Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review

Abstract Introduction Acute appendicitis is one of the most frequent intra-abdominal diseases requiring emergency surgical consult and treatment. The diagnosis of this condition is based on clinical features and radiologic findings. One-third of patients with acute appendicitis present unusual symptoms. There are several circumstances that may cause misdiagnosis and unclear prognostic prediction. Among these, situs viscerum inversus totalis and midgut malrotation can be challenging scenarios, leading to a delay in treatment, especially when these conditions are unknown. We decided to carry on a systematic review of published cases of acute appendicitis in the context of anatomical anomalies…

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

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

A Novel Expert System for Non-Invasive Liver Iron Overload Estimation in Thalassemic Patients

Expert Systems can integrate logic based often on computational intelligence methods and they are used in complex problem solving. In this work an Expert System for classifying liver iron concentration in thalassemic patients is presented. In this work, an ANN is used to validate the output of the L.I.O.MO.T (Liver Iron Overload Monitoring in Thalassemia) method against the output of the state-of-the-art method based on MRI T2 assessment for liver iron concentration. The model has been validated with a dataset of 200 samples. The experimental Mean Squared Error results and Correlation show interesting performances. The proposed algorithm has been developed as a plug in for OsiriX Dicom View…

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

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

Computerised tomography and magnetic resonance imaging of laryngeal squamous cell carcinoma: A practical approach

Squamous cell carcinoma is the most common head and neck cancer. This review describes the state-of-the-art computerised tomography and magnetic resonance imaging protocols of the neck and the normal larynx anatomy, and provides a practical approach for the diagnosis and staging of laryngeal squamous cell carcinoma.

STUDIO DEL DELAYED ENHANCEMENT NEI PAZIENTI CON NON COMPATTAZIONE DEL VENTRICOLO MIOCARDICO (NCVM) COME POTENZIALE ESPRESSIONE DELLA SEVERITA' DELLA MALATTIA: NOSTRA ESPERIENZA

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

SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media

Abstract Hypersensitivity reactions (HRs) to contrast media (CM) can be distinguished in immune-mediated (including allergic reactions) and non-immune-mediated reactions, even if clinical manifestations could be similar. Such manifestations range from mild skin eruptions to severe anaphylaxis, making it important for radiologists to know how to identify and manage them. A panel of experts from the Società Italiana di Radiologia Medica e Interventistica (SIRM) and the Società Italiana di Allergologia, Asma e Immunologia Clinica (SIAAIC) provided a consensus document on the management of patients who must undergo radiological investigations with CM. Consensus topics included: the risk stratif…

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

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

Self-inflicted long bone fractures for insurance fraud.

Self-inflicted fractures simulating traffic accident represent a new social fraud opportunity for criminality. Recognising scams through an increase of awareness of existence of self-inflicted arm fractures for insurance fraud could help community health workers to report these injuries to the competent authorities. In this article, authors have recognised an unusual but consistent pattern of upper and lower limb fractures whose incidence does not coincide in numerical terms with what is reported in literature. The aim of the present study is to describe fracture patterns observed over the past 2 years. Further, authors describe clinical presentations of these fractures and attempt to defin…

Coartazione aortica in tomografia computerizzata multistrato

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

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

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

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

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

L'ESSENZIALE NELL'IMAGING RM DI DIFFUSIONE, COLLO

Right atrium compression by a renal cyst: a tomographic diagnosis.

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

Aims and objectives Methods and materials Results Conclusion Personal information References

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

Caso 37 Patologia Aortica

Clinical case

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

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

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

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

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

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

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

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

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

A multicenter evaluation of a deep learning software (LungQuant) for lung parenchyma characterization in COVID-19 pneumonia

Abstract Background The role of computed tomography (CT) in the diagnosis and characterization of coronavirus disease 2019 (COVID-19) pneumonia has been widely recognized. We evaluated the performance of a software for quantitative analysis of chest CT, the LungQuant system, by comparing its results with independent visual evaluations by a group of 14 clinical experts. The aim of this work is to evaluate the ability of the automated tool to extract quantitative information from lung CT, relevant for the design of a diagnosis support model. Methods LungQuant segments both the lungs and lesions associated with COVID-19 pneumonia (ground-glass opacities and consolidations) and computes derived…

Cardio-RM nel paziente talassemico

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

Valvular Heart Disease

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

Gestione della dose in Cardio-TC

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

Cardiovascular magnetic resonance characterization of a hamartoma in an asyntomatic child

Abstract Background The prevalence of primary cardiac neoplasms is approximately 0.3% and these masses should be distinguished from many of other primary and secondary processes that can occur in the heart. Further assessment of the left ventricular mass presents important clinical implications. Cardiovascular magnetic resonance was used. Clinical case An asyntomatic 12-year-old child was referred for cardiovascular magnetic resonance imaging to further assess a left ventricular mass found after an echocardiography, executed for assessment for sport activity. His past medical history was absolutely negative. The patient was in optimal state of health. The EKG showed an aspecific ST elevatio…

Assessment of Lung Cancer Development in Idiopathic Pulmonary Fibrosis Patients Using Quantitative High-Resolution Computed Tomography:A Retrospective Analysis

Purpose The purpose of this study was to investigate histogram-based quantitative high-resolution computed tomography (HRCT) indexes in the assessment of lung cancer (LC) development in idiopathic pulmonary fibrosis (IPF) patients. Materials and methods From IPF databases of 2 national respiratory centers, we retrospectively studied patients with and without LC development-respectively, divided into Group A (n=16) and Group B (n=33). The extent of fibrotic disease was quantified on baseline and follow-up HRCT examinations using kurtosis, skewness, percentage of high attenuation area (HAA%), and percentage of fibrotic area (FA%). These indexes were compared between the 2 groups using the Man…

Diffusion-weighted MRI of colo-rectal liver metastases treated by new anti-angiogenetic chemotherapy

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

Potential clinical value of quantitative fluorine-18-fluorodeoxyglucose-PET/computed tomography using a graph-based method analysis in evaluation of incidental lesions of gastrointestinal tract: correlation with endoscopic and histopathological findings.

Objectives To identify the clinical relevance of incidentally detected lesions (IDLs) in the gastrointestinal tract (GIT) with 18F-FDG PET/CT and to assess the potential benefit of using semiquantitative PET measures to discern malignant from benign lesions. Methods Forty-one patients who underwent F-FDG PET/CT scans during the oncologic follow-up, revealing abnormal incidental 18F-FDG accumulations in the GIT were included in this retrospective analysis. Incidental PET/CT findings were correlated with endoscopic and histological findings. Semiquantitative PET values (SUVmax, SUVmean, SULpeak, and TLG) were evaluated by using a new graph-based method. Two sample t-test analysis has been per…

Ventricular dysfunction and number of non compacted segments in non compaction: Non-independent predictors.

Abstract Background Isolated ventricular noncompaction (IVNC) is characterized by multiple prominent trabeculations and deep intertrabecular recesses. Some reports prove that the chronic heart failure may occur in approximately half of the patients. In this report we investigate the correlation between the number of non compacted segments and entity of systolic dysfunction from the registry and subregistries of the SIEC. Method To identify the correlation between ventricular dysfunction and number of segments involved in non compaction we evaluated a consecutive series of 238 patients affected by non compaction, from the SIEC (Societa Italiana di Ecografia Cardiovascolare) registry. The ave…

Post-operative computed tomography imaging evaluation of ascending aorta surgery

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

SIRM-SIN-AIOM: appropriateness criteria for evaluation and prevention of renal damage in the patient undergoing contrast medium examinations-consensus statements from Italian College of Radiology (SIRM), Italian College of Nephrology (SIN) and Italian Association of Medical Oncology (AIOM).

AbstractThe increasing number of examinations and interventional radiological procedures that require the administration of contrast medium (CM) in patients at risk for advanced age and/or comorbidities highlights the problem of CM-induced renal toxicity. A multidisciplinary group consisting of specialists of different disciplines—radiologists, nephrologists and oncologists, members of the respective Italian Scientific Societies—agreed to draw up this position paper, to assist clinicians increasingly facing the challenges posed by CM-related renal dysfunction in their daily clinical practice.The major risk factor for acute renal failure following CM administration (post-CM AKI) is the preex…

Isolated, Subtle Neurological Abnormalities in Mild Cognitive Impairment Types.

Isolated, subtle neurological abnormalities (ISNA) are commonly seen in aging and have been related to cerebral small vessel disease (SVD) and subcortical atrophy in neurologically and cognitively healthy aging subjects.To investigate the frequency of ISNA in different mild cognitive impairment (MCI) types and to evaluate for each MCI type, the cross-sectional relation between ISNA and white matter hyperintensities (WMH), lacunes, caudate atrophy, and ventricular enlargement.One thousand two hundred fifty subjects with different MCI types were included in the analysis and underwent brain magnetic resonance imaging. WMHs were assessed through two visual rating scales. Lacunes were also rated…

Update nella diagnosi delle lesioni posterolaterali del ginocchio

Nell’ultimo decennio sono stati fatti grossi passi in avanti nella chirurgia ricostruttiva legamentosa del ginocchio. La ricerca dei fattori che possono condurre al fallimento della ricostruzione del legamento crociato anteriore (LCA) ha aperto la strada allo studio di diverse strutture anatomiche come quelle posterolaterali, rimaste nella penombra per troppo tempo. Nonostante l’estrema variabilità delle strutture anatomiche posterolaterali, studi di dissezione anatomica hanno permesso di osservare come il legamento collaterale laterale (LCL), il popliteo ed il legamento popliteo-fibulare (LPF) risultino essere quasi costantemente presenti. Sono state inoltre chiarite le specifiche funzioni…

Left ventricular non-compaction cardiomyopathy in children: Is segmental fibrosis the cause of tissue Doppler alterations and of EF reduction?

Noncompaction of the ventricular myocardium (LVNC) is a rare congenital cardiomyopathy resulting from an arrest in normal endomyocardial embryogenesis. In 2002 Jenni et al. [Jenni R, Wyss CA, Oechslin EN, Kaufmann PA. Isolated ventricular noncompaction is associated with coronary microcirculatory dysfunction. J Am Coll Cardiol 2002; 39:450-454.] reported a microvascular dysfunction in 12 patients affected by non compaction: areas of restricted myocardial perfusion have been documented by scintigraphy, suggesting a reduction of Coronary flow reserve. McMahon et al reported in a recent article a reduction of TD velocities in children with noncompaction of the left ventricle, compared with nor…

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

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

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

Takotsubo cardiomyopathy features at cardiac magnetic resonance

Abstract Diagnosis of Takotsubo cardiomyopathy is based on clinical symptoms, electrocardiographic changes, absence of angiographic significant coronary lesions and presence of suggestive wall motion abnormalities. CardioMRI is an useful complementary tool especially to role out the diagnosis of myocarditis and of myocardial infarction with angiographically normal coronary artery and to document complications of the disease.

Imaging the COVID-19: a practical guide

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

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

Ischemic and non-ischemic dilated cardiomyopathy

Abstract Dilated Cardiomyopathy is a high-incident disease, which diagnosis of and treatments are clinical priority. The aim of our study was to evaluate the diagnostic potential of cardiac magnetic resonance (CMR) imaging; echocardiography and the biochemical parameters that can help us differentiate between the post-ischemic and non-ischemic dilated cardiomyopathy. Materials and methods. The study enrolled 134 patients with dilated cardiomyopathy: 74 with the post-ischemic form and 60 with the non-ischemic one. All patients underwent a coronary imaging test, with echocardiogram, cardiac magnetic resonance and a blood test. Pro-inflammatory cytokines were evaluated using Luminex kit. Data …

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

Purpose Methods and Materials Results Conclusion References Personal Information

Tagging in thalassemia could help diagnostic/clinical assessment of the patient?

CARDIOVASCULAR MAGNETIC RESONANCE IN CHILDREN WITH IDIOPATHIC MONOMORPHIC VENTRICULAR TACHYCARDIA OR COMPLEX VENTRICULAR EXTRASYSTOLES

Utility of post mortem MRI in definition of thrombus in aneurismatic coronary arteries due to incomplete Kawasaki Disease in infants

Abstract Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that primarily affects the coronary artery (CA) and presents in childhood. The characteristic coronary arterial lesion is an aneurysm, which may lead to thrombosis, dilatation, stenosis, and occlusion. Such an aneurysm is typically calcified and generally develops five or more years after the onset of acute KD. It becomes more noticeable after ten years. KD is sometimes difficult to diagnose because of the limited clinical features, especially in infants younger than 6 months old, where the clinical presentations often do not fulfill the diagnostic criteria for KD. We report a case of Incomplete Kawasaki…

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

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

Morpho-volumetric assessment of the right ventricle: a comparison between three-dimensional echocardiography and cardiac magnetic resonance

The morpho-volumetric assessment of the right ventricle (RV) is useful in the diagnosis and prognosis of many congenital and acquired cardiovascular diseases. The complexity of the right ventricular shape does not allow an adequate and satisfactory evaluation of the RV. Two-dimensional (2D) echocardiography is the most used tool for the assessment of RV function, as it is a noninvasive, reproducible and widespread technique, but the geometric assumptions required for measurement of RV volumes reduce its accuracy. At present, cardiac magnetic resonance is the gold standard for the evaluation of RV volumes because it does not need any assumption and is reproducible, though not always availabl…

Diagnosis and definition of biventricular non-compaction associated to Ebstein's anomaly

Abstract Background Non-compaction of ventricular myocardium is a rare congenital cardiomyopathy characterized by the presence of an extremely thickened endocardial layer with prominent trabeculations and deep recesses in communication with ventricular chamber and determining the typical spongeous aspect. The diagnosis of non-compaction of ventricular myocardium is possible through the identification of morphological alterations by echocardiographic evaluation. Ebstein's anomaly is a rare congenital cardiac disease, defined as the significant apical displacement of the part of the tricuspid valve causing significant tricuspid regurgitation and reduction of the functional right ventricle, ri…

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

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

The Delayed Enhancement technique in patients with new diagnosed left ventricular systolic dysfunction

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

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

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

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

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

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

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

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

How to avoid collision between PCL and MCL femoral tunnels during a simultaneous reconstruction.

PURPOSE: The purpose of the present study was to assess the risk of femoral tunnel collisions between the medial collateral ligament (MCL) and the posterior cruciate ligament (PCL) tunnels during a simultaneous PCL and MCL reconstruction. METHODS: Fourth generation medium and large synthetic femur bones were used. On each femur, a MCL tunnel and a PCL tunnel were reamed. The MCL tunnel was drilled at 0°, 20° and 40° of axial and coronal angulations. The PCL femoral tunnel was reamed to simulate two different tunnel directions that could be obtained through an inside-out and outside-in technique. Tunnels were filled with epoxy resin augmented with BaSO4, and a multidetector CT examination of…

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

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…

Ventricular arrhythmias in children : the usefulness of MRI

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

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

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

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

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

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

A mistaken case of non-q wave acute infarction

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

Cardiovascular magnetic resonance characterization of a hamartoma in an asymptomatic child

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

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

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

MRI evaluation to predict tendon size for knee ligament reconstruction.

Background The aim of this study is to evaluate a possible correlation between specific anthropometric parameters and sizes of knee tendons commonly used for ACL reconstruction. We hypothesized that specific clinical and radiological knee measurements could be better tendon sizes predictors than age, gender, height and weight. Materials and methods 100 consecutive patients were enrolled and 77 patients met the inclusion criteria of the study. All patients underwent a MRI of the knee with a 1.5 T super conducting MR System. For each patient, anthropometric data such as gender, height, weight, body mass index (BMI) and knee circumference were recorded. Specific MRI knee measurements were perf…

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

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

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

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

Imaging evaluation of cardiac stem cells transplantation

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

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

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

CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain

AbstractEpiploic appendagitis is a rare cause of acute abdominal pain, determined by a benign self-limiting inflammation of the epiploic appendages. It may manifest with heterogeneous clinical presentations, mimicking other more severe entities responsible of acute abdominal pain, such as acute diverticulitis or appendicitis. Given its importance as clinical mimicker, imaging plays a crucial role to avoid inaccurate diagnosis that may lead to unnecessary hospitalization, antibiotic therapy, and surgery. CT represents the gold standard technique for the evaluation of patients with indeterminate acute abdominal pain. Imaging findings include the presence of an oval lesion with fat-attenuation…

A cardiac fibroma in a 7-year-old asymptomatic girl admitted for ECG anomalies

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

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

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

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

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

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

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

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

Aims and objectives Methods and materials Results Conclusion Personal information References

Clinical and Prognostic Value of 18F-FDG-PET/CT in the Restaging Process of Recurrent Cutaneous Melanoma

Background: Several studies on 18F-FDG-PET/CT have investigated the prognostic role of this imaging modality in different tumors after treatment. Nevertheless, its role in restaging patients with recurrent CM still needs to be defined. Objective: The aim of this retrospective multicenter study was to evaluate the clinical and prognostic impact of 18F-FDG-PET/CT on the restaging process of cutaneous melanoma (CM) after surgery in patients with suspected distant recurrent disease or suspected metastatic progression disease. Materials and Methods: 74 patients surgically treated for CM underwent 18F-FDG-PET/CT for suspected distant recurrent disease or suspected metastatic progression disease.…

Updated diagnosticprognostic paradigm for CAD: a narrative review.

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

Requisiti hardware e software: preparazione del paziente

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

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

Atherosclerotic pattern of coronary myocardial bridging assessed with CT coronary angiography

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

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

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

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

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

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

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…

Movement abnormalities in the left ventricle of Thalassemia Major patients

Aims and objectives Methods and materials Results Conclusion Personal information References

Resovist enhanced MR imaging of the liver: Does quantitative assessment help in focal lesion classification and characterization?

Purpose: To improve characterization of focal liver lesions by a prospective quantitative analysis of percentage signal intensity change, in dynamic and late phases after slow (0.5 mL/s) Resovist administration. Materials and Methods: Seventy-three patients were submitted on clinical indication to MR examination with Resovist. Signal intensity of 92 detected focal lesions (5–80 mm) were measured with regions of interest and normalized to paravertebral muscle in arterial, portal, equilibrium and T1/T2 late phases, by two observers in conference. Five values of percentage variations per patient were obtained and statistically evaluated. Results: The enhancement obtained on dynamic study is mo…

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

Computed tomography of bowel obstruction: Tricks of the trade

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

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

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…

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

Noncompaction of the Right Ventricle

Noncompaction of the ventricular myocardium is a disease characterized by an increase of the ventricular trabecular meshwork caused by arrest of the normal endomyocardial morphogenesis (Figs. 1, 2, 3). In accordance with the normal human anatomy, the left ventricular wall is well compacted with a few thin trabeculae; on the contrary, the normal right ventricular wall is furrowed by many trabeculae (the trabecula of the marginal septum as well as other ones). For this reason, the term ‘‘noncompaction’’ usually refers to an exclusive or prevalent disease of the left ventricle [1–16]. Recently Song and Aragona et al. [1–3] reported two cases of isolated right-ventricular noncompaction. Accordi…

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

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

Purpose Methods and Materials Results Conclusion References Personal Information

CONTRATTILITÀ MIOCARDICA REGIONALE IN TALASSEMIA MAJOR TRAMITE TECNICA TAGGING IN RISONANZA MAGNETICA

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

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

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

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

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

Magnetic resonance in isolated noncompaction of the ventricular myocardium

Abstract Non-compaction of the ventricular myocardium (LCVM) is a rare disorder of myocardial morphogenesis usually diagnosed in paediatric age. The diagnosis was echocardiographically made on the basis of a reported spongeous/compacted ratio >2 in one or more segments of the left ventricle during the diastolic period. We aimed to test the diagnostic accuracy of cardiovascular magnetic resonance (CMR) imaging in distinguishing pathological left ventricular non-compaction. Methods We collected a consecutive series of 8 patients, 5 males and 3 females, with a mean age of 14.9 years with non-compaction of left ventricular myocardium. All patients were admitted in our divisions of cardiology. I…