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Publications (17)29.24 Total impact

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    ABSTRACT: The case is described of a 74-year-old woman who presented with an abdominal abscess 1.5 years after laparascopic cholecystectomy. CT and ultrasound showed the presence of gallstones within the abscess. Spillage of gallstones from perforation of the gallbladder is a well recognized complication of laparascopic cholecystectomy, although subsequent abscess formation is unusual especially after a long delay as in this case.
    British Journal of Radiology 03/1999; 72(854):201-3. · 1.22 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the capability of Gd-DTPA-enhanced MRI to differentiate between exudative and transudative pleural effusions. An MRI examination was performed on 22 patients with different types of pleural effusion (10 transudative and 12 exudative effusions). T1-weighted SE images were obtained before and 20 min after administration of Gd-DTPA (0.1 mmol/kg). The degree of enhancement of pleural effusions was evaluated both by visual assessment and by quantitative analysis of images. None of 10 transudative effusions showed significative enhancement, whereas 10 of 12 exudative effusions showed enhancement (sensitivity 83 %, specificity 100 %, positive predictive value 100 %). The postcontrast signal intensity ratios (SIRs) of exudates were significantly higher than corresponding precontrast ratios (P = 0. 0109) and the postcontrast SIRs of exudates were significantly higher than those of transudates (P = 0.0300). Exudative pleural effusions show a significant enhancement following administration of Gd-DTPA. We presume that this may be caused by increased pleural permeability and more rapid passage of a large amount of Gd-DTPA from the blood into the pleural fluid in case of exudative effusions. In our limited group of patients, signal enhancement proved the presence of an exudative effusion. Absence of signal enhancement suggests a transudate, but does not exclude an exudate.
    European Radiology 02/1997; 7(6):860-4. · 4.34 Impact Factor
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    ABSTRACT: Postthoracotomy atrophy of chest wall muscles results from nerve injury during surgery. After encountering patients with different patterns of chest wall muscular atrophy postthoracotomy, we performed this study to determine the relationship between type of thoracotomy and atrophic muscles as seen on CT scans. CT scans of 58 patients who had previously undergone unilateral thoracotomy were reviewed. Forty patients had a posterolateral thoracotomy, and 18 had an anterolateral thoracotomy. In two cases, the incision extended posteriorly. Atrophy seen on CT scans was defined as a marked decrease in size or thickness of a muscle compared with the muscle on the other side. Atrophy of the latissimus dorsi muscle and of the inferior portion of the serratus anterior muscle was detected on CT scans in 40 patients. No atrophy was found in 16 patients. The remaining two displayed atrophy only in the serratus anterior muscle. Atrophy of the latissimus dorsi muscle and of the inferior portion of the serratus anterior muscle developed in all patients who had a posterolateral thoracotomy. Atrophy developed in only two of the 18 patients who had an anterolateral thoracotomy, and in these two, the incision had been extended posteriorly. A direct correlation was found between type of thoracotomy and site of atrophy of the chest wall muscles seen on CT scans. This finding may account for different CT appearances of the thoracic wall in patients who have had thoracic surgery.
    American Journal of Roentgenology 04/1995; 164(3):599-601. · 2.90 Impact Factor
  • C Frola, S Cantoni, I Turtulici, F Loria
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    ABSTRACT: Computed tomography (CT) is used increasingly as an early radiological examination in patients with suspected bowel infarction because it provides information about the intestinal wall, mesenteric circulation and peritoneal cavity [1, 2]. Other disorders that present with similar symptoms such as intraabdominal abscess, pancreatitis and ulcerative colitis can be excluded [3]. CT can demonstrate small amounts of air within the bowel wall, in the spleno-mesenteric-portal venous system and in the peritoneal cavity, making it possible to differentiate portal venous gas from pneumobilia. The authors describe a patient in whom a specific diagnosis of bowel infarction was made on the characteristic CT findings. Furthermore, air embolism was observed in the splenic parenchyma. This finding has not been previously reported in bowel infarction or in any other abdominal disorder.
    British Journal of Radiology 01/1995; 67(804):1272-4. · 1.22 Impact Factor
  • European Journal of Ultrasound 01/1995; 2(4).
  • C Frola, F Loria, S Cantoni
    La radiologia medica 12/1994; 88(5):687-8. · 1.46 Impact Factor
  • La radiologia medica 10/1994; 88(3):320-3. · 1.46 Impact Factor
  • M Gaeta, G Loria, S Cantoni, F Loria, C Frola
    La radiologia medica 07/1994; 87(6):903-5. · 1.46 Impact Factor
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    ABSTRACT: In this paper the authors try to define CT criteria for the evaluation of hepatic and splenic injuries in blunt abdominal traumas, to suggest and guide the nonoperative management of trauma in hemodynamically stable patients. The predictive value of CT on the outcome of the nonoperative treatment in adult patients with blunt hepatic and splenic trauma is trusted more and more also thanks to the good results of conservative management in similar injuries in pediatric patients. Thus, we reviewed 314 emergency abdominal CT scans performed in our center March 1990 to March 1992. The hepatic and splenic injuries detected on CT scans were evaluated according to a CT-based injury classification in grades, with a score reflecting progressive severity of lesions. Moreover, the presence of intraperitoneal hemorrhage was determined and quantified on the basis of a standard classification system. Of 314 cases, CT revealed blunt hepatic injury in 17 patients and blunt splenic injury in 38. We excluded the patients who exhibited, besides the hepatic or splenic injury, other severe visceral lesions which might need surgery. Nonoperative management was attempted in 9 of 17 patients with hepatic injury and in 4 of 38 patients with splenic injury detected by CT; the scores given according to the above classification system were compared with the clinical outcome. The results indicate that hepatic injuries up to and including grade III, as assessed by CT, can be successfully managed without surgery in hemodynamically stable patients. As for splenic traumas, nonoperative management was attempted in a very small number of patients. Even though a case of grade-III splenic injury in our series was successfully treated without surgery, this may not be the rule, because the outcome of splenic injury and of intraperitoneal hemorrhage is often unpredictable.
    La radiologia medica 01/1994; 86(6):833-40. · 1.46 Impact Factor
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    ABSTRACT: This study was aimed at assessing the role of CT in the investigation of extraductal spread of hilar cholangiocarcinoma. October 1990 to November 1993, twenty-one patients with hilar cholangiocarcinoma were examined. The diagnosis was made on the basis of the following CT findings: intrahepatic bile ducts dilatation, nonunion of the right and the left bile ducts, normal size of extrahepatic bile ducts and the tumor depicted "per se". As for extraductal spread, we considered parenchymal invasion, involvement of vascular structures and parenchymal, lymph node and peritoneal metastases. In all cases CT demonstrated intrahepatic bile duct dilatation and nonunion at the confluence. CT demonstrated a hypodense mass in 10/21 cases and an isodense mass in 11/21 cases. Portal vein involvement was detected in 7/10 cases and hepatic artery involvement was correctly suspected in 1/8 cases; CT demonstrated parenchymal and lymph node metastases in 1/6 and 2/7 cases. In conclusion, CT proved to be a valuable technique, like PTC and US, to assess tumor resectability.
    La radiologia medica 01/1994; 88(1-2):63-7. · 1.46 Impact Factor
  • La radiologia medica 01/1994; 86(6):917-9. · 1.46 Impact Factor
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    American Journal of Roentgenology 11/1993; 161(4):753-4. · 2.90 Impact Factor
  • C Frola, S Cantoni, M Panetta, C Leoni
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    ABSTRACT: Rounded atelectasis is a peculiar form of lung collapse which is well known by radiologists. Its appearance on conventional radiographs and CT is by now well recognized and widely reported. Even though these two techniques usually allow a diagnosis to be made, the MR appearance of rounded atelectasis is worth mentioning as well. This diagnostic imaging technique is widely employed, and our experience suggests that, in some cases, MR Imaging can give an important contribution to the study of this condition. We report our experience with 6 cases of rounded atelectasis in 5 patients (one patient had bilateral lesions). Five signs characteristic of rounded atelectasis were observed: some of them are seen on both conventional radiographs and CT scans, others are typical of the latter technique. All cases showed peripheral location of the lesions and the "comet tail" sign--i.e., vascular structures gently curving into the mass. These two signs are also observed on conventional radiographs and CT scans. Typical of MR imaging are the extant 3 signs: low signal in T1 and high signal in T2-weighted images in the whole of our cases; no signal from pleural thickening next to the mass in T2-weighted images, and, finally, the "kidney-like" pattern--i.e., hypointense lines converging toward the center of the mass. All these signs, which were always observed in our series, support the current etiopathogenetic hypothesis of pleural effusion as an early sign, which is reported to be followed by fibrous pleural involution which wraps atelectatic parenchyma up. On the basis of these typical MR features a correct diagnosis can usually be made even in those cases in which conventional radiography and CT do not allow a definite diagnosis.
    La radiologia medica 05/1992; 83(4):423-7. · 1.46 Impact Factor
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    ABSTRACT: The authors investigated the real contribution of low-field MR imaging in the follow-up of pneumonectomized patients. Literature on the subject is surprisingly poor, even though MR diagnostic capabilities seem to be great in these patients. Because of the peculiar anatomical features of pneumonectomized patients, low-field MR imaging yields high-quality images. The operated hemithorax, with the postpneumonectomy space full of fluid, in the absence of respiratory movements is free of movement artifacts. The latter are known to worsen image quality in thoracic MR imaging, especially without respiratory gating. In the study of mediastinum and operated hemithorax MR imaging provides the highest diagnostic contribution. In the mediastinum MR images demonstrate enlarged lymph nodes and tumor recurrences and is superior to CT especially when great vessels are involved. In the study of the operated hemithorax, MR imaging is preferable to CT to identify parietal lesions, because of its higher spatial resolution. Moreover, MR imaging allows tumor recurrences to be differentiated from normal muscular tissue and from fibrous tissue on the basis of their different signal intensities as observed on the various pulse sequences.
    La radiologia medica 12/1990; 80(5):609-13. · 1.46 Impact Factor
  • G B Ratto, C Frola, S Cantoni, G Motta
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    ABSTRACT: The criterion of choice for computed tomographic scan identification of metastatic mediastinal nodes is not clearly fixed. This prospective study was designed to define the most suitable computed tomographic criterion for detection of nodal metastasis, enabling improvement of the test's clinical efficacy. One hundred twenty-three patients with potentially operable non-small cell lung cancer underwent mediastinal evaluation by computed tomographic scan and cervical mediastinoscopy followed by thoracotomy with mediastinal node dissection. There were 116 men and seven women; the mean age was 59.3 +/- 9.1 years. Forty-six tumors were classified after operation as stage I, 20 as stage II, 27 as stage IIIa, and 30 as stage IIIb. Mediastinal nodes were classified as metastatic according to the following computed tomographic scan criteria: (1) shorter axis 1 cm or larger; (2) shorter axis 1.5 cm or larger (nodes less than 1 cm were classified as negative and those 1 to 1.5 cm as indeterminate); and (3a) shorter axis 1 cm or larger, plus evidence of central necrosis or discontinued capsule, or (3b) shorter axis 2 cm or more, regardless of the nodal morphologic condition. The highest sensitivity rate was achieved by using criterion 1 (90%) and the poorest by criterion 3 (75%). The greatest specificity rate was obtained by applying criterion 3 (90%) and the lowest by criterion 1 (54%). The prediction by using computed tomographic criterion 3 correlated better with pathologic findings than that derived by adopting the criterion 1 or 2. When mediastinal nodes were identified as negative according to criterion 1, 2, or 3, the complete resection rate was 92%, 92%, or 95%, respectively, rendering cervical mediastinoscopy unnecessary. When mediastinal nodes were classified as positive, the resectability rate was 55%, 27%, or 13%, respectively. In these instances cervical mediastinoscopy allowed identification of different degrees of mediastinal involvement; it proved to be the most useful procedure for preoperative selection of those patients with N2 tumors who are amenable to a complete resection. In conclusion, the use of computed tomographic criterion 3 does improve the clinical efficacy of the test, by sparing a large number of unnecessary mediastinal explorations, without increasing the rate of useless thoracotomies.
    Journal of Thoracic and Cardiovascular Surgery 04/1990; 99(3):416-25. · 3.53 Impact Factor
  • La radiologia medica 10/1986; 72(9):667-9. · 1.46 Impact Factor