[Digestive hemorrhages in cirrhotic patients. Their etiopathogenetic definition and choice of therapy].
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Biomedical subjects
Publications and source records attributed to G Gozzi.
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The diagnostic accuracy of sialography and ultrasonography (US) in the evaluation of parotid masses is evaluated. Furthermore the role of computed tomography (CT) in this pathology is discussed. In the personal experience US proved to be the best method in the recognition of a parotid tumor while sialography was superior in defining the intra or extraparotid site. The two investigations showed the same accuracy in the definition of benign or malignant nature of the mass. Therefore we consider US the only investigation in most instances; sialography could be performed when the site of the lesion is uncertain or an inflammatory lesion is suspected. CT is never the first investigation; its use is limited to a low number of cases, mainly for the evaluation of large masses and when the association US-sialography does not allow a sure diagnosis.
The performances of 4 real-time scanners (2 mechanical sector scanners and 2 linear electronic scanners) have been tested. The clinical test used was the examination of liver, gallbladder and biliary tract and in other circumstances the examination of kidney and breast. The quality of the scanners has been judged on the ground of four parameters: the diagnostic quality of the image (DQI) the overall quality of the image (OQI), the efficiency of the exploration (EE) and feasibility of use (FU). The ideal conditions of use for each technology are described and the authors emphasize the impact of improved technology on the quality of the ultrasonographic scanners.
The diagnostic value of Computed Tomography (CT) in the diagnosis of the aseptic necrosis of the femoral head is discussed. The CT findings in the different evolutive stages are reported and the respective diagnostic value of Conventional Radiology and CT are discussed. The CT findings of femoral head necrosis in the early phases are emphasized. The capability of CT to demonstrate structural changes in femoral heads with regular morphology allows to consider this technique when there exists a clinical doubt of osteonecrosis of the femoral head and in risk patients.
The authors evaluated 177 cases of expansive lesions observed in diffusely dysplasic breast. The size of the lesions was less or equal to cm 2. They found that mammography had its diagnostic difficulties in benign lesions such as fibroadenomas and fibrocystic disease. Ultrasonography was carried out on 106 of those patients. The sensitivity of ultrasonography was the same for the definition of benign and malignant lesions. Moreover, it was not modified by the diffuse dysplasia.
A two years-experience, using the biphasic contrast method in the evaluation of the stomach, is reported. Endoscopic and radiological results are compared. Our previous reports with standard contrast method are also reviewed. Ulcerative and neoplastic pathologies were studied and classified as proposed in the "trial policentrico multidisciplinare paritetico". The double contrast method has greatly increased the accuracy of X-ray diagnosis, considerably reducing the difference with endoscopy.
The authors report their results in the evaluation of 181 gastroresected patients. All these cases were clinically selected; 96 of them have been examined by using standard biphasic-contrast examination and 85 by using traditional radiological technique. Their aim was to determine the contributions of the new technique in the evaluation of the resected stomach and to effect a critical review of the traditional one. Their results show that the standard biphasic-contrast examination carries out a notable improvement in the radiological diagnostic accuracy. It reduces greatly the discrepancy between radiology and endoscopy.
In 12 X-ray and gastroenterology departments 1570 patients, clinically suspected to have a gastric pathology, have been examined by double contrast (surface) examination of the stomach followed by gastroscopy. Diagnostic accuracy was 93% in respect of endoscopic data, assumed correct by hypothesis. On the basis of a cost and benefit evaluation, made according to the well known criteria, a wider routine use of the double contrast technique is proposed.
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The physical dimensions to be kept in mind in choosing the screen-film system in radiography are defined and discussed. As an example of applying the method, the results of measuring these dimensions on 5 types of film and 6 types of screen are reported and their optimal combinations indicated as a function of examination conditions.
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When a competition is made for the supply of sensitive photographic material, each USL is asked, in a time scan of one or more years, to evaluate the characteristics of the screen-film systems proposed by the various companies. In the last years the authors had several opportunities to check different screen-film systems for many Friuli-Venezia Giulia hospitals. For this reason they have set an evaluation form tested after following changes and recently employed in its final version. The check form is reported on in this paper with some personal considerations originated by the authors' experience. The technical parameters which must be evaluated are reported, together with the instrumentation needed to perform the technical examination, the examination modality, and the score-attributing criteria. The evaluation form is very flexible for it allows each Radiology Department to evaluate each parameter in a personal way and to fit it to its own needs.