Cecal trap: CT findings of isolated cecal necrosis

Learning objectives Background Findings and procedure details Conclusion Personal information References

Prevalence and characteristics of coronary artery disease in a population with suspected ischaemic heart disease using CT coronary angiography: correlations with cardiovascular risk factors and clinical presentation

Purpose. This study was undertaken to describe the correlation between the distribution of coronary artery disease (CAD) in a symptomatic population with suspected ischaemic heart disease, cardiovascular risk factors (RF) and clinical presentation. Materials and methods. We studied 163 patients (mean age 65.5 years; 101 men and 62 women) referred for multidetector computed tomography coronary angiography (MDCT-CA) to rule out CAD. The patients had no prior history of revascularisation or myocardial infarction. We analysed how the characteristics of CAD (severity and type of plaque) can change with the increase in RF and how they are related to different clinical presentations. Results. Pati…

Imaging of atherosclerotic plaque with non invasive Multislice Computed Tomography Coronary Angiography

Caustic ingestion: CT findings of esophageal injuries and thoracic complications

Ingestion of caustic substances, whether accidental or for the purpose of suicide, can cause severe lesions of the lips, oral cavity, pharynx, upper gastrointestinal system, and upper airways. In particular, caustic agents could be responsible for severe esophageal injuries resulting in short- and long-term complications. Because of these important clinical implications, timely diagnosis and appropriate management are crucial. In the evaluation of esophageal injuries, thoraco-abdominal computed tomography (CT) is preferable to endoscopy as it avoids the risk of esophageal perforation and allows the evaluation of esophageal injuries as well as of the surrounding tissue. In this review, we re…

Impiego della Cardio-TC in pazienti con aneurisma gigante dell'aorta ascendente

Imaging dell'amiloidosi cardiaca in Risonanza Magnetica: Case Report.

Amyloidosis is a rare group of diseases characterized by the deposition of amyloid protein level of various tissues and organs, including myocardial tissue, with progressive evolution towards heart failure. We report the case of a 76-year-old male patient with dyspnoea and easy fatigue, whose picture of Magnetic resonance imaging enabled the diagnosis of cardiac amyloidosis.

Valutazione dei parametri volumetrici e funzionali cardiaci

CONFRONTO TRA RM WHOLE BODY E PET/TC NELLA STADIAZIONE DEI LINFOMI FDG-AVIDI.

Scopo Scopo del nostro studio è stato quello di comparare la RM whole body (RM-WB) con la PET/TC nella stadiazione dei linfomi FDG-avidi. Materiale e metodi 68 pazienti (37 maschi, età mediana 42 anni, range 15-86) con diagnosi istologica di Linfoma (37 Hodgkin, 16 Diffuso B a grandi cellule, 10 Follicolare, 5 Mantellare) sono stati sottoposti a RM-WB e PET/TC prima del trattamento. Sono stati valutati e confrontati sensibilità, specificità, valore predittivo positivo e negativo (PPV e NPV) della RM-WB e PET/TC, quest’ultima considerata come standard di riferimento. Lo stadio Ann Arbor (AA) ottenuto con RM-WB (sequenze DWIBS assiali, T1w e T2w-STIR coronali, senza mezzo di contrasto) e con …

Valutazione quantitativa tridimensionale del parenchima polmonare affetto da fibrosi cistica : risultati preliminari

Purpose. The aim of this study was to assess the feasibility of three-dimensional (3D) reconstructions and quantitative analysis of the volume of each component of the lung with cystic fibrosis (CF). Materials and methods. Twenty-two patients with CF (mean age 17±8 yeas) were included in the study. The patients underwent an unenhanced single-slice spiral computed tomography (CT) chest scan with the following parameters: collimation 3 mm, table feed 6 mm×rot-1, reconstruction interval 1 mm, soft tissue reconstruction kernel. Four image data sets were obtained: native axial slices, cine-mode display, virtual bronchographic volumerendered images with algorithm for tissue transition display and…

DIGITAL CINERADIOGRAPHIC STUDY OF SWALLOWING IN PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS

Purpose. This study was performed to evaluate the usefulness of digital cineradiography in detecting swallowing disorders in dysphagic patients affected by amyotrophic lateral sclerosis (ALS) with a view to planning an adequate therapeutic approach. Material and methods. From January 2005 to September 2006, 23 patients (10 men and 13 women; mean age 41.3±8.6 years) affected by ALS were evaluated with digital cineradiography to assess the grade of dysphagia. All patients were classified using the Hillel ALS Severity Scale (ALSSS). All examinations were performed with radiocontrolled equipment provided with a digital C-arm. Results. The cineradiographic technique enabled us to differentiate p…

Influence of the heart rate in the selection of the optimal reconstruction phase in clinical routine Multislice Coronary Angiography

Focal hepatic intrinsically hyperattenuating lesions at unenhanced CT: Not always calcifications.

Due to the growing use of CT, there has been an increase in the frequency of detecting focal liver lesions. Intrinsically hyperattenuating hepatic lesions or pseudolesions are not uncommon at unenhanced CT. Hyperattenuating hepatic lesions can be divided into non-calcified and calcified. Causes of intrinsic hyperattenuation include hemorrhage, thrombosis, and calcifications. Focal liver lesions can show hyperattenuation on unenhanced CT in case of severe liver steatosis. Recognition of etiologies associated with hyperattenuation on unenhanced CT can help the radiologist in characterizing focal liver lesions and pseudolesions. In this paper, we describe the spectrum of intrinsically hyperatt…

Influenza della concentrazione iodica dei mezzi di contrasto sulla caratterizzazione della placca aterosclerotica coronarica valutata mediante TC Multistrato in un modello umano ex-vivo

Role of Contrast-Enhanced Ultrasound in the Assessment of Splenic Hemangiomas

Angiografia Coronarica non invasiva mediante Tomografia Computerizzata a 64 strati del carico aterosclerotico in pazienti ad elevato rischio di eventi acuti

Diagnostic accuracy of 64-slice computed tomography coronary angiography in patients with low-to-intermediate risk

Purpose. Our aim was to evaluate the diagnostic accuracy of 64- slice computed tomography coronary angiography (MSCT-CA) for detecting significant stenosis (≥50% lumen reduction) in a population of patients at low to intermediate risk. Materials and methods. We studied 72 patients (38 men, 34 women, mean age 53.9±8.0 years) with atypical or typical chest pain and stratified in the low- to intermediate risk category. MSCT-CA (Sensation 64 Cardiac, Siemens, Germany) was performed after IV administration of 100 ml of iodinated contrast material (Iomeprol 400 mgI/ml, Bracco, Italy). Two observers, blinded to the results of conventional coronary angiography (CAG), assessed the MSCT-CA scans in c…

Aspetti normali e patologici delle valvole cardiache studiate mediante TC Multistrato cardiosincronizzata

Influence of image reconstruction parameters on cardiovascular risk reclassification by Computed Tomography Coronary Artery Calcium Score

Objective: To investigate the influence of different CT reconstruction parameters on coronary artery calcium scoring (CACS) values and reclassification of predicted cardiovascular (CV) risk. Methods: CACS was evaluated in 113 patients undergoing ECG-gated 64-slice CT. Reference CACS protocol included standard kernel filter (B35f) with slice thickness/increment of 3/1.5 mm, and field-of-view (FOV) of 150–180 mm. Influence of different image reconstruction algorithms (reconstructed slice thickness/increment 2.0/1.0–1.5/0.8–3.0/2.0–3.0/3.0 mm; slice kernel B30f-B45f; FOV 200–250 mm) on Agatston score was assessed by Bland-Altman plots and concordance correlation coefficient (CCC) ana…

A SIR based method for pancreas iron burden measurement in MRI T2* GRE sequences.

[Diagnosis, prognosis and treatment of "myocardial bridging": state of the art and unresolved issues].

The current gold standard for the diagnosis of myocardial bridging is conventional coronary angiography; however, it shows only indirect signs of the disease, due to the systolic compression of the artery caused by the myocardial bridge with narrowing of the lumen and diastolic relaxation. On the other hand, computed tomography coronary angiography, even though exposing to radiation, clearly demonstrates the intramural course, the overlying muscular bands and the surrounding tissues also in asymptomatic patients and in absence of systolic compression. The prognosis of patients with myocardial bridge is usually good, but further studies are needed to evaluate the long-term prognosis of these…

Aortic valve and vascular calcium score in pre-TAVI CT: correlation with early post-procedural complications

Abstract Purpose The aim of our study was to evaluate the prevalence of early complications after Transcatheter Aortic Valve Implantation (TAVI) and their correlation with the Calcium Score (CS) of the aortic valve, aorta and ilio-femoral arteries derived from pre-procedural computed tomography (CT). Materials and methods We retrospectively reviewed 226 patients (100 males, mean age 79.4 ± 6.7 years) undergoing 64-slice CT for pre-TAVI evaluation from January 2018 to April 2021. The population was divided into CS quartiles. Results Overall, 173 patients underwent TAVI procedure, of whom 61% presented paravalvular leak after the procedure, 28% presented bleeding or vascular complications, 25…

OTTIMIZZAZIONE DEL MDC IN ANGIOGRAFIA CORONARICA MEDIANTE TC A 64 STRATI: USO DELLO IOMERON® 400 MG IODIO/ML

Coartazione aortica in tomografia computerizzata multistrato

Aortic coarctation (CA) is a congenital focal narrowing of the aortic lumen forming part of an arteriopathy generalized (5-8% of all congenital heart diseases). Classically distinct in a predeterminal and postductal form, at present this classification is not used much. Clinical manifestations of affected patients range from systolic hypertension of the originating vessels a upstream of the part coarctated to the hypotension dependent on those downstream and strictly depend on the degree of stenosis.

Collateral findings

Clinical value of Multislice CT Coronary Angiography in a cohort of asymptomatic high risk patients with dysmetabolic syndrome

Diagnostic accuracy with non-invasive 64-slice CT coronary angiography

Quantification of epicardial fat with cardiac CT angiography and association with cardiovascular risk factors in symptomatic patients: From the ALTER-BIO (alternative cardiovascular bio-imaging markers) registry

PURPOSE We aimed to assess the association between features of epicardial adipose tissue and demographic, morphometric and clinical data, in a large population of symptomatic patients with clinical indication to cardiac computed tomography (CT) angiography. METHODS Epicardial fat volume (EFV) and adipose CT density of 1379 patients undergoing cardiac CT angiography (918 men, 66.6%; age range, 18–93 years; median age, 64 years) were semi-automatically quantified. Clinical variables were compared between diabetic and nondiabetic patients to assess potential differences in EFV and adipose CT density. Multiple regression models were calculated to find the clinical variables with a significant a…

Prognostic outcome of routine clinical noninvasive Multidetector row Computed Tomography Coronary Angiography in Patients with suspected coronary artery disease: a 2-years follow-up study.

The aim of the study was to assess the prognostic value of multidetector-row CT coronary angiography (MDCT-CA) in patients with suspected coronary artery disease (CAD) in a routine clinical context.A total of 125 patients (82 men, age 57.4±10.3 years) with suspected CAD underwent MDCT-CA. All patients were assessed for cardiovascular risk factors, symptoms and coronary calcium score. A 2-year follow-up study for the occurrence of major adverse cardiac events was performed.According to the Morise pretest score, 76 patients (60.8%) were at intermediate risk. Patients with suspected CAD presented the following prognostic outcome (p0.0001): in 41 patients with normal coronary arteries at MDCT-C…

Cardioradiologia

Quantification of epicardial adipose tissue in coronary calcium score and CT coronary angiography image data sets: comparison of attenuation values, thickness and volumes

The aim of the study was to compare epicardial adipose tissue (EAT) characteristics assessed with coronary calcium score (CS) and CT coronary angiography (CTCA) image data sets.In 76 patients (mean age 59 ± 13 years) who underwent CS and CTCA owing to suspected coronary artery disease (CAD), EAT was quantified in terms of density (Hounsfield units), thickness and volume. The EAT volume was extracted with a semi-automatic software.A moderate correlation was found between EAT density in CS and CTCA image data sets (-100 ± 19 HU vs -70 ± 24 HU; p  0.05, r = 0.55). The distribution of EAT was not symmetrical with a maximal thickness at the right atrioventricular groove (14.2 ± 5.3 mm in CS, 15.…

“Visual Dictionary” of Coronary Artery Imaging by 64-slice CT Coronary Angiography: “How to” Correctly Describe Imaging Findings of CT Coronary Angiography for the Referring Physicians

Osteonecrosis detected by whole body magnetic resonance (WB-MRI) in patients with Hodgkin lymphoma treated by BEACOPP

Purpose: The purpose of our retrospective study was to assess the incidence of osteonecrosis in patients who received different chemotherapies. Methods and Materials: We evaluated the Whole Body Magnetic Resonance (WB-MRI) scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6 ABVD, 2 ABVD + 4 BEACOPP, 2 ABVD + 8 BEACOPP), excluding the patients with main risk factors for osteonecrosis. Results: Six out of 7 patients (85.7%) who received 8 BEACOPP and 1 out of 5 patients (20%) treated by 4 BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p<0.05); no injury has been reporte…

Imaging quantitativo dell’aterosclerosi coronarica in-vivo con software dedicato: TC multistrato vs. Ecografia intracoronarica

The Know-how to Apply an Appropriate Reconstruction Filtering in MSCT Coronary Angiography.

Regression of benign hepatic lesions associated with exogenous estrogens withdrawal

Learning objectives Background Findings and procedure details Conclusion Personal information References

Appropriateness criteria for the use of cardiac computed tomography, SIC-SIRM part 2: Acute chest pain evaluation; Stent and coronary artery bypass graft patency evaluation; Planning of coronary revascularization and transcatheter valve procedures; Cardiomyopathies, electrophysiological applications, cardiac masses, cardio-oncology and pericardial diseases evaluation

In the past 20 years, cardiac computed tomography (CCT) has become a pivotal technique for the noninvasive diagnostic workup of coronary and cardiac diseases. Continuous technical and methodological improvements, combined with fast growing scientific evidence, have progressively expanded the clinical role of CCT. Randomized clinical trials documented the value of CCT in increasing the cost-effectiveness of the management of patients with acute chest pain presenting in the emergency department, also during the pandemic. Beyond the evaluation of stents and surgical graft patency, the anatomical and functional coronary imaging have the potential to guide treatment decision-making and planning …

Il Tecnezio: storia, usi e applicazioni.

To bring to the knowledge of all the Italian paternity of the discovery of the first artificial chemical element in history: the Technetium or Technetium (Tc).

Assessment of volume and density of epicardial fat: comparison between CT calcium score and CT coronary angiography scans.

Aims and objectives Methods and materials Results Conclusion Personal information References

Prognostic outcome of atherosclerotic plaques in patients with suspected coronary artery disease assessed with Multislice Computed Tomography Coronary Angiography: a 30-month follow-up study

Coronary plaque imaging with multislice computed tomography: technique and clinical applications.

The composition of an atherosclerotic lesion, rather than solely the degree of stenosis, is considered to be an important determinant of acute coronary events. Whereas until recently only invasive techniques have been able to provide clues about plaque composition with consistent reproducibility, several recent studies have revealed the potential of multislice computed tomography (MSCT) for noninvasive plaque imaging. Coronary MSCT has the potential to detect coronary plaques and to characterize their composition based on the X-ray attenuating features of each structure. MSCT may also reveal the total plaque burden (calcified and noncalcified components) for individual patients with coronar…

Caso 37 Patologia Aortica

Clinical case

Diagnostic value of hypoenanced miocardial region observed in MSCT-CA: comparison with other diagnostic tools

SIRM–SIC appropriateness criteria for the use of Cardiac Computed Tomography. Part 1: Congenital heart diseases, primary prevention, risk assessment before surgery, suspected CAD in symptomatic patients, plaque and epicardial adipose tissue characterization, and functional assessment of stenosis

AbstractIn the past 20 years, Cardiac Computed Tomography (CCT) has become a pivotal technique for the noninvasive diagnostic work-up of coronary and cardiac diseases. Continuous technical and methodological improvements, combined with fast growing scientific evidence, have progressively expanded the clinical role of CCT. Recent large multicenter randomized clinical trials documented the high prognostic value of CCT and its capability to increase the cost-effectiveness of the management of patients with suspected CAD. In the meantime, CCT, initially perceived as a simple non-invasive technique for studying coronary anatomy, has transformed into a multiparametric “one-stop-shop” approach abl…

Imaging features of solid renal masses

The widespread use of abdominal imaging techniques has increased the detection of solid renal masses over the past years. Imaging plays a crucial role in the management and surveillance and in determining which lesions need treatment. The "classical angiomyolipoma" is the only benign solid renal mass that can be characterized with confidence by imaging through the detection of a fat-containing lesion without calcifications. There is a large overlap of imaging features between benign and malignant renal masses that often makes difficult a correct characterization of these lesions. In this review, we discuss the imaging features of the main solid renal masses that may suggest a likely benign …

Integrated non-invasive approach to atherosclerosis with cardiac CT and carotid ultrasound in patients with suspected coronary artery disease

The aim of the study was to compare the atherosclerotic disease in the coronary and carotid arteries in patients who underwent non-invasive imaging for suspected stable coronary artery disease (CAD). 107 patients (64 men, age 59 ± 12) with atypical chest pain underwent cardiac CT (CCT) and carotid ultrasound (US) on the same day. Severity (obstructive or not-obstructive disease), location, shape, and composition of atherosclerotic plaques in the two districts were evaluated. Patients presented normal coronary arteries in 36 % (n = 38), not-obstructive CAD in 36 % (n = 39), and obstructive CAD in 28 % (n = 30), while had normal carotid arteries in 53 % (n = 57), not-obstructive disease in 44…

64-MDCT coronary angiography in women: a critical issue?

Accuratezza diagnostica della Cardio TC a doppia sorgente di 3^ generazione con protocollo FLASH per la rilevazione di stenosi coronariche in pazienti candidati a procedura TAVI

Evaluate the performance of cardio TC performed by third generation Dual Source equipment and thoraco-abdominal FLASH protocol for the evaluation of coronary stenosis in a population of patients candidates for TAVI

Imaging of Gastrointestinal Stromal Tumors: From Diagnosis to Evaluation of Therapeutic Response

Once considered an obscure tumor entity with poor prognosis, gastrointestinal stromal tumors (GISTs) are nowadays recognized as the most common mesenchymal tumors of the alimentary tract. GISTs differ from other mesenchymal neoplasms at pathology since 90% of them exhibit strong immunohistochemical staining for KIT, a tyrosinase kinase growth factor receptor. In the early 2000s, the ability of imatinib mesylate, a tyrosine kinase inhibitor, to inhibit KIT established a new paradigm for cancer treatment. A reduction in lesion size may not be observed or may appear many months after therapy; thus, tumor response criteria alternative to the Response Evaluation Criteria in Solid Tumors were dev…

Diagnosi di osteonecrosi mediante WB-MRI in paziente con Linfoma di Hodgkin resistente trattato con BEACOPP: Case Report.

Hodgkin's lymphoma is a very common haematological neoplasm with high possibilities of response to treatment. On the other hand, therapies are often responsible for clinically relevant complications. Among these is osteonecrosis, generally determined by the high dosages of corticosteroids included in the chemotherapeutic protocols, which lead to bone ischemia through multifactorial mechanisms such as hypercoagulability and increase of intraosseous pressure due to hyperplasia of the adipose component. We report the case of a 29-year-old man with resistant Hodgkin's lymphoma undergoing chemotherapy which determined the appearance of multifocal osteonecrosis detected by Magnetic Resonance whol…

Relazione tra decorsi miocardici e carico aterosclerotico coronarico studiata mediante angiografia coronarica con TC a 64 strati (AC-TCMS)

Assessment of EVAR Complications using CIRSE Complication Classification System in the UK Tertiary Referral Centre: A ∼6-Year Retrospective Analysis (2014-2019).

Purpose: To retrospectively analyse complications in endovascular aortic repair (EVAR) interventions and evaluate if the CIRSE (Cardiovascular and Interventional Radiological Society of Europe) complication classification system is appropriate as a standardized classification tool for EVAR patients. Materials and Methods: Demographic, procedural and complication data in 719 consecutive patients undergoing EVAR at one institution from January 2014 to October 2019 were retrospectively reviewed. Data (imaging reports, procedural reports, nurse notes, discharge summary reports) were collected consulting the electronic patient record system (EPR) of the hospital and cleaned and stored in a Micro…

Role of multidetector-CT enteroclysis (MSCT-E) in complications of advanced Crohn's disease (CD) patients

Health technology assessment della TC del cuore: analisi globale e multidisciplinare della procedura diagnostica

Risonanza Magnetica (RM) renale per la valutazione quantitativa del sovraccarico di ferro con sequenze T2*: valori normali per età e sesso.

The objective of this study is to examine the reliability and reproducibility of multi-echo gadient-echo (ME-GRE) T2 sequences for the measurement of global and regional renal T2 values, establish normal cut-offs in healthy patients and evaluate the correlation of values ​​obtained with age and sex.

Whole-body MRI in patients with lymphoma: collateral findings.

To assess the incidence of collateral findings detected on whole-body magnetic resonance (WB-MRI) scans performed on patients with lymphoma. 114 patients (65 male; median age 45.2 years, range 15–86) with histologically confirmed lymphoma (47 Hodgkin, 67 Non-Hodgkin) underwent WB-MRI. The collateral findings were classified into three classes, according to their clinical significance, as follows: not or low significant (class 1), moderately or potentially significant (class 2), and significant (class 3). A Chi-square (χ 2) test was performed to assess the statistical significance of differences in the incidence of collateral findings based on age (≤50 and >50 years old), gender and histolog…

Imaging features of pancreatic metastases: A comparison with pancreatic ductal adenocarcinoma

Purpose: To compare imaging features of pancreatic metastases (PM) with those of pancreatic ductal adenocarcinomas (PDAC). Methods: CT and MR scans of 24 patients with 54 PM and 30 patients with PDAC were reviewed to evaluate the imaging features, which were compared by using a Chi square test. Results: We found a statistically significant difference between PM and PDAC based on location (P < 0.001), margins (P < 0.001), arterial enhancement (P = 0.004), rim enhancement (P < 0.001), pancreatic duct dilatation (P = 0.01), common bile duct dilatation (P = 0.003), vascular involvement (P = 0.02), parenchymal atrophy (P < 0.001), peripancreatic fluid (P = 0.03). Conclusion: Imaging features mig…

Registro quinquennale dell’attività di un singolo centro in TC Coronarica: appropriatezza clinica e considerazioni prognostiche

Accuratezza diagnostica nella valutazione della restenosi negli stent coronarici mediante TC a 64 strati

Cardio-RM nel paziente talassemico

Magnetic resonance imaging (RM) today represents a method non-invasive and accurate imaging to determine levels of iron in various tissues, even at the myocardial level, and it comes used as a monitoring and management method for thalassemic patients, so that they can recognize early those alterations that will then lead to the appearance of heart failure, or the so-called "cardiomyopathy from accumulation of iron".

Comprehensive cardiovascular ECG-gated MDCT as a standard diagnostic tool in patients with acute chest pain

Acute myocardial infarction, pulmonary embolism, and aortic dissection are diseases associated with acute chest pain and may lead to severe morbidity and mortality. These diseases may not be trivial to diagnose in the settings of emergency room. ECG-gated multi-detector computed tomography (MDCT), already established for the assessment of pulmonary embolism and aortic dissection, provides reliable information regarding the triage of patients with acute coronary syndrome in the emergency room. MDCT recently appeared to be logistically feasible and a promising comprehensive method for the evaluation of cardiac and non-cardiac chest pain in emergency department patients. The possibility to sca…

INCIDENZA DI NUOVI FOCI DI EPATOCARCINOMA (HCC) IN PAZIENTI SOTTOPOSTI AD ABLAZIONE CON RADIOFREQUENZA (RFA) DI HCC: RUOLO DELLA TC MULTIDETETTORE

Non-invasive visualisation of coronary atherosclerosis: state-of-art.

Coronary artery disease remains the leading cause of death in the Western world. Non-invasive coronary artery imaging challenges any diagnostic modality because the coronary arteries are small and tortuous, whereas cardiac contraction and respiration cause motion artifacts. Therefore, non-invasive coronary imaging requires high spatial and temporal resolution. This review discusses the feasible applications in coronary imaging of magnetic resonance imaging and multi-slice computed tomography (MSCT), which are currently the only non-invasive diagnostic modalities for direct coronary atherosclerosis imaging. Particular attention and focus is devoted to the potential indications and clinical i…

Intrabiliary rupture of hepatic hydatid cyst: MRI findings

Learning objectives Background Findings and procedure details Conclusion Personal information References

Regressione di lesioni epatiche benigne associate a sospensione di contraccettivi orali: nostra esperienza

Masse cardiache e paracardiache

Valvular Heart Disease

Valvular heart disease (VHD) refers to a wide spectrum of cardiac disorders that affect a large number of patients. Echocardiography is still considered the pivotal imaging method to evaluate the cardiac valves. However, echocardiography has some intrinsic limitations due to operator dependence and patient habitus. In the last two decades three-dimensional techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) have provided valuable assessment of VHD. MRI overcomes the limitation of the poor acoustic window of echocardiography without ionizing radiation. Nowadays, MRI aims to be considered as the reference standard for imaging cardiac valves because of the improved…

Gestione della dose in Cardio-TC

Exposure to ionizing radiation for diagnostic investigations has aroused much concern in recent years both in scientific literature and in the media. The exposure has dramatically increased in the last two decades; in fact, CT represents 11% of diagnostic tests, but contributes 68% to the collective dose. On the other singing, a plethora of TC investigations, including screening of the thorax in smokers, virtual colonoscopy and the study of coronary, they are affirmed for the relative simplicity of execution and high diagnostic performance, sometimes alternatively to traditional and more expensive invasive techniques. Between these investigations, the Cardio TC (CTC) has achieved a remarkab…

CENTRIFUGAL (INSIDE-OUT) ENHANCEMENT OF LIVER HEMANGIOMAS: A POSSIBLE ATYPICAL APPEARANCE ON CONTRAST-ENHANCED US

Searching the right coronary artery we found a rare anomaly documented by 3-dimensional volume rendering

Coronary artery anomaliesLipton classificationCoronary angiographyComputed tomography angiography (CTA)3-Dimensional volume rendering (VR)Unstable angina (UA)

Role of contrast-enhanced ultrasound in the assessment of spleen hemangiomas

Prognostic value at 24 months of Multislice Computed Tomography Coronary Angiography in patients with atypical chest pain.

Varianti anatomiche dell’albero coronarico visualizzate mediante angiografia coronarica con TC a 64 strati

Role of 64-slices MDCT-enterography in the evaluation of patients with suspected small bowel neoplasm.

Purpose Methods and Materials Results Conclusion References Personal Information

Influence of increasing convolution filters on plaque imaging with multislice CT using an ex-vivo model of Coronary Artery

Splenic Graulomatosis

Learning objectives Background Findings and procedure details Conclusion Personal information References

Prevalence of Anatomical Variants and Coronary Anomalies in 202 Consecutive Patients by 64-slice CT Coronary Angiography

CORONARY VARIANTS AND ANOMALIES : METHODOLOGY OF VISUALISATION WITH 64-SLICE CT AND PREVALENCE IN 202 CONSECUTIVE PATIENTS

Graft patency and late outcomes for patients with ST-segment elevation myocardial infarction who underwent coronary surgery

Objective: The aim of our study was to assess the long-term clinical outcomes and the grafts patency rates of patients with ST-segment elevation myocardial infarction (STEMI) who underwent urgent or emergency coronary artery bypass grafting (CABG). Materials: Participants in two previous studies comprising 207 STEMI patients undergoing on-pump (145 patients) or off-pump (62 patients) coronary artery bypass graft (CABG) surgery in our institution were prospectively followed to assess late mortality, graft patency, and major adverse cardiac-related event (MACE) rates. Graft patency was evaluated by multi-detector computed tomography angiography 64-slice scan. Mean times of graft implantation…

Diagnostic accuracy of 64-slice CT in the assessment of coronary stents

PURPOSE: The purpose of this study was to assess the diagnostic accuracy of 64-slice computed tomography (64-CT) coronary angiography in the detection of coronary in-stent restenosis. MATERIALS AND METHODS: Ninety-five patients (72 men and 23 women, mean age 58+/-8 years) with previous percutaneous coronary intervention with stenting and suspected restenosis underwent 64-CT (Sensation 64, Siemens). The mean time between stent deployment and 64-CT was 6.1+/-4.2 months. The scan parameters were: slices 32 x 2, individual detector width 0.6 mm, rotation time 0.33 s, feed 3.84 mm/rotation, 120 kV, 900 mAs. After the intravenous administration of iodinated contrast material (Iomeprol 400 mgI/ml,…

Computed tomography coronary angiography in asymptomatic patients

This study assessed the accuracy of computed tomography coronary angiography (CT-CA) for detecting significant coronary artery disease (CAD; a parts per thousand yen50% lumen reduction) in intermediate/high-risk asymptomatic patients. A total of 183 consecutive asymptomatic individuals (92 men; mean age 54 +/- 11 years) with more than one major risk factor (obesity, hypertension, diabetes, hypercholesterolaemia, family history, smoking) and an inconclusive or nonfeasible noninvasive stress test result (stress electrocardiography, stress echocardiography, nuclear stress scintigraphy) underwent CT-CA in an outpatient setting. All patients underwent conventional coronary angiography (CAG) with…

Prognostic value of clinical routine multislice computed tomography coronary angiography in patient with suspected or known coronary artery disease: a 2-year follow-up study.

Diffuse Liver Diseases: Role of imaging

Nowadays, the most common imaging techniques allow to study focal liver lesions with high diagnostic accuracy but a relatively recent emerging field of interest is represented by diffuse liver disease. They include a variegated series of storage and metabolic pathologies (ie, iron overload disorders and steatosis) requiring a precise diagnosis not always possible at imaging due to the overlapping of findings at conventional ultrasound, CT, or MR studies. In recent years, several imaging tecniques and specific softwares have been developed, especially for ultrasound and MR imaging, in order to identify different parameters useful in the noninvasive recognition and follow-up of these diffuse …

Prevalenza e caratteristiche delle varianti ed anomalie coronariche in 543 pazienti consecutivi studiati mediante Coronarografia-TC

Post-operative computed tomography imaging evaluation of ascending aorta surgery

Ascending thoracic aorta disease is often a life-threatening condition. Aortic aneurysm and aortic dissection are the most frequent ascending aorta diseases requiring surgical intervention. Surgical repair techniques of the ascending aorta are various; they include reconstruction of the ascending aorta by using a graft with or without a prosthetic valve, reconstruction with a composite artificial graft or using a biological graft, and reconstruction of the ascending aorta with a composite graft preserving the native valve and arch repair. The radiologist plays a key role in the identification of post-operative complications; differentiation from normal postoperative findings is fundamental.…

Whole-body magnetic resonance imaging and FDG-PET/CT for lymphoma staging: Assessment of patient experience

Purpose: To compare patient experience of whole-body MRI and FDG-PET/CT performed for lymphoma staging. Methods: One-hundred-fifteen patients (59 males, 56 females; 53 Hodgkin, 62 non-Hodgkin; mean age: 43.8 years) with lymphoma underwent whole-body MRI and FDG-PET/CT for staging and filled a questionnaire regarding their experience of the examinations using a 4-point Likert scale (1, very good; 4,very bad). Differences were evaluated using Wilcoxon signed-rank test. Patients were asked to express their preference on both techniques. Preferences were compared on the basis of gender, age, and Ann Arbor stage using the chi-square test. A p-value ≤ .05 was considered significant. Results: Most…

Profilo di accettabilità dell’angiografia coronarica non invasiva mediante TC Multistrato: per una medicina dalla parte del paziente

Multiplanar and Multiparametric MR Enterography in Crohn’s disease

Learning objectives Background Findings and procedure details Conclusion Personal information References

Three-year follow-up of patients at intermediate probability of coronary artery disease assessed with Multislice Computed Tomography Coronary Angiography

Purpose Methods and Materials Results Conclusion References Personal Information

Role of 64-slice CT Multiplanar Reconstructions in Acute Mechanichal Bowel Obstruction

Imaging della coartazione aortica mediante angiografia con Tomografia Computerizzata Multistrato cardiosincronizzata

Imaging techniques for the vulnerable coronary plaque

The goal of this article is to illustrate the main invasive and noninvasive diagnostic modalities to image the vulnerable coronary plaque, which is responsible for acute coronary syndrome. The main epidemiologic and histological issues are briefly discussed in order to provide an adequate background. Comprehensive coronary atherosclerosis imaging should involve visualization of the entire coronary artery tree and plaque characterization, including three-dimensional morphology, relationship with the lumen, composition, vascular remodelling and presence of inflammation. No single technique provides such a comprehensive description, and no available modality extensively identifies the vulnerab…

Role of contrast-enhanced ultrasound in the characterization of incidentally discovered focal liver lesions

La TC coronarica nel paziente stabile: approccio clinico e aspetti di imaging

Describe the clinical use of coronary CT and the characteristic aspects of imaging in the stable patient.

TCMD a 64 canali nell’occlusione intestinale meccanica acuta: ricostruzioni multiplanari versus immagini assiali

Fetuin-A is Associated to Serum Calcium and AHSG T256S Genotype but Not to Coronary Artery Calcification

Vascular calcification has been recently associated to an increased cardiovascular risk and mortality. In few studies, Fetuin-A showed an association to coronary artery calcification (CAC), although the physiopathological mechanism underlying this association has not been fully established yet. Seventy-four patients with one or more cardiovascular risk factor and asymptomatic for coronary vasculopathy were included in the study. CAC was evaluated by Agatston score. Serum Fetuin-A levels were determined by ELISA. Molecular analysis of AHSG T256S gene variant (rs4918) was performed by PCR-RFLP. Serum Fetuin-A was correlated to serum calcium (r = 0,321; P = 0,018), but not to serum phosphorous…

Imaging the COVID-19: a practical guide

The Coronavirus Disease 2019 (COVID-19) represents the first medical catastrophe of the new millennium. Although imaging is not a screening test for COVID-19, it plays a crucial role in evaluation and follow-up of COVID-19 patients. In this paper, we will review typical and atypical imaging findings of COVID-19.

“Visual guidebook” of coronary atherosclerotic plaque features by Multislice CT Coronary Angiography

Long-term prognosis of patients with a zero calcium score assessed by Multislice Computed Tomography Coronary Angiography.

Purpose Methods and Materials Results Conclusion References Personal Information

A rare case of a coronary artery anomaly detected on multidetector computed tomography

An anomalous aortic origin of the coronary artery arising from the opposite sinus with an interarterial course is a rare condition that is associated with a high risk of sudden cardiac death during or after strenuous exertion. We herein report the case of a 47-year-old woman presenting with chest pain, syncope and palpitations who presented with a rare coronary artery anomaly on multidetector computed tomography coronary artery (MDCT-CA) with prospective electrocardiogram (ECG) gating.

Valore prognostico della TC coronarica nella routine clinica: follow-up a 24 mesi in 166 pazienti con sospetta o nota aterosclerosi coronarica.

Extrabiliary and extrapancreatic incidental findings at MRCP: a 4 years’ Italian experience

Aims and objectives Methods and materials Results Conclusion Personal information References

Cardiac Magnetic Resonance with Delayed Enhancement of the Right Ventricle in patients with Left Ventricle primary involvement: diagnosis and evaluation of functional parameters.

: Cardiac Magnetic Resonance (CMR) allows an accurate Right Ventricle (RV) assessment that could be of great relevance in diseases causing inflammation or fibrosis. The aim of this study was to evaluate the concomitant involvement of the RV in patients with delayed enhancement (DE) of the Left Ventricle (LV-DE) using CMR. We retrospectively enrolled 95 (male n. 66; age 55±18years; BMI 26±5kg/m2) consecutive patients with LV-DE who underwent a CMR (Achieva 1.5 T, Philips) for different indications: post-ischemic dilated cardiopathy (PDM), hypertrophic cardiomyopathy (HCM), myocardial infarction (MI), myocarditis/pericarditis (MP) and congenital heart disease (CD). We assessed the presence an…

Parameters for coronary plaque vulnerability assessed with multidetector computed tomography and intracoronary ultrasound correlation

In the absence of a fixed relationship between plaque vulnerability and flow-limiting stenosis, alternative morphological expressions exist that could predict the liability of coronary lesions to rapidly progress or rupture, causing acute coronary syndromes. Modern multidetector computed tomography technology is capable of noninvasively detecting lesion location, attenuation, remodeling and calcification pattern, which may be considered as surrogate morphological markers of vulnerability and could contribute to increase the prognostic value of individual coronary plaque burden. J Cardiovasc Med 10:821 -826 (C) 2009 Italian Federation of Cardiology.

Noninvasive evaluation of the celiac trunk and superior mesenteric artery with multislice CT in patients with chronic mesenteric ischaemia.

This study sought to assess the role of multislice computed tomography (MSCT) in patients with suspected chronic mesenteric ischaemia (CMI). Forty-five patients (29 men; mean age 68) underwent MSCT angiography of the abdomen for suspected CMI (main clinical finding: postprandial abdominal pain). The scan protocol was detectors/collimation 16/0.75 mm; feed 36 mm/s; rotation time 500 ms; increment 0.4 mm; 120-150 mAs and 120 kVp. A volume of 80 ml of contrast material was administered through an antecubital vein (rate 4 ml/s), followed by 40 ml of saline (rate 4 ml/s). Images were analysed on the workstation with different algorithms (axial image scrolling, multiplanar reconstructions, maximu…

Quantitative analysis of coronary arteries with computer tomography coronary angiography: Methodology and preliminary results using intracoronary ultrasound as reference standard using a software prototype (QCT)

Can ECG-gated MDCT be considered an obligatory step to plan and manage a new chest-pain unit?

The recent improvements in multi-detector computed tomography technology and its application in cardiac field allow to consider this non-invasive imaging technique as a promising comprehensive method for detecting significant coronary stenoses in a chest-pain unit. The possibility to use the ECG-synchronisation acquisition protocol, normally limited to the cardiac volume, for the entire thoracic vascular system should have the remarkable potential to reduce invasive and non-invasive procedures actually used to investigate acute chest pain and the number of unnecessary hospital admissions without reducing appropriate admissions in patients with chest pain.

CT anatomy of the heart and classification in coronary segments.

Anatomia TC del cuore e classificazione in segmenti coronarici

Cardioradiologia: miti e realtà di una nuova era dell’imaging

Principi tecnici ed applicazioni dei filtri di ricostruzione in angiografia coronarica mediante TC Multistrato

Collateral non cardiac findings in clinical routine CT coronary angiography: results from a multi-center registry.

Purpose: The aim of the study was to evaluate the prevalence of collateral findings detected in computed tomography coronary angiography (CTCA) in a multi-center registry. Materials and methods: We performed a retrospective review of 4303 patients (2719 males, mean age 60.3 ± 10.2 years) undergoing 64-slice CTCA for suspected or known coronary artery disease (CAD) at various academic institutions between 01/2006 and 09/2010. Collateral findings were recorded and scored as: non-significant (no signs of relevant pathology, not necessary to be reported), significant (clear signs of pathology, mandatory to be reported), or major (remarkable pathology, mandatory to be reported and further invest…

Prevalenza e valore prognostico a 2 anni delle placche aterosclerotiche coronariche in 123 pazienti sottoposti ad Angiografia Coronarica mediante Tomografia Computerizzata Multistrato

Outcome of LR-3 and LR-4 observations without arterial phase hyperenhancement at Gd-EOB-DTPA-enhanced MRI follow-up

Objective: The aim of this study was to retrospectively analyze the outcome of LR-3 and LR-4 without arterial phase hyperenhancement (APHE), and identify which features could predict LR-5 progression on serial Gd-EOB-DTPA-enhanced MRI follow-up. Methods: Forty-nine cirrhotic patients with 55 LR-3 and 19 LR-4 without APHE were evaluated. Observations were classified as decreased, stable or increased in category at follow-up. Observation size and LI-RADS major and ancillary features were evaluated. Results: Seventeen/fifty-five (31%) LR-3 and 8/19 (42%) LR-4 progressed to LR-5 at follow-up. Baseline LI-RADS major and ancillary features were not significantly different among LR-3 and LR-4. A d…

Heart Rate Sequential Analysis During Multidetector Computed Tomography Coronary Angiography: What Factors Do You Take Into Account In Understanding Its Variability?

Studio quantitativo della densità ossea dell’ottava vertebra toracica in pazienti sottoposti a TC del cuore

The location of vertebral fractures due to osteoporosis is more frequent in the middle thoracic tract (T8) and in the thoraco-lumbar junction (T12-L1): the T8 vertebra is included in the CT scan volume of the heart. The purpose of the study is to evaluate the density T8 bone in relation to cardiovascular risk factors and the severity of the pathology found in the CT of the heart.

Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography

During the last decade coronary computed tomography angiography (CTA) has become the preeminent non-invasive imaging modality to detect coronary artery disease (CAD) with high accuracy. However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging. Myocardial CTP imaging can be performed with a single static scan during first pass of the contrast agent, with monoenergetic or dual…

Prevalence of anatomical variants and coronary anomalies in 543 consecutive patients studied with 64-slice CT coronary angiography

The aim of our study was to assess the prevalence of variants and anomalies of the coronary artery tree in patients who underwent 64-slice computed tomography coronary angiography (CT-CA) for suspected or known coronary artery disease. A total of 543 patients (389 male, mean age 60.5 +/- 10.9) were reviewed for coronary artery variants and anomalies including post-processing tools. The majority of segments were identified according to the American Heart Association scheme. The coronary dominance pattern results were: right, 86.6%; left, 9.2%; balanced, 4.2%. The left main coronary artery had a mean length of 112 +/- 55 mm. The intermediate branch was present in the 21.9%. A variable number …

Confronto tra aterosclerosi coronarica mediante CardioTC e aterosclerosi carotidea mediante ecocolorDoppler

Osteonecrosis detected by whole body magnetic resonance in patients with Hodgkin Lymphoma treated by BEACOPP

Objectives: The purpose of our retrospective review of prospectively acquired Whole Body Magnetic Resonance (WB-MRI) scans was to assess the incidence of osteonecrosis in patients who received different chemotherapies. Methods: We evaluated the WB-MRI scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6ABVD, 2ABVD + 4BEACOPP, 2ABVD + 8BEACOPP), excluding patients with the main risk factors for osteonecrosis. Results: Six out of seven patients (86 %) who received eight BEACOPP and one out of five patients (20 %) treated by four BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients…

Assessment of atrial diastolic function in patients with hypertrophic cardiomyopathy by cine magnetic resonance imaging

Purpose: This study was conducted to assess the role of atrial function by cardiac magnetic resonance (CMR) for the evaluation of diastolic physiology in patients with hypertrophic cardiomyopathy (HCM) compared to healthy controls. Materials and methods: We enrolled 23 consecutive patients affected by HCM and 43 healthy subjects as age-matched control cases (CC). CMR was performed through acquisition of cine steady-state free precession sequences using a 1.5-T scanner. Image postprocessing was carried out using Tracking Tool software. Results: Atrial volumes were significantly higher in patients with HCM compared to CC: maximum atrial volume (p = 0.007) and minimum atrial volume (p = 0.01).…

64-slice CT coronary angiography in patients with acute coronary syndromes: first experience

Anatomical Variants of Coronary Artery Tree by 64-slice CT Coronary Angiography with Conventional Coronary Angiography Correlation

Analisi della funzione ventricolare sinistra (FVS) in cardio-TC: influenze dell’intervallo di ricostruzione e dello spessore di strato sull’accuratezza diagnostica e sul time-consuming

Intravenous Contrast Material for Cardiac Computed Tomography

Purpose: The Italian Registry of Contrast Material use in Cardiac Computed Tomography (iRCM-CCT) is a multicenter, multivendor, observational study on the use of contrast media (CM) in patients undergoing cardiac computed tomography (CCT). The aim of iRCM-CCT is to assess image quality and safety profile of intravenous CM compounds. Materials and methods: iRCM-CCT enrolled 1842 consecutive patients undergoing CCT (≥50 per site) at 20 cluster sites with the indication of suspected coronary artery disease. Demographic characteristics, CCT, and CM protocols, clinical indications, safety markers, radiation dose reports, qualitative (ie, poor vascular enhancement) and quantitative (ie, HU attenu…

ECG-GATED MULTIDETECTOR COMPUTED TOMOGRAPHY FOR THE ASSESSMENT OF THE POSTOPERATIVE ASCENDING AORTA

This study was undertaken to define the role of electrocardiographically (ECG)-gated multidetector computed tomography (MDCT) in the assessment of the postoperative ascending aorta. From November 2006 to June 2007, 21 patients, [11 men, ten women; age +/- standard deviation (SD): 62.7 +/- 10.8 years] with a history of ascending aorta replacement underwent ECG-gated MDCT and were prospectively included in our study. Ascending aorta replacement had been performed with different surgical techniques: Bentall-De Bono (four patients, 19%), Tirone-David (five patients, 23%), and modified Tirone-David with creation of aortic neosinuses (12 patients, 57%). Two patients were excluded from MDCT evalua…

PREVALENCE OF MYOCARDIAL BRIDGING AND CORRELATION WITH CORONARY ATHEROSCLEROSIS STUDIED WITH 64-SLICE CT CORONARY ANGIOGRAPHY

Ruolo dell’ecografia con mezzo di contrasto nella valutazione degli angiomi splenici

Computed tomography coronary angiography vs. stress ECG in patients with stable angina

PURPOSE: This study compared the role of multislice computed tomography coronary angiography (MSCT-CA) and stress electrocardiography (ECG) in the diagnostic workup of patients with chronic chest pain. MATERIALS AND METHODS: MSCT-CA was performed in 43 patients (31 men, 12 women, mean age 58.8+/-7.7 years) with stable angina after a routine diagnostic workup involving stress ECG and conventional CA. The following inclusion criteria were adopted: sinus rhythm and ability to hold breath for 12 s. Beta-blockers were administered in patients with heart rate>or=70 beats/minute. In order to identify or exclude patients with significant stenoses (>or=50% lumen), we determined posttest likelihood r…

Angioplastica coronarica

Whole-Body Magnetic Resonance Imaging: Current Role in Patients with Lymphoma.

Imaging of lymphoma is based on the use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) and/or contrast-enhanced CT, but concerns have been raised regarding radiation exposure related to imaging scans in patients with cancer, and its association with increased risk of secondary tumors in patients with lymphoma has been established. To date, lymphoproliferative disorders are among the most common indications to perform whole-body magnetic resonance imaging (MRI). Whole-body MRI is superior to contrast-enhanced CT for staging the disease, also being less dependent on histology if compared to 18F-FDG-PET/CT. As well, it does not require exposure to i…

Comparison between whole-body MRI and PET/CT in staging newly diagnosed FDG-avid lymphomas: our experience.

To compare whole body RMI (WB-RMI) and FDG-PET/CT for staging newly diagnosed FDG-avid lymphoma

Acceptance of non-invasive Multislice CT Coronary Angiography: is it a real patient-friendly technique?

Come quantificare la fibrosi del miocardio ventricolare sinistro mediante software semiautomatico in pazienti sottoposti a risonanza magnetica cardiaca per sospetta miocardite

64-slice CT instead of Intravascular Ultrasound to Support Conventional Coronary Angiography in the Diagnosis and Treatment of Coronary Lesions

Characterization of focal liver lesions undetermined at grayscale US: contrast-enhanced US versus 64-row MDCT and MRI with liver specific contrast agent

Heart anatomy

MSCT in GIST patients with hepatic metastases treated with new generation tyrosinkinase inhibitors: comparison between density and dimension

Purpose Methods and Materials Results Conclusion References Personal Information

Imaging dell'emottisi non traumatica mediante TC Multistrato

Valore della TC coronarica nella stratificazione dei pazienti con dolore toracico cronico

Il referto in angiografia coronarica con TC a 64 strati: una nuova sfida per il radiologo

64-slice computed tomography assessment of left ventricular volumetric and functional parameters

Comparison between whole-body MRI with diffusion-weighted imaging and PET/CT in staging newly diagnosed FDG-avid lymphomas.

Abstract Objectives To compare whole body-MRI (WB-MRI) with diffusion-weighted imaging and FDG-PET/CT in staging newly diagnosed FDG-avid lymphomas. Methods 68 patients (37 males, 31 females; median age 42 years; range 15–86 years) with histologically confirmed lymphoma (37 Classical Hodgkin, 16 Diffuse large B-cell, 10 Follicular, 5 Mantle cell) underwent both MRI and FDG-PET/CT before treatment. Ann Arbor stages obtained with WB-MRI and FDG-PET/CT were compared using Cohen’s k statistics. Moreover WB-MRI and FDG-PET/CT stages were compared with the pathological stages obtained after the diagnostic iter using also bone marrow and available biopsies if clinically indicated. Results The agre…

Non Invasive Imaging of Myocardial Infarction with Computed Tomography and Magnetic Resonance

Myocardial infarction is a major cause of death and disability worldwide. Myocardial infarction may represent a major catastrophic event leading to severe hemodynamic failure or sudden death or it may occur repeatedly in patients with established heart disease. In this context, the role of imaging techniques may become useful for the understanding of the determinants in a preclinical setting before acute coronary events, and for an accurate and correct diagnosis of myocardial infarction. Three-dimensional noninvasive imaging techniques, such as Cardiac CT (CCT) and Cardiac MR imaging (CMR) were widely developed in the last two decades. These imaging techniques may provide new insights into …

Myocardial bridging and related coronary atherosclerotic burden by 64-slice CT coronary angiography

La TC coronarica nelle donne: approccio clinico e aspetti dell'imaging.

The abnormal hepatic morphology: not always cirrhosis

Learning objectives Background Findings and procedure details Conclusion Personal information References

Role of cardiac computed tomography in the evaluation of coronary artery stenosis in patients with ascending aorta aneurysm detected at transthoracic echocardiography

OBJECTIVE The aim of our study was to evaluate the diagnostic performance of cardiac computed tomography (CCT) in the evaluation of coronary artery stenosis in patients with ascending aorta aneurysm detected at transthoracic echocardiography. METHODS We conducted a retrospective analysis of patients with an aneurysm 45 mm or greater at transthoracic echocardiography who underwent CCT from 2012 to 2014 in our hospital. We calculated the sensitivity, specificity, and positive and negative predictive values of CCT for the assessment of coronary artery stenosis (<50% or ≥50% stenosis) in patients who underwent conventional coronary angiography. RESULTS We included 104 patients (73 men, aged 64 …

A mistaken case of non-q wave acute infarction

Over the last few years, enormous progress has been made in Cardiovascular imaging. Myocarditis is today an underdiagnosed cause of acute sudden death, heart failure, and chronic dilated cardiomyopathy. Its diagnosis is frequently missed or delayed and it can simulate an acute coronary syndrome because of its clinical presentation and elevation of cardiac enzymes. Cardiac Magnetic Resonance has become the leading modality for its noninvasive diagnosis, and it often replaces endomyocardial biopsy in clinical practise.

Role of contrast-enhanced ultrasound in the assessment of hemangiomas of the spleen

Technical development in cardiac CT: current standards and future improvements—a narrative review

Non-invasive depiction of coronary arteries has been a great challenge for imaging specialists since the introduction of computed tomography (CT). Technological development together with improvements in spatial, temporal, and contrast resolution, progressively allowed implementation of the current clinical role of the CT assessment of coronary arteries. Several technological evolutions including hardware and software solutions of CT scanners have been developed to improve spatial and temporal resolution. The main challenges of cardiac computed tomography (CCT) are currently plaque characterization, functional assessment of stenosis and radiation dose reduction. In this review, we will discu…

Communicating with the hepatobiliary surgeon through structured report

Communicating radiological findings to hepatobiliary surgeons is not an easy task due to the complexity of liver imaging, coexistence of multiple hepatic lesions and different surgical treatment options. Recently, the adoption and implementation of structured report in everyday clinical practice has been supported to achieve higher quality, more reproducibility in communication and closer adherence to current guidelines. In this review article, we will illustrate the main benefits, strengths and limitations of structured reporting, with particular attention on the advantages and challenges of structured template in the preoperative evaluation of cirrhotic and non-cirrhotic patients with fo…

Myocardial bridging and associated coronary atherosclerosis studied by 64-slice CT Coronary Angiography.

Ruolo della Cardio TC in pazienti con aneurisma dell’aorta ascendente.

The aim of our study is to evaluate the diagnostic accuracy of cardio CT (CTC) in patients with ascending aortic aneurysm displayed at Transthoracic Echocardiography (ETT).

Spectrum of collateral findings in multislice CT coronary angiography.

Purpose. The aim of the study was to investigate the prevalence of the noncardiac collateral findings during multislice computed tomography coronary angiography (MSCT-CA). Materials and methods. Six hundred and seventy patients undergoing MSCT-CA with 16-slice and 64-slice CT scanners for suspected atherosclerotic disease of the coronary arteries were retrospectively reviewed. All data sets obtained with a large field of view (FOV) were analysed by two radiologists using standard mediastinal and lung window settings. Collateral findings were divided according to clinical importance into nonsignificant, remarkable and compulsory to be investigated. Results. Eighty-five percent of patients re…

Clinical indications for the use of cardiac MRI. By the SIRM Study Group on Cardiac Imaging

Cardiac magnetic resonance (CMR) is considered an useful method in the evaluation of many cardiac disorders. Based on our experience and available literature, we wrote a document as a guiding tool in the clinical use of CMR. Synthetically we describe different cardiac disorders and express for each one a classification, I to IV, depending on the significance of diagnostic information expected.

Angiografia coronarica mediante TC (AC-TC) a 64 strati in pazienti con sindromi coronariche acute: rilevazione della culprit lesion e caratteristiche morfo-densitometriche in correlazione con Ecografia intracoronarica (ICUS)

Ottimizzazione dell’enhancement vascolare

Retrospective comparison of MDCT-CA and SPECT to detect significant coronary artery disease

Clinical relevance of myocardial bridging detected by coronary CT angiography in patients with atypical chest pain

Reproducible coronary plaque quantification by multislice computed tomography

BACKGROUND: The aim of this study was to investigate reproducibility and accuracy of computer-assisted coronary plaque measurements by multislice computed tomography coronary angiography (QMSCT-CA). METHODS AND RESULTS: Forty-eight patients undergoing MSCT-CA and coronary arteriography for symptomatic coronary artery disease and quantitative intravascular ultrasound (IVUS, QCU) were examined. Two investigators performed the QMSCT-CA twice and a third investigator performed the QCU, all blinded for each other's results. There was no difference found for the matched region of interest (ROI) lengths (QCU 29.4 +/- 13 mm vs. QMSCT-CA 29.6 +/- 13 mm, P = 0.6; total length = 1,400 mm). The compari…

Assessment of left main coronary artery atherosclerotic burden using 64-slice CT coronary angiography: correlation between dimensions and presence of plaques.

PURPOSE: The aim of this study was to correlate left main (LM) coronary artery dimensions with the presence of atherosclerosis by multidetector-row computed tomography (MDCT) coronary angiography (CA) and to assess coronary atherosclerotic plaques with a semiquantitative method. MATERIALS AND METHODS: Sixty-two consecutive patients (41 men, mean age 60+/-11) with suspected coronary artery disease underwent 64-MDCT coronary angiography. LM dimensions (length, ostial and bifurcation diameters), quantitative [location, Hounsfield unit (HU) attenuation] and qualitative (composition, shape) analysis of plaques within the LM were performed. All patients underwent conventional CA. RESULTS: Thirty …

Myocardial bridging and related coronary atherosclerotic burden by 64-slice CT coronary angiography

Lithiasis and Spontaneous Hemobilia

Learning objectives Background Findings and procedure details Conclusion Personal information References

L’aterosclerosi nel tronco comune: relazione tra dimensioni e placche valutata mediante angiografia coronarica con TC a 64 strati

64-MDCT ECG gating in the evaluation of pre and post-operative ascending aorta: what is essential to know and necessary to report?

Ischemic Heart Disease, CT

Performance diagnostica della TCMD a 64 strati ECG-GATED vs. GATED-SPECT in pazienti a rischio di malattia coronarica intermedio-alto con dolore toracico atipico

Value of hypoenhanced myocardial region detected in MDCT-CA in comparison with other diagnostic tools to predict coronary artery disease

Anatomical variants and anomalies of the coronary tree studied with MDCT coronary angiography

Le anomalie delle arterie coronariche sono presenti alla nascita nella maggior parte dei casi asintomatiche ma possono manifestarsi con sintomatologia severa quale angina pectoris o addirittura l’arresto cardiaco. L’angiografia coronarica mediante tomografia computerizzata multistrato (TCMS) permette, tramite ricostruzioni multiplanari secondo piani curvilinei e riformattazioni 3D, la visualizzazione dell’albero coronarico e delle sue varianti ed anomalie in maniera non invasiva, fornendo migliore e più accurata alternativa alla angiografia coronarica (AC). Lo scopo di questo pictorial consiste nella descrizione mediante immagini TCMS con ricostruzioni multiplanari e 3D delle principali var…

Elderly dysphagia: our 10-year experience in Presbyesophagus and Primary Presbyphagia.

Learning objectives Background Findings and procedure details Conclusion Personal information References

Come effettuare il calcolo del volume del grasso epicardico mediante software semiautomatico in pazienti sottoposti a TC del cuore

IL PROCESSO DELL'IMAGING NELLA DIAGNOSTICA DELLA CARDIOPATIA ISCHEMICA - RISONANZA MAGNETICA.

64-MDCT ECG gating in the evaluation of pre and post-operative ascending aorta: what is essential to know and necessary to report?

Guida alla refertazione degli esami TC a 64 strati dei bypass aorto-coronarici

Imaging evaluation of cardiac stem cells transplantation

Cardiovascular Disease is the number one cause of death in the World. Although advances in treatment and intervention have reduced the mortality rate in patients with coronary artery disease, the number of patients with refractory myocardial ischemia and congestive heart failure is rapidly increasing. “Cellular therapy” represents an important new approach in the treatment of cardiovascular disease and the scientific community needs to establish not only the appropriate type and timing of cellular administration but also the diagnostic gold standard to better enable the study of subjects before and after cellular therapy

Working in the mirror: The safety and effectiveness of closure access leading venous advanced gain new ability in a patient with dextrocardia

The evolution of devices in serious cardiac rhythm pathology management and in other medicine areas and its optimal management have progressively become a worldwide serious challenge. We present an upgrading to dual chamber im-plantable cardioverter-defibrillator (ICD) without complications in a 68 year old woman through closure access leading venous advanced gain new ability, complementing the mechanical multiple venous entry-site approach extraction. This is another of the few cases present in literature about ICD in patients with dextrocardia and it focuses on the safety and effectiveness of our simple technique also in a patient with dextrocardia.

Quantificazione del grasso epicardico mediante TC del cuore: associazione con i fattori di rischio cardiovascolare e con l'aterosclerosi coronarica

Infarct characterization using CT

Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination. Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contra…

Stent Imaging: A Road Map To Overcome All The Factors Interferring With A Good Image Quality

Imaging features of adrenal masses

Abstract The widespread use of imaging examinations has increased the detection of incidental adrenal lesions, which are mostly benign and non-functioning adenomas. The differentiation of a benign from a malignant adrenal mass can be crucial especially in oncology patients since it would greatly affect treatment and prognosis. In this setting, imaging plays a key role in the detection and characterization of adrenal lesions, with several imaging tools which can be employed by radiologists. A thorough knowledge of the imaging features of adrenal masses is essential to better characterize these lesions, avoiding a misinterpretation of imaging findings, which frequently overlap between benign …

Filtering Impact On Stent Imaging: The Appropiate Application To Reduce The Blooming Effect

Centrifugal (inside-out) enhancement of liver hemangiomas: a possible atypical appearance on contrast-enhanced US.

Abstract Objective To report the prevalence and to describe the atypical centrifugal (inside-out) appearance of contrast-enhancement of liver hemangiomas on contrast-enhanced sonography. Materials and methods Baseline and SonoVue ® -enhanced ultrasonography of 92 patients with 158 liver hemangiomas – considered atypical at grey-scale examination and confirmed by computed tomography, magnetic resonance imaging and ultrasound follow-up – were reviewed in consensus by two experienced radiologists, who evaluated baseline echogenicity and the dynamic enhancement pattern of each lesion looking for the presence of central enhancing foci in the arterial phase followed by a centrifugal (inside-out) …

Prevalenza delle anomalie coronariche in 4000 pazienti con sospetta malattia coronarica sottoposti a TC del cuore

The aim of this work is to retrospectively study the prevalence of coronary abnormalities in a large population of patients undergoing CT of the heart.

Valutazione delle arterie coronarie mediante TC a doppia sorgente di 2^ e 3^ generazione: qualità d’immagine e dose di radiazioni in pazienti non selezionati con protocollo FLASH ad alto pitch.

To evaluate the performance of a high pitch FLASH protocol with second and third generation dual source devices in the evaluation of coronary arteries in an unselected population of patients undergoing thoracic or thoracic-abdominal CT angiography (primarily non-coronary exams)

Transcranial Magnetic Resonance Imaging-Guided Focused Ultrasound with a 1.5 Tesla Scanner: A Prospective Intraindividual Comparison Study of Intraoperative Imaging

Background: High-quality intraoperative imaging is needed for optimal monitoring of patients undergoing transcranial MR-guided Focused Ultrasound (tcMRgFUS) thalamotomy. In this paper, we compare the intraoperative imaging obtained with dedicated FUS-Head coil and standard body radiofrequency coil in tcMRgFUS thalamotomy using 1.5-T MR scanner. Methods: This prospective study included adult patients undergoing tcMRgFUS for treatment of essential tremor. Intraoperative T2-weighted FRFSE sequences were acquired after the last high-energy sonication using a dedicated two-channel FUS-Head (2ch-FUS) coil and body radiofrequency (body-RF) coil. Postoperative follow-ups were performed at 48 h usin…

“Handbook” per la valutazione preoperatoria con CardioRM dei pazienti con insufficienza mitralica post-ischemica.

Role of computed tomography and magnetic resonance imaging in local complications of acute pancreatitis

Acute pancreatitis (AP) represents a pancreas inflammation of sudden onset that can present different degrees of severity. AP is a frequent cause of acute abdomen and its complications are still a cause of death. Biliary calculosis and alcohol abuse are the most frequent cause of AP. Computed tomography (CT) and magnetic resonance imaging (MRI) are not necessary for the diagnosis of AP but they are fundamental tools for the identification of the cause, degree severity and AP complications. AP severity assessment is in fact one of the most important issue in disease management. Contrast-enhanced CT is preferred in the emergency setting and is considered the gold standard in patients with AP.…

Alterazioni della morfologia epatica: non sempre cirrosi

Review the CT and MRI characteristics of the cirrhotic liver; to recognize the pathological conditions that can mimic cirrhosis

Quantificazione del tessuto adiposo epicardico in Calcium Score e Cardio-TC: confronto tra valori di attenuazione, spessore e volumi.

The aim of the study is to compare the characteristics of epiphonic adipose tissue (TAE) studied using Calcium Score (CS) and Cardio-CT (CTC).

Whole-Body MRI and 18F-FDG-PET-CT for Lymphoma Staging: Comparison of Patient Experience

Aims and objectives Methods and materials Results Conclusion Personal information References

Anomalie coronariche mediante angiografia coronarica con TC a 64 strati e relativo quadro angiografico convenzionale

[Coronary artery ectasia: etiopathogenesis, diagnosis and treatment].

Coronary ectasia is a dilation of coronary arteries, angiographically defined if the diameter of the artery is ≥ 1.5 times greater than that of the intact adjacent vascular segment. An association has been found between coronary artery ectasia and a broad spectrum of different diseases, first of all atherosclerotic coronary artery disease. The mechanisms that determine the abnormal dilatation of the vascular lumen and the etiology of coronary artery ectasia are still poorly understood. Various hypotheses have been formulated over the time, the most accredited between these recognizes as main responsible an uncontrolled activity of a particular family of enzymes that degrade the extracellula…

Confronto tra mezzi di contrasto con differente concentrazione iodica nell’imaging di placca coronarica mediante Tomografia Computerizzata Multistrato in un modello ex-vivo

Updated diagnosticprognostic paradigm for CAD: a narrative review.

Cardiovascular diseases are the first cause of death globally; early detection of coronary artery disease (CAD) is a challenge for clinicians and radiologists. Over the past 2 decades there have been several improvements in the methods for the assessment of diagnosis and prognosis in patients with suspected CAD; most of these methods are imaging methods and they operate with high-end technologies. Cardiac computed tomography (CCT) as we know it today was introduced in 1998 and has ever progressed with constant pace. The first decade was the technical validation phase of the method while the second decade was the clinical validation phase. CCT has developed an excellent diagnostic and progno…

Coronary Vessel Wall Remodelling as a Parameter for Plaque Vulnerability Displayed with 64-slice CT Coronary Angiography with Intravascular Ultrasound Correlation

La placca coronarica in TC

Requisiti hardware e software: preparazione del paziente

Prognostic value of Morise clinical score, calcium score and computed tomography coronary angiography in patients with suspected or known coronary artery disease

Our aim was to determine the prognostic value of computed tomography coronary angiography (CTCA), coronary artery calcium scoring (CACS) and Morise clinical score in patients with known or suspected coronary artery disease (CAD). A total of 722 patients (480 men; 62.7 +/- 10.9 years) who were referred for further cardiac evaluation underwent CACS and contrast-enhanced CTCA to evaluate the presence and severity of CAD. Of these, 511 (71%) patients were without previous history of CAD. Patients were stratified according to the Morise clinical score (low, intermediate, high), to CACS (0-10, 11-100, 101-400, 401-1,000, &gt; 1,000) and to CTCA (absence of CAD, nonsignificant CAD, obstructive CAD…

Comparison of iodinated contrast media for the assessment of atherosclerotic plaque attenuation values by CT coronary angiography: observations in an ex vivo model

Objective: To compare the influence of different iodinated contrast media with several dilutions on plaque attenuation in an ex vivo coronary model studied by multislice CT coronary angiography. Methods: In six ex vivo left anterior descending coronary arteries immersed in oil, CT (slices/collimation 64x0.625 mm, temporal resolution 210 ms, pitch 0.2) was performed after intracoronary injection of a saline solution, and solutions of a dimeric isosmolar contrast medium (Iodixanol 320 mgl ml(-1)) and a monomeric high-iodinated contrast medium (Iomeprol 400 mgl ml(-1)) with dilutions of 1/80 (low concentration), 1/50 (medium concentration), 1/40 (high concentration) and 1/20 (very high concent…

Coronary CT angiography: a guide to examination, interpretation, and clinical indications

Introduction: The introduction of Cardiac Computed Tomography (CCT) has changed the paradigm in the field of diagnostic cardiovascular medicine. CCT is the primary tool in the assessment of suspected Coronary Artery Disease (CAD) and should be followed by functional assessment when needed to stratify disease and to plan potential interventional or surgical therapy. Areas Covered: We provided the current state of the knowledge on the main aspects of technique of examination, image interpretation and clinical indications. We have focused our attention on the basic routine applications and activities. Expert Opinion: The primary role of CCT in suspected CAD will progressively become the standa…

An Overview of Coronary Artery By-pass Graft (CABG): Anatomical Configuration and Visualization Technique Using 64-slice CT Coronary Angiography

La Cardio-TC nel paziente diabetico: approccio clinico e aspetti dell'imaging

TCMD-64 strati ECG-GATED nella valutazione della funzione globale del ventricolo sinistro: quanto tempo è necessario e quanto sono attendibili i valori ottenuti?

Atherosclerotic pattern of coronary myocardial bridging assessed with CT coronary angiography

The aim of our study was to evaluate the atherosclerotic pattern of patients with coronary myocardial bridging (MB) by means of CT Coronary Angiography (CT-CA). 254 consecutive patients (166 male, mean age 58.6 +/- A 10.3) who underwent 64-slice CT-CA according to current clinical indications were reviewed for the presence of MB and concomitant segmental atherosclerotic pattern. Coronary plaques were assessed in all patients enrolled. 73 patients (29%) presented single (90%) or multiple (10%) MB, frequently (93%) localized in the mid-distal left anterior descending artery. The MB segment was always free of atherosclerosis. Segments proximal to the MB presented: no atherosclerotic disease (n…

Impatto della Cardio-TC in una popolazione di giovani adulti

Evaluation of Cardiac Volumetric and Functional Parameters

Prevalence and clinical relevance of collateral findings in a cohort of patients with suspected coronary artery disease assessed with Multislice Computed Tomography Coronary Angiography

Prognostic Value of Computed Tomography Coronary Angiography in Patients with Suspected Coronary Artery Disease: Five Years’ Experience at a Single Center

Mesenteric inflammation on multidetector computed tomography enterography in Crohn’s disease versus Crohn disease activity index: does a correlation exist?

INFLUENCE OF INTRA-CORONARY ENHANCEMENT ON DIAGNOSTIC ACCURACY WITH 64-SLICE CT CORONARY ANGIOGRAPHY

We assessed the effect of intra-coronary attenuation on diagnostic accuracy using 64-slice computed tomography coronary angiography (CT-CA). We enrolled 170 patients with suspected coronary artery disease who underwent conventional coronary angiography (CA) and 64-slice CT-CA (100 ml of Iomeprol 400 mg I/ml at 4 ml/s). The study population was divided into two groups (85 patients each based on median attenuation of 326 HU) based on mean arterial attenuation; group 1 with low attenuation and group 2 with high attenuation. Diagnostic accuracy for the detection of significant coronary artery stenosis was determined for both groups using CA as reference standard. Overall, 163 significant stenos…

Valutazione del grado di attivita’ del morbo di Crohn tramite clisma-RM con sequenza in perfusione.

Descrizione degli aspetti qualitativi e quantitativi della placca aterosclerotica coronarica mediante angiografia coronarica con TC a 64 strati

Imaging dell’ischemia mesenterica mediante TC Multistrato

Review the etiology and pathophysiology of mesenteric ischemia with an outline of the mesenteric circulation. Describe the TC protocol to be used for the study of mesenteric ischemia and the TC signs that characterize it.

Assessment of Coronary Plaque with Multislice Computed Tomography

Influenza della frequenza cardiaca sulla valutazione della frazione di eiezione del ventricolo sinistro mediante tomografia computerizzata a 64 strati: studio sperimentale su modello animale vivente

64 slice computed tomography angiography detects grafts and native coronary artery in patients with previous coronary artery bypass

Physiopathology of the aging heart.

Coronary heart disease remains the leading cause of morbidity and mortality in older adults, despite improved survival and declining mortality. Prevalence in and impact of heart disease on elderly people, increasing risk factors, and the underlying physiologic changes of aging are briefly reviewed. High prevalence of clinical and subclinical heart disease provides a basis for considering opportunities for prevention and follow-up. This article focuses on recently developed noninvasive techniques, such as cardiac multislice CT and cardiac MR imaging.

Lesions of Proximal Coronary Arteries

Coronary artery disease (CAD) remains the leading cause of death in the Western world. Conventional coronary angiography (CCA) is the gold standard method for evaluation of the vascular lumen and provides excellent results in demonstrating stenotic lesions of CAD. However, it is an invasive procedure with a small risk of fatal events. Furthermore, CCA is a lumen-oriented technique that does not permit a direct visualization and evaluation of the coronary artery wall. The characterization of coronary plaques without a significant lumen narrowing is also not feasible with CCA. This information is relevant since the comparison of angiographic studies of coronary arteries performed before and a…

Ruolo dell’angiografia TC Multistrato cardiosincronizzata nella valutazione dell’aorta ascendente dopo chirurgia conservativa della valvola aortica.

Cardio TC

Characterisation of focal liver lesions undetermined at grey-scale US: contrast-enhanced US versus 64-row MDCT and MRI with liver-specific contrast agent

The aim of this study was to assess the role of contrast-enhanced ultrasonography (CEUS) in the characterisation of focal liver lesions in comparison with multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) with liver-specific contrast agent.One hundred and eighty-seven focal liver lesions, 91 malignant and 96 benign (mean size 3.2 cm) - proved by biopsy (n=12), histology (n=4), MDCT (n=108), MRI (n=44) MDCT/MRI (n=19) - in 159 patients were studied by CEUS. Two expert radiologists consensually evaluated the contrast-enhancement patterns at CEUS. For each lesion, they assessed: (a) nature (benign, malignant, not assessable), (b) specific diagnosis and (c) need for …

Spectrum of non-cardiac collateral findings in patients with suspected coronary artery disease assessed with Multislice Computed Tomography Coronary Angiography

Prognostic value of cardiac CT

In the past decades, coronary computed tomography angiography (CCTA) has become a powerful tool in the management of coronary artery disease. The diagnostic and prognostic value of CCTA has been extensively demonstrated in both large observational studies and clinical trials among stable chest pain patients. The quantification of coronary artery calcium score (CACS) is a well-established predictor of cardiovascular morbidity and mortality in asymptomatic subjects. Besides CACS, the main strength of CCTA is the accurate assessment of the individual total atherosclerotic plaque burden, which holds important prognostic information. In addition, CCTA, by providing detailed information on corona…

Influence of convolution filtering on coronary plaque attenuation values: observations in an ex vivo model of multislice computed tomography coronary angiography.

Attenuation variability ( measured in Hounsfield Units, HU) of human coronary plaques using multislice computed tomography (MSCT) was evaluated in an ex vivo model with increasing convolution kernels. MSCT was performed in seven ex vivo left coronary arteries sunk into oil followingthe instillation of saline (1/infinity) and a 1/50 solution of contrast material ( 400 mgI/ml iomeprol). Scan parameters were: slices/ collimation, 16/0.75 mm; rotation time, 375 ms. Four convolution kernels were used: b30f-smooth, b36f-medium smooth, b46f-medium and b60f-sharp. An experienced radiologist scored for the presence of plaques and measured the attenuation in lumen, calcified and noncalcified plaques …

MR imaging of perianal Crohn’s disease: Is contrast medium necessary?

Purpose Methods and Materials Results Conclusion References Personal Information

Valore diagnostico dell’ipodensita’ miocardica riscontrata nell’AC-TCMS: confronto con altre tecniche strumentali

New advances in radiomics of gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GISTs) are uncommon neoplasms of the gastrointestinal tract with peculiar clinical, genetic, and imaging characteristics. Preoperative knowledge of risk stratification and mutational status is crucial to guide the appropriate patients' treatment. Predicting the clinical behavior and biological aggressiveness of GISTs based on conventional computed tomography (CT) and magnetic resonance imaging (MRI) evaluation is challenging, unless the lesions have already metastasized at the time of diagnosis. Radiomics is emerging as a promising tool for the quantification of lesion heterogeneity on radiological images, extracting additional data that cannot be assessed b…

Artificial Intelligence Applications on Restaging [18F]FDG PET/CT in Metastatic Colorectal Cancer: A Preliminary Report of Morpho-Functional Radiomics Classification for Prediction of Disease Outcome

Featured Application Based on results defined in this study, new investigations might propose morpho-functional-based radiomics algorithms for risk stratification with possible impact on treatment management in colorectal cancer. The aim of this study was to investigate the application of [F-18]FDG PET/CT images-based textural features analysis to propose radiomics models able to early predict disease progression (PD) and survival outcome in metastatic colorectal cancer (MCC) patients after first adjuvant therapy. For this purpose, 52 MCC patients who underwent [F-18]FDGPET/CT during the disease restaging process after the first adjuvant therapy were analyzed. Follow-up data were recorded f…

La preparazione in angiografia coronarica mediante TC a 64 strati nelle donne: una “sfida” per il radiologo?

Coronary calcium score and computed tomography coronary angiography in high-risk asymptomatic subjects: assessment of diagnostic accuracy and prevalence of non-obstructive coronary artery disease

The aim of the study was to compare the coronary artery calcium score (CACS) and computed tomography coronary angiography (CTCA) for the assessment of non-obstructive/obstructive coronary artery disease (CAD) in high-risk asymptomatic subjects. Two hundred and thirteen consecutive asymptomatic subjects (113 male; mean age 53.6 +/- 12.4 years) with more than one risk factor and an inconclusive or unfeasible non-invasive stress test result underwent CACS and CTCA in an outpatient setting. All patients underwent conventional coronary angiography (CAG). Data from CACS (threshold for positive image: Agatston score 1/100/1,000) and CTCA were compared with CAG regarding the degree of CAD (non-obst…

Low dose CT of the heart: a quantum leap into a new era of cardiovascular imaging.

In 10 years, computed tomography coronary angiography (CTCA) has shifted from an investigational tool to clinical reality. Even though CT technologies are very advanced and widely available, a large body of evidence supporting the clinical role of CTCA is missing. The reason is that the speed of technological development has outpaced the ability of the scientific community to demonstrate the clinical utility of the technique. In addition, with each new CT generation, there is a further broadening of actual and potential applications. In this review we examine the state of the art on CTCA. In particular, we focus on issues concerning technological development, radiation dose, implementation,…

I by-pass aorto-coronarici: visualizzazione delle configurazioni anatomiche mediante TC multistrato a 64 strati

Evaluation of Cardiac Volumetric and Functional Parameters

The milestone definition of “Cardiac Function” has to be attributed to William Harvey, the discoverer of the circulation, who in 1628 stated: “The movement of the blood is constantly in a circle, and is brought about by the beat of the heart” [1, 2]. From a modern point of view, the main function of the heart is the delivery of oxygen to metabolizing tissues. Since oxygen delivery is dependent on (1) the oxygen-carrying capacity of blood, (2) the flow output from the heart, and (3) regional distribution of flow, then the heart is nowadays regarded as a pump with the function of supplying flow in blood vessels [2].

Role of contrast-enhanced ultrasound in the characterization of incidentally discovered focal liver lesions

Analisi sequenziale della frequenza cardiaca durante l’esecuzione di una Cardio-TC: quali fattori influenzano la sua variabilità?

Computed tomography of bowel obstruction: Tricks of the trade

Bowel obstruction (BO) is a frequent cause of hospitalization and surgical consultation for acute abdominal pain. It is usually suspected at physical examination, but clinical and laboratory data are often nonspecific. Thus, computed tomography plays a crucial role in a correct diagnosis of BO. Indeed, computed tomography can confirm a diagnosis of BO, and identify the location and cause of the obstruction. In this review, the computed tomography appearances of common and uncommon causes of BO and pseudo-obstruction are reviewed.

MDCT-CA volume rendering/auto track vs. MPR/MIP analysis to assess coronary artery stenosis

Una elevata attenuazione intra-vascolare aumenta l’accuratezza diagnostica della coronarografia TC a 64 strati

Coronary anomalies

GI/Liver/Biliary/Pancreas

Visualizzazione non invasiva dell’aterosclerosi coronarica con TC e RM

Valutazione dei pattern di aterosclerosi coronarica mediante Cardio-TC: differenze nei due sessi

Confronto tra acquisizioni di Calcium Score e CardioTC per la quantificazione del volume e della densità del grasso epicardico

64-detector Computed Tomography in Reoperative Assessment of Vascular Anatomy of Middle Colic Artery in Left-sided Colon Cancer

Pitfalls nelle RM whole body con sequenze DWIBS eseguite in pazienti con linfoma.

Obiettivi didattici: Illustrare i principali artefatti ed insidie nella valutazione della Risonanza Magnetica Whole Body (RM-WB) dopo revisione di 331 RM-WB eseguite in pazienti con linfoma. Introduzione: La RM-WB con imaging pesato in diffusione (DWI) è un esame che consente uno studio total body con elevata risoluzione di contrasto, evitando l’esposizione a radiazioni ionizzanti e la somministrazione di mezzo di contrasto [1]. Nel 2004 Takahara ha introdotto una sequenza DWI con tecniche di soppressione del segnale chiamata DWIBS [2]. Questa consente di acquisire rapidamente immagini di multiple aree del corpo sfruttando l’imaging parallelo SENSE che incrementa la risoluzione e riduce gli…

TAVI imaging: over the echocardiography

Aortic valve stenosis (AS) is a common valvular heart disease. Recently, transcatheter aortic valve implantation (TAVI) has changed the treatment of severe AS in elderly patients with contraindications to traditional surgical replacement. Echocardiography is conventionally used as the first imaging modality to assess the presence and severity of AS and to provide anatomical and functional information. Nowadays, imaging techniques play a crucial role in the planning of TAVI to define suitable candidates. Computed tomography (CT) is essential to display the anatomy of the aortic valve complex (including aortic annulus, Valsalva sinuses, coronary arteries ostia, sinotubular junction), thoracoa…

Focused Ultrasound in Neuroscience. State of the Art and Future Perspectives

Transcranial MR-guided Focused ultrasound (tcMRgFUS) is a surgical procedure that adopts focused ultrasounds beam towards a specific therapeutic target through the intact skull. The convergence of focused ultrasound beams onto the target produces tissue effects through released energy. Regarding neurosurgical applications, tcMRgFUS has been successfully adopted as a non-invasive procedure for ablative purposes such as thalamotomy, pallidotomy, and subthalamotomy for movement disorders. Several studies confirmed the effectiveness of tcMRgFUS in the treatment of several neurological conditions, ranging from motor disorders to psychiatric disorders. Moreover, using low-frequencies tcMRgFUS sys…

Integrated non invasive approach to atherosclerosis with cardiac CT and carotid ultrasound in patients with suspected coronary heart disease.

The aim of the study was to compare the atherosclerotic disease in the coronary and carotid arteries in patients who underwent non-invasive imaging for suspected stable coronary artery disease (CAD).

Ca-score nella valutazione del paziente a rischio intermedio di eventi cardiaci acuti: modificazioni del profilo di rischio

Dual-Source Computed Tomography (DSCT) Angiography for the Visualization of Coronary Artery Bypass Grafts (CABG)

Combined approach to atrial and ventricular function for assessment of diastole through MRI: Hypertrophic Cardiomyopathy (HCM) vs Healthy Controls (HC)

Purpose Methods and Materials Results Conclusion References Personal Information

Influence of heart rate in the selection of the optimal reconstruction window in routine clinical multislice coronary angiography

Purpose. The aim of our study was to assess the influence of heart rate on the selection of the optimal reconstruction window with 40-slice multidetector-row computed tomography (40-MDCT) coronary angiography. Materials and methods. We studied 170 patients (114 men, age 60 +/- 11.3 years) with suspected or known coronary artery disease with 40-MDCT coronary angiography. Patients [mean heart rate (HR) 62.9 +/- 9.3 bpm, range 42-94 bpm] were clustered in two groups (group A: HR &lt;= 65 bpm; group B: HR &gt;65 bpm). Multiphase reconstruction data sets were obtained with a retrospective electrocardiogram (ECG)-gated 40-MDCT coronary angiography scan from 0% to 95% every 5% of the R-R interval.…

Riconoscere ed evitare i fattori che portano alla degradazione dell’immagine degli stent coronarici studiati mediante angiografia coronarica con Tomografia Computerizzata Multi Detettore (AC-TCMD)

How to describe Coronary Atherosclerotic Plaque Features by State-of-the-Art Multislice CT

Patients with acute chest pain, elevated troponin and normal coronary arteries, could be the Cardiovascular Magnetic Resonance advantageous?

Analisi retrospettiva degli aspetti dell’imaging radiologico in pazienti con TBC.

The aim of our study is to evaluate the frequency and specificity of radiological imaging aspects in patients with suspected tuberculosis (TBC).

Prevalenza e rilevanza clinica dei reperti collaterali non coronarici in corso di Angiografia Coronarica mediante TCMS.

CT Radiomic Features and Clinical Biomarkers for Predicting Coronary Artery Disease

AbstractThis study was aimed to investigate the predictive value of the radiomics features extracted from pericoronaric adipose tissue — around the anterior interventricular artery (IVA) — to assess the condition of coronary arteries compared with the use of clinical characteristics alone (i.e., risk factors). Clinical and radiomic data of 118 patients were retrospectively analyzed. In total, 93 radiomics features were extracted for each ROI around the IVA, and 13 clinical features were used to build different machine learning models finalized to predict the impairment (or otherwise) of coronary arteries. Pericoronaric radiomic features improved prediction above the use of risk factors alon…

Aggressive Angiomyxoma: unusual pelvic mass

Learning objectives Background Findings and procedure details Conclusion Personal information References

64-rows MSCT assessment of left ventricular functional parameters

Computed tomography coronary angiography plaque burden in patients with suspected coronary artery disease.

Purpose To determine the relationship between established cardiovascular risk factors, clinical presentation and the extent of coronary artery disease (CAD), as described with computed tomography coronary angiography. Material and methods In this cross-sectional study, we included 567 symptomatic individuals without a history of CAD who consecutively underwent 64-slice computed tomography coronary angiography for evaluation of suspected CAD. We analyzed the prevalence of CAD depending on sex, age, symptoms and risk factors. Results A total of 8542 segments were analyzed. No evidence of CAD was observed in 225 patients (40%), nonsignificant CAD in 221 patients (39%) and significant CAD (lumi…

Coronary artery calcium score on low-dose computed tomography for lung cancer screening

Aim: To evaluate the feasibility of coronary artery calcium score (CACS) on low-dose non-gated chest CT (ngCCT). Methods: Sixty consecutive individuals (30 males; 73 ± 7 years) scheduled for risk stratification by means of unenhanced ECG-triggered cardiac computed tomography (gCCT) underwent additional unenhanced ngCCT. All CT scans were performed on a 64-slice CT scanner (Somatom Sensation 64 Cardiac, Siemens, Germany). CACS was calculated using conventional methods/scores (Volume, Mass, Agatston) as previously described in literature. The CACS value obtained were compared. The Mayo Clinic classification was used to stratify cardiovascular risk based on Agatston CACS. Differences and corre…

Pitfalls in whole body MRI with diffusion weighted imaging performed on patients with lymphoma: What radiologists should know

The technological advances in radiological imaging and the relevance of a diagnostic tool that may reduce radiation-induced long-term effects have led to a widespread use of whole body magnetic resonance imaging (WB-MRI) with diffusion weighted imaging for oncologic patients. A lot of studies demonstrated the feasibility and reliability of WB-MRI as an alternative technique for lymphoma staging and response assessment during and after treatment. In this paper, taking advantage of our 2years of experience using WB-MRI for lymphoma, we discuss the main pitfalls and artifacts radiologists should know examining a WB-MRI performed on this typology of patients in order to avoid images misinterpre…

Bicuspid aortic valve and unruptured sinus of Valsalva aneurysm, a rare association

Bicuspid aortic valve (BAV) is one of the most common forms of congenital heart defect and is associated with other congenital vascular and cardiac defects. The most common comorbidity is dilation of thoracic aorta and clinical manifestations are usually related to function of the aortic valve and to other cardiovascular acquired complications. Sinus of Valsalva aneurysm (SVA) is an uncommon congenital cardiovascular anomaly and the combination of these two anomalies is very rare. Common complications are rupture and obstruction of the termination chamber due to space-occupying effect of large unruptured aneurysms. Early cardiac imaging can help limiting morbidity and mortality in these pat…

Role of 64-slice CT multiplanar reconstructions in acute mechanical bowel obstruction

Left Ventricular Function Analysis by MDCT: cardiac phase, slice thickness, and number of short-axis sections really change accuracy and time consuming?

Lipoleiomiomi uterini; aspetti TC e RM in due casi