Combined isotope ventriculography and lumbar myelocisternography in the diagnosis of communicating syringomyelia. Case report.

Several investigative procedures are currently used to diagnose communicating syringomyelia. The combination of isotope ventriculography and lumbar myelocisternography has never proposed nor carried out to verify this condition. We feel that this is a safe and valuable procedure to identify a patent central canal communicating with the fourth ventricle and is worth considering when diagnosing communicating syringomyelia.

Myelography with metrizamide in the study of the lumbosacral tract.

The authors report their experience with Metrizamide (Amipaque) in the myelographic study of the lubosacrale) in the myelographic study of the lumbosacral tract. They compare their results with those obtained with other hydrosoluble contrast agents and correlate them with surgical findings. Metrizamide appears to be preferable to other hydrosoluble contrast agents due to its better radiological definition and because of the lower frequency of complications related to its use.

[Hepatic scintigraphy and laparoscopy in the diagnosis of the metastatic liver neoplasms. Comparative studies in 112 cases]. / Scintigrafia epatica e laparoscopia nella ricerca delle metastasi del fegato. Osservazioni comparative in 112 casi

Personal experience of hepatic scintigraphy and laparoscopy in the diagnosis of secondary tumors of the liver is reported. The usefulness of both the techniques, associated, is proved by the small number of cases (2,98%) where metastases remained undiagnosed before surgery. Considering only the results of scanning, a larger number of "false positive" is noted, while those of laparoscopy are more often "false negative".

[Value and limitations of intravenous cholangiography in the diagnosis of the main bile duct diseases. Studies in 209 cases controlled surgically]. / Valore e limiti della colangiografia endovenosa nella diagnostica delle affezioni della via biliare principale

The value and limits of i.v. cholangiography were appraised in the light of the surgical picture in 209 patients. Exact preoperative diagnosis was possible in many cases, while no more than dilatation of the main bile duct was demonstrable in others. False negatives mainly concerned lithiasis of the common duct without jaundice, whereas false positive lithiasis was primarily observed in papilitis and cephalopancreatitis.

[Computerized tomography and scintigraphy in the evaluation of osteoid osteoma]. / Tomografia computerizzata e scintigrafia nella valutazione dell'osteoma osteoide.

The authors report their experience of bone scintigraphy and computed tomography in 19 patients, with suspected osteoid osteomas, who underwent surgery. Basing on surgical findings, the role of these techniques in diagnosis, surgical planning and follow-up of osteoid osteoma is stressed and the results are compared with those of conventional radiography.

[Perinatal cerebral ischemic injury. Neuropathologic bases and correlations with computerized tomography]. / Il danno ischemico cerebrale perinatale. Basi neuropatologiche e correlazioni con la tomografia computerizzata.

The term "hypoxic-ischemic encephalopathy" covers a large part of neonatal neuropathology including the various forms of intracerebral haemorrhage. In the present work the term is confined to ischemic brain edema and actual infarction, be it diffuse or focal. Eighteen newborns with CT evidence of ischemic brain lesions and infarct necrosis were selected. Emphasis is placed on current data on neuropathology of ischemic brain edema and its CT appearance. Particular entities such as periventricular leukomalacia and multicystic encephalopathy are discussed. Relationship between CT and temporal profile of cerebral damage is emphasized in order to predict the structural sequelae and the longterm prognosis.

MR of benign peripheral nerve sheath tumors.

Seventeen benign peripheral nerve sheath tumors were studied using MR. In all cases T2 relaxation time, signal intensity on T1-weighted images (lesion/muscle ratio), detectability of nerve of origin, nerve-lesion relationship, and presence of a capsule were assessed. Sixteen tumors showed marked hyperintensity on T2-weighted images with T2 relaxation times values greater than 95 ms. One schwannoma was almost isointense with fat (T2 60 ms). All lesions were isointense with muscle on T1-weighted images. In schwannomas the nerve was usually situated at the periphery of the lesion and only in one case was it obliterated by the mass. In neurofibromas the nerve was either visible in a central position within the mass (two cases) or no longer visible (five cases). A capsule could be detected in 70% of the schwannomas and in 30% of the neurofibromas. In patients with soft tissue masses, MR may contribute to recognition of nerve sheath tumors by showing the nerve of origin and typical signal hyperintensity on T2-weighted images. It can also be helpful in distinguishing between schwannomas and neurofibromas by the location of the nerve of origin and the presence of a capsule.

The radiologic "Target sign" of septic pulmonary embolism in a case of acute myelogenous leukemia.

The authors report the appearance of septic pulmonary embolism in a case of acute myelogenous leukemia. The pulmonary lesions are characterized radiographically by the uncommon appearance of central densities suspended within thin-walled pseudocystic air spaces. A possible pathogenic mechanism explaining these radiographic findings is discussed. Such images must be distinguished from those of a fungus ball or tuberculous cavities.

[Fibrinolytic therapy in acute myocardial infarction. Coronarographic evaluation of short-term results]. / La terapia fibrinolitica nell'infarto miocardico acuto. Valutazione coronarografica dei risultati a breve termine.

The authors report their experience in fibrinolytic therapy with Urokinase in acute myocardial infarction. There were 3 groups of treatment: 100 patients with intracoronary fibrinolytic therapy; 77 patients with peripheral venous fibrinolytic administration; 31 patients with conventional therapy. The 3 groups underwent, between 21 and 28 days after the acute event, a coronarographic examination to evaluate the persistence of patency of the vessels involved in the myocardial infarction. The short term results show that the fibrinolytic therapy (with the limitations due to the hemorrhagic complications associated with the use of Urokinase), especially via intracoronary, is significantly more useful and reliable than conventional therapy, which appears unsatisfactory. Therapeutic failures are probably due to diffuse atherosclerosis of the vessel and/or to the old age of the thrombus.

[Computerized tomography in the study of myelopathy in cervical spondylosis]. / La tomografia computerizzata nello studio della mielopatia da spondilosi cervicale.

This study involved 107 patients selected according to symptoms and signs of myelopathy due to cervical spondylosis. All patients were examined by high resolution CT without intravenous or intrathecal contrast enhancement. Diagnostic accuracy of CT is discussed with regard to idiopathic and degenerative cervical spinal stenosis. Emphasis is placed on CT findings of ossification of posterior longitudinal ligament. The authors conclude that plain CT may be a reliable method for diagnosing cervical spondylothic myelopathy. Nevertheless the authors stress how intrathecal contrast enhanced CT is far superior to plain CT in the selection of a definitive anterior or lateral surgical approach without a delay.

Laparoscopic cholangiography in the diagnosis of cholestasis: experience with 103 cases.

The results of 103 laparoscopic cholangiographies performed in patients with cholestasis are reported and the technique used is described. Minimal or no secondary effects were noted. A correct diagnosis was reached in 92 cases, 53 of which presented cholestasis of an extrahepatic nature and 39 of intrahepatic origin. In the latter group, the technique made exploratory laparotomy unnecessary. The procedure allows a roentgenologic examination of the biliary system, a direct evaluation of the liver and gallbladder and, if necessary, a liver biopsy.