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Biomedical subjects

F Giovagnorio

Publications and source records attributed to F Giovagnorio.

At least 19 recordsLinked to original sources
PubMed2006

Transrectal colour Doppler contrast sonography in the diagnosis of local recurrence after radical prostatectomy--comparison with MRI.

OBJECTIVE: To assess the usefulness of colour power-Doppler transrectal sonography before/after contrast agent in the detection of local recurrence in patients with rising prostate-specific antigen values after radical prostatectomy and to compare with magnetic resonance imaging . MATERIALS AND METHODS: 18 patients with rising prostate-specific antigen values after prostatectomy underwent digital rectal examination, bone scintigraphy, magnetic resonance imaging, transrectal colour power-Doppler sonography before/after contrast agent, and transrectal sonography-guided biopsy. Sensitivity, specificity, accuracy, positive and negative predictive values were calculated. Results were correlated using McNemar binomial 2-tailed P-test. RESULTS: Baseline and contrast-enhanced transrectal colour power-Doppler sonography and contrast-enhanced magnetic resonance imaging identified recurrent disease in 6, 10 and 10 patients, respectively. Biopsy confirmed recurrence in 10 patients, but was positive also in 2 additional patients who were negative at contrast-enhanced transrectal colour power-Doppler sonography and contrast-enhanced magnetic resonance imaging. The remaining 6 patients were negative also at diagnostic imaging and biopsy after 30 days. Grey-scale transrectal sonography values were: sensitivity 91.7 %, specificity 66 %, PPV 91.6 %, NPV 40 %. Baseline colour power-Doppler transrectal sonography values were: sensitivity 38.5 %, specificity 85 %, diagnostic accuracy 50 %, PPV 83.3 %, NPV 33.3 %. Contrast enhanced colour power-Doppler transrectal sonography and magnetic resonance imaging values were: sensitivity 76.9 %, specificity 100 %, diagnostic accuracy 83.3 %, PPV 100 %, NPV 62.5 %. CONCLUSION: Contrast-enhanced transrectal colour power-Doppler sonography increases specificity in the detection of local recurrence after prostatectomy. Magnetic resonance imaging yields equivalent accuracy. Biopsy remains the diagnostic gold standard, but the use of imaging methods may reduce the number of biopsies.

Aged↗
PubMed2004

Ultrasonography in follow-up of soft tissue augmentation of the face with synthetic materials: a pilot study.

PURPOSE: To assess ultrasonography in the evaluation of reactions after soft tissue augmentation of the face with synthetic materials. MATERIAL AND METHODS: Six female patients (mean age 39+/-8 years) treated for facial tissue augmentation noticed unpleasant or painful effects in the intervention site after a mean of 24 months were evaluated with ultrasonography. Two patients had been treated with injections of microparticles, two with Gore-Tex implants, and two had been injected with liquid silicone. Fifteen female patients (age 27-55 years, mean 41+/-14 years) who had received the same treatment 14-48 months before without any complications were also evaluated and used as controls. Biopsy was performed in all patients, while four underwent re-intervention. RESULTS: In all patients with Gore-Tex implants, a thick, homogeneous hypoechoic halo was seen surrounding the implants. Small hypoechoic nodules were noticed in the patients who had been treated with microparticles and with liquid silicone. In two cases treated with liquid silicone the subcutaneous tissue was invaded by an irregular area of marked inhomogeneity. CONCLUSION: Sonography must be considered the method of choice for producing instrumental evidence of foreign body reactions after soft tissue augmentation of the face with synthetic materials.

Adult↗
PubMed2001

Ultrasound of the elbow.

Ultrasonography (US) is an efficient alternative to magnetic resonance (MR) imaging for evaluation of soft tissues of the elbow. US is able to diagnose several abnormalities affecting tendons, muscles, ligaments and bursae around the elbow joint. In cubital tunnel syndrome, US identifies ulnar nerve abnormalities and extrinsic lesions that may cause nerve entrapment. Occult fractures, osteophytes and intra-articular loose bodies can also be imaged. In para-articular swelling, US is able to assess the presence of capsular and synovial processes and to differentiate them from soft tissue tumors. Key advantages of this technique include cost-effectiveness, availability and ability to perform a dynamic examination.

Elbow Joint↗
PubMed2001

Power Doppler sonography in knee arthritis--a pilot study.

We compared power Doppler sonography to laboratory indices of disease activity in patients with knee arthritis to determine the clinical relevance of hypervascularity. Eight healthy volunteers and 22 patients with symptoms and signs of knee arthritis were studied. Presence or absence of hypervascularity, synovial thickening, effusion, and Baker's cysts were recorded. Disease activity was measured by erythrocyte sedimentation rate, c-reactive protein, alpha2-globulins, sideremia, hemoglobinemia, and serum white cell count. Various grades of synovial hyperemia were found in 12/22 cases. Patients with and without synovial hypervascularity showed statistically significant differences in age (P=0.017), erythrocyte sedimentation rate (ESR) (P = 0.039), hemoglobinemia (P = 0.009), and sideremia (P = 0.012). Power Doppler sonography is able to demonstrate synovial hyperemia, which is correlated with some laboratory indices of inflammation.

Female↗
PubMed2001

Sonography of the cervical vagus nerve: normal appearance and abnormal findings.

OBJECTIVE: The purpose of this study was to assess the appearance of the cervical vagus nerve in healthy individuals and to investigate the potential role of sonography in revealing neck masses that cause vagal dysfunction. SUBJECTS AND METHODS: We examined 150 consecutive patients. In 144 patients the presence of thyroid, salivary gland, or lymph node disease was suspected. In three patients a cervical mass was palpable, and three patients had symptoms of dysfunction of the inferior laryngeal or vagal nerves. The pathologic diagnoses of the masses were obtained at biopsy. RESULTS: In 144 individuals the normal vagus nerve was recognized on each side of the neck as a thin band that occupied the posterior angle formed by the common carotid artery and the internal jugular vein. Three patients had tumors arising from the vagus nerve: one neurofibroma, one neurinoma, and one chemodectoma. These tumors were located in the neurovascular bundle and posterior to the vessels; their origin from the vagus nerve was clearly visible in all patients because of the contiguity of the mass with the nerve bundle. In the other three patients, sonography revealed an extrinsic mass that compressed and displaced the vagus nerve out of its longitudinal axis; two cases were hyperplastic nodules of the thyroid, and in one case the nodule was a branchial cyst. CONCLUSION: Sonography can reveal the vagus nerve in healthy conditions and correctly reveal the vagal origin of some tumors in the parapharyngeal spaces.

Adolescent↗
PubMed2000

Identification of feeding arteries to establish the intra- or extraparotid location of jugulodigastric nodules: value of color Doppler sonography.

OBJECTIVE: The objective of our study was to determine the value of color Doppler imaging as an adjunct to gray-scale sonography to reveal the intra- or extraparotid origin of jugulodigastric nodules of uncertain location. SUBJECTS AND METHODS: Forty nodules in the jugulodigastric area from 38 patients were imaged with gray-scale, color, and power Doppler sonography. Nodules receiving vessels from salivary glands were assumed to be intraglandular; those accepting vessels from paraparotid spaces were considered to arise from outside the gland. Imaging results were correlated with biopsy and surgical findings. RESULTS: In 38 of 40 cases, color and power Doppler sonography displayed discrete feeding arteries leading to the nodules: 25 nodules had one supplying artery, nine received two arteries, and four had three or more arteries. Intraparotid nodules received vessels from the gland in 20 cases. In two cases, the source of vessels was indeterminate. In two malignant tumors, multiple arteries derived from both the parotid and the neck spaces. All 14 extraparotid nodules received the arterial supply from paraparotid spaces. Color Doppler sonography enabled prediction of the intraglandular location of the nodules in 91% of cases and the extraglandular location in 87.5% of cases. The correct diagnosis was achieved in 34 of 40 nodules, with a global accuracy of 85%. CONCLUSION: Color Doppler sonography can help to assess the intra- or extraparotid location of jugulodigastric nodules. In practice, this technique can support the diagnosis when gray-scale sonography raises doubts about the origin of a jugulodigastric nodule.

Adenolymphoma↗
PubMed2000

Sonography of lacrimal glands in Sjögren syndrome.

This study evaluates the potential role of high resolution sonography and color Doppler sonography in the evaluation of the lacrimal glands in Sjögren syndrome. We examined 15 women (age range, 52-73 years) affected by Sjogren syndrome and 15 women with no history and signs of lacrimal disease (age range, 47-75 years). The lacrimal glands were visualized bilaterally in 6 of 15 patients. The lacrimal artery was detectable in all patients; the resistive index was higher than normal (0.72+/-0.04). An abnormal Schirmer test was present in six of six patients with visible glands and in two of nine patients with invisible glands; xerophthalmia was present in six of six patients with visible glands and in four of nine patients with invisible glands; high levels of serum immunoglobulins were present in six of six patients with visible glands and in three of nine patients with invisible glands. Sonography is able to provide noninvasively much of the information needed by the clinician.

Aged↗
PubMed2000

[A statistical evaluation of the variability in the measurements of the resistive index in kidney transplantation].

INTRODUCTION: Doppler ultrasound (US) is a valuable tool to measure blood flow in the transplanted kidney, but its operator-dependence can greatly affect repeatability and reproducibility of measurements. Aim of this work was to evaluate intraobserver and interobserver variability in measuring the resistive index (RI) in renal transplants. PATIENTS AND METHODS: Ten renal transplant recipients were randomly selected among those undergoing follow-up and examined by two operators (FG and LB) with 3.5 MHz and 10 MHz scanheads to assess the variability of RI measurements. Each observer obtained two measurements of the RI with each scanhead within a 10-15 minutes' period. In all, 80 measurements were made, 4 per patient per observer. The statistical analysis included two-tailed Student's t-test for paired data and calculation of repeatability/reproducibility coefficients. RESULTS: Student's t-test analysis demonstrated a statistically significant difference (p = 0.037) between the means of the first and second measurements by FG with the 3.5 MHz scanhead and the first and the second measurements by LB with the same scanhead. Differences between the other means were not statistically significant. Intraobserver variability ranged 0.03 units (or 2.07%) and 0.07 units (or 4.24%), while interobserver variability was 0.04 units with both 3.5 and 10 MHz scanheads, or 3.61 and 3.73%, respectively. CONCLUSIONS: Doppler US of renal transplants has statistically quantifiable operator-dependent variability: the possible evidence of statistically significant differences can be minimized by having the same operator make the measurements. However, RI variations ranging 0.02 to 0.04 units should not be considered significant.

Adult↗
PubMed1999

Color Doppler sonography of focal lesions of the skin and subcutaneous tissue.

We evaluated with color Doppler sonography 71 visible and palpable nodules of the skin and subcutaneous tissue from 51 patients. The nodules were classified as avascular (type I), hypovascular with a single vascular pole (type II), hypervascular with multiple peripheral poles (type III), and hypervascular with internal vessels (type IV). Of the 32 malignant nodules, 9% showed a type I pattern, 50% had a type III pattern, and 41% had a type IV pattern; of the 39 benign nodules, 86% showed a type I pattern and 14% had a type II pattern. The sensitivity and specificity of hypervascularity in malignant lesions were 90% and 100%, respectively, whereas the sensitivity and specificity of hypovascularity in benign lesions were 100% and 90%, respectively. The authors conclude that color Doppler sonography is able to increase the specificity of ultrasonography in the evaluation of nodular lesions of the skin.

Biopsy, Needle↗
PubMed1999

[Doppler color in superficial adenopathies].

INTRODUCTION: Superficial lymph nodes are frequently involved in different diseases. Their location makes them suitable for effective assessment with high-resolution US and color Doppler has been recently suggested as a tool for increasing sensitivity in lymph node studies. Thus, we investigated the main vascular patterns detectable in abnormal superficial lymph nodes. PATIENTS AND METHODS: We evaluated 260 nodes in 180 adult patients; the nodes were located in the cervicofacial ring (78, 30%), internal jugular stations (104, 40%), and supraclavicular (44, 17%), axillary (21, 8%), and inguinal (13, 5%) stations. Color Doppler was performed with 7.5-13 MHz linear transducers, with parameters adjusted for slow-flow detection (5-6 MHz frequency, 700-900 Hz PRF, 50 Hz band filter, high color persistence). Disease assessment required fine-needle biopsy (95 nodes in 95 patients) and clinical follow-up (165 nodes in 85 patients). RESULTS: Fifty-five nodes (21%) presented acute and 130 (50%) chronic inflammation: 75 nodes (29%) were metastatic. The following vascular patterns were detected: a single vascular pole (type I) was seen in chronic inflammation (72% sensitivity, 86% specificity, 57% positive and 92% negative predictive value); an enlarged single vascular pole, with 2-3 enlarged branches (type II) in acute adenitis (80% sensitivity, 81% specificity, 78% positive and 83% negative predictive value); multiple vascular poles with many deformed and displaced branches converging centrally (type III) in metastases (76% sensitivity, 100% specificity, 100% positive and 91% negative predictive value). CONCLUSIONS: We conclude that color and power Doppler are useful integrations to B-mode US because they can detect specific signs of malignancy such as peripheral vascular poles and intranodal displacement of vessels.

Humans↗
PubMed1998

Doppler sonography of the superior mesenteric artery in Crohn's disease.

OBJECTIVE: The aim of this study was to evaluate blood flow in the superior mesenteric artery (SMA) in patients with active and inactive Crohn's disease (CD) using Doppler sonography to dynamically assess the changes of resistance in both fasting and postprandial states. SUBJECTS AND METHODS: Doppler sonography of the SMA was performed on 15 patients (mean age, 38 +/- 4 years) with active CD and on 15 patients (mean age, 41 +/- 5 years) with inactive CD. Imaging was performed at both fasting and 15 min after an 1890-kJ meal. A preliminary examination of 10 healthy volunteers with no signs of intestinal disease (mean age, 28 +/- 2 years) was necessary to define the parameters of normality. Because we wanted to express the postprandial resistive change in the SMA, we introduced a parameter called resistive difference (RD), defined as the mathematic difference between the resistive index measured at fasting (highest value) and measured at 15 min after the meal (lowest value). RESULTS: By evaluating the relationship between the RD and extension of disease, we found a direct correlation between progressive extension of disease and reduction of the RD in patients with active CD (correlation coefficient, .98) whereas we found no such correlation in patients with inactive CD (correlation coefficient, .05). CONCLUSION: We believe that Doppler sonography of the SMA is a promising noninvasive method to detect inflammatory disease of the small bowel, to evaluate its extension, and to document resolution of disease after therapy.

Adult↗
PubMed1998

Evaluation with Doppler sonography of mesenteric blood flow in celiac disease.

OBJECTIVE: The aim of this study was to investigate with Doppler sonography the variations of resistance in the superior mesenteric artery, both at fasting and in the postprandial state, in patients with celiac disease. SUBJECTS AND METHODS: Twenty-five patients with celiac disease (20 women, five men; mean age, 30 +/- 7 years) and 10 healthy volunteers (seven women, three men; mean age, 28 +/- 6 years) were examined with Doppler sonography. Nineteen patients were untreated (no dietary restrictions) and six patients were treated with a gluten-free diet at the time of the examination. Imaging was performed at both fasting and 15 min after an 1890-kJ meal. We introduced a parameter called "resistive difference," defined as the mathematic difference between the resistive index measured at fasting (highest value) and that measured at 15 min after the meal (lowest value) as a way to express the postprandial resistive change in the superior mesenteric artery. RESULTS: Untreated patients with flat mucosa showed a resistive difference of 0.03 +/- 0.05, followed by untreated patients with mucosal subatrophy (0.05 +/- 0.04), treated patients (0.09 +/- 0.02), and healthy volunteers (0.12 +/- 0.04). A statistically significant difference was noticed between the resistive difference of healthy volunteers and both those of the untreated patients with subatrophy (p = .016) and of the patients with complete atrophy (p = .011), as well as between the resistive difference of the treated patients and both those of the untreated patients with subatrophy (p = .021) and of the patients with complete atrophy (p = .020). CONCLUSION: We believe that Doppler measurement of resistive difference in the superior mesenteric artery can be an effective way to express severity of celiac disease and to document its regression after diet therapy.

Adult↗
PubMed1997

Evaluation of vascular patterns of cervical lymph nodes with power Doppler sonography.

Power Doppler sonography was used to evaluate 105 benign and malignant cervical lymph nodes in 60 patients. Three main vascular patterns were identified: type I (single vascular pole), type II (hypertrophic vascular pole), and type III (mainly peripheral vascularity). The first one was related to chronic inflammation (sensitivity 85%, specificity 90%); the second and third were related, to a lesser extent, to acute inflammation and neoplasm (sensitivity 68% and 55%, specificity 47% and 91%, respectively). The authors conclude that the sensitivity and specificity of power Doppler sonography cannot compete with those of fine-needle aspiration biopsy in the diagnosis of adenopathy.

Acute Disease↗
PubMed1997

Sonography of cutaneous non-Hodgkin's lymphomas.

Sonographic examination (10 MHz) of 25 patients with cutaneous non-Hodgkin's lymphomas of B-cell type (10 patients), of T-cell type (nine patients) and non-B non-T-cell type (six patients) demonstrated "diffuse' (11 patients) and "focal' patterns (14 patients): the former, which can be described as an homogeneous, hyperechoic thickening of the dermis, occasionally involving the subcutaneous layer, was exclusively observed in T-cell (nine cases) and non-T non-B cell (two cases) types, while the latter, characterized by small, hypoechoic and well-defined nodules, was observed in B-cell (10 cases) and non-T non-B-cell (four cases) types. These observations indicate a possible relationship between histologic and sonographic appearance.

Aged↗
PubMed1997

Ultrasonographic evaluation of de Quervain disease.

De Quervain disease is a job-related tenosynovitis that affects the synovial sheath of the tendons of the abductor pollicis longus and extensor pollicis brevis muscles; it is associated with pain and functional impairment and progresses to cause local fibrosis with blockage or triggering of the thumb. High-resolution ultrasonography of the wrist was performed in eight patients with de Quervain disease; the examination was performed in axial and coronal scans with a 13 MHz linear transducer. The evaluation of normal wrists helped to define the normal sonographic anatomy of the first extensor compartment; obvious changes of the tendon sheath were noted in all cases of de Quervain disease (thickening and edema of the synovial sheath and fluid within the sheath). We conclude that ultrasonography is able to confirm the clinical diagnosis of de Quervain disease and may have a role in the follow-up of this disorder.

Acute Disease↗
PubMed1997

[Computerized tomography assessment of complications secondary to abdominal aortic prosthesis].

PURPOSE: CT has gained an important role in the diagnosis of the complications of prosthetic surgery of the abdominal aorta: the importance of such complications comes from their frequency, which is proportional to the increasing number of interventions, and their severity. We investigated the CT patterns of the most frequent complications. MATERIALS AND METHODS: 24 patients referred for strongly suspected postoperative complications were examined in 2 years: fever and leukocytosis (20 cases) and progressive anemia (4 cases) were the most frequent findings. The operation had been performed 7 +/- 12 weeks before (2 patients were excluded because surgery dated less than 3 weeks). RESULTS: 14 patients had infective complications: thickening (57%) and inhomogeneity (43%) of the periprosthetic wrap and ectopic gas bubble (78%) were the most frequent CT findings. We also observed 2 periprosthetic hematomas, 1 aneurysm relapse and 1 prosthetic graft rupture. CONCLUSIONS: In conclusion, CT confirmed its important role in the study of the complications of prosthetic aortic surgery, despite its known poor specificity in the demonstration of the aorta in the first 2-3 months postoperatively, in the initial stages of infection and in the diagnosis of aorto-enteric fistulas.

Aorta, Abdominal↗
PubMed1997

[The echographic and computed tomographic assessment of "spontaneous" hematomas of the abdominal wall].

INTRODUCTION: Hematomas of the abdominal and pelvic wall are frequent findings, particularly in the patients undergoing long-term anticoagulant therapy. MATERIALS AND METHODS: We reviewed a series of 9 cases of "spontaneous" hematomas of the rectus abdominis muscle (7 cases), of the obliquus internus muscle (one case) and of the gluteus muscles (one case) studied with US and CT. During the last 4 years, 9 patients complaining of the recent onset of a painful muscular swelling were examined: 8 of them were on anticoagulant therapy, while one was on long-term hemodialysis. They were examined with US (3.5 MHz, integrated with 7.5 MHz in 7 cases) and CT (contiguous 10-mm slices before and after i.v. contrast agent injection). Color Doppler was used in 3 cases. RESULTS: US showed different signs depending on hematoma onset and extent: the muscle was swollen, with an inhomogeneous structure with both coalescing liquid and echogenic areas in 2 cases, while the hematomas were bigger and appeared with mostly liquid areas and internal inhomogeneity due to blood clots in the remaining 7 cases. The evidence of pseudocystic areas with fluid blood levels (the so-called pseudohematocrit effect) was particularly specific of diffuse hematomas (4 patients). CT helped make the final diagnosis by showing the typical hyperdensity of fresh blood (at least 50 HU) in 9 cases and by defining the typical pattern of the pseudocysts with the hematocrit effect, but was useless in characterizing "pseudotumoral" lesions (3 cases), which were better defined by B-mode and color Doppler US. CONCLUSIONS: US is the examination of choice, even though it may misdiagnose small hematomas as muscular tumors or large hematomas as other diseases; color Doppler can be useful in the former case. CT usually permits the correct diagnosis by detecting fresh blood, which can however be found also in some muscular neoplasms.

Abdominal Muscles↗