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E Biscaldi

Publications and source records attributed to E Biscaldi.

9 recordsLinked to original sources
PubMed2006

Multidetector-row CT enteroclysis: indications and clinical applications.

This paper examines the diagnostic potential of multislice computed tomography enteroclysis (MSCT-E) to detect and assess different diseases affecting the small bowel, emphasising the increasingly important role assumed by the technique in the study of this anatomical region. After a short summary of the technical aspects, we discuss the different findings that can be observed during an MSCT-E study and that enable detection of small-bowel disease and, if necessary, assessment of the extent and stage of disease.

Humans↗
PubMed2000

A girl with severe fistulizing Crohn's disease.

We report the case of a girl with a severe perianal fistulizing Crohn's disease who during intravenous infusion of cyclosporine developed headache, general seizures and cortical blindness. Head magnetic resonance imaging showed spread, cortical-subcortical nonenhancing signal changes. Full neurological recovery was achieved in 24 hours. Cyclosporine was stopped and a single dose of infliximab was infused with rapid improvement of the fistula that at 7 months' follow-up is still closed.

Brain Diseases↗
PubMed2000

[Spiral computerized tomography without perfusion of contrast media as first line investigation in patients with renal colic].

INTRODUCTION: We investigated the diagnostic accuracy of unenhanced helical CT in the detection of stones in patients with suspected renal colic from ureteral stones and compared CT findings with the results of plain abdominal film and US. MATERIAL AND METHODS: We reviewed the findings relative to 80 patients (age range 24-75) who came to our observation to the Emergency Department with acute flank pain. All patients had been examined with plain abdominal radiography, US and unenhanced helical CT. RESULTS: While abdominal radiography showed the presence of radiopaque stones in 38 patients only (47.5%), US demonstrated ureter dilatation in 72 patients and detected stones in 36 of them (45%). Helical CT performed best, depicting a stone in 72 patients (90%), with high sensitivity and specificity. Mean stone size was 3 mm, with 7 mm-1 mm range. The biggest stones were seen in 3 cases and the smallest ones in 34. In 8 patients with no signs of stones we found other extraurinary conditions, namely pancreatitis, diverticula, renal cancer. We also found a case of urinary tract infection. CONCLUSIONS: Thanks to its short execution time and accuracy, helical CT makes the examination of choice in patients with acute flank pain due to renal colic. It is also a most valuable tool in the differential diagnosis of other pathological causes of pain such as abdominal or pelvic masses and inflammatory conditions.

Adult↗
PubMed1998

[Study with thoracic and abdominal spiral CT in intensive care unit patients].

INTRODUCTION: The severe clinical conditions of intensive care unit patients need frequent imaging studies to detect the pathologic changes in the patients' situation and to plan the correct therapeutic management. The yield of bedside plain radiography is often not diagnostic but moving the patients to the radiology department could affect their clinical conditions. Conventional CT is difficult to perform in these patients because they need continuous assistance and cannot cooperate during the diagnostic examination. MATERIAL AND METHODS: The authors examined with Spiral CT 46 unconscious patients in poor clinical conditions who presented a variety of pulmonary and abdominal diseases. Thirty coma patients were submitted to bedside chest radiography and then to Spiral CT because there was disagreement between the radiographic and the clinical findings. Sixteen patients with abdominal conditions underwent Spiral Ct, 11 of them after bedside US. The chest and abdomen were examined with Spiral CT in 2/16 patients and the abdomen only in 5 cases; twenty-two of 46 patients were under assisted ventilation. During all the Spiral CT studies, the patients had their arms along the body. Spiral CT results were compared with those of bedside chest radiography in 30 cases and with those of bedside abdominal US in 11 patients. DISCUSSION AND CONCLUSIONS: Spiral CT is a fast examination technique with no major artifacts which can be used safely also in unconscious patients. It confirmed a variety of pathologic conditions which may be misdiagnosed by conventional chest radiography, which improves the care of these patients. Bedside plain radiography is limited by several factors depending on the patient (no cooperation, variable respiration, still decubitus), the examination technique (X-ray projection, exposure, poor diagnostic yield), and the anatomical region of interest (mediastinal vessels). Even though our technical standard for conventional radiography was high, Spiral CT was better in detecting parenchymal consolidation and pleural effusion, a missed pneumothorax or thromboembolic disease. We always performed Spiral CT when the clinical findings did not match the results of bedside plain radiography. Moving the patients was very easy because the intensive care unit in our hospital is in the same building as the radiology department and there were dedicated devices supporting the coma patients.

Aged↗
PubMedDate not supplied

Spiral CT of the abdomen after distention of small bowel loops with transparent enema in patients with Crohn's disease.

BACKGROUND: [corrected] To evaluate the capability of a computed tomographic (CT) technique that combines distention of the small bowel loops with a transparent enema with contrast-enhanced spiral CT of the abdomen in patients with Crohn's disease. METHODS: We evaluated the abdomen with spiral CT after distention of the small bowel loops with a transparent enema of methylcellulose in 40 patients consecutively referred for radiologic evaluation of Crohn's disease of the small bowel. Fluid was infused through a nasojejunal catheter with a peristaltic pump. Ultrasonography was used to prevent bowel overdistention and detect arrival of methylcellulose to the cecum. Contrast-enhanced spiral CT of the abdomen was then performed, and the degree of contrast enhancement and the thickness of the walls of the involved loops were evaluated. A series of 10 patients with retrograde distention of the last ileal loop from large bowel water enema was used as a control. The results of the CT were compared with those of conventional radiographic small bowel studies. RESULTS: The normal small bowel wall was 1.9-2.5 mm thick (mean = 2. 1 mm); density values of the normal enhanced wall varied between 25 and 60 HU (mean = 32 HU) and presented a homogeneous structure. Bowel segments involved by the disease were 4-12.5 mm thick (mean = 9.2 mm), had density values of 75-150 HU (mean = 105 HU), and showed a multilayered appearance. Compared with conventional radiography, CT detected longer lesions or additional segments involved by the disease process in 14 cases, 11 additional fistulas, two abscesses, and mesenteric changes in 21 cases. CONCLUSIONS: The small bowel CT enema technique provides good results in the study of patients with Crohn's disease and can be used to evaluate patients with advanced lesions.

Adult↗
PubMedDate not supplied

Regarding six cases of mesenteric panniculitis: US, spiral CT, Magnetic Resonance.

PURPOSE: Mesenteric panniculitis is a rare inflammatory disease. The inflammation produces a lesion which appears as a mass, and normally produces abdominal pain without any other significant clinical signs. The radiological pattern is not typical, but the diagnosis is aided by a number of elements which are important to recognise in order to avoid invasive diagnostic methods or therapy. Six cases are presented, all evaluated with sonography, Color-Doppler US, Spiral CT and Magnetic Resonance Imaging (MRI). MATERIALS AND METHODS: We evaluated six patients with negative clinical histories and endoscopic examinations. The patients reported the recent onset of indefinite symptoms and abdominal pain treated at home. Abdominal plain film radiography, performed also in the upright position, was negative in all cases. All the patients underwent abdominal sonography and Colour-Doppler ultrasound. Spiral CT scanning was carried out with 5-mm slice thickness, a pitch of 1.3, and single breath-hold volumetric acquisitions starting 60 s after intravenous injection of iodinated contrast medium. Only in one case, where Crohn's disease was suspected and subsequently not confirmed, did we perform small bowel enema with transparent contrast medium to distend the bowel loops. MR imaging was performed using a medium-field 0.5 T magnet, T1-weighted Fast SE, T2-weighted Fast SE and Fast STIR sequences. We considered: the mass effect of the lesion; the presence of vascular infiltration; the presence of a peripheral pseudocapsule; the presence of perivascular loose tissue proper, having densitometric characteristics distinctive from the remaining fatty tissue of the diseased mesentery. RESULTS: In all cases ultrasound detected only an central abdominal mass. The fatty content of the mass, however, reduced US transmission, preventing the acquisition of more complete information. The color-Doppler US also produced little data, except some isolated colour spots within the mass. In no case did CT directly detect a peripheral pseudocapsule, although it did identify a difference in density between the perivisceral abdominal loose tissue and the mesentery proper, which is hyperdense. The vessels inside the mesentery on no occasion appeared infiltrated. The CT scans were unable to identify differential elements between the perivascular loose tissue and the fatty tissue of the main mass. MRI, on the other hand, enabled the detection of the peripheral pseudocapsule which surrounded the mesenteric mass as a band of tissue with low signal intensity in all the sequences performed. In fast STIR sequences suppression of the fat signal of the mesenteric mass was insufficient, being suppressed only in the adipose tissue surrounding the arterial branches of the mesenteric artery. Four of the six patients underwent exploratory laparotomy. The histological examination of the biopsies revealed a massive inflammatory infiltration of the mesentery, with relatively little involvement of the perivascular adipose tissue. CONCLUSIONS: In mesenteric panniculitis, sonography and spiral-CT are useful in focusing diagnostic attention on the mesentery, but only MRI is capable of providing the information necessary formulating a complete diagnosis of the disease.

Aged↗
PubMedDate not supplied

Pseudomixoma peritonei: a case report.

Pseudomixoma peritonei is a rare neoplasm characterized by mucinous ascites and the mucinous involvement of peritoneal surfaces, omentum and bowel loops. Usually pseudomixoma peritonei is associated with benign or malignant mucinous tumor of the appendix or ovary. The diagnosis of pseudomixoma peritonei is difficult because laboratory and radiology results are frequently nondiagnostic. We report a case that was initially mistaken for carcinomatosis of unknown origin and that underwent cytoreductive procedure and omentectomy as the treatment of choice.

Aged↗