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17 results on '"Giansiracusa, C"'

4. Agreement of two-dimensional and three-dimensional transvaginal ultrasound with magnetic resonance imaging in assessment of parametrial infiltration in cervical cancer

Author

Chiappa, V, Di Legge, A, Valentini, Al, Gui, Benedetta, Miccò, M, Ludovisi, M, Giansiracusa, C, Testa, Antonia Carla, and Valentin, L.

Subjects
Adult, Cervical cancer, Magnetic resonance, Parametrial infiltration, Ultrasonography, Aged, Cross-Sectional Studies, Female, Humans, Imaging, Three-Dimensional, Magnetic Resonance Imaging, Middle Aged, Neoplasm Invasiveness, Pelvic Floor, Prospective Studies, Uterine Cervical Neoplasms, equipment and supplies, Imaging, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Three-Dimensional, human activities
Abstract

To compare two-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound with magnetic resonance imaging (MRI) as the gold standard in assessment of parametrial infiltration of cervical cancer and to determine if all parts of the cervix are equally assessable with ultrasound.Patients with macroscopically evident and histologically confirmed cervical cancer were staged using International Federation of Gynecology and Obstetrics (FIGO) criteria and underwent MRI and 2D and 3D ultrasound examination before treatment. When assessing parametrial infiltration with 3D ultrasound and MRI, the cervix was (virtually) divided into three cylinders (cranial, middle and caudal) of equal size and each cylinder was then divided into six sectors in a clockwise manner following a consensus between radiologists and ultrasound examiners. The presence and the extent of parametrial invasion were recorded for each sector. Results of 2D ultrasound, 3D ultrasound and MRI were compared and reported in terms of percentage agreement and kappa value.A total of 29 consecutive patients were included in the study. The percentage agreement between 2D ultrasound and MRI in assessing parametrial infiltration (yes or no) was 76% (kappa, 0.459) and that between 3D ultrasound and MRI was 79% (kappa, 0.508). The results of 2D ultrasound showed the following agreement with those of MRI: 90% for the ventral parametrium (kappa, 0.720), 72% for the right lateral parametrium (kappa, 0.494), 69% for the left lateral parametrium (kappa, 0.412) and 58.5% for the dorsal parametrium (kappa, 0.017). The results of 3D ultrasound showed the following agreement with those of MRI: 62.5% for the ventral parametrium (kappa, 0.176), 81% for the right lateral parametrium (kappa, 0.595), 70% for the left lateral parametrium (kappa, 0.326) and 52% for the dorsal parametrium (kappa, 0.132). The best agreement between 3D ultrasound and MRI was for the middle cervical cylinder (76%; kappa, 0.438) and the poorest agreement was for the caudal cylinder (42%; kappa, 0.125).The results of 2D and 3D ultrasound showed similar moderate agreement with MRI; 2D and 3D ultrasound examinations are less costly and more readily available than MRI and should be considered in the preoperative work-up for cervical cancer.

Published
2015

5. Imaging in gynecological disease (10): Clinical and ultrasound characteristics of decidualized endometriomas surgically removed during pregnancy

Author

Mascilini, F, Moruzzi, C, Giansiracusa, C, Guastafierro, F, Savelli, L, De Meis, L, Epstein, E, I E, Timor-Tritsch, Mailath-Pokorny, M, Ercoli, A, Exacoustos, C, B R, Benacerraf, Valentin, L, and A C, Testa

Subjects
endometriosis, Adult, retrospective study, decidualization, pattern recognition, transvaginal ultrasound, Cross-Sectional Studies, Diagnosis, Differential, Endometriosis, Female, Humans, Ovarian Cysts, Ovarian Neoplasms, Predictive Value of Tests, Pregnancy, Prognosis, Retrospective Studies, Risk Factors, Ultrasonography, Doppler, Color, Diagnosis, Differential, Ultrasonography, Doppler, Color, Settore MED/40 - Ginecologia e Ostetricia
Abstract

To describe the clinical history and ultrasound findings in women with decidualized endometriomas surgically removed during pregnancy.In this retrospective study, women with a histological diagnosis of decidualized endometrioma during pregnancy who had undergone preoperative ultrasound examination were identified from the databases of seven ultrasound centers. The ultrasound appearance of the tumors was described on the basis of ultrasound images, ultrasound reports and research protocols (when applicable) by one author from each center using the terms and definitions of the International Ovarian Tumor Analysis (IOTA) group. In addition, two authors reviewed together available digital ultrasound images and used pattern recognition to describe the typical ultrasound appearance of decidualized endometriomas.Eighteen eligible women were identified. Median age was 34 (range, 20-43) years. Median gestational age at surgical removal of the decidualized endometrioma was 18 (range, 11-41) weeks. Seventeen women (94%) were asymptomatic and one presented with pelvic pain. In three of the 18 women an ultrasound diagnosis of endometrioma had been made before pregnancy. The original ultrasound examiner was uncertain whether the mass was benign or malignant in 10 (56%) women and suggested a diagnosis of benignity in nine (50%) women, borderline in eight women (44%), and invasive malignancy in one (6%) woman. Seventeen decidualized endometriomas contained a papillary projection, and in 16 of these at least one of the papillary projections was vascularized at power or color Doppler examination. The number of cyst locules varied between one (n = 11) and four. No woman had ascites. When using pattern recognition, most decidualized endometriomas (14/17, 82%) were described as manifesting vascularized rounded papillary projections with a smooth contour in an ovarian cyst with one or a few cyst locules and ground-glass or low-level echogenicity of the cyst fluid.Rounded vascularized papillary projections with smooth contours within an ovarian cyst with cyst contents of ground-glass or low-level echogenicity are typical of surgically removed decidualized endometriomas in pregnant women, most of whom are asymptomatic.

Published
2014

6. Imaging of gynecological disease: clinical and ultrasound characteristics of decidualized endometriomas surgically removed during pregnancy

Author

Mascilini, F, Moruzzi, C, Giansiracusa, C, Guastafierro, F, Savelli, L, De Meis, L, Epstein, E, Timor Tritsch, Ie, Mailath Pokorny, M, Ercoli, A, Exacoustos, C, Benacerraf, Br, Valentin, L, and Testa, Antonia Carla

Subjects
endometriosis, transvaginal ultrasound, Settore MED/40 - GINECOLOGIA E OSTETRICIA, decidualization, pattern recognition, restrospective study
Published
2014

8. Agreement of two-dimensional and three-dimensional transvaginal ultrasound with magnetic resonance imaging with regard to parametrial infiltration in cervical cancer.

Author

Chippa, Valentina, Di Legge, Alessia, Valentini, Anna Lia, Gui, Benedetta, Micco', Maura, Ludovisi, Manuela, Giansiracusa, C., Testa, Antonia Carla, Valentin, L., Valentini, Anna Lia (ORCID:0000-0001-6746-692X), Testa, Antonia Carla (ORCID:0000-0003-2217-8726), Chippa, Valentina, Di Legge, Alessia, Valentini, Anna Lia, Gui, Benedetta, Micco', Maura, Ludovisi, Manuela, Giansiracusa, C., Testa, Antonia Carla, Valentin, L., Valentini, Anna Lia (ORCID:0000-0001-6746-692X), and Testa, Antonia Carla (ORCID:0000-0003-2217-8726)

Abstract

Objectives: To compare two-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound with magnetic resonance imaging (MRI) as gold standard in the assessment of parametrial infiltration of cervical cancer, and to determine if all parts of the cervix are equally assessable with ultrasound. Methods: Patients with histologically confirmed macroscopically evident cervical cancer were staged using FIGO criteria and underwent MRI, 2D- and 3D-ultrasound before treatment. When assessing parametrial infiltration with 3D-ultrasound and MRI, the cervix was (virtually) divided into three cylinders of equal size (cranial, middle, caudal) and each cylinder into six sectors in a clockwise manner following a consensus between radiologists and ultrasound examiners. The presence and the extent of parametrial invasion were recorded for each sector. The results for 2D-ultrasound, 3Dultrasound and MRI were compared, results being reported as percentage agreement and Kappa value. Results: 29 consecutive patients were included. The percentage agreement between 2D-ultrasound and MRI in assessing parametrial infiltration (yes or no) was 76% (kappa 0.459), that between 3Dultrasound and MRI 79% (kappa 0.508). 2D-ultrasound showed the following agreement with MRI: 90% for the ventral parametria (kappa 0.720), 72% for the right lateral parametrium (kappa 0.494), 69% for the left lateral parametrium (kappa 0.412), 58.5% for the dorsal parametria (kappa 0.017). 3D-ultrasound showed the following agreement with MRI: 62.5% for the ventral parametria (kappa 0.176), 81% for the right lateral parametrium (kappa 0.595), 70% for the left lateral parametrium (kappa 0.326), 52% for the dorsal parametria (kappa 0.132). The best agreement between 3Dultrasound and MRI was obtained for the middle cervical cylinder (agreement 76%, kappa 0.438) and the poorest agreement for the caudal cylinder (agreement 34.5%, kappa 0.125). Conclusion: 2D- and 3D-ultrasound showed similar moderate agreement with MRI.

Published
2015

9. The sonographic prediction of invasive carcinoma in unilocular-solid ovarian cysts in premenopausal patients: a pilot study.

Author

Fagotti, Anna, Ludovisi, Manuela, De Blasis, I., Virgilgio, B., Di Legge, A., Mascilini, F., Moruzzi, M., Giansiracusa, C., Fanfani, Francesco, Tropeano, Giovanna, Di Bidino, Rossella, Scambia, Giovanni, Testa, Antonia Carla, Fagotti, Anna (ORCID:0000-0001-5579-335X), Fanfani, Francesco (ORCID:0000-0003-1991-7284), Tropeano, Giovanna (ORCID:0000-0003-0237-1772), Scambia, Giovanni (ORCID:0000-0003-2758-1063), Testa, Antonia Carla (ORCID:0000-0003-2217-8726), Fagotti, Anna, Ludovisi, Manuela, De Blasis, I., Virgilgio, B., Di Legge, A., Mascilini, F., Moruzzi, M., Giansiracusa, C., Fanfani, Francesco, Tropeano, Giovanna, Di Bidino, Rossella, Scambia, Giovanni, Testa, Antonia Carla, Fagotti, Anna (ORCID:0000-0001-5579-335X), Fanfani, Francesco (ORCID:0000-0003-1991-7284), Tropeano, Giovanna (ORCID:0000-0003-0237-1772), Scambia, Giovanni (ORCID:0000-0003-2758-1063), and Testa, Antonia Carla (ORCID:0000-0003-2217-8726)

Abstract

BACKGROUNDUnilocular-solid ovarian cysts are a rare but challenging pathology in young women, with a desire to spare their fertility. In these cases, the risks of borderline and invasive disease are around 10 and 20%, respectively. No ultrasound rule has yet demonstrated the ability to discriminate with high accuracy, a borderline tumor from a benign tumor or 'invasive tumor'. The aim of this study was to assess the predictive performance of different ultrasound parameters in differentiating benign and borderline tumors versus invasive malignant tumors in premenopausal patients with unilocular-solid ovarian masses.METHODSWomen aged ≤50 years with unilocular-solid adnexal masses with a maximum diameter ≤10 cm, undergoing surgery in our department within 3 months from ultrasound examination, were included in this retrospective study. A standardized ultrasound examination technique and predefined definitions of ultrasound characteristics were used. The results of ultrasound examination using gray scale and color Doppler were compared with the histological examination of the respective surgical specimens.RESULTSThe study included 51 patients. On histological examination, 36 (70%) lesions were classified as benign, 10 (20%) as borderline ovarian tumors and 5 (10%) as invasively malignant tumors. In receiver-operating characteristic curve analysis, the best cut-off for the largest solid component with regard to discriminating non-invasive (benign or borderline) from invasive tumors was 14 mm. A largest solid component >14 mm, the presence of papillation blood flow and the combination of the two parameters provided a sensitivity of 100% and a specificity of 63, 63 and 80%, respectively.CONCLUSIONSTransvaginal ultrasound examination seems to be able to discriminate between invasive and non-invasive tumors in the premenopausal patients with unilocular-solid adnexal masses. Because of the retrospective nature of the study, further prospective clinical trials are needed to

Published
2012

10. OC14.03: Clinical and ultrasound characteristics of tubal cancer

Author

Ludovisi, M., primary, De Blasis, I., additional, Virgilio, B., additional, Giansiracusa, C., additional, Fischerova, D., additional, Franchi, D., additional, Pascual, M., additional, Savelli, L., additional, Epstein, E., additional, Van Holsbeke, C., additional, Guerriero, S., additional, Czekierdowski, A., additional, Jurkovic, D., additional, Rossi, A., additional, Timmerman, D., additional, Mascilini, F., additional, Valentin, L., additional, and Testa, A., additional

Published
2013
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13. OP03.09: The sonographic prediction of invasive carcinoma in unilocular-solid ovarian cysts in premenopausal patients: a pilot study

Author

Fagotti, A., primary, Ludovisi, M., additional, De Blasis, I., additional, Virgilio, B., additional, Di Legge, A., additional, Mascilini, F., additional, Fanfani, F., additional, Tropeano, G., additional, Giansiracusa, C., additional, Moruzzi, C., additional, Di bidino, R., additional, Scambia, G., additional, and Testa, A., additional

Published
2012
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16. Selective medicated (saline + natural surfactant) bronchoalveolar lavage in unilateral lung contusion. A clinical randomized controlled trial.

Author

Marraro GA, Denaro C, Spada C, Luchetti M, Giansiracusa C, Marraro, Giuseppe A, Denaro, Carmelo, Spada, Claudio, Luchetti, Marco, and Giansiracusa, Carla

Abstract

Objective: Open lung and low tidal volume ventilation appear to be a promising ventilation for chest trauma as it can reduce ARDS and improve outcome. Local therapy (e.g. BAL) can be synergic to remove from the lung the debris, mitigate inflammatory cascade and avoid damage spreading to not compromised lung areas.Materials and Methods: 44 pulmonary contused patients were randomized to receive broncho-suction and volume controlled low tidal volume ventilation-VCLTVV (Control Group) or the same ventilation plus medicated (saline + surfactant) BAL (Treatment Group). Tidal volume <10 ml/kg, PEEP of 10-12 cm H(2)O and PaO(2) 60-100 mm Hg and PaCO(2) 35-45 mm Hg were used in both groups. BAL was performed using a fiberscope. 4 boluses of 25 ml saline with 2.4 mg/ml of surfactant were introduced into each contused lobe in which, subsequently, 240 mg of surfactant was instilled.Results: All patients survived. In the Control Group 18 patients developed pneumonia, 5 ARDS and days of intubation were 11.50 (3.83) compared to 5.05 (1.21) of Treatment Group in which OI and PaO(2)/FiO(2) significantly improved from 36 h.Conclusions: VCLTVV alone was not able to prevent ARDS and infection in the Control Group as the reduction of intubation. In the Treatment Group, VCLTVV and medicated BAL facilitated the removal of degradated lung material and recruited the contused lung regions, enabling the healing of the lung pathology. [ABSTRACT FROM AUTHOR]

Published
2010
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17. [Rule of early diagnosis for sigmoid volvulus. Case report].

Author

Di Carlo I, Sofia M, Toro A, Sparatore F, Giansiracusa C, and Guastella T

Subjects
Aged, Aged, 80 and over, Colectomy, Colostomy, Female, Follow-Up Studies, Humans, Radiography, Abdominal, Time Factors, Tomography, X-Ray Computed, Intestinal Volvulus diagnosis, Intestinal Volvulus diagnostic imaging, Intestinal Volvulus surgery, Sigmoid Diseases diagnosis, Sigmoid Diseases diagnostic imaging, Sigmoid Diseases surgery
Abstract

The sigmoid colon is the most frequent site for a volvulus due to anatomical and pathological reasons. When the rotation of the loop occurs slowly, the sigma can greatly blow up and stretch. We report the clinical case of an 80-year-old woman admitted to our Department for an enormous volvulus of sigmoid colon. Physical examination, abdominal X-ray and CT-scan were performed to diagnose the disease. At the surgical procedure the sigma was about 50 centimetres in length and 15 centimetres in diameter, with a gangrenous necrosis of the loop; the treatment was a sigmoidectomy by Hartmann procedure. Surgical resection is the only therapeutical option for volvulus in advanced stage due to a late diagnosis.

Published
2004

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