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F Maccioni

Publications and source records attributed to F Maccioni.

At least 19 recordsLinked to original sources
PubMed2005

[Magnetic resonance and traditional radiology in the spine localizations of alkaptonuric ochronotic arthropathy].

AIM: To study the spine alterations in alcaptonuria with traditional radiology and magnetic resonance (MR), comparing the results of the two techniques. PATIENTS AND METHODS: Five patients (4 males, 1 female, mean age 51 years) underwent the examinations. For the study with X-rays we performed anteroposterior and lateral scan and the images have been studied making reference to a radiographic score; it examines the alterations of the joint space and the presence of calcifications. MR scan, oriented in the three spatial planes, were performed using spin echo T1-weighted and spin echo T2-weighted sequences. RESULTS: Both MR and X-rays pointed out, in the cases with known diagnosis, the typical alterations of the ochronosis: narrowing of the articular spaces, even osseous ankylosis, calcifications of the discs, osteophytosis, multiple disc protrusions and reactive sclerosis of the articular surfaces, evident above all to dorso-lumbar tract; nevertheless MR has been more accurate than X-rays for individualizing the lesions and recognizing alterations, such as the thickness of the anterior longitudinal ligament. In the case of new diagnosis, the MR is fundamental to recognize typical signs of the ochronotic arthropathy not well detected by X-rays. CONCLUSIONS: Imaging techniques, first of all the MR, are essential in the differential diagnosis of ochronosis vertebral lesions with other articular diseases.

Adult↗
PubMed2003

Behaviour of Cd, Cr, Mn, Ni, Pb, and Zn in sewage sludge incineration by fluidised bed furnace.

Cd, Cr, Mn, Ni, Pb, and Zn behaviour during sewage sludge incineration was investigated in seven pilot tests using a circulating fluidised bed furnace. Dewatered sludge at a solids concentration of 15-18% was fed to the furnace either alone (two tests) or spiked with chlorinated organic compounds (five tests). The behaviour of metals in the fluidised bed furnace was studied by comparing metal concentrations in the two main ash streams: ash separated from the cyclone immediately following the fluidised bed furnace, and fly ash recovered in the final bag filter. A metal enrichment factor was defined as the ratio of metal concentration between filter ash and cyclone ash. Only Cd and Pb showed any significant enrichment. Their enrichment factors were mainly affected by chlorine concentration in the feed sludge. To check whether simple equilibrium models may explain and predict metal behaviour, experimental data were compared with percentage of the metal vaporisation in the combustion chamber predicted using a thermodynamic model. Discrepancies between model predictions and experimental results are accounted for by considering that kinetics may be a limiting factor in the formation of metal chloride gaseous species. Due to the very short sludge residence time in the fluidised bed furnace, the gaseous compounds have little chance to evolve completely.

Forecasting↗
PubMed2003

CT cystoscopy in the evaluation of bladder tumors.

The aim of the present study was to assess the role of virtual cystoscopy in the identification of bladder tumors. Fifteen patients (11 men and 4 women, median age: 61 years, range: 46-74 years) with a positive finding of bladder tumor at fiber-optic cystoscopy were studied by multislice-CT. Scans were downloaded to a workstation with the aid of a software for the processing of 3-D reconstructions, with a volume-rendering technique which allowed the "navigation" within the bladder in search of wall lesions. In this group of 15 patients, cystoscopy was able to detect 19 neoplastic lesions, 13 with a diameter >10 mm and 6 with a diameter <10 mm. Virtual cystoscopy, instead, identified 17 lesions (89%) only. In particular, all those lesions with a diameter >1 cm (13/13=100%) were correctly identified, whereas only 4 of the 6 lesions with a diameter <1 cm were depicted. The 2 false negative cases were 2 lesions with a flat morphology, measuring 5 and 6 mm. Most recent technological advances allowed the employement of virtual endoscopies, characterized by the absence of invasivity as compared with fiber-optic studies and based on data obtained by spiral- and multislice-CTs. According to our experience, virtual CT-cystoscopy revealed to be a complementary tool in the evaluation of cross-sectional images and proved to be an easy procedure without complications, well-accepted by the patients, and with a reliable detection of those bladder lesions measuring more than 5 mm in case of polypoid formations and at least 10 mm in case of flat lesions. This technique, however, does not allow the collection of a bioptic sample and--with the present resolution power of available equipments--it could be unable to correctly detect small-sized flat lesions. We, nonetheless, believe that this procedure, in the future, thanks to rapid technological improvements in virtual imaging techniques, could become a useful diagnostic tool in the management of those patients with bladder tumors. Further studies on larger study groups are therefore desirable for a more reliable validation of the technique.

Aged↗
PubMed2002

Adenocarcinoma on horseshoe kidney studied with computed tomography.

Horseshoe kidney is a congenital anomaly of the upper urinary system frequently associated with atypical vascularization, mostly asymptomatic, usually undetected until the onset of infectious, obstructive or neoplastic complications. Although intravenous pyelography and US are useful tools, the role of CT is of vital importance especially in the pre-operative planning of related complications and in those cases where other techniques have correctly diagnosed the disease but have missed the visualization of an underlying malformation. We report here two cases of adenocarcinoma in two patients with a horseshoe kidney, where CT has clearly depicted both the malformation and the associated pathologic findings.

Adenocarcinoma↗
PubMed1999

Local invasion of gastric cancer: CT findings and pathologic correlation using 5-mm incremental scanning, hypotonia, and water filling.

OBJECTIVE: Our purpose was to assess the accuracy of CT with drug-induced hypotonia and water filling in revealing the depth of tumor invasion of the gastric wall, according to the T factor of TNM classification, and to verify the capability of this technique in differentiating diffuse from intestinal gastric cancer. SUBJECTS AND METHODS: Forty patients (age range, 35-78 years) with histologically proven gastric tumors underwent CT, in the prone position, with drug-induced hypotonia and water filling. The images were prospectively reviewed by two radiologists who were asked to assess the depth of tumor invasion in the gastric wall. The thickening of the hypodense layer and the contrast enhancement of lesion were measured. RESULTS: CT correctly assessed gastric wall invasion in 77% and 82% of cases for observers A and B, respectively; overstaging was 20% and 15%, respectively; and understaging occurred in 3% of cases for both observers. Diagnostic sensitivity for serosal invasion was 100% for both observers; specificity was 80% and 87%, respectively. Substantial agreement between the observers was obtained (kappa = .6). Diffuse and intestinal cancers could be differentiated by CT in 92% of cases, considering the thickening of the hypoattenuating layer of the gastric wall (diffuse cancer: 7 +/- 1.2 mm; intestinal cancer: 1.4 +/- 0.4 mm) and contrast enhancement (diffuse cancer: 85 +/- 8.2 H; intestinal cancer: 51 +/- 3 H). CONCLUSION: CT with patients in a drug-induced hypotonia and in a prone position, and using water filling, is a promising technique for evaluating the depth of tumor invasion and for differentiating intestinal from diffuse gastric cancer.

Adult↗
PubMed1999

[Optimization of dosage and exam technique in the use of oral contrast media in magnetic resonance].

PURPOSE: Aim of our study was to optimize the dose, scan delay and sequences for use in MR studies with an oral contrast agent (FerriSeltz, Bracco, Milan, Italy) to obtain positive or negative contrast enhancement in the bowel lumen. MATERIAL AND METHODS: In vitro: 10 mL vials with increasing concentrations (10-100 mg/mL) of the agent, containing 200 mg ferric ammonium citrate/g, were studied with a 1.5 T magnet (Philips NT, The Netherlands), by acquiring T2-weighted STIR and TSE and T1-weighted TFE sequences. Signal intensity was compared by using a ROI. In vivo: 16 volunteers were examined with the same sequences at 20 minutes and 2 hours after the oral administration of 6-27 g of the product diluted in 600 mL water. Images were analyzed by two radiologists and scored on a 4-point scale based on signal intensity; results were compared with Student's "t"-test. RESULTS: In vitro: MR signal was always hyperintense on T1-weighted images, as well as on T2-weighted TSE and SPIR images at concentrations lower than 45 mg/mL. Hypointense signal was seen on T2-weighted TSE and SPIR images at higher concentrations and on STIR sequences at 10-20 mg/mL concentrations. In vivo: the bowel exhibited positive enhancement on T1-weighted TFE and T2-weighted TSE and SPIR images 20 minutes after contrast agent administration at concentrations lower than 45 mg/mL. At 2 hours, bowel loops were hypointense on T2-weighted TSE and SPIR images at 15-20 mg/mL concentrations. STIR images showed hypointense bowel loops at both 20 minutes and 2 hours after 10-20 mg/mL contrast agent administration. Quantitative analysis showed a statistically significant superiority (p < .05) of T2-weighted STIR images in providing negative opacification of the bowel lumen. CONCLUSIONS: Ferric ammonium citrate, being a positive or negative contrast agent according to its dilution, permits to tailor the dose to optimize bowel lumen opacification.

Administration, Oral↗
PubMed1998

[Computerized tomography, magnetic resonance, and nuclear medicine in the non-invasive diagnosis of focal nodular hyperplasia of the liver].

INTRODUCTION: Focal nodular hyperplasia (FNH) is a benign liver lesion requiring a prompt diagnosis and a conservative management. Aim of our study was to prospectively integrate enhanced CT, MRI, nuclear medicine in the noninvasive diagnosis of FNH. MATERIAL AND METHODS: 20 FNH lesions (diameter ranging 1.5-13 cm) in 18 asymptomatic patients were investigated with MRI and nuclear medicine. MRI examinations were performed with a 1.5 T superconducting system (Philiphs NT) by acquiring T1-weighted, T2-weighted, T2-weighted fat-suppressed Turbo Spin-Echo and dynamic MRI sequences, with breath-hold T1-weighted Turbo Field Echo and Gd-DTPA. Nuclear medicine included in all cases 99mTc sulfur colloid or 99mTc iminodiacetic acid studies. Diagnostic sensitivity of MRI was compared with that of nuclear medicine, and the sensitivity of the two modalities combined. The definitive diagnosis was made by percutaneous core-needle biopsy (12 lesions), surgery (2 lesions) and longterm follow-up (6 lesions). RESULTS: In 13 lesions larger than 3.5 cm typical findings, such as the central scar and homogeneous pattern, were observed in 9 cases (75%) with enhanced CT, in 10 cases (83%) with unenhanced MRI and in 11 cases (91%) after gadolinium injection. Hepatobiliary scintigraphy showed increased tracer uptake in delayed scans in 10/12 cases (83%) while sulfur colloid studies were diagnostic in 2/12 cases only (16%), showing the same tracer uptake than the surrounding liver parenchyma. In 7 lesions smaller than 3.5 cm, only 1 case showed typical findings; dynamic MRI showed typical early hypervascularity in 5 of the 6 remaining lesions (71%) which persisted on late images. In lesions smaller than 3.5 cm, sulfur colloid studies were diagnostic in 1/7 lesions (14%) and hepatobiliary scintigraphy in 3/7 lesions (42%). Considering all 20 lesions, MRI-nuclear medicine integration performed better than MRI alone. CONCLUSIONS: Enhanced MRI and biliary scintigraphy are important tools to make the final diagnosis of FNH. In small lesions both examinations should performed, but in large lesions MRI may be sufficient to make an unquestionable diagnosis, limiting hepatobiliary scintigraphy to questionable cases.

Contrast Media↗
PubMed1997

Hydro-CT in patients with gastric cancer: preoperative radiologic staging.

A total of 35 patients (age range 35-78 years) with gastric tumors on the lesser curve, or in the antro-pyloric region, underwent angio-CT in the prone position after filling the stomach with 500 ml of water and intravenous administration of glucagon. The films were reviewed by three radiologists independently, staging each tumor according to the TNM classification preoperatively. The overall accuracy of tumor staging ranged between 66-77 %, overstaging between 17-25 %, and understaging between 3-8.5 %. The diagnostic sensitivity, specificity, and accuracy for serosal invasion ranged between 90 and 100, 76 and 84, and 80-88 %, respectively, and the overall accuracy for N staging was 46, 48, and 51 % for the three observers. If, however, N1 and N2 tumors were considered as a single group, N-stage accuracy increased, ranging between 63 and 77 %. The "K test" for analyzing the interobserver agreement was 60 %, i. e., the diagnostic results are reproducible. Water filling of the stomach optimizes visualization of the gastric wall on contrast-enhanced CT. The prone position and drug-induced hypotony allows for good distension without any disturbing artifact reduction obscuring the lower gastric body.

Adult↗
PubMed1997

US and CT findings of small bowel neoplasms.

Small bowel (SB) neoplasms are very rare tumours, but are still associated with high mortality rates, since the tumour-related symptoms occur late and are non-specific. In addition, endoscopy is not feasible in most cases, and radiological contrast studies do not reach the high accuracy obtained in the evaluation of upper and lower gastrointestinal tract. Cross-sectional imaging, and particularly CT, is becoming increasingly relevant in the diagnosis of these tumours. Both US and CT allow tumour detection, even when performed on an emergency basis, and are capable of showing the lesion as well as possible complications. Moreover, CT offers the possibility of a preoperative staging by evaluating tumour extension through the bowel wall, lymph node involvement and possible metastases. Finally, in most cases a direct correlation between cross-sectional findings and histology can be found, thus permitting tumour characterisation.

Contrast Media↗
PubMed1997

[Comparison of computerized tomography and magnetic resonance with fast sequences with and without paramagnetic contrast media in the assessment of liver metastasis: qualitative and quantitative analysis].

We compared unenhanced and contrast-enhanced fast MRI and CT in the detection of liver metastases. Eleven patients with single or multiple hepatic lesions (42 in all) were submitted to CT and MR studies; T1- and T2-weighted TSE, T2-weighted TSE with fat suppression, unenhanced breath-hold TFE and early or delayed enhanced breath-hold TFE images were acquired with a 1.5 T super-conductive magnet (Philips NT). The quantitative analysis of all MR images was performed for contrast/noise ratio (CNR) and number of detected lesions; MR and CT images were also compared qualitatively for lesion conspicuity, anatomical structure identification and artifacts. The results were compared with Student's t test. Early enhanced breath-hold TFE was statistically superior to T1-weighted TSE (p = .0009), T2-weighted TSE (p = .01) and CT (p = .0004) for lesion conspicuity and to T1-weighted TSE, T2-weighted TSE, unenhanced TFE (p = .0001) and CT (p = .01) for anatomical structure identification. CT was superior to T1- and T2-weighted TSE (p = .0001) and unenhanced TFE (p = .004) for the lack of artifacts. Fat-suppressed T2-weighted TSE images had a statistically higher CNR than T2-weighted TSE (p = .02), T1-weighted TSE (p = .0006) and unenhanced and delayed TFE sequences (p = .007; p = .0001, respectively). To conclude, MRI appears superior to CT in the detection of liver metastases; the examination should include early enhanced breath-hold T1-weighted TFE and T2-weighted fat-suppressed TSE images.

Adult↗
PubMed1996

Self-expanding stents in transjugular intrahepatic portosystemic shunt: experience with nitinol Strecker stents.

The aim of our study was to evaluate the performance and efficacy of a new self-expanding stent (nitinol Strecker stent) in the transjugular intrahepatic portosystemic shunt (TIPS) procedure. We have successfully placed 64 nitinol Strecker stents in 48 patients. The average portosystemic gradient decreased from 22 to 11 mm Hg. Balloon dilatation was necessary in 12 of 35 angiographically controlled cases at 5 days (34%), because of incomplete stent expansion, small thrombi within the stent or obstruction. At 1-6 months stent malfunctions occurred in 8 of 23 patients who underwent control angiography (34%) and at 6-24 months in 6 of 7 patients (85%). Rebleeding occurred in 2 of 39 patients (follow-up > 1 month) (5%) and temporary crises of de novo encephalopathy were observed in 11 of 48 patients (23%). Refractory ascites completely resolved in 4 of 6 patients (66%) and improved in the remaining 2 cases. Compared with other self-expanding stents, nitinol Strecker stents seem to be equally effective in TIPS; no increase in complication rate was observed, either clinical or stent-related.

Adult↗
PubMed1996

[Leiomyosarcoma in jejunal diverticulum. A case report and review of the literature].

The Authors describe a case of double jejunal diverticulum, characterized by the presence of a leiomyosarcoma in one diverticulum and ectopic pancreatic mucosa in the other. The rarity of the occurrence of a leiomyosarcoma in the diverticular area is outlined; only few cases have been reported in Literature, excluding those originating, from Meckel's diverticulum. Barium X-rays of the small intestine allowed the neoplasia to be discovered, while an Echo-Color-Doppler examination suggested the histological type given the high vascularization typical of leiomyosarcomas.

Diverticulum↗
PubMed1995

[Long-term survival of patients with inoperable hepatocarcinoma, treated with interventional radiology].

Survival rates in untreated patients with unresectable HCC are rather disappointing. Our study was aimed at assessing long-term survival in the patients submitted to combined transarterial chemoembolization (TACE) and percutaneous ethanol injection (PEI). We treated 223 patients, but long-term follow-up is available in 143 of them only. Eighty-seven of 143 patients had Child's A liver cirrhosis, 45 had Child's B and 6 Child's C. Five patients did not have cirrhosis. Eighty-seven patients had single lesions--45 of them < 5 cm and 42 > 5 cm. Fifty-six patients had multiple/diffuse lesions. All patients underwent TACE while PEI was performed in selected patients with single or double lesions. Survival rates were calculated with the life-table analysis by Kaplan and Meyer. Follow-up was 1-72 months (median: 28 months). At 1, 3 and 5 years, the overall survival rates were 72%, 34.5% and 16.4%, respectively. The survival rates at 1, 3 and 5 years in single lesions < 5 cm were 90.4%, 52.1% and 34.8%, respectively, vs. 69.4%, 37.4% and 18.7% in lesions > 5 cm and 58.8%, 12.5% and 0% in multiple/diffuse lesions. In conclusion, the long-term results of the radiologic treatment of unresectable HCC are comparable with surgical results obtained in selected cases.

Actuarial Analysis↗
PubMed1994

[Carbon dioxide as an intra-arterial contrast agent in echography: a technic for its preparation and the preliminary results in assessing hepatocarcinoma vascularization].

This paper reports on an original method to prepare a contrast agent consisting of CO2 microbubbles to be injected i.a. during ultrasound examinations (ultrasound angiography-USA), whose value was investigated in the study of tumor neovascularity in HCC patients. Thirty-five HCC patients underwent USA. CO2 was drawn out from a gas container under pressure and, through a sublimation process, made available in predetermined quantities in test tubes. USA was performed during angiography in 9 cases and immediately before arterial chemoembolization in the other 26 cases. In 51 lesions vascularity was evaluated with conventional angiography, USA and lipiodol CT. USA demonstrated lesion hypervascularity in 91% of cases, as confirmed by lipiodol CT (88%), versus 72.4% of angiography. In 3 of 35 patients USA demonstrated 6 more lesions undetected by other modalities: two of them were proved to be HCC and adenomatous hyperplasia at percutaneous biopsy. USA is a cost-effective procedure, which is easy to perform during conventional angiography: it is more sensitive than conventional angiography in the study of lesion neovascularity and can help plan lesion management, anticipating the results of chemoembolization. The role of USA in the diagnosis and treatment of HCC is, however, still to be defined.

Aged↗