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Biomedical subjects

M Bazzocchi

Publications and source records attributed to M Bazzocchi.

At least 19 recordsLinked to original sources
PubMed1992

Sonographic diagnosis of obstructed afferent loop.

We reviewed the sonographic findings in four patients with afferent loop obstruction from tumor of the gastric stump. All had undergone partial gastrectomy with Billroth type II gastrojejunostomy. The obstructed afferent loop was visible in all cases as a distended fluid-filled segment with multi-layered wall and few mucosal folds. Its course could be traced from the region of the hepatic hilum to the gastric stump. In two patients, the relationships between the loop and the mesenteric vessels, aorta and inferior vena cava allowed us to recognize it as postoperative duodenum. Thickening of the gastric remnant and obstructive jaundice were diagnosed in three cases. Since sonography is often used as the first imaging method in patients with abdominal complaints, knowledge about postsurgical appearance of the gastrointestinal tract is very important in detecting such pathological conditions.

Afferent Loop Syndrome↗
PubMed1991

[The imaging diagnosis of hepatic focal nodular hyperplasia].

Focal nodular hyperplasia (FNH) is a rare benign hepatocellular tumor occurring in noncirrhotic patients, mostly females, 20-50 years of age. It is usually asymptomatic. The authors took the lead from 5 cases of FNH studied over last year to analyze the different patterns exhibited by the condition on the various imaging techniques currently available. At scintigraphy with 99mTc DISIDA or with TcSC, FNH can be hyper, normal, or hypocaptating. On US scans, the lesion is often homogeneous and isoechoic, but it can also be hyper/hypoechoic. With Doppler US, high-flow signals can be observed. On unenhanced CT scans the lesion is solid, well-demarcated, isodense or slightly hyperdense; sometimes it shows a central hypodense area corresponding to fibrovascular scar. On postcontrast scans it appears hyper/isodense. At dynamic CT the lesion density, which is high during the arterial phase, decreases quickly in the parenchymal and the venous phases and reaches equal/inferior values to surrounding liver parenchyma. On liver angio-CT it is sometimes possible to visualize the bile ducts in the central scar. At angiography, FNH is hypervascular and homogeneous. On MR scans, in T1-weighted SE sequences, the condition is isointense or slightly hypointense, whereas on T2-weighted pulse sequences it is slightly hyperintense; the central scar is hypointense on T1, and hyperintense on T2, weighted scans. As we have no pathognomonic patterns but only orientative ones, a reliable differential diagnosis with hepatocellular adenoma (HA) and fibrolamellar hepatocellular carcinoma (FL-HCC) must be based on biopsy or cytology or, even better, histology. The differential diagnosis is nevertheless necessary because, while FNH does not usually require a surgical approach but only a radiological follow-up, both HA (due to possible bleeding and degeneration) and FL-HCC require surgery.

Adult↗
PubMed1991

[Transvaginal echocystourethrography].

The anatomo-physiologic appearances of female urination obtained with a new ultrasonographic technique is illustrated. The technique is performed using an intravisceral linear probe positioned in the vagina and a special chair which allows the urination in physiological position; at the same time the urination is videorecorded. The results, compared with X-Ray cystourethrography, enabled us to show the normal aspects (both dynamic and morphologic) and several pathologic aspects. Basing upon the direction of the urethra, it is possible to establish the change of the position of the floor and the neck bladder, which are often responsible of stress incontinence. The Authors stress the relative simplicity and noninvasiveness of the echographic technique. X-Ray radiation aren't used: this test is particularly advisable to study the urination disease of women in fertile-age.

Adult↗
PubMed1991

[Echography: problems and errors in the diagnosis of renal masses].

US plays an extremely important role in the diagnosis of renal masses. However, a number of diagnostic difficulties still exists in both identification of the mass and definition of its nature. The most frequent causes of diagnostic errors are discussed. Errors may be due to the radiologist, to technical limitations, and to the lesion itself. The radiologist is responsible for inexperience and negligence (incorrect application of the technique, limited clinical information, poor knowledge of US findings). Technical limitations are due to poor spatial and contrast resolution, to extremely fat patients, and to artifacts. As far as lesions are concerned, cystic and solid masses must be distinguished, since the problems are different. As for cystic lesions, problems are relative to their visualization and to the definition of their nature in cases of atypical or complex cysts, due to the complexity of some US findings. The latter involve both cystic wall and content and are related to calcifications, septa, vegetations, blood, purulent debris. In case of solid masses, problems concern the identification of small renal tumors, the differentiation among the various anatomical variants, the differential diagnosis of benign from malignant tumors, and the evaluation of tumor extent. The authors conclude that, whereas operator-dependent errors can be avoided, those inherent to technical parameters and to the lesion itself represent the diagnostic limitation of US.

Diagnostic Errors↗
PubMed1990

Radiological anatomy of the kidney revisited.

In recent years some structures or features such as the "inter-renuncular septum", the "echogenic triangle" and the "echogenic line" have been described to support the concept of a kidney resulting from the fusion of two masses or renunculi. To clarify this concept and to understand the meaning of the above echographic features better, the authors have examined prospectively by sonography the kidneys of 50 children, 200 adults with a single collecting system, 25 adults with a duplicated collecting system and 32 cadavers. Furthermore, to help explain the sonographic features, we have examined 32 cadaver kidneys with sonography and 10 cadaver kidneys with magnetic resonance imaging (MRI). The sonographic, MRI and anatomical correlations have shown that the "echogenic triangle" and the "echogenic line" are not renuncular residuals, but simply an extension of the hilar fat visible when the renal sinus is rather deep. The intermediate cortical mass is not a septum dividing the kidney into an upper and lower renunculus, but a column of parenchymal tissue crossing the renal sinus, which, from an anatomical point of view, is an accessory renal lobe. The presence of two renunculi, suggested in a previous study with cortical nephrotomography, has not been confirmed.

Adolescent↗
PubMed1990

[Radiourology].

Explore the source record for details and available documents.

Contrast Media↗
PubMed1990

[Echography and cytology in the study of spreading pathology of the salivary glands].

The contribution of the combined use of US and cytology is evaluated in the diagnosis of masses in the salivary glands and adjacent structures. US had 87.2% sensitivity in locating the mass; its accuracy in defining both physical structure and benign/malignant nature of the lesion was 91% and 74%, respectively. Thus US, after demonstrating a lesion, does not always allow the exact definition of its characteristic. In many of these cases, other imaging modalities do not help either. In our series of cases, cytology allowed an unquestionable diagnosis to be made in 87.2% of cases, and the combined use of US and cytology rose the figure to 97%. The only limitation is the evaluation of the deep extent of large masses: in such cases CT or, if available, MR imaging are recommended.

Cytodiagnosis↗
PubMed1990

[Simplified urographic technique using non-ionic contrast media].

Urography is not to be performed following a standard procedure. However, some key-films can be defined which are to be routinely employed. If needed, additional radiographs can be performed. We tried to optimize the urographic technique combining low X-ray exposure and adequate diagnostic assessment with the injection of 17.5 gI of a non-ionic agent. Two groups of 50 patients each were investigated. In the former, the technique we currently employ in our Institute was used: plain film, 2 nephrotomograms (1'), full-length view (7'), kidney view with ureteral compression (15'), and full-length or bladder view (20'). In the latter group, a more simplified technique was used: plain film, 2 nephrotomograms (1'), kidney view (7'), and full-length view (15'). A compression device was positioned immediately before contrast medium injection and released immediately before the 15-minute exposure. Both urographic techniques allowed high scores to be reached (after the Kelsey Fry method), with no significant differences among the evaluated parameters. Thus, the technique employed on the second group is to be preferred, because it shortens examination time and reduces X-ray exposure. However, a simplified technique increases the radiologist's responsibility: it is thus essential for an experienced uroradiologist to accurately supervise the procedure and immediately decide what to do next.

Adult↗
PubMed1989

[High-risk focal breast lesions in echography and mammography].

Proliferative breast diseases include a group of lesions which occupy an intermediate position between benign and malignant lesions and are extremely likely to develop into carcinomas. The authors studied 81 patients who had been surgically biopsied on the basis of mammographic and/or US findings. In 33/81 (40.7%) of them proliferative lesions were diagnosed at histology. Mammography was able to identify 18/33 lesions (54.5%) versus US 26/33 (81.8%). On the basis of these findings, a group of patients at risk for cancer could be identified. As a matter of fact, proliferative lesions, especially those presenting with atypical hyperplasia, are associated with a higher risk of developing into carcinomas than those presenting with typical features. For these patients, the authors suggest more frequent clinical and instrumental screening.

Adult↗
PubMed1988

Myelolipoma of the adrenal gland: sonographic and CT features.

The radiologic findings in 13 patients with pathologically proved adrenal myelolipomas were reviewed. All lesions involved the right adrenal gland; they ranged from 2 to 9 cm in diameter. Sonograms showed hyperechoic tumors in 11 cases (five homogeneous, six heterogeneous). Two myelolipomas composed primarily of myeloid tissue were hypoechoic. A propagation speed artifact was seen in seven lesions, all of which were composed primarily of fat and larger than 4 cm. CT identified fat-density tissues in all lesions. Contrast-enhanced CT showed positive attenuation values in the two predominantly myeloid tumors. CT appears to be sensitive for the diagnosis of adrenal myelolipomas. However, precontrast images are required to avoid errors.

Adrenal Gland Neoplasms↗
PubMed1988

[Dynamic ultrasonic hysteroscopy].

An attempt was made to establish Dynamic Echohysteroscopy (DEHS) diagnostic criteria for the study of female genital apparatus, as recently proposed. DEHS consists of a pelvic ultrasonography during and following an injection of physiological solution in the uterine cavity. Since this technique does not use X-rays, it has been proven useful to study female infertility. The authors have studied the normal and pathological aspects of 33 patients who underwent both DEHS and hysterosalpingography (HSG) (comparison diagnostic test). The results lead to the following conclusions: 1) DEHS can be considered a useful alternative to HSG, in the evaluation of uterine pathology; 2) in the evaluation of tubal pathology, DEHS has fewer diagnostic possibilities than HSG. Nevertheless, DEHS indirectly allows the patency of at least one tube.

Adult↗
PubMed1988

[Simplified micturitional cystourethrography in female urinary incontinence].

A new technique of mictional cystourethrography has been developed. The examination is performed with the patient sitting on a radiolucent chair with the feet high on a footstool, in order to avoid the superimposition of the femoral heads in the lateral projection. Fifty patients were examined, 26 of whom were continent and 24 incontinent. The technique allowed the evaluation of the site of the bladder neck, of vesico-urethral angles, and of the urethra. The investigation made it possible to obtain accurate information on the position of the vesical floor relative to the inferior margins of the obturator foramina. It was thus possible to correlate the position of the bladder floor with the clinical symptomatology: in our experience the position of the bladder floor was higher in incontinent that in continent patients. A low position of the bladder baseplate was usually associated with incontinence. Other parameters turned out to be less specific. This paper emphasizes the simplicity and the reproducibility of our technique, which allows a reduction of X-ray exposure dose.

Female↗
PubMed1987

[The urethral canal in the prostatectomy patient. Echographic aspects].

An evaluation of the urethra has been made in patients who underwent open surgery or endoscopic resection of the prostate, by means of transrectal echography (EG). The technique used is described; studies have been performed both in basal conditions and in various functional phases, including micturation. Echographic findings are compared to those achieved with micturating cystourethrography (MCU). In case of total prostatectomy EG and MCU findings are similar, showing the surgical bladder neck and the urethral aspect even during micturation. EG shows furthermore possible liquid fluid collections. In partial prostatectomies EG and CUM findings differ, showing the first, besides the site of the surgical intervention, the possible presence of calculi, while CUM findings do not differ from those visible in total prostatectomies. Conclusions are that for the whole study of the urethra CUM is necessary, while for the study of the prostatic region EG gives more information. Therefore EG is proposed as method complementary to CUM in the evaluation of the proximal urethra.

Humans↗
PubMed1987

[Instrumental diagnosis of non-glandular superficial inflammation].

The study of soft tissues has greatly improved since the introduction of ultrasonography (US) and computed tomography (CT). In order to define the role of instrumental investigations, 51 patients affected by non glandular superficial soft tissue masses underwent US and 9 were also examined with CT. US proved to be accurate to define the size, the structure of the mass (93%), the benign or malignant nature (91%). US was also useful for percutaneous biopsy. However, US cannot be considered the only investigation because it does not give enough data about bony and articular structures: a conventional X-ray film must be performed in order to define the relation of the mass with the adjacent bone and to clarify the possible presence of fatty tissue in a solid mass shown at US. CT has a role in case of large masses, surrounding a bone diaphysis, when the malignant nature is suspected and to define the relationship with vessels and muscles.

Abscess↗
PubMed1987

[Quality control in urography with iopamidol and iohexol. A parallel comparison].

Iohexol has a slightly higher osmolarity in comparison with iopamidol; therefore it might induce a more pronounced diuretic effect and then a better distension of the excretory pathway. A trial was carried out in two groups of 50 patients with normal renal function who underwent urography, namely with 50 ml (15 gI) of iopamidol and of iohexol. No significant differences in the evaluated parameters (nephrography, calyces, pelvis, ureters and bladder) have been found. Both contrast media allowed to perform good quality urographies.

Adolescent↗