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Carlo Faletti

Publications and source records attributed to Carlo Faletti.

7 recordsLinked to original sources
PubMed2005

Contrast enhanced gray-scale sonography in assessment of joint vascularity in rheumatoid arthritis: results from the IACUS study group.

The purpose of this study way to assess the value of contrast enhanced gray-scale ultrasound (CEUS) in detection of vascularity in joints of patients with rheumatoid arthritis (RA) in a multicenter study of the International Arthritis Contrast Ultrasound (IACUS) study group. We assessed 113 joints in 113 patients (44 men, 69 women; mean age 51+/-14 years) with clinical diagnosis of RA. Gray-scale ultrasound (US), power Doppler US (PDUS) and CEUS, using a low mechanical index US technique, was performed. CEUS was done by bolus administration of the contrast agent SonoVue (Bracco, Milan, Italy) with a dosage of 4.8-ml SonoVue flushed with 10 ml saline. Detection of joint vascularity was performed for differentiation of active synovitis from inactive intra-articular thickening (synovitis/effusion). With the use of US and PDUS, active synovitis could be differentiated from inactive intra-articular thickening in 68/113 joints (60.1%), whereas CEUS enabled differentiation in 110/113 (97.3%) joints (p<0.0001). Thickness measurement of active synovitis was significantly improved after contrast administration (p=0.008). In conclusion, CEUS improves the differentiation of active synovitis from inactive intra-articular thickening. Since CEUS has shown an ability to improve assessment of vascularized synovial proliferation in RA affected joints, this technique may have further potential in monitoring therapy.

Adult↗
PubMed2005

Osteoid osteoma: our experience using radio-frequency (RF) treatment.

PURPOSE: To present the results of two years experience with a minimally invasive radio-frequency technique designed by our team in the treatment of osteoid osteoma. MATERIALS AND METHODS: A total of 21 osteoid osteoma patients (15 males, 6 females, age range 13 to 34 yrs) were treated between January 2001 and April 2003. Localizations of the osteoid osteoma were the pelvis (n = 1), the femur (n = 12), the tibia (n = 3), the foot (n = 3), and the humerus (n = 2). All patients underwent an X-ray examination, a CT scan and a bone Scintiscan. In the initial phase, a K-wire just slightly larger than the 17G needle electrode is positioned manually at the zenith of the target area under CT guidance and using an orthopaedic drill it is inserted at the centre of the nidus. A tailor-made metal sheath is inserted on the K-wire to create a ''tunnel'' through which the needle electrode can substitute the K-wire; at the same time, the electrode needle is positioned inside the lesion. The temperature of the exposed tip of the needle is 90 degrees C and duration of hyperthermia is 6 minutes on average. Once the procedure has been completed, a scan os performed to measure the density of the treated site and this measurement is then used as an evolution index for the evaluation of the healing process during follow-up. RESULTS: No serious complications were observed at follow-up. General anaesthesia was only required in the case with hip involvement; peripheral anaesthesia was used in all the other cases. Complete resolution of the pain was reported in all cases after a maximum of three weeks. DISCUSSION AND CONCLUSIONS: After two years experience, we believe percutaneous RF treatment of osteoid osteoma to be the first choice technique when compared to traditional surgery due to the fact that it is almost non-invasive, quick, repeatable if need be and offers a high reduction in costs. Moreover early weight bearing is the norm and the patient is dismissed after only one day of hospitalization. The clinical results indicate a 100% success rate with complete remission of symptoms and no relapses having been reported at the time of writing for those patients who have arrived at the two year follow up (4 out of 21).

Adolescent↗
PubMed2002

Postmeniscectomy osteonecrosis.

In the last few years, postmeniscectomy osteonecrosis has been reported, especially in elderly patients, with low incidence, unclear physiopathology, and without long periods of follow-up. We report a case diagnosed and followed-up for a 3-year period using magnetic resonance imaging. In the initial phase, a large area of intramedullary edema was evident; after 3 months, the edema had decreased (it was no longer evident at 1 year examination) and a clearly defined area of osteonecrosis was evident with very high signal intensity on high-contrast sequences. After 3 years, the lesion showed a degenerative cyst appearance with an osteosclerotic rim and completely disrupted cartilage.

Aged↗
PubMedDate not supplied

A preliminary experience in the study of soft tissue superficial masses. Color-Doppler US and wash-in and wash-out curves with contrast media compared to histological result.

PURPOSE: A morphological analysis of wash-in and wash-out curves was carried out to assess their significance in the evaluation of superficial masses with US after the introduction of contrast medium, and to compare the findings with the histological analysis. MATERIALS AND METHODS: From April to December 2000 we studied 70 patients with palpable masses in different body sites. Each patient underwent US examination at baseline and after the introduction of Levovist contrast medium (Schering, Berlin, Germany), performed with an AU5 Harmonic device (Esaote Biomedica, Genoa, Italy), using linear probes with frequencies ranging from 7.5 to 13 MHz and software assessing wash-in and wash-out curves. All the patients underwent surgical excision of the mass. Histological confirmation of the nature of the mass was therefore available for all cases. RESULTS: Out of 70 examined patients, 43 had benign and 27 had malignant lesions. In cases of dubious interpretation of ultrasound and MR imaging, color Doppler US with contrast medium and the subsequent analysis of wash-in and wash-out curves exhibited a particular curve pattern indicating the nature of the lesion. DISCUSSION AND CONCLUSIONS: Based on the preliminary data gathered, we believe that the analysis of wash-in and wash-out curves can be useful and reliable in diagnosing an expansile soft tissue lesions. Because our study is still in its early stages and is based on a small number of cases, no conclusions can be drawn as yet but just an observation and description of data obtained.

Adolescent↗
PubMedDate not supplied

MR Arthrography: a proposal for solution optimization with lidocaine. An in vitro experience.

PURPOSE: Pain on capsule distension in painful joints may affect feasibility of the MR Arthrography. We tried to overcome this limitation by adding a local anesthetic (lidocaine) to the paramagnetic contrast agent solution. We aimed at: a) investigating which contrast agent dilution provides the best signal-to-noise ratio in the SE T1 sequences; b) evaluating the effects of lidocaine on the signal intensity and on the viscosity of the solutions; assessing the viscosity of solutions containing iodinated contrast agent. MATERIALS AND METHODS: The paramagnetic contrast agent was diluted with saline and lidocaine at various concentrations. Signal intensity was measured with a 1.5 Tesla superconductive MR unit with a dedicated head coil; we used T1-weighted spin-echo sequence. The viscosity coefficient of the solutions was analyzed and compared with that of solutions containing iodinated contrast agents (but not lidocaine). RESULTS: Signal intensity is also unaffected by variations in the concentration of lidocaine, which does not interfere with the biphasic behavior of Gadolinium. Viscosity is scarcely affected by changes in lidocaine concentration when the paramagnetic contrast agent concentration is not changed. CONCLUSIONS: The optimal signal-to-noise ratio in T1-weighted sequences is provided by 0.4%, contrast agent dilution but contrast agent-saline solutions, with(out) lidocaine, cannot be considered steady and signal intensity values change over time. The addition of lidocaine does not significantly influence the signal-to-noise ratio and the viscosity of the solutions. The low viscosity of the paramagnetic contrast agent appears to favor quicker spread of the solution, even in tiny defects; thanks to its anesthetic effect, lidocaine could facilitates execution of the examination in painful joints without affecting the diagnostic result.

Anesthetics, Local↗