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Augustin G, Bruketa T, Kunjko K, Romić I, Mikuš M, Vrbanić A, Tropea A. Colonic gallstone ileus: a systematic literature review with a diagnostic-therapeutic algorithm. Updates Surg 2023:10.1007/s13304-023-01537-0. [PMID: 37209317 DOI: 10.1007/s13304-023-01537-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 05/10/2023] [Indexed: 05/22/2023]
Abstract
Rare complication of gallstone disease is gallstone ileus. The common location is the small intestine, followed by the stomach. The rarest location is colonic gallstone ileus (CGI). To summarize and define the most appropriate diagnostic methods and therapeutic options for CGI based on the paucity of published data. Literature searches of English-, German-, Spanish-, Italian-, Japanese-, Dutch- and Portuguese language articles included and Italian-language articles using PubMed, EMBASE, Web of Science, The Cochrane Library, and Google Scholar. Additional studies were identified from the references of retrieved studies. 113 cases of CGI were recorded with a male to female patient ratio of 1:2.9. The average patient age was 77.7 years (range 45-95 years). The usual location of stone impaction was the sigmoid colon (85.8%), followed by a descending colon (6.6%), transverse colon (4.7%), rectum (1.9%), and lastly, ascending colon (0.9%). Gallstones ranged from 2 to 10 cm. The duration of symptoms was variable (1 day to 2 months), with commonly reported abdominal distension, obstipation, and vomiting; 85.2% of patients had previous biliary symptoms. Diverticular disease was present in 81.8% of patients. During the last 23 years, CT scan was the most common imaging method (91.5%), confirming the ectopic gallstone in 86.7% of cases, pneumobilia in 65.3%, and cholecytocolonic fistula in 68%. The treatment option included laparotomy with cololithotomy and primary closure (24.7%), laparotomy and cololithotomy with diverting stoma (14.2%), colonic resection with anastomosis (7.9%), colonic resection with a colostomy (12.4%), laparoscopy with cololithotomy with primary closure (2.6%), laparoscopy with cololithotomy with a colostomy (0.9%), colostomy without gallstone extraction (5.3%), endoscopic mechanical lithotripsy (success rate 41.1%), extracorporeal shock wave lithotripsy (1.8%). The cholecystectomy rate was 46.7%; during the initial procedure 25%, and as a separate procedure, 21.7%; 53.3% of patients had no cholecystectomy. The survival rate was 87%. CGI is the rarest presentation of gallstone ileus, mainly in women over 70 years of age, with gallstones over 2 cm, and predominantly in the sigmoid colon. Abdominal CT is diagnostic. Nonoperative treatment, particularly in subacute presentations, should be the first-line treatment. Laparotomy with cololithotomy or colonic resection is a standard procedure with favorable outcomes. There are no robust data on whether primary or delayed cholecystectomy is mandatory as a part of CGI management.
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Affiliation(s)
- Goran Augustin
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Tomislav Bruketa
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Kristian Kunjko
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ivan Romić
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mislav Mikuš
- Department of Gynecology and Obstetrics, University Hospital Centre Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia.
| | - Adam Vrbanić
- Department of Gynecology and Obstetrics, University Hospital Centre Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
| | - Alessandro Tropea
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT, University of Pittsburgh Medical Center, Palermo, Italy
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Jerjen F, Zaidi T, Chan S, Sharma A, Mudliar R, Soomro K, Jimenez Y, Reed W. Magnetic Resonance Imaging for the diagnosis and management of acute colonic diverticulitis: a review of current and future use. J Med Radiat Sci 2021; 68:310-319. [PMID: 33607699 PMCID: PMC8424307 DOI: 10.1002/jmrs.458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 12/14/2022] Open
Abstract
Diverticular disease is one of the most common causes of outpatient visits and hospitalisations across Australia, North America and Europe. According to the Gastroenterological Society of Australia (GESA, 2010), approximately 33% of Australians over 45 years of age and 66% over 85 years of age have some form of colonic diverticulosis. Patients with colonic diverticulosis are known to develop subsequent complications such as acute colonic diverticulitis (ACD), and when more than one attack of diverticulitis occurs, there is a 70-90% chance that the individual will experience ongoing problems and recurring infections throughout their lifetime. Medical imaging is fundamental in the diagnosis, treatment and ongoing management of ACD and its complications, with Computed Tomography (CT) identified as the prevailing gold standard in the last few decades. Cross-database searching highlighted a large gap in the literature regarding the effectiveness of Magnetic Resonance Imaging (MRI) as a non-ionising radiation alternative imaging tool for ACD imaging after the mid-2000s, despite ongoing technological advancements in this modality. This narrative review identified 13 key publications (11 primary prospective cohort studies, 1 systematic review and 1 meta-analysis) that evaluate MRI for ACD imaging, of which five were published within the last decade. Several existing MRI protocols are deemed suitable for ACD imaging, and it is recommended they be re-evaluated in larger cohorts. Future studies should consider the rapidly growing technological improvements of MRI, its cost efficiency and its applicability in modern day healthcare settings when addressing ACD management. This is especially important considering the gradual rise in radiation dose among the Australian population attributable to increased CT referrals, alongside increased reporting of ACD cases in younger individuals.
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Affiliation(s)
- Franziska Jerjen
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Tooba Zaidi
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Shannon Chan
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Ajay Sharma
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Reuel Mudliar
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Khadija Soomro
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Yobelli Jimenez
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Warren Reed
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
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Pagnini F, Cervi E, Maestroni U, Agostini A, Borgheresi A, Piacentino F, Angileri SA, Ierardi AM, Floridi C, Carbone M, Ziglioli F, De Filippo M. Imaging guided percutaneous renal biopsy: do it or not? ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:81-88. [PMID: 32945282 PMCID: PMC7944675 DOI: 10.23750/abm.v91i8-s.9990] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/11/2020] [Indexed: 01/03/2023]
Abstract
Since its first reported application, renal biopsy became an important part of the diagnostic algorithm, considered advantages and risks, to better manage therapeutic options. The biopsy can be performed with different techniques (open, laparoscopic, transjugular, transurethral and percutaneous). Currently, the percutaneous approach is the modality of choice. Percutaneous biopsy can be performed under CT or US guidance, but critical benefits and disadvantages have to be considered. Core needle biopsy is usually preferred to fine-needle aspiration because of the sample quality, usually obtaining multiple cores, especially in heterogeneous tumors. Principal complications are hematuria (1-10%), perinephric hematoma (10-90%), pneumothorax (0,6%), clinically significant pain (1,2%).
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Affiliation(s)
- Francesco Pagnini
- Department of Medicine and Surgery, Unit of Radiology, University of Parma, Parma, Italy.
| | - Eleonora Cervi
- Department of Medicine and Surgery, Unit of Radiology, University of Parma, Parma, Italy.
| | - Umberto Maestroni
- Department of Urology, Azienda Ospedaliero-Universitaria di Parma, University of Parma, Parma, Italy.
| | - Andrea Agostini
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche and Department of Radiology - Division of Special and Pediatric Radiology, University Hospital "Umberto I - Ancona, Italy.
| | - Alessandra Borgheresi
- Department of Radiology - Division of Special and Pediatric Radiology, University Hospital "Umberto I - Ancona, Italy.
| | - Filippo Piacentino
- Department of Diagnostic and Interventional Radiology, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
| | - Salvatore Alessio Angileri
- Radiology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
| | - Anna Maria Ierardi
- Radiology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
| | - Chiara Floridi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche and Department of Radiology - Division of Special and Pediatric Radiology, University Hospital "Umberto I - Ancona, Italy.
| | - Mattia Carbone
- Department of Radiology, San Giovanni E Ruggi D'Aragona Hospital, Salerno, Italy.
| | - Francesco Ziglioli
- Department of Urology, Azienda Ospedaliero-Universitaria di Parma, University of Parma, Parma, Italy.
| | - Massimo De Filippo
- Department of Medicine and Surgery, Unit of Radiology, University of Parma, Parma, Italy.
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Reginelli A, D'Andrea A, Clemente A, Izzo A, Urraro F, Scala F, Nardone V, Guida C, Scialpi M, Cappabianca S. Does multiparametric US improve diagnostic accuracy in the characterization of small testicular masses? Gland Surg 2019; 8:S136-S141. [PMID: 31559180 DOI: 10.21037/gs.2019.04.03] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Recent advances in ultrasonography (US) have produced new innovative techniques for the non-invasive assessment of testicular masses. The aim of this study was to investigate the diagnostic performance of multiparametric US, including gray-scale, Color-power Doppler and real-time elastography (RTE) analysis, in the characterization of testicular lesions. Methods Fifty-four patients (median 42.2 years; range, 10-64 years) with testicular lesions detected with gray-scale US and power Doppler US were evaluated with RTE. The tissue elasticity was assessed in all lesions. Hard lesions were suspected of being malignant while testicular lesions with normal or decreased tissue stiffness (soft lesions) were considered benign. Intraoperative findings were the standard of reference. Sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic accuracy were calculated for each US method and in combination. Results Forty-six of the 54 lesions (85.2%) were testicular malignant tumors. Thirty-five out of 46 (76%) were ≥2 cm [seminomas (n=18), mixed seminomatous and/or nonseminomatous tumors (n=9), embryonal carcinomas (n=2), immature teratomas (n=3) and Leydig cell tumors (n=3)] while the remaining 11 tumors were <2 cm [seminomas (n=5), mixed germinal cells tumors (n=2), immature teratomas (n=2) and Leydig cell tumors (n=2)]. Eight out of 54 lesions (14.8%) were benign lesions (orchitis n=2, dermoid cyst n=1, adrenal rest n=1, papillary cystadenoma n=1, sclero-hyaline nodule n=1, focal fibrosis n=1 and post-traumatic focal fibrosis n=1). RTE showed the presence of hard pattern in 40 out of 46 (87%) malignant tumors and in 2 out of 8 (25%) of benign lesions. The combination of gray-scale US, Color-power Doppler and RTE aided a sensitivity of 100%, a specificity of 83%, a negative predictive value of 100%, a positive predictive value of 91% and accuracy of 90%. Conclusions RTE demonstrated to increase the diagnostic accuracy of conventional US in the characterization of testicular lesions providing additional information on tissue stiffness. The multiparametric US evaluation has proven to increase the diagnostic performance in the characterization of testicular lesions.
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Affiliation(s)
- Alfonso Reginelli
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Alfredo D'Andrea
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Alfredo Clemente
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Andrea Izzo
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Fabrizio Urraro
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Fernando Scala
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Valerio Nardone
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Cesare Guida
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Michele Scialpi
- Section of Diagnostic Imaging, Department of Surgical and Biomedical Sciences, S. Maria della Misericordia Hospital, Perugia University, S. Andrea delle Fratte, Perugia, Italy
| | - Salvatore Cappabianca
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
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Pagnini F, D'Amuri FV, Bevilacqua A, Sabatino V, Russo U, Zappia M, Natella R, Palumbo P, Pradella S, Miele V, De Filippo M. Ultrasound-guided percutaneous irrigation of calcific tendinopathy: technical developments. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:95-100. [PMID: 31085978 PMCID: PMC6625565 DOI: 10.23750/abm.v90i5-s.8333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Indexed: 12/26/2022]
Abstract
Rotator cuff calcific tendinopathy (RCCT) is a common and painful shoulder disease characterised by deposition of calcium into the rotator cuff’s tendond. Different therapeutic options have been proposed, but the ultrasound-guided percutaneous irrigation (US-PICT) is been proved as an effective and safe first-line treatment. It can be performed with a single- of a double-needle tecnique, using warm saline solution to improve the dissolution of the calcific deposit. The procedure is ended with an intrabursal injection of local anaesthetics and slow-release steroids to improve the pain relief and to prevent complications. US-PICT leads to significative improvement in the shoulder funtion and pain relief in the short and long term, with a low complications rate. (www.actabiomedica.it)
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Affiliation(s)
- Francesco Pagnini
- Department of Medicine and Surgery, Unit of Radiologic Science, University of Parma, Maggiore Hospital, Parma, Italy.
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6
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Bevilacqua A, D'Amuri FV, Pagnini F, Sabatino V, Russo U, Maggialetti N, Palumbo P, Pradella S, Giovagnoni A, Miele V, De Filippo M. Percutaneous needle biopsy of retroperitoneal lesions: technical developments. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:62-67. [PMID: 31085974 PMCID: PMC6625572 DOI: 10.23750/abm.v90i5-s.8331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Indexed: 02/08/2023]
Abstract
Percutaneous Needle Biopsy (PNB) is the insertion of a needle into a suspected lesion or an organ with the aim to obtain cells or tissue for diagnosis. It’s a relatively non-invasive procedure and is performed by radiologist under guidance of imaging techniques such as ultrasound (US), computed tomography (CT), fluoroscopy, magnetic resonance imaging (MRI), and positron emission tomography CT (PET-CT). The choice of imaging technique depends on the evaluation of the target lesion and patient compliance. PNB includes two categories: fine-needle aspiration biopsy (FNAB) that is the use of a thin needle (18-25 gauge) to extract cells for cytological evaluation; and core needle biopsy (CNB) that is the use of a larger needle (9-20 gauge) to extract a piece of tissue for histological evaluation. The indications for biopsy are the characterization of nature (benign or malignant) of a lesion, diagnosis and staging of tumor, and biological or immunohistochemical/genetic analisys on tissue. Success of PNB is the procurement of sufficient material to characterize lesions and to guide the patient outcome. Major complications are rare. PNB became a useful technique in diagnosis and study of retroperitoneal lesions, because of a more suitable access to specific intra-abdominal structures, lowering the risk of injury of interposed structures (such as bowel, great vessels). (www.actabiomedica.it)
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Affiliation(s)
- Andrea Bevilacqua
- Department of Medicine and Surgery, Unit of Radiologic Science, University of Parma, Maggiore Hospital, Parma, Italy.
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Manetta R, Capretti I, Belleggia N, Marsecano C, Viscido A, Bruno F, Arrigoni F, Ma L, Guglielmi G, Splendiani A, Di Cesare E, Masciocchi C, Barile A. Magnetic resonance enterography (MRE) and ultrasonography (US) in the study of the small bowel in Crohn's disease: state of the art and review of the literature. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:38-50. [PMID: 31085972 PMCID: PMC6625566 DOI: 10.23750/abm.v90i5-s.8337] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Indexed: 02/06/2023]
Abstract
Crohn’s disease (CD) is a chronic idiopathic disease and its diagnosis is based on a combination of clinical symptoms, laboratory tests and imaging data. There isn’t a diagnostic gold standard: the ileocolonoscopy with mucosal biopsies represents the standard for luminal disease, while cross-sectional imaging such as Ultrasound (US), Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) can show transmural alterations and extraintestinal manifestations. CD is usually diagnosed in the young age and after baseline diagnosis, the patients have to undergo to variable follow-up depending on remission or active disease. The aim of our review is to compare Magnetic Resonance Enterography (MRE) to Ultrasonography (US) in the follow-up of CD. (www.actabiomedica.it)
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Affiliation(s)
- Rosa Manetta
- Division of Radiology, S. Salvatore Hospital, L'Aquila, Italy.
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Mariniello G, De Liso M, Russo C, Del Vecchio W, De Divitiis O, Bruno F, Maggialetti N, Arrigoni F, Brunese L, Caranci F. Radiation-induced brain cavernomas in elderly: review of the literature and a rare case report. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:77-83. [PMID: 31085976 PMCID: PMC6625569 DOI: 10.23750/abm.v90i5-s.8328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Indexed: 12/16/2022]
Abstract
Radiation-induced brain cavernomas have been mainly reported in children who underwent radiotherapy for medulloblastoma, leukemia, or low-grade glioma. Otherwise, the “de novo” appearance of a cavernoma in an elderly long-survivor patient after resection and radiotherapy of a glioblastoma is a rare event. We report the case of a 62-year-old female patient who underwent surgical resection of a right temporal glioblastoma, followed by radiation therapy of the operative field and surrounding brain and concomitant adjuvant temozolomide. Four years after the operation, a follow-up Magnetic Resonance revealed a good tumor control and a small round lesion at the superior surface of the right cerebellar hemisphere, close to the margins of the previous irradiation field. The radiological items were consistent with a cavernous angioma. Because of the small size of the malformation and the absence of related symptoms, no treatment was performed. The patient died for tumor progression 86 months after the initial operation, with unchanged cerebellar cavernoma. The occurrence of a cavernous angioma in an elderly patient after radiotherapy for brain glioblastoma is an exceptional event; the distribution of radiotherapy-induced cavernous malformations reported in current literature is presented and the mechanism of their formation is discussed. (www.actabiomedica.it)
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Affiliation(s)
- Giuseppe Mariniello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Neurosurgical Clinic, University of Naples Federico II, Naples, Italy.
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9
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De Filippo M, Brunese L, Reginelli A. Advances in diagnostic and interventional radiology. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:5-8. [PMID: 31085969 PMCID: PMC6625574 DOI: 10.23750/abm.v90i5-s.8327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Indexed: 11/23/2022]
Affiliation(s)
- Massimo De Filippo
- Department of Medicine and Surgery, Unit of Radiologic Science, University of Parma, Maggiore Hospital, Parma, Italy.
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10
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Bruno F, Arrigoni F, Mariani S, Patriarca L, Palumbo P, Natella R, Ma L, Guglielmi G, Galzio RJ, Splendiani A, Di Cesare E, Masciocchi C, Barile A. Application of diffusion tensor imaging (DTI) and MR-tractography in the evaluation of peripheral nerve tumours: state of the art and review of the literature. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:68-76. [PMID: 31085975 PMCID: PMC6625568 DOI: 10.23750/abm.v90i5-s.8326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Indexed: 12/18/2022]
Abstract
Peripheral nerves can be affected by a variety of benign and malignant tumour and tumour-like lesions. Besides clinical evaluation and electrophysiologic studies, MRI is the imaging modality of choice for the assessment of these soft tissue tumours. Conventional MR sequences, however, can fail to assess the histologic features of the lesions. Moreover, the precise topographical relationship between the peripheral nerve and the tumor must be delineated preoperatively for complete tumour resection minimizing nerve damage. Using Diffusion tensor imaging (DTI) and tractography, it is possible to obtain functional information on tumour and nerve structures, allowing the assess anatomy, function and biological features. In this article, we review the technical aspects and clinical application of DTI for the evaluation of peripheral nerve tumours. (www.actabiomedica.it)
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Affiliation(s)
- Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
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11
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Reginelli A, Vacca G, Zanaletti N, Troiani T, Natella R, Maggialetti N, Palumbo P, Giovagnoni A, Ciardiello F, Cappabianca S. Diagnostic value/performance of radiological liver imaging during chemoterapy for gastrointestinal malignancy: a critical review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:51-61. [PMID: 31085973 PMCID: PMC6625573 DOI: 10.23750/abm.v90i5-s.8346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Indexed: 12/28/2022]
Abstract
This article reviews the main toxic effect, complications and relative imaging findings of the liver that may appear during the oncologic follow up among patients affected by gastrointestinal malignancy. Awareness of the causative chemotherapeutic agent and regimens, pathophysiology and relative characteristic imaging findings of hepatic injuries is critical in order to obtain an accurate diagnosis especially when these parenchymal lesions are focal. An accurate synergic radiological diagnosis with Computed Tomography (CT) and Magnetic Resonance (MR) techniques may induce a potential termination of ineffective/toxic chemotherapy during early phases of treatment, changing the therapeutic plan in order to avoid first unnecessary liver biopsy and then invasive treatment as hepatic resection if not required.
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Affiliation(s)
- Alfonso Reginelli
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.
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12
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Curved Needles in CT-Guided Fine Needle Biopsies of Abdominal and Retroperitoneal Small Lesions. Cardiovasc Intervent Radiol 2015; 38:1611-6. [DOI: 10.1007/s00270-015-1107-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/28/2015] [Indexed: 10/23/2022]
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13
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De Filippo M, Bozzetti F, Martora R, Zagaria R, Ferretti S, Macarini L, Brunese L, Rotondo A, Rossi C. Radiofrequency thermal ablation of renal tumors. Radiol Med 2014; 119:499-511. [PMID: 25024061 DOI: 10.1007/s11547-014-0412-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 04/30/2014] [Indexed: 01/08/2023]
Abstract
Percutaneous radiofrequency ablation (PRFA) of renal malignancies is currently a therapeutic option for patients who are not able to undergo surgery. Some authors consider PRFA as the therapeutic standard in the treatment of renal neoplasms in non-operable patients due to comorbid conditions and in patients with mild-moderate renal failure, to preserve residual renal functionality. The use of PRFA has become more and more widespread due to a rise in the incidental detection of renal cell carcinomas with the ever-increasing use of Imaging for the study of abdominal diseases. Clinical studies indicate that RF ablation is an effective therapy with a low level of risk of complications, which provides good results in selected patients over short and medium term periods of time, however up to now few long-term studies have been carried out which can confirm the effectiveness of PRFA.
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Affiliation(s)
- Massimo De Filippo
- Section of Diagnostic Imaging, Department of Surgical Sciences, University Hospital of Parma, Via Gramsci 14, 43100, Parma, Italy,
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