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Biomedical subjects

P Falappa

Publications and source records attributed to P Falappa.

At least 19 recordsLinked to original sources
PubMed2002

Magnetic resonance imaging in the diagnosis of melanoma: in vivo preliminary studies with dynamic contrast-enhanced subtraction.

The aim of this study was to analyse the potential of fast dynamic subtraction magnetic resonance (MR) imaging in differentiating in vivo melanomas from benign melanocytic lesions. Dynamic MR imaging was performed after intravenous administration of gadopentetate dimeglumine (Gd-DTPA) in 18 patients with melanocytic skin lesions. Using a post-processing algorithm, time-signal intensity curves were obtained for the lesions and classified according to their shapes as type I (steady enhancement increase), type II (plateau of signal intensity) or type III (wash-out of signal intensity). Other parameters evaluated for their potential to differentiate melanomas from benign lesions were the enhancement rate (percentage of signal intensity increase) in the first minute after Gd-DTPA administration, the peak value of the enhancement rate, and the wash-out slope. The pigmented lesions were then surgically excised and the MR results compared with the histological assessment. In melanomas, the mean value of the enhancement rate in the first minute was 611%, whereas in benign lesions it was 131% (P = 0.001). The distribution of curve types was also different: seven of the nine naevi showed type I curves, while eight of the nine melanomas displayed a type III curve. In addition, distinctive wash-out dynamics were observed: the enhancement rate began to decrease between the first and third minutes for melanomas, but continued to increase until the sixth minute for naevi (P = 0.000). These findings, which are most likely related to the neoangiogenesis present in melanomas, indicate that dynamic MR imaging can be helpful in the differential diagnosis of pigmented skin lesions.

Adult↗
PubMed1994

Treatment of intraosseous arteriovenous fistulas of the extremities.

Intraosseous arteriovenous fistulas of the extremities are rare malformations frequently associated with severe systemic hemodynamic alterations. In many cases, it is quite difficult to eliminate these anomalous vascular structures, but the possibilities for successful treatment are much greater when surgery is combined with interventional radiology. Selective embolization of the malformed vessels can be produced with a variety of agents that are injected into afferent arteries, via percutaneous puncture or through direct surgical access. The intraosseous portion of the fistula should be resected at the time of embolization or later. The authors describe the successful treatment of three patients having intraosseous arteriovenous fistulas of the upper extremities, who have had follow-up for 2 to 10 years.

Adolescent↗
PubMed1994

[Preoperative ultrasonographic measurement of melanoma thickness with 20 MHz probe].

The authors report on the preoperative evaluation of melanoma thickness with very high frequency US probes (20 MHz). Thirty patients with clinical suspicion of melanoma were examined preoperatively with US. The high quality of the images obtained with 20-MHz US probes allowed the lesions involving the superficial derma or, in more advanced cases, all derma, to be demonstrated and tumor thickness to be measured accurately. The latter is a major prognostic factor and indeed Breslow's classification is based on tumor thickness. The preoperative US study of melanoma thickness allows the surgeon to plan excision depth, which is necessary for accurate and safe tumor resection, that is, whose margins are proportionate to melanoma thickness. In the 30 patients submitted to preoperative US measurements of tumor thickness, US and histologic findings were in agreement. US overestimated melanoma thickness by 7 to 11%, which however had no impact on prognosis and surgical planning. While US can differentiate melanomas from other types of benign or malignant pigmented skin lesions such as blue nevus, pigmented basalioma or pigmented seborroic cheraosis, no unquestionable US signs have been found yet to differentiate melanoma from nevus, which makes US useless for the differential diagnosis. Nonetheless, surgeons can use preoperative US to adapt the exeresis of melanoma to its actual severity and to reduce scars to a minimum. Possible skin metastases can also be detected by US and thus removed.

Humans↗
PubMed1993

[Percutaneous transluminal renal angioplasty. Italian experience at 13 centers].

The data relative to 13 years' experience with percutaneous transluminal renal angioplasty (PTRA) in the 13 major interventional radiology centers in Italy were collected and analyzed to evaluate technical and clinical results. Our aim was to collect homogeneous results in a large series of patients, evaluating both the technical and the clinical success with a long-term follow-up (1 month-13 years). One thousand three hundred forty seven PTRA procedures (including 42 restenoses) in 1,073 patients were retrospectively reviewed. In 807 cases the cause of stenosis was atherosclerosis, in 442 cases fibromuscular dysplasia and in 24 cases arteritis in 12 cases, stenoses were present in patients that had undergone a surgical by-pass. Sixty-two stenoses in patients with solitary kidney and 102 in patients with renal failure were studied separately. The technical success (based on the morphology of the dilated tract) obtained in 91% of cases was considered, together with the clinical success (in 81% of cases), based on the decrease in blood pressure evaluated according to Martin's classification. The blood pressure values collected after the maneuver were also evaluated separately for the different types of stenosis etiology: atherosclerosis, fibromuscular dysplasia or arteritis; moreover, blood pressure was studied in solitary kidney patients and in those with renal failure. Complications were classified as major (4.2%) and minor (4.9%). The high success rate and the low incidence of complications we observed in our series suggest PTRA as the procedure of choice for high blood pressure patients with renal artery stenosis > 50% of the normal caliber.

Adolescent↗
PubMed1991

[Integrated imaging of hepatocarcinoma. Personal experience].

Hepatocellular carcinoma (HCC) is the commonest primary tumor of the liver; of late, its incidence has increased in the Western world. The authors report their experience with 42 patients affected with HCC; 36 cases were confirmed by fine-needle biopsy (FNAB), and 2 by surgery. All patients were studied with US and CT; 25 of them underwent color-Doppler US, and 30 angiography. In 9 patients, Lipiodol-CT was performed after hepatic arterial chemo-embolization. Thirty-six expansive and expansive-infiltrative lesions were observed, 4 infiltrative ones, and 1 neoplastic thrombosis of the portal vein with no evidence of parenchymal mass; 28 cases were multinodular in nature. US showed the primary lesion in all cases, while CT missed 2 lesions of 15 mm in diameter. In 19 of 25 cases studied with color-Doppler US, arterial pathologic signals were observed. Angiography confirmed all the primary lesions diagnosed by US in 30 patients and was found to be the most sensitive method to reveal multinodular lesions 8-15 mm phi, whereas Lipiodol-CT had higher resolution in detecting nodules up to 3 mm phi. The retrospective review of our results pointed out the capabilities of diagnostic imaging techniques in characterizing and staging HCCs--which is the reason why the role of biopsy has not been emphasized. The whole of the morphofunctional data obtained with the different techniques allowed lesion tissue characterization.

Adolescent↗
PubMed1990

Transvenous sclerotherapy of the gonadal veins for treatment of varicocele: long-term results.

Percutaneous occlusion of the spermatic vein has been performed on 136 consecutive patients with varicocele scroti during the last six years. The authors report their long-term results on the first 119 cases to have a follow-up of at least six months. Occlusion of the insufficient gonadal vein is induced by the selective transcatheter injection of sclerosing agent with local anesthesia. Their patients are always evaluated before and after the procedure by Doppler examination. A spermiogram is done before the procedure and after six months. In this series they registered only 4 recurrences with no major complications.

Follow-Up Studies↗
PubMed1987

Therapeutic embolization of renal artery to control severe hypertension due to renal trauma.

In a young patient with a post-traumatic renal hematoma, severe systemic hypertension, secondary to the activation of the renin-angiotensin axis, developed. Because of persistent hypertension, after 3 months of drug therapy, selective percutaneous embolization of the damaged vessels was performed. One year after procedure, the patient is normotensive without drugs.

Adult↗
PubMed1986

Rounded atelectasis: considerations on its radiological diagnosis.

Rounded atelectasis is a particular form of peripheral lung collapse, adjacent to the pleura and causing a pulmonary opacity, often resembling a neoplastic mass. Its early identification avoids further investigations with more invasive techniques, especially unnecessary thoracotomy. The aim of this report is to contribute some case studies to the body of information which characterizes this radiographic and tomodensitometric entity; aspiration biopsy can possibly be performed to resolve diagnostic uncertainties.

Adult↗
PubMed1985

[Contrast dose and signal/noise ratio in digital angiography].

In a digital angiographic system the variations of the signal to noise ratio in relation to the contrast medium quantity and to the exposure data are analyzed. On these basis, the greater flexibility of the digital angiographic equipments in comparison with conventional ones is underlined.

Angiography↗
PubMed1984

Primary aldosteronism: complete remission after adrenal venography.

A remission of adrenal adenoma producing aldosterone is described as a consequence of adrenal venous catheterization. The patient did not undergo surgery but she was kept on frequent clinical controls. The complete remission of the syndrome is still persisting three years after the incident. Since adrenal insufficiency is described after adrenal venous catheterization, the authors suggest that this procedure is to be restricted to well selected patients. When this incident occurs in pathological glands, a remission of endocrine syndrome may be expected.

Adenoma↗
PubMed1984

Echographic follow-up of an abdominal aortic aneurysm treated with a prosthetic bypass.

The history of a patient with two thoracoabdominal aneurysms and lumbar Pott's disease is reported. A bypass was implanted from the ascending to the abdominal aorta. In the postoperative course the patient experienced acute low back pain. Ultrasonography suggested patency of the vascular graft. Therefore the symptoms were attributed to the vertebral pathology, and so the correct treatment could be given. The utility of ultrasonography in the early postoperative course, when aortography is contraindicated, is stressed.

Aorta, Abdominal↗
PubMed1983

Hepatic hemangiomas on 33 patients. Evaluation by ultrasound, nuclear medicine, computed tomography and angiography.

33 cases of hepatic hemangioma evaluated by various diagnostic tools (ultrasound, nuclear medicine, computed tomography and angiography) are reported. Nuclear medicine is the least sensitive and specific (only a report of a lacunar area). Ultrasound sensitivity is very high, also for lesions below 2 cm. Specificity initially very low, is now going to increase according to the operator's experience. Computed tomography shows good sensitivity and provides typical signs of hemangiomas, especially in the largest tumors. Angiography was not demonstrated in all cases (2 false-negative in lesions below 2 cm). In fact, in smaller hemangiomas often fibrotic tissue is predominant and vascular anomalies may not appear. When surgery is not performed, ultrasound is recommended as non-invasive follow-up.

Adult↗
PubMed1982

Angiographic study of digital arteries in workers exposed to vinyl chloride.

Five patients exposed to vinyl chloride were studied by hand angiography and other non-invasive methods, including photoplethysmography, rheography, and thermography. Raynaud's phenomenon was present in all five subjects, while acro-osteolysis affected only one. Organic vascular lesions, such as narrowing, segmentary occlusions of digital arteries and bridge collaterals, were found in angiographic studies. Only one patient did not show clear segmentary occlusions, but his vessels were crooked and diffusely narrowed. Angiographic results appear to correlate well with the changes shown by non-invasive techniques.

Adult↗