Diagnostic imaging in a case of choledocholithiasis.

A case of a patient with the diagnosis of a neoformation of the blind intestine is discussed. On CT for staging an image at the level of the intrapancreatic tract of main bile duct of not certain interpretation was visualized. On US choledocholithiasis shown by the typical appearance of a hyperechoic image with posterior shadowing was diagnosed.

Increased estradiol levels in venous occlusive disorder: a possible functional mechanism of venous leakage.

Venous insufficiency of the corpora cavernosa is the second most common cause of erectile dysfunction (ED). A functional insufficiency of the venous system has been hypothesised, but the cause is still unclear. To evaluate a possible endocrine mechanism, we have studied hormone profile in a group of nine patients with pure venous-leakage (VL) compared with a control group of 15 patients with ED of different origin.

Solitary liver metastasis from Hürthle cell thyroid cancer: a case report and review of the literature.

Metastasis to the liver from thyroid cancer is a rare event with a reported frequency of 0.5%. Metastatic liver involvement from differentiated thyroid cancer (DTC) is nearly always multiple or diffuse and usually found along with other distant metastases (lung, bone and brain).

"Lights and shadows" in ultrasonography.

The case of a 40-year-old male patient come to the emergency service with symptoms suspicious of biliary colic, is presented. Liver sonography was requested to evaluate the parenchyma, the gallbladder and bile duct caliber in the suspicion of lithiasis. During the examination a hyper-reflecting image with posterior shadowing was detected at the level of the gallbladder infundibulum.

Megaureter and ureteral valves.

Primary megaureter is visualized as a typical dilatation on urography. Adequate oblique projections should be added to depict the juxtavesical tract of normal caliber. In even the most severe forms pyelocaliectasis is absent or mild and the ureter is not tortuous.

Multi-centre clinical study evaluating the efficacy of SonoVue (BR1), a new ultrasound contrast agent in Doppler investigation of focal hepatic lesions.

Objectives: SonoVue is a new ultrasound contrast agent, which consists of stabilised microbubbles of a sulphur hexafluoride gas. The aim of the study was to assess its efficacy in the Doppler investigation of focal hepatic lesions.

Materials And Methods: Seventy patients with focal liver tumours were studied.

[Role of Doppler color ultrasonography in the diagnosis of thyroid carcinoma].

The aim of this study is to assess the efficacy and accuracy of color flow-Doppler sonography (CFDS) in predicting the malignancy of thyroid nodules. Seventy eight consecutive patients (52 females and 26 males), with 78 thyroid nodules (29 single nodules and 49 in a nodular goiter) have been examined by CFDS, before surgery, evaluating the hypoechogenicity of the nodule, the presence of microcalcifications and the halo sign absent and the vascular pattern, which has been classified as follows: absence of blood flow (type I), perinodular blood flow (type II), intranodular, with or without perinodular blood flow (type III), which is considered the most typical pattern of malignancy. On histology 22 nodules as carcinoma (CA) and 56 as benign nodules (BN) have been diagnosed.

Contrast-enhanced gray-scale and color Doppler voiding urosonography versus voiding cystourethrography in the diagnosis and grading of vesicoureteral reflux.

Purpose: The purpose of this study was to compare contrast-enhanced gray-scale voiding urosonography (CE-VUS) and contrast-enhanced color Doppler voiding urosonography (CE-CDVUS) with voiding cystourethrography (VCUG) to verify whether the use of color Doppler imaging improves the diagnosis and grading of vesicoureteral reflux (VUR).

Methods: In 74 patients, CE-VUS and CE-CDVUS were compared with VCUG, which was used as the gold standard. SHU 508 A (Levovist) was used as the echo-enhancing contrast agent.

Diagnostic approach, genetic screening and prognostic factors of medullary thyroid carcinoma.

Medullary thyroid carcinoma is the least frequent thyroid neoplasm; it originates in thyroid parafollicular cells (calcitonin secreting C cells). In 80% of cases it is sporadic, in the remaining 20% it is familial, associated or not to other endocrinopathies as pheochromocytoma and hyperparathyroidism (MEN 2A, MEN 2B, and isolated familial medullary thyroid carcinoma). Preclinical diagnosis in relatives of affected subjects (preferably at pediatric age) is essential for successful therapy and is performed with genetic and biochemical screening tests.

Diagnostic imaging of differentiated thyroid carcinoma.

The role of diagnostic imaging in differentiated thyroid carcinoma is analyzed. 99mTc-pertechnetate 123I and 131I scintigraphy allows the evaluation of nodules with their differentiation in cold (hypofunctioning) and hot (functionally autonomous) nodules; thyroid carcinomas are cold nodules even if most of them are benign. On sonography thyroid nodules are well visualized with the definition of their site, number, size (not very useful parameters for the diagnosis of malignancy), echoic structure, and vascularization on color Doppler.

Metastatic lymphadenopathy from ENT carcinoma: role of diagnostic imaging.

Problems concerning the use of different imaging modalities in N staging of the neck are dealt with. The peculiar features, findings, sensitivity, specificity and diagnostic accuracy of each modality in the diagnosis of nature of cervical lymphadenopathy are described, as reported in most recent reports of literature, and according to the personal experience. CT/MRI criteria commonly used to establish whether a lymph node is metastatic or benign/reactive are related to the size, morphology, density (CT), signal intensity (MRI), evidence of central necrosis and extracapsular spread.

Improvement of hysterosalpingographic accuracy in the diagnosis of peritubal adhesions.

Objective: Our purpose was to compare hysterosalpingography with laparoscopy in the diagnosis of peritubal adhesions and to verify whether a combination of radiographic signs improves hysterosalpingographic accuracy.

Subjects And Methods: Thirty candidates for laparoscopy underwent hysterosalpingography before surgery. Two radiologists evaluated the presence or absence and types of radiographic signs of peritubal adhesions (convoluted tubes, vertical tubes, loculation of contrast medium in peritoneum, halo effect, and fixed laterodeviation of the uterus) using two different criteria for normality or abnormality: no sign means a normal result, one or more signs mean an abnormal result (first criterion); no sign or one sign means a normal result, two or more signs mean an abnormal result (second criterion).

Diagnostic imaging in thyrotoxicosis.

In thyrotoxicosis, imaging mainly scintigraphy, color Doppler sonography and radioiodine uptake test are used in the differential diagnosis as well as in the morphofunctional evaluation of the thyroid before and after therapy (mainly pharmacological or with radioiodine). Radioiodine uptake test differentiates high uptake thyrotoxicosis (Graves'disease, toxic nodular goiter) and low uptake thyrotoxycosis (subacute or silent thyroiditis, ectopic thyrotoxicosis, iodine-induced hyperthyroidism). In Graves'disease scintigraphy shows thyroid enlargement with intense homogeneous tracer uptake; rarely nodules with no uptake are present.

Diagnostic imaging of euthyroid goiter.

In diffuse or nodular euthyroid goiter, diagnostic imaging is indicated to define, by sonography, the morphology, size and structure of the goiter and to evaluate, by scintigraphy, the regional thyroid function. The instrumental diagnosis of thyroid nodule is essentially based on sonography, scintigraphy and (US-guided) needle aspiration cytology. The evaluation of some sonographic findings (echogenicity, calcification, lesion margins and presence of peripheral ring) may direct to the differentiation of a benign or malignant lesion.

Diagnostic imaging of the thyroid: methodology and normal patterns.

The diagnostic imaging of the thyroid is based on sonography and scintigraphy, which to-date play a unique role in the morphofunctional study of the thyroid gland. The high spatial resolution of sonography allows an accurate evaluation of the thyroid morphology, size and parenchymal structure. Color Doppler sonography allows a qualitative assessment associated with quantitative parameters of glandular vascularization.

An introduction to benign thyroid disease: pathophysiologic, epidemiologic aspects and diagnostic methodology.

The role of preoperative noninvasive diagnostic procedures in the management of benign thyroid diseases is critically reviewed and on the basis of a series of more than 13,000 thyroid nodules, sequentially examined, the role of preoperative fine needle aspiration (FNA) cytology in discriminating benign from malignant lesions, is assessed. Retrospective studies were performed to determine the diagnostic accuracy of FNA adopted as routine preoperative screening procedure as compared to intraoperative frozen section (FS) analysis. US-guided FNA was shown to be more accurate allowing the preoperative identification of occult or minimal carcinoma: in fact about 3% of malignant thyroid nodules were detected.

Ovarian factor infertility.

The diseases of the ovary which most frequently cause infertility are: anovulation from follicular atresia, the empty follicle syndrome, the luteinized unruptured follicle syndrome; chronic anovulation syndromes, within which polycystic ovarian syndrome plays a major role; ovarian endometriosis. Sonography and Color Doppler US are the first choice procedures in the monitoring of ovarian cycles, which combined with serum hormone values, are able to identify possible changes in the physiologic sequence of the cycle. In follicular atresia, ovaries with minute follicles (3mm or less) and early disappearance of primary follicle are observed on sonography.

Uterine intracavitary disorders: role of sonography and combination with other radiologic techniques.

Since it serves as the site for the implantation of the fertilized ovum, it is evident that significant disorders in the uterine cavity and endometrial mucosa represent potential factors of sterility/infertility. Among the acquired pathological conditions, a possible cause of sterility, there are inflammatory (endometritis) or post-traumatic (synechiae) disorders and proliferative mucosal (endometrial hyperplasia, polyps) and muscular (fibroma) disorders. Sonography (by transabdominal or preferably endovaginal route, and sonohysterography) is the first choice procedure being in most cases adequate for clinical assessment.

Cervical cancer response to neoadjuvant therapy: MR imaging assessment.

Purpose: To determine the accuracy of magnetic resonance (MR) imaging in evaluating the invasive cervical carcinoma response to concurrent chemotherapy and radiation therapy.

Materials And Methods: MR imaging was performed before and after concurrent chemotherapy and radiation therapy in 18 patients with locally invasive cervical carcinoma. Surgery followed neoadjuvant therapy in all patients.

Diagnostic imaging of genitourinary tuberculosis.

The mechanisms of the spread to the kidney and urinary tract of miliary tuberculosis which involves the urinary system with a rather high incidence, and, if not detected, may result in a functionless kidney for the often nonspecific symptomatology, are analyzed. These considerations account for the seriousness of the problem of urinary tuberculosis, whose great topical interest is unfortunately proven not only in the African continent where it is particularly common, but also in Europe. The lesions underlying the damage to the renal parenchyma and lower urinary tract are carefully examined for a correct interpretation of the radiologic signs.

New prospects for ultrasound contrast agents.

Considering the several suggestions regarding the future developments of echocontrast agents, there is a striking difference between the few compounds actually available on the market and used in clinical practice and those undergoing experimental clinical trials. It is therefore difficult to predict what will be the actual impact of these agents in the next future. Future developments will probably go beyond color enhancement which was the end-point till a very short time ago.

[Color Doppler echography in the tissue characterization of renal masses].

To investigate color-Doppler US capabilities in tissue characterization, 42 renal masses were studied from November, 1993, to July, 1994. B-mode morphologic patterns were studied first and then integrated with color flow patterns; color areas and blood flow distribution were assessed for each lesion. Color signals were used as a guide to obtain arterial and venous Doppler spectra and to calculate flow velocities and pulsatility index (PI).