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William C Torreggiani

Publications and source records attributed to William C Torreggiani.

At least 19 recordsLinked to original sources

CT-guided bone biopsy: Initial experience with a commercially available hand held Black and Decker drill.

PURPOSE: To describe the use of a simple commercially available Black and Decker hand based drill in performing CT-guided bone biopsies. MATERIALS AND METHODS: Three international institutions were enrolled in the study. In each centre, a fellowship trained musculoskeletal radiologist directed the assessment of a hand based commercial drill for performing CT-guided bone biopsies. A specially designed component was engineered which allowed the connection of a standard bone biopsy set to a commercial drill. The component was distributed to the three centres involved. Over a 3-year period, data from all three institutions was collected. Information regarding technical success, diagnostic data and complication rates were all collated to assess the technical feasibility of this technique. RESULTS: In total 68 patients underwent bone biopsy using a hand held commercial drill. Technical success was achieved in 65 patients. Diagnostic material was obtained in 53 patients. Non-diagnostic material was obtained in 12 patients. Five out of the 12 patients with non-diagnostic material had repeat biopsies with diagnostic material obtained in 2 of these. No major complications occurred in any patient. CONCLUSION: CT-guided bone biopsy using a hand held commercial drill has a technically high success rate with minimal complications.

Aged↗

Pictorial review: magnetic resonance imaging of colonic diverticulitis.

Magnetic resonance imaging (MRI) is rapidly emerging as a useful imaging modality for the evaluation of the gastrointestinal tract. Increasingly rapid sequences and improving hardware have significantly improved the visualisation of diseases of the colon. MRI has a major advantage over CT in that there is no ionising radiation. In our institution, MRI has increasingly been used as a complimentary imaging modality to CT in the diagnosis and evaluation of diverticulitis and its complications. In this review article, we illustrate the emerging role of MRI in the diagnosis and evaluation of colonic diverticulitis.

Diverticulitis, Colonic↗

Inguinal hernia repair protects testicular function: a prospective study of open and laparoscopic herniorraphy.

BACKGROUND: Despite the frequency of open and laparoscopic herniorraphy the effect of the hernia and subsequent repair on testicular function is unknown. Our objective was to determine if there is an association between inguinal hernia and hernia repair on testicular function. STUDY DESIGN: Thirty-seven men aged 18 to 70 years were enrolled in a prospective internally controlled cohort study. They underwent Doppler ultrasonography and serum testicular hormone analysis pre- and post- either open Lichtenstein's repair or laparoscopic totally extraperitoneal hernioplasty. These surrogates of testicular function were measured up to 6 months postrepair. RESULTS: Thirty-seven consecutive patients underwent either Lichtenstein (n = 17) or totally extraperitoneal hernioplasty (n = 20) hernia repair as per surgeon preference. Preoperatively there was a significant elevation in the sonographic resistive index (RI) in the affected (hernia) side compared with the normal side (0.601, 0.569; p < 0.001). This elevation in RI was reversed posthernia repair at a median followup of 6.1 months. Inguinal hernia or repair did not affect testicular volume. The choice of either Lichtenstein or totally extraperitoneal hernioplasty hernia did not significantly alter the testicular function. CONCLUSIONS: Patients with inguinal hernia have an elevated testicular vascular resistance, which is reversed after repair. The choice of laparoscopic or open herniorraphy did not affect reversal of this surrogate of testicular function.

Adolescent↗

Atlanto-occipital dislocation: case report and discussion.

Atlanto-occipital dislocation (AOD) is a devastating condition that frequently results in prehospital cardiorespiratory arrest and accounts for 15% of fatal spinal trauma. Atlanto-occipital dislocation occurs 5 times more commonly in children than adults, and is believed to be caused by hyperextension. Because of improvements in prehospital resuscitation, more victims with AOD now survive to reach the emergency department. Neurologic injury is usually severe secondary to ligamentous disruption that allows the cranium to move with respect to the cervical spine, and associated facial and head injuries are common. There are, however, reports of survivors without neurologic deficits. We present the case of a 46-year-old woman who suffered an AOD after a motor vehicle crash and we discuss the diagnosis of this condition. The signs of AOD are often subtle, and the possibility of this diagnosis must be kept in mind in all patients with a neck injury, even in the absence of neurologic signs. A systematic approach to assessing the cranio-cervical relationship on the lateral cervical x-ray and the appropriate use of CT scanning is essential to identifying AOD. Through this case report we hope to familiarize clinicians with mechanisms of injury and appropriate imaging interpretation that will assist in the diagnosis of AOD.

Accidents, Traffic↗

Aorto-caval fistula.

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Aortic Aneurysm, Abdominal↗

A devilish surprise.

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Catheterization, Central Venous↗

Dynamic magnetic resonance imaging of the pelvic floor in patients with idiopathic combined fecal and urinary incontinence.

The etiologies of combined fecal and urinary incontinence may be interrelated but remain poorly understood. A potential variable in this process is global pelvic floor dysfunction. The aim of this study was to prospectively assess the use of phased-array, body coil dynamic MRI in identifying pelvic floor abnormalities in patients with combined incontinence symptoms. Symptomatic patients were compared to asymptomatic control subjects and were selected from those referred to the pelvic physiology laboratory with complaints of combined urinary and fecal incontinence. All patients underwent standard urodynamic studies and anorectal physiologic assessment. Colonoscopy and endoanal ultrasonography were also performed. A standardized protocol was used for dynamic MRI, and the parameters were measured using workstation software (callipers, compass, and densitometer). In the incontinent group there was a significant difference, when compared to control subjects, in the angle of the levator ani muscle arch of the levator plate complex (3.0+/-5 degrees vs. 14+/-10 degrees; P=0.004), the width of the levator hiatus (58.3+/-8 mm vs. 46.5+/-8 mm; P=0.001), the area and tissue density of the levator ani muscle (19.5+/-1 mm(2) vs. 26.9+/-1 mm(2); P=0.001, and 157.3+/-47 pixels vs. 126.1+/-23 pixels; P=0.025, respectively), and in the length of the external anal sphincter (20.0+/-5 mm vs. 26.6+/-13 mm; P=0.03). Body coil dynamic MRI is a noninvasive and well-tolerated imaging modality. Our data show that it can identify changes in pelvic muscle morphology in patients with disorders of incontinence, and this may help in planning better management strategies.

Adult↗

The accuracy of references in manuscripts submitted for publication.

OBJECTIVE: To analyze the errors present in references cited in papers submitted for peer review for possible publication. METHODS: Nineteen consecutive manuscripts submitted for peer review were assessed. They contained a total of 261 references. Manuscripts were submitted to 1 of 5 major radiology journals. Journal references were compared with either the original articles or abstracts obtained through MEDLINE. Book references were checked against the original book. In total, 259 of 261 references were obtained. The remaining 2 references were both out-of-print books that were not available. Each reference was checked and errors were identified as either major or minor, depending on the gravity of the error. Errors were analyzed to see whether they could be attributed to not adhering to journal guidelines or to other reasons. RESULTS: Of a total of 259 references, 56% (n = 145) contained at least 1 error, 53% (n = 137) contained minor errors and 15% (n = 39) contained major errors. Five per cent (n = 13) of references had more than 3 errors, and 79% (n = 274) of all errors were the direct result of authors not following journal instructions. CONCLUSION: Over half of all references included in manuscripts submitted to radiology journals contain at least 1 error. The majority are avoidable, resulting from failure to follow the journal's instructions to authors.

Bibliographies as Topic↗

Pelvic bone asymmetry in 323 study participants receiving abdominal CT scans.

STUDY DESIGN: Retrospective review of all CT scans of pelvis and abdomen performed at our institution in October and November 2000. OBJECTIVE: To determine the prevalence and extent of radiographic pelvic asymmetry in a population of patients not preselected for having low back pain. SUMMARY OF BACKGROUND DATA: Pelvic asymmetry refers to asymmetric positioning of landmarks on the two sides of the pelvis and may have a structural or functional etiology. Pelvic asymmetry can be associated with the presence of true leg length discrepancy, lead to false diagnosis or inaccurate measurement of leg length discrepancy, or itself be independently associated with back pain. Although the prevalence of pelvic asymmetry has been reported in patients with back pain to be 24-91%, its prevalence in the general population is not known. METHODS: A total of 323 consecutive CT scans of the pelvis/abdomen were assessed for pelvic asymmetry by one of three examiners. Pelvic asymmetry was defined as an unequal distance from the iliac crests to the acetabuli bilaterally, measured on the anteroposterior scout view of the CT scan. Measurements made on 30 randomly selected scans by the three examiners were used to assess interrater reliability of the measurement method. RESULTS: Pelvic asymmetry ranged in magnitude from -11 mm to 7 mm [right pelvis (mm) - left pelvis (mm)]. Pelvic asymmetry was >5 mm in 17 of 323 (5.3%) and >10 mm in 2 of 323 (0.6%) of the subjects; 172 of 323 (53.3%) had a smaller right hemipelvis (mean asymmetry = -3.0 mm). A total of 95 of 323 (29.4%) had a smaller left hemipelvis (mean asymmetry = 2.1 mm). The intraclass correlation coefficient [ICC(2,1)] between the three observers was high (0.91). CONCLUSION: Pelvic asymmetry of >5 mm was uncommon, with a prevalence of approximately 5% in the population studied. CT scanography was found to be a practical and reliable method for the assessment of suspected pelvic asymmetry.

Adolescent↗

Fibroid in the buttock: an unexpected diagnosis.

Uterine leiomyomas (fibroids) are very common lesions with well-described imaging features. We present an unusual case of a fibroid which presented in the buttock with atypical clinical and imaging features in a woman who had had a previous hysterectomy. Despite extensive imaging and biopsies, the diagnosis was not suspected until pathological evaluation of the resected mass. The differential diagnosis for such a lesion, and the imaging and pathological features of fibroids, including atypical and parasitic leiomyomas, are discussed.

Buttocks↗

Comminuted fracture of the ulnar sesamoid of the metacarpophalangeal joint of the thumb: an uncommon injury.

Fracture of the ulnar sesamoid of the metacarpophalangeal joint of the thumb is rare. Injury may be caused as a result of hyperextension or, less frequently, direct trauma. A sesamoid may be incompletely ossified, making it difficult to diagnose the fracture on radiographs. Early recognition of this entity leads to appropriate management. The case of a 26-year-old man who sustained a hyperextension injury of the thumb is presented. Radiographs demonstrated a fracture of the ulnar sesamoid of the thumb metacarpophalangeal joint. The literature regarding this uncommon injury is discussed.

Accidental Falls↗