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L Grazioli

Publications and source records attributed to L Grazioli.

59 records · Page 4Linked to original sources
PubMedDate not supplied

[The role of magnetic resonance angiography in the assessment of arterial stenosis in the transplanted kidney].

Artery stenosis in the transplanted kidney is the most frequent vascular complication; hypertension onset or worsening may be associated and, at an end stage, also renal insufficiency. The diagnosis must be early and accurate and provide guidelines for medical, interventional or surgical therapy. To assess the diagnostic reliability or MRA, 27 patients were examined. On the basis of clinical, biochemical, pharmacological (Captopril test) and instrumental (color-Doppler US) examinations, the artery of the transplanted kidney was considered normal in 6 patients and stenotic in 21. In the control group, MRA results were in agreement with color-Doppler findings. On the contrary, in 8 of 21 abnormal conditions, the two techniques were in disagreement. Digital angiography, considered as the gold standard, was performed in any questionable case, confirming a slight overestimation of the stenoses by MRA (3 cases) and 2 false positives by color-Doppler US. The authors believe color-Doppler US to be a reliable technique for screening stenosed arteries in the transplanted kidney. MRA is proposed as a complementary investigation useful to define stenosis type and to provide guidelines for treatment.

Adult↗
PubMedDate not supplied

[Do clinical or physiopathological parameters exist for rationalizing the demand for thoracic radiograms in patients admitted to an intensive care unit].

To rationalize the demand of chest radiography in Intensive Care Unit patients, 423 radiographs of 35 patients were studied prospectively. The radiologic findings were compared with clinical data, blood gas analysis and laboratory data. No significant correlation was demonstrated between pulmonary radiographic changes and patient clinical conditions classified as unchanged, improving and worsening. In contrast, a good correlation (R = 0.65; p < 0.001) was observed between the chest radiographic score of pulmonary changes and the PaO2/FiO2 ratio. Changes in this parameter may be a good reason to perform bedside chest radiographs, whereas this exam appears rather useless when PaO2/FiO2 ratio is unchanged.

Adolescent↗
PubMedDate not supplied

Arterial chemoembolization in hepatocellular carcinoma suitable for resective surgery.

BACKGROUND/AIMS: Authors examined transcatheter arterial embolization (TAE) reliability in modifying diagnosis, staging, choice of treatment after a common instrumental evaluation and in increasing results in patients with hepatocarcinoma(s) potentially suitable for surgery; this value was compared to TAE-related mortality and morbidity. MATERIALS AND METHODS: Thirty-nine patients underwent TAE. Diagnostic value, reduction in tumor size and necrosis' percentage after treatment were computed. Immediate and long term results were compared to those obtained by primary liver resection in 62 patients. RESULTS: TAE showed more lesions than any other diagnostic tool, thus excluding 4 patients (10.2%) from surgery. TAE-related mortality (1 patient) and severe morbidity (11 patients) excluded 4 more patients. Complications were correlated to Gelfoam embolization (p < 0.01). After TAE tumor size reduction was sporadic; tumor necrosis > 70% was present in 13/29 resected tumors. Intraoperatively 16/25 patients had TAE-related anatomical alterations; a choledochus' wall necrosis and a tumor' explosion must be mentioned. TAE and intraoperative echography had an equivalent diagnostic value. Immediate and long term results were comparable to those obtained by primary liver resection. CONCLUSIONS: TAE has a high diagnostic accuracy but the capacity in changing the final judgment after a good instrumental evaluation is low. The specific risk-benefit ratio is not favourable, in particular after mechanical embolization, and clinical benefit is not evident.

Aged↗
PubMedDate not supplied

[Magnetic resonance angiography with TOF-TONE tridimensional sequences in the study of steno-occlusive diseases of the renal arteries. Comparison with digital angiography].

The authors examined 32 patients (68 renal arteries in all) with suspected renovascular hypertension with MRA (3D TOF-TONE sequences) and DSA. MRA visualization of the renal vessels was considered good in 96.8%, 91.6%, 76.6% and 16.6% of cases for the ostium, the proximal third, the distal third and the hilum, respectively. MRA correctly assessed the 4 occlusions in our series and 19/20 atherosclerotic stenoses, all in proximal site. In proximal stenosis detection, MRA had 100% sensitivity and 98% specificity in atherosclerotic sclerosis-occlusion grading considering a 50% caliber reduction as the cut-off value. The two techniques were in agreement in 68% of cases; MRA overestimated stenosis grade in 25% of cases. The 3D TOF-TONE sequence is a reliable diagnostic tool in the study of the proximal tract of the renal arteries, but its major limitation remains in distal tract studies. Nevertheless, this technique has elective indications in a selected group of patients, namely the elderly with hypertension and impaired renal function.

Adolescent↗