Biomedical subjects
Publications and source records attributed to G Gavelli.
The authors present their own experience in the diagnosis of thoracic adenopathies and mediastinal masses by transbronchial needle aspiration (Wang needle). The diagnostic usefulness and safety of the method is stressed. Radiology plays an important role in choosing biopsy site (by CT), in monitoring the procedure by fluoroscopy and looking for complications following completion of the examination.
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After a general review of the US findings in acute renal allograft rejection, the results are discussed of a retrospective sonographic-histologic study in 17 patients affected by acute rejection. The high sensitivity of sonography in detecting acute rejection is confirmed, but echographic studies were unable to differentiate between vascular and cellular sub-types of rejection and to provide a prognostic evaluation.
Clinical and radiographic findings in bronchiolo-alveolar carcinoma are presented, with particular emphasis on differential diagnosis between diffuse and localized forms. A series is presented of 18 patients, observed in our Istitutes since 1980. Diagnostic role of radiology and bioptic techniques is discussed and the leading importance of broncoscopic biopsy is stressed.
Authors examine the most actual radiologic techniques for the investigation of pleura and chest wall. Advantages of decubitus views in the study of effusion are considered; diagnostic possibilities of echography and CT in the evaluation of abnormal findings in these regions are analyzed.
This study evaluates the usefulness of chest x-ray in the diagnosis of pulmonary arterial hypertension. Twelve patients with severe interstitial fibrosis were studied by respiratory functional tests and right heart catheterization. A quantitative radiologic diagnosis of pulmonary arterial hypertension in pulmonary fibrosis results more difficult than in chronic obstructive airway disease, mitral stenosis or pulmonary thromboembolism. Nevertheless in case of severe interstitial fibrosis pulmonary hypertension was regularly present even if specific radiologic findings were not available. We have found some interesting correlations, i.e. a trend to a relationship between mean pulmonary pressure and right descending pulmonary artery diameter.
The chest radiographs of 78 adult asthmatic patients admitted with severe acute asthma over a three-years period were reviewed. Radiographic findings were compared with functional data. Overinflation was demonstrated in 32% of chest X-rays. In four patients the presence of atelectasis was shown. On admission only PaO2 was significantly lower in patients with radiological abnormalities than in patients with normal chest radiographs. The usefulness of chest radiographs in patients with acute asthma is discussed.
The authors summarize clinical findings and radiological aspects of pleural malignant mesothelioma. This tumor, previously uncommon, is now observed with increasing frequency in developed countries (pathogenetic relationship with asbestos fibers inhalation is proved). Common and uncommon findings are described and 8 new cases are presented. Differential diagnosis between malignant mesothelioma and other primary or secondary pleural tumors is difficult and always requires a confirmation by multiple biopsies and/or thoracotomy. The usefulness of CT study in the accurate staging of mesothelioma is particularly emphasized. In this field CT may completely replace the conventional tomography.
Seventy-four uremic patients in chronic hemodialysis were studied by X-ray of the thorax before and after the same dialysis. Radiological signs and variables (originally proposed by Milne) related to hemodynamics of pulmonary and systemic circulation were evaluated in relation to fluid subtraction. The study demonstrated the high sensitivity and the clinical value of thoracic radiography in the follow-up of these patients and particularly in the evaluation of fluid overload.
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The authors emphasize the role of renal sonography in detecting post renal-transplant complications, such as fluid collections and hydronephrosis. Ultrasonic study proved also to be useful in the diagnosis and follow-up of renal allograft rejection. A total of 32 renal allograft patients were studied. Focal areas of decreased parenchymal echogenicity were the most striking sonographic finding in renal rejection. Cortico medullary demarcation was difficult to interpret and was inconsistently related to rejection.
A correct staging of sarcoidosis is of the uppermost importance in the diagnosis and treatment of the disease. In the last few years new concepts have been stated: --radiological staging of sarcoidosis is particularly difficult --in no one phase the radiological pattern can be considered typical but sometimes it is highly suggestive for sarcoidosis --anatomical studies recently showed that sarcoid disease seems to begin with a non granulomatous interstitial pneumonia. Following this individual microscopic deposit may conglomerate to form the typical non caseating granulomas. In the lung the disease seems to procede from the interstitium to the lymphnodes. Usually, in the first stage, possible sarcoidosis is diagnosed by the radiologist, but a confident diagnosis needs a pathological confirmation. Transbronchial biopsy guided by fluoroscopy is the first diagnostic choice for obtaining confirmation of the disease and for determining the type and entity of parenchymal lesions.
The clinical and radiologic findings of the chronic eosinophilic pneumonia are presented. A personal observation of one case is reported. This should be the first in the Italian roentgenologic literature. The importance of radiology in the diagnosis and in the evolution of the disease is stressed.
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A method that can be profitably employed in the clinical and functional evaluation of nevrogenic bladder is illustrated and discussed. It is primarily based on retrograde and micturition urethrocystography and urography with high doses of contrast medium.
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A 65-year-old man with lung carcinoma is presented. Chest radiography showed unilateral Kerley B lines in the right midlung and base, suggestive of lymphangitic carcinomatosis. High resolution CT demonstrated that this finding was due to residual normal interlobular septa, suspended between areas of paraseptal emphysema.