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Biomedical subjects

F Stacul

Publications and source records attributed to F Stacul.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Contrast media in venous digital angiography: ionic or non-ionic?].

Nonionic contrast media (cm) are more and more widely employed in vascular radiology. These cm are the choice in some conventional arteriographies owing to their better tolerability. In intravenous digital subtraction angiography (DSA) the analysis of the personal material and of the literature allows to state that: the image quality with ionic and non ionic cm is similar; the tolerability of nonionic cm is slightly superior; the cardiac and renal toxicity of nonionic cm is slightly lower; reactions to nonionic cm take place with a lower frequency; the price of nonionic cm is considerably higher. Therefore nonionic cm seem to be slightly superior to ionic agents on the basis of these data and they should be theoretically preferred. The only doubt to their routine use in intravenous DSA is the high cost. Therefore we prefer to employ them in risk patients only, as ionic cm in current use are safe and cheap.

Brain↗
PubMed1985

Criteria for choice and use of contrast media in intra-arterial D.S.A.

The authors investigated the optimal characteristics of contrast media for use in intra-arterial DSA. 209 injections in 108 patients were evaluated, most of them in the abdominal and peripheral regions. In order to decrease contrast media osmolarity and obtain an adequate mixing with blood, contrast media with low iodine concentration were injected using the same volumes and flow rates of conventional arteriography. Good results were obtained with ionic contrast media, 100 and 150 mgI/ml. depending on the area investigated. The low concentrations allowed the use of ionic agents with an osmolarity very close to that of the non ionic contrast media: the pain has been eliminated and the heat sensation reduced. Furthermore the comparison with the cost of nonionic agents shows a great saving.

Angiography↗
PubMed1985

Routine evaluation of arteriopathies of the lower extremities by digital subtraction angiography.

Intravenous digital subtraction angiography (DSA) was performed in 119 patients with lower extremity ischemia using a 14" amplifier. Four injections of contrast medium were usually necessary for a complete evaluation of this vascular region. Images of good quality were obtained in most cases; movement artifacts and a faint opacification accounted for any poor results, which occurred mainly under the knee. The technique of pixel shifting turned out to be very useful to remove movement artifacts. The "measuring field" allowed us to minimize the problem of the inhomo geneous saturation of the amplifier. In 8% of the cases an intra-arterial DSA has been performed after an unsatisfactory intravenous examination. Conventional angiography appears to be no longer necessary.

Aged↗
PubMed1985

[Digital radiology. Clinical experience].

The authors report the experience achieved at the Stanford University (USA) with a digital radiography system which allows the digitization of the film and of the images collected with photostimulable phosphors. The phosphor is essentially an intensifying screen where a latent image is stored after exposure to X-rays and is extracted by a laser scanning. The images collected with the digitized film and with the phosphor (chest, breast, bone) have been analyzed. The digitized film offers potential diagnostic advantages over the conventional film, because of the contrast manipulation and many other processing options. The possibility to recover the information of overexposed films appears very attractive. The photostimulable phosphors allow to get good quality images, with a consistent reduction of dose and costs. These plates offer the possibility, in the next future, to replace the conventional screen-film systems.

Female↗
PubMed1984

Digital subtraction angiography in postoperative evaluation of peripheral vascular disease.

The authors present the results of intravenous Digital Subtraction Angiography (DSA) in 41 patients examined after vascular surgery for peripheral disease. The digital technique has always been able to show the patency of the graft or the existence of complications (obstruction, stenosis, pseudoaneurysm), even in asymptomatic patients. The images were of good or excellent quality in 90% of the cases. The equipment with C-arm proved to be very useful for the oblique projections which were required in about 20% of the examinations.

Angiography↗
PubMed1984

The role of ultrasonography in the diagnosis of tumours of the renal pelvis.

The authors have evaluated 22 patients with renal pelvis tumour (RPT) by means of excretory urography and ultrasonography. Six patients also underwent arteriography. The value of the three investigations in the diagnosis of the lesion, the nature, the pyelic origin and the extension are presented. It is concluded that urography remains the method of choice for the evaluation of RPT while ultrasonography may be considered complementary to urography in cases of non-functioning kidney, when the urographic filling device defect is uncertain and in the differentiation between the pyelic or parenchymal origin of the tumour.

Angiography↗
PubMed1983

Ultrasonography in the diagnosis of hydronephrosis in patients with normal renal function.

In order to define the sensitivity and specificity of ultrasonography (US) in the diagnosis of hydronephrosis, 125 patients with normal renal function were examined after urography using high-resolution real-time scanning. The overall diagnostic accuracy of US in detecting hydronephrosis was 85.2%, with a specificity of 84.4% and a sensitivity of 89.9%. It is concluded that US may be considered the screening test of choice for the diagnosis of hydronephrosis. However, urography is still required for the evaluation of renal function, site, and nature of the obstruction when US shows a dilated collecting system and in the patient with a normal US but renal colic.

Diagnostic Errors↗
PubMed1983

Intra-arterial digital angiography of the liver. Preliminary results.

The authors report the preliminary results of the intraarterial digital angiography of the liver. A series of 30 patients were examined comparing conventional and digital technique following the injection of the coeliac, splenic, hepatic and mesenteric arteries. The results obtained with the digital technique have been of good quality and sometimes even better in spite of significant dilution of the contrast medium. It is concluded that intraarterial digital angiography of the liver gives some advantages compared with the conventional technique, that is the use of a much lower concentrated contrast medium, the better visualization of the portal branches and its collaterals and the very low cost of the film material.

Adult↗
PubMed1983

[Percutaneous pyelostomy: technic and indications].

The authors evaluated the results of 24 percutaneous nephrostomies. Pelvic neoplasms involving ureters were the most frequent indications to the procedure (71% of the cases). In all patients the placement of a catheter was possible. The authors describe the techniques performed and evaluate their advantages and limits. The problems related to the use of nephrostomy in patients with widespread neoplasms and severely ill are discussed. The most frequent drawback was catheter dislodgement (25% of the cases). No serious complications occur. Percutaneous nephrostomy is a temporary or permanent form of urinary diversion in obstructive nephropathies, alternative to surgical nephrostomy.

Aged↗
PubMed1982

Iopamidol in urography. A comparison between ionic and nonionic contrast media in patients with normal and impaired renal function.

The radiographic results obtained in urography with iopamidol, a new low osmolality contrast medium, given to 50 patients with normal renal function and 42 patients with impaired renal function, have been evaluated and compared with those obtained with ionic media of current use (meglumine sodium diatrizoate and sodium iothalamate). Based on this comparison, the authors believe there are no significant radiographic advantages to iopamidol.

Contrast Media↗
PubMed1980

[Angiography in the evaluation of pancreatic carcinoma after the introduction of echotomography (author's transl)].

The authors refer the results of angiography in 46 patients with proven pancreatic carcinoma. Based on the prospective report there were 40 correct diagnoses, giving an overall accuracy of 86.95%. The incidence of the angiographic features has been investigated; basing on these findings the possibility of a radical surgery was suggested. 24 of these patients have undergone echotomography. The authors compare the results of the two investigations, concluding that these are complementary in diagnosis and prediction of resectability (invasion of great vessels, secondary deposits to the liver). Echotomography allows to recognize a large number of small dimension carcinomas, suggesting its use in the screening of those patients with suspected pancreatic neoplasm. Angiography is still essential to perform radical surgery.

Angiography↗
PubMedDate not supplied

Trieste PACS project: a functional assessment.

A picture archiving and communication (PAC) system (CommView by AT&T and Philips) has recently been installed in the Radiology Department of the University of Trieste, Italy, and is currently under experimental evaluation. The current status of the system and the planned developments are reported. A major project at present is the evaluation of the impact of the PAC system on the radiology system on a functional basis, by applying in the medical field a modelling methodology developed to analyse manufacturing systems. Other research in progress is devoted to technical, clinical and ergonomic aspects, on the basis of a comprehensive assessment project.

Hospital Information Systems↗
PubMedDate not supplied

[Modular project of the Picture Archiving and Communication System (PACS). Preliminary clinical experience. II].

In the previous paper in this volume the PAC System installed in the Radiology Department of the University of Trieste has been described and its advantages and limitations have been analyzed, mainly from an operational point of view. This paper deals with the clinical evaluation of the system in ordinary operative conditions. A series of cases with specific characteristics was monitored in order to reveal different performances in both diagnostic process and conclusions using the PACS viewing console (DW) vs. conventional CRT film images on alternators. In a first test, 100 routine (not pre-selected) brain CT cases were independently analyzed by 4 radiologists, each of them giving 2 interpretations of the same case, one based on film and the other on PACS. The data were analyzed by conventional statistical methods, showing a substantial agreement of the results obtained with the 2 modalities. A second test concerned the evaluation of 100 lumbar intervertebral disks by CT, with the same procedure as above. Four radiologists were again asked to decide on film and PACS images about normality, protusion, or herniation of the disks. The results demonstrate the possibility of adequately reporting on the PACS monitor and stress the need of an adequate training period and the efficacy of the image processing capabilities of the system.

Brain Diseases↗
PubMedDate not supplied

[Modular project of the Picture Archiving and Communication System (PACS). Preliminary operational experience. I].

Since september 1988 a PAC System (Comm View by AT & T and Philips) has been operating in the Radiology Department of the University Hospital, Trieste. A research project is presently in progress aiming at providing factual evidence for the evaluation of this kind of systems as far as operational, technical, clinical and economic aspects are concerned. The general approach to this research consists in implementing and monitoring a PACS in a stepwise way, starting with a small system connected to some digital modalities only, in order to test the feasibility and effectiveness of the system within a Radiology Department, and to test the possibility of matching the PACS to the Radiological System. The present paper describes in detail the present configuration of this entry-level system and its technical features. The planned development (october 1989) is also depicted. Further developments devise at managing in an integrated way all the radiological images of the four hospitals of Trieste. At present, the PACS is currently used to manage and store on optical disks all the images acquired from the connected modalities plus the related reports, and to perform the reporting sessions for CT examinations (brain and abdomen). The present research effort is devoted to two main areas: clinical evaluation and operational analysis. The object of the operational analysis was the assessment of the impact of PACS on the operations of a Radiology Department. The general approach followed for this research consists in analysing the procedures as they are performed in the conventional way (manual operations), and comparing them to the way they are, or could be, performed using a PACS System (automatic operations). This stage of the project is divided into three phases, concerning respectively the analysis of the organization and operations before PACS, the analysis of the impact of PACS in its initial configuration and the forecast of the influence of PACS in its future setting. A first evaluation concerned the activities carried out from the moment the images are generated to the moment they are ready to be achieved. They include image acquisition, reporting, delivering and returning of images from the departments. The time required to carry out each of the activities involved was recorded, both in the manual and in the automatic version; furthermore, a more detailed analysis was performed on the reporting procedure. The conclusions reached through this analysis are that this kind of operation is mostly affected by the way the Radiology Department is managed, rather than by the tools employed.(ABSTRACT TRUNCATED AT 400 WORDS)

Computer Systems↗
PubMedDate not supplied

[An information system for the management support of a radiology institute. Critical analysis and experience].

The Radiology Information System (RIS) for the management of the Radiology Department at the Trieste University Hospital is here presented. It consists of 3 subsystems: the first one is devoted to the management of the patients archive and to the examination scheduling function, the second deals with the statistical and administrative reporting task, and the third manages the archives of scientific data. Each subsystem is analysed in details, in terms of functions, hardware, software, archives, and personnel. The actual implementations of such systems are considered, with respect to the main functions of the Radiology Department, on the basis of the authors' actual experience. An attempt is made to set aside features related to the local situation, thus providing useful data for different realities. Specific quantitative measures are presented, whenever appropriate, to provide a solid ground to explain and motivate the most relevant aspects relative to the management of the Radiology Department in general and of the RIS in particular. Workloads and/or execution times of the main functions were collected and the RIS has turned out to yield significant benefits (e.g., easier and more confident access to the information). On the other hand, the costs are not negligible and must be carefully planned during the projecting phase. Some expected future developments of the RIS are outlined: in the short run the network conversion is devised, and a functional integration among the subsystems; in the medium run an autonomous system is planned, and in the long run a connection is considered with a Picture Archiving and Communication System (PACS) and with the Hospital Information System (HIS).

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

[Digital radiography in urography].

The clinical utility was evaluated of a computed radiographic system in urography. The system (FCR 101, Philips Medical Systems, Inc., Shelton, CT) is based on a photo-stimulatable phosphor screen (imaging plate) for X-ray image detection and storage. The X-ray information recorded on the imaging plate is converted into digital from and processed by means of a computer. After processing is completed, the digitized image is reversed back to analogic signals, which modulate the intensity of a laser beam scanning the image on a single-emulsion film (Fuji CR 633). Two hundred IVP's were obtained in four groups, of 50 patients each, with normal azotemic values by rapid infusion of a low osmolality contrast medium (iopamidol 150 mgI/ml). While conventional radiographs were performed on the first group of patients with the injection of 0.6 gI/kg body weight of contrast medium, digital examinations were carried out, in the remaining three groups, with the injection of 0.6, 0.3 and 0.12 gI/kg, respectively. The digital images were processed with the "Abdomen-routine" program. A specific algorithm was implemented in order to reduce the excessive contrast resolution of the bladder, which is due to the characteristics of the nonionic contrast medium and enhanced by the reading program. The image details were evaluated by two observers and then statistically analyzed with nonparametric tests. Statistical analysis did not show any difference in the quality of digital and screen-film images. Image processing improved some inadequate images, by reducing the contrast resolution of the bladder, and allowed a better detection of some details. Low doses (0.3 gI/kg) of a low osmolality (150 mgI/kg) contrast medium were enough to obtain good images. Another biological advantage was obtained by a consistent radiation dose reduction (about 40%).

Adolescent↗
PubMedDate not supplied

[Echography in renal colic].

To determine the role of sonography (US) in patients with renal colic, 40 patients were examined by means of US, plain abdominal film (PF), and intravenous pyelography (ivp). US sensitivity was 92.3% in diagnosing hydronephrosis and 75% in detecting calculi. Small calculi were correctly identified, irrespective of their chemical composition. It must be stressed how US, as compared to ivp, proved unsatisfactory in such cases as difficult visualization of the middle portion of the ureter, unsuccessful identification of acute obstructions without hydronephrosis (although the patient's hydratation may be useful in this respect), poor functional information (although there was a correlation between renal hyper-echogenicity and obstructive nephrogram). US is safe and easy to perform, and is suggested for the initial evaluation of patients with renal colic, together with PF, and as an alternative to ivp. Moreover, US is the ideal technique in the follow-up of these patients. Therefore, ivp should be performed in case of differing clinical and sonographic findings, when the calculus is not ejected within the expected time, and when surgery or lithotripsy are foreseen.

Adult↗