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Biomedical subjects

D Minorati

Publications and source records attributed to D Minorati.

10 recordsLinked to original sources

Treatment of iatrogenic submandibular sialocele with botulinum toxin. Case report.

We report the case of a 40-year-old woman with a submandibular sialocele (diagnosed by ultrasonography and magnetic resonance sialography) after sialoadenectomy for sialolithiasis. Type A botulinum toxin was injected percutaneously under colour Doppler ultrasonographic guidance into the sialocele and the residual salivary gland. Five months later the submandibular swelling had gone, and we gave a second injection of botulinum toxin to block any residual secretory activity. There were no side effects. This is, as far as we know, the first published report of the use of botulinum toxin to treat an iatrogenic submandibular sialocele.

Adult↗

[The measurement parameters in dental radiography: a comparison between traditional and digital technics].

Digital and conventional techniques for dental, panoramic and intraoral radiography, were compared to assess measurement accuracy. The study was carried out on two plastic models of maxillary and mandibular arches, each containing 14 teeth extracted and positioned in their anatomical site. The teeth were prepared by opening the pulpal cavity and inserting endodontic wires within the canals. Intraoral x-ray images were taken with long-cone technique using a commercial high-resolution film and with a charge coupled device (CCD) sensor (radiovisiography). The models were then submitted to panoramic tomography with photostimulable phosphor plates. The length of the canals was measured on each image and compared to the length of the inserted wires. For the digital pictures, the measurement was performed directly on the monitor with the aid of electronic calipers. Magnification averages 3.40%, 9.47% and 14.11% for anterior teeth in intraoral radiography, in radiovisiography and panoramic radiography, respectively. The results demonstrate the presence of some degree of magnification for every radiographic procedure. This effect becomes statistically significant for both radiovisiography and digital panoramic techniques, especially in the latter. In spite of their well-known practical and dosimetric advantages, digital techniques in dental radiology must be used carefully whenever a reliable measurement is required.

Analysis of Variance↗

[Traumatic rupture of thoracic aorta: review of a 10-year experience].

We retrospectively reviewed the diagnostic imaging examinations of 22 patients affected with traumatic rupture of the thoracic aorta acquired in a 10-year period. Our study was aimed at investigating if the diagnostic approach to these patients has changed in the last 10 years, especially relative to the extensive use of Computed Tomography (CT). All the patients in our series were submitted to chest radiography and aortography; only 15 of them were submitted also to CT. Plain radiography showed enlarged mediastinum and altered aortic profiles in 22/22 patients, rightward deviation of the trachea and nasogastric tube with downward displacement of the left mainstem bronchus and apical cap in 7/22 patients and associated pleuropulmonary injuries in 11 patients. CT image quality was poor because of artifacts in 5 patients, while it demonstrated mediastinal hematoma in 10 patients and associated aortic outline alterations in 5 patients. Aortography always showed the site and number of aortic ruptures. In our experience, aortography should be performed next if chest radiography suggests mediastinal hematoma. CT should be performed before aortography if chest radiography demonstrates no mediastinal hematoma but is not convincingly normal and the patient needs CT studies for associated head and/or abdomen injuries. In this case, if CT is technically correct and its results are normal, aortography needs not be performed, whereas if CT findings are abnormal or not convincingly normal, aortography is mandatory. In the future, the approach to aortic trauma could be modified by transesophageal echocardiography, Magnetic Resonance Imaging and spiral CT, but the results of these imaging methods must still be validated with further extensive studies.

Adolescent↗

[Digital radiology in dentistry: experience with direct intraoral techniques (radiovideography)].

The aim of this paper was to discuss the techniques for intraoral digital radiography (radiovisiography) and to compare their accuracy in dental radiographical diagnosis. Emphasis was given to their potential applications in oral radiology. Radiovisiography was compared with intraoral films and electronic magnifications from digital panoramic radiographs in 38 patients, for a total amount of 36 caries, 27 periapical conditions and 58 metal implants. Moreover, the accuracy of the measurements made with the three techniques was assessed on a specimen of mandibular and maxillary arches containing 28 extracted teeth with endodontic files of known length. Radiovisiography was as effective as intraoral films and more effective than digital panoramic radiographs in the diagnosis of caries and periapical lesions. Nevertheless, it produced a significant magnification and yielded unreliable measurements of root canals and metal implants. Radiovisiography is very easy to use and does not require dark room procedures nor chemicals of any kind. In addition, it reduces patient's X-ray exposure by over 50% with respect to film studies. For these reasons, this technique seems to be worthy of widespread use in dental radiography, with the exception of the conditions requiring an exact measurement of working length.

Adult↗

[A comparison between endoral radiography and electronic magnification of digital orthopantomography].

We compared the electronic magnifications obtained from digital panoramic radiographs with intraoral radiographs with a new high resolution film. Fifty-two patients were submitted to both examinations--76 comparative studies and 217 teeth studied in all. The two techniques appeared substantially comparable in terms of diagnostic effectiveness. The measurement of the alveolar ridge was strictly equivalent for the two examinations (< 1 mm disagreement in 80% of cases). The profile of lamina dura and the image of the radicular canal were better depicted with intraoral films. A useful advantage offered by digital images was the possibility of recognizing the soft tissues. In dental caries intraoral films was more effective than digital images and were correctly depicted small carious cavities (< 2 mm depth, 87 vs 74%). Digital panoramic radiography can be considered a promising alternative to panoramic film. Its electronic magnification may be a valuable diagnostic complement to intraoral films for the study of periodontal disease, but it cannot replace intraoral films for the assessment of fine dental details, small caries in particular. The new intraoral film was substantially equivalent to digital images for the assessment of bone lesions and of periodontal disease.

Adult↗

[Magnetic resonance imaging in assessing the complications of cardiac surgery involving the ascending aorta].

Complications involving the ascending aorta after cardiac surgery are rare (< 1%). Clinical findings are aspecific and may present a long time after surgery. Diagnostic imaging is used to show the type of complication and to provide adequate information for a suitable therapy. The authors investigated both efficacy and usefulness of MRI in the study of cardiac surgery complications involving the ascending aorta. Ten patients treated for heart disease were examined with MRI. Eight of them had had aortic valve replacement, 1 ascending aorta replacement and 1 both. Chest radiography and MRI were performed in every patient; 4 patients underwent transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE), 2 patients TTE and 1 TEE; 2 patients were submitted to CT and 4 to angiography. MRI showed 3 ascending aorta aneurysms, 3 dissecting aneurysms and 4 pseudoaneurysms. In the patients with aneurysms and dissecting aneurysms, MRI correctly demonstrated both the aneurysm and the intimal flap. MRI showed only large pseudoaneurysms, depicting mediastinal hemorrhage suggestive of pseudoaneurysm if the latter was small. In such cases, only angiography showed the breach site. In conclusion, MRI can be considered the method of choice to depict cardiac surgery complications involving the ascending aorta if aneurysms and dissecting aneurysms are present, because it yields enough information for both diagnosis and surgery. In contrast, in pseudoaneurysms or mediastinal hematomas angiography is necessary to show the exact rupture site of the aortic wall.

Adolescent↗

[Photo Compact Disc: proposal for the electronic storage of images].

We applied the Photo-CD technology to create an electronic image file easy and quick to use to optimize the retrieval of medical images for teaching purposes. We digitized 1,500 slides of diagnostic examinations from the archive of our Institution: the corresponding electronic files were stored on Photo-CD disks. The data relevant to every image were collected and recorded with the help of a relational data-base program. Thus, each user could retrieve the suitable images from the optical disks by a multiple and flexible key-word search. We compared the use of the electronic archive with a traditional hand-based file with the help of 3 teachers committed to prepare a lesson containing 5 slides on different subjects. The use of the electronic image archive corresponded to markedly shorter searching and file updating times. We tried also to assess the capabilites of this filing procedure for image post-processing and for the build-up of self-assessment programs.

CD-ROM↗

[Magnetic resonance in postoperative evaluation of aortic dissection].

The value of MRI was investigated in the demonstration of residual alterations and postoperative complications of aortic dissection. October 1988 to December 1992, fifty-nine patients were examined with MRI. The series consisted of 53 patients affected with type A and 6 with type B aortic dissection, all of them surgically treated. The following parameters were studied: 1) aortic dilatation above and 2) below the prosthesis, 3) redissection, 4) persistent intimal flap, 5) origin of abdominal vessels from the false lumen and 6) study of supra-aortic vessels. Twelve of 59 patients were considered normal since all parameters were negative. The aorta was dilated in 19 patients distal to the graft and in 4 proximal to it. Redissection was observed in 33 of 59 patients. Residual intimal flap was clearly demonstrated in 33 of 59 patients; the state of the false lumen was clearly depicted in 12 patients with SE images alone and in 18 of the extant 21 with phase imaging. In 11 of 59 patients abdominal vessels originated from the false lumen. In 53 of 59 patients supra-aortic vessels were clearly demonstrated and appeared to be involved in 10 patients. In 6 cases MRI failed to yield enough information. In our experience MRI is the method of choice for monitoring the aorta after surgical dissection to detect changes and complications and therefore choose the most appropriate treatment.

Adult↗

[Digital orthopantomography with memory phosphorus in the study of periodontal pathology].

Digital images can improve the quality of panoramic radiography also because they can be magnified by the computer in the post-processing phase. In this study, 100 patients with periodontal disease were examined with digital panoramic radiography. The degree of alveolar bone resorption was assessed by measuring the depth of infraosseous pouches. The distance between the amelodental junction and the alveolar ridge was considered abnormal when it exceeded 1-1.5 mm. Our results confirm the high quality of digital panoramic radiographs which were always rich in details and allowed the clear depiction of the alveolar edge. The incidence and depth of infraosseous pouches are higher in older patients (mean distance between the amelodentinal junction and the alveolar ridge > 4 mm in patients over 40). The measurements made on digital panoramic radiographs and on intraoral films were compared and high agreement was observed (+/- 1 mm disagreement in 80% of measurements). In our experience, digital panoramic radiography can be considered a valuable diagnostic alternative to intraoral films to study periodontal disease and to measure bone resorption.

Adult↗