Biomedical subjects

R Nessi

Publications and source records attributed to R Nessi.

At least 37 records · Page 2Linked to original sources

PubMed1989

Ultrasonic diagnosis of Osgood-Schlatter and Sinding-Larsen-Johansson diseases of the knee.

High resolution ultrasonography of the knee was performed on 82 young patients with clinically suspected Osgood-Schlatter disease and on 30 normal subjects; in 45 pathological cases (55%) comparative X-ray films were taken. The ultrasound pictures were equally or more effective than X-ray images in 45/45 cases; their value was particularly marked for soft tissue study. The typical sonographic changes of the ossification center, of the cartilage, and of the surrounding soft tissues are described and classified, both for Osgood-Schlatter and for Sinding-Larsen-Johansson diseases. These signs are based mainly upon cartilage swelling and edema, fragmentation of the ossification center, thickening of the patellar tendon, and bursitis of the infra-patellar bursa. Ultrasonography is proposed as a simple and reliable method for the diagnosis of knee joint osteochondrosis. The ultrasound picture is also suitable for periodical follow-up the course of the disease.

Adolescent↗

PubMed1988

Dynamic ultrasonography of capsulo-ligamentous knee joint traumas.

Ultrasonography was performed on 10 patients with acute posttraumatic conditions of the knee in which X-ray films could exclude the presence of fractures. In 2 of 10 cases, the sonographic picture was normal; in the remaining 8 patients, ultrasonography disclosed capsulo-ligamentous lesions of different degrees of severity that were confirmed by surgery in 5 of 8 cases. The main sonographic signs of articular traumas were abnormal widening of the joint space (7 cases), intra-articular hemorrhage (8 cases), rupture of the medial collateral ligament (4 cases), or irregularity of its structure (3 cases). Ultrasonography is proposed as an effective and simple first-line method for the study of knee joint traumas. It can be performed in all cases presenting with painful joint swelling without radiographical evidence of fractures.

Humans↗

PubMed1988

Ultrasonographic evaluation of Peyronie's disease.

High-resolution ultrasonography was performed on 58 patients with Peyronie's disease and on 6 healthy men; in 3 patients the examination was repeated during medical treatment for a follow-up period of 4 months. Peyronie's plaques always corresponded to abnormal echographic findings. In 54/58 cases (93%) they appeared as hyperechoic lesions. In 4 cases (7%) the plaques were hypoechoic and corresponded to a localized widening of the pericavernous tissues: this condition was observed more frequently in the earliest stages of the disease. There was good agreement between the palpable size of the plaques and their size measured by ultrasonography, with some degree of clinical overestimation of the smallest lesions. Calcified mature plaques corresponded to dense hyperechoic lesions with acoustical shadowing. High-resolution ultrasonography is proposed as a first-line diagnostic approach and as a reliable follow-up examination for Peyronie's disease. The possibility of differentiating calcified plaques from the more recent ones is helpful to allow a correct choice of medical or surgical treatment.

Humans↗

PubMed1988

Detection of foreign bodies in soft tissues: experimental comparison of ultrasonography and xeroradiography.

The value of xeroradiography and of high-resolution ultrasonography was compared on minute samples of foreign bodies of various radiographic density (wood, plastic, metallic wires and needles, glass, fish bones). The samples were introduced into pieces of veal meat at different angles with respect to the surface. Xeroradiographic images were taken at 60 kVp, with 32 mAs, and were developed in both positive and negative mode. The echographic examinations were performed using a real-time sector 10 MHz probe placed directly over the specimen, with constant gain rates. The results confirm the value of xeroradiography and demonstrate the effectiveness of high-resolution ultrasonography for the detection of minute foreign bodies. Some materials showed a peculiar echographic pattern, like sand, that corresponded to a frank acoustic shadow, or like metal and glass, showing a comet tail of reverberation artifacts. Wood and fish bones were well outlined, while plastic was less effectively represented. High-resolution ultrasonography is considered to be a first-line technique in searching for many kinds of minute foreign bodies, to be used in combination with xeroradiography in routine clinical examination.

Animals↗

PubMed1987

High-resolution ultrasonography of wrist ganglia.

High-resolution ultrasonography was performed on 14 patients with soft tissue swelling of the wrist and hand. The examination was done using a real-time 10-MHz sector probe placed directly on the lesion. The sonographic image could always demonstrate the liquid nature of cystic lesions. In recent ganglia, the fluid content was anechoic, and the cystic walls were rather thin; in some older lesions, irregular internal echoes and thicker walls were found. Rather often, multiple ganglia were observed, grouped in clusters. The presence of a liquid-filled duct directed to the articular space was demonstrated in 8/11 cases (73%). This finding is considered a diagnostic characteristic of ganglia, and it is very useful for correct surgical planning. In extensor cystic tenosynovitis, the echographic picture was quite different: the anechoic cavity was longitudinal in shape, following the tendon sheath, and the communicating duct was absent. Finally, the sonographic pattern of one case of de Quervain's disease was analyzed and discussed.

Adult↗

PubMed1987

Digital angiography of erectile failure.

Digital angiography of pudendal and penile arteries was performed in 44 consecutive patients with erectile failure of suspected vascular origin. Intra-arterial injection of contrast medium via selective catheterisation of the hypogastric arteries was used in six cases. In 39 patients, one of whom had already had arterial catheterisation, contrast medium was administered by the intravenous route, using a single, large volume, high speed bolus. In 12/44 cases (27%), digital angiography showed a normal vascular picture at the pudendal and penile level but the remaining 32 patients (73%) had steno-occlusive lesions of different degrees of severity. The pictures obtained after administration of intravenous contrast were diagnostically as good as the studies with selective arterial catheterisation. In addition, the intravenous route allowed the simultaneous representation of the arterial network on both sides and was quicker and less invasive. In 31/44 patients (79%), functional determinations of nocturnal penile tumescence and of penile blood flow with Doppler ultrasonography were performed for comparison. Nocturnal penile tumescence results correlated well with the angiographic picture. Penile blood flow measurements with the Doppler technique were less sensitive than digital angiography.

Adult↗

PubMed1987

[Echocardiographic gating in non-cardiac digital angiography].

This paper reports the results of the ECG-gating in non-cardiac digital subtraction angiography (DSA). One hundred and fifteen patients underwent DSA (126 examinations); ECG-gating was applied in 66/126 examinations: images recorded at 70% of R wave were subtracted. Artifacts produced by vascular movements were evaluated in all patients: only 40 examinations, carried out without ECG-gating, showed vascular artifacts. The major advantage of the ECG-gated DSA is the more efficient subtraction because of the better images superimposition: therefore, ECG-gating can be clinically helpful. On the contrary, it could be a problem in arrhythmic or bradycardic patients. ECG-gating is helpful in DSA imaging of the thoracic and abdominal aorta and of the cervical and renal arteries. In the examinations of peripheral vessels of the limbs it is not so efficient as in the trunk or in the neck.

Adult↗

PubMed1986

[Peripheral stenosing-occlusive arteriopathies. Doppler echographic and digital angiographic evaluation].

The value of Doppler ultrasound examination and digital intravenous angiography was comparatively evaluated in 207 patients with peripheral vascular disease submitted to both techniques. Owing to the fact that in some patients more than one vascular district was examined, the overall number of evaluations was 232 Doppler ultrasounds and 233 digital angiographies. Doppler ultrasound revealed a normal picture in 18/232 cases, steno-occlusive disease in 186/232 cases and various pathological conditions in the remaining 18 cases. With digital angiography, normal vascularity was observed in 33/233 patients, while steno-occlusive disease was present in 164/233 and vascular anatomical abnormalities, like kinking, were found in 20 cases. Doppler/angiographical correlation was fairly good, being complete in 83/207 patients and substantial (i.e.: the same diagnosis but different degree of pathological involvement) in 79 additional cases: the overall diagnostic agreement between Doppler and angiography was 162/207 cases (78%). False negative Doppler results were 29/207, while the false positive Doppler examinations were 16/207. The most common causes of diagnostic errors are evaluated and discussed, both for Doppler ultrasound and for digital angiography. Arterial kinking and vascular abnormalities are recognized as an obvious cause of wrong Doppler diagnoses which can be easily discovered by the angiographic picture. The usefulness of performing both techniques in combination is demonstrated and stressed.

Angiography↗

PubMed1986

[Postoperative intravenous digital angiography of the carotid].

Intravenous digital angiography was performed in 55 patients previously submitted to carotid endarterectomy. The angiographic examination was performed in asymptomatic subjects in 43/55 cases, as a routine procedure. In 12/55 cases (22%) the examination was performed following an ischemic recurrency. In 27 patients (49%), digital angiography was repeated before and after surgery, giving the opportunity of a serial evaluation of the vascular pattern. The angiographic findings in the site of operation was normal in 49/55 patients; in 6 patients (12%) steno-occlusive recurrencies were observed. In 21/55 cases (38%) carotid stenosis on the opposite side was demonstrated, owing to the pan-angiographic effect of intravenous contrast administration: among these cases, 18 appeared angiographically normal at the operation site. The clinico-angiographical correlation resulted fairly good (41/55-75%), taking into account the fraction of patients with contralateral carotid stenosis and neurological symptoms. Intravenous digital angiography is proposed as a first-choice diagnostic procedure for the follow-up after carotid surgery.

Arteriosclerosis↗

PubMed1985

[Intravenous digital angiography of pulmonary circulation].

Intravenous digital angiography was performed in 92 patients with pulmonary diseases. The examination yielded satisfactory results in 82/92 cases (89%). The most promising fields of application of pulmonary digital angiography are: vascular malformations (3 cases: 3%), pulmonary emphysema (24 cases: 26%) and pulmonary embolism (38 cases: 41%). In tumoral masses (14 cases: 15%) digital angiography showed dislocation of the surrounding pulmonary vessels but failed to demonstrate the intrinsic vascularity of the mass, deriving from the bronchial arteries. In post-lobectomy controls (10 cases: 11%) the examination gave a good demonstration of the absence of vascular supply at the site of the previous surgery. Intravenous digital angiography shows many technical limitations, namely a reduced resolution power and a small field of view; in addition, it requires patient immobility, which results sometimes impossible in critically ill patients. In spite of these inconvenients, however, intravenous digital angiography appears to be an important diagnostic step for the evaluation of pulmonary embolism and vascular malformations: in these conditions, digital angiography can be the procedure of choice.

Angiography↗

PubMed1984

[Digital angiography of the pudendal arteries in erectile impotence].

Digital angiography of pudendal and penile arteries was performed on 32 consecutive patients with erectile failure of suspected vascular origin. Intra-arterial injection of contrast medium via selective catheterization of the hypogastric arteries was used in 6 cases. In 27 cases, one of which already submitted to arterial catheterism, the intravenous route was employed for contrast administration, using a single, large volume, high speed bolus. In one case, digital angiography was diagnostically unreliable due to patient's motion and to blurring artifacts. Among the remaining cases, 9/31 (29%) showed a normal angiographic picture, while 22/31 (71%) possessed stenotic-obstructive lesions of different severity. The pictures obtained after intravenous contrast administration were diagnostically equivalent to those obtained with arterial catheterism: in addition, intravenous route allowed the simultaneous representation of the arterial network of both sides and the overall examination resulted less invasive and quicker. In 22/32 patients (69%), functional determinations of erectile capability and of penile blood flow were performed for comparison. Nocturnal penile tumescence (12 cases diagnostically useful) was well correlated with the angiographic picture. Penile blood flow measurements with the Doppler technique (21 cases) seemed on the contrary to be less sensitive than digital angiography.

Adult↗

PubMed1984

[Xeroradiography in the evaluation of surgical scars and in research on recurrence of sarcomas in soft tissues].

Xeroradiography was performed for the follow-up of 182 patients operated for soft tissues sarcomas. In 63/182 cases, xeroradiographic examination was repeated twice or more times during the course of years, so that the overall amount of diagnostic evaluations reached the number of 283 useful examinations. In 115/182 cases the presence of a neoplastic recurrency was demonstrated on histopathological or clinical grounds; in the remaining 67/182 cases no evidence of tumoral growth was found. The xeroradiographic diagnosis of neoplastic recurrencies was correct in 271/283 evaluations (95,75%). The false negative diagnosis were prevailing (11/283 = 3,9%), while only 1/283 false positive result occurred (0,35%). The xeroradiographic features of surgical scars within soft tissues are discussed and the semeiologic landmarks of neoplastic recurrencies are outlined.

Cicatrix↗

PubMed1984

[Tietze's syndrome. Xerographic contribution].

Xeroradiography of the anterior thoracic wall was performed on 7 patients with Tietze's syndrome. This technique gave a good representation of the rib cartilages which are enlarged in this disease. The complete imaging of all the structures of the thoracic wall allowed also to exclude other possible causes of soft tissue swelling, tumoral growths as first. Xeroradiography is held to be a first-choice examination in Tietze's syndrome.

Adult↗

PubMed1983

Lack of efficacy of xeroradiography to preoperatively detect axillary lymph node metastases in breast cancer.

Xeroradiography of the axilla was performed in 132 patients with operable breast cancer to investigate the status of the axillary lymph nodes. Pathologic findings were correlated with the results of clinical examination and xeroradiographic findings. Xeroradiography does not appear to have improved our ability to identify axillary lymph node metastases in patients with breast cancer.

Axilla↗

PubMed1983

[Xeroradiography of axillary lymph nodes in patients with tumors of the breast].

The use of axillary xeroradiography for the detection of lymph node metastases from breast cancer was evaluated on 125 consecutive patients submitted to surgery and to axillary dissection. The clinical and xeroradiographic aspect of lymph nodes was related to their histological diagnosis. Axillary xeroradiography was useful in predicting the metastatic involvement of lymph nodes in a fair good percent of cases, but it gave sometimes unpredictable results due to the superimposition of superficial soft tissues and to the lack of reliable diagnostic criteria. For these reasons, axillary xeroradiography cannot be used as a primary procedure before surgery is performed, and the xeroradiographic diagnosis cannot be assumed as the unique prognostic factor in predicting the metastatic spread of the tumour. This technique may prove useful, however, for the study of the axilla in obese patients and for the evaluation of the size and of the relationships of an axillary mass.

Axilla↗

PubMed1983

[Role of teletermography in the diagnosis of primary tumors of soft tissues and bones].

The thermographic behaviour of bone and soft tissue tumors (168 malignant), submitted to this examination from 1971 to 1981, has been retrospectively analyzed and statistically evaluated. In the group of malignant neoplasms, thermography reached a good sensitivity (81.5%), a little better (but not significantly) in soft tissue tumors. Mainly three pathological features have been analyzed: histological type, size and site of neoplastic masses. None of them appears to be related with the result of thermographic examination. The authors emphasize (also from a possible prognostic point of view) the peculiar behaviour of Ewing's sarcoma, whose tendency to uniform distribution through the different thermographic classes cannot be currently explained.

Bone Neoplasms↗

PubMed1982

[Thermography in the follow-up of bone and soft tissue tumors].

Thermography was used for the follow-up of 16 cases of bone tumors and of 16 cases of soft tissue tumors, after conservative treatments (surgery and/or radio- and chemio-therapy). The hyperthermia, which corresponds to the primary tumor, underwent a marked reduction during the first six months after the treatment. The thermographic picture appeared normal at the first follow-up of 12/16 bone tumors and of 9/16 soft tissue tumors. The presence of local recurrencies, at 12 months distance or more, corresponded to a new hyperthermic spot and to the increase of local vascularity. Thermography is proposed as a simple and harmless procedure for the follow-up of bone and soft tissue tumors after conservative treatments.

Adolescent↗

PubMed1981

Xeroradiography of soft tissue tumors.

The main features of 300 consecutive cases of soft tissue tumors at xeroradiography were submitted to retrospective evaluation. The parameters assessed were: visibility, density, shape, size, outline and relationships of the lesions. The distribution of each parameter between benign and malignant tumors was evaluated by means of statistical analysis. The xerographic signs of malignancy of soft tissue tumors are reviewed and the typical features of some particular tumors are outlined.

Diagnosis, Differential↗