Anatomia e patologia del labirinto membranoso studio con sequenze RM sensibili al flusso

Nonostante i deludenti esordi nella valutazione delle strutture labirintiche costituenti l'orecchio interno, la risonanza magnetica costituisce oggi, grazie anche al miglioramento dell'hardware e del software disponibili, una modalità diagnostica di grande efficacia non solo nell'analisi della patologia espansiva o infiammatoria coinvolgente il VII ed VIII nervo cranico, ma anche nella valutazione delle alterazioni patologiche del segnale endolabirintico in rapporto a focolai emorragici o, come recentemente dimostrato mediante uso di Gd-DTPA, nell'analisi delle alterazioni a carico della capsula oticanella fase spongiotica dell'otosclerosi. Tuttavia, lo scarso contrasto esistente tra liqui…

MRI findings and evoked potentials in patients with myotonic dystrophy versus facioscapulohumeral dystrophy

Evoked potentials recordings have been applied to many neurological disorders, localizing the lesions in the central nervous system (CNS) pathways. Facioscapulohumeral muscular dystrophy (FSHD) is a slowly progressive degenerative disease involving the muscles of the face and shoulders. On the contrary, myotonic distrophy (MD), the most frequent and severe myotonic disease, is caracterized by myotonia (delay of relaxation after voluntary contraction), muscular atrophy and dystrophic changes in non-muscular tissues. In the present investigation, patients with clinically and electromyographically verified FSHD and MD were examined using somatosensory evoked potentials (SEP) and brainstem aud…

Idiopathic intracranial hypertension: orbital MRI

The case is reported of a patient with idiopathic intracranial hypertension examined with magnetic resonance imaging. Marked enhancement of the optic nerve heads was found, which might be related to blood-retinal barrier breakdown related to a sudden rise in intracranial cerebrospinal fluid pressure.

Familial Cavernous Angioma: MRI Study of three Generation in two Italian Families and Literature Review

According to recent magnetic resonance imaging studies, cavernous angioma (CA) seems to involve the central nervous system in 0.5%-1% of the population 1 - in a similar percentage to a large autopsy series 2.The incidence of familial CA is unknown 3: the first paper in the literature concerning familial CA was published in 1936 5: recently however, thank to the widespread use of MR, at least 13 families have been described.We report MR findings in two Italian families with familial CA.In conclusion, familial CA should be included in the differential diagnosis of patients with intracranial haemorrhage, seizures or cerebrovascular disease.

1308 Evaluating the prognostic role of serum extracellular domain (ECD) of HER-2/neu (s-HER2) in patients (PTS) with metastatic (M) breast cancer (BC): results of an observational study

Gd-DTPA in blood-ocular barrier damage: a new diagnostic tool for future application in MRI?

The blood-brain barrier is not the only neuroepithelial blood filter in the body: the eye too is supported by a highly specialised microvascular filter, the so-called blood-ocular barrier (BOB). The BOB is actually divided into a blood-aqueous (BAB) and a blood-retinal (BRB) barrier, filtering the aqueous fluid and biological supplies, respectively, to the retina. The authors’ purpose was to study the possibility of imaging BAB or BRB damage by contrast-enhanced MRI: they examined 21 patients with a 0.5 T system and surface coil. Despite the normal findings in the damaged eyes immediately after a Gd-DTPA bolus, delayed contrast-enhanced MRI was able to show focal or diffuse barrier damage.

Ventrolateral Compression of the Brain Stem in Essential Hypertension: MR Angiography Study

Our purpose was to evaluate neurovascular compression at the level of ventrolateral medulla and NVC with the IXth and the Xth cranial nerves in patients with essential hypertension and in healthy volunteers using high resoluted Spoiled Recalled Gradient Echo (SPGR) sequences, allowing the detection of stationary tissues and moving spins. Thirty patients (19 men and 11 women) with essential hypertension were examined. Patient's ages ranged from 24 to 64 years-old (mean age was 48 y.o.). Patients older than 65 were excluded. The average of systolic blood-pressure of hypertensive patients was 183 ± 10 mmHg, while the diastolic pressure was 98 ± 10.5 mmHg. In conclusion, we consider axial sing…

“Randomised, open-label, phase II trial of paclitaxel, gemcitabine and cisplatin versus gemcitabine and cisplatin as first-line chemotherapy in advanced transitional cell carcinoma of the urothelium”

The purpose of the study was to evaluate the antitumor activity and the safety of paclitaxel combined with gemcitabine and cisplatin in patients affected by advanced transitional cell carcinoma of the urothelium (TCC). Eighty-five patients affected by advanced TCC and measurable disease were randomized to receive either paclitaxel at dosage of 70 mg/m2, gemcitabine 1000 mg/m2 and cisplatin 35 mg/m2 on days 1 and 8 every 3 weeks (GCP) or gemcitabine 1000 mg/m2 on days 1, 8, 15 and cisplatin 70 mg/m2 on day 2 every 4 weeks (GC). All enrolled patients were considered evaluable for response and toxicity (intention to treat). The observed response rate was 43% for GCP and 44% for GC combination,…

Fast Spin Echo e Spin-Echo

Uno dei maggiori problemi connessi alio studio del SNC di pazienti in età pediatrica con RM è indubbiamente costituito dalla durata dell'esame stesso, che impone sovente la necessità di una sedazione farmacologica del paziente e limita allo stretto indispensabile il numero delle acquisizioni effettuate. Appare pertanto facilmente intuibile l'entusiasmo rivolto verso nuovi tipi di sequenze che presentino quale caratteristica principale una drastica riduzione dei tempi di acquisizione pur mantenendo un'affidabile qualità diagnostica. Le sequenze di tipo Fast-Spin-Echo (FSE) costituiscono il successivo sviluppo delle sequenze denominate RARE (Rapid Acquisition Relaxation Enhanced) descritte d…

Su di un caso di Schwannoma primitivo intraorbitario

Gli Schwannomi costituiscono il 6,8% dei tumori intracranici ed originano solitamente dai nervi sensitivi, con particolare predilezione per il V e VIII nervo cranico. Uno schwannoma a partenza da un nervo oculomotore costituisce invece una evenienza piuttosto rara, e solo 17 casi di s. del III n.c. sono stati documentati in letteratura. Sono da considerare ancora più rari gli schwannomi ad esclusiva localizzazione intraorbitaria (1–5, 7% dei tumori orbitari). Solitamente tipico dell'uomo adulto, con l'eccezione dei soggetti affetti da Neurofibromatosi di tipo 2, lo schwannoma orbitario esordisce solitamente come un processo espansivo a lento accrescimento, determinante diplopia, esoftalmo …

“Weekly docetaxel and gemcitabine as first line treatment for metastatic breast cancer: results of a multicenter phase II study”

<i>Objectives:</i> We conducted a multicenter phase II study to evaluate the clinical efficacy, toxicity, and dose intensity of a new weekly schedule of docetaxel and gemcitabine as first-line treatment of metastatic breast cancer patients. <i>Methods:</i> We enrolled 58 patients, 52% of whom had received a previous anthracycline-containing chemotherapy. The treatment schedule was: docetaxel 35 mg/m<sup>2</sup> and gemcitabine 800 mg/m<sup>2</sup> i.v. on days 1, 8, 15 every 28 days. <i>Results:</i> All patients were assessable for toxicity and 56 for efficacy. Overall response rate was 64.3% with 16.1% of complete responses and 48…