ABSTRACT
The value of transrectal US is known in the preoperative staging of rectal cancer but remains debated in the follow-up of the patients submitted to anterior resection or local therapy. The authors report their experience with the postoperative follow-up of 80 patients submitted to 125 transrectal US exams to study method reliability. The results were 9 true positive, 2 false positive, 113 true negative and 1 false negative cases, with 90% sensitivity, 98.3% specificity and 97.6% accuracy rates. Positive predictive value was 81.8% and negative predictive values was 99.1%. Twelve patients were submitted also to MRI which correctly diagnosed one false negative result of transrectal US. Twenty-one patients were examined also with transrectal Doppler and color-Doppler US: in rectal cancer recurrences the peak velocity of hemorrhoid vascular flow was higher than in non-recurrent patients. On the basis of our results, transrectal US deserves to be included in the postoperative follow-up of the patients submitted to anterior resection or to local therapy for rectal cancer. Moreover, according to our preliminary findings, Doppler and color-Doppler US can improve transrectal US reliability in detecting local recurrences.
Subject(s)
Neoplasm Recurrence, Local/diagnostic imaging , Rectal Neoplasms/diagnostic imaging , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Rectum , Sensitivity and Specificity , Ultrasonography/methodsSubject(s)
Breast Neoplasms/diagnostic imaging , Fibroma/diagnostic imaging , Adult , Female , Humans , RadiographyABSTRACT
Our personal experience is reported with the use of vascular endoprostheses (Strecker and Palmaz stents) in the non-surgical treatment of iliacofemoral steno-occlusive arteriopathy. Over a 15-month period, 56 PTAs were performed in 40 patients; 20 vascular endoprostheses were positioned--17 Strecker and 3 Palmaz stents--in 16 patients, to correct such PTA complications as dissections or to improve the results of a suboptimal PTA maneuver. Venous DSA follow-up was performed at 30 days, and serial color-Doppler US studies were performed every fourth month. Immediate and satisfying clinical results were observed in 15/16 patients (93.7%): only one case of acute thrombosis following the procedure was observed, which could not be treated with intraarterial fibrinolytic therapy and was therefore operated on. Overall long-term patency rate is 100%, mean follow-up is 13.8 months. Finally, the indications for the use of such devices in iliacofemoral arteriopathies are critically discussed, together with the criteria of choice of a type of stent over another one, the immediate and long-term results and the best follow-up protocols.