La Radiologia medica
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La Radiologia medica · Jun 1997
[Computerized tomography-guided neurolytic block of the splanchnic nerve].
CT-guided neurolytic splanchnic nerve block is a technique for relieving abdominal cancer pain; the goal is the alcoholic neurolytic interruption of the sensitive structures in retroperitoneal space. CT yields accurate anatomical detailing and the course for needle placement and alcohol spread. January, 1993, to July, 1996, twenty-one bilateral splanchnic nerve blocks were performed through the posterior access. ⋯ The whole procedure usually lasted 60 min (range: 45 to 90 min). Splanchnic nerve neurolysis is a useful treatment in the patients with severe chronic abdominal pain. It is used as a second line treatment when large lesions change celiac anatomy and complicate the percutaneous block of the celiac plexus.
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La Radiologia medica · Jun 1997
Case Reports[Server World-Wide Web on the Internet for the provision of clinical cases and digital radiologic images for training and continuing education in radiology].
The Internet, as a global computer network, provides opportunities to make available multimedia educational materials, such as teaching files and image databases, that can be accessed using "World-Wide Web" client browser to provide continuing medical education. Since August, 1995, at the Institute of Radiology-University of Palermo, we developed a World-Wide Web server on the Internet to provide a collection of interactive radiology educational resources such as teaching files and image database for continuing medical education in radiology. Our server is based on a UNIX workstation connected to the Internet via our campus Ethernet network and reachable at the uniform resource locator (URL) address: http:/(/)mbox.unipa.it/approximately radpa/ radpa.html. ⋯ Nine teaching files are presently available on the server, together with 49 images in the database, a list of international radiological servers, a section devoted to the museum of radiology hosted by our Institute, the electronic version of the Journal Eido Electa. In the first 12 months of public access through the Internet, 12,280 users accessed the server worldwide: 45% of them to retrieve teaching files; 35% to retrieve images from the database; the remaining 20% to retrieve other documents. Placing teaching files and image database on a World-Wide Web server makes these cases more available to residents and radiologists to provide continuing medical education in radiology.
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La Radiologia medica · Jun 1997
Comparative Study[Twenty-six consecutive patients with acute superior mesenteric infarction. Comparison of conventional radiology, ultrasonography, and computerized tomography].
Ischemic bowel disease is a rare disorder whose incidence is increasing as the mean age of the population increases. Diagnosis by clinical, laboratory and radiologic means is often difficult, and delay in definitive therapy results in substantial morbidity and mortality. A series of 26 consecutive patients, with proved acute superior mesenteric ischemia, was retrospectively reviewed: the authors report the diagnostic methods performed preoperatively, the site and the cause of infarction and the time passed between the first radiograph ans surgery. ⋯ Abdominal CT showed air-fluid levels (79%), dilated loops and free intraperitoneal fluid (47%), intramural gas and thickened bowel loops (36.8%), engorgement of the mesenteric vessels (31%), mesenteric-portal gas, mesenteric thrombus and marked reduction in the volume of gas in the small bowel (10.5%) and paper-thin bowel loops (5%). The authors conclude that air-fluid levels, dilated loops and intraperitoneal free fluid are the most frequent findings, even though they are not specific. While abdominal plain film and screening ultrasonography can be negative, CT detects at least one abnormal finding and at least three abnormal findings in 73% of cases.
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La Radiologia medica · Jun 1997
Comparative Study[Comparison of computerized tomography and magnetic resonance with fast sequences with and without paramagnetic contrast media in the assessment of liver metastasis: qualitative and quantitative analysis].
We compared unenhanced and contrast-enhanced fast MRI and CT in the detection of liver metastases. Eleven patients with single or multiple hepatic lesions (42 in all) were submitted to CT and MR studies; T1- and T2-weighted TSE, T2-weighted TSE with fat suppression, unenhanced breath-hold TFE and early or delayed enhanced breath-hold TFE images were acquired with a 1.5 T super-conductive magnet (Philips NT). The quantitative analysis of all MR images was performed for contrast/noise ratio (CNR) and number of detected lesions; MR and CT images were also compared qualitatively for lesion conspicuity, anatomical structure identification and artifacts. ⋯ CT was superior to T1- and T2-weighted TSE (p = .0001) and unenhanced TFE (p = .004) for the lack of artifacts. Fat-suppressed T2-weighted TSE images had a statistically higher CNR than T2-weighted TSE (p = .02), T1-weighted TSE (p = .0006) and unenhanced and delayed TFE sequences (p = .007; p = .0001, respectively). To conclude, MRI appears superior to CT in the detection of liver metastases; the examination should include early enhanced breath-hold T1-weighted TFE and T2-weighted fat-suppressed TSE images.
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La Radiologia medica · Jun 1997
[Biomechanics and semiology of transient lateral patellar dislocation: reliability of magnetic resonance diagnosis].
Transient patellar dislocation is a rare finding. It is usually due to direct trauma in mediolateral direction or to indirect trauma related to violent quadriceps muscle contraction. The clinical diagnosis of transient forms is usually rather difficult because the associated signs (hemarthros and pain at the joint and/or at the vastus medialis insertion) are not specific. ⋯ Finally, other joint components, such as the posterior horn of the medial meniscus or the anterior cruciate ligament were involved in 6/13 cases. Arthroscopy was performed in 6 patients with associated injuries and confirmed all MR findings (100% agreement). To conclude, in our experience MRI was a very reliable tool to study the injuries due to transient patellar dislocation because it showed specific changes and possible associated traumas, which helps choose the most suitable treatment.