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R S Pozzi-Mucelli

Publications and source records attributed to R S Pozzi-Mucelli.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Comparative analysis of the technics of preoperative localization of the parathyroid glands].

Parathyroid surgery needs an appropriate diagnosis and a preoperative localization. We conducted a prospective study to compare the efficacy of 4 different imaging modalities in 17 patients: thallium-technetium subtraction scintigraphy, ultrasonography, computed tomography and arteriography. The sensitivity was: scintigraphy 58%, echotomography 86%, Tc 92% and arteriography only 33%. Neck exploration confirmed the imaging results. We found 15 cases of adenomas (2 cases of double adenoma) and 1 case of hyperplasia; in 1 patient, no lesions were found. We conclude that the association of such techniques appears to be the optimal strategy in about 100% of the patients.

Adenoma↗
PubMed1989

[CT study of the cervical spine with intravenous administration of the contrast medium].

Computed tomography (CT) without contrast medium is largely applied to the study of intervertebral disk pathology in the lumbar spine, but has not been widely accepted in the cervical spine, due to technical and anatomical limitations. For these reasons many neuroradiologists still prefer myelography or myelo-CT. CT may yield better results if combined with iv contrast medium injection, which allows a better visualization of disk herniation. This technique is aimed at enhancing the density of the venous plexus which is located close to the intervertebral disk, the vertebral bodies and the neural foramina. A better contrast enhancement is thus obtained between the disk and the spinal cord. The authors' experience is based on 61 patients who underwent contrast enhanced CT; in 22 cases myelography and myelo-CT were also performed. The authors describe their technique and the most frequent CT findings of disk herniation: the typical finding includes a focal hypodensity surrounded by a linear blush, due to a posteriorly dislocated epidural vein. The posterior linear blush alone may be present in few cases. Contrast-enhanced CT is very useful in the study of disk pathology of the cervical spine, even when compared with myelography and myelo-CT, due the increase in the density of epidural plexus it allows. However, the technique must be very accurate if the same results as those of myelo-CT are to be obtained.

Adult↗
PubMed1988

[Evaluation of mineral bone content using quantitative computerized tomography].

The authors have evaluated bone mineral content in the vertebral spongiosa by means of Computed Tomography. The method proposed by Genant and Cann has been applied to examine 164 healthy volunteers and 108 patients. Both healthy males and females showed a progressive bone mineral loss increasing with age; the bone mineral loss was most severe in females during the 4th and 5th decade of life. Pathology included patients with osteoporotic fractures (vertebral and femoral neck), patients with partial gastrectomy, renal failure, primary hyperparathyroidism, Cushing syndrome, corticosteroid therapy. Bone mineral values were significantly lower in most pathologic groups. Computed Tomography proves thus to be a valuable method to assess bone mineral content and to identify patients at risk for fractures.

Adolescent↗
PubMed1987

[Preprocessing programs of CT images for three-dimensional reconstruction].

Up to now three-dimensional reconstructions in computed tomography have been applied mainly to the skeleton. This limitation is due to technical difficulties when dealing with images of the soft tissues. In order to overcome these limitations three new softwares were developed, thus enabling the operator to pre-elaborate and modify the axial CT images. The first program allows the operator to isolate the lesion and/or the anatomical structures of interest from the surrounding areas. The second program eliminates the areas of isodensity with the lesion it is obtained by means of a trackball. The third program enables the operator to write the modified axial images on the original file. The lesion and/or the structures of interest can thus be processed more easily by the 3D reconstructive program. The new softwares have been applied to 3D reconstructions of brain lesions, and two significant cases are presented. Furthermore, since the new softwares can enhance the quality of 3D images of the skeleton, the programs were also tested in cases of acetabular traumas.

Acetabulum↗
PubMed1986

Bone mineral changes in primary hyperparathyroidism.

We studied 34 patients with primary hyperparathyroidism in order to assess their bone mineral status, to determine its relationship to biochemical parameters (serum calcium and parathyroid hormone) and surgical status, and to determine the relationship between peripheral cortical bone and spinal trabecular bone in this disease. These patients were studied with radiogrammetry of the metacarpals, Norland-Cameron photon absorptiometry of the radius, quantitative computed tomography (QCT) of the spine, industrial radiography of the hands, and conventional radiography of the thoracolumbar spine. We also calculated a spinal fracture index from thoracolumbar spine films. We found that the appendicular measurements correlated well together, but less well with spinal QCT. The spinal fracture index correlated best with QCT (r = -0.55), although significant dispersion was noted. We found that, in general, these hyperparathyroid patients had statistically significant decrements in bone mineral content in both the appendicular and the axial portions of the skeleton. However, the decrement in the appendicular skeleton did not correlate well with that in the axial skeleton. Therefore we conclude that it is necessary to measure both peripheral and central bone mineral content in order to reliably assess the skeletal demineralizing effects of primary hyperparathyroidism in an individual patient.

Adult↗
PubMed1985

Routine evaluation of arteriopathies of the lower extremities by digital subtraction angiography.

Intravenous digital subtraction angiography (DSA) was performed in 119 patients with lower extremity ischemia using a 14" amplifier. Four injections of contrast medium were usually necessary for a complete evaluation of this vascular region. Images of good quality were obtained in most cases; movement artifacts and a faint opacification accounted for any poor results, which occurred mainly under the knee. The technique of pixel shifting turned out to be very useful to remove movement artifacts. The "measuring field" allowed us to minimize the problem of the inhomo geneous saturation of the amplifier. In 8% of the cases an intra-arterial DSA has been performed after an unsatisfactory intravenous examination. Conventional angiography appears to be no longer necessary.

Aged↗
PubMed1984

The role of ultrasonography in the diagnosis of tumours of the renal pelvis.

The authors have evaluated 22 patients with renal pelvis tumour (RPT) by means of excretory urography and ultrasonography. Six patients also underwent arteriography. The value of the three investigations in the diagnosis of the lesion, the nature, the pyelic origin and the extension are presented. It is concluded that urography remains the method of choice for the evaluation of RPT while ultrasonography may be considered complementary to urography in cases of non-functioning kidney, when the urographic filling device defect is uncertain and in the differentiation between the pyelic or parenchymal origin of the tumour.

Angiography↗
PubMed1983

Ultrasonography in the diagnosis of hydronephrosis in patients with normal renal function.

In order to define the sensitivity and specificity of ultrasonography (US) in the diagnosis of hydronephrosis, 125 patients with normal renal function were examined after urography using high-resolution real-time scanning. The overall diagnostic accuracy of US in detecting hydronephrosis was 85.2%, with a specificity of 84.4% and a sensitivity of 89.9%. It is concluded that US may be considered the screening test of choice for the diagnosis of hydronephrosis. However, urography is still required for the evaluation of renal function, site, and nature of the obstruction when US shows a dilated collecting system and in the patient with a normal US but renal colic.

Diagnostic Errors↗
PubMed1982

Grey-scale ultrasonography in the evaluation of primary carcinomas of the bile ducts.

The authors report the echographic findings observed in 24 proven cases of primary carcinoma of the bile ducts. Most tumours, either vegetating or infiltrating with extraductile extension, were recognized on ultrasound. This technique turned out to be accurate in detecting peripheral, hilar and distal ductal carcinomas. Ultrasonography complements PTC and ERCP. Their combined use allows the surgeon a better selection of the cases and of the proper operative procedure.

Adenoma, Bile Duct↗
PubMed1982

Ultrasonographic aspects of inflammatory and neoplastic diseases of the gallbladder.

The authors present the incidence of the typical ultrasonographic signs of acute cholecystitis (46 cases), chronic cholecystitis (25 cases), cholecystosis (9 cases), empyema (28 cases) and carcinoma of the gallbladder (30 cases). Ultrasonography, together with the clinical picture, enables the identification of the lesion, its extension and evolution in most of the cases. Rarely do differential diagnostic problems exist. The ultrasonographic follow-up examination has been useful in acute inflammatory diseases to evaluate the efficiency of medical therapy and to detect complications which require immediate surgery. The authors emphasize the value of high-resolution real-time technique.

Adult↗
PubMed1982

Combined use of ultrasonography and transhepatic percutaneous cholangiography in obstructive jaundice.

The authors have evaluated the results of ultrasonography (US) and transhepatic percutaneous cholangiography (PTC) in 85 patients. The comparative results of US and PTC in the diagnosis of the level (proximal or distal) and the nature (benign or malignant) of the obstruction and in the evaluation of the extension and the site of the lesion are illustrated. PTC is superior in the evaluation of the level and the nature of the obstruction while US gives more information about extension and site of the lesion. It is concluded that US and PTC should be considered as two complementary modalities.

Cholangiography↗
PubMed1981

Computed tomography in the diagnosis of retroperitoneal fibrosis.

We report the findings on computed tomography (CT) in idiopathic and secondary retroperitoneal fibrosis in 7 patients. In all cases CT showed the fibrotic mass, accurately defining its extent and the involvement of adjacent anatomic structures. The densitometric and anatomopathologic aspects were correlated; contrast uptake was less in areas thought to be dense in collagen than it was in areas with more vascular regions of inflammatory change. CT assessed the extent and nature of the fibrotic plaque.

Absorptiometry, Photon↗
PubMed1981

[Ultrasonographic evaluation of jaundiced patients: accuracy in 246 controlled cases (author's transl)].

In 246 controlled jaundiced patients, the value of ultrasonography was confirmed. The differentiation of medical from surgical jaundice was 96% accurate. There was an increase in the overall accuracy due to technological developments and better scanning techniques. Nevertheless important diagnostic problems are still unresolved. Although the precise location of the obstructing lesion was determined in 86% of surgical case, the cause was established in only 69%. In medical jaundice diagnostic findings were observed only in congestive liver due to chronic heart failure and in some cases of cirrhosis.

Bile Duct Neoplasms↗
PubMed1980

Grey-scale ultrasonography in the evaluation of carcinoma of the gall bladder.

Ultrasonography was used to evaluate 18 proven cases of carcinoma of the gall-bladder and a prospective diagnosis was correctly achieved in 88.8%. The ultrasonographic findings may be classified into primary and associated. The diagnostic role of ultrasonography is considered and a flow-chart of further investigations is suggested. The diagnostic limits for early detection are underlined.

Aged↗
PubMed1980

[Three-dimensional study of normal adrenal glands by a fast CT scanner (author's transl)].

The results of an anatomic study of the normal adrenal in the three spatial dimensions by computed tomography are presented. The use of a fast scanner let us to obtain good quality images on the axial plane and to visualize adrenals in 95% on the right and 99.2% on the left; moreover, the electronical reconstruction let us complete the anatomic study of adrenals on the coronal and sagittal planes.

Absorptiometry, Photon↗
PubMed1980

[Angiography in the evaluation of pancreatic carcinoma after the introduction of echotomography (author's transl)].

The authors refer the results of angiography in 46 patients with proven pancreatic carcinoma. Based on the prospective report there were 40 correct diagnoses, giving an overall accuracy of 86.95%. The incidence of the angiographic features has been investigated; basing on these findings the possibility of a radical surgery was suggested. 24 of these patients have undergone echotomography. The authors compare the results of the two investigations, concluding that these are complementary in diagnosis and prediction of resectability (invasion of great vessels, secondary deposits to the liver). Echotomography allows to recognize a large number of small dimension carcinomas, suggesting its use in the screening of those patients with suspected pancreatic neoplasm. Angiography is still essential to perform radical surgery.

Angiography↗