RESUMEN
The aim of this study was to evaluate the accuracy of enteroclysis in the diagnosis of Crohn's disease of the small bowel in a group of consecutive patients. From January 1992 to December 1995, 165 patients with suspected Crohn's disease of the small bowel presented to our institution for enteroclysis. In 14 patients up to three enteroclysis exams were performed. Most patients (78%) underwent colonoscopy and retrograde ileoscopy. In the remaining patients clinical follow-up was used as gold standard. In 79 patients no radiographic abnormalities were found. Sixty-one patients (40 men and 21 women; mean age 34.2 years) had a radiological diagnosis of Crohn's disease. This involved the terminal ileum in 39 patients (64%) either alone (n = 25) or in association with the pelvic ileum (n = 14). In 12 of these patients retrograde ileoscopy was not feasible. Twenty-one patients underwent surgery. In 4 patients pathology revealed diseases other than Crohn's. These patients had all ileocecal diseases (tuberculosis = 2; non-Hodgkin's lymphoma = 1; adenocarcinoma = 1). One false-negative result was observed. Overall, enteroclysis showed a sensitivity of 98.2% and a positive predictive value of 93.4%. Enteroclysis is a sensitive technique in evaluating both the extent and the severity of small bowel involvement in Crohn's disease, although the overlap of radiographic findings may hamper its accuracy when the disease is confined to the ileocecal area.
Asunto(s)
Medios de Contraste , Enfermedad de Crohn/diagnóstico por imagen , Intestino Delgado/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Sulfato de Bario , Niño , Errores Diagnósticos , Enema , Femenino , Humanos , Neoplasias Intestinales/diagnóstico por imagen , Masculino , Metilcelulosa , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Radiografía , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
In the present study micronucleus induction and cell proliferation in human peripheral blood lymphocytes cultured in vitro and exposed to 50 Hz sinusoidal magnetic fields for 72 h at different intensities (1.0, 0.75, 0.5, 0.25, and 0.05 mT rms) were investigated. The results obtained from 42 healthy donors aged between 26 and 54 y indicate that, for the field intensities tested, no genotoxic effects were found, as assessed by the cytokinesis-block micronucleus assay. On the contrary, cell proliferation, evaluated by the cytokinesis-block proliferation index, was slightly affected by the field at the intensities tested.
Asunto(s)
Linfocitos/efectos de la radiación , Magnetismo , Micronúcleos con Defecto Cromosómico/efectos de la radiación , División Celular/efectos de la radiación , Células Cultivadas , Humanos , Linfocitos/ultraestructura , Micronúcleos con Defecto Cromosómico/ultraestructura , Pruebas de MicronúcleosRESUMEN
The transcatheter embolization of hepatic artery pseudoaneurysms and of its branches is now considered the most effective tool for their treatment. These lesions are caused by abdominal traumas or inappropriate surgical treatment. These pseudoaneurysms must be treated promptly because they are at high risk for rupture, with subsequent complications such as hematemesis, hemobilia and hemoperitoneum. We treated 7 patients with pseudoaneurysms: 4 of them were in the right hepatic artery, 1 in a right hepatic artery branch, 1 in the common hepatic artery and 1 in the suprahilar hepatic artery. Two pseudoaneurysms were treated with Gianturco coils, 2 with Ivalon particles, 1 with Contour particles, 1 with fibrin particles and 1 with transcatheter occlusion with Bucrylat. Six of 7 patients recovered completely after embolization and in 1 patient only subsequent surgery was required. The success rate of transcatheter embolization was 85%. In our personal experience and from international literature reports, percutaneous embolization emerges as the safest therapeutic approach to hepatic artery pseudoaneurysms, yielding optimal results. In particular, percutaneous embolization is indicated for intrahepatic pseudoaneurysms and extraparenchymal saccular pseudoaneurysms of the common hepatic artery. Moreover, this technique exhibits a lower complication rate than surgery, whose mortality rate ranges 15-20%.
Asunto(s)
Aneurisma/terapia , Embolización Terapéutica , Arteria Hepática , Adulto , Anciano , Aneurisma/diagnóstico por imagen , Niño , Femenino , Arteria Hepática/diagnóstico por imagen , Humanos , Lactante , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
The diagnostic accuracy of Magnetic Resonance Imaging (MRI) in the preoperative staging of unifocal hepatocellular carcinoma (HCC) was investigated and compared with that of ultrasonography (US) and Computed Tomography (CT). Eighteen patients with focal HCCs underwent MRI, CT and US scans before surgery. In all cases the histopathologic diagnosis was made with CT-guided fine-needle aspiration biopsy (FNAB). The diagnostic accuracy of each imaging modality was investigated with the assessment of three parameters thought to be of the utmost importance for surgical planning, i.e., lesion unifocality, the presence of a capsule and finally vascular involvement. MRI proved to be more sensitive than CT in demonstrating both lesion unifocality (100% vs. 94.4%) and the presence of a capsule (100% vs. 71.4%). In 2 of 18 patients some blood vessels were involved, which was clearly demonstrated only by MRI, CT missing it. Both MRI and CT had 100% specificity in the detection of a perilesional capsule and of vascular involvement. To conclude, MRI exhibited higher diagnostic accuracy than US and CT, thus confirming its major role in the preoperative staging of unifocal HCCs.