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Biomedical subjects

A Siani

Publications and source records attributed to A Siani.

At least 55 records · Page 3Linked to original sources
PubMed1999

[Multiphasic spiral computed tomography in hepatocarcinoma. An evaluation following different percutaneous ablative procedures].

PURPOSE: To report our personal experience with helical CT evaluation of hepatocellular carcinoma treated with various percutaneous interventional procedures. We assessed both nodular response and the spectrum of changes within normal parenchyma. MATERIAL AND METHODS: December 1996 to September 1998 we examined with helical CT 41 patients (73 nodules in all) with hepatocellular carcinoma treated with percutaneous ablation therapies: conventional ethanol injection in 18 subjects (31 nodules), one-shot ethanol injection in 3 (8 nodules), radiofrequency thermal ablation in 16 (25 nodules), and combined chemoembolization and ethanol injection in 4 (9 nodules). CT performed was 4-27 days after the last session, acquiring biphasic volumetric images in 14 patients and triphasic volumetric images in 27. A second treatment with subsequent CT study was performed for 28 lesions; 15 underwent 3 serial studies and 6 underwent 4 studies. RESULTS: Compared with pretreatment findings, the diameter was unchanged in 62% of the nodules and increased in 38%. Morphology was unchanged in 63% of the lesions while in 37% a mild deformation toward the needle path or a more regular and round shape was evident. Borders were unchanged in 37% of the cases and modified in 63%, appearing well-defined in 73% and ill-defined in 27%. The necrotic portion had a low attenuation with a nodule-to-parenchyma gradient more evident on delayed than on venous and finally arterial acquisitions; 8% of the lesions were not recognizable on unenhanced scans. Residual viable tissue was identified in 44% of the nodules and quantified as 100% in 1% of all lesions, > 75% in 3%, > 50% in 4%, > 25% in 12%, < 25% in 23%. It was located centrally in 6% of the cases, peripherally in 12%, and eccentrically in 81%, and the shape was crescent in 66% of the cases, oval in 19%, and different in 16%. During the arterial phase the residual tumor appeared hyperdense in 97% of the nodules and isodense in 3%, while during the portal phase it was hyperdense in 22%, isodense in 28% and hypodense in 50%, and during the delayed phase hypodense in 100%. For what concerns the uninvolved parenchyma, lobar atrophy was present in 4% of the nodules, segmental atrophy in 8%, and subsegmental in 16%; caval thrombosis was found in 1 patient, portal thrombosis in 4. Arterioportal fistulas were identified in 5% of the nodules and areas of transient inhomogeneous attenuation in several cases. Subsegmental biliary dilation was detected in 4% of the lesions. CONCLUSION: Multiple-phase helical CT allows optimal depiction of primitive liver nodules treated with percutaneous interventional procedures and has a central role in the assessment of tumor response. Accurate is also the evaluation of changes or complications involving the surrounding parenchyma. Regarding the ablation effect, two typical features can be identified: after total necrosis nodular volume is unchanged or increased, borders are well-defined, and density is low and homogeneous (especially in delayed phases), while after partial necrosis the diameter is not modified, margins are ill-defined, attenuation is less decreased, and peripheral tumor maintains high density in arterial phase and low density in delayed phases. As for the treatment procedure, we found that thermal ablation with radiofrequency and single-session ethanol injection cause more evident alterations within both nodule and hepatic parenchyma, while after multi-session ethanol injection changes are less dramatic and consequently more difficult to assess.

Adult↗
PubMed1998

Ethnic differences in red blood cell sodium/lithium countertransport and metabolic correlates of hypertension: an international collaborative study.

Arterial hypertension is frequently associated with metabolic abnormalities. An abnormal activity of the erythrocyte sodium/lithium countertransport (Na/Li CT), an ion transport system under strong genetic control, is also found in people with hypertension and concomitant metabolic abnormalities. However, little information exists with regard to these clinical associations in different racial groups. The aim of this international collaborative study was to investigate Na/Li CT and the metabolic correlates of hypertension in two comparable samples of normotensive and hypertensive populations in the cities of Naples, Italy, and Shanghai, China, using identical, carefully standardized techniques. Blood pressure, anthropometric and metabolic variables, Na/Li CT, and 24-h urinary Na and K excretion were measured in untreated essential hypertensive (HPT) and normotensive (NT) individuals selected by age (35-60 years), body mass index (BMI; < 30 kg/m2), and blood pressure (BP; HPT, DBP > or = 95 mm Hg; NT, DBP < 90 mm Hg). The analysis of variance with adjustment for age was used to compare the groups. In the Neapolitan population, hypertensive individuals had higher serum triglyceride (P < .05) and uric acid levels (P < .001) than the normotensive group and also had a reduced glucose tolerance (P < .01) and an enhanced insulin response to the oral glucose tolerance test (OGTT) (P < .05). No such differences were seen between normotensive and hypertensive Chinese participants. The Neapolitan population (both NT and HPT) had a higher BMI (P < .01) than their Chinese peers. In the comparison of hypertensive patients in Shanghai and in Naples, the Neapolitans were heavier (P < .001), had a lower HDL/total cholesterol ratio (P < .01), an elevated fasting blood glucose (P < .05), and also a higher glucose (P < .001) and insulin response (P < .001) to OGTT. By contrast, they showed a significantly lower urinary Na/K ratio (P < .001). Na/Li CT was significantly increased in HPT both in Naples (286 +/- 24 v 224 +/- 13 micromol/L RBC x h; P < .05, M +/- SE) and in Shanghai (388 +/- 45 v 265 +/- 30 micromol/L RBC x h; P < .05). Furthermore, Na/Li CT was significantly and inversely associated with HDL cholesterol both in the Neapolitan (P < .01) and in the Chinese (P < .05) population, whereas it was directly correlated with serum triglyceride (P < .001) and serum uric acid (P = .001) only in the Neapolitan population. These results indicate that essential hypertension is associated with a higher prevalence of obesity, impaired glucose tolerance, and hyperinsulinemia in Naples than in Shanghai; and Na/Li CT is linked to both high blood pressure and metabolic abnormalities in the Italian sample, whereas it is an isolated marker of hypertension in the Chinese sample.

Adult↗
PubMed1998

Red blood cell sodium-lithium countertransport and risk of future hypertension: the Olivetti Prospective Heart Study.

An elevated red blood cell (RBC) sodium-lithium countertransport (Na-Li CT) is associated with high blood pressure (BP) in cross-sectional investigations; however, its value as a predictor of future hypertension, and thus of cardiovascular risk, has not been defined. The present study evaluated the association between Na-Li CT and risk of future hypertension in a sample of 106 untreated normotensive middle-aged men participating in the Olivetti Prospective Heart Study in southern Italy. BP, anthropometric and metabolic variables, and RBC Na-Li CT were measured at baseline in 1987 and at a follow-up visit in 1994 through 1995. Na-Li CT was stable over time (r=0.85) and was significantly associated to systolic BP in both visits. Of the 106 initially normotensive participants, 14 were found to be hypertensive at the 8-year follow-up examination. Eleven of these 14 hypertensives were in the highest tertile of systolic BP at baseline, and 9 of 11 also had an elevated baseline Na-Li CT. In multiple logistic regression analysis, baseline BP, Na-Li CT, and age were all significant predictors of the risk of future hypertension. Individuals with baseline systolic BP in the highest tertile had a 60% risk of developing hypertension if their Na-Li CT was also high, whereas their risk was only 5% if Na-Li CT was in the two lowest tertiles (P=0.003). RBC Na-Li CT was a valuable predictor of subsequent hypertension in middle-aged men with a high-normal BP level for their age.

Age Factors↗
PubMed1998

[The correlation between Doppler echography with a contrast medium and CT in the study of a hepatocarcinoma submitted to chemoembolization].

PURPOSE: We report our preliminary experience concerning Doppler studies with the intravenous injection of a galactose-based echo contrast agent (SHU 508 A) in hepatocellular carcinomas (HCCs) treated with transcatheter arterial chemoembolization. We correlated US findings with those of iodized-oil helical CT. MATERIAL AND METHODS: In 1997 we examined 18 patients with cirrhosis and HCC (31 nodules in all) submitted to hepatic oily chemoembolization 15-30 days earlier. The lesions were studied with color and power Doppler US before and after echo contrast agent infusion (300 mg/mL, injection/nodule, constant rate in 60-90 s) and with Lipiodol CT (0-7 days after US). In the retrospective analysis, special care was paid to Doppler signals from pulsatile intra- and perinodular flow and to the detection of new small vessels on enhanced images. The signal was graded as absent (0), weak (1), medium (2) and strong (3). The oily agent uptake on CT images was graded as absent (0), grade I (< 10%), II (< 50%), III (> 50%) and homogeneous (IV). All scores were given on a blind basis. RESULTS: Liver enhancement was found in all cases and always lasted long enough to allow the accurate depiction of parenchymal lesions (at least 8 minutes). Signal intensity could be evaluated in 27 of 31 HCCs (2 were too deeply seated and two were too affected by cardiac activity). We had the following scores: basal color Doppler: grade 0 = 15 lesions, grade 1 = 8 lesions, grade 2 = 4 lesions; contrast-enhanced color Doppler: grade 0 = 11 lesions, grade 1 = 7 lesions, grade 2 = 8 lesions, grade 3 = 1 lesion; basal power Doppler: grade 0 = 12 lesions, grade 1 = 8 lesions, grade 2 = 6 lesions, grade 3 = 1 lesion; contrast-enhanced power Doppler: grade 0 = 10 lesions, grade 1 = 7 lesions, grade 2 = 8 lesions, grade 3 = 2 lesions; Lipiodol-CT: grade 0 = 1 lesion, grade I = 1 lesion, grade II = 7 lesions, grade III = 8 lesions, grade IV = 10 lesions. The difference between color and power Doppler scores, both compared to each other and between basal and enhanced images, never exceeded one. CONCLUSIONS: Contrast-enhanced Doppler US is a simple and fast technique allowing strong, constant and long-lasting enhancement. Doppler US techniques permit the effective and realistic study of HCC nodules treated with chemoembolization and show a better correlation with Lipiodol CT than basal studies. Power Doppler is slightly more sensitive and accurate than color Doppler and shows a better correlation with Lipiodol CT.

Adult↗
PubMed1998

[Echo-guided radiofrequency percutaneous ablation of hepatocellular carcinoma in cirrhosis using a cooled needle].

INTRODUCTION: Radiofrequency hyperthermia using the newly-developed "cooled-tip" needle is one of the latest US-guided percutaneous treatments of hepatocellular carcinoma arising in cirrhosis. The continuous cooling of the needle tip allows tissue heating and necrosis far from the electrode without tissue charring, which was the major drawback of the old monopolar technique. Herein we report our preliminary results on feasibility and effectiveness of the thermoablation of mono- or paucifocal hepatocellular carcinoma with the cooled-tip needle. MATERIAL AND METHODS: November, 1996, to January, 1998, we treated thirteen cirrhotic patients (mean age 69.5 yrs, 10 men, 12 HCV-positive; 11 in Child's Class A and 2 in Class B) with 19 hepatocellular carcinoma nodules (mean diameter: 27 mm; range: 10-41 mm; 6 with diameter > 3 cm). None of the patients had portal thrombosis and/or extrahepatic spread. We used a radiofrequency generator (100 W power) connected to an 18 G perfusion electrode needle with an exposed tip of 2-3 cm. The circuit is closed through a dispersive electrode positioned under the patient's thighs. A peristaltic pump infuses a chilled (2-5 degrees C) saline solution to guarantee the continuous cooling of the needle tip. The needle was placed into target lesions under US guidance. The interventional procedure was carried out under general anesthesia using Propofol without intubation. Dynamic CT (more recently with the helical technique) was carried out 15-20 days after thermoablation to assess treatment efficacy. RESULTS: In all, 31 thermal injuries (at 1000-1200 mA for 10-15 minutes) were caused in 21 sessions in the 19 hepatocellular carcinoma nodules (mean: 1.5 lesions per nodule and 1.6 sessions per patient). Complete necrosis as assessed at dynamic CT (no enhancement during the arteriographic phase) was achieved in 16 of 19 nodules (84%). No side-effects occurred. During the follow-up (median: 11 months) no death occurred and five patients had recurrent hepatocellular carcinoma appearing either as single nodule or as multinodular liver involvement. CONCLUSIONS: In our experience radiofrequency hyperthermia with the cooled-tip needle permits effective and safe percutaneous ablation of HCC in cirrhosis. In addition, treatment time is short and lesions > 3 cm can be treated. Further experience is needed to better define the role of percutaneous thermoablation in the treatment strategy of hepatocellular carcinoma.

Aged↗
PubMed1997

Effect of dietary versus pharmacological correction of hypertriglyceridemia on red blood cell membrane sodium/lithium countertransport activity.

An elevated red blood cell Na/Li countertransport (Na/Li CT) is often associated with high blood pressure and metabolic abnormalities. Recent studies suggested that a reduction in serum TG levels is associated with a decrease in Na/Li CT activity. However, it is still unclear if this phenomenon could be originated from systemic metabolic alterations or from modifications of the membrane dynamic properties. Aim of the present study was to investigate whether dietary or pharmacological TG lowering therapy might have a different effect on Na/Li CT activity and related metabolic parameters. Twenty normotensive hyper-TG patients were recruited from the Lipid outpatient Clinic: they had a baseline Na/Li CT activity significantly higher compared with age- and BMI-matched normolipidemic controls (386+/-33 vs 274+/-39 umol/l RBC/h, p<0.05). The patients were randomly prescribed one of the following two-months treatment: Group 1)-triglyceride lowering diet; Group 2)-lipid lowering drug (Gemfibrozil 600 mg b.i.d.). Na/Li CT and metabolic and anthropometric variables were measured at baseline and after 1 and 2 months of treatment. At the end of intervention, there was in both groups a significant and comparable fall in plasma triglyceride (group 1: -2.61+/-0.73 mmol/l p<0.01; group 2: -4.29+/-1.20 mmol/l p<0.01). In the diet-treated group there were, in addition small but significant reductions in body weight (-3.7+/-0.8 kg p<0.01), fasting glucose (-0.36+/-0.14 mmol/l p<0.05) and insulin levels (-2.1+/-0.5 mU/l, p<0.01), while no such changes were observed in the fibrate treated patients. Na/Li CT activity was significantly and comparably reduced at the end of treatment in both groups (group 1: -97+/-28 umol/l cell/h, p<0.01; group 2: -89+/-30 umol/l cell/h, p<0.01). In conclusion, these results indicate that the decrease in Na/Li CT associated with both dietary and drug treatment of hypertriglyceridemia is to be traced to a direct effect of plasma TG concentration on this transport system (probably as a result of modification in the membrane lipid environment) rather than to changes in plasma insulin levels or insulin resistance.

Adult↗
PubMed1996

Increased proximal sodium reabsorption is associated with increased cardiovascular risk in men.

OBJECTIVE: To explore the relationship between fractional lithium excretion (taken as an index of proximal sodium excretion), blood pressure and metabolic risk factors for coronary heart disease in a sample of a general white male population. DESIGN: A cross-sectional survey of a sample of a white male working population carried out as part of the Olivetti Heart Study. SETTING: The Olivetti factory in Pozzuoli, a suburb of Naples, Italy. PARTICIPANTS: Five hundred and sixty-seven untreated white male workers aged 21-68 years. MEASUREMENTS: Anthropometry, blood pressure, a blood test to determine the lipid profile, electrolytes, glucose and uric acid levels, a detailed questionnaire and urinary measurements on a fasting timed urine sample after a 300 mg lithium carbonate capsule taken the night before the investigation. RESULTS: The fractional excretion of lithium was inversely associated with body weight, body mass index, diastolic blood pressure, serum triglycerides level and serum uric acid level whereas it was positively associated with serum high-density lipoprotein cholesterol level. The greater the percentage of filtered sodium reabsorbed at the proximal tubule the greater the overall metabolic cardiovascular risk. The association was consistent across tertiles of fractional excretion of lithium, was independent of age, smoking, alcohol consumption and sodium excretion (taken as an index of sodium intake) and persisted in multiple regression analysis. Men with high serum triglycerides, high serum uric acid and low serum high-density lipoprotein cholesterol levels and higher blood pressure had significantly lower fractional excretion of lithium (and thus enhanced proximal sodium reabsorption) than did men with a normal metabolic profile (21.8 +/- 5.6 versus 26.5 +/- 5.1%, p = 0.002). CONCLUSIONS: The independent association between a cluster of risk factors for cardiovascular disease suggestive of insulin resistance and increased proximal sodium reabsorption at the renal tubule indicates a new feature of the metabolic syndrome that, if causal, could be amenable to intervention.

Adult↗
PubMed1993

The relationship of erythrocyte sodium-lithium countertransport to blood pressure and metabolic abnormalities in a sample of untreated middle-aged male workers.

OBJECTIVES: To investigate the relationship between erythrocyte sodium-lithium countertransport and blood pressure in a randomly selected sample of untreated male workers and to evaluate the influence of a set of metabolic abnormalities commonly associated with hypertension on this relationship. DESIGN: A cross-sectional investigation of a randomly selected sample of untreated male workers (n = 216, age range 21-59 years) at the Olivetti factory in Pozzuoli, Naples. METHODS: Standardized measurements of anthropometric and metabolic parameters, blood pressure and Na(+)-Li+ countertransport were performed. RESULTS: In a simple linear correlation analysis Na(+)-Li+ countertransport was directly related to plasma triglycerides and uric acid concentrations, body mass index (BMI) and systolic and diastolic blood pressure. Significantly higher values of Na(+)-Li+ countertransport were observed in the two upper quintiles of the serum triglycerides and uric acid distributions, and of the BMI distribution. Na(+)-Li+ countertransport accounted for approximately 2% of the blood pressure variation in this study population, but its contribution to the effect of metabolic covariates was not statistically significant. Hypertensive individuals with one or more metabolic abnormality had a significantly higher mean level of Na(+)-Li+ countertransport than those hypertensives who were free of such alterations. CONCLUSIONS: The results of the present study suggest that a high level of Na(+)-Li+ countertransport is more common in those hypertensive individuals who have concomitant metabolic abnormalities than in hypertensives who are free of such abnormalities.

Adult↗
PubMed1991

Increasing the dietary potassium intake reduces the need for antihypertensive medication.

OBJECTIVE: To determine whether an increase in dietary potassium intake from natural foods reduces the need for antihypertensive medication in patients with essential hypertension. DESIGN: Randomized, controlled trial with 1-year follow-up. SETTING: Hypertension outpatient clinic of a university hospital. PATIENTS: Fifty-four patients with well-controlled hypertension, 47 of whom completed 1 year of follow-up. INTERVENTION: Patients were randomly assigned to one of two groups and were given dietary advice aimed at selectively increasing potassium intake (group 1) or at keeping their customary diet unchanged (group 2). During a 1-year follow-up period, drug therapy was reduced in stepwise fashion, according to a fixed protocol, provided that blood pressure remained below 160/95 mm Hg. MAIN RESULTS: Potassium intake was checked monthly by referring to 3-day food records and by measuring 24-hour urinary potassium excretion. Potassium intake increased in group 1 but did not change in group 2 (P less than 0.001). No change was observed in either urinary sodium excretion or in body weight. After 1 year, the average drug consumption (number of pills per day) relative to that at baseline was 24% in group 1 (95% Cl, 15% to 32%) and 60% in group 2 (Cl, 44% to 76%) (P less than 0.001). By the end of the study, blood pressure could be controlled using less than 50% of the initial therapy in 81% of the patients in group 1 (Cl, 66% to 96%) compared with 29% of the patients in group 2 (Cl, 10% to 48%) (P = 0.001). Patients in group 1 ended the study with a lower number of reported symptoms compared with patients in the control group (P less than 0.001). CONCLUSION: Increasing the dietary potassium intake from natural foods is a feasible and effective measure to reduce antihypertensive drug treatment.

Adult↗
PubMed1990

Insulin-induced increase in heart rate and its prevention by propranolol.

Acute hyperinsulinaemia in the absence of changes in blood glucose increases heart rate in man. Animal studies have suggested that beta-adrenergic blockade does not prevent the insulin-induced increase in heart rate. The aim of the present study was to investigate the acute effect of insulin on heart rate and blood pressure in non diabetic subjects and, in particular, to determine whether beta-adrenergic receptor blockade would significantly influence the effect. On separate days 9 healthy young volunteers were pretreated with either 80 mg propranolol or placebo p.o. After a 60-90 min period of heart rate and blood pressure stabilization, a placebo injection was given intravenously and heart rate and blood pressure were then monitored every 5 min. After 30 min insulin Actrapid MC 0.2 IU/kg body weight was given i.v. A 20% glucose infusion was given to maintain blood glucose at its fasting level. After insulin administration, a rapid and statistically significant increase in heart rate was observed when the patients were pretreated with placebo; pretreatment with propranolol completely prevented this effect. Serum insulin levels were significantly higher than baseline at all times and there was no significant change in blood glucose. The results are consistent with the hypothesis that the insulin-induced increase in heart rate in man may result from stimulation of cardiac sympathetic activity.

Adult↗
PubMed1989

Oral calcium supplementation and blood pressure: an overview of randomized controlled trials.

Over the past few years, several trials on the effect of oral calcium supplementation on blood pressure have been undertaken both in normal subjects and in patients with high blood pressure. Of these, 15 randomized, controlled studies were reviewed: 10 included patients with high blood pressure, three studied normal subjects, and two used a low-calcium diet for comparison. The 15 studies reviewed investigated a total of nearly 400 peoples. No significant evidence for a supine blood pressure-lowering effect of oral calcium supplementation was found in the trials as a whole or in those trials carried out in hypertensives only. However, a small effect on standing blood pressure was detected. Our study indicates that the overall effect of oral calcium on blood pressure, if any, is very small and confined to standing blood pressure, it is, therefore, inappropriate to recommend oral calcium supplementation for the treatment of essential hypertension.

Administration, Oral↗
PubMed1989

Comparison of variability of urinary sodium, potassium, and calcium in free-living men.

The variability of 24-hour urinary sodium, potassium, and calcium excretion was studied in a sample of 22 Neapolitan men with mild blood pressure elevation. On 5 days within a 1-month period, 24-hour urine specimens were collected by each subject. The estimated ratio of intraindividual-to-interindividual variance was 1.12 for urinary sodium, 2.46 for urinary potassium, and 0.52 for urinary calcium. Based on these values, five 24-hour urine collections are necessary to reduce to less than 10% the diminution of the correlation coefficient between urinary sodium and another related variable; this number is substantially lower than that found in previous studies in a North American population sample, but similar to the one reported for Chinese population samples. Ten urinary collections are needed for potassium excretion. A different and more favorable situation is observed for 24-hour calcium excretion, as only two collections are necessary for the adequate characterization of individuals in a population.

Adult↗
PubMed1988

Controlled trial of low calcium versus high calcium intake in mild hypertension.

A controlled trial of the effect of low versus high calcium intake on blood pressure was performed in 15 patients with mild essential hypertension (supine blood pressure after a 1-month run-in period: 145.7 +/- 2.6/97.8 +/- 0.9 mmHg, mean +/- s.e.m.). After a 1-week baseline period on a standard calcium intake (900 mg/day, obtained by giving a 500-mg calcium tablet daily, in addition to a 400-mg calcium diet), the patients were randomly entered into a double-blind crossover study of 4-week low calcium intake (400 mg calcium diet plus two placebo tablets/day) and 4-week high calcium intake (1400 mg/day: 400-mg calcium diet plus two 500-mg calcium tablets/day). Compliance with the diets appeared to be satisfactory, based on the results of food record analysis. No significant blood pressure change was observed at the end of the low-compared to the high-calcium regimen. Serum ionized calcium was slightly, but not significantly lower, while 24-h urinary calcium excretion was significantly reduced during the low-calcium diet. No difference was found in urinary sodium and potassium excretion between the two study periods. We conclude that moderate modifications of oral calcium intake are not associated with changes in blood pressure within the time span of this study.

Adult↗
PubMed1988

[Hemorrhagic aneurysm of the celiac trunk. Diagnosis by ultrasound, CT and angiography].

The authors report their experience in the study of bleeding aneurysms of the celiac arteries. Eleven patients were examined with US, CT, and angiography (8 hepatic artery aneurysms and 3 splenic artery aneurysms). Clinical findings included digestive bleeding, upper abdominal pain, palpable pulsating masses, and jaundice. Patient history included blunt abdominal trauma, penetrating trauma due to gunshot, acute pancreatitis, recent hepatic biopsy. In all cases US showed an abdominal mass ranging in size from 2 to 10 cm. US findings included cyst-like lesions (8 cases), a lobulated solid-like lesion, and complex lesions (2 cases). Continuity of the lesion with adjacent arterial vessels was noted in 5/11 cases, and pulsing activity in 3/11 cases. US patterns, although not specific, play an important role in the diagnosis when associated to other elements such as arterial continuity, mass pulsatility, patient history, and gastrointestinal bleeding. They suggest the need for more specific imaging exams, i.e. CT and angiography, and help avoid dangerous diagnostic biopsies. CT was performed to confirm US findings in 5 cases, and detected either hypodense cystic masses, or inhomogeneous masses with arterial enhancement after bolus injection of cm. CT was used to better demonstrate the lumen, patency of the vessel, the walls of the vessel, and the parietal thrombotic component. The typical arterial enhancement was the decisive finding for the diagnosis, even though a total continuity with arterial vessels was never observed. Angiography was the method of choice for the preoperative demonstration of hepatic artery aneurysms (10 cases) and for occlusive treatment with Gianturco coils (3 cases).

Adult↗