[Comparison of mammographic and industrial films in dialysis patients]. / Confronto tra pellicole mammografiche e pellicole industriali nei pazienti dializzati.

PURPOSE: To optimize the technique for radiographic studies of bone and joint damage in renal osteodystrophy. MATERIAL AND METHODS: Sixty-four patients with chronic renal failure on dialysis for 0-10 years, were divided into two homogeneous groups and submitted to two different radiographic examinations of the nondominant hand. Group A patients were examined with a conventional radiological unit and an industrial film and a conventional radiological unit with a mammographic film with a dedicated screen, while group B patients with a mammographic with an industrial film and a conventional radiologic unit with a mammographic film with a dedicated screen. The examinations were evaluated by three radiologists in a double-blind fashion. RESULTS: Bone conditions such as osteoporomalacia, trabecular rarefaction, channel enlargement and intracortical absorption were equally demonstrated by mammographic films and the mammograph with industrial films. The mammographic film was superior to the mammograph with an industrial film in 8 cases, comparable in 25 and inferior in 6, but when compared with the conventional radiological unit with an industrial film it was superior in 19 cases, comparable in 2 and never inferior. CONCLUSIONS: The industrial film without a screen combined with a mammograph is considered the gold standard to study fine bone alterations in renal osteodystrophy. However the conventional radiological unit with a mammographic film with a dedicated screen provides the same results with lower irradiation doses and can therefore be considered a good alternative.

[Congenital luxation of the hip. Clinico-echographic correlations]. / Lussazione congenita dell'anca. Correlazioni clinico-ecografiche.

The authors report their experience with US of the hip in 1000 children aged 1 day to 8 months. US study was carried out following Graf's method. All the children were previously examined by a pediatrician, who recorded all the clinical signs on a chart. After US examination, the radiologist recorded US findings on the same chart. Thus, US findings could be compared to clinical ones: there was agreement in 71% of cases, and disagreement in the extant 29%. Furthermore, clinics exhibited a high false-negative rate (64%) and a low false-positive rate (23%). This suggests US as an useful screening method able to show early morphological and functional alterations in the infant hip. The authors also examined the incidence of the single clinical signs and risk factors, and correlated them with US findings.

[Magnetic resonance angiography of the intracranial vessels. Technique and anatomy]. / Angiografia a risonanza magnetica del circolo intracranico. Tecnica-anatomia.

Fifty volunteers were studied by means of MR angiography of the intracranial vessels, with a 1.5 T Siemens Magnetom. The technical features of the most employed MR angiographic techniques were analyzed. The inflow technique was tested with refocused gradient-echo sequences for the FISP 3DFT flow and a dedicate coil. The study was aimed at evaluating the resolution power of each technique and at identifying the most useful rotations and angles for each chosen vessels. The acquisition volume of the gradient-echo sequence was positioned on the axial plane with sella turcica in the center. TR was set at 0.04 s, TE at 10 ms, and flip angle was 15 degrees. A 256 x 256 matrix was used, and an 80-mm acquisition volume, with 64 partitions. The chosen images were rotated on the axial and sagittal planes 0 degrees-180 degrees. The results showed that both rotation planes and their relative angles allow the visualization of all the vessels. To reduce post-processing time, with immediate availability of computer keyboard, a standardization is suggested with 0 degrees-180 degrees rotations on the axial plane, with 15 degrees interval and 0 degrees-45 degrees rotations on the sagittal plane, with 15 degrees interval. The main limitation of this method is its spatial resolution, which was 1.2 mm in rotations and acquisitions on the axial plane and 1 mm in acquisitions on the axial plane rotated on the sagittal plane.

[Congenital hip dislocation. The clinico-echographic correlations]. / Lussazione congenita dell'anca. Correlazioni clinico-ecografiche.

The authors report their experience with US of the hip in 200 children aged 9 days to 8 months. All the children previously were under-gone physical examination. The sonographic study was carried out with Graf's method. The clinical-sonographic correlation proves the utility of US as a screening method able to show early morphological and functional alterations in the hip. US is thus suggested as a valid alternative to conventional methods to use in those cases where either plastering or surgery is required.

[Echography compared with conventional radiology in Osgood-Schlatter disease]. / L'ecografia a confronto con la radiologia tradizionale nella malattia di Osgood-Schlatter.

This paper was aimed at estimating sonographic (US) accuracy in patients with clinical suspicion of Osgood-Schlatter's disease. This disease affects the patellar tendon in its attachment to the tibial tuberosity; boys are affected more frequently than girls, and during adolescence. Its pathognomic signs are: focal soft-tissue swelling anterior to the tibial tuberosity, edema of the inferior infrapatellar fat pad, and swelling of the ligamentum patellae with loss of the interface between the latter and posterior soft tissue. A comparative study was carried out of the X-rays and US examinations of the knee in 21 patients with Osgood-Schlatter's disease; X-rays exams employed the double-shield and double-film box methods, to allow the contemporaneous evaluation of both skeletal and soft-tissue features. The results prove that the soft-tissue changes observed with X-rays can be correctly depicted also by US. Thus, in our opinion, US has proved to have the same diagnostic accuracy as X-rays, and could therefore become the first-choice examination in both the diagnosis and the follow-up of Osgood-Schlatter's disease.

[Computerized tomography in the diagnosis and follow-up of 3 cases of primary suprasellar germinoma]. / Tomografia computerizzata nella diagnosi e follow up in tre casi di germinoma soprasellare primitivo.

Three cases of primitive suprasellar germinomas are reported: the tumors show typical clinical signs (diabetes insipidus, visual disturbances and anterior pituitary dysfunctions), but CT findings are not so specific. It is very important to reach a correct diagnosis based on clinical and radiological findings, because of a very high radiosensibility of the tumor. The accuracy of preoperative diagnosis has been enhanced by CT in addition to conventional neuroradiological examinations. Due to the possible risk of meningeal spreading following biopsy, some authors prefer to avoid biopsy and to treat directly the patient by radiotherapy; a rapid reduction of the tumor size at the dose of 30 Gy suggests a possible germinoma.