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C Bartolozzi

Publications and source records attributed to C Bartolozzi.

205 records · Page 12Linked to original sources
PubMedDate not supplied

[Dixon's technic for fat suppression. Its potential applications in combination with gadolinium-DTPA].

Modification of the Dixon technique enables the reconstruction of water and fat images operating at midfield strength. The technique was combined with intravenous administration of gadolinium-DTPA in five patients with lumbosacral spine conditions, four patients with soft tissue neoplasms and three with skeletal neoplasms; all patients were examined at 0.5 T. Mean attenuation of fat signal in T1-weighted images was 85% and implied a redistribution of the gray-scale dynamic range. This allowed easier appreciation of normal and abnormal enhancement in both areas containing fat tissue and areas without it. This was useful in the evaluation of fresh scars in two patients recently submitted to lamino-discectomy and of the prevertebral extension of the inflammatory process in one patient with spondylodiscitis. In the patients with soft tissue neoplasms the combination of fat suppression and Gadolinium was helpful to assess lesion size. Finally, in the patients with skeletal neoplasms fat-suppressed images obviated for the lesion disappearance observed on conventional T1-weighted SE images after contrast administration. The combination of intravenous administration of gadolinium-DPTA with Dixon's fat-suppression technique is a new promising capability of midfield MRI.

Adipose Tissue↗
PubMedDate not supplied

[The magnetic resonance and histological correlations in hepatocellular carcinoma].

Hepatocellular carcinoma (HCC) exhibits variable features on Magnetic Resonance (MR) images. In this study, the correlations between MR patterns of HCC and histopathologic findings are investigated. Fifty patients with HCCs were studied with MR at 0.5 T. All neoplastic lesions were subsequently submitted to biopsy: structural pattern, tumor grading (following the Edmonson and Steiner classification), the presence of fatty degeneration, and intracellular glycogenic content (established on the basis of staining by the periodic acid Schiff-PAS-method) were evaluated. Thirteen HCCs were < 3 cm, 16 ranged 3-5 cm, and 21 were > 5 cm. On spin echo (SE) T1-weighted images (T1w), 18 tumors were hyperintense, 10 isointense, and 22 hypointense with respect to the surrounding liver parenchyma. On SE T2-weighted images (T2w), 46 HCCs resulted hyperintense and 4 isointense. Histopathologic examination demonstrated 46 tumors with trabecular pattern and 4 tumors with pseudoglandular pattern; however, no significant correlation between structural pattern and signal intensity was observed. Thirty-one HCCs were classified as well-differentiated tumors (grade 1), 12 as moderately differentiated tumors (grade 2), and 7 as poorly-differentiated tumors (grade 3). Hyperintensity on SE T1w and isointensity on SE T2w significantly correlated with grade 1 tumors (p < 0.01). No MR feature demonstrated significant correlation with grade 2 or grade 3 tumors. Fatty degeneration was demonstrated in 4 HCCs: none of them resulted hyperintense on SE T1w (2 were isointense and 2 hypointense). PAS staining was strongly positive in 16 lesions, slightly positive in 20 and negative in 14 lesions. Strong positive staining by the PAS method significantly correlated with hyperintensity on SE T1w (p < 0.01). Hyperintensity on SE T1w and isointensity on SE T2w strongly suggest well-differentiated HCCs. High signal intensity on SE T1w correlates with high glycogenic content of the tumor cells and seems unaffected by the presence of fatty degeneration.

Aged↗
PubMedDate not supplied

[Hemophilic arthropathy: echography and radiology].

Our experience is reported with the combined use of radiology and US in the study of 210 joints of hemophilic patients. The study was carried out considering that in hemophilia the classification of the grades of disease generally relies upon X-ray findings which, although reliable in the advanced stages of the disease, appear inadequate in the early stages. In fact, synovial hypertrophy, cartilage erosions and initial subchondral cysts are most often missed on X-ray films. In the examined cases, US was employed to evaluate: 1) the degree of synovial hypertrophy, 2) the status of the explorable cartilage, 3) the presence of effusions and 4) the status of bone linings--whenever erosions, even of minimal extent, were suspected, X-rays were always performed and the results employed as the reference standard. The examined joints did not exhibit the same grade of involvement: the knee, elbow and ankle had advanced arthropathy in 85% of cases, corresponding to > or = 7 according to Pettersson score. On the contrary, the shoulder and hip were found to be equally involved either by initial (Pettersson score: 0-6) or by advanced arthropathy (Pettersson score: > or = 7). Moreover, in nearly 10% of the cases, hemarthrosis was found which showed no correlation with the grade of joint involvement. Our results indicate that: 1) US appears very useful in the early stages of the disease when the X-ray picture is negative or poorly significant. The demonstration of early alterations is useful mainly in those cases in whom synoviectomy is considered (for prevention); the latter is useful only if performed before cartilage erosion appear; 2) US appears equally useful in hemarthrosis cases, especially in those of limited extent in which the clinical therapeutic management may be difficult; 3) US appears unnecessary in the cases of advanced arthropathy in which X-rays serve as the reference standard.

Arthrography↗
PubMedDate not supplied

[Combined treatment of hepatocarcinoma with chemoembolization and alcohol administration. Long-term results].

We investigated the long-term outcome of combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) for the treatment of hepatocellular carcinoma (HCC). A series of 86 patients with biopsy-proved HCC were treated at our Institution January, 1991, to June, 1996. All patients had a single primary tumor bigger than 3 cm, occurring solitary or associated with no more than 2 daughter nodules. Forty-eight patients were in Child class A and 38 patients were in Child class B. The diameter of the lesions ranged 3 to 8 cm (mean: 5.3 cm). The treatment schedule included a single TACE performed via a segmental approach by injecting an emulsion of 20-70 mg adriblastin or farmorubicin and 5-20 ml Lipiodol followed by gelatin sponge particles. Four weeks later, CT and MR follow-up studies were performed and PEI was subsequently started. PEI included 4-16 treatment sessions (mean: 6.8 sessions) performed under US guidance. The total amount of alcohol administered ranged 16 to 215 ml (mean: 69 ml). All patients were followed after therapy with clinical examinations. laboratory tests, and US, CT, and MR studies performed at regular time intervals. The follow-up period ranged 4 to 65 months (mean: 27.8 months; median: 26 months). No major treatment-related complication occurred. The therapeutic response, as assessed with imaging studies performed after the end of treatment, was complete tumor necrosis in 71 of 86 patients (82%) and partial tumor necrosis in the remaining 15. Overall survival rates by the Kaplan-Meier method were 92% at 1 year, 83% at 2 years, 69% at 3 years, 58% at 4 years, and 47% at 5 years. The survival of Child A patients (75% at 3 years and 59% at 5 years) was significantly longer (p < .01) than that of Child B patients (61% at 3 years and 35% at 5 years). During the follow-up, a recurrence of the treated tumors was observed in 5 patients, and new HCCs appeared in 46 patients. The 1-, 2-, 3-, 4-, and 5-year recurrence rates by the Kaplan-Meier method were 14%, 35%, 56%, 69%, and 82%, respectively. The long-term results of combined treatment with TACE and PEI confirm the effectiveness of this therapeutic approach in patients with large uninodular HCC.

Aged↗
PubMedDate not supplied

[Diagnostic imaging and interventional therapy in hepatocarcinoma. Multicenter study of 290 cases].

We report the results of a multicenter study on the diagnosis and interventional therapy of hepatocellular carcinoma (HCC). The first aim--diagnosis--was to evaluate the sensitivity of 4 imaging techniques, namely ultrasonography (US), Computed Tomography (CT), digital arteriography (DSA) and Lipiodol CT (LCT), in HCC detection. The accuracy of these techniques was also investigated in tumor staging, which is important for treatment planning. Two hundred ninety patients underwent this imaging protocol. The patients were classified by tumor spread into three groups, namely group 1 (single HCCs < 5 cm), group 2 (multifocal HCCs with max. 3 nodules or tumor volume < 80 cc), group 3 (multifocal HCCs with more than 3 nodules and/or tumor volume > 80 cc). US and CT diagnosed more cases as group 1 and fewer cases as group 3 than DSA and LCT; the latter two techniques gave a similar classification. With LCT as the gold standard, US and CT understaged 27.9% and 26.5% of cases, respectively. Even though LCT is known to have 53% sensitivity, it is currently the most sensitive preoperative investigation and therefore the best tool for treatment planning. In surgical patients, however, intraoperative US, with its nearly 100% sensitivity, is suggested. The second aim--treatment--consisted in assessing the therapeutic efficacy of intraarterial chemoembolization (CEAT) versus percutaneous ethanol injection (PEI) in non advanced HCC and of CEAT versus no treatment (NT) in advanced HCC. Treatment efficacy was evaluated with the following randomized protocols: PEI versus CEAT in group 1, PEI versus CEAT in group 2 and CEAT versus NT in group 3. The data were analyzed relative to 215 patients for 6 to 30 months. The Kaplan-Meier method was used to calculate survival rates, which were, at 24 and 30 months, 72% and 72% for PEI and 72% and 52% for CEAT in group 1, 52% and 28% for PEI and 70% and 50% for CEAT in group 2 and finally 30% and 20% for NT and 45% and 30% for CEAT in group 3. In group 1, PEI appeared markedly superior to CEAT. In group 2, the difference between PEI and CEAT was not statistically significant; the results in this group indicate that CEAT should be considered when three nodules are present because of PEI invasiveness in these cases. In group 3, CEAT results were definitely better in the first two years, but there was no difference with NT patients at the end of the third year. Therefore, CEAT is indicated in advanced HCC because it improves the survival rate in the first 24 months. After this period, the survival time is not modified by treatment.

Antineoplastic Agents, Hormonal↗
PubMedDate not supplied

[Percutaneous alcohol administration for hepatocarcinoma: long-term results].

We investigated the long-term outcome of percutaneous ethanol injection (PEI) in the treatment of hepatocellular carcinoma (HCC). A series of 184 HCC patients received PEI as the sole anticancer treatment over an 8-year period, December, 1987, to December, 1995. Ninety-four patients had a single tumor < or = 3 cm, 50 patients had a single lesion of 3.1-5 cm, and 40 patients had multiple nodules (up to four) < or = 3 cm each. All patients had liver cirrhosis, classified as Child-Pugh class A in 127 cases and as Child-Pugh class B in 57 cases. The treatment schedule included, for each lesion, 6-14 therapeutic sessions performed once or twice weekly. The total amount of alcohol administered ranged 10 to 110 ml (mean: 36 ml). All patients were followed after therapy with clinical examinations, laboratory tests, and imaging studies performed at regular time intervals. The follow-up period ranged 2 to 94 months (mean: 23.6 months). Overall survival rates by the Kaplan-Meier method were 67% at 3 years, 41% at 5 years, and 19% at 7 years. The survival rates of patients with single lesion < or = 3 cm (78% at 3 years, 54% at 5 years, and 28% at 7 years, respectively) were significantly higher (p < .01) than those of the patients with a single lesion of 3.1-5 cm (61% at 3 years, 32% at 5 years, and 16% at 7 years) or multiple lesions (51% at 3 years, 21% at 5 years, and 0% at 7 years). The survival of Child-Pugh A patients (79% at 3 years, 53% at 5 years, and 32% at 7 years) was significantly longer (p < .01) than that of Child-Pugh B patients (50% at 3 years, 28% at 5 years, and 8% at 7 years). A selected group of 70 patients with Child-Pugh A cirrhosis and a single lesion < or = 3 cm had a 3-, 5-, and 7-year survival of 89%, 63% and 42%, respectively. During the follow-up, new lesions appeared in 93 patients. The recurrence rates by the Kaplan-Meier method were 15% at 1 year, 34% at 2 years, 51% at 3 years, 67% at 4 years, 78% at 5 years, 88% at 6 years, and 94% at 7 years. The analysis of the survival curves of the treated patients confirms the effectiveness of PEI in the treatment of HCC. This therapeutic approach is particularly indicated for patients with a single lesion 3 cm or less in greatest diameter, as in these cases the long-term results of PEI are comparable to those reported in the best surgical series published in the literature.

Adult↗