La Radiologia medica
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La Radiologia medica · Sep 1999
[Gunshot wounds of the abdomen studied by computed tomography. The authors' personal experience in 30 cases].
CT plays an important role in depicting gunshot wounds in parenchymal and hollow organs in the abdomen. Relative to other techniques and to emergency laparotomy, CT permits good assessment of abdominal content, major injuries and changes in other districts, such as chest, pelvis and skull. We investigated the yield and role of CT in diagnosing abdominal gunshot wounds, with their rich and varied radiological signs and associated injuries. ⋯ Tissue damage extent depends on the speed and kinetic energy the bullet carries into the abdomen. Abdominal radiography shows the bullet and its site, pneumoperitoneum from gastrointestinal perforation, crash bone injuries, vertebral trauma and subcutaneous emphysema. Instead, CT depicts early parenchymal damage and vascular injury and thus becomes a complete and necessary tool for imaging gunshot wounds. CT provides early diagnostic information which help plan emergency treatment and thus decrease mortality. As for angiography and US, we suggest they be used subsequently because in emergency they may delay the diagnosis. Moreover, vessel rupture and active intraabdominal bleeding are easily detected with spiral CT, which appears the best tool for prompt assessment of the injuries associated with gunshot wounds in other districts such as, the skull. To conclude, CT permits adequate planning of emergency surgery and helps select the cases for follow-up, intensive care and conservative treatment.
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La Radiologia medica · Sep 1999
[Vascular complications in intestinal obstructions. The role of computed tomography].
We investigated CT capabilities in showing vascular complications (ischemia, infarction) secondary to intestinal obstruction. ⋯ CT is a sensitive tool for diagnosing small bowel obstruction and for assessing the site and cause of obstruction. CT plays a pivotal diagnostic role in vascular complications, giving very important indications for a correct treatment.
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La Radiologia medica · Sep 1999
Comparative Study[Brain magnetic resonance with magnetization transfer in multiple sclerosis. Lesion hyperintensity before and after intravenous gadolinium administration].
To evaluate lesion contrast enhancement in brain magnetic resonance (MR) images with and without magnetization transfer pulse (MT) in patients affected with multiple sclerosis (MS). ⋯ The postcontrast sequence obtained with the MT pulse detects more active lesions than the postcontrast sequence without MT. However, the comparison with the plain images with the MT pulse is mandatory to exclude pseudoenhancement foci, i.e. hyperintense areas already present in the precontrast images with the MT pulse, without disruption of the blood-brain barrier. The post-Gd without MT sequence needs not be compared with the precontrast images without MT. Differences in evaluation time are practically negligible.
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La Radiologia medica · Sep 1999
Comparative Study[Color Doppler-echo in rheumatoid arthritis with extra-articular location. Preliminary experience].
Chronic inflammation in rheumatoid arthritis usually involves articular synovia and extends to other joint components such as bursae, tendons and sheaths. Conventional US with high frequency transducers is an accurate tool for assessing abnormal changes in evolutive rheumatoid arthritis. We investigated the role of color and power Doppler imaging in staging extra-articular involvement, monitoring local inflammatory changes and drug treatment response. ⋯ Color and power Doppler can be a necessary and useful integration to high resolution US for flow mapping in rheumatoid arthritis patients with tendon and extra-articular involvement. These modes depict local circulation changes related to disease stage and treatment response.
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La Radiologia medica · Sep 1999
[The role of computed tomography after functional surgery on the paranasal sinuses. Normal findings and an assessment of the surgical failures].
Functional endoscopic sinus surgery has become the technique of choice to treat benign or inflammatory diseases of paranasal sinuses resistant to medical therapy. The goal of this type of surgery is to open the obstructed sinus ostia and restore normal aeration and mucociliary clearance. Messerklinger's is the most widely used technique. ⋯ CT permitted an accurate assessment of extension and results of functional endoscopic sinus surgery. CT is indicated in the postoperative study of the patients who a) present symptoms of cerebral and ocular complications (early after functional endoscopic sinus surgery); and b) do not respond to medical treatments 8-32 weeks after unsuccessful functional endoscopic sinus surgery. In these patients CT can demonstrate recurrent and/or residual nasosinusal disease and bony defects unintentionally caused by the surgeon during the procedure.