La Radiologia medica
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La Radiologia medica · Oct 2014
ReviewTransthoracic ultrasound in the assessment of pleural and pulmonary diseases: use and limitations.
Interest in transthoracic ultrasound (US) procedures increased after the availability of portable US equipment suitable for use at the patient's bedside. It is possible to detect space-occupying lesions of the pleura, pleural effusion, focal or diffuse pleural thickening and subpleural lesions of the lung, even in emergency settings. Transthoracic US is useful as a guidance system for thoracentesis and peripheral lesion biopsy, where it minimises the occurrence of pneumothorax and haemorrhage. ⋯ In order to clarify some confusion and to report on the state of the art, we present a review of the literature on transthoracic US in diseases of the pleura and peripheral lung regions and our own clinical experience over 3 decades. The review focuses on quality assurance procedures and their value in diagnostic imaging and patient monitoring and warns against possible inappropriate indications and misleading information. Thoracic US is much more than "fishing for the moon in the well".
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La Radiologia medica · Oct 2014
Comparative StudyRole of whole-body diffusion-weighted MRI in detecting bone metastasis.
The aim of this study was to compare the results of whole-body diffusion-weighted magnetic resonance (DW-MR) imaging with staging based on computed tomography (CT) and nuclear scintigraphy using Tc99m results as the standard of reference. ⋯ Whole-body DW-MR imaging was more sensitive in the detection of osseous metastases than were skeletal scintigraphy and CT bone survey.
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La Radiologia medica · Sep 2014
Comparative StudyFirst-line sonographic diagnosis of pneumothorax in major trauma: accuracy of e-FAST and comparison with multidetector computed tomography.
Combined clinical examination and supine chest radiography have shown low accuracy in the assessment of pneumothorax in unstable patients with major chest trauma during the primary survey in the emergency room. The aim of our study was to evaluate the diagnostic accuracy of extended-focused assessment with sonography in trauma (e-FAST), in the diagnosis of pneumothorax, compared with the results of multidetector computed tomography (MDCT) and of invasive interventions (thoracostomy tube placement). ⋯ Thoracic ultrasound (e-FAST) is a rapid and accurate first-line, bedside diagnostic modality for the diagnosis of pneumothorax in unstable patients with major chest trauma during the primary survey in the emergency room.
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La Radiologia medica · Aug 2014
Comparative StudyRecurrent glioblastoma multiforme versus radiation injury: a multiparametric 3-T MR approach.
The discrimination between recurrent glioma and radiation injury is often a challenge on conventional magnetic resonance imaging (MRI). We verified whether adding and combining proton MR spectroscopic imaging ((1)H-MRSI), diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) information at 3 Tesla facilitate such discrimination. ⋯ The multiparametric 3-T MR assessment based on (1)H-MRSI, DWI and PWI in addition to MRI is a useful tool to discriminate tumour recurrence/progression from radiation effects.
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La Radiologia medica · Aug 2014
Role of paravertebral block anaesthesia during percutaneous transhepatic thermoablation.
This paper discusses the technique and preliminary results of right thoracic paravertebral block (TPVB) for percutaneous thermal ablation of liver tumours. ⋯ In most cases, TPVB is a safe and effective technique for conscious anaesthesia during percutaneous thermal ablation of liver tumours. Failures probably derive from left sympathetic and parasympathetic fibre stimulation. We recommend performing a TPVB in the presence of the anaesthetist.