Biomedical subjects

C Bartolozzi

Publications and source records attributed to C Bartolozzi.

At least 127 records · Page 7Linked to original sources

PubMed1993

Percutaneous injection of ethanol to treat autonomous thyroid nodules.

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of sonographically guided percutaneous injection of ethanol for treating autonomous thyroid nodules in order to assess that technique's feasibility as an alternative to traditional ablative (radionuclide and surgical) therapies. SUBJECTS AND METHODS: Thirty-two patients with autonomous thyroid nodules were included in the study: seven had thyrotoxicosis, and 25 were in the pretoxic clinical phase. Ethanol was injected percutaneously on an outpatient basis once or twice a week for a total of three to 10 injections per nodule, mainly depending on the nodule's size. Scintigrams obtained 3 months after the end of treatment were used to assess response to this therapy. The follow-up period was from 3 to 30 months. RESULTS: Thyroid scintigraphy 3 months after percutaneous injection of ethanol showed complete recovery of function in extranodular tissue in 26 patients (81%), partial recovery in five patients (16%), and no recovery in one patient (3%). In all patients, the volume of the nodules decreased by more than 50% after treatment. In three of five patients in whom scintigraphy showed only partial recovery of function in extranodular tissue, a second percutaneous injection of ethanol was given after 15 months. The therapy was well tolerated, and after a total of 216 injections, no patient had permanent side effects. CONCLUSIONS: Our experience shows that percutaneous injection of ethanol is a practical alternative to traditional treatments for autonomous thyroid nodules and that it is an option for treating pretoxic adenoma.

Adult↗

PubMed1993

[Diagnosis with high resolution computerized tomography of early asbestos-induced diseases].

This study was aimed at investigating the possibility of detecting lung and pleural asbestos-related lesions by means of conventional chest films and high-resolution Computed Tomography (HRCT) in a study population of asymptomatic workers of a shipyard factory in northwestern Tuscany, Italy. Thus, a blind study was carried out by two radiologists who reviewed 144 conventional chest films previously considered as negative by outside readers. Thirty-eight of 144 workers were selected, whose conventional films had been confirmed as negative, together with 34 more subjects with suspected pleural plaques or mild parenchymal involvement (ILO profusion score: 0/1). These 72 subjects were submitted to HRCT: 19 of them were negative, while in 33 cases pleural plaques were found; 7 workers exhibited parenchymal involvement alone, while in 13 both pleural and parenchymal alterations were found. HRCT findings were correlated with the duration of amosite exposure and the latency time since first exposure. Relative to conventional radiographs, the threshold of exposure and latency times allowing asbestos-related diseases to be demonstrated was markedly lower. Our study suggests that pleural and/or lung involvement in asbestos-exposed workers can be shown by HRCT before the onset of clinical symptoms or the appearance of pleural/parenchymal involvement on chest films. Moreover, the HRCT-detectable lung and/or parenchymal involvement appeared to be related to exposure and latency times, as in most of clinically-apparent asbestos-related lung diseases.

Adult↗

PubMed1993

[Systematic evaluation of the pulmonary circulation with computerized tomography: normal and post-embolic pathologic features].

Pulmonary circulation was evaluated in normal subjects and in post-embolic patients. Eight normal subjects, 3 patients with acute pulmonary embolism and 8 patients with chronic thromboembolic pulmonary hypertension underwent CT of the chest. High-resolution CT and angio-CT were performed to study pulmonary parenchyma and pulmonary arteries, respectively. CT showed thrombi in the main or interlobar pulmonary arteries in all 3 cases of acute pulmonary embolism and in 4 of 8 patients affected with chronic thromboembolic pulmonary hypertension. The diameters of the main pulmonary and right interlobar arteries correlated with systolic pulmonary artery pressure (p < 0.001), as measured by right heart catheterization. In the patients affected with chronic thromboembolic pulmonary hypertension, the ratio of the calibers of the segmental arteries to the corresponding bronchi was markedly higher, which was observed also in the patients with acute pulmonary embolism. The bronchial arteries were dilated in 4 of 8 cases of chronic thromboembolic pulmonary hypertension. Lung density was significantly high in the perihilar compartment in the patients with acute thromboembolic hypertension, but not in normal controls and in the cases of acute pulmonary embolism. In conclusion, CT can help to diagnose pathological pulmonary circulation. Particularly, the ratio of the diameters of the segmental arteries to the corresponding bronchi can be useful to evaluate blood circulation.

Adult↗

PubMed1993

Cine-MR imaging of aqueductal CSF flow in normal pressure hydrocephalus syndrome before and after CSF shunt.

Reproducibility of the aqueductal CSF signal intensity on a gradient echo cine-MR sequence exploiting through plane inflow enhancement was tested in 11 patients with normal or dilated ventricles. Seven patients with normal pressure hydrocephalus (NPH) syndrome were investigated with the sequence before and after CSF shunting. Two patients exhibiting central flow void within a hyperintense aqueductal CSF improved after surgery and the flow void disappeared after shunting. One patient with increased maximum and minimum aqueductal CSF signal as compared to 18 healthy controls also improved and the aqueductal CSF signal was considerably decreased after shunting. Three patients with aqueductal CSF values similar to those in the controls did not improve, notwithstanding their maximum aqueductal CSF signals decreasing slightly after shunting. No appreciable aqueductal CSF flow related enhancement consistent with non-communicating hydrocephalus was found in the last NPH patient who improved after surgery. Cine-MR with inflow technique yields a reproducible evaluation of flow-related aqueductal CSF signal changes which might help in identifying shunt responsive NPH patients. These are likely to be those with hyperdynamic aqueductal CSF or aqueductal obstruction.

Adolescent↗

PubMed1993

[Abdominal Doppler ultrasonography in the diagnosis of renovascular diseases. Double-blind prospective study].

Our work was aimed at evaluating the sensitivity and specificity and the positive and negative predictive values of abdominal Doppler US in the diagnosis of renovascular disease. Fifty hypertensive patients (23 men and 27 women) with 100 bilaterally single renal arteries (66 of them normal and 34 stenosed) were studied by means of color (26 cases) and duplex (24 cases) Doppler US. The following US variables were considered in the diagnosis of renal artery stenosis: increased peak systolic velocity in the renal artery, increased ratio between peak systolic velocity in the renal artery and in the aorta, increased parenchymal acceleration time and increased resistive index. Feasibility was 100% for all variables. The general multivariate statistic model of discriminate analysis was used to define three calculation levels, according to: a) duplex vs. color Doppler equipment, b) hemodynamic variables and c) optimal cutoff values. US examinations were performed by a single observer in a double-blind study, before angiography, so as to eliminate interobserver variability. On the whole abdominal Doppler US exhibited optimal specificity and fairly good sensitivity. Specificity increased (94% to 97%) with the use of color Doppler according to the different combinations of variables, but sensitivity remained the same. The calculation including all the Doppler variables increased sensitivity from 73% (with true values) to 93% (with threshold values). The positive predictive value demonstrated that 90% of the renal arteries with increased peak systolic velocity and 100% of those with increased parenchymal acceleration time were stenosed. However, the negative predictive value demonstrated that 15% of the renal arteries with no increase in peak systolic velocity is misdiagnosed as normal. In conclusion, abdominal Doppler US can be used to study renovascular disease patients, but the examination must always be based on different hemodynamic variables and true values.

Double-Blind Method↗

PubMed1993

[Echography and echo-Doppler in the study of thoracic outlet syndrome. Correlation with angiographic data].

This study was aimed at assessing the clinical utility of conventional and color duplex-Doppler US in the diagnosis of thoracic outlet syndrome. Conventional US and Doppler examinations were performed in a prospective study. The results were correlated with angiographic findings. Thirteen patients affected with thoracic outlet syndrome were studied by means of both conventional US and spectral Doppler flow imaging. Five cases (5/13) had neurovascular symptoms in the right upper limbs, 7/13 in the left upper limbs and 1/13 in both upper limbs. An accessory cervical rib was demonstrated in 2/13 cases (associated with muscular hypertrophy in one case and bilateral in the other), by means of plain films of the spine. Conventional US depicted muscular hypertrophy in 7/13 cases--bilateral in one case and monolateral in 6/13 cases, with marked muscular asymmetry. In 5/13 cases, no bone/muscle anomalies were demonstrated. The patients with an accessory cervical rib and scalenus muscle hypertrophy were seen to exhibit two types of hemodynamic alterations in the subclavian artery--i.e., turbulence and changes in the systolic window with no increase in peak systolic velocity in 5/13 cases with mild stenosis, normal or reduced peak systolic velocity with changes in the reversed flow in 3/13 cases with mild/medium-grade stenosis, either during indifferent position or after dynamic tests. In 2/13 patients with no bone/muscle alterations, turbulence was demonstrated in the subclavian artery. However, in 3/13 cases Doppler US revealed no arterial flow abnormalities--3/13 false negatives relative to mild vascular compression. Selective arteriography demonstrated vascular alterations in the subclavian artery in all cases, with or without Doppler anomalies; while angiography was often positive during hyperabduction maneuvers color duplex Doppler demonstrated hemodynamic alterations at rest with indifferent position of the upper limb. In conclusion, conventional US allowed the evaluation of the thickness of both anterior and middle scalene muscles and of possible muscular asymmetries. Color duplex Doppler US demonstrated primary and secondary alterations in the subclavian artery or vein. Therefore, conventional US, duplex and color Doppler prove to be valuable non-invasive tools in the patients with neurovascular symptoms in the upper limbs and could allow the selection of the cases to submit to arteriography.

Adult↗

PubMed1993

[The Achilles tendon: echography at different frequencies. Comparative study].

The authors report their experience with a comparative US study employing different-frequency probes (7.5, 10, 13 and 15 MHz) in Achilles tendon conditions. The study population included 49 patients, 37 of them athletes. All patients complained of the same symptoms: achillodynia in the middle third (group A, 29/49 cases), achillodynia in the lower end (group B, 16/49 cases), suspected partial rupture in the middle third (group C, 2/49 cases) and suspected distal rupture in the upper third (group D, 2/49 cases). In group A, the different frequencies yielded different results. 7.5 MHz frequencies yielded negative results in 13/29 patients, versus 3/29 with higher frequencies, which demonstrated peritenon inflammation in 10/29 cases. In the remaining 16 cases, where 7.5 MHz frequencies had shown tendon inflammation and degeneration, the higher frequencies confirmed the findings, even though their accuracy was greater. On the contrary, in the cases of distal achillodynia where pain was mainly due to inflammation of the retrocalcaneal bursa, the different frequencies yielded similar results, even though the higher ones proved more accurate in revealing tendon abnormalities--i.e., thickening, focal hypolucencies, spotty microcalcifications, irregularity of the bone lining. In group B, the different frequencies once again exhibited similar results showing a focal hypoechoic discontinuity which was correctly diagnosed on the basis of clinical history. Finally, as for group C, the lower frequencies gave better results because of the deeper location of the region of interest. In both cases a small blood collection was visible, between gastrocnemius and soleus, in the absence of clear-cut tendon lesions. No matter what the condition, the higher frequencies were extremely valuable since they allowed excellent demonstration of tendon anatomy. The tendon is enveloped by the peritenon, made of two macroscopically distinct sheaths the distinction of which is allowed by higher frequencies when a minimal amount of fluid is present. From the peritenon, the intratendon septa originate circumscribing spaces containing tendon fiber bundles. The vessels, which run longitudinally, are located within the confluence of the septa. On US images, the septa appear as thin hypoechoic stripes or small hyperechoic spots depending on the type of scan (longitudinal/axial). As to tendon fibers--i.e., tenocytes, collagen and elastic fibers--their pattern is homogeneous and hypoechoic since devoid of interfaces.

Achilles Tendon↗

PubMed1992

[Percutaneous alcoholization of a small hepatocarcinoma].

Twenty-nine small hepatocellular carcinomas (sHCCs) less than 5 cm in diameter were treated with percutaneous ethanol injection (PEI) under US guidance in 24 cirrhotic patients. The nodules were treated on an outpatient basis with 6-18 ethanol injections; the total amount of alcohol delivered to each lesion was 10-103 ml. Twenty-seven of the 29 HCCs (93.1%) showed no evidence viable neoplastic tissue at a dynamic CT scan combined with multiple fine-needle biopsies performed one month after the end of treatment; in 10 cases MR confirmed the presence of necrosis showing marked hypointensity of the lesions in T2-weighted images. None of the 27 necrotized sHCCs recurred locally during a 4-44 months' follow-up period (mean 18 months). Two lesions larger than 4 cm showed incomplete response to treatment. No complications occurred after a total number of 264 alcohol injections. The 1-year survival rate in the 16 patients with a follow-up longer than 12 months was 93.7%. PEI proved to be a safe and effective treatment for sHCCs. In particular, PEI can be viewed as a reliable alternative to surgery in the management of nodules less than 3 cm in diameter, considering the operative hazards and the high risk of new lesions occurring in resected livers.

Administration, Cutaneous↗

PubMed1992

MR imaging with STIR technique and air insufflation for local staging of bladder neoplasms.

Fifty-six patients with bladder carcinoma were studied with MR imaging for the assessment of the local stage, using the inversion recovery pulse sequence with fat suppression (STIR) with air in the bladder. With this technique images of the inner and the outer parts of the bladder wall were obtained, showing high contrast between the latter and the tumor (tumor/muscle contrast 89.9%). Four tumor stages were recognized: superficial neoplasms (Tis, Ta, and T1), partial wall infiltrating neoplasms (T2); total wall infiltrating neoplasms (T3a, T3b), and neoplasms involving other pelvic organs (T4). MR imaging was compared with histopathologic diagnosis obtained at transurethral resection or cystectomy. True-positive diagnosis was obtained in 80.4%; false-positive in 14.3% of cases; false-negative in 5.3%. Despite the relatively high incidence of overstaged neoplasms, STIR technique combined with air in the bladder allowed a good accuracy in local staging.

Adult↗

PubMed1992

[Ultrasound-guided biopsy of small abdominal lesions. Methodology implications].

In the present study the diagnostic accuracy of US-guided fine-needle biopsy was evaluated in a series of 219 abdominal lesions < or = 3 cm in diameter (21 between 0.6 and 1 cm; 83 between 1.1 and 2 cm; 115 between 2.1 and 3 cm). One-hundred-eighty-three of them were located in the liver and 36 in other abdominal organs (pancreas, 10, adrenals 9, lymphnodes 9, kidney 5, spleen 3). Biopsies were performed with "free-hand" technique using up-to-date ultrasound equipment. The demonstration of the correct location of the needle tip at the time of sampling was looked for with great care. The sensitivity rate was 93%, with a progressive improvement with the increase of the lesion size (83.3% between 0.6 and 1 cm; 91.1% between 1.1 and 2 cm; 95.4% between 2.1 and 3 cm). The specificity rate was 100%. In 207 cases in which the location of the needle tip was clearly demonstrated, the sensitivity reached 97.3% and the negative predictive value 93%. No noteworthy complications were observed. Ultrasonography is a highly reliable guidance modality also in biopsies performed on small abdominal lesions; if the correct location of the needle tip is clearly shown, even a diagnosis of benignity can be confidently made.

Abdominal Neoplasms↗

PubMed1992

[The echographic aspects of prostatic carcinoma before and after radiation treatment].

The authors evaluated the US patterns of 50 prostatic carcinomas before and after radiation therapy, analyzing the correlation of US patterns with histologic (bioptic) findings and with treatment outcome. Before radiation therapy, 28 tumors were hypoechoic, 8 were isoechoic and 14 mixed. In 18 of 28 hypoechoic carcinomas, the lesion showed a progressive increase in echogenicity, becoming completely isoechoic 9-18 months after the end of treatment. In this group of patients the final response to treatment was complete in 17 cases and partial in 1; during the follow-up (24-90 months, mean 48 months) neither local recurrences nor distant metastases were observed. In 10 of 28 hypoechoic carcinomas, a hypoechoic area of variable size was still clearly recognizable within the lesion after a minimum period of 18 months since the end of treatment. Nine of these patients underwent histology and persistent carcinomas were found in 8 of them; one patient developed distant metastases. In the group of isoechoic and mixed carcinomas, no significant differences were observed in the US patterns relative to treatment outcome. Persistent prostatic carcinoma after radiation therapy seems not to affect its US pattern. If the tumor is hypoechoic before treatment, the persistence of a hypoechoic area within the lesion 18 months after the end of treatment must be regarded as a possible therapeutic failure and histologically verified. On the contrary, the evolution of the lesion toward isoechogenicity is usually related to a favorable outcome. If the tumor is isoechoic or mixed before treatment, a reliable US evaluation is not possible and the correct assessment of the response to treatment can only be made with multiple biopsies.

Adenocarcinoma↗

PubMed1992

[Echography in the study of lipomas of superficial soft tissues].

High-resolution sonography (US) was used to evaluate 47 superficial soft tissue lipomas. Forty-one lesions were found in subcutaneous tissues and 6 in superficial muscles. The lipomas were classified by location, shape, echotexture, homogeneity and US beam attenuation values. Moreover, 21 lipomas underwent histology and histologic patterns were correlated with echogenicity. Most lesions were elongated and their greatest diameter was parallel to the skin. Eighty-four percent exhibited well-defined margins. Twenty-six percent of the lipomas were hypoechoic, 24% were isoechoic, 34% hyperechoic and 16% exhibited a mixed pattern. In 27% of cases, a hypoechoic capsule was present. Superficial soft tissue lipomas exhibit unsteady echotexture: most of them are hyperechoic. The correlation between echotexture and histology showed that no typical and steady patterns can be identified, since lipomas vary from a histologic point of view. The clinical diagnosis of superficial lipomas is based on clinical history and the palpation of a well-defined, mobile and soft superficial mass. When palpation is not diagnostic, US can be used to rule out a cyst. An elongated isoechoic or hyperechoic mass in the subcutaneous tissue should suggest a lipoma, whereas a hypoechoic mass is associated with a broader range of differential diagnoses, including malignant tumors. However, malignant masses are not likely to have an elongated or flattened shape. Even though tissue characterization is less specific with US than with CT and MRI, the former method is quick, easy and less expensive and, thanks to high-frequency transducers, is also well-suited to diagnose soft tissue lipomas.

Adolescent↗

PubMed1992

[Renal artery stenosis. Doppler color study before and after angioplasty].

Doppler flowmetry can be successfully employed to assess arterial patency after percutaneous transluminal angioplasty (PTA). The aim of this study was to assess color Doppler sensitivity in detecting renal artery stenosis prior to percutaneous angioplasty (PTRA) and vessel patency after it. Eleven patients (7 males and 4 females) affected with renal artery stenosis, unilateral in 9 cases and bilaterally in 2, underwent color-Doppler evaluation 1 day before and 7 days after PTRA. The operator was unaware of dilatation results. A total of 13 stenoses were treated. The qualitative and quantitative parameters we employed were: a) broadening of the spectrum, b) peak systolic frequency > 4000 Hz, c) stenosis index > 50%. Before PTRA, mean systolic peak at the stenosis was 7978 (range 4050-12500 Hz), while stenosis index was 71.9% (range 48-89%). After PTRA complete recovery was observed in 5 cases, no improvement in 1 and incomplete recovery in 7. Doppler results were in agreement with those of angiography in 6/13 while partial agreement only was seen in 7/13. Our results, although obtained in a small and highly selected group of patients, would seem to support the value of color-Doppler for the follow-up of patients after PTRA.

Adult↗

PubMed1992

[Atkinson prosthesis in esophageal carcinoma. Radiologic study: when CT?].

The endoscopic palliative treatment of esophageal and esophagocardial neoplastic stenoses is generally performed in the patients in whom surgery is not indicated for oncological and general reasons and endoscopic dilatation is uneffective. Our experience is reported concerning 92 patients submitted to palliative therapy through placement of Atkinson prostheses; the patients underwent radiologic studies--i.e. (a) plain chest radiographs (before and after intubation), (b) esophagogastric studies with iodate cm, and (c) CT (performed in the last 20 cases only). The mortality rate at 30 days was 6.5% (6 cases), in no case due to specific complications related to intubation. The mean survival was 3.6 months (range: 1-12). As to the complications specifically related to intubation, they were basically 3: perforation, dislocation, and obstruction (of the prosthesis). As to the methods allowing best demonstration of the same: a) CT proved to be superior in revealing perforation, which usually occurs early after intubation. However, considering its low incidence (2 cases only, in our series), the routinary use of CT does not seem justified. CT should be reserved to selected patients in whom the shape of the neoplasm or peculiar anatomical conditions make intubation difficult, with high risks of perforation--e.g., kiphoscoliosis, hiatal hernia, previous surgery or radiotherapy, angulation of the prosthesis, neoplasm of scirrhous or necrotic type or causing luminal deviation; b) if dislocation occurs, as it more often happens (9 cases in our series) in the presence of soft neoplastic tissue or in cases of mild or asymmetrical stenosis, CT seems likewise unnecessary. Conventional radiology proved superior thanks to its more comprehensive view, and therefore sufficient to suggest the correct treatment--e.g. repositioning of the prosthesis by means of fiberoscopy, or withdrawal after gastrostomy; c) CT appeared useless in the cases due to alimentary causes (easily detectable from the clinical history), but proved useful in the cases due to neoplastic overgrowth. In the latter, CT can yield information as to the site and size of the neoplasm, as well as to its relationship to surrounding tissues, and thus help suggest proper treatment--e.g. dilatation and repositioning of the prosthesis, gastrostomy, recanalization by means of NdYAG laser, no treatment at all.

Adult↗

PubMed1992

[Prostatic carcinoma: the importance of echographic monitoring of gland volume after radiotherapy].

Prostatic volume modifications were retrospectively analyzed by means of serial endorectal US in 50 patients affected with prostatic adenocarcinoma previously submitted to external radiotherapy. A progressive reduction in glandular volume (of low, medium, and high grade) was observed in 48/50 patients respectively within 3 months, between 3 and 6 months, and 6-9 months after treatment. After 9 months only lesser modifications were observed. A statistically significant correlation (p less than 0.05) was found between volume decrease percentage and histologic grading of the tumor, but not with its stage. Within the groups of patients affected with similar-grade neoplasms, a statistically significant difference (p less than 0.05) was observed, relative to the decrease rate of prostatic volume, between the patients with complete response and those with partial or no response. US monitoring of prostatic volume after radiotherapy, if correlated with histologic grading, can yield early predictive elements as to treatment outcome, thus contributing to select non-responsive patients to submit to biopsy and, if necessary, to therapeutic alternatives or combinations. Longer-term studies are needed to prove its effectiveness, to prognostic purposes, in the single patient.

Adenocarcinoma↗

PubMed1992

[Computerized tomography of the orbit in Graves' ophthalmopathy. New observations].

In order to evaluate Graves' ophthalmopathy new CT parameters have been introduced such as: the diameters of the five extraocular muscles, the value of their addition, the grade of apical crowding, the enlargement of optic nerve sheaths and of the superior ophthalmic vein, and the anterior displacement of the lacrimal gland. On this subject we report our further experience after reviewing 68 cases in which the new ocular parameters were correlated with altered ocular motility and optic neuropathy. The results confirmed our previous study, dealing with several groups of patients, which at the moment seem to be 2, instead of 3 groups: a) patients with increase in both muscular and fatty tissue (54/68 cases); b) patients with main or exclusive increase in fatty tissue (14/68 cases). Relevant clinical signs were present only in the first group of patients, where the medial, inferior and superior muscles were affected in 53/55, 53/55 and 50/55 cases respectively. A muscle increase by nearly 50% was more frequently found in cases with altered ocular motility, an increase by 90% was often associated with optic neuropathy. In case of optic neuropathy apical crowding was often observed, mainly in coronal scans, together with significant enlargement of the optic nerve sheath and of the superior ophthalmic vein. As to proptosis, preseptal area and anterior displacement of the lacrimal gland, they demonstrated lower correlation with the reference symptoms, even though their occurrence was high in symptomatic patients.

Graves Disease↗

PubMed1992

[Echography in gynecologic emergencies].

The authors report their experience with US in gynecologic emergencies through a retrospective study on 105 patients presenting with acute abdomen of suspected gynecologic nature. The series included 3 groups of patients: Group I: 59 patients all submitted to immediate surgery. The following pathologic conditions were observed: ectopic pregnancy (23 cases), torsion or hemorrhage from ovarian cysts (13 cases), pyosalpinx or tubo-ovarian abscess (9 cases), torsion of pedunculated uterine leiomyoma (7 cases), intraperitoneal bleeding from hemorrhagic corpus luteum (6 cases), hematocolpos and hematometra from imperforate hymen (3 cases). Two false positives, not included in this group, resulting from appendicular abscesses and misinterpreted as ovarian, were submitted to surgery in a gynecologic unit. Group II: 19 patients treated with medical therapy for the following conditions: torsion or hemorrhage from hyperstimulated ovary (10 cases), pyosalpinx or tubo-ovarian abscess (9 cases). Group III: 25 patients in whom neither US nor clinical examination revealed positive gynecologic findings. Both US and clinical follow-up were negative in these patients. The study was aimed at evaluating the role of US in identifying both lesion and peritoneal involvement, and in the diagnosis of nature. US proved a valuable tool in the first two diagnostic steps, allowing to confirm/dismiss active pathologic conditions, to indicate the medical/surgical treatment (immediate or delayed), to detect associated pathologies to study with further examinations. As for lesion nature, US alone proved poorly useful if not correlated with an accurate clinical history.

Abdomen, Acute↗

PubMed1991

[Solitary intraductal papilloma of the breast. An echographic study of 12 cases].

Solitary intraductal papillomas (SIP) of the breast are relatively common lesions (incidence: 2-3%) originating from proximal ducts or from retroareolar lactiferous ducts. This work was aimed at evaluating the diagnostic reliability of US in the diagnosis of this condition and at discussing the differential diagnosis with similar focal lesions. Twelve cases of SIP were diagnosed with US among 31 selected female patients (aged 16-35 years) who had been referred for serohematic discharging breast and/or palpable nodules. All cases had surgical confirmation. US patterns typical of SIP were: 1) solid hypoechoic nodules with peripheral anechoic areas (7 cases); 2) small papillary excrescences within a cystic cavity, corresponding to papillary cystadenocarcinoma (4 cases); 3) periareolar overdistended ducts filled with dense material (1 case). Surgery was performed directly in 8 patients with positive cytology while mammography, ductography and fine-needle biopsy were performed in the extant 4 patients with negative or questionable cytologic findings. US combined with cytologic samples allowed the correct diagnosis to be made in 8 of 12 cases (66%): this is noteworthy when considering the low reliability of mammography in young patients and the poor tolerance to ductography in general. US allows the differential diagnosis with other focal lesions and subsequently helps shorten the diagnostic route.

Adolescent↗