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F Stacul

Publications and source records attributed to F Stacul.

At least 19 recordsLinked to original sources
PubMed1992

PACS experiences in Trieste.

The installation of a commercial PACS in the Hospitals of Trieste has been the start-point for a project of technology assessment, aimed at the evaluation of technical, clinical and economic aspects related to the introduction of this new and expensive technology in the health care system. During more than two years of use of this system in the clinical environment, several research activities have been carried out concerning the analysis of the organization of radiology departments in Italy, the analysis of work and data volumes, the evaluation of technical and clinical performances of PACS versus conventional film-based radiology, the integration between PACS and RIS, the experimentation of teleradiology applications. An overview of the most important activities and related results is given in this paper as well as some indications about future developments of the Trieste Project.

Computer Communication Networks↗
PubMed1990

[Simplified urographic technique using non-ionic contrast media].

Urography is not to be performed following a standard procedure. However, some key-films can be defined which are to be routinely employed. If needed, additional radiographs can be performed. We tried to optimize the urographic technique combining low X-ray exposure and adequate diagnostic assessment with the injection of 17.5 gI of a non-ionic agent. Two groups of 50 patients each were investigated. In the former, the technique we currently employ in our Institute was used: plain film, 2 nephrotomograms (1'), full-length view (7'), kidney view with ureteral compression (15'), and full-length or bladder view (20'). In the latter group, a more simplified technique was used: plain film, 2 nephrotomograms (1'), kidney view (7'), and full-length view (15'). A compression device was positioned immediately before contrast medium injection and released immediately before the 15-minute exposure. Both urographic techniques allowed high scores to be reached (after the Kelsey Fry method), with no significant differences among the evaluated parameters. Thus, the technique employed on the second group is to be preferred, because it shortens examination time and reduces X-ray exposure. However, a simplified technique increases the radiologist's responsibility: it is thus essential for an experienced uroradiologist to accurately supervise the procedure and immediately decide what to do next.

Adult↗
PubMed1990

[Evaluation of the role of mammography and echography in breast diseases in a controlled caseload].

Data concerning patients who underwent mammography and breast ultrasonography and then breast surgery were collected and analyzed with a computer archive system. In previous papers the authors reported both design and implementation of the computer archive and analyzed the results concerning uncontrolled collected data; in the present paper data concerning controlled cases are evaluated, distinguishing between symptomatic and asymptomatic cases. Asymptomatic patients represented 92% of the whole evaluated population. However only one third of the patients who underwent surgery for breast cancer was included in this group. Breast cancer was discovered in 65% of the patients who underwent diagnostic procedures and then surgery because of a palpable nodule. This percentage was lower (52%) in asymptomatic patients. Mammographic accuracy was about 90% in symptomatic patients and 81% in asymptomatic patients. Breast ultrasonography was performed as a subsequent step and always detected the lesion when palpable. Its sensitivity was 86% in asymptomatic patients. In patients who underwent surgery the false positive rate for cancer was higher with ultrasonography (59%) than with mammography (45%). Focal dysplasis were responsible for the majority of false positive diagnoses with both procedures. However, the false positive rate is low referring to the whole investigated population and is reshuffled by guided bioptic procedures. Ultrasonography was a useful tool when mammography had limitations: in fact ultrasonography detected a focal lesion in all patients with a surgically proven cancer and a previous negative mammography. The sets of data available from the continuous updating of the computer archive immediately clarified the differences between symptomatic and asymptomatic patients and stressed the diagnostic capabilities of the different procedures.

Breast Diseases↗
PubMed1990

[The definition and realization of a computerized archive for radiological data of scientific interest].

The general requirements are analyzed of a system designed to acquire and manage radiological data of scientific interest. These requirements consist in: easy implementation, to develop the system in the same environment where it is going to be used; easy use, to avoid excessive needs and resources for the system to be managed in practice; reduced implementation cost, in terms of resources required for its implementation; user-oriented approach, in the sense of meeting the radiologists' requirements, and flexibility, for the system to be an effective tool for the widest range of possible applications. Two actual applications of this general approach are then discussed, one relative to breast investigations data, and the other to digital procedures (US, CT, DSA, MR) data. For each application the software tools employed are analyzed, together with the archive structures and the used codes, the collecting data procedures and the programs. For the breast investigations archive the possibility of obtaining standard periodic reports is pointed out. These reports summarize the global department activity in this area during selected periods (six months-one year). They allow interesting clinical conclusions to be drawn. As for the digital procedures archive, the possibility is stressed of searching different combinations of scientific data out of tens of thousands of cases in just a few minutes.

Computer Systems↗
PubMed1990

[Tha data management of a breast radiology section via a computerized archive].

In the Institute of Radiology of the University of Trieste, from January to December 1988, 7123 patients underwent breast diagnostic procedures following a screening program for breast cancer or in order to evaluate specific symptoms. The data relative to this series of cases were collected and processed using the system described in a colleague's paper. Several sets of data became available concerning the percentage distribution of the techniques employed, their main indications, the distribution of pathological features in relation to different indications, the diagnostic value of combining different techniques, and the suggestions based on the findings collected. Both mammography and US proved to be able to solve the great majority of diagnostic problems, sometimes also as a tool to guide bioptic procedures. Other techniques (galactography, pneumocystography, CT) were devoted to specific diagnostic problems. The results are interesting in view of their clinical, epidemiological and management implications.

Breast Neoplasms↗
PubMed1988

[The role of computerized tomography in the diagnosis of postoperative intervertebral diskitis].

Six patients with diskitis following lumbar disk surgery were investigated by Computed Tomography (CT). Four patients underwent CT in a rather early phase of the disease (5-37 days after the onset of the symptoms): a posterior paravertebral fluid collection was always recognized, while the plain film was normal. Later on (2-4 months), the classical signs of diskitis were evident, with both CT and the plain film. The collection was always present at CT. A reintervention, performed on 3 patients, revealed the purulent content of the collections. It seems reasonable to suggest a relationship between the collection and the subsequent diskitis; the collection is probably an early sign of the disease. Its detection is of great value, because it could allow an immediate and adequate therapy. The authors stress the usefulness of performing CT in an early phase on this kind of symptomatic patients.

Adult↗
PubMed1987

Contrast agent nephrotoxicity: comparison of ionic and nonionic contrast agents.

The effects on glomerular and proximal tubular function of an ionic contrast agent (sodium meglumine diatrizoate) and a nonionic agent (iopamidol) were compared in 34 patients with normal renal function. The patients received large doses (2.5 ml/kg body weight) of contrast material for IV digital subtraction angiography. Urine samples, collected before, immediately after, and on the first and third days after digital subtraction angiography, were analyzed for albumin, alanil-aminopeptidase, alpha-glucosidase, and beta-2-microglobulin. The changes noted were mild and of short duration with both contrast agents, despite the high dose given. These results suggest that, at least as far as renal toxicity is measured by these tests is concerned, ionic monomers can be safely used instead of more expensive nonionic media in procedures, such as digital subtraction angiography, that require high doses of contrast material.

Adult↗
PubMed1987

[Preprocessing programs of CT images for three-dimensional reconstruction].

Up to now three-dimensional reconstructions in computed tomography have been applied mainly to the skeleton. This limitation is due to technical difficulties when dealing with images of the soft tissues. In order to overcome these limitations three new softwares were developed, thus enabling the operator to pre-elaborate and modify the axial CT images. The first program allows the operator to isolate the lesion and/or the anatomical structures of interest from the surrounding areas. The second program eliminates the areas of isodensity with the lesion it is obtained by means of a trackball. The third program enables the operator to write the modified axial images on the original file. The lesion and/or the structures of interest can thus be processed more easily by the 3D reconstructive program. The new softwares have been applied to 3D reconstructions of brain lesions, and two significant cases are presented. Furthermore, since the new softwares can enhance the quality of 3D images of the skeleton, the programs were also tested in cases of acetabular traumas.

Acetabulum↗
PubMed1987

[Quality control in urography with iopamidol and iohexol. A parallel comparison].

Iohexol has a slightly higher osmolarity in comparison with iopamidol; therefore it might induce a more pronounced diuretic effect and then a better distension of the excretory pathway. A trial was carried out in two groups of 50 patients with normal renal function who underwent urography, namely with 50 ml (15 gI) of iopamidol and of iohexol. No significant differences in the evaluated parameters (nephrography, calyces, pelvis, ureters and bladder) have been found. Both contrast media allowed to perform good quality urographies.

Adolescent↗
PubMed1986

Impact of technology and technique on the performance of the intravenous D.S.A. of the carotid arteries.

Intravenous Digital Subtraction Angiography (i.v. D.S.A.) was performed at the carotid bifurcation level in 259 patients with clinical or physical findings of a Cerebrovascular Insufficiency (C.V.I.). The angiographic examinations have been performed during two different periods, basically differing for the technology of the digital equipment and for the technique used. The personal experience showed how these two factors are important in determining the quality of the image and therefore the accuracy of the i.v. studies. Images of good quality of the common and internal carotid arteries have been obtained in 73% and 54% of the cases of the first period and in 93% and 82% of the cases of the second period. The role of the i.v. D.S.A. in the management of the C.V.I. depends not only upon the quality of the images, but also upon the surgical policy and from the availability of ultrasounds.

Angiography↗
PubMed1986

[Percutaneous drainage of abdominal abscesses].

Percutaneous puncture with echographic guide was performed in 37 patients with suspected abdominal abscesses. The abscess has been confirmed in 31 cases and it has been related to previous surgery in 21. In 3 cases the 3 small cavities were evacuated by a single-stage aspiration; in the other cases different drainage catheters, in relation to the size and the content of the cavities have been employed. Benefits of proteolytic agents, irrigation with saline solution and permanent aspiration are stressed. Successful drainage avoiding surgery was achieved in 23/31 patients (74%), and positive results have been obtained in multiple abscesses, multilocular abscesses and infected haematomas as well. A partial success was achieved in 3 cases (10%): the patients were submitted to surgery after a clinical improvement. Two complications occurred (bowel perforation and small liver laceration). The percutaneous drainage turned out to be a technique of choice in the great majority of abdominal abscesses, and should be considered a good alternative to surgery, particularly in high risk patients.

Abdomen↗
PubMed1986

[Quality control in urography using non-ionic contrast media (iopamidol) and induced hydration].

A trial was carried out with the aim to overcome the limits of the non ionic contrast medium (cm) in the urographic evaluation of ureters and bladder (poor distention and high density). 200 urographies have been performed in patients with normal renal function (group 1: sodium iodamide; group 2: iopamidol; group 3: iopamidol with glucose solution; group 4: iopamidol and injection of glucose solution after 15'). The scores ascribed to the four groups have been compared: in the comparison between ionic and non ionic cm a slight advantage of iodamide is evident, particularly in the evaluation of calyces and ureters. By adding glucose solution to iopamidol after 15', an improvement in the quality of the urogram has been obtained, but not statistically significant.

Adolescent↗
PubMed1986

[3-dimensional craniofacial computerized tomography].

Computed tomography allows today to reconstruct three-dimensional (3D) images from axial scans. The authors report their experience in cranio-facial pathology achieved in two Departments of Radiology (University of Trieste, Italy and University of Stanford, California). 3D images have been realized using two different softwares, one of which allows to reconstruct both soft tissue and bone structures. The applications in maxillo-facial traumas, cranio-facial malformations and head tumours are discussed. 3D images turned out to be very useful for the optimal visualization and for the spatial demonstration of the lesion and have potential applications in cranio-facial surgery and radiotherapy.

Facial Bones↗