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G P Cornalba

Publications and source records attributed to G P Cornalba.

At least 19 recordsLinked to original sources
PubMed2006

Common carotid artery pseudoaneurysm after neck dissection: colour Doppler ultrasound and multidetector computed tomography findings.

Common carotid artery pseudoaneurysm is a rare disease, which has been previously unreported in association with neck dissection. We describe the Doppler ultrasound and multidetector computed tomography (CT) findings of a case of carotid pseudoaneurysm, one month after pharyngolaryngectomy with bilateral neck dissection. Multidetector CT confirmed the diagnosis made on the basis of Doppler ultrasound; the high image quality of axial and three-dimensional reconstructions avoided the need for pre-operative conventional angiography. In the presence of a pulsatile cervical mass after neck surgery, pseudoaneurysm of the carotid artery should be included in the differential diagnosis, and multidetector CT can be the sole pre-operative diagnostic imaging modality.

Aged↗
PubMed2006

Low-fat angiomyolipoma of the liver studied with contrast-enhanced ultrasound and multidetector computed tomography.

We report the case of a 30-year-old woman with persistent pain at the right hypochondrium, relapsing fever, and normal serum tests. Ultrasound showed a hyperechoic inhomogeneous mass; following sulfur hexafluoride injection, uniform enhancement at 14-16 s and rapid wash-out at 26 s was found. Multidetector computed tomography showed an inhomogeneously hypodense mass, with no detectable negative density values, characterized by inhomogeneous enhancement at the arterial phase and wash-out at the portal phase. Histopathology demonstrated a hepithelioid angiomyolipoma with a poor fatty component. This diagnosis should always be considered in the presence of a very rapid wash-out after intravenous contrast injection. However, a hepatocellular carcinoma cannot be excluded and the final diagnosis of low-fat angiomyolipoma must be pathologically proved based on immunohistochemistry.

Adult↗
PubMed2003

Safety and efficacy of laparoscopic radiofrequency ablation of hepatocellular carcinoma in patients with liver cirrhosis.

BACKGROUND: The optimal treatment for hepatocellular carcinoma (HCC) is surgical resection. However, only a small percentage of patients are operative candidates. Percutaneous radiofrequency interstitial thermal ablation (RITA) has been shown to be efficacious in the treatment of unresectable HCC. Recent advances in laparoscopic ultrasound have greatly improved the accuracy in detecting intrahepatic HCC nodules, many of which were missed by computed tomography. Our objective was to introduce a novel operative combination of laparoscopic ultrasound with laparoscopic RITA in the treatment of HCC. METHODS: Eighty-eight patients with HCC in liver cirrhosis were submitted to laparoscopic RITA under sonographic guide. Most patients were in Child's A class of liver function. Patients with large tumors (> 5 cm), portal vein thrombosis, or severe liver disease (Child's C class) were excluded. RESULTS: The laparoscopic RITA procedure was completed in 86 of 88 patients (98% feasibility rate). Laparoscopy with laparoscopic ultrasound identified 23 new malignant lesions (27%) in comparison with the results of preoperative imaging. A total of 127 lesions were treated by RITA. There was no operative mortality. Sixty-one patients had no complication (71%). After a mean follow-up of 14.3 +/- 11.6 months, a complete response with a 100% necrosis was achieved in 70 of 83 patients examined (86%). During follow-up, 9 patients (11%) locally recurred at the RITA site and 38 patients (46%) had new malignant nodules. CONCLUSIONS: Laparoscopic RITA of HCC proved to be a safe and effective technique in the short term. This technique may be indicated when the percutaneous approach to the lesion is very difficult or if the patient is too ill to undergo laparotomy.

Adult↗
PubMed1997

Arteritis following intra-arterial chemotherapy for liver tumors.

Primary and metastatic tumors of the liver can be treated successfully with transcatheter chemoembolization (TACE) during selective arterial catheterism. Arteritis is a possible referred side effect which can lead to tortuosity of the arteries, stenosis and occlusion of vessels. In our hospitals 117 consecutive patients were treated with TACE from January 1990 to December 1992; 61 patients were affected by hepatocellular carcinoma (HCC) and 56 were affected by metastases from colorectal carcinoma. Each patient received from 1 to 4 treatments at monthly intervals using epirubicin/Lipiodol ultrafluid (E/LUF) or a mixture of epirubicin and mitomicin C (MC)/LUF and followed by gelatine sponge injection in the hepatic artery. Selective angiography performed 30-62 days after the first chemoembolization showed artery stenosis in 7 patients and thrombosis in 2 cases related to toxic arteritis due to chemoembolization. Reports about arteritis during TACE treatments are discussed.

Aged↗
PubMed1996

[Pneumocystis carinii lung infections in AIDS patients: a study with high-resolution computed tomography (HRCT)].

In 1993, a hundred and fifty AIDS patients were submitted to high-resolution CT (HRCT). In 102 patients, bronchoalveolar lavage and/or transbronchial biopsy findings suggested the diagnosis of Pneumocystis carinii pneumonia--a pure Pneumocystis carinii infection in 75 patients and associated with other pathogenic agents in 27. We report the most common HRCT patterns, such as ground-glass opacities, cysts, interstitial changes and nodules. Ground-glass opacities were demonstrated in 57.8% of cases, cysts in 44.1%, interstitial involvement in 52.9% and nodules in 28.4%. HRCT permitted lung disease to be demonstrated in 55% of our patients, suffering from impaired breathing, with negative chest films. Respiratory function tests and gallium scintigraphy show their low specificity in the diagnosis of Pneumocystis carinii infection because, although depicting diffuse interstitial involvement, they fail to detect the pathogenic agent. As for hemogasanalysis, in the presence of hypoxia, this technique can suggest the diagnosis of Pneumocystis carinii infection, while the pathogenic agent can be isolated with bronchoalveolar lavage, which demonstrates the simultaneous decrease in CD4 and increase in CD8 lymphocytes, respectively. To conclude, HRCT does detect the basic changes occurring in Pneumocystis carinii pneumonia, thus contributing to the diagnosis of this condition.

AIDS-Related Opportunistic Infections↗
PubMed1996

[High-resolution computerized tomography in diffuse forms of bronchiolo-alveolar carcinoma].

Bronchioloalveolar carcinoma (BAC) is a relatively uncommon tumor of the lung accounting for 1 to 9% of all pulmonary neoplasms. Its radiologic appearance is characterized by solitary nodular opacity or diffuse air-space consolidation. The aim of this work is to report the different patterns of this neoplasm, particularly in the diffuse form, and to demonstrate the sensitivity and specificity of HRCT in its early identification. We examined 11 patients affected with multifocal bronchioloalveolar carcinoma to identify HRCT signs which could lead to improved diagnostic criteria. These signs are represented by ground-glass opacity (8/11) and alveolar consolidation (6/11), with a plurilobular, segmentary or lobar distribution. The lesions were bilateral in 8/11 cases and abnormal mediastinal lymph nodes were found in 5/11 cases. Air bronchogram was seen in all cases of ground-glass opacity and in 5/11 cases of air-space consolidation. In conclusion, in our experience, HRCT is a useful tool in the study of BAC, which has a long and slow evolution and is underestimated at chest radiograph in its early stage. Moreover, HRCT can help distinguish this condition from other lung diseases characterized by diffuse air-space consolidations, whose clinical history is useless to make an unquestionable diagnosis.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1994

[Atypical radiological images in Pneumocystis carinii infection in HIV-positive patients].

To assess the prevalence of atypical PCP patterns in AIDS patients, the chest films of 300 patients with clinical and laboratory diagnosis of PCP were reviewed. We considered as atypical patterns the finding of an asymmetric lesion, the involvement of apical regions, pleural effusion, hilar and/or mediastinal lymphadenopathy, parenchymal nodules and pneumatoceles. In some patients more than one of these patterns was found. Atypical patterns were observed in 32% of cases and consisted of: unilateral involvement in 11% of cases, apical involvement in 6%, pleural effusion in 9%, hilar and/or mediastinal lymph nodes in 4%, parenchymal nodules in 6% and finally pneumatocele in 12% of cases.

AIDS-Related Complex↗
PubMed1994

[Abdominal manifestations in immunocompromised patients].

Abdominal infections or tumors in the immunocompromised host are both common in AIDS but uncommon in transplant recipients. The role of diagnostic imaging modalities differs in the patients with specific symptoms such as dysphagia, diarrhea, malabsorption and jaundice and in the patients with aspecific clinical findings such as fever, weight loss, superficial lymphadenopathies and abdominal pain. In the former patients, the symptoms suggest a disease of one or more alimentary tracts, in which case radiology is ancillary to clinics and endoscopy plays the leading role to make the diagnosis. However, X-ray barium studies yield valuable information on different types of infections--e.g., Candida, Cytomegalovirus, mycobacterium avium intracellulare and Cryptococcus infections--in Kaposi's sarcoma and in gastrointestinal lymphoma. In these cases CT findings may suggest the diagnosis. In the patients with aspecific findings, US, as an easy immediate examination, and CT, as a panoramic means, can demonstrate deep lymphadenopathies and focal parenchymal lesions which are sometimes suspected to be abscesses or tumors. Moreover, both methods can provide indications and guide to percutaneous needle biopsies. Especially CT findings can distinguish mycobacterial infections from neoplastic lesions on the basis of the involved anatomical sites and of densitometric features. US and CT are useful means to monitor HIV+ subjects, to manage AIDS patients and to follow-up transplant recipients.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Interventional modalities in immunosuppressed patients].

In immunocompromised patients interventional modalities have diagnostic and/or therapeutic purposes--in both cases they are justified on the basis of the frequently aspecific clinical and instrumental findings and because of the clinical need to carry out the most specific treatment as soon as possible. The authors stress the particular weakness of immunocompromised patients to invasive approaches and discuss the indications, contraindications and precautions which must be taken when performing interventional radiologic modalities. Diagnostic imaging uses radioscopy, US and CT for guidance, each of them allowing a rapid percutaneous confirmation of lesion nature, the assessment of infection in a collection, of a neoplastic lesion type, or of the microbiology of an infectious lesion. Interventional modalities are frequently indicated in chest diseases--e.g., for punctures and percutaneous drainage of empyematous pleural collections or of pulmonary abscesses, percutaneous needle biopsies of lung lesions, or endoscopic dilatation of tracheobronchial stenoses. The percutaneous drainage of lung abscesses in immunocompromised patients makes recovery easier. The diagnostic accuracy of the results of needle biopsy is lower in lung infections than in neoplastic lesions. Indications to abdominal interventional procedures are less frequent--i.e., percutaneous drainage of rare abscesses, percutaneous needle biopsy of nodal mesenteric or lumboaortic masses. Some clinical conditions are diagnosed only with invasive radiologic procedures--e.g., ERCP diagnoses sclerosing cholangitis in AIDS. CT is the basic and the best modality to guide percutaneous drainage in both the abdomen and the chest, to assess contraindications or to indicate some specific modes; in some cases even plurifocal abscesses can be treated with a percutaneous imaging approach.

Abdomen↗
PubMed1993

Therapeutic embolization of bronchial artery: a successful treatment in 209 cases of relapse hemoptysis.

Still today bronchial artery embolization (BAE) is an important procedure in the management of hemoptysis, as an alternative to, or in association with, surgical or medical therapy. From 1974 to 1990, BAE was performed in 209 patients who suffered from hemoptysis with different etiopathogeneses and severity. Bronchiectasis were the most frequent indication (46%) followed by tuberculosis (31%), cystic fibrosis (16%), lung cancer (4%), and aspergillosis (3%). BAEs were performed by means of polyvinyl alcohol particles and absorbable gelatin sponge. In a few cases complete occlusion of the main truncus of particularly large bronchial arteries was obtained by use of Gianturco steel coin (5 mm o) technique. In the last seven years, together with the traditional angiographic techniques, selective digital angiography (SDA) was performed, above all in preliminary control phases, to evaluate occlusion during embolization. SDA reduced catheterization time and the mean quantity of contrast administered, decreasing side effects; 98% of hemoptysis was controlled in the first twenty-four hours, the other 2% in the following forty eight hours; 16% relapses occurred within the first year; 27 patients needed reembolization (15 patients twice, 11 patients three times, 1 patient five times). No complications were seen. If diagnosis, therapeutic indications, operative technique, and equipment selection are adequate, BAE has a high reliability in patients affected by relapsing hemoptysis, which is difficult to resolve.

Angiography, Digital Subtraction↗
PubMed1993

[Percutaneous transluminal renal angioplasty. Italian experience at 13 centers].

The data relative to 13 years' experience with percutaneous transluminal renal angioplasty (PTRA) in the 13 major interventional radiology centers in Italy were collected and analyzed to evaluate technical and clinical results. Our aim was to collect homogeneous results in a large series of patients, evaluating both the technical and the clinical success with a long-term follow-up (1 month-13 years). One thousand three hundred forty seven PTRA procedures (including 42 restenoses) in 1,073 patients were retrospectively reviewed. In 807 cases the cause of stenosis was atherosclerosis, in 442 cases fibromuscular dysplasia and in 24 cases arteritis in 12 cases, stenoses were present in patients that had undergone a surgical by-pass. Sixty-two stenoses in patients with solitary kidney and 102 in patients with renal failure were studied separately. The technical success (based on the morphology of the dilated tract) obtained in 91% of cases was considered, together with the clinical success (in 81% of cases), based on the decrease in blood pressure evaluated according to Martin's classification. The blood pressure values collected after the maneuver were also evaluated separately for the different types of stenosis etiology: atherosclerosis, fibromuscular dysplasia or arteritis; moreover, blood pressure was studied in solitary kidney patients and in those with renal failure. Complications were classified as major (4.2%) and minor (4.9%). The high success rate and the low incidence of complications we observed in our series suggest PTRA as the procedure of choice for high blood pressure patients with renal artery stenosis > 50% of the normal caliber.

Adolescent↗
PubMed1985

[Intravenous digital ventriculography in the evaluation of left ventricular function in patients with acute myocardial infarct].

Thirty patients with myocardial infarction were studied using Digital Subtraction Ventriculography with Intravenous injection (DSVIV) between 3 and 6 days from myocardial infarction and were checked after 30 and 90 days. The variation of ejection fraction in the controls was not important. The wall motion provided precise indications regarding the infarctual regions. Digital subtraction ventriculography seems to be a very interesting tool in the study of the left ventricle in the evolution of myocardial infarction, thanks to a low invasivity, providing data on ventricular function.

Angiocardiography↗
PubMed1985

[Pseudo-aneurysm of the left ventricle. Non-invasive diagnosis of 2 cases].

Left ventricular pseudoaneurysm is a rare condition which may develop after rupture of the ventricular myocardial wall. A localized hemopericardium confined is then formed outlined by the parietal pericardium. The pseudoaneurysmal sac is formed by clots and fibrous pericardial tissue and is directly connected to the ventricular chamber. There are no specific clinical signs to identify the disease. Two dimensional echocardiography and computerized tomography can allow the correct diagnosis to be made before cardiac catheterization. Two cases of left ventricular pseudoaneurysm occurring one after chest trauma and the other after acute myocardial infarction are reported.

Aged↗
PubMed1985

[Intravenous digital angiography of pulmonary circulation].

Intravenous digital angiography was performed in 92 patients with pulmonary diseases. The examination yielded satisfactory results in 82/92 cases (89%). The most promising fields of application of pulmonary digital angiography are: vascular malformations (3 cases: 3%), pulmonary emphysema (24 cases: 26%) and pulmonary embolism (38 cases: 41%). In tumoral masses (14 cases: 15%) digital angiography showed dislocation of the surrounding pulmonary vessels but failed to demonstrate the intrinsic vascularity of the mass, deriving from the bronchial arteries. In post-lobectomy controls (10 cases: 11%) the examination gave a good demonstration of the absence of vascular supply at the site of the previous surgery. Intravenous digital angiography shows many technical limitations, namely a reduced resolution power and a small field of view; in addition, it requires patient immobility, which results sometimes impossible in critically ill patients. In spite of these inconvenients, however, intravenous digital angiography appears to be an important diagnostic step for the evaluation of pulmonary embolism and vascular malformations: in these conditions, digital angiography can be the procedure of choice.

Angiography↗