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G Braccini

Publications and source records attributed to G Braccini.

At least 37 records · Page 2Linked to original sources
PubMed1996

An intelligent system for the diagnosis of complex images.

An intelligent system suitable to perform a computer aided diagnosis of complex images should have a knowledge base containing all information related both to the images to be interpreted and to their symbolic description. In this paper, a system able to classify unknown medical digital images into four classes is proposed (searched pathology recognized, searched pathology absent, different pathology from the searched one recognized, unknown pathology). A main component of this system is a knowledge base that, startling from information deduced from sample images, can be processed to create synthetic reference models that, in turn, permit the interpretation of real scenes. The system has been tested on digitized plain film of the thorax, in order to perform a computer-aided diagnosis of pneumothorax cases.

Artificial Intelligence↗
PubMed1996

[Quantitative evaluation of the dynamics of the coronary wall in man: description of a new method based on tridimensional time-dependent reconstruction of intravascular ultrasonographic images].

BACKGROUND: Intravascular ultrasound imaging provides information on vascular lumen and arterial wall structure and it has potential application in arterial wall dynamic study. The aim of this study was to develop a computer assisted system for analysing digitised cross sectional ultrasound images of coronaries to easily display and quantify coronary dynamic and its relationship with arterial wall morphology. METHODS AND RESULTS: To extract the anatomical regions of interest from the digitised sonograms, automatic image segmentation and interactive procedures for manual correction were implemented. This step included the recognition of the lumen edge and an analysis of gray level intensity of the wall. Subsequently, a virtual 3D reconstruction of lumen and vessel wall was done in a Cartesian system where the XY plane was parallel to each cross-sectional sonogram, while the Z axis corresponded to the acquisition time. The baricentre of vascular lumen was used as a reference for alignment. We obtained a cylinder-like solid representing the behavior of the arterial cross-sectional sonogram in time, with the possibility to look either at the wall or at the lumen. In this virtual solid it was possible to measure the variation of lumen area and of 16 hemidiameters; in addition, the derivatives of these values, allowing an estimate of the velocity of events, can be obtained. CONCLUSIONS: The described computerised system for the analysis of intravascular ultrasound images could become a very useful tool for 3D representation and quantitative monitoring of coronary compliance and their relationship with segmental arterial wall morphology.

Coronary Vessels↗
PubMed1996

[Occult post-traumatic osteochondral changes in the knee. Assessment with magnetic resonance].

Occult posttraumatic osteochondral injuries of the knee are bone and/or cartilage abnormalities which cannot be detected on plain radiographs. This study was aimed at investigating MR capabilities in the detection and characterization of occult bone and/or cartilage injuries in symptomatic patients with previous musculoskeletal trauma of the knee. We retrospectively selected 60 patients (45 men and 15 women; mean age: 33.1 +/- 16.3 years; range: 12-70 years) from our patients submitted to MRI of the knee during a 3-year period. These patients had a history of previous acute musculoskeletal trauma, negative conventional radiographs and MR signal intensity changes of the osteochondral structures. MR protocol included: SE T1-, PD and T2-weighted images and GRE T2-weighted images; imaging planes were the sagittal, the axial and the coronal planes. Plain radiographs and MR images were interpreted by three experienced readers in musculoskeletal radiology. Our reviewers confirmed normal conventional radiographic findings in all the patients enrolled in the study. According to morpho-topographic and signal intensity patterns, we identified three types of occult posttraumatic injuries: bone contusions or bone bruises or occult subcortical fractures (n 30), osteochondral injuries (n 26) and chondral injuries (n 4). A bone contusion was defined as a typical subcortical area of signal loss, with various shapes, on T1-weighted images and increased signal intensity on T2-weighted images. The cortical bone and articular cartilage below were normal in all cases. On the contrary, osteochondral lesions presented an association of cartilage and bone injuries with the same M(R) signal abnormalities. Thinning and focal interruptions of the cortical bone were demonstrated in all cases. Chondral lesions were characterized by a sudden discontinuity and irregularity of cortical bone outline and by small high-intensity spots in cartilage thickness on T2-weighted images, in the absence of any subchondral bone abnormality. Finally, 42 of 60 patients (70%) had an anterior cruciate ligament tear and 28 (45%) had a medial meniscus tear. In conclusion, MRI appears a very useful tool in the detection and characterization of the different types of occult bone and/or cartilage injuries of the knee in the patients with previous acute trauma. Moreover, the correct and early diagnosis of an osteochondral lesion does affect prognosis.

Adolescent↗
PubMed1996

[Inflammatory aneurysm of the abdominal aorta: TC assessment of the postoperative course].

This study was aimed at investigating CT reliability in the postoperative follow-up of inflammatory abdominal aortic aneurysms (IAAA) previously treated with prosthesis positioning. During the last 5 years, 13 male patients operated on for subrenal IAAA with intraluminal prosthesis positioning, were followed-up with CT. All CT images were reviewed by three radiologists to assess prosthesis integrity; the possible presence of intraluminal thrombosis was investigated, together with pre/postprosthetic dilatation and the involvement of inferior vena cava, ureters and third duodenal segment. The prostheses were intact and no signs of intraluminal thrombosis were depicted in all patients; a periprosthetic dilation of abdominal aorta associated with parietal thrombosis was observed in one patient. Nine patients exhibited mild-moderate thickening of the original aortic or iliac walls; the inferior vena cava was involved in 6 of them and the left ureter in one. Contact with the III duodenal segment was found in 3 patients. In conclusion, CT proves to be a reliable technique in the postoperative follow-up of IAAA, yielding accurate information about the prosthesis, the aortoiliac walls and retroperitoneal structures. Moreover, in our experience late postoperative complications were not of major clinical importance.

Aged↗
PubMed1996

[Usefulness of pirenzepine in the study of the upper digestive tract and the large intestine with double contrast media: comparison with scopolamine methylbromide].

The purpose of the present study is to assess the importance of pirenzepine, a selective M1 antimuscarinic drug, as hypotonic agent for diagnostic double-contrast studies of the upper gastrointestinal tract and for double-contrast barium enema studies of the large bowel. Pirenzepine and scopolamine methylbromide (SMB) (Buscopan) were compared in a single blind randomized trial. One hundred-thirty consecutive patients were enrolled in the study. Seventy of them underwent double-contrast studies of the stomach and duodenum and sixty double-contrast barium enema studies of the large bowel. Visceral distension and painting of stomach, duodenal bulb and large bowel and global quality of the images were blindly evaluated by 4 independent observers by means of a numerical score (1 to 4). Quantitative analysis of bowel distension was done measuring the maximum diameter of the transverse colon before and after drug administration. No differences were found in the diagnostic performance between the two drugs in the study of the duodenal bulb (2.8 +/- 0.8 vs 2.9 +/- 0.7, p = NS) and of the large bowel (3.0 +/- 0.6 vs 3.1 +/- 0.6, p = NS). Under SMB, slightly but significantly better results were obtained in the stomach (3.0 +/- 0.6 vs 2.7 +/- 0.6, p = 0.01). However, large bowel distension was slightly but significantly improved with Pirenzepine (68 +/- 12 vs 65 +/- 8 mm, p = 0.02). Heart rate and rhythm during the study were recorded by ECG. SMB induced tachycardia in all patients while pirenzepine did not. Moreover, after SMB, 3 patients exhibited faintness, some patients complained of visual accommodation defects, dryness of the mouth and dizziness. Under pirenzepine, no side-effects were reported. To conclude, pirenzepine gives good results in double contrast studies, as good as SMB but with no adverse effects; thus, it could be proposed as the hypotonic agent of choice in upper gastrointestinal and large bowel examinations.

Adult↗
PubMed1996

[Adrenal myelolipomas: their magnetic resonance assessment].

Adrenal myelolipomas are rare nonfunctioning neoplasias consisting of a variable mixture of mature fat and bone marrow tissue. In the present study MRI appearances of six adrenal myelolipomas are presented. MR exams of six patients in which a conclusive diagnosis of adrenal myelolipomas was reached by means of surgery (1 case), US-guided fine-needle biopsy (3 cases) and typical diagnostic imaging in association with stability on US follow-up for at least two years (2 cases) were retrospectively evaluated. MR sequences protocol included pre- and post-contrast (Gd-DTPA) SE T1-weighted images and SE proton density and T2-weighted images. Five adrenal masses were examined by means of combination of gadolinium administration with a SE T1-weighted modified three-point Dixon technique. Three different MR structural patterns were pointed out: a) homogeneous hyperintense masses on T1-weighted images with intermediate signal on T2-weighted images, suggestive for predominantly fat-containing lesions (2 cases); b) heterogeneous masses with fat intensity areas and hyperintense areas on T2-weighted images and on post-contrast T1-weighted images, suitable for mixed fatty and myeloid elements (2 cases); c) nodules hypointense to the liver on T1-weighted images and hyperintense on T2-weighted images and after gadolinium administration, suggesting tumors primarily composed of myeloid cells (2 cases). A precise determination of fatty and myeloid elements within the lesions was observed by means of "water" and "fat" images provided by modified three-point Dixon technique. In conclusion, MRI allows to determine the various structural components of myelolipomas and therefore appears to be a very reliable technique in the diagnosis and characterization of the different structural patterns of this rare adrenal pathology.

Adrenal Gland Neoplasms↗
PubMed1994

The role of ultrasonography in blunt abdominal trauma: results in 250 consecutive cases.

The accuracy of ultrasonography (US) in detecting abdominal lesions and free fluid collections in patients with blunt abdominal trauma was evaluated in 250 patients. Particular attention was paid to the role of associated US-guided paracentesis in doubtful cases and in those referred for nonsurgical therapy. The overall sensitivity of US in detecting free fluid collection was 98% (51 of 52 cases) with a specificity of 99% and a positive predictive value of 100%. The overall sensitivity was 93% in spleen injuries, 80% in liver injuries, and 100% in kidney lesions with a positive predictive value of 93%, 100%, and 100%, and a specificity of 99%, 100%, and 100%, respectively. Three stable patients underwent celiotomy on the basis of the results of US-guided paracentesis. The versatility, sensitivity and, repeatability of US, along with its feasibility at bedside and the possibility of performing a guided paracentesis represent the main characteristics that make US the first diagnostic approach to patients with blunt abdominal trauma.

Abdominal Injuries↗
PubMed1993

Seronegative spondylarthropathy without spine involvement in Behçet's syndrome.

The case of a 49-year-old man affected by Behçet's syndrome (BS) without any clinical or radiological evidence of ankylosing spondylitis, exhibiting a peripheral enthesitis typical of seronegative spondyloarthropathy (SpA) is reported. The diagnosis of SpA is supported by computed tomographic evidence of sacroiliitis. This case confirms our hypothesis that patients with BS may have other forms of SpA than AS.

Achilles Tendon↗
PubMed1993

[Computed tomography diagnosis of small intestine carcinoid].

This study was aimed at evaluating CT diagnostic capabilities in detecting carcinoid tumors of the small bowel and comparing CT results with conventional radiographic findings. The CT diagnosis of carcinoid tumor was made in 6 cases based on CT findings. All patients had undergone conventional radiographs (transit or double-contrast studies of the small intestine) and 2 patients had undergone double-contrast barium enema of the colon. 500 ml of oral contrast medium were administered 2 hours, 1 hour and 15 minutes before CT scans, respectively. A hypotonic agent was injected i.v. immediately before the examination. Primary lesion extent, mesenteric involvement, extramesenteric lymph nodes and hepatic metastases were the investigated CT patterns. The first two variables were also assessed on plain radiographs. In all patients the diagnosis of enteric carcinoid tumor was confirmed at surgery or liver biopsy. CT proved to be useful in demonstrating the primary tumor in 5 cases, mesenteric involvement in all patients, liver metastases in 3, lymphadenopathy in none. CT yielded very accurate findings and thus allowed the diagnosis of carcinoid tumor to be made in all the 6 patients, while plain films resulted normal in 2 cases and aspecific in 4. In conclusion, CT, if adequately performed, proved the best technique to detect carcinoid tumors of the small bowel. Of course, further evidence is required.

Carcinoid Tumor↗
PubMed1993

[Echography and echo-Doppler in the study of thoracic outlet syndrome. Correlation with angiographic data].

This study was aimed at assessing the clinical utility of conventional and color duplex-Doppler US in the diagnosis of thoracic outlet syndrome. Conventional US and Doppler examinations were performed in a prospective study. The results were correlated with angiographic findings. Thirteen patients affected with thoracic outlet syndrome were studied by means of both conventional US and spectral Doppler flow imaging. Five cases (5/13) had neurovascular symptoms in the right upper limbs, 7/13 in the left upper limbs and 1/13 in both upper limbs. An accessory cervical rib was demonstrated in 2/13 cases (associated with muscular hypertrophy in one case and bilateral in the other), by means of plain films of the spine. Conventional US depicted muscular hypertrophy in 7/13 cases--bilateral in one case and monolateral in 6/13 cases, with marked muscular asymmetry. In 5/13 cases, no bone/muscle anomalies were demonstrated. The patients with an accessory cervical rib and scalenus muscle hypertrophy were seen to exhibit two types of hemodynamic alterations in the subclavian artery--i.e., turbulence and changes in the systolic window with no increase in peak systolic velocity in 5/13 cases with mild stenosis, normal or reduced peak systolic velocity with changes in the reversed flow in 3/13 cases with mild/medium-grade stenosis, either during indifferent position or after dynamic tests. In 2/13 patients with no bone/muscle alterations, turbulence was demonstrated in the subclavian artery. However, in 3/13 cases Doppler US revealed no arterial flow abnormalities--3/13 false negatives relative to mild vascular compression. Selective arteriography demonstrated vascular alterations in the subclavian artery in all cases, with or without Doppler anomalies; while angiography was often positive during hyperabduction maneuvers color duplex Doppler demonstrated hemodynamic alterations at rest with indifferent position of the upper limb. In conclusion, conventional US allowed the evaluation of the thickness of both anterior and middle scalene muscles and of possible muscular asymmetries. Color duplex Doppler US demonstrated primary and secondary alterations in the subclavian artery or vein. Therefore, conventional US, duplex and color Doppler prove to be valuable non-invasive tools in the patients with neurovascular symptoms in the upper limbs and could allow the selection of the cases to submit to arteriography.

Adult↗
PubMed1993

Eosinophilic gastroenteritis: possible role of sonography in diagnosis and follow-up.

Eosinophilic gastroenteritis (EGE) is a rare disease of unknown etiology. The clinical and radiological diagnoses have to be confirmed by histological examination of biopsy specimens. The authors now present a case of a 19-year-old man with recurrent epigastric pain and vomiting, whose sonographic features and eosinophilia suggested the diagnosis of EGE, which was subsequently confirmed by histology. Sonographic follow-up permitted an effective evaluation of the evolution of the disease under steroid therapy.

Adult↗
PubMed1988

[Echographic aspect of the diaphragm].

The authors investigated the sonographic patterns of the right hemidiaphragm, with high-resolution real-time equipments. Sixty healthy subjects and two patients were examined; the patients suffered from ascites and pleural effusion, and ascites and pulmonary emphysema, respectively. Even though the muscle is generally described as a thin, highly echogenic line surrounding the liver, in a large number of cases the diaphragm could be demonstrated as a hypoechoic layer, bordered by thin echogenic lines (pleural and peritoneal membranes). This pattern was observed in the lateral part of the muscle in 81% of cases, and along the whole border of the liver in 37% of cases. Such findings were detected in pathological cases too. Thus, the patterns described in previous experimental works on specimens of human diaphragm were confirmed in vivo. As the perfect knowledge of normal appearance is the first step towards diagnosis, the above peculiarities of the normal diaphragm should become more widely known.

Ascites↗
PubMedDate not supplied

Usefulness and safety of pirenzepine in double-contrast study of upper gastrointestinal tract: comparison with scopolamine methylbromide.

To evaluate usefulness of pirenzepine, a selective M1 antimuscarinic drug, for diagnostic double-contrast study of the upper gastrointestinal tract, pirenzepine and scopolamine methylbromide (SMB) were compared in a single blind randomized trial. Seventy consecutive patients were enrolled in the study. Artifacts, bowel distention, painting of stomach and duodenal bulb, and global quality of the images were blindly evaluated by four independent observers by means of a numerical score (1-4). Under SMB slightly but significantly better results for stomach were scored (3.1 +/- .7 vs. 2.7 +/- 7, p < 0.01). No differences were found in the study of the duodenal bulb. Heart rate and rhythm during the study were recorded by electrocardiogram (ECG). SMB induced tachycardia in all patients (from 77 +/- 20 to 117 +/- 28 beats/min, p < 0.01) while pirenzepine did not (from 77 +/- 16 to 81 +/- 23, p = NS). After SMB, two patients exhibited faintness, and some patients complained of visual accommodation defects, dryness of the mouth, and dizziness. Thus, pirenzepine provides good results in double-contrast studies (equal to SMB), while presenting no adverse effects. It could be proposed as a first choice hypotonic agent in upper gastrointestinal examination.

Adult↗