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R Dore

Publications and source records attributed to R Dore.

At least 19 recordsLinked to original sources
PubMed1992

The clinical value of computed tomography and lymphography in detecting lymph node metastases from epithelial ovarian cancer.

We investigated the accuracy of both lymphography and computed tomography (CT) in detecting lymph node metastases in 58 patients with primary epithelial ovarian cancer (group a) and subsequently submitted to surgery including pelvic and/or lumbo-aortic lymphadenectomy. CT accuracy was also investigated in 41 patients with clinically suspected relapse of ovarian cancer (group b). In the first group (a) overall results in the pelvis were, respectively, for lymphography and CT: 94.8 vs 89.6% accuracy, 85.7 vs 57.1% sensitivity, 97.7 vs 100% specificity, 97.7 vs 100% positive predictive value and 95.5 vs 88% negative predictive value. In the lumbo-aortic region, we had: 88.8 vs 86.1% accuracy, 71.4 vs 64.2% sensitivity, 100% specificity and positive predictive value for both techniques, and 84.6 vs 81.6% negative predictive value. In the second group (b) CT accuracy, sensitivity and specificity were 90.2, 80 and 100%, respectively. CT, thanks to its high specificity and positive predictive value, can represent the method of choice for the evaluation of pelvic and lumbo-aortic lymph node metastases in untreated and relapsing ovarian cancer. CT demonstration of lymph node metastases can affect not only lesion staging, but also chemotherapy; different indications for lymphadenectomy may also depend on CT.

Adult↗
PubMed1992

[Computed tomography and tumor markers as diagnostic alternatives to second-look surgery in the treatment of malignant ovarian tumors].

Advanced malignant ovarian cancers are treated, after initial surgery, with first-choice mono/polychemotherapy, the response to which is evaluated by means of second-look laparotomy. The poor prognostic value of second-look results, the incidence of false negatives, the lack of valuable second-choice therapies, and the high incidence of complications after repeated interventions, lead to the testing of diagnostic imaging modalities--especially CT and tumor markers (Ca 125 and Ca 15-3). To define their actual clinical value, CT and serum assays of Ca 125 and Ca 15-3 have been performed on 32 treated patients affected with ovarian cancers (stages II-IV), who were clinically free of disease. The results have been compared with second-look pathology, but especially with patient follow-up (min. 24 months). Second-look laparotomy yielded a high number of false negatives (9/22 = 41%); moreover, many important/severe complications were observed. Thus, its value appears to be questionable. CT exhibited high positive predictive value (76.9% over the 24-month follow-up); high for both Ca 125 and Ca 15-3 (100% respectively, at 24-month follow-up) thus, few false positives were observed. Moreover CT, having higher sensitivity (55.5%) than Ca 125 (11.5%) and Ca 15-3 (27.7%), has greater diagnostic capabilities, especially when the lesion is in extraperitoneal location.

Aged↗
PubMed1991

[Computerized tomography versus lymphography in the assessment of lymph node metastasis in epithelial carcinoma of the ovary].

We investigated the accuracy of both lymphangiography and CT in detecting lymph node metastases in 59 patients evaluated preoperatively and subsequently submitted to surgery with selective/systemic pelvic and paraaortic lymphadenectomy. CT accuracy was also investigated in 46 patients with a clinically suspected relapse of ovarian cancer (verified by means of clinical and/or CT follow-up in 36 patients, by laparotomy in 7, by fine-needle biopsy in 1 and by necroscopy in the last 2). In the first group (previously untreated patients) the overall results in the pelvis were, respectively, for lymphangiography and CT: 94.9% vs 89.8% accuracy, 86.6% vs 60% sensitivity, 97.7% vs 100% specificity, and 92.8% vs 100%, 95.5% vs 88% positive and negative predictive values. In the paraaortic region the results were: 89.1% vs 86.5% accuracy, 73.3% vs 66.6% sensitivity, 100% specificity for both techniques, 100% positive predictive value, and 84.6% vs 81.5% negative predictive value. In the second group (clinically suspected relapse), CT accuracy, sensitivity, and specificity were, respectively: 91.3%, 81.8%, and 100%. Our experience demonstrated a high incidence of lymph node metastases in ovarian cancer, both in pelvic (15/49; 25.5%) and especially in aortic (15/37; 40.5%) locations in untreated patients, and an even higher incidence in relapses (22/42; 52.5%). The high specificity and positive predictive value of CT depended on the fact that there were no false positives. We arbitrarily considered as metastatic a lymph node with phi greater than 2 cm, and this threshold seemed to be of clinical value since it made a good predictor of metastases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Serous carcinoma of the ovary: value of computed tomography in detection of calcified pleural and pulmonary metastatic implants.

Reported are three cases of serous papillary cystoadenocarcinoma of the ovary with pleural and pulmonary calcified metastatic implants detected by computed tomography (CT), but not by chest X-ray. CT patterns of metastatic calcifications were considered because of the unexpected frequency of this finding (15.7%) and in view of a possible clinical use of CT in monitoring extraabdominal disease.

Adult↗
PubMed1990

[Pseudoaneurysm of the left ventricle. Description of a clinical case].

The paper describes a case of pseudoaneurysm of the left ventricle following an earlier operation to close a post-infarction interventricular defect. The nosological entity is described paying particular attention to preoperative functional tests and intraoperative anesthesiological procedures. The careful monitoring of refilling pressure and cardiac load represents an essential for the correct infusion of drugs and optimal volemic refilling.

Heart Aneurysm↗
PubMed1990

[Lymph node metastasis of carcinoma of the cervix uteri. Role of lymphography and computerized tomography].

The presence of lymph nodal metastases in the patients affected with carcinoma of the uterine cervix is of the utmost clinical relevance. In the Radiology, Obstetrics and Gynecology Departments of Pavia University we have evaluated the accuracy of lymphangiography and CT in recognizing lymph nodal metastases in 95 patients, 58 of them evaluated preoperatively (49 subsequently submitted to radical hysterectomy). CT accuracy was also evaluated in 37 patients with a clinically suspected relapse of cervical cancer. In the first group the overall results were: 91% accuracy, 88% sensitivity, 92.5% specificity for lymphangiography and 87.9% accuracy, 72.2% sensitivity, and 95% specificity for CT (in 49 patients, stage I-II, submitted to lymphadenectomy, lymphangiographic accuracy was 91%, sensitivity was 88%, specificity 92% versus CT accuracy 85.7%, 44.4% sensitivity, and 95% specificity). In the second group (relapse) CT accuracy, sensitivity and specificity were 94%, 100%, and 91%, respectively. In conclusion, lymphangiography gives better results than CT in the patients with early stages (I-II) of the disease. In advanced stages and relapses CT was found to have high accuracy in demonstrating lymph node status. This information is useful for treatment planning and for avoiding unnecessary surgical exploration.

Adult↗
PubMed1990

Computed tomography of cystic lymphangioma in a wandering spleen.

A large cystic lymphangioma in a wandering spleen was discovered by chance in a young woman, 2 months after she delivered her first child. The clinical finding was that of a pelvic mass, which at CT was found to be a wandering spleen, containing multiple cystic lesions. The diagnosis of cystic lymphangioma was made at the pathological examination of the specimen after splenectomy. The association of cystic lymphangioma in a wandering spleen has not been reported previously.

Adult↗
PubMed1989

Clinical value of computerized tomography (CT) in assessment of recurrent uterine cancers.

Fifty-one patients with a clinically suspected relapse of uterine cancer were evaluated with computerized tomography (CT) in the Departments of Obstetrics/Gynecology and Radiology of the University of Pavia. The accuracy of these scans was always compared with biopsy results (31 cases) or clinical outcome (20 cases). To evaluate the role CT played in the treatment of each patient we divided the results of these examinations into "Confirmative" (when there was clinical evidence of a tumor) and "Diagnostic" (when physical examination and conventional radiologic techniques were inconclusive). Overall diagnostic accuracy was 92%, specificity 80%, and sensitivity 92%. The authors found that CT provides information that is useful for planning treatment and for avoiding unnecessary surgical exploration when a tumor is clinically evident; furthermore, CT was found to be better than conventional diagnostic means in doubtful cases, especially those in which post-therapeutic pelvic fibrosis was not extensive (correct diagnosis is 15 of 19 cases).

Adult↗
PubMed1988

Unusual CT features in ruptures of abdominal aortic aneurysms.

The authors present two cases of impending rupture of abdominal aortic aneurysms correctly diagnosed by means of some unusual CT findings. The clinical signs were not clear. On CT examination, despite the absence of haematomas, minor, but precise, changes allowed the correct diagnosis: loss of definite contours of the aneurysm, non-homogeneous peri-aortic and peri- and para-renal adipose tissue, thickening of the renal fascia and a thin fluid collection over the psoas muscles.

Acute Disease↗
PubMed1988

[Ovarian dermoid cysts. Radiographic fat floating sign and CT diagnosis of chronic rupture].

Unsuspected chronic rupture was discovered during surgical removal of a very large ovarian dermoid cyst. Abdomen X-ray, US and CT examinations were preoperatively performed. Standing X-ray projection of the abdomen allowed the appearing of a new radiographic finding of dermoid cyst, the "fat floating" as the equivalent of the "gravity dependent layering" in US and CT features. This radiographic sign appears as an horizontal line between two soft tissues of different opacity; it is caused by oily and sebaceous fluid floating over serous fluid and over intracystic debris. Literature was reviewed and radiographic findings in dermoid cysts were reconsidered; the sign of "fat floating" could enhance the diagnostic accuracy of abdomen X-ray. So when a pelvic or an abdominal-pelvic mass is discovered in a young woman, standing projection is required for abdomen X-ray. Rupture of a dermoid cyst may happen without notice and chronically; CT has been more accurate than US in evaluating rupture, in particular the peritoneal spread of oily pseudocyst.

Adult↗
PubMed1988

[Computerized tomography in surgically treated lumbar disk hernia. Multicenter study].

Results are reported of a multicenter analytic-statistical CT study on 128 postoperative lumbar herniated disk (HD) cases (50 at L4-L5, 64 at L5-S1, 2 at L3-L4, 12 multiple). CT was performed from 10 days to 204 months (47.7 months of mean) after surgery, in 51 patients without and in 77 with intravenous contrast medium (42 in bolus, 35 in perfusion). In 59 cases (38%) a recurrent hernia was found, and in 8% a new hernia. In 81% of patients epidural fibrous scars were demonstrated, in a rough 50% of cases associated with recurrent/new hernia: posterior fibrosis was found in 81% of cases, while unilaterally, bilaterally, or anteriorly extended fibroses were present in 20%, in 4.7%, and in 29% of cases respectively. In 72% of the patients injected with contrast medium, various kinds of fibrosis contrast enhancement were detected. In 8% neither fibrosis nor recurrent herniation was found. In 22% of cases lateral and/or central bony canal stenosis was present, in 26% vacuum disk, in 9% intracanalar calcifications, in 39% and in 19.5% dural sac stretching and compression respectively. In 5 cases a pseudomeningocele was found, and in 3 only a postoperative diskitis. Fibrosis is an almost inevitable postoperative consequence (4 out of 5 cases); it can be demonstrated by CT with high sensitivity and good specificity. A series of diagnostic criteria, such as the post-contrast media reaction, allow fibrosis to be discriminated from recurrent hernia. However, the possible association must be kept in mind of both diseases and/or of included roots in the scar. Myelography is hardly ever able to supply further resolutive diagnostic elements, while Myelo-CT is sometimes more useful. The importance of bone changes is questionable, with the exception of evident cases of canal stenosis, also because in most cases the radiologist cannot count on a preoperative CT study. Furthermore, the correlation between CT and clinical findings (possible asymptomatic fibrosis) is often difficult, which gives way to contrasting therapeutic attitudes.

Adult↗
PubMed1987

[Thrombosis of the false lumen in acute aortic dissection. CT diagnosis].

Three cases are reported of acute aortic dissection with complete thrombosis of the false channel, which is a very uncommon event in De Bakey's I and II type aortic dissections. The 3 patients entered hospital because of severe thoracic pain without any ECG sign of myocardial infarction. Emergency CT showed evidence of pericardial effusion suggesting hemopericardium, enlargement of the ascending aorta and a peripheral semilunar filling defect which caused a slight deformation of the true channel. On precontrast scans, only one case showed inward displacement of peripheral intimal calcifications and high-density aortic wall. No typical signs of aortic dissection were reported, except in the first patient--where a double contrast filled lumen, separated by an intimal flap was seen. CT findings are individually discussed. It is emphasized that in all patients more than one CT sign was present at a time. The correct evaluation of these signs together with the clinical data could lead to the right diagnosis of aortic dissection in spite of the lack of a filled false channel.

Acute Disease↗
PubMed1987

[Quantitative computerized tomography of the vertebral spongiosa. Proposal of a method applicable to the study of postmenopausal osteoporosis].

A Quantitative Computed Tomography (QCT) method, simplifying the well-known technique proposed by Genant (1982) and applied to a standard third generation whole body CT scanner is described. This technique was applied in the measurement of the trabecular bone which has high sensitivity for metabolic changes. The BMC (Bone Mineral Content) measured in different groups of subjects (healthy postmenopausal patients versus women with postmenopausal osteoporosis) showed a highly significant difference (p less than 0.001). The precision of repositioning (coefficient of variation 1.8% to 2.3%, obtained in healthy male patients) and the good, linear relationship computed from the phantom values, minimize measurement errors. Since this method is quickly applied and involves low-dose radiation-exposure, it could be introduced in the clinical study of metabolic bone diseases.

Female↗
PubMed1986

[Updating the diagnosis of neonatal cerebral pathology. Comparison of ultrasonic diagnosis and CT x-ray in hemorrhage-ischemia-anoxia].

The authors compare the accuracy of Ultrasound and Computed Tomography in the diagnosis of hypoxic-ischemic brain damage and intracranial haemorrhage in 25 newborns with respiratory distress syndrome. Both examinations are performed at a maximum interval of 48 hours, within the first 8 days of life, and lately, after the third week. The results allow the introduction of a diagnostic protocol.

Age Factors↗
PubMed1986

[Serous-papillary carcinoma of the endometrium. Usefulness and limitations of computerized tomography].

The staging of endometrial carcinoma and the evaluation of tumor recurrences take advantage from Computerized Tomography (CT). The CT appearances are described of six new cases and two recurrences of uterine papillary serous carcinoma (UPSC), which is a particularly aggressive and rare form of endometrial carcinoma. CT has been scarcely useful in first clinical stages, while in advanced stage and when the tumor appears as a pelvic mass CT has allowed to recognize the uterine origin, to define the involvement of surrounding tissue and to depict the extrauterine spread patterns. CT has been extremely useful in the evaluation and in the search for tumor recurrences.

Carcinoma, Papillary↗
PubMed1985

[Rapid identification of Enterobacteriaceae: evaluation of 3 commercial systems].

We have compared three rapid systems for the identification of Enterobacteriaceae: MS-2, Rapid 20E, Micro-ID. These methods allows to identifications of bacteria within 4-5 hours. We have chosen API 20E as reference system; because it is normally used in the clinical microbiology laboratories. We have noted good agreement of concordance for MS-2, Micro-ID and Rapid 20E towards API 20E, respectively 95, 90, 84%. We have, moreover, analysed significative difference about three systems biochemical tests in comparison with the same of API 20E.

Enterobacteriaceae↗