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P Bortolotto

Publications and source records attributed to P Bortolotto.

9 recordsLinked to original sources
PubMed1998

Chest roentgenology in the intensive care unit: an overview.

Chest roentgenology in the intensive care unit is a real challenge for the general radiologist. Beyond the basic disease, the critically ill is at risk for developing specific cardiopulmonary disorders, all presenting as chest opacities, their diagnosis often being impossible if based only on the radiological aspect. To make things harder, their appearance can vary with the subject's position and the mechanical ventilation. Patients require a continuous monitoring of the vital functions and their mechanical and pharmacological support, for which they are connected to different instruments. The radiologist should know the normal position of these devices, and promptly recognize when they are misplaced or when complications from their insertion occurred. Our aim is to suggest for each of the above-mentioned conditions a guideline of interpretation based not only on the radiological aspect and distribution of the lesions, but also on the physiopathological and clinical grounds.

Diagnosis, Differential↗
PubMed1996

Imaging of pleural diseases.

The main pleural disorders are: effusion, thickening, masses and pneumothorax. Chest radiography is the first approach to evaluation of pleural disease; further evaluation is based upon ultrasounds (US), computed tomography (CT), and high-resolution CT (HRCT). The typical appearance of free pleural effusion is a homogeneous opacity with concave upper boundary; subpulmonic or intrafissural collections may also occur; the exudative effusions can be organized by adhesions between the pleural layers; consequently, loculated collections result. Radiographs allow us to assess the presence, amount and arrangement of effusions, but US and, especially, CT are needed to detect the modifications of the underlying pleura: circumferential thickenings, irregular and more than 1 cm thick are mostly malignant and denote mesothelioma or metastases: subtle and regular thickening is the typical appearance of fibrosis; a normal pleura does not exclude a malignant effusion. CT plays a major role in the diagnosis and management of empyema and in differentiating it from the pulmonary abscess. With CT it is also possible to differentiate the true pleural thickening from the false one due to a simple increase of extrapleural fat, and to disclose the activity of a fibrothorax through the detection of a small amount of fluid between the pleural layers. Pleural plaques are clearly visible by conventional radiography, especially with oblique views; US and CT are needed in the assessment of pleural tumors (fibroma, lipoma, fibro- and liposarcoma) and in determining the involvement of the lung and the chest wall. Pneumothorax is easily detected by conventional radiographs in the upright patient; when supine, the air collects in the anterobasal regions and particular projections are required; CT can reveal small amounts of air and is recommended in critically ill or trauma patients.

Humans↗
PubMed1992

[An evaluation of the N parameter according to the system of the American Thoracic Society (ATS) in pulmonary carcinoma. A comparison between radiology, surgery and histological diagnosis].

The hilar and mediastinal lymph nodes of 36 patients with bronchogenic carcinoma were evaluated with computed tomography (CT). The American Thoracic Society (ATS) mapping was employed, which defines nodal stations in terms of well-recognized anatomic landmarks which are easily identified with CT and during thoracotomy. The differences (30 cases) between CT and surgical measurements in the 124 nodal stations which could be analyzed are discussed in detail. A better correlation was found using a 2-cm threshold value to define a "positive" or "negative" lymph node with CT. The comparison of radiologic data and the presence of metastases showed how with the 2-cm size criterion sensitivity drops from 81% to 53%, whereas specificity rises from 53% to 84%, thus affecting the subsequent diagnosis and therapy positively.

Aged↗
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↗
PubMed1988

[Malpositions and complications following central venous catheterization in relation to the access site].

Malpositions and complications following central venous catheterization largely depend on the site of venous approach. Malpositions are very common after subclavian vein catheterization, and even more common after left jugular vein catheterization. On the contrary, their incidence after right jugular puncture is very low. Among complications, pneumothorax is quite common after subclavian vein catheterization, and migration of the catheter towards the heart after right jugular puncture. Vascular damages may occur in any approach: their early detection on chest radiographs very much depends on a rigorous technique. Radiology plays an important role in the early detection of malpositions and complications, which is greatly facilitated by a few ml of contrast medium injected through the catheter.

Axillary Vein↗
PubMed1988

[Evaluation of expansive myelo-vertebral pathology using different radiologic modalities, magnetic resonance excluded].

The authors review their personal experience in tumors of the spine and the spinal cord, based on 30 cases evaluated with plain x-ray film of the spine, plain Computed Tomography (CT), myelography and myelo-CT. The value of both plain film of the spine and CT in tumoral lesions involving the skeleton is assessed; however, as far as nervous structures are concerned myelography and myelo-CT are necessary. Both myelography and myelo-CT showed high sensitivity (96%), thus allowing the definition of intra- extra-thecal extension of the tumor, and its relationships with the spinal cord and surrounding structures. Myelo-CT turned out to be extremely useful in myelographic stop: the upper extension of the lesion could be defined in 85% of cases. However, the contribution of myelography and myelo-CT was relatively limited when positive findings were present at CT. The evaluation of the density of the lesions proved to be of limited value since no significant differences could be recognized in different tumors. Finally, a diagnostic protocol is proposed for patients with spinal neurologic symptoms, based upon the clinical level of the lesion.

Adult↗