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Biomedical subjects

O Tamburrini

Publications and source records attributed to O Tamburrini.

At least 19 recordsLinked to original sources
PubMed2004

Multidetector row computed tomographic angiography of the abdominal aorta and lower limbs arteries. A new diagnostic tool in patients with peripheral arterial occlusive disease.

AIM: The aim of this study is to evaluate the accuracy of multidetector row CT angiography (MDCTA) of the abdominal aorta and lower extremities arteries in patients with peripheral arterial occlusive disease who did not receive any prior treatment whether interventional or surgical. METHODS: Twenty-two patients with peripheral vascular occlusive disease (16 male, 6 female, age range 44-85 years) underwent MDCTA of the abdominal aorta and lower extremities. Digital subtraction angiography (DSA) of the same districts was performed within 3 months. Images were blindly interpreted by 2 interventional radiologists and compared with the results of digital subtraction angiography. RESULTS: Sensitivity and specificity of MDCTA were 92% and 94%, respectively, with positive and negative predictive values of 93% and 95%. Overall diagnostic accuracy was 93%. Normal arterial segments and 100% occlusions were correctly identified in all cases by MDCTA. Moderately stenotic segments interpretation in the calves appeared to be more controversial, but no statistical difference in accuracy in this district was noted with respect to accuracy in more proximal arteries. CONCLUSION: MDCTA of the abdominal aorta and lower extremities is a feasible, accurate imaging modality in clinical practice when compared to DSA.

Adult↗
PubMed2001

Comparison of endothelial function evaluated by strain gauge plethysmography and brachial artery ultrasound.

Strain gauge plethysmography and brachial artery ultrasound are widely used to study endothelial function. No data on correlation between these two procedures are reported. The present study compared these two methods and investigated the correlation between vasodilation and brachial wall shear stress. In six healthy subjects and ten patients with hypertension or obesity, strain gauge plethysmography was performed in resting conditions and after infusion of 7.5,15 and 30 microg/min of acetylcholine, and brachial artery ultrasound in resting conditions and after 5 min hand ischemia. Wall shear stress was calculated as: blood viscosity x blood velocity/internal diameter. Forearm blood flow following acetylcholine infusion increased more in healthy subjects than in patients with hypertension or obesity. In addition, brachial artery dilated more in the former group. Change in brachial artery diameter correlated with change in forearm blood flow, calculated as area under the curve of acetylcholine infusion (r=0.739, P<0.001). Wall shear stress was higher in healthy subjects (67.8+/-20.0 dynes/cm(2)) than in patients with either hypertension or obesity (39.2+/-16.7, P<0.001), and correlated with variations of diameter (r=0.796, P<0.0002), and marginally of blood flow (r=0.516, P<0.05). The present findings demonstrate that there is a high correlation between endothelial function evaluated by strain gauge plethysmography and brachial artery ultrasound. Wall shear stress correlates with brachial artery diameter change following hand ischemia, and marginally with blood flow change following acetylcholine infusion.

Acetylcholine↗
PubMed2001

[The value of the MR imaging in the evaluation of Müllerian duct anomalies].

PURPOSE: To reaffirm the role of MRI in the assessment of the M#159;llerian duct anomalies (MDAs). MATERIAL AND METHODS: Between November 1997 and April 2001, 22 patients, age range 18-40 years (mean 29 years) were investigated with MRI and US. The MRI study was performed with a 0,5 Tesla imager (Vectra, GE Medical System) with body-coil; neither oral nor intravenous contrast was used. We obtained SE T1-weighted, fast STIR with fat suppression and FSE T2-weighted sequences. Sagittal, paracoronal and paraxial images were acquired. The paraxial images were obtained to produce true coronal images of the uterus. In evaluating MDAs, imaging the uterus in its true coronal plane is essential to assess the external fundal contour. US examination was performed with an HDI 3000, ATL, using the trans-vaginal approach. The MDAs were subdivided according to the Buttram and Gibbons classification. RESULTS: There were 22 cases of laparoscopic and hysteroscopic proved anomalies; MRI allowed correct diagnosis of 21 uterine anomalies (accuracy, 95%) whereas U.S. was correct in 20 of 22 cases (accuracy, 92%). The MRI was excellent in depicting the uterine morphology in one case of unicornuate uterus with rudimentary horn non-comunicating with the main cavity and distended by hematometra and associated hematosalpinx. Further-more evaluating composition, thickness and extension of the uterine septum and aspect of the fundal contour, MRI allowed to differentiate definitively between bicornuate uterus and septate uterus. This is a very important distinction to do because it significantly affects patient treatment: a septate uterus requires hysteroscopic septectomy, while a bicornuate uterus does not requires surgical treatment. CONCLUSIONS: Given its characteristics, MRI is a very accurate imaging modality in uterine evaluation and contributes significantly to treatment planning. Although ultrasonography remains the modality of choice for the initial study of patients who are suspected of having a MDAs, we propose, in accordance with many authors in the literature, to reserve MRI imaging for patients with a technically inadequate or indeterminate ultrasound examination.

Adolescent↗
PubMed1999

[The role of magnetic resonance in the diagnosis of the os trigonum syndrome].

PURPOSE: We investigated the yield of Magnetic Resonance Imaging (MRI) in hindfoot conditions, particularly the os trigonum syndrome, which are very difficult to diagnose clinically. MATERIAL AND METHODS: We examined 7 consecutive patients complaining of hindfoot pain for more than 4 months (male:female = 1:6; age range 16-22 years, average 18.6). Three patients practiced competitive sports and 4 ballet. We performed conventional radiography (orthogonal projections) and then MRI with a 0.5 T superconductive unit with surface coils; MR images were acquired with T1-weighted spin-echo (SE), T2-weighted gradient-echo (GRE), and fast inversion recovery (FIR) fat-suppressed sequences with 4 mm thickness and 0 mm gap. RESULTS: In 2 cases the os trigonum had irregular margins with subchondral sclerosis and widened synchondrosis. In 3 patients we found flexor hallucis longus tenosynovitis, likely caused by tendon compression and displacement within its sheath; there were neither os trigonum marrow edema nor synchondrosis widening. One patient had os trigonum hypertrophy, mild synchondrosis widening and marrow edema, in the os trigonum and the posterior aspect of talus. One patient had the os trigonum, but no signs referable to the os trigonum syndrome. CONCLUSIONS: In the posterior impingement syndrome, our objective is to show inflammatory changes in the posterior capsule of the ankle joint, adjacent ligaments, tendons and chondrosynovial surface. In these cases, the yield of conventional radiography and CT is rather poor, while MRI provides important information on soft tissues involvement, synovial reaction, chondral and subchondral bone injuries and the association of flexor hallucis longus synovitis, if present. MRI also yields detailed information for correct therapeutic approach. In conclusion, for the (differential) diagnosis of hindfoot pain in clinically suspected os trigonum syndrome, MRI appears to be the technique of choice, after conventional radiography, thanks to its noninvasiveness, multiplanarity, and high spatial and contrast resolution.

Adolescent↗
PubMed1998

Magnetic resonance imaging in evaluation of the common bile duct.

BACKGROUND: The ideal method for evaluation of the common bile duct (CBD) before or during cholecystectomy remains controversial. Magnetic resonance cholangiography (MRC) is a new, promising technique. A prospective evaluation is reported. METHOD: Sixty-one patients (45 women) were studied by MRC. There were 29 patients with symptomatic gallstone disease and without clinical, biochemical or ultrasonographic evidence of CBD stones (group 1); 28 of them also underwent intraoperative cholangiography (IOC). In addition, there were 21 patients with symptomatic gallstone disease, with mild biochemical and ultrasonographic signs of CBD involvement (group 2), of whom 19 underwent IOC, and 11 patients with symptomatic CBD stones (group 3), nine of whom had preoperative endoscopic retrograde cholangiopancreatography (ERCP) following MRC. RESULTS: MRC showed that no patient in group 1 and three patients in group 2 had CBD stones. Three patients (one in group 1, two in group 2) did not undergo IOC because of technical or clinical problems. In group 3, ERCP confirmed the results of MRC in nine patients. Two patients underwent open surgery because of ultrasonographic, MRC and radiographic signs of pancreatic malignancy. CONCLUSION: MRC could replace IOC and ERCP for identification of asymptomatic CBD stones. In symptomatic patients MRC combined with other non-invasive imaging techniques can direct the surgeon to appropriate management.

Cholangiography↗
PubMed1998

[Villous-lipomatous proliferation of synovial membrane of the knee (lipoma arborescens). Magnetic resonance findings].

PURPOSE: We reviewed the imaging patterns of the villous-lipomatous proliferation of the knee synovial membrane (lipoma arborescens), with special reference to the role of MRI in the diagnosis of this rare condition. MATERIAL AND METHODS: 1994 to 1996, we examined four patients, none of them with a history of knee trauma. The clinical picture was characterized by moderate and painful suprapatellar swelling in three cases and by moderate suprapatellar swelling alone in one case. All patients were examined with conventional radiography and MRI; two were submitted to US and two to CT. The diagnosis of lipoma arborescens was suggested on the basis of imaging patterns and then confirmed by histologic findings. RESULTS: Conventional radiography showed a roughly oblong slim opacity in the suprapatellar recess in all cases; the joint space was always preserved. US showed a villous lesion surrounded by fluid, but provided no specific data on its nature. CT and MRI not only provided better location and morphologic detailing and showed the relationships with articular structures better, but also permitted the direct identification of the fat nodules within the abnormal synovial reaction. CONCLUSION: We stress the role of MRI in suggesting the correct diagnosis of lipoma arborescens, as it was subsequently confirmed in our series by histologic findings. In fact, fat-suppression sequences, after T1-weighted SE, can typify fat tissue.

Bone Neoplasms↗
PubMed1997

["Occult" posttraumatic lesions of the knee: can magnetic resonance substitute for diagnostic arthroscopy?].

PURPOSE: We investigated the actual role of MRI versus arthroscopy in the detection and characterization of occult bone and/or cartilage injuries in patients with previous musculoskeletal trauma of the knee, pain and severe functional impairment. Occult post-traumatic osteochondral injuries of the knee are trauma-related bone and/or cartilage damage missed at plain radiography. MATERIAL AND METHODS: We retrospectively selected 70 patients (men:women = 7:3; age range: 35 +/- 7 years) with a history of acute musculoskeletal trauma, negative conventional radiographs, pain and limited joint movements. All patients were submitted to conventional radiography, arthroscopy and MRI, the latter with 0.5 T units and T1-weighted SE. T2-weighted GE and FIR sequences with fat suppression. RESULTS AND DISCUSSION: We identified three types of occult post-traumatic injuries by morpho-topographic and signal intensity patterns: bone bruises (no. 25), subchondral (no. 33) and osteochondral (no. 35) injuries. Arthroscopy depicted 45 osteochondral and 19 chondral injuries. A bone bruise was defined as a typical subcortical area of signal loss, with various shapes, on T1-weighted images and of increased signal intensity on T2-weighted and FIR images. The cortical bone and articular cartilage were normal in all cases, while osteochondral injuries exhibited associated bone and cartilage damage with the same abnormal MR signal intensity. Sprain was the mechanism of injury in 52 cases, bruise in 12 and stress in 6. In 52 sprains (30 in valgus), the injury site was the lateral compartment in 92.3% of cases (100% in valgus), associated with meniscal damage in 73% of cases (90% in valgus) and with ligament injury in 90.4% (100% in valgus). In 12 bruises, the injury site was the lateral compartment in 58.3% of cases, the knee cap in 25% and the medial compartment in 16.7%; meniscal damage was associated in 25% of cases and ligament damage in 8.3%. In 6 stress injuries, the injury site was localized in the medial tibial condyle in 80% of cases, while meniscal and ligament tears were absent. CONCLUSIONS: After comparing MR with arthroscopic findings and reviewing the available literature, we conclude that arthroscopy permits the direct visualization of even fine articular surface changes but does not depict the subchondral bone, the most frequent site of injury detected with MRI. MRI was a very useful tool in the detection and characterization of the different types of occult bone and/or cartilage injuries and showed a statistically significant correlation between site and distribution of bone and cartilage injuries and between internal damage and trauma mechanisms. Therefore, we believe that MRI can help avoid diagnostic arthroscopy in the patients with a history of post-traumatic pain, acute articular blocks and negative radiographic findings.

Adult↗
PubMed1996

Autosomal recessive hereditary motor and sensory neuropathy with focally folded myelin sheaths: clinical, electrophysiologic, and genetic aspects of a large family.

We describe 10 patients from a large family with early onset motor and sensory neuropathy. Six were still living at the time of the study. In all cases, early motor milestones had been achieved. Mean age at onset of symptoms was 34 months; these included progressive distal and proximal muscle weakness of lower limbs. Pes equinovarus developed in all patients during childhood. Slight facial weakness was present in four patients, and one of them also had bilateral facial synkinesia. Intellectual function was normal in all cases. There was no evidence of thickened peripheral nerves. All three adult patients (mean age, 27 years) were seriously handicapped and wheelchair-bound. Death occurred in the fourth to fifth decade of life and the duration of the illness varied from 27 to 39 years. Motor nerve conduction velocities ranged from 15 to 17 m/sec in the upper limbs of the youngest patients, and were undetectable in the adult patients. Sensitive action potentials were almost always absent. In all patients, auditory evoked potentials showed abnormally delayed interpeak I-III latencies. The most prominent pathologic finding was a highly unusual myelin abnormality consisting of irregular redundant loops and folding of the myelin sheath. The genealogic study gave strong evidence of autosomal-recessive inheritance. The molecular analysis failed to demonstrate either duplication in the chromosome 17p11.2-12, point mutations in the four exons of the PMP-22 (17p11.2) and the six exons of the Po (1q21-q25) genes, or linkage to chromosome 8q13-21.1.

Adult↗