Biomedical subjects

N Gandolfo

Publications and source records attributed to N Gandolfo.

40 records · Page 3Linked to original sources

PubMedDate not supplied

Metastatic nodules of the abdominal wall: US and CT evaluation..

PURPOSE: Metastatic recurrence in the abdominal wall surgical scar is not uncommon. Our aim was to evaluate the role of ultrasonography (US), computed tomography (CT) and percutaneous fine needle aspiration biopsy in the diagnosis of metastatic recurrence along the surgical scar. MATERIALS AND METHODS: We evaluated 17 nodules in the surgical scar, either single (n=9 patients) or multiple (n=2 patients), in 11 patients operated on for known abdominal neoplasm confirmed by histology. The most common primary tumour was colonic carcinoma. All patients had undergone open surgery, and the lesions were detected at routine follow-up or at diagnostic examinations performed for clinical suspicion of recurrence. Ultrasonography (7.5-10/10-13 MHz) and fine needle biopsy were performed in all cases; contrast-enhanced CT was carried out in 10 patients. All lesions underwent histopathological examination. RESULTS: The histological findings showed 16/17 metastatic nodules and one suture granuloma. Lesions had variable size (15-55 mm), roundish shape, ill-defined margins (60% cases) and hypoechoic solid echotexture. All were characterised by marked contrast medium uptake on CT examination. US-guided aspiration biopsy precisely defined the metastatic nature of the nodules in 16/17 cases. In the patient with suture granuloma, both CT and US findings suggested malignancy; however, cytology showed only scant fibrous material. The anterior abdominal wall was the most common site of metastatic disease (14 lesions). CONCLUSIONS: US enables an accurate detection and diagnosis of metastatic nodules along the surgical scar. Fine needle aspiration biopsy represents, in our opinion, the most suitable procedure for providing an accurate diagnosis of this condition.

Abdominal Neoplasms↗

PubMedDate not supplied

[Intraoperative use of radiofrequency thermoablation of liver tumors: considerations on indications and related therapeutic aspects].

PURPOSE: To evaluate the usefulness of intraoperative radiofrequency thermoablation of liver tumours in association or not with hepatic resection. MATERIALS AND METHODS: 21 patients were treated between January 1998 and December 2001, there were 4 hepatocellular carcinoma and 17 metastasis. In 13 cases radiofrequency was associated to hepatectomy, in 3 cases to resection of extraepatic disease and in 5 cases were performed alone. 23 lesions were treated by radiofrequency (range 1-3); the mean dimension was 26 millimetres (range 8-70). A clamping of the liver pedicle was always done. RESULTS: There were no operative deaths, 3 (14.3%) patients developed complications related to radiofrequency (2 biliary leakages, 1 hepatic abscess). 14 (66.7%) patients were alive after a mean follow up of 14.5 months, 2 of all (9.5%) had a recurrence in the site previously treated with thermoablation. Association between hepatectomy and radiofrequency increased the number of curative liver resections from 10.1% to 16.3% (in case of colorectal metastasis). DISCUSSION: Intraoperative radiofrequency is useful to increase the number of curative hepatectomies, to treat liver masses which demonstrate unresectable or found by ultrasonography at the operating time and even to reach tumours difficult to manage by percutaneous approach. In any case the aim is to obtain the absence of macroscopic neoplastic disease (RO status). It is a safe and effective therapeutic strategy, anyway all procedures and indications are still not completely cleared. CONCLUSIONS: Intraoperative thermoablation of liver tumour is safe and effective and increases therapeutic the number of curative hepatectomies. Further progresses may improve the efficacy and extend the indications of this strategy.

Adult↗

PubMedDate not supplied

[Retrospective analysis of color Doppler ultrasonography and flowmetry findings in solid nodular pathology of the breast].

The authors tried to identify useful flowmetric values and color-Doppler patterns for the differential diagnosis between benign and malignant solid breast lesions. To this purpose, 106 patients with breast nodules detected at mammography and/or high resolution US were examined. A US scanner with a linear 7.5 MHz transducer, a narrow sample volume, a PRF ranging (650-800 Hz) and a wall filter value of 50 Hz were used. Three parameters were considered: the number vascular sites, systolic peak velocity and pulsatility index. All these parameters related to tumor volume. Several (> 2) vascular sites, high peak velocity and quite high pulsatility index were demonstrated in malignant tumors (46 lesions). Among benign tumors no vascular site was identified in 32 of 60 lesions and no more than 2 sites were identified in 26 of 60 lesions, except for 2 phylloides tumors. Sensitivity, specificity, positive and negative predictive values and overall accuracy rates were, as for the "vascular sites" parameter, 78%, 96%, 94%, 85%, 88%, respectively; as regards the "peak systolic velocity" 81%, 86%, 89%, 75%, 83% respectively; as regards the "pulsatility index" 100%, 85%, 100%, 85%, 94% respectively.

Adult↗

PubMedDate not supplied

[Long biceps brachii instability. Role of ultrasonography].

INTRODUCTION: Dislocation of the long head of biceps tendon, including subluxation to displacement out of the bicipital groove, is an uncommon cause of shoulder pain. We investigated the role of US in the diagnosis of this condition. MATERIAL AND METHODS: We examined eight patients with dislocation of the long head of biceps tendon: seven had a displaced, and one a subluxated tendon. All patients had early radiographic and US studies of the shoulder; then, three (37%) were submitted to CT-arthrography and two (25%) to MRI. US was performed at 7.5-13 MHz frequency, CT-arthrography with a volumetric acquisition technique and MRI with a surface coil at 1.5 T. Three patients with tendon dislocation had surgical confirmation of the diagnosis. RESULTS: Dislocation of the long head of biceps tendon was always diagnosed with US in all our eight patients; CT-arthrography and MRI confirmed the US findings. In the patient with subluxation of the long head of biceps tendon, US showed the tendon displaced over the lesser tuberosity whereas, in the 7 cases of complete luxations, the groove was empty and the tendon displaced medially. At CT-arthrography, the tendon was well outlined by contrast medium within its sheath. In dislocations, it was close to the anterior aspect of the humeral head. In two cases of dislocation, MRI showed both the empty bicipital sulcus and the medial tendon displacement. The subscapularis tendon tear was always associated with tendon dislocation; a supraspinatus tendon tear was observed in 6 cases. CONCLUSIONS: When imaging a painful shoulder, we should investigate the integrity and course of the long head of biceps tendon. In clinical practice, dislocation of this tendon can be reliably diagnosed with US. CT-arthrography and MRI should be used only to supplement inconclusive US studies.

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