[Percutaneous transjugular intrahepatic portosystemic shunt (TIPS). The preliminary experience and proposal of a new method].

A new interventional procedure employing metallic stents has been recently suggested to perform percutaneous portosystemic shunts in the treatment of variceal bleeding in portal hypertension; the technique is called TIPSS (transjugular intrahepatic portosystemic stent shunt). This percutaneous treatment presents several advantages over surgery: the shunt diameter can be calibrated according to the degree of portal hypertension; moreover, TIPSS can be performed in patients waiting for liver transplantation because it does not alter the vascular anatomy of liver. The original technique employed transhepatic portography.

[Accuracy of CT in the demonstration of lymph node metastasis in pulmonary carcinoma].

The CT, surgical and histological findings were examined of 350 lymph nodes in a perspective study of 50 patients affected with lung cancer. CT accuracy could thus be evaluated in assessing the size of hilar and mediastinal lymph nodes; the incidence of histologically-proven metastases in nodes more/less than 10 cm in diameter could also be determined, together with CT diagnostic accuracy for nodal metastases. Finally, CT capabilities were also evaluated in distinguishing N0 from N1-N2 patients.

[CT and MR compared in the study of hypophysis].

Normal CT and MR anatomy was studied in two series (53 and 25 cases respectively) of young volunteers of both sexes, asymptomatic and certainly without lesions of the pituitary gland. 115 other pathological cases (73 hyperprolactinemias, 8 acromegalies, 15 Cushing syndromes, 2 hyperthyroidisms, 17 nonsecreting adenomas) were examined using both CT and MRI. Both an accurate review of the relative literature and the results of our own series prove that MR is superior to CT in diagnosing pituitary microadenomas (3.

[Percutaneous needle biopsy of the lung. Critical review of 496 cases].

Between February 1979 and December 1986, 618 lung biopsies were performed on 496 patients (122 with double puncture, using Tru-cut and 19-20 G needles). Overall diagnostic accuracy was 84.5%; the 77 patients examined in the past 18 months only underwent thin needle (19-20 G) biopsies--which were carried out by an experienced radiologist--and more sophisticated cyto-histological techniques were employed.

[MR tomography in adrenal pathology. Preliminary report on 25 histologically controlled cases].

Twenty-five patients affected by adrenal glands pathology underwent CT and MRI: 6 non-functioning adenomas, 2 Cushing's adenomas, 2 Conn's adenomas, 6 metastases, 3 cysts, 2 carcinomas (Cushing's syndrome), 1 lymphoma and 3 pheochromocytomas. Diagnosis was subsequently confirmed either at surgery, or autopsy, or with needle biopsy. In all cases normal adrenal glands and pathological lesions were showed by MRI.

[Interventional radiology in non-neoplastic diseases of the biliary tract. A report on 93 personal cases].

Most references in the literature on interventional radiology of the biliary tract refer to the treatment of cancer; only occasionally are benign conditions mentioned. An updated list of useful radiosurgical instruments on the market in Italy is presented. The operating technique from the preparation of the patient to the performance of percutaneous transhepatic cholangiography (PTC), biliary drainage, transhepatic bilioplasty, percutaneous extraction and chemical cholelitholisis of biliary calculi and drainage of biliary collections is then described.

[Transcutaneous chemical cholelitholysis with methyl tert-butyl ether (MTBE). lst results in man].

Three patients have been treated, with instillation of MTBE through a transcutaneous biliary drainage after transduodenal sphincterotomy. The first had gallbladder stones, the second common bile duct stones and the last intrahepatic stones (V segment). While in the first case there has been only a partial success in the other two we have obtained a total dissolution of the stones, with complete clinical recovery.

[Cholecystography and ultrasound compared in the radiological diagnosis of chronic cholecystitis].

In 50 patients awaiting cholecystectomy, both cholecystography and cholecystosonography have been performed (or repeated), in order to examine the gallbladder wall implementing both examinations with the cholecystokinetic test. The results, related to the surgical, anatomical- and histo-pathological reports, show that, to detect gallbladder parietal lesions, the two studies are complementary in the diagnosis of cholecystitis: consequently, in the authors' opinion, they should always be carried out in association, with the exception of cases when cholecystography may not be possible either because of radiation protection reasons or because of jaundice. Although further experiments are required, it is suggested that the cholecystokinetic test be revalued.

[Chromosome aberrations in subject occupationally exposed to radiation. Statistical analysis (author's transl)].

The percentage of subjects affected by different chromosomes aberrations, does not differ in subjects occupationally exposed to radiations and in controls. On the other hand the higher percentage of aberrations in the total number of cells in radioexposed subjects is highly significant. Severe limitations employing the cariotipic investigation for insurance finalities are prospected.

[Correlations between splenoportographic findings and risk of digestive hemorrhage in portal hypertension].

In 102 cases examined by splenoportography (93 cirrhosis with patent splenoportal axis and 9 splenoportal thrombosis without appreciable liver changes), the occurrence of episodes of digestive haemorrhage was statistically correlated with age, sex, type of portal impediment, type of collateral circulation, and the presence or otherwise of ascites, and with portal pressure values measured by splenomanometry. The only statistically significant correlation was that concerning the type of hepatofugal collateral circulation, as digestive haemorrhage proved gradually less frequent in patients with gastro-oesophageal collateral circulation, in those with so-called infraportal collateral circulation and, finally, in those where angiography was unable to demonstrate the presence of any collateral circulation at all.

[Abnormal pulmonary vein outlet. Radiological aspects (author's transl)].

6 cases of abnormal pulmonary venous outlet, 5 of them partial anomalies without cardiocirculatory symptoms, are reported. Diagnosis was formulated by means of angiocardiography resorted to on the basis of the radiographic picture: retraction of the right hemithorax (left in 1 case), heart attraction, pulmonary veiling, tomographic pictures of anomalous vessels.

[Arteriography of the celiac tripod in lymphomas. Critical evaluation].

The possible contribution of arteriography of the coeliac tripod to lymphoma staging is discussed with special regard to the demonstration of spleen and liver involvement; as regards the former, caution is advised owing to the chance of errors of interpretation; as for the latter, mention is made of the possibility of demonstrating infiltrations of the liver and stenosis of the hepatic artery due to lymphnode involvement that cannot be shown up by laparotomy.

[The late effects of radiotherapy for enlargement of the thymus in early infancy (author's transl)].

In a survey of 380 subjects irradiated over 20 years earlier for enlargement of the thymus, no increase in mortality for malignant tumours were noted. There was a high incidence (3.75%) of benign thyroid diseases, though this could not be attributed to irradiation with any degree of certainty.