Biomedical subjects

Adolfo Canadè

Publications and source records attributed to Adolfo Canadè.

17 recordsLinked to original sources

PubMed2006

Sonographic quantitative evaluation of scrotal veins in healthy subjects: normative values and implications for the diagnosis of varicocele.

OBJECTIVES: To define the normative values of scrotal vein diameters, investigate the eventual presence and characteristics of scrotal reflux in healthy subjects, and describe its implication for the diagnosis of scrotal varicocele. METHODS: Color-Doppler ultrasonography was performed on a population of 145 healthy, symptomless subjects, with clinical examinations and semen analyses within normal limits. RESULTS: The upper limit of the scrotal veins diameter (3.7-3.8mm) exceeds values presently employed for a diagnosis of varicocele. Furthermore, a high percentage of healthy subjects (53%) were found to have reflux in the scrotal veins, currently considered one of the criteria for diagnosing varicocele, especially in its subclinical form. CONCLUSIONS: To reduce the risk of misinterpretations between the various specialists involved in Color-Doppler ultrasonography and urologists, quantitative data of the scrotal veins (i.e., maximum diameter and the presence, velocity, and duration of reflux) should be described in reports of sonographic examinations performed for scrotal varicocele.

Adult↗

PubMedDate not supplied

Megaureter and ureteral valves.

Primary megaureter is visualized as a typical dilatation on urography. Adequate oblique projections should be added to depict the juxtavesical tract of normal caliber. In even the most severe forms pyelocaliectasis is absent or mild and the ureter is not tortuous. Sonography as well as fluoroscopy during urography shows hyperperistalsis in the dilated tract and aperistalsis in the juxtavesical tract. Cystography rules out vesicoureteral reflux. In prune-belly syndrome the megaureter is bilateral and massive with no evidence of obstructions. The sonographic finding of hydronephrosis or hydroureteronephrosis and the absence of vesicoureteral reflux on voiding cystography lead to the suspicion of ureteral valves, directly documented on urography as sharp and transverse filling defects. Retrograde pyelography can better define the obstructing area and documents the normality of the underlying tract. With this procedure, the valvular flaps appear with a superior convexity (like a small umbrella). MR-urography still to be validated clinically, will be able to provide novel perspectives.

Diagnostic Imaging↗

PubMedDate not supplied

Role of magnetic resonance imaging in the diagnosis of recurrence after breast conserving therapy.

The sensitivity, specificity and accuracy of MRI in detecting breast cancer recurrence were analyzed. 40 patients undergoing breast conserving therapy were studied with MRI. Cytohistologic examinations of suspected local recurrence were carried out. In these patients, the clinical, mammographic and sonographic characteristics of local recurrence were nonspecific or dubious. All patients were examined at least 1 year after completion of radiation therapy. Qualitative and quantitative information was acquired with dynamic MRI. Statistical analysis was performed with the Student's t test. Breast cancer recurrence identified in 22 patients was confirmed on histology in all of them. There were only 2 cases of false positive results. MRI showed 95% accuracy, 100% sensitivity and 88.8% specificity with 5% false-positives and 100% negative predictive value. Dynamic MRI appears a valuable technique for differentiation of post-treatment changes in recurrent carcinoma and for guiding the histological confirmation.

Adult↗

PubMedDate not supplied

Radial scar: from conventional imaging to the new techniques. Case reports.

The role of MR-mammography in radial scar was assessed in 4 female patients. All 4 patients showed mammographic findings of radial scar and underwent dynamic MR-mammography. MR-mammographic findings were compared with histopathological results. On MR-mammography a focal enhancing lesion with irregular margins, plateau or rapid wash-out time/signal intensity curves, with maximum signal intensity > 100% were documented in the 4 patients. The histological diagnosis identified i case of infiltrating lobular carcinoma, 1 case of atypical hyperplasia and 2 cases of typical hyperplasia. In the preliminary study, MR-mammography was superior to mammography in the assessment of the extent and margins of the lesions. However, in the 4 study patients it could not accurately differentiate between carcinoma and benign lesions. It should be observed that lesions suggestive of radial scar have to be removed by surgery.

Breast↗

PubMedDate not supplied

Diagnostic imaging in the clinical management of patients at high risk for breast cancer.

Although being predominantly anecdotal, breast carcinoma shows a considerable component of multifactorial genetic transmission, referable to dominant autosomal inheritance. Among the genes responsible for hereditary breast cancer two main genes (BRCA1 and BRCA2) have already been identified. At present, genetic tests to identify known inherited mutations associated with breast tumor predisposition, are available. Asymptomatic subjects with genetic BRCA1/2 mutations represent a group at high risk; therefore it is now indispensable to work out adequate strategies of prevention and/or of early diagnosis. Besides education (information) and genetic counselling, there are three perspectives of intervention for these subjects: bilateral prophylactic surgery, pharmacologic prophylaxis and periodical diagnostic monitoring; unfortunately all of them are still burdened by limitations.

Adult↗

PubMedDate not supplied

Molecular imaging: state of the art.

Molecular imaging includes all imaging methods applied in the identification, characterization and assessment "in vivo" of biological processes which occur at the cellular and molecular level. Molecular imaging parallels the remarkable advances achieved in the medical field, culminated in the sequencing of human DNA, the genome project. The understanding of the genetic basis of diseases and of human biology in general, together with the development of new drugs, led to a growing need for novel, sensitive and safe imaging technology to be rapidly translated from animal models into patients. The present evaluation of presence/absence of disease is based on anatomic and morphologic changes, the result of underlying molecular alterations. Direct "in vivo" visualization of these alterations allows early diagnosis before the onset of typical pathologic manifestations. Similarly, short-term effects of therapy can be directly visualized. In a near future, "evidence-based" medicine will become "presymptomatic" medicine. Histopathology will be replaced by "molecular pathology" with genomic implications in disease classification. In the near future the conventional morphologic methods should be supported and then replaced by the new functional and molecular methods with additional information proved useful for the diagnostic approach. In this article, the potentialities and applications of Nuclear Medicine, Magnetic Resonance Imaging, Optical Imaging and Contrast-enhanced Ultrasound are reviewed.

Diagnostic Imaging↗

PubMedDate not supplied

Web-based radiology: a future to be created.

The impact of Internet on Medicine and Surgery is certainly remarkable, however the influence it had on Diagnostic Imaging was even stronger. The standardization of digital images acquired by the different medical imaging equipment has further facilitated the diffusion, transmission and communication in radiology within hospitals as well as on WEB. Radiology departments are bound to become "filmless" and with the present "tablet PC" radiological images will be directly transferred to the patient's bed in the relative electronic patient report. For radiology, interactive education could be envisaged with a tutor who guides the student(s) through the network. The Internet is an inexhaustible source of radiologic educational and information material with a number of sites of clinical cases, tutorial and teaching files, journals and magisterial lectures on-line. In a near future, the Internet could be applied in the simulation of clinicoradiologic cases or in applications of artificial intelligence with expert systems to support the solution of most complex cases.

Analog-Digital Conversion↗

PubMedDate not supplied

"Lights and shadows" in ultrasonography.

The case of a 40-year-old male patient come to the emergency service with symptoms suspicious of biliary colic, is presented. Liver sonography was requested to evaluate the parenchyma, the gallbladder and bile duct caliber in the suspicion of lithiasis. During the examination a hyper-reflecting image with posterior shadowing was detected at the level of the gallbladder infundibulum. However, the shadowing was not typical of lithiasis. This aroused some doubts and the scan was repeated after some minutes: an absolutely normal infundibulum was visualized. The shadowing was therefore an artifact probably due to a partial volume effect of the air contained in the distended duodenum, in contact with the gallbladder. The formation process of the sonographic image is carefully analyzed with particular reference to the situations generating artifacts.

Adult↗

PubMedDate not supplied

Diagnostic imaging of the chest: exemplification of a reasoned integration.

Based on the discussion and integrated management of a case of chest radiology, the reasoned approach to the perceptive-interpretative analysis and the "reasoned" diagnostic integration is tentatively exemplified. The request of a chest X-ray from the emergency department concerned a 75-year old patient, heavy smoker and chronic alcoholic with reduced vesicular murmur, diffuse hissing sounds, basal rales, weight loss and lack of appetite. The finding of right apical nodular opacities was critically evaluated to establish its diagnostic relevance (contours, opacity, site, accessory signs). After broad-spectrum antibiotic therapy a second chest X-ray was substantially unchanged. For careful diagnostic assessment CT of the chest was performed and the definitive diagnosis of main airway obstruction, bronchiolitis and right nonspecific apical outcomes was established.

Aged↗

PubMedDate not supplied

Combined diagnostic and therapeutic imaging of hemosuccus pancreaticus.

The justification of a request of ERCP in a patient with hematobilia, was evaluated, based on the medical history and negative endoscopy findings for gastrocolic bleeding. The diagnostic examination was performed: it confirmed the release of blood from the papilla of Vater, however the definitive diagnosis could not be established; CT, as the examination of first choice was performed. It provided additional information and the diagnosis of aneurysm of the splenic vein apparently non communicating with the main pancreatic duct, was established. Angiography of the splenic artery was performed as the examination of second choice to definitely ascertain the source of bleeding. During the examination, the aneurysm embolization excluded the affected vessel from the circulation and allowed immediate benefit to the patient.

Abdominal Pain↗

PubMedDate not supplied

Suspected cup syndrome. Diagnostic imaging of a misunderstood breast tumor for its uncommon location.

The case of a 41-year-old female patient with axillary lymphadenopathies and negative clinical and mammographic examinations is discussed. In the suspicion of a cup syndrome of breast origin, breast sonography was performed. While the absence of alterations was confirmed, a right parasternal swelling was highly suggestive of malignancy. On histology, a malignant parasternal nodule was diagnosed. Breast MRI was performed and an ipsilateral malignant focal lesion was visualized. Chemotherapy was administered but after a disease-free interval leptomeningeal and cerebral metastases appeared.

Adenocarcinoma↗

PubMedDate not supplied

Diagnostic imaging of the digestive tract. Reasoned approach to a duodenal filling defect.

A case of a patient with sideropenic anemia of suspected gastrointestinal origin is presented. A radiologic study of the upper digestive tract was performed. It documented a duodenal filling defect giving rise to an analytic discussion throughout various perceptive-interpretative logical steps: the image reality, the formation of the filling defect image and its nature. The radiologist's conclusions supported the presence of a benign submucosal neoformation to be treated with surgical resection for its size and for the patient's clinical conditions.

Anemia, Iron-Deficiency↗

PubMedDate not supplied

Combined diagnostic imaging of transitional cell carcinoma of the upper urinary tract.

The case of a female patient with recurrent macroscopic hematuria and negative vesical and renal ultrasonography, is discussed. On urography a gross pyelocaliceal filling defect was visualized. Urographic findings were suggestive of the diagnosis of transitional cell carcinoma of the upper urinary. CT was performed to confirm the diagnosis and stage the tumor: it showed the presence of an advanced lesion. At histology the diagnosis of transitional cell carcinoma of the upper urinary tract was confirmed.

Carcinoma, Transitional Cell↗

PubMedDate not supplied

Diagnostic imaging of the small bowel in a case of occult gastrointestinal bleeding.

A case of a male patient with occult gastrointestinal bleeding and negative gastroscopy and colonoscopy is presented and discussed. Oral small bowel barium follow-through was performed upon the patient request. It documented a jejunal neoformation. The analysis of radiologic findings directed towards a probably extramucosal origin. Subsequent CT evaluation confirmed a neoformation inseparable from a jejunal loop with inhomogeneous contrast enhancement, therefore of suspected malignant nature. The histological examination on the surgical specimen documented the presence of a stromal tumor of indeterminate malignancy.

Gastrointestinal Hemorrhage↗

PubMedDate not supplied

Diagnostic imaging of the diabetic foot. What the clinician expects to know from the radiologist....

A case of diabetic foot in a patient with advanced diabetes is presented. The correct diagnostic approach was analyzed based on the reasoned combination of available diagnostic imaging procedures (color-Doppler US, CT-angiography, MR-angiography and digital subtraction angiography) and on the clinician's instances. Angiographic findings contraindicated intravascular treatment. Femorotibial surgical bypass was performed.

Diabetic Foot↗

PubMedDate not supplied

Radiation therapy of breast cancer. Reasoned approach to a clinical case.

The case of a patient undergoing quadrantectomy of lower quandrants of the right breast and ipsilateral axillary lymph node dissection for breast cancer followed by adjuvant radiotherapy is discussed. The stage of the disease and prognostic factors are analyzed for prognosis. Comorbidities ruled out chemotherapy. Radiation therapy was planned followed by clinicoinstrumental controls. After the second control ipsilateral costal bone metastases were observed; radiation therapy for palliation was prescribed.

Bone Neoplasms↗

PubMedDate not supplied

Reasoned approach to multiple osteosclerotic lesions. Combined diagnostic imaging in a case of osteopoikilosis.

The case of a female patient who had undergone mastectomy for infiltrating ductal carcinoma and come to the Orthopedics Division for lumbosacral pain unresponsive to conventional treatment is discussed. Pelvic X-ray, CT and scintigraphy were performed. The presence of multiple areas of selerosis of the pelvis and proximal femurs were documented. The differential range could be limited to osteoblastic metastasis and osteopoikilosis. The diagnosis of osteopoikilosis was established based on scintigraphy which proved the absence of uptake of the radiotracer.

Adult↗