Hepatic incidentaloma: An asymptomatic ectopic thyroid tissue

An ectopic thyroid is a form of thyroid dysgenesis in which the entire thyroid gland or parts of it may be located in another part of the body than the usual place. The most frequent location is the base of the tongue. Although most cases are asymptomatic, symptoms related to tumor size and its relationship with surrounding tissues, hormonal dysfunction, and seldom malignancy may also occur. Here, we describe the case of an asymptomatic woman who was thyroidectomized 19 years previously for a toxic goiter and treated with conventional L-thyroxine therapy, until we enacted a progressive reduction of dosage of the replacement therapy. Incidentally, because of occasional abdomen discomfort, sh…

[Radiomics and artificial intelligence: new frontiers in medicine.]

Radiomics is a new frontier of medicine based on the extraction of quantitative data from radiological images which can not be seen by radiologist's naked eye and on the use of these data for the creation of clinical decision support systems. The long-term goal of radiomics is to improve the non-invasive diagnosis of focal and diffuse diseases of different organs by understanding links between extracted quantitative imaging data and the underlying molecular and pathological characteristics of lesions. In the last decade, several studies have highlighted the enormous potential of radiomics in both tumoral and non-tumoral diseases of many organs and systems including brain, lung, breast, gast…

TRANSCRANIAL MAGNETIC RESONANCE-GUIDED FOCUSED ULTRASOUND (TCMRGFUS) CON SCANNER DA 1.5T: NOTA TECNICA

Scopo La terapia dei disordini neurologici mediante tcMRgFUS è stata effettuata utilizzando esclusivamente scanner RM da 3T. Utilizzando uno scanner RM da 1.5T la qualità delle sequenze morfologiche utilizzabili per la pianificazione di questi trattamenti è risultata essere soddisfacente utilizzando la bobina body RF (quella utilizzata con scanner 3T). Tuttavia l'SNR delle sequenze utilizzate per la termometria RM è risultato inferiore allo standard accettabile per i trattamenti. È stata quindi sviluppata una bobina a 2 canali per assicurare un adeguato SNR. Presentiamo il protocollo di imaging efficacemente utilizzato per eseguire procedure tcMRgFUS con il primo sistema mai integrato …

Transcranial MRgFUS for movement disorder: Toward a wider and affordable employment for functional neurosurgery through 1.5-T MRI?

ROLE OF ENDOVASCULAR EMBOLIZATION IN THE MULTIDISCIPLINARY MANAGEMENT OF RUPTURED BRAIN ARTERIOVENOUS MALFORMATIONS

Brain arteriovenous malformations (bAVMs) are congenital defects of vasculogenesis, the natural history of which is characterized by a significant morbidity and mortality related to the risk of bleeding. Their management remains challenging, since complete eradication is often difficult. Embolization, surgery, or radiosurgery alone are safe and effective for small unruptured AVMs, while a multidisciplinary approach should be pursued for larger ones. We report a case of intracerebral haemorrhage due to the rupture of a large bAVM, for which a multidisciplinary approach was adopted: endovascular partial embolization followed by complete surgical removal.

Crohn’s disease: Radiological features and clinical-surgical correlations

This book describes and illustrates the radiological findings that are characteristic of Crohns disease and correlates these appearances with clinical and surgical findings in order to assist the reader in implementing an appropriate diagnostic approach in this complex disease, which often differs from patient to patient. All of the modern imaging modalities and techniques are covered, including ultrasound, multidetector row computed tomography (MDCT), magnetic resonance imaging (MRI), and combinations of MDCT and MRI with enteroclysis and enterography. The current value of X-ray and the role of endoscopy are also examined. Care is taken to cover specific patient groups, including pediatric…

DIAGNOSTIC ACCURACY OF IXIP INDEX AND PROSTATE MRI IN THE DIAGNOSIS OF PROSTATE CANCER: PRELIMINARY RESULTS ON A COMBINED APPROACH

The purpose of this study was to assess whether Immune CompleX Predictive Index (iXip) improves diagnostic accuracy of multiparametric prostate MRI (mpMRI) for clinically significant prostate cancer. This study included 72 patients (mean age: 68±8 years) with suspicion of prostate cancer and available iXip score. mpMRI images were evaluated by two radiologists according to the PI-RADS v2.1. Reference standard was based on fusion biopsy and standard transperineal 12-point biopsy. Diagnostic accuracy of iXip, mpMRI and their combination were calculated. Optimal cutoff of iXip with sensitivity and specificity was identified using the Youden index. Patients with clinically significant prostate …

Pancreaticoduodenal arteries aneurysms: Evaluation of frequency and association with celiac artery stenosis due to compression by median arcuate ligament

The aim of the study is to evaluate the prevalence of pancreaticoduodenal arteries (PDA) aneurysms in a large population, and to define possible correlations with celiac artery stenosis due to compression by the median arcuate ligament. Radiological reports of abdominal contrast-enhanced CT scans of 18,180 patients were scrutinized to identify patients with true PDA aneurysms. Two abdominal radiologists classified the aneurysms according to size, location and morphology and scored the presence of celiac artery stenosis due to either median arcuate ligament compression or atherosclerotic disease. Eleven true PDA aneurysms were identified in 10 patients. Nine out of 10 patients had stenosis o…

I più recenti sviluppi costituzionali del ciclo di bilancio

The A. answer to a series of questions by the Director of the "Gruppo di Pisa" Journal. The questions concern the parliamentary procedure followed to enact the State Budget Law for the year 2023 (law No 197/2022). The A. debates over: the possibility to prove the evident violation of parliamentary privileges in the procedure followed by the two chambers of the Italian parliament (Const. court. orders Nos. 17/2019 and 60/2020); the impact of Next Generation EU and of NPRR over the National Budgetary procedures; the role played by the Budget Parliamentary Office (UPB) and by the State General Accounting Office in parliamentary procedures concerning the State Budget Law for the year 2023

L'ERNIAZIONE DELLE GHIANDOLE LACRIMALI IN PAZIENTI CON OFTALMOPATIA DI GRAVES: UN POSSIBILE MARKER DI ATTIVITÀ DELLA MALATTIA.

Scopo Il coinvolgimento delle ghiandole lacrimali (GL) in pazienti affetti da Oftalmopatia di Graves (OG) è stato considerato come una potenziale causa dei sintomi tipicamente associati a questa malattia. Diversi studi hanno rilevato che le dimensioni delle GL nei pazienti OG sono aumentate, ma non ci sono studi che prendono in considerazione pazienti con diversa attività della malattia. Abbiamo valutato l'erniazione delle GL rilevata sulle immagini di risonanza magnetica (RM), in pazienti con diversa attività OG. Materiale e metodi Trentadue pazienti (10M, 22F, età media 49,5 anni, range 30-68) con OG sono stati arruolati e raggruppati in base all'attività della malattia (A: n = 16 co…

Cystic lymphangioma of adrenal gland. Case report and review of the literature

Il linfoangioma surrenalico cistico è una neoplasia beni- gna rara che origina da una ectasia dei vasi linfatici; questa lesione si localizza, più frequentemente, nella regione del collo, ascellare e mediastinica. Lo scopo di questo studio è descrivere il caso di una donna di 60 anni con dolore addominale ricorrente che si è sot- toposta ad un esame ecografico che ha mostrato la presenza di una massa cistica in corrispondenza del polo superiore del rene; quindi l’origine della massa, il surrene, è stata identificata attraverso la Tomografia Compiuterizzata, eseguita con mezzo di contrasto. Successivamente la paziente ha effettuato la Risonanza Magnetica che ha meglio caratterizzato la lesio…

MDCT Enteroclysis and Enterography

Since the first studies suggesting its possible role in the management of Crohn’s disease patients, multidetector computed tomography has usually been considered a useful diagnostic technique in Crohn’s disease for the detection of extraenteric complications, as intra-abdominal abscesses, the study of strictures, prestenotic dilatations, fistulas, and postsurgical complications. Moreover, it is a widely available technique and is considered the gold standard in emergency.