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P Nardis

Publications and source records attributed to P Nardis.

10 recordsLinked to original sources
PubMed2003

High-resolution multidetector CT in the preoperative evaluation of patients with renal cell carcinoma.

OBJECTIVE: The purpose of our study was to evaluate the accuracy of multidetector CT (MDCT) using a high-resolution protocol in the preoperative assessment of patients with renal cell carcinoma who are possible candidates for nephron-sparing surgery. MATERIALS AND METHODS: Forty patients with suspected renal cell carcinoma underwent MDCT. Contrast-enhanced acquisitions were obtained during arterial, nephrographic, and urographic phases using a thin-slice protocol. One-millimeter-thick source images were evaluated by two observers on a dedicated workstation for the identification and characterization of the tumor, presence of a pseudocapsule or invasion of perirenal fat, involvement of adrenal glands or surrounding tissues, presence of satellite lesions within Gerota's fascia, infiltration of renal vein and inferior vena cava, involvement of lymph nodes, and presence of distant metastases. Imaging findings were compared with surgical specimens using criteria from the Robson and TNM classification systems. RESULTS: The presence and size of all lesions were correctly shown in all patients. In evaluating Robson stage I of renal cell carcinoma, we were able to diagnose fat infiltration on 1-mm scans with 96% sensitivity, 93% specificity, and 95% accuracy; the positive and negative predictive values were, respectively, 100% and 93%. One hundred percent accuracy was achieved in staging high-grade lesions. CONCLUSION: High-resolution MDCT is accurate in the preoperative evaluation of patients with renal cell carcinoma.

Adult↗
PubMed1997

[Dynamic magnetic resonance of the knee. Considerations on techniques and anatomy with a magnetic resonance system with open magnet].

MRI is currently considered the best technique to study the joints--knee joints in particular. Most studies are performed with the knee straightened out or slightly flexed, which position is mandatory with contemporary MR units. Recently, however, the MR equipment for limb studies and the larger tunnels of total body magnets have permitted partially dynamic knee studies, up to 30-40 degrees flexion; this joint excursion cannot be exceeded. In 1996, Muhle and Niitsu demonstrated that dynamic MRI can be useful to study cruciate ligament injuries, some types of meniscal injuries, all femoropatellar conditions and, mostly, cruciate ligament reconstruction. We used an open magnet MR unit for thorough functional dynamic knee studies, acquiring the images at 0-120 degrees flexion. The open magnet MR unit permits free joint movements. We examined 25 subjects: 10 healthy volunteers and 15 patients with meniscal, capsuloligamentous, femoropatellar or synovial conditions. This technique schedules axial, coronal or sagittal images, according to the diagnostic suspicion, suitably directed with the patient in lateral decubitus and with the knee flexed to maximum joint excursion. Dynamic MR findings are easily transferred to an X-ray film, so that the radiologist can send them to the orthopedist with no need of any videotape or TV take. The current cine MR programs display the dynamic images of the moving joint on an MR monitor, but this option is not yet widely available. The quality of dynamic MR studies is exactly the same as that of conventional images, with a particular emphasis on the small diagnostic details of the injuries. We report our preliminary experience with this technique, indicating some possible clinical applications of dynamic MRI which permits thorough studies of knee flexion-extension.

Humans↗
PubMed1996

[Meniscal deformities associated with fractures of the tibial proximal extremity. Considerations in 7 cases].

Lateral tibial plateau fractures are a fairly frequent event in emergency clinical practice. In these fractures, when bone depression exceeds 5 mm, surgery is indicated. On the rule, conventional plain films combined with tomography can answer diagnostic questions about bone trauma. CT and MRI permit to study associated meniscocapsular injuries for better therapeutical management. Since February, 1991, we have examined 24 patients with tibial plateau fractures with conventional radiography and CT. CT was performed using thin sections, within 0 to 48 hours of the traumatic event. In our series, 7 patients had a lateral meniscal trauma associated with a fracture of the homologous tibial plateau; in all of these 7 women, surgery confirmed complete meniscal avulsion. In these cases, CT showed the following signs of meniscocapsular disinsertion: marked diastasis between capsular structure, popliteal tendon and meniscal profile; associated hypodense hemorrhagic fluid in the popliteal recess; inhomogeneous densitometry of the popliteal tendon resulting from hemorrhagic infarction. Furthermore, CT showed a characteristic and constant morphological alteration of the lateral meniscus with fibrocartilage deformation, that is with a wider or more narrow pattern relative to its normal "C"-like shape. We conclude that this morphological alteration of meniscal fibrocartilage, when associated with a tibial fracture, is a diagnostic CT sign of complete meniscal avulsion. This finding can be a useful integration to other CT signs of this meniscal injury, towards better and more complete therapeutical management.

Adolescent↗
PubMed1996

[Occult or unknown traumatic osteochondral lesions of the knee. Assessment of 19 cases studied with conventional radiology and magnetic resonance].

Occult fractures of the knee represent a major cause of posttraumatic knee pain in patients with negative plain films. These injuries can cause severe sequelae if they are not properly diagnosed and rapidly treated. In our series of 1330 exams of the knee we found 19 traumatic osteochondral injuries (1.5%). MR studies were performed with a dedicated permanent magnet (0.2 T) (Artoscan, Esaote Biomedica, Genoa, Italy). All the patients were submitted to conventional radiography (AP and LL projections). In 14 patients oblique plain films were also performed. The following osteochondral injuries were found: 2 purely chondral fractures, 5 occult fractures (4 tibial and 1 of the medial femoral condyle) and 12 plateau fractures of the tibial posterior margin (8 lateral and 4 medial). CT of the knee was performed in 3 patients only. In 19 patients MRI correctly showed the traumatic injury and depicted: fracture site, the morphologic characteristics of fracture line, cortical bone and articular cartilage involvement, the exact extent of marrow signal changes, the associated injury of menisci or cruciate ligaments. To conclude, MR sensitivity and diagnostic accuracy are excellent in the patients with traumatic injuries of the knee. In the patients with posttraumatic knee joint pain, MRI appears to be an extremely useful tool in the detection and assessment of bone and cartilage disorders.

Adolescent↗
PubMed1996

[Synovial cyst of the cruciate ligament. Findings with magnetic resonance in 8 symptomatic cases].

Intraarticular ganglion cysts are uncommon findings: only 30 cases have been reported since the first paper by Caan in 1924 and they were all associated with cruciate ligaments. Many different cystic or pseudocystic lesions are found in articular knee conditions: the most common cystic lesions are popliteal cysts (Baker's cysts), followed by synovial pseudocysts of the posterior cruciate ligament, meniscal cysts and, finally, ganglion cysts of the cruciate ligaments. In our series of 1600 knee MR exams carried out in our MR department since June, 1994, we have found 8 ganglion cysts of the cruciate ligaments. MR studies are always performed on a dedicated 0.2-T permanent magnet (Artoscan, Esaote Biomedica, Genoa, Italy). Five patients were operated on with arthroscopy. The ganglion cysts affected the anterior cruciate ligaments in 4 cases and the posterior cruciate ligaments in 4 cases. The symptoms were mainly pain radiating to the medial side and worsening in forced flexion or extension. The diagnostic suspicion was meniscal tears in 4 patients, chondral lesions in 3 and a loose intraarticular body in one patient. The shape and structure of ganglion cysts in the cruciate ligaments are clearly depicted with MRI. The ganglion cysts in the anterior cruciate ligaments are usually spindle-shaped and within the ligament, while those in the posterior cruciate ligaments have a well-defined outline, with multilocular appearance, and they are usually localized along the ligament, most often on the dorsal aspect. MR signal studies show intermediate signal intensity on SE T1-weighted images and markedly increased signal intensity on SE T2-weighted images. These typical patterns may change depending on lesion content, for instance in the presence of hemoglobin due to an associated angioma. The origin of ganglion cysts in the cruciate ligaments is still unknown, even though many theories have been suggested, including a synovial herniation in ligament fibers, the ectopic inclusion of synovial tissue, a posttraumatic connectival degeneration and, finally, the proliferation of totipotent mesenchymal cells. From a histologic point of view, "synovial ganglion" is a much better definition than "synovial ganglion cyst", because the typical wall of real synovial cysts is missing. The MR patterns are typical of the morphological features described and of the presence of high protein fluid content.

Adult↗
PubMed1995

[Clinical usefulness of a computerized tomography study of morphology of the femoral canal in patients candidates for hip prosthesis].

In the last few years hip arthroplasty has been increasingly used and both metaphysis and diaphysis of the proximal femur are studied preoperatively for best compliance between prosthesis and bone. Indeed, the best results can be obtained by reducing the risk of stem end mobilization, which means to choose the prosthesis fitting the femoral canal best and to limit the use of cement prostheses, which are at high risk of mobilization in time, to advanced osteoporosis patients. We used a simple and repeatable CT technique to study femoral canal structure and size. After accurately positioning the patients inside the gantry, we acquired some axial scans at scheduled levels referring to the horizontal midline of the lesser trochanter. The axial scans were acquired 2 cm above and 5 and 10 cm below the horizontal midline in 105 patients. Measurements were bilateral in 13 patients. Finally, the results were compared with the surgical outcome. Femoral canal cross-diameters and cortical bone width varied greatly, which variations were confirmed in bilateral measurements and in the same patient between the two femurs. Femoral canal structure, which can be remodelled, influences the choice of the stem and thus the amount of cement. We believe this method to be fundamental for correct surgical planning and for best treatment outcome.

Female↗
PubMed1983

Duodenal stenosis from retroperitoneal fibrosis secondary to traumatic retroperitoneal hematoma: a case report.

A case is presented of retroperitoneal fibrosis secondary to post-traumatic retroperitoneal hematoma, resulting in duodenal obstruction six years after the traumatic event. The fibrotic encasement of the duodenum and the head of pancreas made it necessary to perform an "en bloc" resection, with excellent results both immediately and after three years of follow-up.

Abdominal Injuries↗
PubMed1980

Lipoma of the omentum in a child.

A solitary giant lipoma of the omentum and gastrocolic ligament in an 8-year-old boy is reported. The patient had a large abdominal mass and signs of partial intestinal obstruction. Radiographs showed the characteristic radiolucency of a fatty mass, excluding a mesenteric cyst.

Child↗
PubMedDate not supplied

Specific diagnosis by CT and HRCT in six chronic lung diseases.

CT and high-resolution CT (HRCT) are both important modalities for imaging lung chronic disease, and certain features (distribution of disease in the axial plane, unilateral or bilateral disease, bronchovascular bundle thickening, septal thickening, central dot thickening, polygons, distortion of parenchyma, air-space disease, nodules) are well known to suggest specific diagnoses. In a series of 54 consecutive patients with six specific diseases (scleroderma or UIP, sarcoidosis, lymphangitic carcinomatosis, drug toxicity, lymphomas, eosinophilic granuloma), these diagnostic CT features were always present. In 50/54 cases, a histologic proof was obtained. In 36 patients with histologic confirmation of four different diseases and in six normal controls, we compared sensibility, specificity, and accuracy of chest radiography, chest CT, and HRCT and found the highest diagnostic accuracy by HRCT together with standard CT.

Adult↗