[Spermatic phlebography and sclerotherapy of the male varicocele]. / Flebografia spermatica e scleroterapia del varicocele maschile.

Phlebographic sclerotherapy and embolization are better methods, from the biological and cost-effectiveness viewpoints, to treat male varicocele than conventional surgery. On the other hand, positive technical results are not always obtained and the rates of relapses and recurrences are high. A retrospective study was carried out on 70 (of 81) sclerotherapies performed in the Radiology Department of S. Anna Hospital, Turin, from 1993 to September, 1995. The results confirmed the feasibility of this treatment in a nonangiographic department, with technical success rates increasing with growing operators' experience (70% success rate in 1993, vs. more than 95% in 1994-95). Recurrence rate was 4.9% and the rate of limited persistence was 7.3% at clinical and Doppler follow-up ranging 6-24 months (mean: 10.2 months). Both rates appeared to be related to varicocele initial size, increasing progressively from grade I to grade III. Therefore, such new and expensive techniques as balloon or spiral embolization are justified only in the most severe cases. The follow-up showed improved or normalized sperm exams in 70.4% of treated and followed-up patients, with 5 full-term pregnancies. To conclude, sclerotherapy and embolization of the spermatic vein are very good tools to treat male varicocele with subfertility.

[Quality and homogeneity monitoring of radiologists in the Turin mammographic screening. Comparison of the pilot phase results]. / Verifiche di qualità e omogeneità dei radiologi nello screening mammografico torinese. Confronto tra i risultati delle fasi pilota.

The Turin mammographic screening program was designed to be carried out in several independent screening centers because of the large proportion of population involved (76,000 women aged 50 to 59 years). The first center began working in 1992 and the second center was opened in 1995. The latter center carried out an early pilot study in which 1024 women were examined to assess the homogeneity and the quality of the results. The results were then compared with European quality standards and with the results of both the pilot and the active screening periods in the first center. The results from the second center were very good as far as detection rate is concerned (7.8/1000-2.9/1000 in carcinoma < or = 1 cm). This rate is higher than the so-called "desirable" European standard. Recall rate and benign/malignant biopsy ratio were higher than the so-called "fair" European standard (recall rate: 7.1%; B/M biopsy ratio: 0.62). These results are slightly superior to those of the pilot period in the first center and slightly inferior to the results of active screening in the same center. The improvement relative to the pilot period in the first center (1991) is probably related to technical progress, such as the introduction of the double mammographic projection. The difference relative to the results from the active screening period in the first center (1992-1994) reflects different specific experience. Even though pilot periods have no statistical significance, they can be used for comparison, and in our experience they have proved, with positive results, the quality of the mammographic screening program provided to the Turin population.

[Anatomo-radiologic definition of minimal interstitial silicosis and diagnostic contribution of high-resolution computerized tomography]. / Definizione anatomo-radiologica della silicosi minima interstiziale e contributo diagnostico della tomografia computerizzata con alta risoluzione.

Minimal interstitial silicosis (MIS) is a histologic entity characterized by questionable radiologic findings--i.e., the p/p 0/1 and 1/0 classes of the International Labour Office (ILO) 1980 classification. Thus, the condition may be responsible for borderline radiologic findings ("suspect" phase of pneumoconiosis). In order to test an alternative method to conventional radiology (CR), HRCT was performed on 35 workers exposed to silica and with histologic diagnosis of MIS: HRCT scans were compared with posteroanterior chest radiographs by using the ILO classification. Histology was the gold standard. HRCT identified many more MIS lesions. Moreover, the superiority of HRCT over CR was also proved by its better correlation with pathologic findings. HRCT provided pieces of information which could not always be obtained by means of conventional chest films. Thus, HRCT can be considered the method of choice in MIS before transbronchial lung biopsy.

[The dynamic magnetic resonance study of focal liver lesions by FLASH sequences with bolus intravenous gadolinium-DTPA]. / Studio dinamico con risonanza magnetica delle lesioni focali epatiche mediante sequenze FLASH con gadolinio-DTPA endovena in bolo.

Thirty-five patients with hepatic hemangioma (n = 12), metastasis (n = 10), hepatocellular carcinoma (HCC) (n = 10) and focal nodular hyperplasia (n = 3) were examined with the fast low-angle shot (FLASH) technique and an intravenous bolus injection of Gd-DTPA. In order to differentiate the lesions, the following criteria were used: a) pre Gd-DTPA intensity of lesions; b) post Gd-DTPA patterns of contrast enhancement. On the basis of these criteria, an unquestionable differential diagnosis could be made. Hemangiomas were characterized by an hypointense mass before Gd-DTPA, by peripheral contrast enhancement and by subsequent continuous hyperintense fill-in; thus, hemangiomas were visualized as hyperintense lesion during the late phase. Before contrast administration hypovascular metastases appeared as hypointense; they were characterized by delayed uptake of contrast agent. HCCs were hyperintense lesions before contrast administrations; then, quick contrast enhancement and rapid decrease in signal intensity were observed with visualization of a hyperintense ring due to the capsule. Finally, focal nodular hyperplasia appeared isointense or hypointense relative to normal liver on precontrast scans; the lesions were enhanced transiently with subsequent quick dismission of contrast agent. This initial experience suggests dynamic contrast-enhanced MR imaging as an effective method to improve the differential diagnosis among hepatic tumors when precontrast T2-weighted images are equivocal.

A follow-up on functional parameters of blood stored in ACD at +4 degrees C.

The main functional parameters of blood stored at +4 degrees C in ACD, according to the common transfusional practice, have been carefully followed in the course of 40 days. The expected depletion of DPG takes place within 10 days, but apparently, no increase of the Hb affinity towards oxygen is observed in this period (or later), because pH lowering acts in the opposite direction during the same time. However, the intrinsic increased affinity of Hb is promptly revealed if the "actual" pHs are corrected at the standard value of 7.4, and/or are extrapolated at this pH from Bohr effect.