Digital angiography of erectile failure.

Digital angiography of pudendal and penile arteries was performed in 44 consecutive patients with erectile failure of suspected vascular origin. Intra-arterial injection of contrast medium via selective catheterisation of the hypogastric arteries was used in six cases. In 39 patients, one of whom had already had arterial catheterisation, contrast medium was administered by the intravenous route, using a single, large volume, high speed bolus. In 12/44 cases (27%), digital angiography showed a normal vascular picture at the pudendal and penile level but the remaining 32 patients (73%) had steno-occlusive lesions of different degrees of severity. The pictures obtained after administration of intravenous contrast were diagnostically as good as the studies with selective arterial catheterisation. In addition, the intravenous route allowed the simultaneous representation of the arterial network on both sides and was quicker and less invasive. In 31/44 patients (79%), functional determinations of nocturnal penile tumescence and of penile blood flow with Doppler ultrasonography were performed for comparison. Nocturnal penile tumescence results correlated well with the angiographic picture. Penile blood flow measurements with the Doppler technique were less sensitive than digital angiography.

[Peripheral stenosing-occlusive arteriopathies. Doppler echographic and digital angiographic evaluation]. / Arteriopatie steno-occlusive periferiche. Valutazione ecografica Doppler e angiografia digitale.

The value of Doppler ultrasound examination and digital intravenous angiography was comparatively evaluated in 207 patients with peripheral vascular disease submitted to both techniques. Owing to the fact that in some patients more than one vascular district was examined, the overall number of evaluations was 232 Doppler ultrasounds and 233 digital angiographies. Doppler ultrasound revealed a normal picture in 18/232 cases, steno-occlusive disease in 186/232 cases and various pathological conditions in the remaining 18 cases. With digital angiography, normal vascularity was observed in 33/233 patients, while steno-occlusive disease was present in 164/233 and vascular anatomical abnormalities, like kinking, were found in 20 cases. Doppler/angiographical correlation was fairly good, being complete in 83/207 patients and substantial (i.e.: the same diagnosis but different degree of pathological involvement) in 79 additional cases: the overall diagnostic agreement between Doppler and angiography was 162/207 cases (78%). False negative Doppler results were 29/207, while the false positive Doppler examinations were 16/207. The most common causes of diagnostic errors are evaluated and discussed, both for Doppler ultrasound and for digital angiography. Arterial kinking and vascular abnormalities are recognized as an obvious cause of wrong Doppler diagnoses which can be easily discovered by the angiographic picture. The usefulness of performing both techniques in combination is demonstrated and stressed.

[Digital angiography of the pudendal arteries in erectile impotence]. / L'angiografia digitale delle arterie pudende nello studio della impotenza erettile.

Digital angiography of pudendal and penile arteries was performed on 32 consecutive patients with erectile failure of suspected vascular origin. Intra-arterial injection of contrast medium via selective catheterization of the hypogastric arteries was used in 6 cases. In 27 cases, one of which already submitted to arterial catheterism, the intravenous route was employed for contrast administration, using a single, large volume, high speed bolus. In one case, digital angiography was diagnostically unreliable due to patient's motion and to blurring artifacts. Among the remaining cases, 9/31 (29%) showed a normal angiographic picture, while 22/31 (71%) possessed stenotic-obstructive lesions of different severity. The pictures obtained after intravenous contrast administration were diagnostically equivalent to those obtained with arterial catheterism: in addition, intravenous route allowed the simultaneous representation of the arterial network of both sides and the overall examination resulted less invasive and quicker. In 22/32 patients (69%), functional determinations of erectile capability and of penile blood flow were performed for comparison. Nocturnal penile tumescence (12 cases diagnostically useful) was well correlated with the angiographic picture. Penile blood flow measurements with the Doppler technique (21 cases) seemed on the contrary to be less sensitive than digital angiography.

[Xeroradiographic diagnosis of lipomas]. / La diagnosi xeroradiografica dei lipomi.

The use of xeroradiography for the study of lipomas (limbs, thoracic wall, pelvic and shoulder girdles) was evaluated on 36 consecutive patients; in 16 cases (44%), histological diagnosis on the surgical specimen was also available. Xeroradiography was more effective than standard x-ray films in 13 cases of 14 submitted to both examination (93%). It allowed to evaluate in detail the size, site and relationships of lipomas as well as to establish their nature. The advantages and drawbacks of xeroradiography in each situation and for the different histological groups of lipomas are discussed. This technique is proposed as a simple and quick procedure for the preoperative diagnosis of lipomas.

Xeroradiography of bone and soft tissue tumors.

Xeroradiography was used for the study of 233 cases of bone and soft tissue tumors, both benign and malignant, 177 of which were histologically proven. In 150 cases, comparative x-ray films were also available. In bone tumors, xeroradiography was more effective than film radiography in 33 cases (44%), less effective in 16 cases (22%) and the 2 techniques were substantially equivalent in 25 cases (34%). In soft tissue tumors, xeroradiography was more effective than film radiography in 59 cases (78%), less effective in 2 cases (3%) and equivalent in 15 cases (19%). Xeroradiography is held to be a useful second-line technique in selected bone tumors, in particular for the study of trabecular structure, periosteal calcifications and cortical bone. In the field of soft tissue tumors, xeroradiography can be a promising first-choice examination in the presence of a mass or when a recurrence is suspected. The advantages and drawbacks of this technique in both types of tumors are reviewed and discussed.