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In this report, the feasibility and efficacy of laparoscopic radiofrequency interstitial thermal ablation of hepatocellular carcinoma has been evaluated in 20 patients.The laparoscopic approach with the use of intraoperative ultrasonography allowed us to obtain additional information regarding liver nodules and a complete treatment of the liver lesions.The complication rate was low and there was no operative mortality. A complete necrosis has been obtained in 90% of the cases at 1 month dynamic computed tomography following the treatment.Laparoscopic radiofrequency thermal ablation of hepatocellular carcinoma proved to be a safe and effective technique; its use may be proposed in selected patients. Larger series are needed to accurately assess its role among the other ablative therapies of hepatocellular carcinoma.

Aim of this report is to present a case of acute occlusion of the abdominal aorta recognized by spiral-CT. After a brief description of the etiology and pathology of abdominal aorta acute occlusion, stress is laid on diagnostic role of spiral-CT, based on personal and literature data. The advantage of spiral respect to non-spiral CT is the quicker examination time which is very important, mostly in emergencies. On the contrary, the diagnosis of acute abdominal aorta occlusion is not modified by volumetric CT respect to non-spiral and it is based on the absence of aorta contrast enhancement above the occlusion level.

Primary immunodeficiencies (PI) are a heterogeneous and relatively uncommon group of conditions. As a result of one or more immune system abnormalities, PI decrease the body resistance to infections. The respiratory tract is affected in most cases as a result of its natural exposure to pathogenic agents; repeated infections can lead to pulmonary alterations. We investigated the yield of High Resolution CT (HRCT) and Helical CT in pediatric patients with different PI and then correlated the CT patterns with the patients' clinical history and physical status.We examined 19 pediatric patients with different types of PI. All patients presented recurrent infections (rhinosinusitis, bronchitis, bronchopneumonia) with cough and chronic catarrh for at least 3 months a year. Fifteen patients were examined with HRCT and 4 with Helical CT. Images were evaluated for presence and severity of alveolitis, bronchiectasis, peribronchial thickening, mucous plugs, air trapping, bronchiolitis, consolidation, abscesses, bullae, emphysema and fibrotic changes. All parameters were given a score and a partial and an overall score calculated for each parameter. All scores were compared to study the correlations between CT patterns, clinical history and patients' status and for possible characterization of the different groups by CT patterns. Finally, all alterations were classified by their anatomical distribution in each pulmonary lobe.Scores ranged 0 to 18, with a mean of 8.1 points. There were no correlations between CT patterns, patients' history and clinical status and any disease type. The midlobe was the preferential site for bronchiectasis while lower lobes were more involved by other conditions, such as consolidation, air trapping and alveolitis.Both HRCT and Helical CT proved to be useful tools for monitoring PI patients. The two techniques can be especially valuable in symptomatic patients with negative radiographic findings because they can show (non-)reversible damage, which helps improve planning of drug and/or physical therapy. The scoring system, even if not closely correlated with clinical signs, could be a major tool for PI follow-up and for monitoring treatment success.

Bronchioloalveolar carcinoma (BAC) is a relatively uncommon tumor of the lung accounting for 1 to 9% of all pulmonary neoplasms. Its radiologic appearance is characterized by solitary nodular opacity or diffuse air-space consolidation. The aim of this work is to report the different patterns of this neoplasm, particularly in the diffuse form, and to demonstrate the sensitivity and specificity of HRCT in its early identification. We examined 11 patients affected with multifocal bronchioloalveolar carcinoma to identify HRCT signs which could lead to improved diagnostic criteria. These signs are represented by ground-glass opacity (8/11) and alveolar consolidation (6/11), with a plurilobular, segmentary or lobar distribution. The lesions were bilateral in 8/11 cases and abnormal mediastinal lymph nodes were found in 5/11 cases. Air bronchogram was seen in all cases of ground-glass opacity and in 5/11 cases of air-space consolidation. In conclusion, in our experience, HRCT is a useful tool in the study of BAC, which has a long and slow evolution and is underestimated at chest radiograph in its early stage. Moreover, HRCT can help distinguish this condition from other lung diseases characterized by diffuse air-space consolidations, whose clinical history is useless to make an unquestionable diagnosis.

We retrospectively reviewed CT scans of 18 patients (12 males and 6 females; mean age: 43.6 years) with the diagnosis of blunt splenic trauma. All patients underwent CT at different times after the trauma. The cases were divided into 2 groups: according to the time at which the CT was performed, the 1st group consisted of 11 patients scanned within 48 h after the trauma; the 2nd group consisted of 7 patients studied with CT at variable times after the traumatic event (mean time: 6.5 days; range 3-13 days). All lesions in the 1st group (11 patients) had indistinct margins, while lesions of patients in the 2nd group (7 patients) always showed clean-cut and regular edges. Early lesions were always hyperdense, late ones hypodense. CT diagnosis always matched the surgeon's diagnosis. We can confirm the diagnostic value of CT of splenic lesions in blunt abdominal traumas.

342 short-stature patients were examined to assess the agreement between anagraphic and bone ages. 190 men and 152 women (age range: 0 to 17.5 years) underwent conventional radiographs of the left wrist. The radiographs were studied with the TW2 method which provides an index of the skeletal maturity of short and long bones and a global index of the hand. The bone ages thus obtained were compared with anagraphic ages. Patients' statures were compared with their parents' ones. Finally, radiation exposures were evaluated. Anagraphic and bone ages were in agreement in 199 patients and in disagreement in 220. Three patients were adult. The short stature in 78 patients was in agreement with their parents' one, while 253 patients had at least one parent with normal stature. No comparison could be made in 11 patients. In conclusion, TW2 is a simple method to calculate bone age (in months and years) and to select the patients to submit to further examinations and to hormone therapy.

The CT scans of 18 patients (12 males and 6 females; mean age: 43.6 years) with splenic blunt trauma were reviewed. CT examinations had been made at different times after trauma. The CT images were grouped according to the time of examination and both structure and densitometry were evaluated in all lesions. In all cases CT findings were correlated with surgical and pathologic data. The patients were divided into two groups: group I included 11 subjects in whom CT had been performed within 48 hours following trauma and group II included 7 patients who had undergone CT at different times after trauma (3-13 days; mean: 6.5 days). All the lesions in group I exhibited blurred outlines, while the lesions in group II had clear-cut margins. The lesions in group I were always hyperdense while those in group II were hypodense. CT diagnosis was always in agreement with surgical findings. In conclusion, we confirm the value of CT in the examination of splenic lesions by blunt abdominal trauma. The evolution of splenic lesions is usually typical: CT yields useful information for injury evaluation and is therefore very important to plan treatment. We believe that CT should be performed as soon as possible, even on the basis of minor clinical and laboratory data.

Thirty patients of both sexes (15 males and 15 females) with chronic renal failure who had under gone hemodialysis for 2-184 months (mean 45.1 months) were examined with conventional radiographs of the cervical spine and thin-layer CT of C4-C5-C6 to evaluate the radiographic patterns of destructive spondyloarthropathy. The radiographic patterns obtained with conventional and CT exams were compared with one another and with clinical (carpal tunnel syndrome) and biochemical data (alkaline phosphatase, parathormon, Ca, P, Ca/P, Al, beta 2-microglobulin). DSA (erosion and narrowing of the intervertebral space, collapse of the vertebral body and erosion of the vertebral plates) was recognized in 7 patients with conventional radiographs and in 11 patients with CT thanks to greater CT capabilities to recognize minimal osteolytic lesions of the vertebral body. All the patients with destructive spondyloarthropathy had personal and hemodialysis age higher than those without destructive spondyloarthropathy: 59.3 vs 57.7 years; 49 vs 39 months. Parathormon and alkaline phosphatase were increased while beta 2-microglobulin was normal. Only 2 patients with DSA had carpal tunnel syndrome. In conclusion, CT is a valuable technique for the diagnosis of destructive spondyloarthropathy but it must be performed only after conventional radiographs of the cervical spine or in the presence of clinical signs of destructive spondyloarthropathy (parathormon and beta 2-microglobulin increased, long-term hemodialysis).

In this paper the authors report on a new technique--percutaneous transluminal laser angioplasty (PLR) which was performed on 9 patients with iliac and/or femoro-popliteal artery occlusion. All patients were males (mean age: 64.5 years) and had arterial occlusion (mean length: cm 12.5). PLR was performed with an argon laser (max power: 16 Watts). In 8 out of 9 patients (88.8%) a complete recanalization was obtained of the occluded arterial tract, without complications. In one case only (12.2%) there was an arterial wall perforation with unsatisfactory results. In our opinion, PLR has proven a simple methodology, which can be performed on any patient due to the very low incidence of severe complications and distal embolism. Moreover, PLR has quite low costs, and does not prevent eventual surgical/percutaneous interventions.