[Diagnosis and treatment of non-palpable breast lesions: from the biopsy to the microhistology results. Our experience]. / La diagnosi ed il trattamento delle lesioni non palpabili della mammella: dalla biopsia su repere alla microistologia. Nostra esperienza.

The aim of modern senology lies in the diagnosis and treatment of non-palpable breast lesions (NPBLs). Through the diffusion of regional mammography screening the lesions being observed are continuously smaller, thus calling for more and more accurate methodology. Our experience in this area is based on the use of certain methods for retrieval and removal of NPBLs, such as Kopan's sec. philo-guide, ultrasound and advanced breast biopsy instrumentation. In our opinion methods allowing total removal of lesions in order to obtain complete histopathological characterization and enabling adequate therapeutic programs are to be preferred. In reviewing case studies a noteworthy increase of initial carcinoma (DCIS or LCIS), from 19.5% to 57.1%, has been observed in the last three years due to the extensive use of the aforementioned methods.

[Clinically manifest or silent primary and secondary syringomyelia. The magnetic resonance findings]. / Siringomielie primitive e secondarie a clinica manifesta o silente. Rilievi con Risonanza Magnetica.

The MR scans were retrospectively reviewed of 40 patients who had been diagnosed as having syringomyelia. Our results demonstrate that syringomyelia can be found in asymptomatic patients as well as in many with atypical symptomatology. Our study stresses MR efficacy in investigating this pathologic condition. As a matter of fact, MR allowed us to visualize the cavity, its extension, the eventual association with Arnold Chiari type-I malformation and/or syringobulbia. In all cases cord enlargement and the presence of septations could also be demonstrated. In most cases the possible pathogenesis of syringomyelia could also be supposed.

MR imaging of white matter lesions in uncomplicated chronic alcoholism.

Chronic alcoholics may have CNS lesions, such as microvasculitis or glial, neural, and myelin degeneration, as documented in postmortem studies on subjects who had Wernicke encephalopathy, corpus callosum degeneration, or central pontine myelinolysis. One may also expect the presence of early white matter disease in patients who do not have neurologic complications of alcoholism. Thirty-five chronic alcoholics (Diagnostic and Statistical Manual III criteria) and 35 normal control subjects were studied by means of magnetic resonance (MR) imaging. Subjects greater than 60 years old, or those with CNS involvement, or clinically evident systemic disorders were excluded. Of the remaining asymptomatic alcoholics, MR detected multiple round hyperintense areas in the white matter of 14 patients, in addition to aspecific corticosubcortical and cerebellar atrophies. None of the normal control subjects showed such a finding. These results suggest an early involvement of the brain in asymptomatic alcoholic patients.

Hemispheric asymmetries and schizophrenia: a preliminary magnetic resonance imaging study.

A magnetic resonance imaging (MRI) study of 20 chronic schizophrenic outpatients (5 women and 15 men) and 20 healthy volunteers, individually matched for age and sex, was conducted. Schizophrenics showed a statistically significant lateral ventricular enlargement and smaller corpus callosum: brain ratio than controls. There were no statistically significant differences in hemispheric measurements between groups. Nevertheless, we found a wider right frontal width versus the left in the patient group but not in the control group, and more frontal protuberances in the right hemisphere in the patient group. Possible meanings and implications of these findings for a pathophysiological hypothesis are discussed.

Standardized magnetic resonance image intensity study in schizophrenia.

A magnetic resonance imaging (MRI) study of 12 chronic schizophrenic outpatients (4 females and 8 males) and 12 healthy volunteers, individually matched for age and sex, found a significantly larger ventricle-brain ratio and smaller corpus callosum area in schizophrenics than in controls. There were no statistically significant differences in the image intensity values between schizophrenic and healthy volunteer groups. However, there were more intragroup differences (left-right) of the image intensity values in the SE-30 sequence than in the SE-120 sequence in schizophrenics than in normals.

[Magnetic resonance in the evaluation of intracranial aneurysms]. / La Risonanza Magnetica nella valutazione degli aneurismi intra-cranici.

Eighteen patients affected by intra-cranial aneurysms, with size ranging from 3 to 30 mm, were studied by means of MRI, CT, and angiography. MRI was performed using Spin-Echo (SE) sequences with different Repetition Times (TR) and Echo Times (TE), which allowed the characterization of the lesions in relation to the relaxation times. MRI could identify all the aneurysms. In 13 subjects the parent vessels could be seen. In 5 patients the aneurysms could be recognized only after angiography, due to their dimension (less than 4 mm). The "flow effects" and the presence of methemoglobin and hemosiderin in the thrombosed portion of the lumen allowed both the detection of flow abnormalities and the characterization of laminate intra-aneurysmal thrombosis. In conclusion, MRI appears to be a sensitive methodology in the detection of intracranial aneurysms, even more sensitive than CT and Angiography in characterizing this kind of lesions.