Proposal for a radiological classification of multiple adenomatosis of the colon

The double contrast enemas of 47 patients with multiple adenomatosis of the colon and rectum were analyzed. According to the density and the distribution of polyps on the mucosal surface, the radiological patterns were classified into three different groups: sporadic, dense and confluent adenomas. Radiographic patterns of each patient were related to the clinical and pathological data collected during the diagnosis and the follow-up. The clinical and pathological features and the evolution of the disease appear to be different in each group of patients (identified by the radiological classification). The occurrence of cancer at the time of the diagnosis of polyposis is closely correlated either to the number of polyps or to their size and the age of patients. The occurrence of metachronous cancer is correlated only to the number of polyps, not to their size, nor to the surgical treatment of the polyposis. If these data are confirmed on a wider number of patients, the role of radiological survey might become a more prominent one, not only in diagnosing, but also in therapy planning, as well as in the prognostic evaluation of multiple adenomatosis of colon

Structuring and use in clinical research of a software for the diagnosis and features of polypoid lesions of the colorectum

Double contrast enema and endoscopy are very important in the diagnosis of adenomas and early cancer of the colon and rectum. These exams can not only detect the presence, but also suggest the histologic diagnosis, of polypoid lesions of the colon. An Olivetti M24 Personal Computer was used to create a software to study the results obtained by double contrast enema, and to compare them with endoscopy and pathology. The data base is formed by 7 files: one anagraphic, 3 collecting the characteristics of the diagnosis--namely the radiologic, the endoscopic and the pathologic one-- and 3 multiple files featuring each lesion, as defined by the three diagnostic techniques. The software allows to evaluate the different lesions that can be detected by the three techniques in the same patient and to compare the diagnosis of presence to the morphologic features of each lesion. False negatives and false positives of each technique are easily recognized. It is also possible to characterize the single morphologic feature leading the radiologist and/or the endoscopist to express an opinion about the histologic diagnosis of each lesion and to compare them with pathological features. The first experience in clinical use of the software, in the analysis of the characters of 336 lesions in 218 patients, is described

Radiologic examination in assessing the response to chemoradiotherapy of esophageal spinocellular carcinoma

Squamous cell carcinoma represents more than 90% of esophageal cancers; its prognosis is still extremely severe. A treatment consisting in the combined use of preoperative chemotherapy and radiotherapy is now in course of experimentation at Istituto Nazionale Tumori, Milan. Over a period of 28 months (July 1985 to October 1987), 21 patients with 22 lesions (stage III) underwent a double contrast study of the esophagus, both before and after therapy. The radiological evaluation of the lesions after treatment was compared with the pathological diagnosis. Radiological diagnosis has been confirmed in 86.3% of cases (19/22 lesions) as far as mucosal detailing was concerned. On the contrary, radiological evaluation has proven unreliable as far as submucosal layers were concerned. No radiological false positives have been observed

Percutaneous transhepatic biliary drainage : complications and their treatment

In the present series of 296 PTBDs in 281 patients, 103 complications of different degree developed (34.7%). Early complications directly connected to the procedure (32/296 = 10.8%) and late complications generally due to malfunctioning of the catheter or progression of the disease (71/296 = 23.9%) are analyzed. Caveats to prevent complications, therapeutic procedures to resolve them, as well as obtained results are reported. On the whole, major complications directly related to the procedure are present in a small percentage and the procedure appears well tolerated also in patients with poor general conditions

Gastrointestinal interventional radiology : technics and preliminary results

Gastrointestinal interventional radiology allows the positioning of feeding tubes in difficult situations, as well as the balloon dilatation of stenoses and the transintestinal drainage of fistulas and collections, with some advantages over endoscopic and surgical procedures. In the present series feeding tubes were positioned in 26 patients, both to get over the strictures in the upper gastrointestinal tract and to exclude fistulous tracts or anastomotic leaks from alimentary transit. Balloon dilatation was performed in 10 patients with stenoses of different aetiologies, at different levels of the gastrointestinal tract: in all cases the clinical symptoms diminished. All the 7 non-neoplastic stenoses were successfully treated (follow-up 6-27 months). The draining of abscesses through the enteric fistulous tract did allow the reduction/resolution of all collections in a short time. These procedures are simple and safe, and help to reduce the interval between diagnosis and therapy. Their failure does not prevent the use of other therapeutic procedures