[Authors' experience with the role of preoperative ultrasonography in the study of benign lesions of the gallbladder]. / La nostra esperienza sul ruolo dell'esame ecografico preoperatorio nello studio delle lesioni parietali benigne della colecisti.

The benign parietal lesions of the gallbladder are diseases that, as known, found their pathogenetic moment on hyperplasia of constituent tissues of the gallbladder wall and comprises the controversial chapter of "cholecystosis". The Authors, to contribute to their better clinical and pathogenetic staging, report their experience on 25 cases. They debate on the usefulness of ultrasonography, surely a diagnostic progress for these formations, which are small structures more or less echogenic and that they develop in the gallbladder; the echographic imaging, for its sharpening, has substituted the cholecystographic procedure. The aim of present study is to analyse the results obtained by using echography as diagnostic preoperative procedure of "cholecystosis". The ultrasonography supplies the surgeon an indication to prophylactic surgical treatment as single, effective procedure in preventing the gallbladder carcinoma.

The role of ultrasonographic percutaneous cholecystostomy in treatment of acute cholecystitis.

BACKGROUND/AIMS: The Authors propose ultrasonographic percutaneous cholecystostomy in the treatment of acute cholecystitis. MATERIALS AND METHODS: During the period between July 1991-December 1993, 26 patients with acute cholecystitis (18 calculous and 8 acalculous) were observed. The cholecystostomy was performed in principle on patients aged over 70 years and in those with acalculous acute cholecystitis. To rationalize the indication for cholecystostomy in patients aged under 70 years with calculous acute cholecystitis, the Authors elaborated a Risk Score. RESULTS: The cholecystostomy was performed in 23 patients, 15 with calculous and 8 with acalculous acute cholecystitis, and was successful in 22 patients (95.7%). In the group with acalculous acute cholecystitis, the cholecystostomy was the resolutive treatment, while in that with calculous acute cholecystitis was associated, when indicated, to the surgery. CONCLUSIONS: The cholecystostomy interrupted the natural history of the disease and has a low morbidity and mortality. It is an effective and rationale contribution to the treatment of the acute cholecystitis.

Diagnosis of hepatic hemangiomas with 99mTc-labeled red blood cell scanning: value of SPECT.

99mTc-labeled red blood cell (RBC) scanning is considered a highly specific technique for the study of hepatic hemangiomas. However, planar imaging displays poor sensitivity for the identification of small lesions. The authors consider a survey group of 119 patients, of whom 66 with a presumed diagnosis of hepatic hemangioma, for a total of 77 lesions ranging from 0.8 to 15 cm in diameter. The study was conducted with three-phase planar imaging and single photon emission computed tomography (SPECT). The results, which confirm a high specificity of 99mTc-RBC scanning (100%) in the study of hepatic hemangiomas, show that SPECT significantly improves the detection of these lesions (71%) compared to the delayed static study (52%), with the largest gain for lesions between 2-3.5 cm (83% versus 51%). However, also SPECT has difficulty in detecting lesions of less than 2 cm. With regard to three-phase imaging, the authors point out that the pattern considered characteristic for hepatic hemangiomas (perfusion blood-pool mismatch) is infrequent (13%).

[Ultrasonic study of the pelvis in patients with Cooley's anemia]. / Studio ecografico della pelvi in pazienti affette da anemia di Cooley.

Nowadays the role of sonography (US) as a method of first choice in female pelvic pathology, is well determined. The authors used sonography in 23 patients aged between 13 and 36 years, affected by thalassemia major, in order to determine biometric and structural data of both uterus and ovaries. Morphological and clinical-laboratory studies have been performed in order to have a complete vision about the delay in ovarian maturation, commonly seen in these patients. Many cases of hypoplastic uterus and micropolycystic ovaries have been found. US, simple and widely diffused method, allow the evaluation of uterine and ovarian pathologic conditions and the relationship with ovarian maturation delay, and their follow-up. In some cases US may have a value in previewing menarche, in association with clinical-laboratory data.

CT demonstration of pelvic hydatid cysts.

We describe the computed tomographic findings in two cases of bilateral hydronephrosis due to hydatid cyst located in the pouch of Douglas. In both cases this location was secondary to the spontaneous rupture of an hepatic cyst.