Biomedical subjects

Paolo Campioni

Publications and source records attributed to Paolo Campioni.

At least 19 recordsLinked to original sources

PubMedDate not supplied

The neurogenic bladder: anatomy and neurophysiology.

Micturition disorders secondary to alterations of complex neural controls do not represent a separate, typified condition but frequently they are symptoms of more complex diseases. Unfortunately, they are often misunderstood leading to severe damages to the patient. In diagnostic imaging of neural alterations of micturition, a major role is played by voiding cystourethrography for its contribution to both the morphologic and functional aspects. The dynamics of micturition is documented by voiding cystourethrography and with the integration between radiologic morphofunctional imaging and urodynamic pressure values the type and level of the neural lesion can be better defined. Therefore, subsequent neuroradiologic study can be specifically planned. Modern diagnostic imaging allows ready detection of the frequent complications of neurogenic bladder as diverticula, lithiasis, inflammation, that, especially in some patients, if misunderstood, can be particularly severe.

Child↗

PubMedDate not supplied

Diagnostic imaging of neurogenic bladder.

Correct radiologic diagnosis of neurogenic bladder is mainly based on morphofunctional information derived from voiding cystourethrography. This examination allows the evaluation of the bladder morphology, the degree of filling, and the validity of muscular contraction. Indications on the bladder neck, striated sphincter function and urethral morphology are also provided. Presence of ureterovesical reflux is detected with its possible precise classification. Abnormal amount of residual urine is identified and often early diagnosis of most common complications of neurogenic bladder as vesical lithiasis, diverticula and infections, can be established.

Child↗

PubMedDate not supplied

Information systems in the management of the radiology department.

Clinical, organizational and administrative service improvement has always been the primary aim of a radiology information system. Studies carried out at Massachusets General Hospital in the late sixties identified two "bottlenecks" in the Departments of Diagnostic Imaging: the planning of examinations and the management of picture archiving. Therefore, the information system started to be viewed as a potential tool for the solution of these problems. In time, the concept of Radiology Information System (RIS) was conceived. With its developments it is now considered an effective support for the daily activity of the Radiology department, to tackle and solve the operational problems posed by the various healthcare professionals. A radiology information system essentially concerns three functional areas: the patient management, the procedure management, the department management. Another major task of RIS is represented by its integration with the other information systems of Radiology and hospital to enable to share information in real time with the hospital information system (HIS) and the other information systems (system of first-aid management, intensive therapy units etc). A modern RIS must be in conformance with DICOM 3 for the service class of the working list to be able to transmit to the diagnostic imaging equipment the patient correct names and demographics and the type of procedure to be performed.

Delivery of Health Care, Integrated↗

PubMedDate not supplied

Picture archiving and communication in radiology.

After over 80 years of exclusive archiving of radiologic films, at present, in Radiology, digital archiving is increasingly gaining ground. Digital archiving allows a considerable reduction in costs and space saving, but most importantly, immediate or remote consultation of all examinations and reports in the hospital clinical wards, is feasible. The RIS system, in this case, is the starting point of the process of electronic archiving which however is the task of PACS. The latter can be used as radiologic archive in accordance with the law provided that it is in conformance with some specifications as the use of optical long-term storage media or with electronic track of change. PACS archives, in a hierarchical system, all digital images produced by each diagnostic imaging modality. Images and patient data can be retrieved and used for consultation or remote consultation by the reporting radiologist who requires images and reports of previous radiologic examinations or by the referring physician of the ward. Modern PACS owing to the WEB server allow remote access to extremely simplified images and data however ensuring the due regulations and access protections. Since the PACS enables a simpler data communication within the hospital, security and patient privacy should be protected. A secure and reliable PACS should be able to minimize the risk of accidental data destruction, and should prevent non authorized access to the archive with adequate security measures in relation to the acquired knowledge and based on the technological advances. Archiving of data produced by modern digital imaging is a problem now present also in small Radiology services. The technology is able to readily solve problems which were extremely complex up to some years ago as the connection between equipment and archiving system owing also to the universalization of the DICOM 3.0 standard. The evolution of communication networks and the use of standard protocols as TCP/IP can minimize problems of data and image remote transmission within the healthcare enterprise as well as over the territory. However, new problems are appearing as that of digital data security profiles and of the different systems which should ensure it. Among these, algorithms of electronic signature should be mentioned. In Italy they are validated by law and therefore can be used in digital archives in accordance with the law.

Algorithms↗

PubMedDate not supplied

IHE: integrating the healthcare enterprise, towards complete integration of healthcare information systems.

Information systems of a modern hospital govern extremely important functions as patient management, control of work flows, administration etc. However a great variety of recommended standards are used while in most cases no effective coordination and intercommunication is possible. Some years ago to simplify and resolve this problem IHE was created; it is a technical framework which identifies a number of components of the healthcare enterprise (the "actors") whose interactions are defined in terms of "transactions", that should be implemented according to HL7 and DICOM standards. Attempting an in-depth understanding of IHE structure and its principles of function, those transactions that can occur among the various actors, which of these are supported and which require specific actors, are analyzed. IHE is continuously evolving, therefore open to the factual contribution of all health professionals who can point out the main instances that emerge daily from their activity in the field. While its origin was specific for the field of radiology, the true soul and driving force of the project lay on the type of approach used: to get together medical specialists and information technology professionals in order to identify and solve the difficulties which hindered an effective and functional integration of healthcare information systems.

Delivery of Health Care, Integrated↗

PubMedDate not supplied

Web-based radiology: a future to be created.

The impact of Internet on Medicine and Surgery is certainly remarkable, however the influence it had on Diagnostic Imaging was even stronger. The standardization of digital images acquired by the different medical imaging equipment has further facilitated the diffusion, transmission and communication in radiology within hospitals as well as on WEB. Radiology departments are bound to become "filmless" and with the present "tablet PC" radiological images will be directly transferred to the patient's bed in the relative electronic patient report. For radiology, interactive education could be envisaged with a tutor who guides the student(s) through the network. The Internet is an inexhaustible source of radiologic educational and information material with a number of sites of clinical cases, tutorial and teaching files, journals and magisterial lectures on-line. In a near future, the Internet could be applied in the simulation of clinicoradiologic cases or in applications of artificial intelligence with expert systems to support the solution of most complex cases.

Analog-Digital Conversion↗

PubMedDate not supplied

Diagnostic imaging and therapy in a case of myasthenia gravis associated with thymic hyperplasia.

The diagnostic approach to a patient with myasthenia gravis to verify the presence of thymic hyperplasia/thymoma is presented. The study of the mediastinal region was necessary. Mediastinal MRI showed the presence of a mass. The differential diagnosis between a mediastinal and an extramediastinal lesion is possible with MRI for its high contrast resolution, good spatial resolution and multiplanarity that allow the detection, localization, evaluation of the extent and/or infiltration of adjacent tissues/organs based on the analysis of adipose cleavages and typing in the different pulse sequences of pathologic tissue with contrast enhancement. Definitive diagnosis of thymic hyperplasia was established. Therefore surgery should be essentially associated with the severity of the clinical presentation rather than with thymic hyperplasia.

Diagnostic Imaging↗

PubMedDate not supplied

Diagnostic imaging of the digestive tract. Reasoned approach to a duodenal filling defect.

A case of a patient with sideropenic anemia of suspected gastrointestinal origin is presented. A radiologic study of the upper digestive tract was performed. It documented a duodenal filling defect giving rise to an analytic discussion throughout various perceptive-interpretative logical steps: the image reality, the formation of the filling defect image and its nature. The radiologist's conclusions supported the presence of a benign submucosal neoformation to be treated with surgical resection for its size and for the patient's clinical conditions.

Anemia, Iron-Deficiency↗

PubMedDate not supplied

Diagnostic imaging of the diabetic foot. What the clinician expects to know from the radiologist....

A case of diabetic foot in a patient with advanced diabetes is presented. The correct diagnostic approach was analyzed based on the reasoned combination of available diagnostic imaging procedures (color-Doppler US, CT-angiography, MR-angiography and digital subtraction angiography) and on the clinician's instances. Angiographic findings contraindicated intravascular treatment. Femorotibial surgical bypass was performed.

Diabetic Foot↗

PubMedDate not supplied

Lung metastases from rectal adenocarcinoma: about the best diagnostic strategy.

A case of suspected lung metastases from colorectal adenocarcinoma is discussed. A diagnostic approach for follow-up of resected patients is proposed. It includes available diagnostic imaging for the characterization of metastatic pulmonary nodules together with methods for the differential diagnosis between primary malignant nodules and benign nodules.

Adenocarcinoma↗

PubMedDate not supplied

Diagnostic imaging of hyaline membrane disease.

The case of a premature infant with hyaline membrane disease (respiratory distress syndrome) is discussed. On chest X-ray reduced volume and transparency of both lungs with ground-glass appearance and presence of bilateral air bronchogram was visualized. These findings are analyzed with respect to possible diagnostic alternatives.

Diagnosis, Differential↗

PubMedDate not supplied

Diagnostic approach to a rare case of osteoid osteoma of the astragalus.

A rare case of osteoid osteoma of the ankle of the left foot is discussed. Standard X-ray and MRI were negative. Triphasic bone scintigraphy followed by CT were performed. Combined clinical CT and scintigraphy findings were highly suggestive of osteoid osteoma. This diagnosis was confirmed on histology.

Bone Neoplasms↗

PubMedDate not supplied

DWI and MR-spectroscopy in the differential diagnosis of focal brain lesions.

The case of a patient with a previous history of cerebral infarction, shown to be positive for a brain neoformation on control CT, is presented. Subsequent MRI for an in-depth diagnostic study was completed with DWI and MR spectroscopy to define the nature of the lesion. The differential diagnosis of the lesion is discussed. In conclusion, the major diagnostic role of combined standard MRI with DWI sequences and MR-spectroscopy in the radiologic study of focal brain lesions, is stressed.

Aged↗

PubMedDate not supplied

Mucinous metastases from occult breast carcinoma.

The case of a 34-year-old female patient come to the Emergency Department for neurological symptoms of recent onset is presented. No-contrast CT documented the presence of a neoformation approximately 3 cm in size in the 4th ventricle. For an in-depth diagnostic study of the lesion contrast enhanced MRI was performed. The examination detected a second minute (< 1cm) intraparenchymal nodule highly suspicious of metastasis from primary extra-cerebral neoplasm. The differential diagnosis of infratentorial lesions is discussed. It is concluded that the diagnostic combination of standard MRI with contrast sequences in the three conventional planes plays a major role in typing the nature of focal brain lesions.

Adenocarcinoma, Mucinous↗

PubMedDate not supplied

Diagnostic approach to a persistent anterior knee pain.

The case of a 67-year-old female patient with persistent pain in the right anterior knee appeared after she had an accidental fall, is discussed. Laboratory tests and imaging were negative. Persistent pain required MRI. Based on MRI findings the diagnosis of patellar fracture responsible for knee pain could be established.

Accidental Falls↗

PubMedDate not supplied

Combined diagnostic imaging in a patient with Forestier disease and dysphagia.

The case of a patient with dysphonia and ingravescent dysphagia, associated with crises of lipothymia "ab ingestis" is discussed. ENT examination with videolaryngoscopy evidenced a swelling of the posterior hypopharyngeal wall. X-ray study of the upper digestive tract was discontinued for inhalation. The scintigraphic study of swalling documented marked alteration of the oropharyngeal phase with phenomena of post-deglutitory aspiration. CT of the cervical vertebral column documented anterior diffuse vertebral hyperostosis of C3-C6: this finding was suggestive of Forestier disease.

Aged↗

PubMedDate not supplied

Obstructive jaundice.

The case of a 67-year-old male patient affected by ingravescent obstructive jaundice, calcific choledocholithiasis and cardiopathic hypertension, is presented. On sonography, marked dilatation of intra- and extrahepatic bile ducts with a hyperechoic round neoformation was visualized. CT was performed to ascertain the nature of the lesion. However, it did not confirm the lithiasic nature of the stenosis. Sampling for ERCP was inadequate. Cholangiopancreatography was therefore necessary to establish a correct diagnosis and the subsequent therapeutic approach. Distal choledochal obstruction was evidenced, suspicious for lithiasis obstruction. A definitive diagnosis could not be established on exclusive imaging findings. Surgery was performed with the diagnosis of cholangiocarcinoma with lithiasis.

Aged↗

PubMedDate not supplied

Reasoned approach to multiple osteosclerotic lesions. Combined diagnostic imaging in a case of osteopoikilosis.

The case of a female patient who had undergone mastectomy for infiltrating ductal carcinoma and come to the Orthopedics Division for lumbosacral pain unresponsive to conventional treatment is discussed. Pelvic X-ray, CT and scintigraphy were performed. The presence of multiple areas of selerosis of the pelvis and proximal femurs were documented. The differential range could be limited to osteoblastic metastasis and osteopoikilosis. The diagnosis of osteopoikilosis was established based on scintigraphy which proved the absence of uptake of the radiotracer.

Adult↗