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C Procacci

Publications and source records attributed to C Procacci.

15 recordsLinked to original sources

Contribution of CT to characterization of focal nodular hyperplasia of the liver.

Our personal series of 20 cases of focal nodular hyperplasia (FNH) of the liver is presented. All lesions were studied with computed tomography (CT), 16 of which with surgical control. Retrospective evaluation of the CT features of the identified FNH, along with those of five hepatocellular adenomas (HCA) and 30 hepatocellular carcinomas (HCC), allowed the definition of specific patterns leading to a correct characterization of FNH in 78% of cases. This greatly reduced the diagnostic errors, with the sole exception of patients with fatty liver in whom nuclear medicine may eventually provide a correct characterization. Fine-needle biopsy is thus only necessary in the dubious cases. A precise diagnostic workup of FNH is necessary, since it may avoid the surgical intervention.

Adenoma

[Invasive pulmonary aspergillosis: possibility of radiologic diagnosis].

The incidence of invasive pulmonary aspergillosis is increasing in the patients with malignant hematologic diseases; this occurs in the phase of granulocytopenia induced by chemotherapy. In these cases an early diagnosis is mandatory to start a prompt antimycotic treatment. The authors reviewed the personal series of 56 patients with malignant hematologic diseases who, in the phase of granulocytopenia, developed a pulmonary lesion: 32/56 with invasive pulmonary aspergillosis; 8/56 with Candida and 16/56 with bacterial infection. All patients underwent several conventional radiologic controls: 9 cases with invasive pulmonary aspergillosis were also studied with Computed Tomography (CT). After a short pathologic introduction, the conventional radiologic and CT patterns of invasive pulmonary aspergillosis are analyzed, both at onset and over its evolutive phase. The most significant feature for an early conventional radiologic diagnosis is the nodular pattern--single or multiple--; this allowed a correct diagnosis, at onset, of 20/32 (62%) invasive pulmonary aspergillosis cases. CT provided a further diagnostic contribution by showing a peri-nodular halo. Of interest was also the CT demonstration of high-density pleural thickening adjacent to the mycotic lesion, probably due to fungal involvement of the sub-pleural space. The routine chest roentgenogram is the modality of choice; CT may be useful in questionable cases.

Aspergillosis

Cystic tumors of the pancreas: evaluation by ultrasonography and computed tomography.

The personal series of 30 cystic tumors of the pancreas [12 serous cystic tumors (SCT) and 18 mucinous cystic tumors (MCT)] is presented. All neoplasms were evaluated with ultrasonography (US) 28 of 30 with computed tomography (CT); the tumoral histotype could be correctly defined in 73% of cases (seven of 12 SCT and 15 of 18 MCT). Percutaneous fine-needle aspiration (FNA) with diagnostic aims (preparation of cytological smears and/or biochemical assays) was performed in only 10 of 30 cases, yielding a 100% sensitivity; on the whole, the combined use of imaging modalities and FNA allowed correct characterization of the cystic tumors in 27 of 30 cases (90%). The usefulness of a precise diagnostic workup of these neoplasms is emphasized, due to their prognostic and therapeutic outcome.

Biopsy, Needle

The contribution of sonography to the measurement of intra-abdominal fat.

A study was conducted on a group of 50 obese females with a mean body mass index of 39 +/- 16, aged 19 years, in order to determine if sonography could be adopted as a direct means for measuring intra-abdominal fat deposits. Adipose tissue evaluation was performed by computed tomography (CT) and ultrasonography (using 3.5-MHz and 5-MHz probes) at the L4 level. CT intra-abdominal fat area (VAT) and ultrasonography visceral thickness from abdominal muscle to aorta were the values mainly considered. Ultrasonographic intra-abdominal thickness correlated well with VAT (r = 0.669, p less than 0.001), supporting the hypothesis that ultrasonography could be useful in the direct evaluation of intra-abdominal fat deposits.

Abdomen

Transient focal leukoencephalopathy following intraventricular methotrexate and cytarabine. A complication of the Ommaya reservoir: case report and review of the literature.

A 14-year-old boy, suffering from acute lymphoblastic leukemia with meningeal involvement, was treated with intraventricular methotrexate and cytosine arabinoside, administered via an Ommaya reservoir (OR). Three months later, right occipital headache, vomiting, and lethargy appeared. Cerebrospinal fluid specimens showed increased proteins and a right frontal slow-wave focus was evident on the EEG recording. The computed tomography scan revealed white matter hypodensity within the right frontal and rolandic regions. After injection of medium contrast, an abscesslike hyperdensity appeared, surrounding both a well-placed cannula tip and the right frontal horn of the lateral ventricle. Brain swelling and shift signs were also evident. Nine cases of focal methotrexate leukoencephalopathy have been previously reported, and in six of these there was a misplaced OR cannula tip. The focal methotrexate leukoencephalopathy seems to be related to the neurotoxicity of the drugs administered, and may also exist with a well-placed OR cannula tip. Immediate removal of the catheter may be associated with a benign evolution.

Adolescent

The contribution of ultrasonography and computed tomography in the diagnosis of nonfunctioning islet cell tumors of the pancreas.

The personal series of 12 nonfunctioning islet cell tumors (NFIT) of the pancreas is reported. The ultrasound and computed tomography features of NFIT are analyzed, and a few signs are identified that may be useful in the differential diagnosis vs ductal carcinoma. The necessity to complete the diagnostic work up by means of fine needle aspiration biopsy and cytologic smears is also emphasized.

Adenoma, Islet Cell

[Diagnostic imaging of pancreatic metastasis].

The authors present their personal series of pancreatic metastases (8 cases) which were evaluated with different imaging modalities--i.e., sonography, computed tomography, and angiography. Possibilities and limitations of non-invasive modalities are pointed out, and the usefulness of angiography is emphasized for the identification of small hypervascular lesions. The fairly rare diagnosis of these tumoral lesions is due to 3 causes: low incidence of pancreatic metastases; their frequently small size which justifies eventual false negatives; the frequent lack of symptoms calling for imaging modalities. Moreover, pancreatic metastases are usually diagnosed in an advanced stage. Thus, the therapeutic approach must be planned in every single case, in relation to the perspectives of survival and to the residual quality of life.

Adult

Accuracy of computed tomography in the screening of obstructive jaundice.

Percutaneous transhepatic cholangiography (PTC) has come back into greater use thanks to Chiba's needle. PTC, however, is useful only in obstructive jaundice (OJ). Since in OJ the dilatation of the intrahepatic biliary tract (IHBTD) is constant, the authors discussed CTs reliability in evaluating IHBTD in a series of 33 patients with OJ studied with PTC. The threshold of CT diagnosis of IHBTD was found to be equal to a doubled caliber of the normal biliary tract. This value is reached by 85% of the patients 2 weeks after the onset of OJ and in 98% between 2 and 3 weeks. CT is therefore usable as a screening method of PTC, as long as it is not performed before 2 weeks after the onset of OJ. After 2 weeks, if CT does not reveal IHBTD, it is possible to exclude OJ.

Bile Ducts, Intrahepatic

[The role of computed axial tomography in pancreatic emergencies (author's transl)].

The role of CT in acute diseases of the pancreas is discussed, in the light of personal experience (25 cases). In acute pancreatitis (22 cases), CT was useful in particular for: differential diagnosis between the necrotic-hemorrhagic type and the edematous type; detection of extra-pancreatic collections and evaluation of their extent; post-operative follow-up of necrotic-hemorrhagic pancreatitis. In the other more rare empergencies (3 cases), CT could recognize respectively the rupture of an infected pseudo-cyst, and intra-cystic hemorrhage, a mediastinitis due to the spread of ascitic fluid containing pancreatic enzymes into the mediastinum. CT always provided diagnostic information which the other radiological techniques did not provide; therefore in acute diseases of the pancreas CT is the method of choice.

Acute Disease

Computed tomography in surgical pancreatic emergencies.

The findings observed with computed tomography (CT) in such pancreatic emergencies as necrotic-hemorrhagic pancreatitis, pancreatic abscess, broken pseudocyst, and pancreatic ascites with mediastinitis are presented. The value of CT in these conditions, which often require surgical intervention, is discussed. Computed tomography appears to be the ideal diagnostic procedure, especially for surgical treatment planning in pancreatic abscess. No deaths occurred in a group of pancreatic abscesses treated surgically with CT assistance.

Abscess