Incidentally discovered thyroid nodules: incidence, and greyscale and colour Doppler pattern in an adult population screened by real-time compound spatial sonography

Purpose. Our aim was to assess the incidence and ultrasound features of thyroid nodules in an adult population screened by means of high-resolution ultrasonography (HRUS) and to evaluate the contribution of real-time spatial compound sonography (CS) in terms of image quality. Materials and methods. A total of 704 consecutive patients (400 women, 304 men) without thyroid disease underwent HRUS and CS examination of the thyroid gland. Number, size, location, echotexture and colour Doppler pattern of detected nodules were assessed. Two radiologists also assessed image quality of the two techniques. Results. Seven hundred and eleven thyroid nodules (size range 0.18-4.1 cm; mean: 1.1 cm) were de…

Cineradiografia digitale della deglutizione nei pazienti sottoposti a laringectomia parziale o totale

Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography.

The prevalence of benign focal liver lesions (BFLL) is high both in the general population and in patients with known malignancies. The gray-scale ultrasound (US) technique is usually the first-line imaging modality used in the radiological workup of such lesions, but unfortunately it lacks specificity. Furthermore, Doppler examination may often be unsatisfactory owing to motion artefacts, or when small or deeply located lesions are evaluated. Recently, microbubble-based contrast agents used in combination with gray-scale US techniques, which are very sensitive to nonlinear behavior of microbubbles, have led to a better depiction of both microvasculature and macrovasculature of focal hepati…

Iperplasia nodulare focale: detenzione dell’aspetto a “ruota di carro” e della cicatrice centrale all’ecografia con mezzo di contrasto

MRI in the Diagnosis of Right Ventricular Dysplasia

ARVD is part of the group of cardiomyopathies characterised pathologically by fibrofatty replacement of the right ventricular myocardium and clinically by right ventricular arrhythmias of the LBBB pattern. Pathogenesis, prevalence, and aetiology are yet not fully known. The diagnosis of ARVD is based on the presence of structural, histological, electrocardiographic, and genetic factors. Therapeutic options include antiarrhythmic medication, catheter ablation, implantable cardioverter defibrillation, and surgery. Angiography and echocardiography lack sensitivity and specificity in the diagnosis of ARVD. MR imaging allows a three-dimensional evaluation of especially the right ventricle, and p…

Liver hemangiomas undetermined at grey-scale ultrasound : contrast-enhencement patterns with SonoVue and pulse inversion US

Valutazione della risposta al trattamento con termoablazione percutanea con radiofrequenza dell’epatocarcinoma: ruolo dell’ecografia con mezzo di contrasto

Synchronous colorectal carcinoma

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…

Imaging findings of liver resection using a bipolar radiofrequency electrosurgical device—Initial observations

Abstract Objective To assess contrast-enhanced US (CEUS), computed tomography (CT) and magnetic resonance (MR) imaging findings and serial changes of the treated area at follow-up in patients who underwent liver resection using a bipolar radiofrequency electrosurgical device. Methods Imaging findings of 27 patients with resected hepatocellular carcinomas (HCCs) ( n  = 24) and metastases ( n  = 3) (mean size: 2.6 cm), were retrospectively evaluated. Two readers assessed: the (a) presence, (b) thickness, (c) shape and (d) echogenicity (CEUS)/attenuation (CT)/signal intensity (MR imaging) at coagulated site and the (e) presence of residual tumor of the bipolar radiofrequency electrosurgical de…

Liver haemangiomas undetermined at grey-scale ultrasound: contrast-enhancement patterns with SonoVue and pulse-inversion US.

The objective of this study was to describe the spectrum of contrast-enhancement patterns of hepatic haemangiomas undetermined at grey-scale ultrasound (US) on SonoVue-enhanced pulse-inversion (PI) US. Twenty patients (11 women, nine men) with 35 haemangiomas (size range: 1-7 cm; mean: 3.1 cm) undetermined at baseline US underwent PI at low M.I. (0.05-0.08) after i.v. injection of SonoVue. All haemangiomas were confirmed by typical helical computed tomography (CT) and/or magnetic resonance imaging (MRI) findings. US examinations were videotaped and then reviewed by two experienced radiologists blinded to the final diagnosis. Readers evaluated by consensus the baseline echogenicity and the d…

CEUS LI-RADS: a pictorial review

AbstractContrast-enhanced ultrasound (CEUS) greatly improved the diagnostic accuracy of US in the detection and characterization of focal liver lesions (FLLs), and it is suggested and often included in many international guidelines as an important diagnostic tool in the imaging work-up of cirrhotic patients at risk for developing hepatocellular carcinoma (HCC). In particular, CEUS Liver Imaging Reporting and Data System (LI-RADS) provides standardized terminology, interpretation, and reporting for the diagnosis of HCC. The aim of this pictorial essay is to illustrate CEUS features of nodules discovered at US in cirrhotic liver according to LI-RADS categorization.

Qualitative and quantitative evaluation of solitary thyroid nodules with contrast-enhanced ultrasound: Initial results

ARRYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY: MULTISLICE COMPUTED TOMOGRAPHY FEATURES

Syncronous colorectal carcinoma.

Is Transcranial Magnetic Resonance Imaging-Guided Focused Ultrasound a Repeatable Treatment Option? Case Report of a Retreated Patient With Tremor Combined With Parkinsonism

Introduction In recent years, transcranial Magnetic Resonance Imaging-guided Focused Ultrasound (tcMRgFUS) treatments for functional neurological disorders are giving a new thrust to the field of therapeutic brain lesioning. Objective To present the case of a patient affected by tremor combined with Parkinsonism who underwent a second tcMRgFUS thalamotomy because of relapsing tremor after a few months from the first tcMRgFUS treatment. Methods A 72-yr-old, right-handed man, came to our observation because of a disabling tremor affecting his upper limbs, refusing any invasive surgical procedure and already treated by tcMRgFUS left Vim thalamotomy. However, clinical benefit had brief duration…

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

Iperplasia nodulare focale in fegato normale e steatosico: valutazione qualitativa e quantitativa con ecografia e mdc

Numerical, dimensional or mixed progression disease to imatinib as prognostic factor in patients with metastatic GIST.

11040 Background: The majority of GIST patients with advanced disease initially achieves disease control from imatinib treatment. Approximately 10% of patients progresses within 6 months of starting therapy (primary resistance) and also 50-60% of the responding patients develops progression disease within two years (secondary resistance). Progression disease (PD) can be numerical, dimensional or mixed. The known prognostic factors of risk stratification in local disease are tumor size, mitotic activity and anatomic site. In this retrospective analysis we explore several clinical factors affecting survival in metastatic setting. Methods: The population included in this large database of 128…

Atypical liver hemangiomas: characterization with SonoVue and pulse-inversion US

Valutazione semi-automatica dell’impregnazione post-contrastografica delle anse intestinali sede di malattia di Crohn, utilizzando diverse finestre temporali.

Patologia congenita

Focal liver lesions: clinical usefulness of contrast-enhanced ultrasound in the selection of surgical patients

Purpose: to evaluate the role of contrast-enhanced ultrasound (CEUS) in the characterization of focal liver lesions (FLLs) for surgical patients selection. Materials and Methods: 135 consecutive patients (71 women, 64 men) with 165 FLLs (mean size: 3.1 cm) - 89 benign (10 simple cysts, 26 hemangiomas, 29 focal nodular hyperplasia (FNH), 2 hepatocellular adenomas, 11 focal fatty sparing, 3 focal fatty areas, 5 regenerative nodules, 2 hydatid cysts, 1 abscess) and 76 malignant - 47 metastases, 26 hepatocellular carcinomas and 3 peripheral cholangiocarcinomas - underwent CEUS after the administration of SonoVue®. Two readers reviewed in consensus baseline US and CEUS scans obtained 25-30 s (ar…

Hepatocellular cancer response to radiofrequency ablation: contrast-enhanced ultrasound

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

DEEP VEIN THROMBOSIS IN A LEFT-PLACED INFERIOR VENA CAVA

Risposta al trattamento mediante ablazione percutanea con radiofrequenza dell’epatocarcinoma: valutazione tramite ecografia con mezzo di contrasto (CEUS)

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…

Transient Hepatic Signal Intensity Differences (THID) Surrounding Focal Hepatic Lesions in Non-Cirrhotic Patients: Prevalence and Characterization with 1.5-MR Imaging Using Hepatospecific Medium Contrast

Real-Time Spatial Compound Sonography versus conventional US of the Achilles Tendon in patients with Heterozygous Familial Hypercholesterolemia

Ecografia convenzionale versus ecografia integrata con “compound digitale” nello studio del tendine d’achille in pazienti con ipercolesterolemia familiare eterozigotica

Angiomi epatici atipici: aspetti contrastografici con ecografia ad inversione di impulso e SH U 508A

Biological effects of ultrasound

Virtual bronchoscopy and preoperative assessment of airways stenosis

BENIGN GASTRIC POLYPS AND HELICOBACTER PYLORI INFECTION.

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…

Contrast-Enhanced Ultrasound in Focal Liver Lesions: Where Do We Stand?

Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in sonography, and it is being increasingly used for the evaluation of focal liver lesions (FLLs). Currently, CEUS is included as a part of the suggested diagnostic workup of FLLs, resulting in a better patient management and delivering cost-effective therapy. After a brief technical note, contrast-enhancement patterns of different types of benign and malignant FLLs, along with hepatic pseudolesions, are described and discussed based on our experience and literature data. At the same time, the most recent concepts and the use of CEUS in different clinical settings are presented.

Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography

Purpose The aim of this study is to assess the role of contrast-enhanced ultrasonography (CEUS) in the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale ultrasonography (US). Methods Thirty-seven consecutive cancer patients (24 women and 13 men; age, 33 to 80 years; mean, 58.1 years) with geographic liver fatty deposition, but without any detectable focal liver lesion on greyscale US, underwent sulphur hexafluoride-enhanced US. Two readers reported by consensus the presence, size, and location of any detected lesion. All patients underwent magnetic resonance imaging (MRI) as a confirmatory study. Sensitivity, specificity, positive and negat…

Hepatic focal nodular hyperplasia: contrast-enhanced ultrasound findings with emphasis on lesion size, depth and liver echogenicity

To correlate contrast-enhanced ultrasound (CEUS) findings of hepatic focal nodular hyperplasia (FNH) with lesion size, depth and liver echogenicity and to compare CEUS with baseline US. Two radiologists evaluated baseline US and CEUS examinations of 92 FNHs (mean size: 3.1 +/- 1.7 cm) in 71 patients (59 women and 12 men) to detect the "spoke-wheel" sign, central scar and feeding vessel. The FNHs were grouped and analysed by dimension, depth and liver echogenicity. At least one sign could be detected at CEUS in 27 out of 36 (75%) FNHs larger than 3 cm and in 17 out of 56 (30%) FNH measuring 3 cm or less (p 0.05) as well as between CEUS or baseline US/CD with regard to lesion size, depth or l…

PIELONEFRITI: IL RUOLO DEL RADIOLOGO AD UNA DIAGNOSI COMPLESSA

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

Primary malignant fibrous histiocytoma of the mesocolon transversum.

Primary malignant fibrous histiocytoma (MFH) is a rare and biologically aggressive tumor. Differential diagnosis must include cystic neoplasms of the pancreas (mucinous and serous cystoadenoma or cystocarcinoma), cystic lymphangioma or mesothelioma and retroperitoneal haematoma. Making the right diagnosis preoperatively may be often difficult, but MFH may be suspected when a huge retroperitoneal mass is found at imaging in elderly patients. We report a case of a primary abdominal MFH originating from the mesocolon transversum.

CT and CT angiography scan technique.

Contrast.enhanced ultrasonography of liver hemangiomas atypical at baseline US.

Tomografia computerizzata e risonanza magnetica

HSP60 and HASP10 overexpression in metastatic colon cancer

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…

Recurrence of hepatocellular carcinoma after liver transplantation: an update.

Liver transplantation is the only curative alternative for selected patients with hepatocellular carcinoma (HCC) who are not eligible for resection and/or with decompensated cirrhosis. According to Milan criteria the 5-year survival rate is 70–85%, with a recurrence-free survival of 75%. However, HCC recurrence rate after liver transplantation remains a significant problem in the clinical practice. The prognosis in patients with HCC recurrence is poor. The treatment of choice for HCC recurrence is surgery, but it seems that a systemic treatment based on combination of an mTOR inhibitor with sorafenib can be used. Data on safety and efficacy are limited, clinical monitoring is necessary. Th…

Tumori gastrointestinali stromali: aspetti con tomografia computerizzata multidetettore (40-strati)

ASPETTI RM DEL LIPOMA ARBORESCENTE DEL GINOCCHIO : NOSTRA ESPERIENZA

Esame radiologico del torace nell’invecchiamento cardiaco

L’invecchiamento e un processo fisiologico, definito omeostenosi caratterizzato da un progressivo declino dell’omeostasi di diversi organi e apparati in assenza di segni e/o sintomi di malattia. Le modificazioni anatomo-patologiche a carico dell’apparato cardiocircolatorio iniziano a comparire gia dalla terza decade di vita con incremento del grasso pericardico, progressivo irrigidimento delle valvole cardiache con segni di insufficienza e/o stenosi. Nella parete cardiaca si puo documentare ipertrofia del miocardio con incremento volumetrico delle fibrocellule muscolari lisce, prevalentemente a carico del distretto sinistro. Analoghe modificazioni sono riscontrabili nella parete vasale del …

Imaging findings of a large meningioma in a 3-years-old infant: a case report

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

Characterization of focal liver lesions

contrast enhanced versus conventional ultrasonography in the characterization of benign focal hepatic lesions

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

Centrifugal (inside-out) enhancement pattern of liver hemangiomas on contrast-enhanced US

Gastrointestinal stromal tumor (GIST): 40-row multislice computed tomography findings

Lobo azygos: variante anatomica spesso misconosciuta

The role of MRI in traumatic rupture of the diaphragm. Our experience in three cases and review of the literature.

PURPOSE: To evaluate the role and effectiveness of Magnetic Resonance Imaging (MRI) in blunt diaphragmatic injuries by reviewing the literature and our experience in three cases. MATERIALS AND METHODS: We reviewed the medical records and MRI findings of three patients with diaphragmatic injury due to blunt abdominal trauma. All patients were previously examined with chest X-ray and CT and later with MRI at our institution. Coronal and sagittal SE TI-w and fast SE T2-w sequence images were acquired. All patients underwent surgery. RESULTS: MRI showed a 5.5 cm tear in the left hemidiaphragmatic dome with herniation of the stomach and colon into the thoracic cavity in the first case; a 1 cm te…

Characterisation of indeterminate focal breast lesions on grey-scale ultrasound: role of ultrasound elastography.

PURPOSE: This study was undertaken to evaluate the role of ultrasound (US) elastography in characterising focal breast lesions classified as indeterminate on B-mode US. MATERIALS AND METHODS: Eighty-four focal breast lesions, 64 benign and 20 malignant (mean diameter, 15.1 mm), detected but not characterised on B-mode US in 72 women, Breast Imaging Reporting and Data System (BI-RADS) US category 3 (n=56) or category 4 (n=28), were studied with US elastography and classified in consensus by two radiologists according to a five-point colour scale. Sensitivity, specificity and positive and negative predictive values (PPV and NPV) of US elastography compared with conventional US were calculated…

Solitary necrotic nodules of the liver: cross-sectional imaging findings and follow-up in nine patients.

OBJECTIVE. The purpose of our study was to retrospectively evaluate the sonographic, CT, and MRI findings (number, diameter, lobar location, depth from the hepatic capsule, and appearance of lesions) in a series of nine patients with pathologically proven solitary necrotic nodules of the liver and the natural evolution at follow-up in four of the nine patients.CONCLUSION. Solitary necrotic nodules are usually small, solitary lesions, mainly located under the liver capsule of the right lobe. They are hypoechoic on sonography, hypoattenuating on CT, have low signal intensity on both T1- and T2-weighted MRI with lack of enhancement after IV contrast administration, and at follow-up have a tend…

Focal nodular hyperplasia in normal and fatty liver: a qualitative and quantitative evaluation with contrast-enhanced ultrasound

The aim of this study was to describe gray-scale appearance of liver parenchyma and focal nodular hyperplasia (FNH) by pulse inversion (PI) ultrasound (US) at baseline and after contrast agent administration in patients with normal and fatty liver. Sixteen consecutive patients (12 women, 4 men) with 29 previously diagnosed FNHs (15 of 29 located in normal liver and 14 of 29 in fatty liver) underwent PI US before and after SH U 508A (Levovist) injection. Signal intensity values were measured within the FNHs and the adjacent liver parenchyma in selected images. Baseline echogenicity of fatty liver was higher (15.19 +/- 2.90 dB +/- SD) than normal liver (10.91 +/- 3.15 dB +/- SD; p<0.001). Aft…

CT and MR imaging of cystic renal lesions

AbstractCystic renal lesions are a common incidental finding on routinely imaging examinations. Although a benign simple cyst is usually easy to recognize, the same is not true for complex and multifocal cystic renal lesions, whose differential diagnosis includes both neoplastic and non-neoplastic conditions. In this review, we will show a series of cases in order to provide tips to identify benign cysts and differentiate them from malignant ones.

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

Liver stiffness quantification in biopsy-proven nonalcoholic fatty liver disease patients using shear wave elastography in comparison with transient elastography

Purpose: This study prospectively assessed the performance of liver stiffness measurements using point shear-wave elastography (p-SWE) in comparison with transient elastography (TE) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD). Methods: Fifty-six consecutive adult patients with a histological diagnosis of NAFLD prospectively underwent TE and p-SWE on the same day. The median of 10 measurements (SWE-10), the first five (SWE-5), and the first three (SWE-3) measurements were analyzed for p-SWE. Liver biopsy was considered as the reference standard for liver fibrosis grade. Receiver operating characteristic (ROC) curves and areas under the ROC curves (AUROCs) were cal…

Riscontro incidentale di noduli tiroidei: incidenza, aspetti B-mode e color Doppler in una popolazione adulta studiata con "real-time compound sonography"

Riscontro incidentale di noduli tiroidei: incidenza, aspetti B-mode e color Doppler in una popolazione adulta studiata con “real-time compound sonography

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

Sicurezza ed efficacia della chemioembolizzazione arteriosa transcatetere nel trattamento dei pazienti con epatocarcinoma: studio triennale di 75 pazienti italiani

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

Neoplasie del surrene

Vesicoureteral reflux in young patients: Comparison of voiding color Doppler US with echo enhancement versus voiding cystourethrography for diagnosis or exclusion

We assessed the accuracy of voiding color Doppler ultrasonography (US) with echo enhancement for diagnosis or exclusion of vesicoureteral reflux (VUR) versus voiding cystourethrography (VCUG) and evaluated patient tolerance of the echo-enhancing agent. One hundred twenty-two patients (ages range, 1 month to 17 years) with 244 ureterorenal units underwent voiding color Doppler US with echo enhancement, which was followed by VCUG on the same day. After US of the urinary tract, the bladder was filled with saline solution via catheter. Then an echo-enhancing agent was instilled, and color Doppler US was performed. Reflux was diagnosed when microbubbles appeared in the ureter or the pelvicalicea…

EVALUATION OF MESENTERIC CHANGES WITH ELASTOSONOGRAPHY AND DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING IN PATIENTS WITH CROHN'S DISEASE: PRELIMINARY RESULTS

Aims and objectives Methods and materials Results Conclusion Personal information References

Imaging findings of hepatic Focal Nodular Hyperplasia (FNH) in Gadoxetic Acid vs Gadobenate Dimeglumine-enhanced MR: preliminary results

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 …

New frontiers in liver ultrasound: From mono to multi parametricity

Modern liver ultrasonography (US) has become a "one-stop shop " able to provide not only anatomic and morphologic but also functional information about vascularity, stiffness and other various liver tissue properties. Modern US techniques allow a quantitative assessment of various liver diseases. US scanning is no more limited to the visualized plane, but three-dimensional, volumetric acquisition and consequent post-processing are also possible. Further, US scan can be consistently merged and visualized in real time with Computed Tomography and Magnetic Resonance Imaging examinations. Effective and safe microbubble-based contrast agents allow a real time, dynamic study of contrast kinetic f…

Hepatic angiomyolipoma: contrast-enhanced pulse inversion US in a case

Virtual bronchoscopy in patients with central endobronchial stenosing lesions. Technique optimisation with single slice spiral CT.

PURPOSE: To describe an original protocol for single slice spiral Computed Tomography (CT) virtual bronchoscopy in the evaluation of patients with central airway stenoses and compare the results with fibreoptic bronchoscopy. MATERIALS AND METHODS: Ten patients (4 female and 6 male; age range 22-60 years; mean age 44 years) with endobronchial disease diagnosed by fibreoptic bronchoscopy (8 malignant tumours, 1 benign tumour and 1 fibroid stenosis) underwent virtual bronchoscopy with single slice spiral CT. A panoramic spiral CT scan of the whole chest was first obtained. Once the area of interest had been identified, a new contrast enhanced scan was performed, from bottom to top, with the fo…

Tumori gastrointestinali stromali: Aspetti con tomografia computerizzata multidetettore (40-strati)

Purpose. The purpose of this study was to describe the findings and evaluate the role of multidetector (40-slice) computed tomography (MDCT) in the preoperative assessment of gastrointestinal stromal tumours (GISTs). Materials and methods. Thirteen patients with histologically proven GIST (size: 4-30 cm; mean: 9 cm) underwent 40-slice MDCT after the ingestion of 1,000 ml of water. Images were obtained before and 70 s after intravenous injection of 120 ml of iodinated contrast agent. Two experienced radiologists reviewed the CT findings to evaluate lesion site, size, margins, attenuation, growth pattern, enhancement pattern, ascites, lymphadenopathy, direct invasion to adjacent organs and di…

Incidence of new foci of Hepatocellular Carcinoma in patients who underwent radiofrequency ablation of Hepatocellular Carcinoma: Role of MDCT

Indeterminate focal liver lesions incidentally discovered at gray-scale US: role of contrast-enhanced sonography.

OBJECTIVES: to assess the role of contrast-enhanced ultrasound (CEUS) in the characterization of focal liver lesions (FLLs) incidentally discovered but indeterminate at gray-scale ultrasound (US). MATERIALS AND METHODS: one hundred forty-two consecutive patients with 174 FLLs (169 benign and 5 malignant) incidentally discovered but indeterminate at gray-scale US, underwent CEUS after the administration of SonoVue. Two readers independently reviewed CEUS scans and: (1) classified each lesion as malignant or benign on a 5-point scale of confidence by means of definite diagnostic criteria; (2) provided if possible a specific diagnosis; (3) were requested if further imaging was needed for lesio…

Imaging findings of hepatic focal nodular hyperplasia in men and women: are they really different?

Purpose This study was undertaken to compare the imaging findings of focal nodular hyperplasia (FNH) in men and women, as seen on multidetector computed tomography (MDCT), magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS). Materials and methods Two radiologists reviewed 195 imaging studies (17 MDCT, 81 MRI and 97 CEUS examinations) pertaining to 111 FNHs (mean size 3 cm) in 91 patients (mean age 39 years). For each lesion, the readers assessed size, location, echogenicity, attenuation, or signal intensity in comparison with adjacent liver parenchyma on both unenhanced and postcontrast images. Results Eighty-nine FNHs (mean size 3.1 cm) were observed in 73 women (mean …

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

ESAME RADIOLOGICO DEL TORACE NELL’INVECCHIAMENTO CARDIACO

On Unsupervised Methods for Medical Image Segmentation: Investigating Classic Approaches in Breast Cancer DCE-MRI

Unsupervised segmentation techniques, which do not require labeled data for training and can be more easily integrated into the clinical routine, represent a valid solution especially from a clinical feasibility perspective. Indeed, large-scale annotated datasets are not always available, undermining their immediate implementation and use in the clinic. Breast cancer is the most common cause of cancer death in women worldwide. In this study, breast lesion delineation in Dynamic Contrast Enhanced MRI (DCE-MRI) series was addressed by means of four popular unsupervised segmentation approaches: Split-and-Merge combined with Region Growing (SMRG), k-means, Fuzzy C-Means (FCM), and spatial FCM (…

Preoperative assessment of GI stromal tumors with 40-row multislice CT

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

Diagnostic performance of 2D-shear wave elastography in the diagnosis of breast cancer: a clinical appraisal of cutoff values

Purpose To assess the role of 2D-shear wave elastography (2D-SWE) in differentiating benign from malignant focal breast lesions (FBLs), providing new vendor-specific cutoff values. Methods 158 FBLs (size: 3.5-50 mm) detected in 151 women (age: 21-87 years) were prospectively evaluated by means 2D-SWE. For each lesion, an expert radiologist assessed US BI-RADS category and calculated the following four 2D-SWE parameters: (1) elasticity maximum (E-max); (2) mean elasticity (E-mean); (3) minimum elasticity (E-min); (4) elasticity ratio (E-ratio). US-guided core-biopsy was considered as standard of reference for all the FBLs classified as BI-RADS 4 or 5. For each 2D-SWE parameter, the optimal c…

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

Congenital pulmonary airway malformation in adult: report of two rare cases and literature review

Congenital pulmonary airway malformations (CPAMs) are a heterogeneous group of congenital, non-hereditary lesions of the lung, cystic and non-cystic type with clear developmental anomalies and evident malformative changes, which derive from the excessive proliferation of the tubular bronchial structures. We described two rare cases of type IV CPAM detected in adult patients with different clinical presentation: one of these cases was symptomatic, complaining of cough and hemoptysis. Conversely, the other case was reported as incidental findings in patient with abdominal pain without respiratory symptoms. Chest computed tomography (CT) scan was performed showing voluminous cystic formations …

Intraforaminal lumbosacral discal herniation. Treatment of symptomatic patients with intradiscal injection oxygen-ozone (O2-O3) mixture

Breast dynamic contrast-enhanced-magnetic resonance imaging and radiomics: State of art

Breast cancer represents the most common malignancy in women, being one of the most frequent cause of cancer-related mortality. Ultrasound, mammography, and magnetic resonance imaging (MRI) play a pivotal role in the diagnosis of breast lesions, with different levels of accuracy. Particularly, dynamic contrast-enhanced MRI has shown high diagnostic value in detecting multifocal, multicentric, or contralateral breast cancers. Radiomics is emerging as a promising tool for quantitative tumor evaluation, allowing the extraction of additional quantitative data from radiological imaging acquired with different modalities. Radiomics analysis may provide novel information through the quantification…

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

Automated classification of focal breast lesions according to S-detect: validation and role as a clinical and teaching tool

Abstract PURPOSE: To assess the diagnostic performance and the potential as a teaching tool of S-detect in the assessment of focal breast lesions. METHODS: 61 patients (age 21-84 years) with benign breast lesions in follow-up or candidate to pathological sampling or with suspicious lesions candidate to biopsy were enrolled. The study was based on a prospective and on a retrospective phase. In the prospective phase, after completion of baseline US by an experienced breast radiologist and S-detect assessment, 5 operators with different experience and dedication to breast radiology performed elastographic exams. In the retrospective phase, the 5 operators performed a retrospective assessment a…

Growth rate of small (≤2 cm) HCC in cirrhotic patient: determining optimal screening interval with serial CT or MRI.

Contrast agent and thyroid gland

Comparison of US Strain Elastography and Entero-MRI to Typify the Mesenteric and Bowel Wall Changes during Crohn’s Disease: A Pilot Study

Purpose. To evaluate and compare the mesenteric and bowel wall changes during Crohn’s disease (CD) on ultrasonography (US) Strain Elastography (SE) and Enterography Magnetic Resonance Imaging (E-MRI). Methods. From July 2014 to September 2016, 35 patients with ileocolonoscopy diagnosis of CD were prospectively examined with E-MRI and in the same time with US and SE. Results. A total of 41 affected bowel segments and 35 unaffected bowel segments in 35 patients were evaluated. US-SE color-scale coding showed a blue color pattern in the fibrotic mesentery and bowel wall in 15 patients and a green color pattern in the edematous ones in 20 patients. The signal of the bowel wall and mesenteric fa…

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

Angiomi epatici atipici all’ecografia di base: caratterizzazione con ecografia ad inversione di impulso e SonoVue

Broncoscopia virtuale in pazienti con lesioni endobronchiali stenosanti. Ottimizzazione della tecnica con TC spirale monostrato

PURPOSE: To describe an original protocol for single slice spiral Computed Tomography (CT) virtual bronchoscopy in the evaluation of patients with central airway stenoses and compare the results with fibreoptic bronchoscopy. MATERIALS AND METHODS: Ten patients (4 female and 6 male; age range 22-60 years; mean age 44 years) with endobronchial disease diagnosed by fibreoptic bronchoscopy (8 malignant tumours, 1 benign tumour and 1 fibroid stenosis) underwent virtual bronchoscopy with single slice spiral CT. A panoramic spiral CT scan of the whole chest was first obtained. Once the area of interest had been identified, a new contrast enhanced scan was performed, from bottom to top, with the fo…

Radiomics analysis of 18F-Choline PET/CT in the prediction of disease outcome in high-risk prostate cancer: an explorative study on machine learning feature classification in 94 patients

Objective: The aim of this study was (1) to investigate the application of texture analysis of choline PET/CT images in prostate cancer (PCa) patients and (2) to propose a machine-learning radiomics model able to select PET features predictive of disease progression in PCa patients with a same high-risk class at restaging. Material and methods: Ninety-four high-risk PCa patients who underwent restaging Cho-PET/CT were analyzed. Follow-up data were recorded for a minimum of 13 months after the PET/CT scan. PET images were imported in LIFEx toolbox to extract 51 features from each lesion. A statistical system based on correlation matrix and point-biserial-correlation coefficient has been impl…

TIROIDE

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

Aims and objectives Methods and materials Results Conclusion Personal information References

Liver haemangiomas undetermined at grey-scale ultrasound: Contrast-enhancement patterns with SonoVue and pulse-inversion US

Hepatocellular cancer response to radiofrequency tumor ablation: contrast-enhanced US

Incidence of new foci of hepatocellular carcinoma (HCC) in patients who underwent radiofrequency ablation of HCC: Role of multidetector CT

Focal breast lesion characterization according to the BI-RADS US lexicon: role of a computer-aided decision-making support

Objectives: to assess the diagnostic performance of a computer-guided decision- making software (S-Detect) in the US characterization of focal breast lesions (FBLs), according to the radiologist's experience. Materials and Methods: 300 FBLs (size: 2.6-47.2 mm; mean: 13.2 mm) in 255 patients (mean age: 51 years) were prospectively assessed in consensus according to BIRADS US lexicon by two experienced radiologists without and with S-Detect; to evaluate intra and inter-observer agreement, the same 300 FBLs were independently evaluated by two residents at baseline and after 3 months. Results: 120/300 (40%) FBLs were malignant, 2/300 (0.7%) high-risk and 178/300 (59.3%) benign. Experts review s…

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…

Acute traumatic acromionclavicular jointlesions: role of ultrasound versus conventional radiography

Potential myocardial iron content evaluation by magnetic resonance imaging in thalassemia major patients treated with Deferoxamine or Deferiprone during a randomized multicenter prospective clinical study.

The purpose of this study was to evaluate if the variations of heart magnetic resonance imaging in beta-thalassemia major patients treated with Deferoxamine B mesylate (DF) or Deferiprone (L1) chelation therapy is a useful tool of the indirect myocardial iron content determination. For this reason, a prospective study was carried out. Seventy-two consecutive patients with beta-thalassemia major (35 treated with DF and 37 with L1) were studied. The main outcome results were laboratory parameters including determination of the liver iron concentration (LIC) and magnetic resonance imaging (MRI) of the heart and liver. The heart to muscle signal intensity ratios (HSIRs) were significantly incre…

Synchronous adenomatous polyps and colorectal carcinoma

Radiomics and artificial intelligence in prostate cancer: new tools for molecular hybrid imaging and theragnostics

AbstractIn prostate cancer (PCa), the use of new radiopharmaceuticals has improved the accuracy of diagnosis and staging, refined surveillance strategies, and introduced specific and personalized radioreceptor therapies. Nuclear medicine, therefore, holds great promise for improving the quality of life of PCa patients, through managing and processing a vast amount of molecular imaging data and beyond, using a multi-omics approach and improving patients’ risk-stratification for tailored medicine. Artificial intelligence (AI) and radiomics may allow clinicians to improve the overall efficiency and accuracy of using these “big data” in both the diagnostic and theragnostic field: from technical…

10-Year Clinical Experience With 18F-Choline PET/CT: An Italian Multicenter Retrospective Assessment of 3343 Patients.

Purpose The primary aim of this multicenter retrospective analysis is to examine the role of(18)F-choline PET/CT as a diagnostic tool for staging and restaging prostate cancer (PCa) in a large population in the light of 10 years of clinical experience. A secondary aim of the study is to produce data on the predictors of a positive(18)F-choline PET/CT result in the setting of PCa primaries and biochemical recurrences. Materials and Methods This multicenter retrospective cohort study is based on data collected by 9 Italian nuclear medicine departments. Between October 2008 and September 2019, 3343 men underwent(18)F-choline PET/CT scans before receiving definitive treatments for a primary PCa…

Usefulness of multiplanar reconstruction with multislice CT to assess HCC response after transcatheter arterial chemoembolization

Virtual bronchoscopy in the pre-operative assessment of peripheral airway stenosis

Riempimento centrifugo (”inside-out”) degli angiomi epatici: un possibile e atipico aspetto all’ecografia con mezzo di contrasto

An uncommon case of pneumothorax

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

Hepatocellular carcinoma with macrovascular invasion: multimodality imaging features for the diagnosis

Hepatocellular carcinoma (HCC) is frequently associated with macrovascular invasion of the portal vein or hepatic veins in advanced stages. The accurate diagnosis of macrovascular invasion and the differentiation from bland non-tumoral thrombus has significant clinical and management implications, since it narrows the therapeutic options and it represents a mandatory con-traindication for liver resection or transplantation. The imaging diagnosis remains particularly challenging since the imaging features of HCC with macrovascular invasion may be subtle, espe-cially in lesions showing infiltrative appearance. However, each radiologic imaging modality may provide findings suggesting the prese…

Atypical liver hemangiomas: contrast enhancement patterns with SH U 508A and pulse inversion ultrasound

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

Urological dysfunctions in patients with Parkinson’s disease: clues from clinical and non-invasive urological assessment

Abstract Background Autonomic nervous system dysfunction, common in patients with Parkinson’s disease (PD), causes significant morbidity and it is correlated with poor quality of life. To assess frequency of urinary symptoms in patients with PD, without conditions known to interfere with urinary function. Methods Non-demented PD patients were consecutively enrolled from the outpatients clinic of our department. Scales investigating motor and non-motor symptoms were carried out. Evaluation of urinary dysfunctions was carried out using the AUTonomic Scale for Outcomes in Parkinson’s disease (SCOPA-AUT) questionnaire. Patients underwent noninvasive urological studies (nUS), including uroflowme…

Nuove prospettive dell’imaging tiroideo : ecografia con mezzo di contrasto

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

Forty-slice Computer Tomography in arrhytmogenic right ventricular cardiomyopathy

CD1A expression in Barrett’s oesophagus: new role for an old molecule against the metaplastic progression

S-Detect characterization of focal breast lesions according to the US BI RADS lexicon: a pictorial essay

High-resolution ultrasonography (US) is a valuable tool in breast imaging. Nevertheless, US is an operator-dependent technique: to overcome this issue, the American College of Radiology (ACR) has developed the breast imaging-reporting and data system (BI-RADS) US lexicon. Despite this effort, the variability in the assessment of focal breast lesions (FBLs) with the use of BI-RADS US lexicon is still an issue. Within this framework, evidence shows that computer-aided image analysis may be effective in improving the radiologist’s assessment of FBLs. In particular, S-Detect is a newly developed image-analytic computer program that provides assistance in morphologic analysis of FBLs seen on US …

Applicazione dei mezzi di contrasto ecografici nelle lesioni focali del fegato steatosico, nelle lesioni epatiche rare e nelle pseudolesioni del fegato

Nonostante i continui progressi tecnologici, l’ecografia convenzionale in scala di grigi non presenta elevata specificita nella caratterizzazione delle lesioni focali epatiche [1]. Inoltre, nella pratica clinica, il non infrequente riscontro di alterazioni diffuse del parenchima epatico, come la steatosi, puo rendere ancora piu difficoltosa una corretta diagnosi [2]. In particolare l’infiltrazione adiposa del fegato,dovuta all’accumulo di trigliceridi sotto forma di vacuoli di differenti dimensioni all’interno degli epatociti, la cui incidenza, secondo alcuni studi autoptici, varia dal 6 all’11%, e responsabile di un’ alterazione diffusa dell’ecogenicita del parenchima epatico che assume un…

Ruolo delle ricostruzioni ottenute con TC multidetettore (TCMD) a 40 strati nella valutazione pre-operatoria delle neoplasie cefalopancreatiche

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

Hepatocellular cancer response to radiofrequency tumor ablation: contrast-enhanced ultrasound

Radiofrequency ablation (RFA) is increasingly being used as percutaneous treatment of choice for patients with early stage hepatocellular carcinoma (HCC). An accurate assessment of the RFA therapeutic response is of crucial importance, considering that a complete tumor ablation significantly increases patient survival, whereas residual unablated tumor calls for additional treatment. Imaging modalities play a pivotal role in accomplishing this task, but ultrasound (US) is not considered a reliable modality for the evaluation of the real extent of necrosis, even when color/power Doppler techniques are used. Recently, newer microbubble-based US contrast agents used in combination with grey-sca…

Transcranial magnetic resonance imaging-guided focused ultrasound treatment at 1.5 T: a retrospective study on treatment and patient-related parameters obtained from 52 Procedures

Objective: To present a retrospective analysis of patient- and sonication-related parameters of a group of patients treated with a transcranial magnetic resonance imaging (MRI)-guided focused ultrasound (tcMRgFUS) system integrated with a 1.5-T MRI unit. Methods: The data obtained from 59 patients, who underwent the tcMRgFUS procedure from January 2015 to April 2019, were retrospectively reviewed for this study. The following data, among others, were mainly collected: skull density ratio (SDR), skull area (SA), number of available transducer elements (Tx), and estimated focal power at target (FP). For each of the four different treatment stages, we calculated the number of sonication proces…

Magnetic resonance imaging of the cirrhotic liver in the era of gadoxetic acid.

Gadoxetic acid improves detection and characterization of focal liver lesions in cirrhotic patients and can estimate liver function in patients undergoing liver resection. The purpose of this article is to describe the optimal gadoxetic acid study protocol for the liver, the unique characteristics of gadoxetic acid, the differences between gadoxetic acid and extra-cellular gadolium chelates, and the differences in phases of enhancement between cirrhotic and normal liver using gadoxetic acid. We also discuss how to obtain and recognize an adequate hepatobiliary phase.

High resolution US versus x-ray study in the early assessment of acute traumatic lesion of the acromioclavicular joint.

Preoperative imaging findings in patients undergoing transcranial magnetic resonance imaging-guided focused ultrasound thalamotomy

AbstractThe prevalence and impact of imaging findings detected during screening procedures in patients undergoing transcranial MR-guided Focused Ultrasound (tcMRgFUS) thalamotomy for functional neurological disorders has not been assessed yet. This study included 90 patients who fully completed clinical and neuroradiological screenings for tcMRgFUS in a single-center. The presence and location of preoperative imaging findings that could impact the treatment were recorded and classified in three different groups according to their relevance for the eligibility and treatment planning. Furthermore, tcMRgFUS treatments were reviewed to evaluate the number of transducer elements turned off after…

Splenic hemangiomas: contrast-enhanced sonographic findings

Objectives The purpose of this study was to illustrate the baseline appearance and enhancement patterns of splenic hemangiomas on contrast-enhanced sonography. Methods Two experienced radiologists retrospectively reviewed by consensus baseline and contrast-enhanced sonographic examinations of 27 patients (14 women and 13 men; mean age, 58.7 years) with 27 splenic hemangiomas (mean size, 2 cm) confirmed by splenectomy, biopsy, computed tomography, and magnetic resonance imaging and follow-up. Results On baseline sonography, 77.8% of the lesions showed a homogeneous echo texture that was mainly hyperechoic. Color Doppler imaging did not show any signal in 81.5% of the cases. After contrast ag…

Contrast-enhanced ultrasound of hepatocellular carcinoma: where do we stand?

Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in ultrasonography (US), and it is being increasingly used for the evaluation of focal liver lesions (FLLs). CEUS is unique in that it allows non-invasively assessment of liver perfusion in real time throughout the vascular phase, which has led to dramatic improvements in the diagnostic accuracy of US in the detection and characterization of FLLs, the choice of therapeutic procedures, and the evaluation of response. Currently, CEUS is included as a part of the suggested diagnostic work-up of FLLs, including in cirrhotic patients with hepatocellular carcinoma, resulting in better patient management and cost-effective d…

Focal liver tumours characterization with contrast-specific modes and sulphur hexafluoride-filled microbubbles: analysis of diagnostic performance and confidence

ATLAS OF CONTRAST-ENHANCED SONOGRAPHY OF FOCAL LIVER LESIONS

This book offers an image-based, comprehensive quick reference guide that will assist in the interpretation of contrast-enhanced ultrasound (CEUS) examinations of the liver in daily practice. It describes and depicts typical and atypical behavior of both common and less frequently observed focal liver lesions. For each type of lesion, the findings on pre- and post-contrast images are presented and key characteristics are highlighted. Individual chapters also focus on the assessment of response to locoregional and systemic treatment and the impact of European guidelines on CEUS. The Atlas of Contrast-Enhanced Sonography of Focal Liver Lesions will serve as an invaluable hands-on tool for pra…

ECG-gated Multidetector Computed Tomography as a Standard Tool before Aortic Surgery

The usefulness of Sonovue-enhanced pulse-inversion US to assess hepatocellular carcinoma response after percutaneous radiofrequency thermal ablation therapy

The use of contrast-enhanced ultrasonography in the diagnosis and follow-up of Crohn's Disease

Valutazione combinata mediante TCMD a 64 strati e CEUS dei noduli epatici in pazienti cirrotici.

Qualitative and quantitative evaluation of solitary thyroid nodules with contrast-enhanced ultrasound: initial results

To assess the feasibility of contrast-enhanced ultrasound (CEUS) of the thyroid gland and to evaluate the potential of this method for characterising solitary thyroid nodules.18 patients affected by solitary thyroid nodules (size range: 0.6 to 3.6 cm; mean: 1.8 cm) confirmed by surgery (nine papillary carcinomas, four follicular carcinomas, three hyperplasias, one follicular adenoma and one Plummer’s adenoma) underwent pulse inversion US at low M.I. (0.06 to 0.08) after i.v. injection of a 2.4-mL bolus of SonoVue. Baseline echogenicity and the dynamic enhancement pattern of each nodule, in comparison with adjacent thyroid parenchyma, were assessed. Signal intensity values on grey-scale imag…

64-detector computed tomography in preoperative assessment of vascular anatomy of middle colic artery in left-sided colon cancer

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

MR enteroclysis versus conventional enteroclysis in Crohn’s disease patients

Learning objectives: To provide a detailed step-by-step description of the technique of MR enteroclysis (MRE). To illustrate the spectrum of MRE findings in patients with Crohn’s disease (CD) and their correlation with findings at conventional enteroclysis (CE). To discuss the advantages and limitations of MRE in patients with CD. Background: CE is the gold standard for small bowel pathologies. However, submucosal and mesenteric involvements, which are common in CD, cannot be assessed by CE. Therefore, the evaluation of the mucosa alone by CE may under-represent the extent and activity of the disease. Also, CE is associated with the risk of several complications, mainly exacerbation in seve…

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

Caratterizzazione delle lesioni focali epatiche ipoecogene in pazienti con fegato steatosico: “performance” e livello di confidenza diagnostica dell’ecografia con mezzo di contrasto

Geographic fatty liver deposition in oncologic patient at gray-scale US: role of contrast-enhanced sonography

Patologie renali chirurgiche

Transcranial magnetic resonance-guided focused ultrasound surgery at 1.5T: a technical note.

Magnetic resonance-guided focused ultrasound is one of the emerging non-invasive technologies offering both image guidance and thermal monitoring. In recent years transcranial application of this technology is starting to impact heavily the neuroscience field. We present here the imaging protocol and the technological methods successfully used with a transcranial magnetic resonance-guided focused ultrasound system certified for clinical treatments of functional neurological disorders, integrated for the first time with a 1.5T magnetic resonance scanner. Compared to the body radiofrequency coil (the one commonly used with transcranial magnetic resonance-guided focused ultrasound system integ…

The “spoke wheel” sign in hepatic focal nodular hyperplasia

CLASSICS IN ABDOMINAL RADIOLOGY

Chemionucleolisi dell’ernia lombosacrale con miscela Ozono-Ossigeno (O2-O3) con tecnica periradicolare e periganglionare: ruolo della TC

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 …

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

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…

Contrast Enhanced Ultrasonography for Focal Liver Lesions Characterization: Clinical Perspective

Role of contrast-enhanced Ultrasound in the Characterization of hypervascular focal liver lesions: spectrum of imaging findings

Neoplasie dei surreni

MR findings of infero-medial displacement: A rare location of a free fragment of the medial meniscus of the knee

SCROTO ACUTO: DIAGNOSI DIFFERENZIALE DI UN'EMERGENZA MEDICO-CHIRURGICA NELL'IMAGING ECOGRAFICO

nd

Focal nodular hyperplasias in normal and fatty liver: a quantitative evaluation with SH U 508A and pulse inversion ultrasound

Type and gene location of kit mutations predict progression-free survival to first-line imatinib in gastrointestinal stromal tumors: A look into the exon

In previous studies on localized GISTs, KIT exon 11 deletions and mutations involving codons 557/558 showed an adverse prognostic influence on recurrence-free survival. In the metastatic setting, there are limited data on how mutation type and codon location might contribute to progression-free survival (PFS) variability to first-line imatinib treatment. We analyzed the type and gene location of KIT and PDGFRA mutations for 206 patients from a GIST System database prospectively collected at an Italian reference center between January 2005 and September 2020. By describing the mutational landscape, we focused on clinicopathological characteristics according to the critical mutations and inve…

Broncoscopia virtuale in pazienti con lesioni endobronchiali stenosanti: ottimizzazione della tecnica con TC spirale monostrato

Ruolo dell’ecografia con mezzo di contrasto nella caratterizzazione delle lesioni focali epatiche scoperte incidentalmente

Analysis of different contrast enhancement patterns after microbubble-based contrast agent injection in liver hemangiomas with atypical appearance on baseline scan

BACKGROUND: We describe different possible enhancement patterns in liver hemangiomas with atypical appearance on baseline ultrasound after microbubble-based contrast agent injection. METHODS: From a series of 253 consecutive lesions that were indeterminate on baseline ultrasound and then scanned after injection of air-filled microbubble contrast agent, 65 focal liver lesions were retrospectively selected on the basis of a diagnosis of liver hemangioma on multiphase contrast-enhanced computed tomography (n = 23), magnetic resonance imaging (n = 27), or histology (n = 15). Each lesion was scanned during arterial phase (30 s after microbubble injection) and late phase (5 min after injection). …

Incidence of new foci of hepatocellular carcinoma after radiofrequency ablation: role of multidetector CT

Purpose. The authors sought to assess the incidence of new foci of hepatocellular carcinoma (HCC) using multidetector computed tomography (MDCT) in patients treated with radiofrequency ablation (RFA). Materials and methods. Two readers retrospectively reviewed by consensus the follow-up MDCT studies of 125 patients (88 men and 37 women; mean age 68 years) with 141 HCCs (size 1–5.2 cm; mean 2.2 cm) treated with RFA. MDCT follow-up was performed at 1 and 3 months and every 6–12 months thereafter. Reviewers assessed: (1) the presence of new HCC foci in the same liver segment or in a different segment; (2) complete or incomplete tumor ablation; (3) tumour progression. Results. A total of 113 ne…

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

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

Role of videoassisted thoracoscopy procedure in the diagnosis and treatment of malignant pleural mesothelioma

Gozzo semplice e nodulare

Minor hepatic resection for hepatocellular carcinoma in cirrhotic patients: Kelly clamp crushing resection versus heat coagulative necrosis with bipolar radiofrequency device

Hemorrhage and postoperative liver insufficiency are frequent and serious complications of hepatic resection in cirrhotic patients. The aim of this study was to assess retrospectively whether the surgical techniques using Kelly clamp crushing resection or heat coagulative necrosis with a bipolar radiofrequency device can reduce the incidence of the above complications and an eventual recurrence of neoplasia on the liver slice. We retrospectively reviewed the results of 35 patients who had undergone resection for monofocal hepatocellular carcinoma at our center. Thirteen patients (Group A) had undergone liver resection with Kelly clamp crushing resection, 22 patients (Group B) had had liver…

Contrast-enhanced versus baseline ultrasonography in the characterization of benign focal lesions.

RUOLO DELLA TC CON MEZZO DI CONTRASTO NELLA DIAGNOSI DELLE COMPLICANZE DELLA PANCREATITE ACUTA NECROTIZZANTE

Digital cineradiographic study of swallowing in patients with amyotrophic lateral sclerosis

Lumbosacral disc herniation: spinal interventional chemonucleolysis with CT-intradiscal oxygen-ozone (O2-O3) mixture with periradicular and periganglionic technique

Thyroid nodules: prevalence, gray-scale and color-doppler pattern in a random adult population screened by high resolution US.

Imaging of hepatic hemangioma: from A to Z

The hemangioma is the most common solid lesion of the liver. Therefore, radiologists must know the typical and atypical imaging findings of this lesion in order to reach a correct diagnosis and avoid diagnostic errors. However, only few papers have comprehensively described the entire spectrum of atypical and uncommon imaging features. In this updated review, we provide the imaging features of hepatic hemangioma, in both typical and atypical forms, as well as its association with abnormalities in the adjacent hepatic parenchyma and other hepatic lesions, and its complications.

Semi-automated and interactive segmentation of contrast-enhancing masses on breast DCE-MRI using spatial fuzzy clustering

Abstract Multiparametric Magnetic Resonance Imaging (MRI) is the most sensitive imaging modality for breast cancer detection and is increasingly playing a key role in lesion characterization. In this context, accurate and reliable quantification of the shape and extent of breast cancer is crucial in clinical research environments. Since conventional lesion delineation procedures are still mostly manual, automated segmentation approaches can improve this time-consuming and operator-dependent task by annotating the regions of interest in a reproducible manner. In this work, a semi-automated and interactive approach based on the spatial Fuzzy C-Means (sFCM) algorithm is proposed, used to segme…

Virtual broncoscopy in the preoperative assessment of airways stenosis

Pigmented villonodular synovitis of the foot: MR findings.

PURPOSE: To evaluate the MRI findings in the various forms of pigmented villonodular synovitis (PVNS) of the foot. MATERIALS AND METHODS: Seven hundred and fifty-three MR studies of the foot performed at our institute between June 1994 and April 2000 were retrospectively reviewed for the presence of PVNS. Spin echo (SE) T1W, Gradient echo (GE) T2*W, and fat suppression (Short Time Inversion Recovery: STIR) images were acquired with a 0.5 T superconductive unit (Vectra, GE Medical System, Milwaukee, WI, USA) provided with a dedicated transmitter/receiver coil. The site and type of lesions, the signal intensity patterns, and the presence of associated changes were evaluated. RESULTS: On the b…

Characterization of hypoechoic focal hepatic lesions in patients with fatty liver: diagnostic performance and confidence of contrast-enhanced ultrasound

Diagnostic Performance of an Artificial Intelligence System in Breast Ultrasound.

Objectives We study the performance of an artificial intelligence (AI) program designed to assist radiologists in the diagnosis of breast cancer, relative to measures obtained from conventional readings by radiologists. Methods A total of 10 radiologists read a curated, anonymized group of 299 breast ultrasound images that contained at least one suspicious lesion and for which a final diagnosis was independently determined. Separately, the AI program was initialized by a lead radiologist and the computed results compared against those of the radiologists. Results The AI program's diagnoses of breast lesions had concordance with the 10 radiologists' readings across a number of BI-RADS descri…

Role of Contrast-enhanced Ultrasound in the Characterization of Incidentally Discovered Focal Liver Lesions

INTERMODALITY AGREEMENT FOR THE DIAGNOSIS OF SMALL (≤2CM) HEPATOCELLULAR CARCINOMAS (HCCS) IN PATIENTS WITH CIRRHOSIS

TYPICAL AND ATYPICAL HEPATOBILIARY PHASE (HB PHASE) APPEARANCES OF FOCAL NODULAR HYPERPLASIA (FNH)

Acute traumatic acromionclavicular joint lesions: usefulness of sonography versus conventional radiography

CT and MR imaging of the inflammatory diseases

Usefulness of SonoVue-enhanced Pulse-Inversion Ultrasonography to Assess Hepatocellular Carcinoma Response after Percutaneous Radiofrequency Thermal Ablation Therapy

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

Advances in liver US, CT, and MRI: moving toward the future

AbstractOver the past two decades, the epidemiology of chronic liver disease has changed with an increase in the prevalence of nonalcoholic fatty liver disease in parallel to the advent of curative treatments for hepatitis C. Recent developments provided new tools for diagnosis and monitoring of liver diseases based on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), as applied for assessing steatosis, fibrosis, and focal lesions. This narrative review aims to discuss the emerging approaches for qualitative and quantitative liver imaging, focusing on those expected to become adopted in clinical practice in the next 5 to 10 years. While radiomics is an emergin…

Role of apparent diffusion coefficient values in prostate diseases characterization on diffusion-weighted magnetic resonance imaging.

BACKGROUND: To evaluate if normal and pathological prostate tissue can be distinguished by using apparent diffusion coefficient (ADC) values on magnetic resonance imaging (MRI) and to understand if it is possible to differentiate among pathological prostate tissues using ADC values.METHODS:Our population consisted in 81 patients (mean age 65.4 years) in which 84 suspicious areas were identified. Regions of interest were placed over suspicious areas, detected on MRI, and over areas with normal appearance, and ADC values were recorded. Statistical differences between ADC values of suspicious and normal areas were evaluated. Histopathological diagnosis, obtained from targeted biopsy using MRI-…

Preliminary experience with a transcranial magnetic resonance-guided focused ultrasound surgery system integrated with a 1.5-T MRI unit in a series of patients with essential tremor and Parkinson's disease.

OBJECTIVETranscranial magnetic resonance–guided focused ultrasound surgery (tcMRgFUS) is one of the emerging noninvasive technologies for the treatment of neurological disorders such as essential tremor (ET), idiopathic asymmetrical tremor-dominant Parkinson’s disease (PD), and neuropathic pain. In this clinical series the authors present the preliminary results achieved with the world’s first tcMRgFUS system integrated with a 1.5-T MRI unit.METHODSThe authors describe the results of tcMRgFUS in a sample of patients with ET and with PD who underwent the procedure during the period from January 2015 to September 2017. A monolateral ventralis intermedius nucleus (VIM) thalamic ablation was pe…

S-Detect characterization of focal solid breast lesions: a prospective analysis of inter-reader agreement for US BI-RADS descriptors

Background: To assess inter-reader agreement for US BI-RADS descriptors using S-Detect: a computer-guided decision-making software assisting in US morphologic analysis. Methods: 73 solid focal breast lesions (FBLs) (mean size: 15.9 mm) in 73 consecutive women (mean age: 51 years) detected at US were randomly and independently assessed according to the BI-RADS US lexicon, without and with S-Detect, by five independent reviewers. US-guided core-biopsy and 24-month follow-up were considered as standard of reference. Kappa statistics were calculated to assess inter-operator agreement, between the baseline and after S-Detect evaluation. Agreement was graded as poor (≤ 0.20), moderate (0.21–0.40)…

Contrast-enhanced ultrasonography in the characterization of benign focal hepatic lesions: spectrum of findings

Robustness Analysis of DCE-MRI-Derived Radiomic Features in Breast Masses: Assessing Quantization Levels and Segmentation Agreement

Featured Application The use of highly robust radiomic features is fundamental to reduce intrinsic dependencies and to provide reliable predictive models. This work presents a study on breast tumor DCE-MRI considering the radiomic feature robustness against the quantization settings and segmentation methods. Machine learning models based on radiomic features allow us to obtain biomarkers that are capable of modeling the disease and that are able to support the clinical routine. Recent studies have shown that it is fundamental that the computed features are robust and reproducible. Although several initiatives to standardize the definition and extraction process of biomarkers are ongoing, th…

Ruolo dell’ecografia con mezzo di contrasto nella caratterizzazione delle lesioni focali epatiche riscontrate incidentalmente

Ultrasound (US) guided central venous catheterization of internal jugular vein on over 65-year-old patients versus blind technique.

Background and Objectives Performing a central venous catheterization (CVC) on older patients for long-term central intravenous therapy could be a very important procedure. It could be associated with a high incidence of related complications, especially on over 65-year-old, high risk, selected patients. Methods The authors analyzed the results of 72 central venous CVC of internal jugular vein performed on over 65-year-old patients with ultrasound (US) guide from January 1998 to April 2003. Results The average performing time was 4 min, with 98.7% of success, 0% of major complications, and 4.1% of minor complications (one mild vagal hypotension and two catheter dislocation). Conclusions The…

Multiparametric MRI and Radiomics in Prostate Cancer: A Review of the Current Literature

Prostate cancer (PCa) represents the fourth most common cancer and the fifth leading cause of cancer death of men worldwide. Multiparametric MRI (mp-MRI) has high sensitivity and specificity in the detection of PCa, and it is currently the most widely used imaging technique for tumor localization and cancer staging. mp-MRI plays a key role in risk stratification of naïve patients, in active surveillance for low-risk patients, and in monitoring recurrence after definitive therapy. Radiomics is an emerging and promising tool which allows a quantitative tumor evaluation from radiological images via conversion of digital images into mineable high-dimensional data. The purpose of radiomics is to…

How to” CT-enteroclysis: A guided step-by-step approach

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) …

Characterization of hypoechoic focal hepatic lesions in patients with fatty liver: diagnostic performance and confidence of contrast-enhanced ultrasound

The objective of this study was to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) to characterize hypoechoic focal hepatic lesions (HFHL) in fatty liver (FL). A study group of 105 patients with FL and 105 HFHLs (52 malignant and 53 benign) underwent CEUS after SonoVue administration. Two blinded readers independently reviewed baseline ultrasound (US) and CEUS scans and classified each lesion as malignant or benign on a five-point scale of confidence, and recorded whether further imaging work-up was needed. Sensitivity, specificity, areas under the receiver operating characteristic (ROC) curve (A (z)), and interobserver agreement were calculated. We observed that th…

Collateral findings at 40-slices computed tomography enteroclysis

Imaging dell’Iperplasia nodulare focale (INF) in Risonanza Magnetica (RM) con GD-EOB-DTPA vs GD-BOPTA

Characterization of benign hepatic tumors arising in fatty liver with SonoVue and pulse inversion US.

Background: We describe the spectrum of contrast-enhancement patterns of benign hepatic tumors arising in fatty liver on contrast-enhanced ultrasound (US). Methods: Sixteen patients (12 women and four men) with 27 benign hepatic tumors (17 hemangiomas, eight focal nodular hyperplasias, and two hepatocellular adenomas) arising in fatty liver underwent baseline and pulse inversion US after administration of SonoVue. Two experienced radiologists evaluated baseline echogenicity and dynamic enhancement pattern of each lesion in comparison with adjacent liver parenchyma. Results: After administration of SonoVue, in the arterial phase 13 of 17 hemangiomas showed peripheral globular enhancement and…

Usefulness of multiplanar reconstruction with multislice computed tomography to assess hepatocellular carcinoma response after transcatheter arterial chemoembolization

3D versus 2D contrast-enhanced sonography in the evaluation of therapeutic response of hepatocellular carcinoma after locoregional therapies: preliminary findings

Objective: To investigate diagnostic performance of 3D contrast-enhanced ultrasound (CEUS) compared with 2D CEUS in the assessment of therapeutic response of hepatocellular carcinoma (HCC) treated with locoregional therapies (LRT). Materials and methods: Twenty-three consecutive patients (13 men and 10 women; mean age 65.5 years) with 23 HCCs (size range 1.2–7.2 cm; mean size 2.9 ± 1.4 cm) treated by means of radiofrequency ablation (RFA n = 9), transarterial chemoembolization (TACE n = 8), combined RFA and TACE (n = 3), percutaneous alcoholization (n = 2), and wedge resection (n = 1) underwent 2D and 3D CEUS 1 month (30 ± 2 days) after treatment. Magnetic resonance (n = 17) and computed to…

Spring ligament chronic injury on MR imaging

ANGIOGRAFIA RM: MEZZI DI CONTRASTO

Assessment of morphological CT imaging features for the prediction of risk stratification, mutations, and prognosis of gastrointestinal stromal tumors

To investigate the correlation between CT imaging features and risk stratification of gastrointestinal stromal tumors (GISTs), prediction of mutation status, and prognosis. This retrospective dual-institution study included patients with pathologically proven GISTs meeting the following criteria: (i) preoperative contrast-enhanced CT performed between 2008 and 2019; (ii) no treatments before imaging; (iii) available pathological analysis. Tumor risk stratification was determined according to the National Institutes of Health (NIH) 2008 criteria. Two readers evaluated the CT features, including enhancement patterns and tumor characteristics in a blinded fashion. The differences in distributi…

Three-dimensional contrast-enhanced ultrasound versus conventional two dimensional contrast-enhanced ultrasound in the evaluation of therapeutic response of hepatocellular carcinoma after local therapies.

Os trigonum syndrome: MR imaging in young athletes

Dynamic versus conventional ultrasonography in the assessment of patellar tendon disease

HSP60 and HSP10 overespression in metastatic colon cancer

PANCREATIC CARCINOMA VERSUS CHRONIC FOCAL PANCREATITIS: CONTRAST-ENHANCED POWER DOPPLER ULTRASONOGRAPHY FINDINGS

Background: We assessed the potential usefulness of contrast-enhanced power Doppler ultrasonography (US) for differentiating pancreatic carcinoma from chronic focal pancreatitis. Methods: Twenty-six consecutive patients with ductal carcinoma (n=16) and chronic focal pancreatitis (n=10) underwent power Doppler US examinations before and after intravenous injection of an air-based contrast agent (Levovist, Schering, Berlin, Germany). Final diagnosis was obtained by surgery in all patients. The following parameters before and after intravenous administration of contrast agent were evaluated for each lesion: number, morphology and course of the vessels within the lesion and time to maximum dete…

An uncommon cause of pneumothorax

3D DCE-MRI Radiomic Analysis for Malignant Lesion Prediction in Breast Cancer Patients

Rationale and Objectives: To develop and validate a radiomic model, with radiomic features extracted from breast Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) from a 1.5T scanner, for predicting the malignancy of masses with enhancement. Images were acquired using an 8-channel breast coil in the axial plane. The rationale behind this study is to show the feasibility of a radio-mics-powered model that could be integrated into the clinical practice by exploiting only standard-of-care DCE-MRI with the goal of reducing the required image pre-processing (ie, normalization and quantitative imaging map generation).Materials and Methods: 107 radiomic features were extracted from a …

Usefulness of SonoVue-enhanced Pulse-Inversion Ultrasonography to Assess Hepatocellular Carcinoma Response after Percutaneous Radiofrequency Thermal Ablation Therapy

An uncomon case of pneumothorax

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

Virtual broncoscopy in the preoperative assessment of peripheral airways stenosis

Caratterizzazione delle lesioni focali epatiche ipoecogene in pazienti con fegato steatosico: “performance” e livello di confidenza diagnostica dell’ecografia con SonoVue®”

Forty-slice MDCT enteroclysis: evaluation after oral administration of isotonic solution in Crohn's disease.

Objective. The aim of this study was to evaluate the accuracy of multidetector computed tomography (MDCT) enteroclysis after oral hyperhydration with isotonic solution in detecting bowel wall alterations in patients with Crohn’s disease. Materials and methods. Twenty-eight patients with a diagnosis of Crohn’s disease established by ileocolonoscopy and histology were enrolled in the study; 15 patients with negative ileocolonoscopy served as controls. In all cases, MDCT enteroclysis was performed after oral administration of 2,000 ml of isotonic solution and intravenous administration of N-butylscopolamine. Axial, isotropic multiplanar and volume-rendered reconstructions were used to evaluate…

40-slice computed tomography enteroclysis after oral hyperhydration with isotonic solution in comparison with ileocolonoscopy in patients with Crohn's disease

Imaging ecografico post-terapia ablativa

Focal nodular hyperplasia: a weight-based, intraindividual comparison of gadobenate dimeglumine and gadoxetate disodium-enhanced MRI

PURPOSE: We aimed to qualitatively and quantitatively compare the enhancement pattern of focal nodular hyperplasia after gadobenate dimeglumine and gadoxetate disodium injection in the same patient. METHODS: 1.5 T magnetic resonance imaging (MRI) examinations of 16 patients with 21 focal nodular hyperplasias studied after the injection of both contrast media were evaluated. Both MRI studies were performed in all patients. A qualitative analysis was performed evaluating each lesion in all phases. For quantitative analysis we calculated signal intensity ratio, lesion-to-liver contrast ratio and liver parenchyma signal intensity gain on hepatobiliary phase. Statistical analysis was performed w…

Focal Pancreatic Lesions: Role of Contrast-Enhanced Ultrasonography.

The introduction of contrast-enhanced ultrasonography (CEUS) has led to a significant improvement in the diagnostic accuracy of ultrasound in the characterization of a pancreatic mass. CEUS, by using a blood pool contrast agent, can provide dynamic information concerning macro- and micro-circulation of focal lesions and of normal parenchyma, without the use of ionizing radiation. On the basis of personal experience and literature data, the purpose of this article is to describe and discuss CEUS imaging findings of the main solid and cystic pancreatic lesions with varying prevalence.

Imaging processing for CT angiography of the cervicocranial arteries: evaluation of reformatting technique.

Purpose. The aim of this study was to compare computed tomography angiography (CTA) sliding-thin-slab (STS) multiplanar reformatting (MPR), STS maximum intensity projection (MIP) and three-dimensional (3D) volume rendering (VR) reformatting techniques in the evaluation of cervicocranial arteries. Materials and methods. Twenty patients examined with multislice CT were included in this study. CTA images were reformatted as STS-MIP, STS-MPR and 3DVR in orthogonal planes and in the oblique-coronal plane. Images were evaluated in consensus by two radiologists, with a third radiologist to resolve discordances in grading image quality parameters. The Spearman correlation analysis was performed to …

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

Focal liver lesions: interobserver and intraobserver agreement of three-dimensional contrast-enhanced ultrasound-assisted volume measurements

Purpose: This study was conducted to assess the interobserver and intraobserver agreement of three-dimensional contrast-enhanced ultrasound (3D-CEUS) volume calculations of focal liver lesions (FLLs).Methods: Thirty-nine patients (15 men and 24 women; mean age, 55.4 years) with 39 Flis (mean size, 3.1 +/- 1.8 cm; size range, 1 to 8 cm) prospectively underwent 3D-CEUS. Four readers calculated the volume of each lesion in an independent and blinded fashion in two separate sessions by means of a semi-automatic, commercially available proprietary software. The differences in lesion volumes (cm(3)) among sessions and readers were assessed using the Mann-Whitney U test and the Kruskal-Wallis test…

Ruolo della Colangio-RM (1,5 T) nella valutazione delle complicanze post-chirurgiche in pazienti trattati con ERCP. Nostra esperienza

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

MRI in perianal Crohn’s disease: STIR versus T1w postcontrast fat-sat imaging

Purpose: To evaluate the diagnostic accuracy of MRI, comparing STIR images versus T1w post-contrast fat-sat images in patients affected by perianal Crohn’s disease (CD). Material and methods: From January 2007 to July 2008, 73 patients with perianal CD underwent pelvic MRI using an external phased array coil. All studies were performed with a 1.5T MRI scanner. STIR and T1w post-contrast fat-sat images were independently analysed by two expert radiologists. Perianal fistulas were classified according to the Parks surgical classification. All patients underwent examination under anesthesia (EUA) that was considered gold standard. Results: By analysing STIR, images documented 31 simple fistula…

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…

Syncronous adenomatous polyps and colorectal carcinoma

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…

Contrast-enhanced versus baseline US in the Characterization of benign focal hepatic lesions.

Value of serial magnetic resonance imaging in the assessment of brain metastases volume control during stereotactic radiosurgery

AIM To evaluate brain metastases volume control capabilities of stereotactic radiosurgery (SRS) through serial magnetic resonance (MR) imaging follow-up. METHODS MR examinations of 54 brain metastases in 31 patients before and after SRS were reviewed. Patients were included in this study if they had a pre-treatment MR examination and serial follow-up MR examinations at 6 wk, 9 wk, 12 wk, and 12 mo after SRS. The metastasis volume change was categorized at each follow-up as increased (> 20% of the initial volume), stable (± 20% of the initial volume) or decreased (< 20% of the initial volume). RESULTS A local tumor control with a significant (P < 0.05) volume decrease was observed in 25 meta…

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

RUOLO DELL’ECOGRAFIA CON MEZZO DI CONTRASTO NELLA VALUTAZIONE DEGLI ANGIOMI SPLENICI

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

Patologie renali chirurgiche

Magnetic resonance and computed tomography findings in childhood central nervous system tuberculosis

GI/Liver/Biliary/Pancreas

Solitary necrotic nodule of the liver: cross sectional imaging findings and follow-up in nine patients

Characterization of Benign Focal Liver lesions after Injection of SonoVue, a Sulphur Hexafluoride-filled microbubble based agent: evaluation of diagnostic accuracy in comparison to baseline US scan

Hepatic focal nodular hyperplasia: detection of spoke-wheel sign and central scar at contrast-enhanced ultrasound

Aspetti mammografici, ecografici e di RM del carcinoma lobulare

Riempimento centrifugo (“inside-out”) degli angiomi epatici all’ecografia con mezzo di contrasto

Imaging findings of hepatic focal nodular hyperplasia in Gd-EOB-DTPA vs Gd-BOPTA -enhanced MR: preliminary results.

Esophageal cineradiography in patients affected by Sclerodermia

Il trattamento dell'HCC mediante RFTA

Intraoperative imaging findings in transcranial MR imaging-guided focused ultrasound treatment at 1.5T may accurately detect typical lesional findings correlated with sonication parameters

To assess the intraoperative neuroimaging findings in patients treated with transcranial MR-guided focused ultrasound (tcMRgFUS) thalamotomy using 1.5T equipment in comparison with the 48-h follow-up.Fifty prospectively enrolled patients undergoing unilateral tcMRgFUS thalamotomy for either medication-refractory essential tremor (n = 39) or Parkinson tremor (n = 11) were included. Two radiologists evaluated the presence and size of concentric lesional zones (zone I, zone II, and zone III) on 2D T2-weighted sequences acquired intraoperatively after the last high-energy sonication and at 48 h. Sonication parameters including number of sonications, delivered energy, and treatment temperatures …

Ultrasonographic Detection of Vascularity of Focal Breast Lesions: Microvascular Imaging Versus Conventional Color and Power Doppler Imaging.

To compare microvascular flow imaging (MVFI) to conventional Color-Doppler (CDI) and Power-Doppler (PDI) imaging in the detection of vascularity of Focal Breast Lesions (FBLs). A total of 180 solid FBLs (size: 3.5–45.2 mm) detected in 180 women (age: 21–87 years) were evaluated by means of CDI, PDI, and MVFI. Two blinded reviewers categorized lesion vascularity in absent or present, and vascularity pattern as (a) internal; (b) vessels in rim; (c) combined. The presence of a “penetrating vessel” was assessed separately. Differences in vascularization patterns (chi2 test) and intra- and inter-observer agreement (Fleiss method) were calculated. ROC analysis was performed to assess performance…

Thyroid nodules: prevalence, grey-scale, and color doppler pattern in a random adult population screened by high-resolution US

Lumbosacral disc herniation: Spinal interventional chemonucleolysis with oxygen-ozone (O2-O3) mixture with periradicular and periganglionic technique (Role of CT)

Cardiac complications in thalassemia: noninvasive detection methods and new directions in the clinical management.

The natural history of thalassemia has shown substantial change during these years. This applies for each aspect of the pathology (for example, endocrinological, hepatological and psychological) and also for the pathology that has presented and still presents the main cause of death: myocardial dysfunction. In this review, the pathophysiology of cardiac complications, possible role of myocarditis, new knowledge on pathogenesis, and noninvasive detection methods for iron overload in the heart are pointed out. Prophylaxis of cardiomyopathy and new therapy strategies of myocardial dysfunction, including the impact of the new chelation treatment, are discussed.

Ecografia con mdc di II generazione versus ecografia di base nella caratterizzazione delle lesioni focali epatiche benigne.

Focal lesions in cirrhotic liver: what else beyond hepatocellular carcinoma?

Detection and characterization of focal lesions in the cirrhotic liver may pose a diagnostic dilemma. Several benign and malignant lesions may be found in a cirrhotic liver along with hepatocellular carcinoma (HCC), and may exhibit typical or atypical imaging features. In this pictorial essay, we illustrate computed tomography and magnetic resonance imaging findings of lesions such as simple bile duct cysts, hemangioma, focal nodular hyperplasia-like nodules, peribiliary cysts, intrahepatic cholangiocarcinoma, lymphoma, and metastases, all of which occur in cirrhotic livers with varying prevalences. Pseudolesions, such as perfusion anomalies, focal confluent fibrosis, and segmental hyperpla…

DETECTION OF LIVER METASTASIS WITH CONTRAST ENHANCED ULTRASONOGRAPHY

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…

Caratterizzazione delle neoplasie epatiche benigne: ecografia ad inversione impulso con mezzo di contrasto di I e II generazione a confronto

RENE A SPUGNA MIDOLLARE VS MALATTIA POLICISTICA RENALE DELL'ADULTO: DIAGNOSI DIFFERENZIALE RADIOLOGICA

Giant hepatocellular adenoma as cause of severe abdominal pain: a case report

Abstract The authors describe the case of a large hepatocellular adenoma diagnosed in a 30-year old woman who came to us complaining of acute pain in the upper abdominal quadrants. The patient had been taking an oral contraceptive pill for the last ten years. We present the clinical features, the diagnostic work-up and the treatment prescribed.

Comparison of the Enhancement Pattern of Hepatic Hemangioma on Magnetic Resonance Imaging Performed With Gd-EOB-DTPA Versus Gd-BOPTA

Abstract Purpose To compare magnetic resonance imaging (MRI) findings with gadoxetic acid and gadobenate dimeglumine for the diagnosis of hepatic hemangiomas. Materials and Methods In this retrospective study, we included 26 hemangiomas (mean size was 14 mm ± 10 mm) in 19 patients (mean age 60 ± 14 years) scanned with both gadobenate dimeglumine MRI and gadoxetic acid MRI. For each patient, we collected multiple lesion variables including location, number, size and enhancement pattern on arterial, portal venous, 3-minute and hepatobiliary phases with both gadoxetic acid and gadobenate dimeglumine. The enhancement pattern with the two contrast agents was then compared. Results The typical en…

Late gadolinium-enhanced magnetic resonance imaging in non-compacted ventricular myocardium (NCVM) as potential expression of the disease severity

FOCAL LIVER LESIONS: CONTRAST-ENHANCED ULTRASOUND

Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in sonography and it is being increasingly used for evaluation of focal liver lesions (FLLs). The unique feature of CEUS of non-invasively assessing in real time liver perfusion throughout the vascular phase has led to a dramatic improvement in diagnostic accuracy of US in either detection and characterization of FLLs, as well as in the guidance and evaluation of response of therapeutic procedures. Currently, CEUS is included as a part of the suggested diagnostic work-up of FLLs, resulting in a better patient management and cost-effective therapy delivering. After a brief description of the basis of different CEUS tec…

Real-time spatial compound sonography of Achilles tendon in patients with heterozygous familial hypercholesterolaemia and normal physical examination

This study was undertaken to assess the prevalence and ultrasound features of Achilles tendon xanthomas (ATX) in patients with heterozygous familial hypercholesterolemia (HFH) and normal physical examination studied with high-resolution ultrasonography (HRUS) and, secondarily, to evaluate the role of real-time spatial compound sonography (CS) in terms of image quality.Both Achilles tendons of 40 patients with HFH were studied with HRUS and CS. Two experienced radiologists evaluated by consensus the presence of ATX described as (1) tendon thickening and/or (2) focal hypoechoic areas and the quality of images obtained with the two techniques.Ten out of 80 tendons showed thickening (mean: 11.2…

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.…

Lumbosacral disc herniation: spinal interventional chemonucleolysis with CT intradiscal oxygen-ozone (O2-O3) mixture

Contrast-enhanced US of liver hemangiomas atypical at baseline US

Senescence-associated HSP60 expression in normal human skin fibroblasts

Normal mammalian fibroblasts cultured in vitro undergo a limited number of divisions before entering a senescent phase in which they can be maintained for long periods but cannot be induced to divide. Senescent cells become unresponsive to growth-promoting signals and exhibit senescent cell morphology with flattened and enlarged cell shape. Several chaperones have a direct effect on cellular senescence. HSP60 has been largely studied in our laboratories and it has been associated with uncontrolled cell proliferation in tumor cells. Since senescence is firmly regulated during cell cycle progression, we wanted to investigate HSP60 protein level during cellular senescence. Our data show that H…

Characterization of focal liver lesions

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