration or tear were always detected but not always correctly identified. False negatives on US included inflammatory processes of cuff structures but never ruptures or degenerations. Therefore, in our diagnostic protocol, US appeared to be a valuable screening method in the exclusion of rotator cuff injuries; other imaging techniques--i.e., arthrography, MR imaging, arthroscopy--were employed only in questionable/positive cases on US.

Adult↗
PubMed1993

[Osteosarcoma: magnetic resonance imaging of the effects of preoperative chemotherapy].

The effects of preoperative chemotherapy for osteosarcoma of the extremities were investigated with MR imaging. Forty-six patients affected with high-grade osteosarcomas of the extremities underwent MRI before and after two cycles of preoperative chemotherapy. At the end of treatment all tumors were resected and the rate of tumor necrosis was assessed on histologic sections. The MR images obtained before and after treatment were compared. Decreased tumor size, perilesional intramedullary edema and more marked lesion outline correlated well with positive histologic response to preoperative chemotherapy. Soft tissue edema and joint effusion did not change significantly and no clear correlation with histologic response was observed. Decreased signal intensity on T2-weighted images is likely to indicate response to chemotherapy. Likewise, poor response correlated with unchanged/increased signal intensity. Therefore, MRI appears a useful means to evaluate chemotherapy-induced changes in osteosarcomas of the extremities.

Adolescent↗
PubMed1993

[Spin-echo anatomy of the larynx in MRI at 1.5 T].

The larynges of 8 healthy and informed volunteers were studied with a superconductive MR unit at 1.5 T together with those of 10 patients with extra-laryngeal pathologic conditions. The study was performed with round surface coils (5'') and with delicated sellar coils in the anterior neck. Slices were 5 mm thick, and acquired on the coronal, axial, and sagittal planes, with T1-weighting; axial scans were repeated in the same locations with double echoes, with proton-density and T2-weighting. Five patients underwent additional scans after Gd-DTPA. The larynx of a semi-frozen cadaver was examined with sellar surface coils, on similar scanning planes and with similar pulse sequences to those described above; the larynx was removed, investigated with mammographic technique, and subsequently analyzed with thin CT slices and a high-resolution reconstruction algorithm for the study of laryngeal cartilage. Axial anatomical sections were then compared with MR and CT scans, and the anatomical structures were recognized on the triplanar MR scans of a volunteer's larynx. Besides MR anatomy of supporting laryngeal structures, the authors describe in detail the muscles, plicae, spaces and cavities which can be identified on the various planes, together with the changes in signal after Gd-DTPA.

Adult↗
PubMed1991

[Spin-echo anatomy of the larynx with magnetic resonance at 1.5 T].

The larynges of 8 healthy and informed volunteers were studied with a superconductive MR unit at 1.5 T together with those of 10 patients with extralaryngeal pathologic conditions. The study was performed with round surface coils (5") and with dedicated sellar coils in the anterior neck. Slices were 5 mm thick, and acquired on the coronal, axial, and sagittal planes, with T1-weighting; axial scans were repeated in the same locations with double echoes, with proton-density and T2-weighting. Five patients underwent additional scans after Gd-DTPA. The larynx of a semi-frozen cadaver was examined with sellar surface coils, on similar scanning planes and with similar pulse sequences to those described above; the larynx was removed, investigated with mammographic technique, and subsequently analyzed with thin CT slices and a high-resolution reconstruction algorithm for the study of laryngeal cartilage. Axial anatomical sections were then compared with MR and CT scans, and the anatomical structures were recognized on the triplanar MR scans of a volunteer's larynx. Besides MR anatomy of supporting laryngeal structures, the authors describe in detail the muscles, plicae, spaces and cavities which can be identified on the various planes, together with the changes in signal after Gd-DTPA.

Contrast Media↗
PubMed1989

[Rotator cuff lesions: evaluation with RM and US].

Physical and instrumental examination of the patients with an "aching shoulder" is often difficult and a positive out-come of surgical treatment may be impaired by the late diagnosis of long-standing rotator cuff lesions causing tendon adhesions and muscle atrophy. The authors report the results obtained in 25 selected patients with an aching shoulder examined with arthrography, real-time ultrasound (US) with a 5 MHz linear probe, and high-field (1.5 T) Magnetic Resonance (MR) imaging. Arthrography was able to demonstrate a cuff tear in 14/25 cases; US detected signs of tear in 14/25 (1 false negative); MR imaging showed a cuff lesion in 16/25 patients, and in one case allowed a partial cuff tear to be demonstrated, which had not been visualized with arthrography. MR imaging could also demonstrate other signs of periarticular pathologies (tendinitis, longhead of biceps inflammation, and bursitis) that may represent the early stages of the inflammatory-degenerative process underlying most of cuff lesions. The high diagnostic accuracy of US (95%) is stressed in the detection of cuff tears, in patients with an aching shoulder; as for questionable cases at US, MR imaging is indicated as a valid alternative to arthrography, which is more invasive and less accepted by the patients.

Arthrography↗
PubMed1989

[1.5 T MR in the diagnosis of parotid masses: comparison with ultrasonography].

Twenty-two patients who presented with laterocervical retromandibular enlargement were examined with both US and MR imaging to assess the intrinsic/extrinsic relationship of the mass to the parotid gland, the involvement of the facial nerve and adjacent structures, as well as the nature of the mass. Both US and MR imaging proved to be poorly specific in the characterization of the inflammatory lesions. Within the mass, both methods revealed high sensitivity (100%) in identifying the lesions, even very small ones. MR imaging allowed the lesion to be accurately located, the facial nerve to be identified, and its possible infiltration to be evaluated, with higher reliability than US, thanks to its higher contrast resolution and to its multiplanarity. Neither US nor MR imaging allowed the benign/malignant nature of the lesion to be assessed. On the basis of their experience, the authors suggest the use of T2-weighted MR sequences, with long TR and TE, to differentiate pleomorphic adenomas from other histotypes, after US assessment of the solid nature of parotid masses.

Adenocarcinoma↗
PubMed1989

[1.5-T MR of the knee: the correlations with arthroscopy].

The authors report their experience of knee articular pathologies studied with MR imaging. Forty patients (36 with and 4 without articular trauma) were examined with both MR imaging and arthroscopy. Arthroscopic findings were correlated with MR results in order to evaluate the accuracy of the latter in detecting meniscal tears. MR images were obtained with a 1.5 T unit and a transmit-receiver surface coil. Spin-echo sequences and, occasionally, fast-scan sequences were used both in the coronal and in the sagittal planes. High resolution MR imaging clearly depicted knee anatomy. As far as meniscal lesions were concerned, the authors employed a grading system to classify intrameniscal signals, as proposed by Lotysch. The preliminary results are encouraging and suggest the use of MR imaging as the first imaging modality for use in knee pathology before arthroscopy is performed.

Adolescent↗
PubMed1987

CT diagnosis of lumbosacral conjoined nerve roots. Findings in 19 cases.

The authors report the observations derived from CT evaluation of 19 cases of lumbosacral conjoined nerve roots; 11 of these have been confirmed by lumbar myelography and/or at surgery. They conclude that CT without intrathecal metrizamide allows the recognition in most cases of the presence of conjoined nerve roots and to differentiate them from a herniated disk fragment; this is especially useful to avoid surgical damage of anomalous roots.

Adult↗