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Biomedical subjects

L Battolla

Publications and source records attributed to L Battolla.

30 records · Page 2Linked to original sources
PubMed1992

[SPECT in the study of pathology of the temporomandibular joint. The authors' personal experience].

Symptomatic temporomandibular joint dysfunctions may affect about 25% of the adult population, with a smaller though significant percentage of patients experiencing severe impairment. From 1986 through 1991, 107 patients with severe temporomandibular joint symptoms and with various temporomandibular joint disorders were evaluated with conventional radiology and with closed/open-mouth temporomandibular joint tomograms. Single-photon emission-computed tomography (SPECT) and planar imaging were performed on 32 patients using a rotating gamma camera equipped with a general purpose collimator. Transaxial, coronal and sagittal tomoscintigrams were reconstructed. Increased radiotracer uptake in the temporomandibular joint was regarded as a positive finding, and the intensity of temporomandibular joint activity was compared with that of adjacent calvarium using regions of interest. In the 32 patients submitted to scintigraphy, conventional radiology showed no pathologic patterns, while SPECT showed pathologic findings in 31 patients (97% of cases). The patient with normal temporomandibular joint findings on SPECT exhibited abnormal maxillary isotope uptake, ipsilateral to the symptoms. Our results indicate that SPECT is a simple, noninvasive, inexpensive and very sensitive screening test relative to the internal derangement of the temporomandibular joint. Moreover, it provides information which is not available by means of routine bone scans or X-ray studies. Thus, SPECT appears to be the modality of choice for patients whose clinical findings are equivocal or whose symptoms are unclear, and it can guide treatment strategies and be useful in the follow-up.

Adult↗
PubMed1992

Digital subtraction radiography in pediatric cystourethrography.

Digital subtraction radiography (DSR) was used to evaluate the anatomy and function of the bladder and urethra in 20 children with clinical urinary disturbances deriving from recurrent urinary tract infections. Following image subtraction, a complete study of bladder and urethra morphology and activity before and during voiding was obtained. Furthermore, DSR permitted a reduction in exposure doses given to children compared to conventional film-screen examinations. Results indicate the applicability of this technique for use on a wider scale and suggest its use as an alternative to other diagnostical techniques for the study of this subject.

Child, Preschool↗
PubMed1991

[Double-contrast enema. Study of the mucosal pattern and the organ profile with conventional and digital methods].

A solid state digital system (FCR 101) was employed in our comparative evaluation of the image quality of conventional versus digital techniques in the study of colon by means of double-contrast enema. Sixty patients were examined with a single AP view, using digital radiography with 100% radiation dose and progressive 50% and 75% reductions; the radiographs thus obtained were then compared with the corresponding conventional ones. The examined parameters were organ profile and mucosal pattern. Each digital and conventional radiograph was evaluated by 2 independent radiologists and a value was given to each parameter i.e., 1 = good, 2 = sufficient, 3 = insufficient. Upon comparison of the average values obtained for digital and conventional radiographs in optimal conditions and with a dose reduced by 50%, the digital technique was seen to give a more detailed and accurate representation of both low-contrast mucosal pattern and of organ profile. With the dose reduced by 75%, a slight increase was observed in background noise which caused a slight loss in image definition, but this did not reduce image readability with respect to conventional radiographs. To conclude, the digital method with a 50% exposure reduction is to be preferred in the examination of the colon, especially in pediatric radiology; furthermore, since this technique allows better detailing at lower contrast, it is to be preferred in the study of the pathologic conditions affecting mainly/only the mucosal pattern--e.g., cancer, ulcerative colitis, Crohn's disease, and so on. An exposure dose reduced by 75% may be used for following lesions previously diagnosed and when a less detailed depiction of the mucosal pattern is enough.

Adult↗
PubMedDate not supplied

Crohn disease of the small bowel: spiral CT evaluation after oral hyperhydration with isotonic solution.

PURPOSE: Our aim was to evaluate the accuracy of spiral CT study of small-bowel Crohn disease with use of oral hyperhydration with isoosmotic solution. METHOD: We prospectively analyzed 33 consecutive patients and 10 control subjects with spiral CT after oral administration of 2,000 ml of polyethylene glycol electrolyte-balanced solution. The CT diagnoses were compared with the results of conventional radiologic oral barium examination (33 cases), ileum colonoscopy (8 cases), and surgery (4 cases). RESULTS: The final diagnoses were Crohn disease (14 cases), no small-bowel disease (16 cases), cancer of ileocecal valve (1 case), carcinosis of mesenteric root (1 case), and intestinal lymphangiectasia (1 case). In the control group, no abnormalities of the small bowel were found. The sensitivity of spiral CT was 85.7%, specificity 100%, positive predictive value 100%, negative predictive value 90%, and diagnostic accuracy 93.9%. CONCLUSION: Our method allowed adequate distension of the small bowel for spiral CT studies, thus resulting in a safe and effective alternative to small-bowel spiral CT enema, which can be used in patients that refuse the nasojejunal balloon catheter.

Adolescent↗
PubMedDate not supplied

[Radiologic study of the thorax using the digital method (FCR 101). Evaluation of various parameters as related to exposure].

A computed radiography system with solid state detectors (FCR 101) was employed to evaluate the quality of digital images, with optimal and progressively lowered doses, in the study of the chest. Routine chest radiographs of in patients with no pathologic conditions of the chest were studied. The patients were divided into 3 groups: each patient in group A underwent two radiographs, one at 100% and the other at 50% exposure; patients in group B were imaged with 100% and 25% doses, and those in group C received 50% and 25% exposure. Several parameters were employed for image evaluation, and a value was given to each of them (1 = good, 2 = sufficient, 3 = insufficient). Upon comparison of the average values obtained, we observed that the digital technique allowed a most accurate and well-defined representation of the examined parameters at 100% exposure dose and that a 50% reduction did not decrease the informative content in the least. A 25% reduction, however, determined a high degree of background noise and a subsequent, though slight, loss of information.

Adult↗
PubMedDate not supplied

[Quantification of pulmonary emphysema with computerized tomography. Comparison with various methods].

Computed Tomography (CT) has been proved to be the most accurate imaging modality to diagnose emphysema in vivo. Our study was aimed at comparing different CT methods for pulmonary emphysema quantification in patients with severe chronic obstructive pulmonary disease (COPD). Forty-six consecutive inpatients affected with COPD underwent high resolution CT (HRCT). Three scans were acquired at 3 preselected anatomic levels at both full inspiration and expiration. Three different observers were asked to subjectively evaluate, under blind conditions, the extent alone and both the severity and the extent of emphysema on the 6 scans. HRCT findings were also analyzed quantitatively by measuring the mean CT number in Hounsfield Units (HU) and the % of lung area with CT numbers < -900 HU (pixel index). Quantitative CT data were compared with reference values obtained in 7 normal nonsmokers. The CT visual score of emphysema exhibited medium-high interobserver reproducibility with correlation coefficients ranging from 0.80 to 0.96 and a good correlation with pulmonary function tests, particularly relative to the assessment of the extent of emphysema alone as expressed by one observer. CT quantification demonstrated an excellent correlation with functional indices of expiratory airflow, lung volumes and diffusion coefficients (p < 0.001). The expiratory measurements were better than the inspiratory ones while the analysis of both CT number and pixel index gave comparable results. Only the CT expiratory quantitative data allowed to differentiate the patients affected with COPD from the controls. In conclusion, the severity of emphysema as expressed by CT correctly reflects the functional impairment of patients with severe COPD.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

[Diagnostic imaging of intestinal invaginations in the adult. Report of 9 cases].

Adult intestinal intussusception affects the distal portions of the small bowel and the colon in 90% of cases. As a rule, its nature is neoplastic, its clinical presentation aspecific and its diagnosis is frequently an occasional finding during routine imaging examinations. We report on 9 adult patients with intestinal intussusception. All patients were examined with more than one of the following imaging modalities: radiologic study of the small bowel, barium enema, ultrasonography (US), and Computed Tomography (CT). The first diagnostic suspicion of intussusception was correctly made at US in 5 patients and at CT in 4 patients. At surgery, intussusception sites were the following: jejunum in one case, ileum in two cases, ileocolon in two cases and colon in four cases. CT correctly detected lesion site in all the patients who underwent it as the first diagnostic step, while US missed lesion site in one case. Pathology diagnosed a hamartomatous jejunal polyp, a lymphomatous ileal polyp, a lymphomatous polyp of the ileocecal valve, four cecocolonic adenocarcinomas and a left colic lipoma. Lesion nature was suspected at US in one case of ileal lymphoma, while CT suggested the presence of lipoma in one case of ileoileal intussusception. Our experience shows that intussusception can be diagnosed not only with conventional radiologic modalities, but also with US and CT, which are useful to depict both the lesion and its site and extent.

Adult↗
PubMedDate not supplied

[Dixon's technic for fat suppression. Its potential applications in combination with gadolinium-DTPA].

Modification of the Dixon technique enables the reconstruction of water and fat images operating at midfield strength. The technique was combined with intravenous administration of gadolinium-DTPA in five patients with lumbosacral spine conditions, four patients with soft tissue neoplasms and three with skeletal neoplasms; all patients were examined at 0.5 T. Mean attenuation of fat signal in T1-weighted images was 85% and implied a redistribution of the gray-scale dynamic range. This allowed easier appreciation of normal and abnormal enhancement in both areas containing fat tissue and areas without it. This was useful in the evaluation of fresh scars in two patients recently submitted to lamino-discectomy and of the prevertebral extension of the inflammatory process in one patient with spondylodiscitis. In the patients with soft tissue neoplasms the combination of fat suppression and Gadolinium was helpful to assess lesion size. Finally, in the patients with skeletal neoplasms fat-suppressed images obviated for the lesion disappearance observed on conventional T1-weighted SE images after contrast administration. The combination of intravenous administration of gadolinium-DPTA with Dixon's fat-suppression technique is a new promising capability of midfield MRI.

Adipose Tissue↗
PubMedDate not supplied

[Reconstruction of the anterior cruciate ligament using the patellar tendon: its magnetic resonance evaluation].

MRI of the knee was performed in 30 patients who had been submitted to arthroscopically-guided reconstruction of the anterior cruciate ligament from patellar tendon. The autograft structure was investigated and MR results were correlated with clinical findings. Partial/total meniscectomy had been carried out in 21/30 cases. The patients were imaged at various postoperative intervals (3-24 months) by means of an 0.5-T magnet (GE MR Max Plus) in full knee extension and internal rotation. Sagittal and axial T1-weighted images (slice thickness: 3 mm) were combined with real-time reconstruction which better demonstrated the whole graft. T2-weighted coronal images (slice thickness: 5 mm) were also acquired. In each patient the following clinical variables were considered: anterior drawer sign, Lachman test, pivot shift, degree of leg extension, and finally functional recovery. The following MR variables were then considered: structure and alignment of bone tunnels, structure and signal intensity of the graft, degree of synovial inflammation, structure and signal intensity of the posterior cruciate ligament and finally structure of the menisci and/or meniscal residues. Symptoms-MR correlation suggests that the different outcome of surgical reconstruction may depend on the correct alignment of the tibial and femoral bone tunnels and on good meniscal condition. Bone tunnels must be located on the same plane, posterior and parallel to the slope of the intercondylar roof, since angulation causes the latter to impact the graft during knee extension, with inflammation and risk for rupture. As for menisci, tiny residues or total ablation overload tha graft, whose signal increases and whose synovia becomes inflamed. The latter pattern is always distinguished from that of the autograft, whose signal intensity seems not to change in time. In conclusion, MR proved an accurate and non-invasive technique to image this kind of postoperative knee, since metallic artifacts do not reach the joint space.

Anterior Cruciate Ligament↗
PubMedDate not supplied

Giant pedunculated liposarcomas of the esophagus: literature review and case report.

Although liposarcoma is the second most common soft-tissue sarcoma in adults, its incidence within the gastrointestinal tract is distinctly low. Esophageal involvement is exceedingly rare and only four cases have been described so far. A fifth case is presented here along with a thorough review of the literature of polypoid lipomatous tumors of the esophagus. Diagnostic and therapeutical strategies of these tumors are discussed in detail.

Diagnosis, Differential↗